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Clinical Examination of Posture

Table 3-1Factors Influencing Posture

Inspection

Image not available. Inspection Findings 3-1: Classifications of Body Types

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Ectomorph

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Mesomorph

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Endomorph

Description Slender, thin build; relatively low body mass index Medium, athletic build, relatively average body mass index Stocky build; relatively high body mass index
Joint Shape Small, flat joint surfaces Medium sized joint surfaces Large, concave-convex joint surfaces
Muscle Mass Minimal muscle bulk, thin muscles Medium muscle build Thick muscle mass
Joint Mobility Increased Within normal limits Decreased
Joint Stability Decreased Within normal limits Increased

Views of Postural Inspection

Image not available. Inspection Findings 3-2: Assessment of Ideal Posture

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Lateral Anterior Posterior

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Alignment relative to plumb line:

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Alignment relative to plumb line:

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Alignment relative to plumb line:

Lower extremity
  • Lateral malleolus: Slightly posterior

  • The tibia should be parallel to the plumb line, and the foot should be at a 90° angle to the tibia

  • Lateral femoral epicondyle: Slightly anterior

  • Greater trochanter: Plumb line bisects

  • Feet: Evenly spaced from plumb line

  • Tibial crests: Slight external rotation

  • Knees: Evenly spaced from plumb line

  • Patella: Facing anteriorly

  • Consistent angulation from joint to joint

  • The lateral malleoli, fibular head, and iliac crests should be bilaterally equal.

  • Feet evenly spaced from plumb line

  • Feet in slight lateral rotation: Lateral two toes are visible

  • Knees evenly spaced from plumb line

  • Consistent angulation from joint to joint

Torso
  • Midthoracic region: Plumb line bisects

  • Umbilicus: Plumb line bisects, although abdominal surgical procedures may alter the alignment.

  • Sternum: Plumb line bisects

  • Jugular notch: Plumb line bisects

  • Median sacral crests: Plumb line bisects

  • Spinous processes: Plumb line bisects

  • Paraspinal musculature bilaterally symmetrical

Shoulder
  • Acromion process: Plumb line bisects

  • Acromion processes: Evenly spaced from plumb line

  • Shoulder heights equal or dominant side slightly lower

  • Deltoid, anterior chest musculature bilaterally symmetrical and defined

  • Scapular borders: Evenly spaced from plumb line

  • Acromion processes: Evenly spaced from plumb line

  • Deltoid, posterior musculature bilaterally symmetrical

  • Shoulder heights equal or dominant side slightly lower

Head and Neck
  • Cervical bodies: Plumb line bisects

  • Auditory meatus: Plumb line bisects

  • Head: Plumb line bisects

  • Nasal bridge: Plumb line bisects

  • Frontal bone: Plumb line bisects

  • Cervical spinous processes: Plumb line bisects

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