DOCSLIB.ORG

Rib Mobilizations Kat Hayes, SPT

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Rib Mobilizations Kat Hayes, SPT Rib Mobilizations Kat Hayes, SPT A) Anatomy a. 12 Thoracic Vertebrae i. Superior facet facets anteraior/lateral ii. Inferior facet facets posterior/medial iii. Plane of motion alows more lateral flexion but limited due to ribs iv. T2-10 have a superior and inferior demifacet where rib articulates with two vertebrae b. 12 Ribs i. Costovertebral facet 1. T2-10 rib head has an inferior and superior facet to articulates with 2 vertebrae 2. T1, T11-12 articulates with only one costal facet 3. Kinematics: gliding and rotation ii. Costotransverse Joint 1. Tubercle of rib articulates with on transverse processes 2. Kinematics: gliding wih some rotation c. Sternum i. Ribs 1-7 attach at sternum via costochondral joint ii. Ribs 8-10 articulate to costal cartilage iii. Ribs 11, 12 are not attached B) Young et al. mapped referral patterns for costotransverse joint patterns a. 8 asymptomatic male subjects b. Received consecutive, same day injections to either right T2,4,6 or to their left T3,5,7 c. OmnipaqueTM was injected using fluoroscopy into joint d. Subects were asked to desribe the pian using given descriptors and also VAS including description of referred pain C) Indications a. Rib or Thoracic hypomobility b. Pain c. Shallow breathing D) Contraindications a. Rib fracture b. Osteoperosis c. Hypermobility d. Malignancy e. Systemic inflamitory disease f. Ligamentous laxity E) Precautions a. Pulmonary Disease b. Severe Scoliosis c. Spinal fussion d. Pregnancy F) Assessment a. While patients sitting, assess breathing patern and palpate ribs for movement during inhilation/exhalation i. Are they a chest or belly breather ii. Observe superior ribs move anterior/superior to posterior/inferior (pump moition) iii. Observe inferior ribs move more laterally upon inhalation (bucket handle motion) b. Generally assess motion of ribs while patient is prone c. Run hand/thumb perpedicular along ribs to assess if any are restricted and/or raised d. Palpate intercostal muscles with 2nd and 3rd finger so compare spacing between ribs and assess myofascial restrictions e. Assess mobility of thoracic spine f. If a raised rib is found, assess the contralateral rib i. Is it raised, is the thoracic spine kyphotic or hypomobile? g. Posture G) Mobilizations a. Prone, arms hanging off plinth i. Find transverse proces (may be a half level or full level up from spinous process) and then will find a divot, then the rib. The divot is the end of the transverse process and where the costotransverse process can be found. ii. Place one hand on ipsilateral transverse process (preventing T-spine segment from rotating) iii. Place other hand’s hypothenar emience on costotransverse joint and rib iv. Use hypotherar eminence to direct an anterior mobilization 1. Can also supinate to get the inferior rotation v. Can also cross hands and mobilize both sides at the same time vi. Can switch hand position to work on oposite rotation of rib along long axis b. Sitting i. Can have the patient place hands behind neck to use arms as a lever ii. Can facilitate sidebending or rotation in this position 1. Rotation measuremnt can be guestemated by having patient sit on corner of plinth and rotate 2. If there shoulders are in line with the length of the plinth than that is about 45o iii. If there is a raised rib, can mobilize rib with movement while sitting 1. Place ulnar border of your hand on the raised rib and have patient rotate ipsilaterally while you block the ribs movement 2. Blocking gives an anterior/lateral/superior mobilization 3. 