Exercises Neck and Upper Back Stretching
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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. -
Active Release Techniques Spine Level 2
Active Release Techniques Spine Level 2 Dates of program- Montvale, NJ February 18-21, 2021 Colorado Springs, CO March 4-7, 2021 Orlando, FL June 10-13, 2021 Chicago, IL September 30 – October 3, 2021 Total Hours: 24 Summary: Active Release Techniques® Spine Level 2 offers intense training in 75 manual treatment protocols of the cervical, thoracic, and lumbar spine. ART® treatment utilizes manual techniques to move tissues and joints while under tension. The system allows for relative motion between the tissues and articulations. This seminar emphasizes the manipulation of the neuromusculoskeletal system to diagnose and correct alterations in tissue texture, tension, movement, and function between tissues. Evaluation and treatment occur simultaneously. Learning Outcomes: 1. By the end of the seminar, learners will be able to correctly identify (palpate) 75 facial seams of soft-tissue structures within the spine. 2. By the end of the seminars, learners will be able to correctly state the muscle actions of two adjacent spinal muscles. 3. By the end of the seminar, learners will be able to effectively recognize common symptom patterns of spinal neuromuscular injuries and disorders. 4. By the end of the seminar, learners will correctly identify the structure treated and associated concentric and eccentric muscle actions via video presentations. 5. By the end of the seminar, the learner will correctly move the muscle from its shortened position to elongated position using two-hand placement techniques. 6. By the end of the seminar, the learner can successfully differentiate between healthy and unhealthy tissue utilizing hands-on palpation techniques. 7. By the end of the seminar, the learner will proficiently palpate 75 anatomical soft-tissue structures within the spine, using an appropriate tension, depth, and motion to properly perform the treatment protocol. -
The Levator Scapulae Muscle – Morphological Variations K
International Journal of Anatomy and Research, Int J Anat Res 2019, Vol 7(4.3):7169-75. ISSN 2321-4287 Original Research Article DOI: https://dx.doi.org/10.16965/ijar.2019.335 THE LEVATOR SCAPULAE MUSCLE – MORPHOLOGICAL VARIATIONS K. Satheesh Naik 1, Sadhu Lokanadham 2. *1 Assistant Professor, Department of Anatomy, Viswabharathi Medical College & General Hospital, Penchikalapadu, Kurnool, Andhrapradesh, India. 2 Associate Professor, Department of Anatomy, Santhiram Medical College and General Hospital, Nandyal, Andhrapradesh, India. ABSTRACT Introduction: Anatomical variations of the levator scapulae are important and therefore clinically relevant. The levator scapulae are now believed to be the leading cause of discomfort in patients with chronic tension-type neck and shoulder pain and a link between anatomical variants of the muscle and increased risk of developing pain has been speculated. The results obtained were compared with previous studies. Materials and methods: The study was conducted on 32 levator scapulae muscle of 16 cadavers over a period of 3 years. The dissection of head and neck was done carefully to preserve all minute details, observing the morphological variations of the muscle in the department of Anatomy, Viswabharathi Medical College, Penchikalapadu, and Kurnool. Results: Total 32 levator scapulae muscles were used. All the sample values were measured to 2 decimal places. The average age of the cadavers in the sample was 82.87 years. The oldest cadaver in the sample was 100 years old and the youngest 61 years. Measurements of the proximal and distal attachments and the total length of the muscles were taken. Between 3 and 6 muscle slips were reported at the proximal attachment. -
Trapezius Origin: Occipital Bone, Ligamentum Nuchae & Spinous Processes of Thoracic Vertebrae Insertion: Clavicle and Scapul
Origin: occipital bone, ligamentum nuchae & spinous processes of thoracic vertebrae Insertion: clavicle and scapula (acromion Trapezius and scapular spine) Action: elevate, retract, depress, or rotate scapula upward and/or elevate clavicle; extend neck Origin: spinous process of vertebrae C7-T1 Rhomboideus Insertion: vertebral border of scapula Minor Action: adducts & performs downward rotation of scapula Origin: spinous process of superior thoracic vertebrae Rhomboideus Insertion: vertebral border of scapula from Major spine to inferior angle Action: adducts and downward rotation of scapula Origin: transverse precesses of C1-C4 vertebrae Levator Scapulae Insertion: vertebral border of scapula near superior angle Action: elevates scapula Origin: anterior and superior margins of ribs 1-8 or 1-9 Insertion: anterior surface of vertebral Serratus Anterior border of scapula Action: protracts shoulder: rotates scapula so glenoid cavity moves upward rotation Origin: anterior surfaces and superior margins of ribs 3-5 Insertion: coracoid process of scapula Pectoralis Minor Action: depresses & protracts shoulder, rotates scapula (glenoid cavity rotates downward), elevates ribs Origin: supraspinous fossa of scapula Supraspinatus Insertion: greater tuberacle of humerus Action: abduction at the shoulder Origin: infraspinous fossa of scapula Infraspinatus Insertion: greater tubercle of humerus Action: lateral rotation at shoulder Origin: clavicle and scapula (acromion and adjacent scapular spine) Insertion: deltoid tuberosity of humerus Deltoid Action: -
