15 - Muscles and Movements of the Back Flashcards

1
Q

Part of spine where flexion mostly occurs

A

Lumbar

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2
Q

Which movement increases stress on spinal facet joints?

A

Hyperextension

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3
Q

What limits mobility of T spine?

A

Ribs

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4
Q

Things that influence spinal movement
1)
2)

A

1) Shape of IV discs. Wedge-shaped

2) Orientation of articular facets

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5
Q

Movements allowed by lumbar articular facets

A

Flexion/extension in sagittal plane

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6
Q

Movements allowed by thoracic articular facets

A

Permit rotation in coronal plane (but limited by ribs)

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7
Q

Movements allowed by sacral articular facets

A

Limit movement in sagittal plane

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8
Q
Superficial back muscles 
1)
2)
3)
4)
A

1) trapezius
2) latissimus dorsi
3 rhomboids
4) levator scapulae

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9
Q

Where do superficial muscles of the back originate from (except trapezius)

A

From cervical myotomes

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10
Q

What innervates superficial back muscles (except trapezius)

A

Anterior rami

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11
Q

Do posterior rami innervate superficial back muscles?

A

No. They pass through superficial back muscles on their way to innervate the skin

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12
Q

Intermediate muscles of the back

A

Serratus posterior superior and inferior

Innervated by anterior rami

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13
Q

Division of the deep muscles of the back
1)
2)

A

1) Erector spinae (run medial to lateral)

2) Transversospinalis (run lateral to medial)

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14
Q

Most common site of rib fracture

A

Lateral border of erector spinae, which runs along rib angle

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15
Q

Erector spinae functions

A

Prime movers of back extension
Concentrically return flexed back to extended position
Eccentrically control back flexion

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16
Q

When are erector spinae electrically silent?

A

When back is fully flexed

17
Q

Transversospinalis function

A

Segmental stabilisers

Form ‘corset’ with deep abdominal muscles (EG: transversus abdominus) around lumbar region with lumbar fascia

18
Q

Muscles that waste quickly following back injury

A

Transversospinalis

19
Q

Where does lymph from the back drain?

A

Anteriorally, as there are no lymph nodes on the back.

20
Q

Path taken from arteries from spinal cord

A

Penetrate through muscles with posterior rami to skin

21
Q

What do posterior rami innervate?
1)
2)
3)

A

1) facet joints
2) deep back muscles
3) overlying skin

22
Q

Two broad types of back pain

A

1) Mechanical pain (EG: muscular pain)

2) Compressive pain (occurs when nerve roots are pinched or irritated)

23
Q

Common causes of compressive back pain

A

Spinal stenosis or herniated IV disc

24
Q

Stenosis

A

Abnormally narrow space

25
Q

Why do IV discs herniate posterolaterally?

A

Because of posterior longitudinal ligament (lies along mid-posterior back)

26
Q

Most-commonly impinged nerve root

A

Between L5/S1.

This is where the largest IV disc is, largest nerve root and narrowest foramen

27
Q
Contributors to disc prolapse
1)
2)
3)
4)
5)
6)
A
1) 15 deg lumbar flexion – forces
nucleus posteriorly
2) 15 deg rotation – max torsion in
annulus, only 50% fibres resist force
3) slight LF forces nucleus posterolaterally

4) be overweight or fat
5) keep lower limbs fully extended
6) pick up heavy object near opposite
foot

28
Q

Spondylosis

A

Bones lose water with ageing, become less dense.

29
Q

How might spondylosis lead to nerve root compression?

A

Spondylosis can lead to osteophyte growth, which narrow IV foramen (stenosis)

30
Q

Non-compressive causes of back pain

A
Cardiovascular (eg. aortic aneurism)
Neoplasia (particularly in older person)
Tumour metastasis (from lung, breast,
thyroid, kidney, prostate)
Infection