Musculoskeletal Physical Therapy 19

(f)Interspinous ligament. spinal cord by a dorsal and ventral root,

(g)Supraspinous ligament. which join to become the spinal nerve in
(h)Transforaminal ligaments. the intervertebral foramen. Spinal nerve
(i)Costotransverse ligament (superior, divides into dorsal and ventral rarni.
posterior, and lateral). (a) Dorsal rami innervate structures on
(j) Iliolumbar ligament. posterior trunk.
(k) Posterior sacroiliac ligaments (short, (b) Ventral rami.
transverse, and long). Cervical ventral rami form cervical
(I) Anterior sacroiliac ligament. and brachial plexuses.
(m) Sacrotuberous ligament. Thoracic ventral rami innervate
(n) Posterior interosseous ligament (SlJ). anterior structures of trunk within
(2) Capsules. thoracic region.
(a) Facet joint: assist ligaments in provid- Lumbar ventral rami form lumbar
ing limitation of motion and stability and lumbosacral plexuses.
of spine. Strongest in the thoracolum- (3) Spinal nerves in various sections of spine.
bar and cervicothoracic regions. (a) Cervical: spinal nerves come out at the
(b) Sacroiliac joints: synovial capsule pres- level above its associated vertebra.
ent surrounding joint which is very (b) Thoracic/lumbar: spinal nerves come
prominent anteriorly; posteriorly it is lost out at level below its associated verte-
within posterior interosseous ligament. bra.
(3) Thoracolumbar fascia. (4) Spinal cord terminates approximately at
(a) Provides stability of vertebral column level of L t _2 disc.
when a force is applied. J. Spinal biomechanics.
(b) Acts as a corset when tension is creat- (l) Arthrokinematics.
ed by contraction of the abdominals, (a) Flexion: upper facets glide anteroprox-
gluteals, and lumbar muscles. imally and tilt forwards.
I. Nerves. (b) Extension: upper facets roo,..,doonward,
(I) Dorsal roots transmit sensory fibers to spinal slightly posterior, and tilt backwards.
cord and ventral roots mainly transmit motor (c) Side bending: when side bending right,
fibers from spinal cord to spinal nerve. upper facet moves do\\n and lightly
(2) Spinal nerves are connected centrally to anterior. Left facet moves upward and
TABLE 1-6C - TRUNK AND RIBCAGE MUSCULAR & NEUROLOGICAL SCREENING
ACTION TO RETESTED MUSCLES CORD SEGMENT NERVES
nspiration diaphragm C3-C5 phremc
levator costarum, external intercostals, Tl-T12 intercostal
anterior intemal intercostals
n-ced expiration internal obliques,transverse abdominis, T7-L1 Intercostal
extemal obliques, T7-T12 intercostal
posterior internal inlercostals, T1-T12 intercostal
rectus abdominis T7-T12 intercostal
spine extension erector spinae, transversospinafis, T1-T12, Ll-L5, 81-83
interspinales, rotatores
intertransversarii
spine flexion rectus abdominislexternal obliques, T7-T12 intercostal
internal obliques, T7-Ll intercostal
psoas minor 11 lumbar plexus
spine lateral flexion (hip quadratus lumborum T12-L3 lumbar plexus
hiking in reverse)
spine rotation rotators, internaVextemal obliques, as above
intertransversarii, transversospinalis

Adapted from Chusid JG: Correlative Neuroanatomy and Functional Neurology. Lange Medical publications. Los Altos, CA, 1970
CA, 1970 and Kendall. FP; McCreary, EK, and Provance, PG. Muscles Testing and Function 4 ed.Williams and Wilkins. Baltimore, 1993).