A BioGeometric Integration Approach To



(Rough Draft)

A Bio-Geometric Integration Approach To

Understanding the Clavicular/Sternal Relationship.

Purpose Of Paper:

Apply BGI framework to clavicular/sternal relationship

Provide a functional explanation of clavicular/sternal region

Provide structural model to visualize the clavicular/sternal region which can assist in future 3-Dimensional modeling

Improve clinical skills through greater clarity of clavicular/sternal region

Introduce a theoretical model to give a possible explanation of the clavicular/sternal region

Introduction:

The Bio-Geometric Integration (BGI) framework shows a geometric model of triangular relationships over regions of the posterior anatomy and the anterior anatomy of the human body. It has provided a bridge between osseous, tonal, and postural approaches within chiropractic. Familiarity with BGI concepts will be important to understanding this paper.

From a medical anatomical perspective, the head resting on the cervical spine connecting with the thoracic spine enclosed by muscles which connect to ribs, the clavicles, the scapulas, and the cervical spine has posed at times difficult clinical problems. In our modern society the effects of tension building in these structures are seen routinely in chiropractic offices as well as other health care professionals. Manifestations include stretched upper back connective tissue, pronounced posterior subluxations of the upper thoracic vertebra, tight neck muscles, cranial pressure, headaches, shallow breathing, anterior projecting heads, tight chest structures, etc… This has provided many problems and questions as to the best way to release this tension with effective treatment. Within chiropractic, doctors jokingly have referred to adjusting the first and second thoracic vertebra with a thumb move as the “million dollar” adjustment. The complexity of the anatomy and current treatment philosophies have proved to be only moderately effective.

BGI offers an alternate model of the body compared with medical anatomy. This paper will propose a model of the clavicular/sternal region based on BGI concepts and offer possible explanations as to the body’s wisdom for this configuration.

Anatomy:

Paragraph on neck muscles with actions. Also, cervical spine impact. (not complete)

Anterior and Posterior Geometry:

Looking closer at the head, neck, upper back, and chest region, five geometric triangles are seen. Three are in the posterior system and two are on the anterior system. Focusing on the head and neck first, the cervical triangle has a base across the atlas-occiput border to the lateral transverse process of the atlas with its tip at the spinous process of C6. The facial triangle has a base across the zygomatic ridge to the ears bilaterally and its tip runs to the episternal notch of the sternum. These two triangles have their tips pointing down into the chest/thorax region. Now, looking at the chest, the sternal triangle has a base which extends from the sternum laterally along the inferior border of the clavicle to the head of the humorous and its tip runs to the xiphisternal junction. The thoracic triangle has a base which extends across T9 and T10 following the angle of the ribs to their posterior lateral borders and its tip is at the spinous process of C7. Therefore, one triangle’s tip points to the neck while the base of the other points toward the neck. This gives the root of the neck 3 points of triangles pointing toward one another with one base. From this perspective, it is easy to see that the root of the neck can be very unstable because 2 tips must be balanced on one tip and base. This instability provides for the necks great mobility. It can produce 6 actions: flexion, extension, right/left lateral rotation, and right/left rotation. It also means that stabilization has to be achieved somehow. This seems to be achieved by the clavicular triangle from the posterior system. Its base extends across the border of the trapezius to the acromial-clavicular joint and runs anterior and medially along the superior surface of the clavicle with its point at the manubrium. It is a transverse plane crossing from posterior to anterior. This provides the stabilization of the root of the neck. Clinically, increases in tension seen in and around these regions can be explained as the bodies attempt to further stabilize an unstable area from perceived stress thus producing all the possible results mentioned in the introduction.

Sagittal Geometry:

In sagittal geometry, the relationship between the anterior and posterior systems is revealed. A posterior triangle has a direct relationship with its anterior counterpart and within the relationship a volume is seen although the direct relationship is planer in nature. In this case, the facial triangle and the cervical triangle have a sagittal relationship. The thoracic triangle and the abdominal triangle have a sagittal relationship. The abdominal triangle has a base which extends across the anterior medial border of the 10th rib cartilage and runs superior and medial along the anterior-medial border of the lower rib cage to its point at the xiphoid. Five of the six sagittal relationships have the posterior and anterior triangle which line up in the same geometric orientation. Each triangle is split into 6 regions with 1 being the base and 6 being the apex. A simple breakdown of the relationship would have all the 1’s of the posterior triangle lining up with the 1’s of the anterior triangle continuing to the 6’s. Extending planes through the 1’s, 2’s, 3’s, 4’s, 5’s, and 6’s would show a frame in which the posterior and anterior systems connect. Looking at the cervical/facial relationships, this arrangement provides the framework which supports the neck much like the spokes of a bicycle wheels or ferris wheel. The problem is that the apexes of the cervical and facial triangles are not stabilized. The thoracic and abdominal sagittal relationship only provide the support for the chest and thorax frame.

