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C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 61 By Joseph E. Muscolino, DC Anatomy, or structure, is the fundamental key for all manual and movement therapy. From anatomy, everything else follows: physiology (function), pathophysiology (altered function), assessment, and treatment. Let's illustrate this using the coracobrachialis muscle as our example. The anatomy of the coracobrachialis is that it attaches from the coracoid process of the scapula to the medial surface of the humerus. From this, we can deduce that it crosses the glenohumeral (GH) joint anteriorly and medially, telling us that this muscle flexes and adducts the arm at the GH joint. Therefore, we now know the muscle's actions (physiology). Knowing this tells us what its pathophysiology would be. If the coracobrachialis were tight, in addition to perhaps causing local and/or referred pain when palpated, it would likely limit the ability of the arm to move into extension and/or abduction. Assessment would also follow: we simply challenge the muscle to stretch by moving the arm into extension and abduction, and look for decreased range of motion. Further, we could use our knowledge of the attachments and actions of the muscle to palpate it and determine the integrity of its tissue. Treatment would follow by performing manual therapy and stretching to loosen and lengthen the coracobrachialis. Even though anatomy course work can feel like a memory game while in school, the effort spent to learn anatomy pays dividends many times over. I view anatomy education as the dues that must be paid to be able to reason through the physiology, pathophysiology, assessment, and treatment necessary for effective clinical orthopedic manual therapy. From a teaching point of view, anatomy can become vibrant and enchanting if the instructor and the learning resources apply the anatomy to the actual assessment and treatment techniques that form the profession—in effect integrating the science content with the hands-on content. IT ALL STEMS FROM ANATOMY