2 sets of 10 reps, then reassess iv. If patient is tender to palpation, mobilization with movement may be more tolerable than the prone mobilization H) Exercises/Self Mobiliation – Deep inhale can be utilized to aid mobilization during exercises or during PT directed mobs a. Rainbow stretch i. Can be a progression of open book ii. Sideline and reaching out to create an arc over one’s head (180o) 1. Focus on extending fingertips as far out as possible 2. Starts and ends with rotation to thoracic spine b. Quadraped thoracic rotation i. Horizontal abduction of one arm to rotate thoracic spine ii. Follow hand with eyes to get cervical rotation iii. Can also do this as a progression of plank c. Ballarina stretch i. Sidebending while reaching ii. Maintain neutral spine and level hip iii. Tball can be utilized d. Sidebending (standing or supine) e. Foam roller or tennis ball i. Half crunches to mobilize segments Lehmkuhl, L. Don, PH.D., and Laura Smith, PH.D. Brunnstrom's Clinical Kinesiology. 4th ed. Philadelphia: F.A. Davis, 1985. Print. "Technique Highlight: Rib Functional Mobilization." Start Here. Modern Manual Therapy, n.d. Web. 02 Aug. 2016. <http://www.themanualtherapist.com/2011/12/technique-highlight-rib-mobilization.html>. Young BA, Gill HE, Wainner RS, Flynn TW. Thoracic costotransverse joint pain patterns: a study in normal volunteers. BMC Musculoskeletal Disorders. 2008;9:140. doi:10.1186/1471-2474-9-140 Image: "LAB - Axial Osteology - Biology 108 with Doyle at Bellarmine University - StudyBlue." StudyBlue. N.p., n.d. Web. 30 July 2016. <https://www.studyblue.com/notes/note/n/lab-axial- osteology/deck/13872938>. Image: "Joints and Ligaments - StudyBlue." StudyBlue. N.p., n.d. Web. 30 July 2016. <https://www.studyblue.com/notes/note/n/joints-and-ligaments/deck/12200812>. Image: "JOURNAL ARTICLE REVIEW." Category. N.p., n.d. Web. 09 Aug. 2016. <http://iiplab.com/category/journal-article-review/>. Image: "Pectoral Region - Basic Sciences Ga1 with Carlos at Southern California University of Health Sciences - StudyBlue." StudyBlue. N.p., n.d. Web. 30 July 2016. <https://www.studyblue.com/notes/note/n/pectoral-region/deck/1187748>. .
Load more

Recommended publications
  • The Structure and Function of Breathing
    CHAPTERCONTENTS The structure-function continuum 1 Multiple Influences: biomechanical, biochemical and psychological 1 The structure and Homeostasis and heterostasis 2 OBJECTIVE AND METHODS 4 function of breathing NORMAL BREATHING 5 Respiratory benefits 5 Leon Chaitow The upper airway 5 Dinah Bradley Thenose 5 The oropharynx 13 The larynx 13 Pathological states affecting the airways 13 Normal posture and other structural THE STRUCTURE-FUNCTION considerations 14 Further structural considerations 15 CONTINUUM Kapandji's model 16 Nowhere in the body is the axiom of structure Structural features of breathing 16 governing function more apparent than in its Lung volumes and capacities 19 relation to respiration. This is also a region in Fascla and resplrstory function 20 which prolonged modifications of function - Thoracic spine and ribs 21 Discs 22 such as the inappropriate breathing pattern dis- Structural features of the ribs 22 played during hyperventilation - inevitably intercostal musculature 23 induce structural changes, for example involving Structural features of the sternum 23 Posterior thorax 23 accessory breathing muscles as well as the tho- Palpation landmarks 23 racic articulations. Ultimately, the self-perpetuat- NEURAL REGULATION OF BREATHING 24 ing cycle of functional change creating structural Chemical control of breathing 25 modification leading to reinforced dysfunctional Voluntary control of breathing 25 tendencies can become complete, from The autonomic nervous system 26 whichever direction dysfunction arrives, for Sympathetic division 27 Parasympathetic division 27 example: structural adaptations can prevent NANC system 28 normal breathing function, and abnormal breath- THE MUSCLES OF RESPIRATION 30 ing function ensures continued structural adap- Additional soft tissue influences and tational stresses leading to decompensation.