Congenital Bilateral Absence of Levator Scapulae Muscles: a Case Report Stephanie Klinesmith, Randy Kuleszat
CASE REPORT Congenital bilateral absence of levator scapulae muscles: A case report Stephanie Klinesmith, Randy Kuleszat Klinesmith S, Kulesza R. Congenital bilateral absence of levator we report dissection of a cadaveric specimen where the levator scapulae muscles: A case report. Int J Anat Var. 2020;13(1): 66-67. scapulae muscle was absent bilaterally. While bilateral congenital absence of the levator scapular appears to be an extremely rare The levator scapulae muscle is a thin, four-bellied muscle occurrence, the absence of this muscle might put neurovascular spanning the posterior neck and scapular region. Previous case bundles in the posterior neck and scapular region at increased risk reports have documented highly variable origins and insertions of this muscle, with the most common variations being from penetrating trauma or surgical procedures. additional slips and bellies. However, there are no previous Key Words: Levator scapulae; Anatomical variation; Congenital reports demonstrating congenital absence of this muscle. Herein, absence INTRODUCTION he levator scapulae muscle (LSM) is a bilaterally symmetric muscle that Toriginates from the transverse processes of the first through fourth cervical vertebrae and inserts onto the superior angle of medial border of the scapula [1]. The LSM is in contact anteriorly with the middle scalene muscle, laterally with the sternocleidomastoid and trapezius muscles, posteriorly with the splenius cervicis muscle and medially with the posterior scalene muscle [2]. The LSM is innervated by the dorsal scapular nerve, as well as the anterior rami of the C3 and C4 spinal nerves. The primary function of the levator scapulae is elevating the scapula [1], however it has been suggested that it also assists in downward rotation of the scapula [2]. -
Myofascial Trigger Points of the Shoulder
Johnson McEvoy and Jan Dommerholt Myofascial Trigger Points of the Shoulder Shoulder problems are common, with a 1-year prevalence in developing a more comprehensive approach to shoulder ranging from 4.7% to 46.7% and a lifetime prevalence of rehabilitation. Inclusion of MTrPs in the assessment and 6.7% to 66.7%.1 Many different structures give rise to shoulder management of shoulder pain and dysfunction does not pain, including the structures in the subacromial space, such necessarily replace other techniques and approaches, but it does as the subacromial bursa, the rotator cuff, and the long head of add an important dimension to the management plan. biceps,2,3 and are presented in various lessons. Muscle and spe- cifically myofascial trigger points (MTrPs), have been recog- nized to refer pain to the shoulder region and may be a source TRIGGER POINTS of peripheral nociceptive input that gives rise to sensitization and pain. MTrP referral patterns have been published for the A myofascial trigger point is defined as a hyperirritable spot in shoulder region.4-6 skeletal muscle, which is associated with a hypersensitive Often, little attention is paid to MTrPs as a primary or sec- palpable nodule in a taut band.4 When compressed, a MTrP ondary pain source. Instead, emphasis is placed only on muscle may give rise to characteristic referred pain, tenderness, motor mechanical properties such as length and strength.7,8 dysfunction, and autonomic phenomena.4 MTrPs have been The tendency in manual therapy is to consider muscle pain as described as active or latent. Active MTrPs are associated with secondary to joint or nerve dysfunctions. -
EMG Analysis of Latissimus Dorsi, Erector Spinae and Middle Trapezius Muscle Activity During Spinal Rotation: a Pilot Study Jamie Flint University of North Dakota
