Table of Contents

Preface To The Fourth Edition ix

Acknowledgements x

Section I: Introduction to movement 1

Chapter 1 Basic units, structure and function: supporting tissues, muscle and nerve 3

Framework and support: the connective tissues 4

Articulations 9

Skeletal muscle 12

Basic units of the nervous system 18

Muscle tone 27

Summary 29

Chapter 2 Movement terminology 31

The anatomical position 32

Planes and axes of movement 33

Structure and movements at synovial joints 34

Group action and types of muscle work 38

Biomechanical principles 41

Summary 49

Chapter 3 The central nervous system: the brain and spinal cord 50

PART I: THE BRAIN 51

Introduction to the form and structure 51

Cerebral hemispheres 56

Basal ganglia 65

Thalamus 66

Hypothalamus and limbic system 67

Brain stem 69

Cerebellum 71

Summary of brain areas: function in movement 73

PART II: THE SPINAL CORD 73

Position and segmentation of the spinal cord 73

Spinal reflex pathways 79

Summary of the functions of the spinal cord 82

Summary 82

Chapter 4 The peripheral nervous system: cranial and spinal nerves 84

Introduction 85

Spinal nerves 86

Peripheral nerves 90

Cranial nerves 92

Autonomic nervous system 96

Summary 99

Section II: Anatomy of movement in everyday living 101

Chapter 5 Positioning movements: the shoulder and elbow 103

Introduction 104

PART I: THE SHOULDER 105

The shoulder (pectoral) girdle 105

The shoulder (glenohumeral) joint 108

Muscles of the shoulder region 109

PART II: THE ELBOW 121

Elbow position and function 121

The elbow joint 121

Muscles moving the elbow 123

Summary of the shoulder and elbow in functional movements 127

Summary 129

Chapter 6 Manipulative movements: the forearm, wrist and hand 130

Introduction 131

Functions of the forearm and wrist 131

The forearm 131

The wrist 134

Functions of the hand 140

Movements of the hand: fingers and thumb 141

Muscles moving the hand: fingers and thumb 144

Types of grip 157

Summary of muscles of the forearm and intrinsic muscles of the hand 160

Summary 161

Chapter 7 Nerve supply of the upper limb 162

Introduction 163

The brachial plexus 163

Terminal branches of the brachial plexus 165

Axillary nerve: shoulder movement 165

Spinal segmental innervation of the upper limb 173

Summary 174

Chapter 8 Support and propulsion: the lower limb 175

Introduction 176

Joints and movements of the pelvis, thigh and leg 176

Muscles of the thigh and leg in support, swing and propulsion 183

Functions of the foot 197

Summary of the lower limb muscles 204

Summary 204

Chapter 9 Nerve supply of the lower limb 206

Introduction 207

Lumbar plexus: position and formation 207

Terminal branches of the lumbar plexus 207

Sacral plexus: position and formation 211

Terminal branches of the sacral plexus 211

Spinal segmental innervation of the lower limb 216

Summary 216

Chapter 10 Upright posture and breathing: the trunk 218

Introduction 219

Upright posture 220

Breathing 230

Pelvic tilt and the pelvic floor 236

Nerve supply of the muscles of the neck and trunk 238

Summary of the muscles of the trunk 239

Summary 239

Section III: Sensorimotor control of movement 241

Chapter 11 Sensory background to movement 243

Somatosensory system 244

Vestibular system 254

Visual system 256

Regulation of posture 258

Summary 259

Chapter 12 Motor control 261

Introduction 262

Spinal mechanisms 262

Descending motor system 267

Planning, co-ordination and motor learning 272

Summary 277

Section IV: Human occupation 279

Chapter 13 Occupational performance skills and capacities 281

Multiple factors in control of occupational performance skills 282

Core positions and patterns of occupational performance skills 286

Summary 300

Chapter 14 Occupational performance 301

Introduction 302

Framework for understanding human occupation 302

Case scenarios 305

PART I 306

Example case scenario 306

Further case scenarios 308

Case scenario 1: Mabel; the ageing process 308

Case scenario 2: Mary; Parkinson’s disease 310

Case scenario 3: John; traumatic brain injury 310

Case scenario 4: Patrick; hand injury 311

Case scenario 5: Christopher; spinal cord injury 311

Case scenario 6: Susan; chronic pain 312

PART II 313

Case scenario 1: Mabel; the ageing process 313

Case scenario 2: Mary; Parkinson’s disease 314

Case scenario 3: John; traumatic brain injury 316

Case scenario 4: Patrick; hand injury 317

Case scenario 5: Christopher; spinal cord injury 318

Case scenario 6: Susan; chronic pain 320

Conclusion 323

References 323

Further reading 324

Appendix I: Bones 326

Appendix II: Segmental nerve supply of muscles 336

Glossary 340

Index 354

Practice note-pad list 365

About the Author

Ian McMillan is the Acting Head of Subject for the Department ofOccupational Therapy, Faculty of Health and Social Sciences, QueenMargaret's University, Edinburgh. Gail Carin-Levy is Lecturer in Occupational Therapy for theDepartment of Occupational Therapy, Faculty of Health and SocialSciences, Queen Margaret's University, Edinburgh. June Grieve MSc BSc, formerly of the London School ofOccupational Therapy, London, UK. Barbara Tyldesley is formerly of the Department of OccupationalTherapy, Liverpool University.