    [Show full text]
  • Ligaments of the Costovertebral Joints Including Biomechanics, Innervations, and Clinical Applications: a Comprehensive Review W
    Open Access Review Article DOI: 10.7759/cureus.874 Ligaments of the Costovertebral Joints including Biomechanics, Innervations, and Clinical Applications: A Comprehensive Review with Application to Approaches to the Thoracic Spine Erfanul Saker 1 , Rachel A. Graham 2 , Renee Nicholas 3 , Anthony V. D’Antoni 2 , Marios Loukas 1 , Rod J. Oskouian 4 , R. Shane Tubbs 5 1. Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies 2. Department of Anatomy, The Sophie Davis School of Biomedical Education 3. Department of Physical Therapy, Samford University 4. Neurosurgery, Complex Spine, Swedish Neuroscience Institute 5. Neurosurgery, Seattle Science Foundation Corresponding author: Erfanul Saker, [email protected] Abstract Few studies have examined the costovertebral joint and its ligaments in detail. Therefore, the following review was performed to better elucidate their anatomy, function and involvement in pathology. Standard search engines were used to find studies concerning the costovertebral joints and ligaments. These often- overlooked ligaments of the body serve important functions in maintaining appropriate alignment between the ribs and spine. With an increasing interest in minimally invasive approaches to the thoracic spine and an improved understanding of the function and innervation of these ligaments, surgeons and clinicians should have a good working knowledge of these structures. Categories: Neurosurgery, Orthopedics, Rheumatology Keywords: costovertebral joint, spine, anatomy, thoracic Introduction And Background The costovertebral joint ligaments are relatively unknown and frequently overlooked anatomical structures [1]. Although small and short in size, they are abundant, comprising 108 costovertebral ligaments in the normal human thoracic spine, and they are essential to its stability and function [2-3].
    [Show full text]
  • Netter's Musculoskeletal Flash Cards, 1E
    Netter’s Musculoskeletal Flash Cards Jennifer Hart, PA-C, ATC Mark D. Miller, MD University of Virginia This page intentionally left blank Preface In a world dominated by electronics and gadgetry, learning from fl ash cards remains a reassuringly “tried and true” method of building knowledge. They taught us subtraction and multiplication tables when we were young, and here we use them to navigate the basics of musculoskeletal medicine. Netter illustrations are supplemented with clinical, radiographic, and arthroscopic images to review the most common musculoskeletal diseases. These cards provide the user with a steadfast tool for the very best kind of learning—that which is self directed. “Learning is not attained by chance, it must be sought for with ardor and attended to with diligence.” —Abigail Adams (1744–1818) “It’s that moment of dawning comprehension I live for!” —Calvin (Calvin and Hobbes) Jennifer Hart, PA-C, ATC Mark D. Miller, MD Netter’s Musculoskeletal Flash Cards 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 NETTER’S MUSCULOSKELETAL FLASH CARDS ISBN: 978-1-4160-4630-1 Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this book may be produced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system, without permission in writing from the publishers. Permissions for Netter Art figures may be sought directly from Elsevier’s Health Science Licensing Department in Philadelphia PA, USA: phone 1-800-523-1649, ext. 3276 or (215) 239-3276; or e-mail [email protected].
    [Show full text]
  • Part 1 the Thorax ECA1 7/18/06 6:30 PM Page 2 ECA1 7/18/06 6:30 PM Page 3
    ECA1 7/18/06 6:30 PM Page 1 Part 1 The Thorax ECA1 7/18/06 6:30 PM Page 2 ECA1 7/18/06 6:30 PM Page 3 Surface anatomy and surface markings The experienced clinician spends much of his working life relating the surface anatomy of his patients to their deep structures (Fig. 1; see also Figs. 11 and 22). The following bony prominences can usually be palpated in the living subject (corresponding vertebral levels are given in brackets): •◊◊superior angle of the scapula (T2); •◊◊upper border of the manubrium sterni, the suprasternal notch (T2/3); •◊◊spine of the scapula (T3); •◊◊sternal angle (of Louis) — the transverse ridge at the manubrio-sternal junction (T4/5); •◊◊inferior angle of scapula (T8); •◊◊xiphisternal joint (T9); •◊◊lowest part of costal margin—10th rib (the subcostal line passes through L3). Note from Fig. 1 that the manubrium corresponds to the 3rd and 4th thoracic vertebrae and overlies the aortic arch, and that the sternum corre- sponds to the 5th to 8th vertebrae and neatly overlies the heart. Since the 1st and 12th ribs are difficult to feel, the ribs should be enu- merated from the 2nd costal cartilage, which articulates with the sternum at the angle of Louis. The spinous processes of all the thoracic vertebrae can be palpated in the midline posteriorly, but it should be remembered that the first spinous process that can be felt is that of C7 (the vertebra prominens). The position of the nipple varies considerably in the female, but in the male it usually lies in the 4th intercostal space about 4in (10cm) from the midline.
