• Cervical lordosis– When starts to hold up his head(3-9 months)
– Lumbar lordosis
– When starts to stand(12-18 months)
Curvatures of the vertebral column /In the sagittal plane ‘S’ shape/Muscle development lead to the early appearance of secondary cervical &lumbar spinal curvature
Curvatures of the vertebral column
R=n2 +1(R=32+1=10)/355kg weight&125kg tension
C1-T2
T2-T12
T12-(L5 S1)
C4-C5
T6-T9
L3
Lumbosacral j-co
Curvatures of the vertebral column with soft tissue
Lateral curvature(Minor degree)
Line of gravity of the vertebral column
Dense of atlas
Ant of body of T2
Centre of body of T12
Rear of body of L5
Forward bending
• Assessing lumbo-pelvic congruency– Palpation from cervical
spine to pelvis
Spinuos process
5-7cm
inion
Foramen magnum in flextion
Cerebellomedullary cysterna puncture
3-6 not palpable(nuchal lig
C7:Vertebral prominence
T1:under C7
T4-10:oblique
T11&12 similar to lumbar
C6
C7
T3
T8
T10
T10
L3 infant
L2
L3
Transverse process
5cm
Lp
2.5 cm
5cm Adult &2.5 infant
Sacrum
Median sacral crest/spinous tubercle/sacral hiatus
Spinous tubercle
PSIS/ASIS/Sacroiliac joint/End of subarachnoid space &CSF
Spinous tubercle
S3(upper part of natal cleft)
S3
Sacral hiatus
5cm
Or 6cm upper to anus
Posterior sacral foramina4 n
Posterior sacral foramina
5cm
3cm
2.5cm
Sacral promontary
Coccyx(Apex,base)
1cm upper anus6cm upper anus
Scoliosis• A medio-lateral curve of the
vertebral column Exceeding 100
– Types• Congenital abnormalities of
thevertebrae(hemivertebrae)
• Neuromuscular(muscular dystrophy,poliomyelitis)
• Idiopathic
– Treatment• Exercises
Back Inspection (Forward Flexion)
Detection of Scoliosis
12cm
Kyphosis• An exaggerated curvature in the
sagittal plane• Possible causes
– Wedge compression fracture– Senile osteoporosis– Destructive tumors of spine
Patient presenting with deformity
Back Inspection (standing)
Fractures to the column
T12-L1
Dene of axis
Forced flextion injury inviolent blow on the back(T5-T6)
Fall on to the feet or head(T9-L2)
vertebral column in elderly
– Dowager s hump in midthoracic region in female( senile osteoporosis)
– lumbar lordosis ( in body weight)
in eldery:changes in the collagen content of the disc&decline in the activity of spinal muscle dynamic decline in vertebral column mobility particularly in the lumbar spine
Inferior angle(7 R)
Scapula
Superior angle(R2)
Scapula
Spine(T4 body)Inferior angle(T7 spine)
48
49
Palpation of rib
Count of rib
5cm
4r
Splenius capitis
Splenius capitis
Superior angle:External occipital protuberanceInferior angle:T12 (spine)Lateral angle:Shoulder
59
Motion Segment
Theory of weight bearingNeck:thick disk/thoracic:thin dick/lumbosacral j thick dick