1- Back Flashcards
7What are the 3 parts of Trapezius?
1- Superior or Descending
2- Middle or Transverse
3- Inferior or Ascending
What are the attachments of the Superior/Descending, Middle/Transverse, and Inferior/Ascending?
Superior/Descending:
External Occipital Protuberance, Medial 1/3 of Superior Nuchal Line, Ligamentum Nuchae, Clavicle lateral 1/3, and Spinous process of C1-C7
Middle/Transverse:
Acromion, Aponeurosis of T1-T4 spinous process
Inferior/Ascending:
Spinous process of T5-T12, Scapular Spine
What is the Trapezius Innervated by?
Accessory Nerve CN XI
What is the action of the Descending part of Trapezius?
Elevate and *rotate the Scapula
Ipsilateral sidebend of the head and Contralateral rotation of the head.
slightly extends the neck
What is the action of the Transverse/Middle Trapezius?
Adducts the Scapular
aka
Retraction
What is the action of the Inferior/Ascending Trapezius?
Medially Depresses and Rotates the Scapula.
also stabalizes the Scapula in the Thorax.
What are the Attachments for Levator Scapulae?
Transverse Process of C1-C4 and Supeior angle of Scapula
What innervates the Levator Scapula?
Dorsal Scapular Nerve
What sort of muscular shaping is the 3 portions of the Trapezius?
Convergent
What is the physical attachment of Nerves and the Muscle fiber called?
Nuero-muscular junction
Where is ths Latissimus Dorsi oriented?
Superior Portion is found just deep to the Trapezius
Is the Latissimus Dorsi Extrinsic/Intrinsic?
Extrinsic
What are the attachments of Latissimus Dorsi?
1- Spinous process of T7-T12 into THORACOLUMBAR FASCIA into lesser tuberosity of the humerus
2- Inferior angle of scapula into the lesser tuberosity of the humerus
3- Ribs 9-12 into the lesser tuberosity of the humerus
4- Posterior 1/3 of the Iliac crest into the lesser tuberosity of the humerus
What innervates the Latissimus Dorsi?
Thoracodorsal Nerve
What are the actions of the Latissimus Dorsi?
Internal rotation of the Humerus
Adduction o fthe UE
Extending the UE
small trunk extension
The Anterior Aponeurosis that originates from the abdominal area wraps around and connects with what inferior portion of the Latissimus dorsi?
Thoraco-lumbar fascia
What is an Aponeurosis?
Broad flattened tendon
Is the Rhomboid Major Extrinsic/Intrinsic?
Extrinsic
What are the attachments of the Rhomboid Major?
T2-T5 to Inferior to the root of the Scapular Spine, medially.
What are all these Superficial back muscles (Rhomboid major, Rhomboid minor, Levator scapula) innervated by?
Dorsal Scapular Nerve C3-C5
The Rhomboid Major and Rhomboid Minor doesn’t move the cervical spine. However what is it’s primary function?
Steadies the scapula
Primary is Retraction
Downward rotation of the scapula
All Rhomboid major, rhomboid minor, Levator scapula are extrinsic/intrinsic?
Extrinsic
What are the attachments for Rhomboid Minor?
C7-T1 to the medial border of the scapula at the root of the scapula. Rhomboid minor is the only muscle attached there.
What are the attachments of Levator Scapula?
Transverse Processes of C1-C4
into
Superior of the Root of the scapula medially
What are the function of Levator scapula?
Elevate the medial portion of the scapula
Downward rotation of the shoulder
Bilaterally causes back extension
Ipsilaterally causes rotation and side bending
What does the Levator scapula prevent?
Anterior Shear of the certical vertebra.
Levator scapula gets overworked when the head is in a protruding posture, there for to stretch it how is it done?
Look down and away contrilaterally.
What is the Triangle of Auscultation? and what is it’s clinical relevance?