    [Show full text]
  • Basic Biomechanics
    Posture analysis • A quick evaluation of structure and function • Doctor views patient from behind (P-A) and from the side (lateral) • References points of patient’s anatomy relative to plumb (a position of balance) 9/3/2013 1 Posture analysis • Lateral View – Knees (anterior, posterior, plumb, genu recurvatum) – Trochanter (anterior, posterior, plumb) – Pelvis (anterior, posterior, neutral pelvic tilt) – Lumbar lordosis (hypo-, hyper-, normal) – Mid-axillary line (anterior, posterior, plumb) – Thoracic kyphosis (hyp-, hyper- normal) – Acromion (anterior, posterior, plumb) – Scapulae (protracted, retracted, normal) – Cervical lordosis (hypo-, hyper-, normal) – External auditory meatus (anterior, posterior, plumb) – Occiput (extended, neutral, flexed) 9/3/2013 2 Posture analysis • Posterior – Anterior View – Feet (pronation, supination, normal) – Achilles tendon (bowed in/out, normal) – Knees (genu valga/vera, normal - internal/external rotation) – Popliteal crease heights (low, high, level) – Trochanter heights (low, high, level) – Iliac crest heights (low on the right/left, normal) – Lumbar scoliosis (right/left, or no signs of) – Thoracic scoliosis (right/left, or no signs of) – Shoulder level (low on the right/left, or normal) – Cervical scoliosis (right/left, or no signs of) – Cervical position (rotation, tilt, neutral) – Mastoid (low on the right/left, or normal) 9/3/2013 3 …..poor postures 9/3/2013 4 Functional Anatomy of the Spine • The vertebral curvatures – Cervical Curve • Anterior convex curve (lordosis) develop in infancy
    [Show full text]
  • The Effects of Aging on the Material Properties of Human Costal Cartilage
    The Effects of Aging on the Material Properties of Human Costal Cartilage A. G. Lau1, J. M. Mattice1, D. Murakami2, M. L. Oyen1, and R. W. Kent1 1 University of Virginia; 2Nissan Motor Corporation ABSTRACT Understanding the mechanical properties of the aging thorax is important in the development of restraint systems to protect the older population. This study investigated how the material properties of costal cartilage change with age. Indentation testing was used to study the material properties of human costal cartilage. Ribcages were obtained from 11 human subjects ranging in age from 23 to 77 years. Costal cartilage from the second, third, and fourth left ribs were excised and prepared into 6 mm thick cross sections. The cross sections were tested using spherical indentation with a ramp-hold relaxation test. Shear and elastic moduli were calculated from the stress relaxation response. The results showed only a slight trend of increasing costal cartilage stiffness with age and there was a larger overall standard deviation in the older specimen values. Differences were observed during specimen preparation which included changes in color, increasing inhomogeneity, and varying regions of calcification. Calcification was observed as shells surrounding the softer cartilage, as well as calcified strata running transversely through the interior of the cartilage. These regions should affect the overall mechanical response during thoracic loading, but were not as apparent in the results of the current study because the indentation area was localized near the center of the cartilage cross sections. 1 This paper has not been peer- reviewed and should not be referenced in open literature.
    [Show full text]
  • Pain Pattern Explanation Forms
    Pain Pattern Explanation Forms 1. Cervical Facet Pain Pattern 2. Cervical Radicular/Dynatome Pain Pattern 3. Costotransverse Joint Pain Pattern 4. Fibromyalgia Points 5. Hip Joint Pain Pattern 6. Lumbar Dermatomes: Chemical Radiculitis 7. Lumbar Dermatomes: Disc Pathology 8. Lumbar Disc Pathology Healed 9. Lumbar Epidural Fibrosis 10. Lumbar Facet Pain Pattern 11. Lumbar Stenosis 12. Sacroiliac Joint Pain Pattern 13. Thoracic Facet Pain Pattern 14. Upper Cervical Joint Pain Pattern The OEA pain pattern handouts are PDF files that can be used for patient education and marketing. They help you explain your diagnosis with original illustrations that the patients can take home with them. There is limited text so you can tell your explanation of the treatment plan. The pain patterns can be printed in color or black and white. Once purchased, our business card will be replaced with yours to personalize each handout. Each illustration is based on the pain patterns that have been established in books or research articles when available. Normal anatomy and pathoanatomy illustrations are shown for the clinician to explain the diagnosis to the patient and how their treatment can influence the pain generator. These can also be utilized as marketing tools. The following pages are some guidelines that can be utilized to explain the handouts to patients. Cervical Facet Pain Pattern The cervical facet joints are the joints of the neck. Neurophysiologic studies have shown that cervical facet‐joint capsules are sources of neck pain.1 Dwyer et al.2 established pain patterns of the cervical facet joints. o Parasagittal cervical and cervicothoracic pain.