University of North Dakota UND Scholarly Commons Physical Therapy Scholarly Projects Department of Physical Therapy 2015 EMG Analysis of Latissimus Dorsi, Erector Spinae and Middle Trapezius Muscle Activity during Spinal Rotation: A Pilot Study Jamie Flint University of North Dakota Toni Linneman University of North Dakota Rachel Pederson University of North Dakota Megan Storstad University of North Dakota Follow this and additional works at: https://commons.und.edu/pt-grad Part of the Physical Therapy Commons Recommended Citation Flint, Jamie; Linneman, Toni; Pederson, Rachel; and Storstad, Megan, "EMG Analysis of Latissimus Dorsi, Erector Spinae and Middle Trapezius Muscle Activity during Spinal Rotation: A Pilot Study" (2015). Physical Therapy Scholarly Projects. 571. https://commons.und.edu/pt-grad/571 This Scholarly Project is brought to you for free and open access by the Department of Physical Therapy at UND Scholarly Commons. It has been accepted for inclusion in Physical Therapy Scholarly Projects by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. ------- ---- ------------------------------- EMG ANALYSIS OF LATISSIMUS DORSI, ERECTOR SPINAE AND MIDDLE TRAPEZIUS MUSCLE ACTIVITY DURING SPINAL ROTATION: A PILOT STUDY by Jamie Flint, SPT Toni Linneman, SPT Rachel Pederson, SPT Megan Storstad, SPT Bachelor of Science in Physical Education, Exercise Science and Wellness University of North Dakota, 2013 A Scholarly Project Submitted to the Graduate Faculty of the -
Sonographic Tracking of Trunk Nerves: Essential for Ultrasound-Guided Pain Management and Research
Journal name: Journal of Pain Research Article Designation: Perspectives Year: 2017 Volume: 10 Journal of Pain Research Dovepress Running head verso: Chang et al Running head recto: Sonographic tracking of trunk nerve open access to scientific and medical research DOI: http://dx.doi.org/10.2147/JPR.S123828 Open Access Full Text Article PERSPECTIVES Sonographic tracking of trunk nerves: essential for ultrasound-guided pain management and research Ke-Vin Chang1,2 Abstract: Delineation of architecture of peripheral nerves can be successfully achieved by Chih-Peng Lin2,3 high-resolution ultrasound (US), which is essential for US-guided pain management. There Chia-Shiang Lin4,5 are numerous musculoskeletal pain syndromes involving the trunk nerves necessitating US for Wei-Ting Wu1 evaluation and guided interventions. The most common peripheral nerve disorders at the trunk Manoj K Karmakar6 region include thoracic outlet syndrome (brachial plexus), scapular winging (long thoracic nerve), interscapular pain (dorsal scapular nerve), and lumbar facet joint syndrome (medial branches Levent Özçakar7 of spinal nerves). Until now, there is no single article systematically summarizing the anatomy, 1 Department of Physical Medicine sonographic pictures, and video demonstration of scanning techniques regarding trunk nerves. and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, In this review, the authors have incorporated serial figures of transducer placement, US images, Taipei, Taiwan; 2National Taiwan and videos for scanning the nerves in the trunk region and hope this paper helps physicians University College of Medicine, familiarize themselves with nerve sonoanatomy and further apply this technique for US-guided Taipei, Taiwan; 3Department of Anesthesiology, National Taiwan pain medicine and research. -
Levator Scapulae Muscle Asymmetry Presenting As a Palpable Neck Mass: CT Evaluation
Levator Scapulae Muscle Asymmetry Presenting as a Palpable Neck Mass: CT Evaluation Barry A. Shpizner1 and Roy A . Hollida/ PURPOSE: To define the normal CT anatomy of the levator scapulae muscle and to report on a series of five patients who presented with a palpable mass in the posterior triangle due to asymmetry of the levator scapulae muscles. PATIENTS AND METHODS: The contrast-enhanced CT examinations of the neck in 25 patients without palpable masses were reviewed to es tablish the normal CT appearance of the levator scapulae muscle. We retrospectively reviewed the contrast-enhanced CT examinations of the neck in five patients who presented with a palpable mass secondary to asymmetric levator scapulae muscles . RESULTS: In three patients who had undergone unilateral radical neck dissection, hypertrophy of the ipsi lateral levator scapulae muscle was found. In one patient, the normal levator scapulae muscle produced a fa ctitious "mass" due to atrophy of the contralateral levator scapulae muscle. One patient had an intramuscular neoplasm of the levator scapulae. CONCLUSION: Asymmetry of the levator scapulae muscles , an unusual cause of a posterior triangle mass, can be diagnosed using CT. Index terms: Neck, muscles; Neck, computed tomography AJNR 14:461-464, Mar/ Apr 1993 The levator scapulae muscle can be identified between January 1987 and March 1991 were reviewed. A ll readily on axial images by its characteristic ap patients presented with a palpable mass in the posterior pearance and its relationship to the other muscles triangle of the infrahyoid neck. The patients, three men forming the boundaries of the posterior triangle. -
Applied Anatomy of the Shoulder Girdle