Rhomboid major
Lower Trapezius
Latissimus Dorsi
where it is the easiest for posterior lung sound due to the thinness of muscles here
Where is the Serratus Posterior Superior oriented?
Just deep to Rhomboids
What are the attachments of Serratus Posterior Superior?
Spinous Process of C7-T3
to
Ribs 2-4
Where is Serratus Posterior Inferior oriented?
Just deep to Latissimus Dorsi
What are the attachments of Serratus Posterior Inferior?
Spinous process of T11-L2
to
Ribs 8-12
Both Serratus Posterior Inferior and Superior is Intrinsic/Extrinsic.
Extrinsic
lungs to ribs to back
What is the innervation of Serratus Posterior Inferior and Superior?
Intercostal nerves (ANTERIOR rami of thoracic region)
What is the function of Serratus Posterior Inf/Sup?
Provides more proprioception and
Serratus post inf= pulls down the ribs
Serratus post sup= pulls up the ribs
Since both Serratus Posterior Inf/Sup are very thing where would they most likely be seen?
They are attached to the muscles superficial to them
What is the innervation to all Deep posterial muscles if they are intrinsic?
All deep Intrinsic muscles are innervated by Dorsal rami
Where is Erector Spinae oriented?
Just deep to Serratus Posterior Inferior
There are three layers of Deep Back Muscles. What are they Superficial to Deep?
Splenius Muscle Group
Erector Spinae
Transversospinal Muscle Group
All Erector Spinae muscles are Extrinsic/Intrisic
Intrinsic
What is the only Erector Spinae muscle found in the Lumbar region?
Iliocostalis
What is the longest portion of the Erector Spinae Muscle group?
Longissimus
Where is Iliocostalis of the Erector Spinae oriented?
It is the most lateral and the only Erector spinae muscle found in the Lumbar region
What is the orientation of Longissimus?
Intermediate in between Iliocostalis and Spinalis.
Projects from Thoracic region
to
Capital region
What is the orientation of Spinalis?
most medial
Projects from Thoracic region
to
Capital region
Where is the Erector Spinae’s Aponeurosis oriented?
Erector spinae’s aponeurosis is deep to Thoracolumnar Aponeurosis
Name the three segments of the Iliocastalis?
1- Iliocostalis Lumborum
2- Iliocostalis Thoracis
3- Iliocostalis Cervicis
Which Erector Spinae muscle segment is the only segment to begin in the Lumbar region?
Iliocostalis
bc they are the only segment to have Lumborum
hence Iliocostalis Lumborum
What is the main function of all Erector Spinae muscles?
Bilateral contraction= extension of the trunk
Unilateral contraction= ipsilateral lateral flexion
What slight and unique motion is Iliocostalis capable of?
Iliocostalis is capable of slight ipsilateral rotation
due to its most lateral flexible nature
Name the three segments of Longissimus.
1- Longissimus Thoracis
2- Longissimus Cervicis
3- Longissimus Capitus
Name the three segments of Spinalis.
1- Spinalis Thoracis
2- Spinalis Cervicis
3- Spinalis Capitus
What is the general attachment sites of Iliocostalis?
Runs superiorly toward ribs and the cervical transverse processes
What is the general attachment of Longissimus?
Runs superiorly to ribs between tubercles and angles
transverse processes in cervical region
to mastoid process
What is the general attachment of Spinalis?
Runs superiorly along spinous process of thoracic and cervical region
to the cranium
Where is Splenius Cervicis oriented?
Found deep to the upper Trapezius
Where is the Splenius Capitis oriented?
Found deep to the upper Trapezius
Splenius Capitis/Cervicis are both Intrinsic/Extrinsic?
Instrinsic therefore are innervated by Dorsal Rami
What is Splenius Cervicis/Capitus innervated by?
Dorsal Rami due to being an Intrinsic back muscle
What are the attachment sites for Splenius Cervicis/Capitis?