    [Show full text]
  • The Influence of the Rib Cage on the Static and Dynamic Stability
    www.nature.com/scientificreports OPEN The infuence of the rib cage on the static and dynamic stability responses of the scoliotic spine Shaowei Jia1,2, Liying Lin3, Hufei Yang2, Jie Fan2, Shunxin Zhang2 & Li Han3* The thoracic cage plays an important role in maintaining the stability of the thoracolumbar spine. In this study, the infuence of a rib cage on static and dynamic responses in normal and scoliotic spines was investigated. Four spinal fnite element (FE) models (T1–S), representing a normal spine with rib cage (N1), normal spine without rib cage (N2), a scoliotic spine with rib cage (S1) and a scoliotic spine without rib cage (S2), were established based on computed tomography (CT) images, and static, modal, and steady-state analyses were conducted. In S2, the Von Mises stress (VMS) was clearly decreased compared to S1 for four bending loadings. N2 and N1 showed a similar VMS to each other, and there was a signifcant increase in axial compression in N2 and S2 compared to N1 and S1, respectively. The U magnitude values of N2 and S2 were higher than in N1 and S1 for fve loadings, respectively. The resonant frequencies of N2 and S2 were lower than those in N1 and S1, respectively. In steady-state analysis, maximum amplitudes of vibration for N2 and S2 were signifcantly larger than N1 and S1, respectively. This study has revealed that the rib cage improves spinal stability in vibrating environments and contributes to stability in scoliotic spines under static and dynamic loadings. Scoliosis, a three-dimensional deformity, prevents healthy development.
    [Show full text]
  • Rib Cartilage Injuries
    PHYSIO4ALL revitalise – bounce – be healthy Rib Cartilage Injuries Structure of the ribcage The ribcage supports the upper body, protects internal organs including the heart and lungs, and assists with breathing. It consists of 24 curved ribs arranged in 12 pairs. Each pair is attached to a vertebra in the spine. At the front of the body, the first seven pairs of ribs are attached directly to the sternum (breastbone) by cartilage known as costal cartilage. These ribs are often called ‘true ribs’. The next three pairs aren’t connected to the sternum. Instead, costal cartilage attaches these ‘false ribs’ to the last pair of true ribs. The remaining two pairs aren’t attached at the front of the body at all and are known as ‘floating ribs’. The ribcage is supported by ligaments and muscles, including the muscles between the ribs (intercostal muscles). These muscles allow the ribcage to expand when you breathe in, and drop when you breathe out. Rib injuries include bruises, torn cartilage and bone fractures. Shop No. P16, NorthPoint, 100 Miller St. North Sydney. NSW – 2060 T – (02) 99222212 F – (02) 99225577 W: www.physio4all.com.au E: [email protected] ABN: 77 548 297 578 PHYSIO4ALL revitalise – bounce – be healthy Symptoms of rib cartilage injury Symptoms of rib injuries depend on the type and severity of the injury, but can include: • Pain at the injury site • Pain when the ribcage flexes – for example when you breathe, cough, sneeze or laugh • Pain when rotating or side flexing your spine • Crunching or grinding sounds (crepitus) when the injury site is touched or moved • Muscle spasms of the ribcage • Deformed appearance of the ribcage • Breathing difficulties.
    [Show full text]
  • MULTIPLE OSSIFIED COSTAL CARTILAGES for 1ST RIB Raghavendra D.R
    International Journal of Anatomy and Research, Int J Anat Res 2014, Vol 2(4):744-47. ISSN 2321- 4287 Case Report DOI: 10.16965/ijar.2014.538 MULTIPLE OSSIFIED COSTAL CARTILAGES FOR 1ST RIB Raghavendra D.R. *1, Nirmala D 2. *1 Post graduate student, Department of anatomy, J J M Medical College, Davangere, Karnataka, India. 2 Associate Professor, Department of anatomy, J J M Medical College, Davangere, Karnataka, India. ABSTRACT Costal cartilages are flattened bars of hyaline cartilages. All ribs except the last two, join with the sternum through their respective costal cartilages directly or indirectly. During dissection for 1st MBBS students in the Department of Anatomy, JJMMC, Davangere, variation was found in a male cadaver aged 45 –50 years. Multiple ossified costal cartilages for 1st rib were present on left side. There were 3 costal cartilages connecting 1st rib to manubrium. There were two small intercostal spaces between them. The lower two small costal cartilages fused together to form a common segment which in turn fused with large upper costal cartilage. The large upper costal cartilage forms costochondral joint with 1st rib. All costal cartilages showed features of calcification. The present variation of multiple ossified costal cartilages are due to bifurcation of costal cartilage. It may cause musculoskeletal pain, intercostal nerve entrapment or vascular compression. Awareness of these anomalies are important for radiologists for diagnostic purpose and for surgeons for performing various clinical and surgical procedures. KEYWORDS: Costal cartilage, bifurcation of Rib, Sternum. Address for Correspondence: Dr. Raghavendra D.R. Post graduate student, Department of anatomy, J J M Medical College, Davangere, 577004, Karnataka, India.
