anatomy exam 1 Flashcards

1
Q

how does regional anatomy organize the body?

A

by major segments or parts

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2
Q

how does systemic anatomy organize the body?

A

focuses on the body’s organ systems

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3
Q

what types of anatomy does clinical anatomy include?

A

regional and systemic anatomy (to describe function)

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4
Q

describe anatomical position

A

head (eyes) and toes directed anteriorly
arms adjacent to the sides with palms facing forward
lower limbs close together with feet parallel

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5
Q

how does the median plane divide the body?

A

divides the body into two halves

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6
Q

how does the sagittal plane divide the body?

A

divides the half into two other halves

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7
Q

how does the frontal (coronal) divide the body?

A

divides the body into front and back halves

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8
Q

how does the transverse plane divide the body?

A

divides body into superior and inferior parts

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9
Q

what are the four terms of laterality (and what do they mean)?

A

bilateral - both sides
unilateral - on one side
ipsilateral - same side
contralateral - opposite sides

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10
Q

what two components make up the central nervous system?

A

brain and spina cord

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11
Q

what connects the spinal cord to the brain?

A

brain stem (medulla oblongata and pons)

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12
Q

what is contained within gray matter in the spinal cord?

A

neuron cell bodies

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13
Q

what types of signals come into the dorsal root / dorsal horn?

A

sensory / afferent signals

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14
Q

what types of signals come out of the ventral horn?

A

motor / efferent signals

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15
Q

what is the outermost layer of meninges?

A

dura mater

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16
Q

what is the middle layer of meninges?

A

arachnoid mater

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17
Q

what is the inner most layer of meninges?

A

pia mater (adhered to tissue of spinal cord)

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18
Q

what is the order of spaces and meninges around the spinal cord? (outer to inner)

A

epidural space
dura mater
subdural space (potential space)
arachnoid mater
subarachnoid space (CSF found here)
pia mater

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19
Q

what are denticulate ligaments made up of and what is their clinical significance?

A

paired extensions of pia mater than attach to the arachnoid and dura mater (run between ventral and dorsal rootlets of the spinal cord)

helps to prevent lateral shifting of the spinal cord within the dural sac

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20
Q

what can be found within the epidural space?

A

adipose tissue, internal vertebral plexus

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21
Q

what can be found within the subarachnoid space?

A

spinal veins and arteries, cerebrospinal fluid, arachnoid trabeculae

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22
Q

what levels of the spinal cord makeup the cervical enlargement and what does it give rise to?

A

C5-T1
cervical plexus and brachial plexus

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23
Q

what levels of the spinal cord makeup the lumbar enlargement and what does it give rise to?

A

L1-S2
lumbar plexus and sacral plexus

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24
Q

how many spinal nerves are there within each segment of the spinal cord? (bilateral, paired)

A

cervical (8)
thoracic (12)
lumbar (5)
sacral (5)
coccygeal (1)

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25
Q

another term for conus medullaris (which level does it usually end at)?

A

terminal end of spinal cord
usually around L1-L2

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26
Q

significance of filum terminale (internum / externum)

A

extensions of pia mater that anchor the spinal cord inferiorly in dura sac (function is same way as denticulate ligaments)

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27
Q

significance of lumbar cistern

A

enlargement of subarachnoid space from L2-S2 (CSF pools here)

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28
Q

significance of cauda equina

A

L2-S5 spinal nerve roots (forms as a result of differential growth of spinal cord and vertebral column)

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29
Q

segmental spinal arteries arise from: (subclavian aa)

A

vertebral aa
ascending cervical aa
deep cervical aa

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30
Q

segmental spinal arteries arise from: (descending aorta)

A

posterior intercostal aa
lumbar aa

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31
Q

segmental spinal arteries arise from: (internal iliac aa)

A

lateral sacral aa

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32
Q

what artery does the anterior spinal artery arise from?
(located in subarachnoid space along spinal cord)

A

vertebral aa

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33
Q

what artery does the paired posterior spinal aa arise from?
(located in subarachnoid space along spinal cord)

A

vertebral aa or cerebellar aa

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34
Q

what types of arteries do segmental arteries give rise to and where do they go?

A

radicular - anterior and posterior
medullary - anterior

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35
Q

what is the largest of the segmental medullary arteries?

A

artery of ademkiewicz (supplies lower spinal cord)

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36
Q

order of venous drainage of spinal cord

A

anterior / posterior spinal veins
anterior / posterior medullary veins and radicular veins
internal vertebral venous plexus
segmental veins
other major systemic routes of venous drainage

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37
Q

what is a significance difference of veins within the internal vertebral venous plexus compared to veins found in other parts of the body?