C7-T3 spinous process
transverse processes of cervical vertebra
superior nuchal line
mastoid process
What are the actions of Splenius Capitus/Cervicis?
unilateral contraction= Ipsilateral rotation
unilateral contraction= Ipsilateral lateral flexion
bilateral contraction= cervical extension
What is the Orientation of Multifidus?
Found deep to Erector spinae running the ENTIRE length of the spine.
running down in the Laminal Groove (space in between the spinous process and transverse process)
What is the Laminal groove and what muscle is found in there?
The space in between spinous process and transverse process
Multifidus
Multifidus is Intrinsic/Extrinsic
Instrinsic therefore is innervated by dorsal rami
Where is the Multifidus much more thicker and well developed?
in the Lumbosacral region
it runs more vertical and is much thicker
attaching to the Mammillary processes o fthe lumbar vertebrae
What is the reason for a thicker Multifidus that attaches to the Mammillary process in the lumbar vertebrae?
to prevent Anterior Shearing that occurs naturally due to Lumbar Lordosis
What are the attachment sites for Multifidus?
runs from transverse process to spinous process
spanning 2-4 segments
What are the actions of Multifidus?
Unilateral contraction= contralateral rotation
Unilateral contraction= ipsilateral lateral flexion
BIlateral contraction= trunk extension
What two muscles are key for core strength?
Multifidus and TA
Chronic back pain will mess up what two muscles?
how is that evident in a cadaver or patient?
TA and Multifidus therefore in cadaver or patient these two muscles will seem more fatty and or yellow with more adipose tissues
What is the Orientation of Rotatores?
Found just deep to the Multifidus, therefore to see it in a cadaver you must first remove multifidus
What are the two types of Rotatores? and what makes them different?
Rotatores Brevis- runs from transverse process to spinous process spanning only 1 segment
Rotatores Longus- spans 2 segments
What is the innervation of Rotatores?
Dorsal Rami due to Intrinsic back muscle
What are the actions of Rotatores?
same as Multifidus
Unilateral contraction= contralateral rotation
Unilateral contraction= ipsilateral lateral flexion
BIlateral contraction= trunk extension
What are the three types of Semisplinalis muscles?
1- Semisplinalis thoracis
2- Semisplinalis cervicis
3- Semisplinalis capitus
Which Semispinalis is easiest to see?
Right under the Splenalis Cervicis/Capitus
is the Semisplinalis Capitus
What is the orientation of all Semispinalis muscles?
Found deep to the Splenius muscles
What innervates all Semispinalis muscles?
Dorsal rami due to it being an Intrinsic back muscle
What are the the attachment sites of Semispinalis muscles?
Runs from C4-T12 transverse processes to spinous processes
spanning 4-6 segments
The semispinalis muscles are very vertical in orientation what does that mean in function?
It will be purely for extension especially the Cervical extension
What nerve travels through semispinalis mucles and what pathalogical results can occur due to muscle issues?
Greater occipital nerve C2
cause headaches which radiate from posterior neck to anterior head.
therefore when the head is extended/protruded it can pinch the C2 nerve causing headaches
What is the orientation of Levator Costarum?
Just lateral to Multifidus/ Lamiillar groove
What is the innervation of Levator Costarum?
is Intrinsic back muscle therefor is inneravted by Dorsal rami
What are the two types of Levator costarum,
and what are the attachments of those Levator Costarum?
Levator costarum brevis- runs from rib to transverse process 1 segment
Levator costarum longus- runs from rib to transverse process 2 segments
What is the action of Levator costarum?
Elevates the ribs of only the Thoracic region
What is the orientation of Quadratus lumborum and a very important fact about it’s positioning?
found lateral to Multifidus and is the most Posterior boudnary of the Abdominal wall.
It is not a muscle of the Back!!!
Since the Quadratus lumborum isn’t part of the back muscle what is it really innervated by?