    [Show full text]
  • Canine Thoracic Costovertebral and Costotransverse Joints Three Case Reports of Dysfunction and Manual Therapy Guidelines for A
    Topics in Compan An Med 29 (2014) 1–5 Topical review Canine Thoracic Costovertebral and Costotransverse Joints: Three Case Reports of Dysfunction and Manual Therapy Guidelines for Assessment and Treatment of These Structures Laurie Edge-Hughes, BScPT, MAnimSt (Animal Physiotherapy), CAFCI, CCRTn Keywords: The costovertebral and costotransverse joints receive little attention in research. However, pain costovertebral associated with rib articulation dysfunction is reported to occur in human patients. The anatomic costotransverse structures of the canine rib joints and thoracic spine are similar to those of humans. As such, it is ribs physical therapy proposed that extrapolation from human physical therapy practice could be used for the assessment and rehabilitation treatment of the canine patient with presumed rib joint pain. This article presents 3 case studies that manual therapy demonstrate signs of rib dysfunction and successful treatment using primarily physical therapy manual techniques. General assessment and select treatment techniques are described. & 2014 Elsevier Inc. All rights reserved. The Canine Fitness Centre Ltd, Calgary, Alberta, Canada nAddress reprint requests to Laurie Edge-Hughes, BScPT, MAnimSt (Animal Physiotherapy), CAFCI, CCRT, The Canine Fitness Centre Ltd, 509—42nd Ave SE, Calgary, Alberta, Canada T2G 1Y7 E-mail: [email protected] The articular structures of the thorax comprise facet joints, the erect spine and further presented that in reviewing the literature, intervertebral disc, and costal joints. Little research has been they were unable to find mention of natural development of conducted on these joints in human or animal medicine. However, idiopathic scoliosis in quadrupeds; however, there are reports of clinical case presentations in human journals, manual therapy avian models and adolescent models in man.
    [Show full text]
  • Download PDF File
    Folia Morphol. Vol. 70, No. 2, pp. 61–67 Copyright © 2011 Via Medica R E V I E W A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl Human ligaments classification: a new proposal G.K. Paraskevas Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece [Received 24 January 2011; Accepted 22 March 2011] A high concern exists among physicians about surgically important ligaments such as cruciate and collateral ligaments of the knee, patellar ligament, tibiofibular syndesmosis, collateral ligaments of the ankle, and coracoclavicular ligament. However, the classification of the ligaments is insufficient in the literature, due to their origin from connective tissue. A new classification is proposed, based on various parameters such as the macroscopic and microscopic features, the function and the nature of their attachment areas. (Folia Morphol 2011; 70, 2: 61–67) Key words: ligaments, classification, Nomina Anatomica INTRODUCTION connective tissue surrounding neurovascular bundles There was always some confusion concerning the or ducts as “true ligaments” [4]. classification of ligaments of the human body, presu- The “false ligaments”, could be subdivided in the mably due to their origin from the connective tissue following categories: that is considered a low quality tissue compared to oth- a) Splachnic ligaments, which are further subdivid- ers. Moreover, orthopaedists are focused only on surgi- ed into “peritoneal” (e.g. phrenocolic ligament), cally important ligaments. For these reasons there is an “pericardiac” (e.g. sternopericardial ligaments), absence of a well-designated classification system that “pleural” (e.g. suprapleural membrane), and subdivides the ligaments into subgroups according to “pure splachnic ligaments” (e.g.
    [Show full text]