Applied anatomy of the shoulder girdle CHAPTER CONTENTS intra-articular disc, which is sometimes incomplete (menis- Osteoligamentous structures . e66 coid) and is subject to early degeneration. The joint line runs obliquely, from craniolateral to caudomedial (Fig. 2). Acromioclavicular joint . e66 Extra-articular ligaments are important for the stability of Sternoclavicular joint . e66 the joint and to keep the movements of the lateral end of the Scapulothoracic gliding mechanism . e67 clavicle within a certain range. Together they form the roof of Costovertebral joints . e68 the shoulder joint (see Standring, Fig. 46.14). They are the coracoacromial ligament – between the lateral border of the Muscles and their innervation . e69 coracoid process and the acromion – and the coracoclavicular Anterior aspect of the shoulder girdle . e69 ligament. The latter consists of: Posterior aspect of the shoulder girdle . e69 • The trapezoid ligament which runs from the medial Mobility of the shoulder girdle . e70 border of the coracoid process to the trapezoid line at the inferior part of the lateral end of the clavicle. The shoulder girdle forms the connection between the spine, • The conoid ligament which is spanned between the base the thorax and the upper limb. It contains three primary artic- of the coracoid process and the conoid tubercle just ulations, all directly related to the scapula: the acromioclavicu- medial to the trapezoid line. lar joint, the sternoclavicular joint and the scapulothoracic Movements in the acromioclavicular joint are directly related gliding surface (see Putz, Fig. 289). The shoulder girdle acts as to those in the sternoclavicular joint and those of the scapula. a unit: it cannot be functionally separated from the secondary This joint is also discussed inthe online chapter Applied articulations, i.e. -
Dry Needling in the Pediatric Population
Dry Needling in the Pediatric Population Dr. Mellony Mann, PT, DPT, CMTPT Dr. Nick Wedel, PT, DPT, ATC The official health care provider of Sporting Kansas City © The Children’s Mercy Hospital, 2017 Objectives Following the presentation you will be able to: – Define dry needling (DN) and describe the benefits, risks, indications, and contraindications. – Describe the mechanism of trigger point dry needling and supporting literature. – Describe clinical application and supplementary treatment options. 2 About Us Dr. Mellony Mann, PT, DPT, CMTPT Dr. Nick Wedel, PT, DPT, ATC • Associate of Science Physical Therapist • Bachelor of Science Athletic Training - Assistant – Washburn University 2008 Kansas State University 2010 • Bachelor Health Services Administration – • Doctor of Physical Therapy - University Washburn University 2008 of Kansas Medical Center 2015 • Doctor of Physical Therapy – Rockhurst • Dry Needling Certification through University 2014 Benchmark Rehab Partners • Dry Needling Certification (CMTPT) through Myopain Seminars Disclosure: We have no financial or relationships to disclose in relation to today’s presentation. 3 Dry Needling is NOT Acupuncture 4 What is Trigger Point Dry Needling? • "Rapid, short term needling to altered or dysfunctional tissue in order to improve or restore function." -PAANZ, 2014 • "Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal -
Anatomy Module 3. Muscles. Materials for Colloquium Preparation
Section 3. Muscles 1 Trapezius muscle functions (m. trapezius): brings the scapula to the vertebral column when the scapulae are stable extends the neck, which is the motion of bending the neck straight back work as auxiliary respiratory muscles extends lumbar spine when unilateral contraction - slightly rotates face in the opposite direction 2 Functions of the latissimus dorsi muscle (m. latissimus dorsi): flexes the shoulder extends the shoulder rotates the shoulder inwards (internal rotation) adducts the arm to the body pulls up the body to the arms 3 Levator scapula functions (m. levator scapulae): takes part in breathing when the spine is fixed, levator scapulae elevates the scapula and rotates its inferior angle medially when the shoulder is fixed, levator scapula flexes to the same side the cervical spine rotates the arm inwards rotates the arm outward 4 Minor and major rhomboid muscles function: (mm. rhomboidei major et minor) take part in breathing retract the scapula, pulling it towards the vertebral column, while moving it upward bend the head to the same side as the acting muscle tilt the head in the opposite direction adducts the arm 5 Serratus posterior superior muscle function (m. serratus posterior superior): brings the ribs closer to the scapula lift the arm depresses the arm tilts the spine column to its' side elevates ribs 6 Serratus posterior inferior muscle function (m. serratus posterior inferior): elevates the ribs depresses the ribs lift the shoulder depresses the shoulder tilts the spine column to its' side 7 Latissimus dorsi muscle functions (m. latissimus dorsi): depresses lifted arm takes part in breathing (auxiliary respiratory muscle) flexes the shoulder rotates the arm outward rotates the arm inwards 8 Sources of muscle development are: sclerotome dermatome truncal myotomes gill arches mesenchyme cephalic myotomes 9 Muscle work can be: addacting overcoming ceding restraining deflecting 10 Intrinsic back muscles (autochthonous) are: minor and major rhomboid muscles (mm.