It has already been introduced that the clavicular triangle provides support to stabilize the root of the neck. The question becomes, how does it provide the stability? It is with its sagittal relationship. Its sagittal partner is the sternal triangle. Instead of the triangles oriented in the same direction, the clavicular triangle’s apex connects in the middle of the base of the sternal triangle. The clavicular triangle as been rotated 90 degrees in an upward arc along its base to become a transverse plane moving the apexes a part by the length of the sternum. The sagittial relationship reveals a narrow volume directly behind the sternum up to the clavicular triangle. The sagittal framework takes on a different configuration than the other relationships. Picture the clavicular and sternal triangles aligned like the other sagittal relationships. Both of the triangles will be pointing down and planes will be going through the 1’s on down to the 6’s. If the clavicular triangle is rotated in an upward arc along the sternum 90 degrees, the planes connecting the two triangles will begin to interfere with each other creating an interlocking weave pattern in the sagittal space. Much like in sewing, the weave increases the strength of the relationship. This can provide a foundation on which the neck and head connect with chest and thorax. An analogy would the foundation of a skyscraper. The height and weight and forces on the building determine the depth and size and strength of the foundation the building needs. A large pit is dug and concrete structures are utilized to anchor the building. Clinically, putting your head and neck through their six actions, the load can be felt in the clavicular/sternal sagittal relationship. The sternum is generally considered an attachment point for the rib cartilages and a protective plate over the heart. It is worth considering that the structure of the sternum may also be related to this sagittal relationship. The apexes of both triangles are sagittally pulled further apart than the other regions of the triangle. By pre-loading the clavicular/sternal relationship like this, a large potential energy is stored here and maybe the size and strength of the sternum is used to compensate. This has been a difficult region to visualize structurally. Seeing it functionally in a “big picture” may help to see why it is organized in this manner.

Coronal Geometry:

Now that the sagittal geometry can explain the support system of the clavicular/sternal relationship, what is it supporting? This is explained by the coronal geometry. As the sagittal volumes begin to release, they begin to move in space. The movement of the head and neck around the external acoustic meatus reflex the cranial coronal plane of motion. The plane itself is a volume geometrically represented as a pyramid. Regions are seen in arcs around the external acoustic meatus in increasing diameters up the cranial in 6 sections. The potential is for 360 degrees of motion although this is limited by the cervical spine and neck structures. However, the head and neck have the effect of swinging around the fulcrum or external acoustic meatus. The clavicular/sternal region are the support structure for the movement of the head and neck much like in a ferris wheel. When viewing a ferris wheel, typically structures are seen which anchor the fulcrum of the wheel to the ground. One difference is the weight of the head is supported by the cervical spine. However, flexion and extension motions which are analogous to 360 degree rotation of a ferris do occur. The structural supports for this are done by the sternocleidomastoid, splenius captitus, and trapezius muscles. The SCM attaches to the sternum and clavicle and the trapezius attaches to the clavicle. The other muscles provide various supports to the head, cervical spine, and ribs. A head and neck can also rotate left and right and laterally flex left and right which a ferris wheel can not do. Clinically is has been determined that the mastoid process is included in the cranial coronal plane. It is shaped like a triangle and palpates in the geometry from base to apex in regions from 1 to 6. It is included in the CCP description. The mastoid has an attachment with the SCM. This muscle not only flexes the head, it can rotate and laterally flex the head as well. It attaches to the sternum and clavicle which gives it a direct connection to the clavicular/sternal region. It makes sense then that the SCM provides not only action for head movement but stability as well. This may explain why this muscle can be so tight on many people. Because of its connection to the SCM, the mastoid process becomes an effective way of releasing coronal tension as well as the rest of the geometry.

Advanced Geometry:

Using triangles to represent the geometry is a simplified way of explaining more complicated geometry. It would be too unwieldy to start there. It has been very difficult for most students of BGI to grasp the clavicular/sternal relationship and only lightly touched on in advanced seminars. The triangles of the posterior and anterior geometry are really tetrahedrons. Basic tetrahedrons are 3 sided pyramids, with the base being a triangle. In the body, they give the geometry depth. The front edge generally palpates as the medial point on the corresponding opposite geometry. The clavicular tetrahedron and the sternal tetrahedron have a different shape than the general tetrahedron. As mentioned earlier, this is due to the apexes the triangles sliding apart from one another. In the study of tetrahedrons, they can came in many different shapes and sizes. The important point is that in behaves as a tetrahedron. This is found in its tonal or vibrational nature. To visualize the sagittal geometry now with tetrahedrons provides for great frustration. It is hoped that 3 dimensional computer modeling can and will be used to provide this picture. It is also hoped that this paper can be used as a starting point to that end.

Conclusion:

(not complete)

(Rough Draft)

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