Ventral rami of T12-L4
What is the attachments of Quadratus Lumborum?
12th rib to transverse processes of L1-L5
and to it’s most inferior attachment site: Iliac crest most inferiorly
What are the action Quadratus Lumborum (4)?
Unilateral contraction= ipsilateral lateral flexion
Unilateral contraction= epsilateral elevation of the pelvis
NO flex/ext because it is perfectly in the coronal plane
moves the 12th rib therefore involved in respiration
What is Interspinalis and Intertransversarii muscles?
Interspinalis- is the muscle intermingled with interspinous ligaments found in btwen spinous processes vertically
Intertransversarii- is the muscle intermingled with intertransverse ligaments found in btwen transverse processes vertically
Where are the Suboccipital muscles located?
located deep to semispinalisin between C2 and Occiput
What innervates all subocciptial muscles?
suboccipital nerve aka C1 dorsal rami
Name all four muscles of the suboccipital muscle gourp.
Rectus capitus posterior minor
Rectus capittus posterior major
Supeior oblique
Inferior oblique
What is the attachments for Rectus capitus posterior minor
Posterior tubercle of C1 to inferior nuchal line
What are the attachments for Rectus capitus posterior major?
Spinous process of C2 to inferior nuchal line
What is the orientation relation between Rectus capitus posterior minor and Rectus capitus posterior major?
Rectus capitus posterior major is lateral to Rectus capitus posterior minor
What is the general orientation of all suboccipital muscles?
between occipital bone and spinous process of C2
What are the attachments of Superior oblique muscle?
Transverse process of C1 to occiput (between superior and inferior nuchal lines)
What are the attachments of Inferior oblique?
Spinous process of C2 to transverse process of C1
What are the bilateral and unilateral contractions produce in the suboccipital muscles?
Bilateral= capital extension aka Little yes nod
Unilateral= isilateral rotation
What position causes the suboccipital muscles to spaz?
constant head protrusion
What are the three boundaries of the Suboccipital triangle?
Rectus capitis posterior major (medially)
Superior oblique (laterally)
Inferior oblique (inferiorly)
What goes through the transverse foramina of the cervical vertebrae in the suboccipital triangle?
Suboccipital nerve
and
Vertebral artery
Where is the Dorsal root oriented, what sort of information does it carry, and where is the cell bodies located of the dorsal root?
- articulates with the dorsal horn
- carries sensory information
- cell body is located in the dorsal root ganglion
Where is the Ventral root oriented, what sort of information does it carry, and where is the cell bodies located of the dorsal root?
- articualtes with the ventral horn
- carries motor information
- cell body is located in the ventral horn
When the dorsal and ventral root converge what does it form?
spinal nerve root
what does the spinal nerve root emerge from?
via the Intervertebral foramen
What does the spinal nerve root split into?
dorsal and ventral rami which carry both motor and sensory information
What does the ventral rami innervate in general?
Anterior aspect of the trunt, UE, LE, and sensation of the anterior skin
What does the dorsal rami innervate in gneneral?
Innervates intrinsic muscles of the back and sensation of the dorsal skin
How are the vertebrae and spinal nerve oriented from C1-T2 vertebrae?
C1 Sp Nerve
C1 Vert
C2 Sp Nerve
C2 Vert
…
C7 Sp Nerve
C7 Vert
C8 Sp Nerve
T1 Vert
T1 Sp Nerve
T2 Vert
What are the 3 connective tissue layers of meninges? superior to deep.
Dura Mater
Arachnoid mater (won’t be visible, collapses into pia mater)
Pia mater.
What level does the spinal cord terminate?
L1-L2
What is the tapering of the spinal cord at L1-L2 known as?
what was noted about this location in class?
Conus Medularis
in a fetus the spinal cord will run the whole length of the vertebral column, but as we grow it will grow slwoer than the vertebral column therefore it will not be the entire length as an adult hence Conus Medularis
