Documente Academic
Documente Profesional
Documente Cultură
BY
HOSSEIN KHORRAMI PhD DOMP
khorrami4@yahoo.com
http://www.scribd.com/khorrami4
Neck Bones
Joints
• Atlanto-occipital joint
• Allow head to nod up/down
• Atlanto-axial joint
• Allow head rotate on the axis side to side
Cervical Vertebrae
Less than 1%
Neck Muscles
Neck Muscles
Splenius Capitis
• Origin:
• C3-T3
• Insertion:
• Occipital bone
• Mastoid process
• Function
• Head & neck extension
• Lat flexion
Same side head rotation
https://www.youtube.com/watch?v=unDACOZpBpI
Splenius Cervicis
• Origin:
• Spinous process of T3-T6
• Insertion:
• Transvers process of C1-C3
• Function
• Head & neck extension
& hyperextension
• Lat flexion
Same side head rotation
Semispinalis Capitis
• Origin
• Articular process of C4-C6
• Transverse process of C7-T6
• Insertion
• Occepital bone
• Function
• Ext & hyperext of the head
and neck
• Head & neck rotation to the
opposite side
Semispinalis Cervicis
• Origin
• Transverse process of T1-T6
• Insertion
• Spinous process C2-C5
• Function
• Ext of the head and neck
• Head & neck rotation to the
opposite side
• Laterally flex neck
Semispinalis Thoracis
• Origin
• Transverse process of T6-T10/12
• Insertion
• Spinous process C6-C7 & T1-T4
• Function
• Ext of the neck thoracic vertebrae
• Neck & thoracic rotation to the
opposite side
• Laterally flex neck & thoracic
vertebrae
Rectus Capitis Posterior Minor
• Origin
• Posterior tubercle of atlas (C1)
• Insertion
• Occipital bone
• Function
• Head extension
• Control infolding movement of dura
• Proprioception
Rectus Capitis Posterior Major
• Origin
• Spinous process of axis(C2)
• Insertion
• Occipital bone
• Function
• Head extension
• Head rotation to the same side
Obliquus Capitis Superior
• Origin
• Transverse process of atlas(C1)
• Insertion
• Occipital bone
• Function
• Head extension
• Head rotation to the same side
• Lateral head flexion, same side
Obliquus Capitis Inferior
• Origin
• Spinous process of axis(C2)
• Insertion
• Transverse process of atlas(C1)
• Function
• Head rotation to the same side
Neck Muscles
Movement Muscle
Flexion R+L SCM(ant fibers)
Extension Splenius cervicus & capitis + semispinalis
+trapezius+SCM(post fibers)
Side flexion, R & L SCM
Rotation, R & L SCM+ splenius+trapezius
Stabilization Trapezius & all other muscles
Neck & Shoulder, Levator Scapulae
• Neck stabilize
TRAPEZIUS MUSCLE
• Origin
• Occipital bone
• Spinous process of C7-
T12
• Insertion
• Lateral clavicle
• Acromion
• Spine of scapula
• Innervation
C3-C4 & XI( accessory
nerve)
Trapezius, functions
• Elevation of scapula
• Retraction(adduct) scapula
• Upwardly rotate scapula
• Depress scapula
• Neck extension
Vertebral Pain
• Disc problem
• Treatment choice:
• LASER + Traction
• ultrasound
• Isometric exercises
• Arthritis
• MVA, whiplash
• Bone spurs
• Cervical spondylosis
• Osteoporosis
• Pinched nerves
• Spinal stenosis
Symptoms Of Neck Pain
• Headaches
• Numbness, weakness, in neck, arm, hands or fingers
• Pain in neck, shoulder, arms or hands
• Reduced ROM in neck
• Walking problem, spastic gait
RA Symptoms
• Pain,
• Morning stiffness
• Swelling
• Decreased ROM
• Increase pain with ADLs(tying shoes, opening jar,
buttoning shirt…)
• Fatigue
• Occasional fever
• Decrease ability to grasp
• Headache
• Irritation of upper cervical facet joint
• Tight levator scapula
• Rounded shoulder+head forward
Head Forward, Exercises
• chin tuck
• Standing
• Supine
• Prone
• Hold 5sec, 5times/hr
• Shoulder retraction, using theraband
• strengthening of sup. Trap & ser. ant
Facet Joint pain( Spinal Osteoarthritis)
• Ice pack
• Ultra Sound
• TENS/IFC
• LASER
• Exercises
Whiplash Treatment
• First 2 wks:
• RICE
• Active ROM but pain free
• Collar
• After 2nd wk:
• Active assistive pain free ROM
• Pain free isometric exercises
• Scapula movement active pain free
• After 6 wk:
• Stretching exercises pain free
• Chin tuck
• Gentle strengthening exercise
• After 4mnth:
• Isometric exercise
• Strengthening exercise
Neck Rotations
• Chin tuck
• Sideward isometric strengthening
• Forward isometric strengthening
• Backward isometric strengthening
• Stretching exercises
NECK STRETCH
• Cervical, 7
• Thoracic, 12
• Lumbar, 5
• Sacral, 5 fused
• Coccygeal, 4 fused
• Four facet joints on
each vertebrae
Spinal Extensors
Thoracic Back Pain Causes
• Soft tissue
• Poor posture,
• back pack
• Prolonged sitting at a computer
• Overuse injuries
Postures
Thoracic back pain
• Scoliosis
• Kyphosis
Scoliosis
• Structural
• Surgery
• exercise
• Postural
• Exercise
• Stretching of lower side
• Strengthening of higher side
Exercises of scoliosis
• McKenzie ex.
• Hanging from a bar
• Side flexion
• Sit on foot, palms on the floor, extension toward the
upper side
• Cat & camel exercise
Kyphotic Posture
• Lordosis
• Disc problems
• Facet joints problems(dysfunction)
• Degenerative vertebrae secondary to degenerative disc
• Spondylolisthesis
Discus
• Nucleus pulposus
• Annulus fibrosus
Discus
• Aging
• Decrease bone density, muscle & ligament weakness
• Improper lifting
• Smoking
• Strenuous repetitive activities
• Obesity
• Sudden pressure
Disk Problem, Sign & Symptoms
• Unilateral pain
• Referral pain to leg
• Increase pain in driving and sitting
• Increase pain with cough & sneeze
• Lumbar disc pain
Referral Pain