A

these veins DO NOT have valves

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38
Q

clinical significance of internal vertebral venous plexus

A

cancer metastases (has many connections to systemic venous circulation)

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39
Q

what are the two sensory (afferent) tracts and what kind of stimulus do they perceive? (lateral and posterior)

A

dorsal columns - fine touch and proprioception
spinothalamic pathway - lateral - pain and temperature and anterior - touch and pressure

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40
Q

where do ascending tracts (sensory pathways) originate and where do they travel to? (

A

originate - peripheral body
travel to - primary sensory cortex

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41
Q

where do descending tracts (motor pathways) originate and where do they travel to?

A

originate - cerebral cortex and brainstem
travel to - muscle

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42
Q

what is the motor (efferent) tract? (lateral and anterior)

A

corticospinal tract (somatic motor - voluntary movement)
lateral - 85-90% to limbs
anterior - 10-15% to trunk

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43
Q

what does the peripheral nervous consist of?

A

cranial nerves, spinal nerves, and ganglia

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44
Q

what direction does sensory innervation get to the body?

A

brings information to the CNS from the environment

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45
Q

what direction does motor innervation come from the body?

A

sends instructions from the CNS to muscle and glands

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46
Q

where are the parts of a motor neuron located?

A

(one axon)
cell body - CNS
axon - comes out as part of a spinal nerve

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47
Q

where are the parts of a sensory neuron located?

A

(bipolar - two axons)
cell body - found outside of CNS, in ganglion
axon branches into peripheral tissue to pick up information and other branch goes to CNS to relay information

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48
Q

what does somatic innervation concern? (voluntary)

A

body wall (skeletal muscle or skin)

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49
Q

what does visceral innervation concern? (involuntary)

A

internal organs (innervation of the heart)

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50
Q

different types of:
body wall (somatic)
internal organs (visceral)

A

somatic sensory (skin)
somatic motor (skeletal muscle)

visceral sensory (brain regulation of internal organ function)
visceral motor (heart, digestive system)

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51
Q

what is the target tissue of somatic motor innervation and is it voluntary or involuntary control?

A

target tissue - skeletal muscle
voluntary control
ONE neuron connects the CNS to the target muscle

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52
Q

how does somatic sensory innervation carry sensory information and is perceived consciously or unconsciousy?

A

carries sensory information from skin and musculoskeletal system
perceived consciously
ONE neuron connects site of stimulus to CNS

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53
Q

examples of somatic sensory stimuli

A

pain from cutting, tearing, crushing, inflammation, burning
temperature
touch
pressure
vibration

THINK STIMULI THAT CAN BE FELT BY SKIN

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54
Q

importance of notochord

A

fiber of tissue that is important in regulating development of surrounding tissues (control segmentation)

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55
Q

importance of paraxial mesoderm

A

columns of tissue along either side of notochord that segments and becomes somite pairs (gives rise to bone, skeletal muscle, dermis - below the head)

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56
Q

what does dermamyotome give rise to?

A

population of somites that gives rise to dermis and muscle

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57
Q

what does sclerotome give rise to?

A

gives rise to axial skeleton (becomes bone)

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58
Q

what does exaxial dermamytomes give rise to?

A

all intrinsic (deep) back muscles and dermis that covers them

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59
Q

what does hypaxial dermamytomes give rise to?

A

all other skeletal muscle and dermis below the neck, including the limbs

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60
Q

what rami supples epaxial dermamytomes?

A

dorsal rami

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61
Q

what rami supples hypaxial dermamytomes?

A

ventral rami

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62
Q

what is the target tissue of visceral motor innervation and are they under conscious or unconscious control?

A

target tissue - smooth muscle, cardiac muscle, glands
under unconscious control (involuntary)
TWO neurons connect the CNS to target tissue

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63
Q

what are visceral structures located within the body wall?

A

sweat glands, arrector pili muscles, smooth muscle in skin and vessel walls

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64
Q

what types of innervation do most internal organs receive?

A

both sympathetic and parasympathetics

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65
Q

what type of innervation do most visceral structures in the body wall receive?

A

sympathetic innervation only

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66
Q

another term for sympathetic

A

fight or flight

67
Q

another term for parasympathetic

A

rest and digest

68
Q

where is parasympathetic outflow located in a spinal cord?

A

craniosacral (cranial nerves 3, 7, 9, 10 and S2-S4)

69
Q

where is sympathetic outflow located in a spinal cord?

A

thoracolumbar (T1-L2)

70
Q

relative length of pre/post ganglionic axons in sympathetic pathways

A

ganglia located roughly halfway between CNS and target (pre/ post ganglionic axons about same length)

71
Q

relative length of pre/post ganglionic axons in parasympathetic pathways

A

long preganglionic axons enter organ before it find the short postganglionic axon

72
Q

what does the vagus nerve supply?

A

parasympathetics to pharynx, larynx, all thoracic organs, and organs of the upper abdomen

73
Q

what supplies parasympathetics to the lower abdomen and pelvis?

A

pelvic splanchnic nerves (preganglionic)

74
Q

where are sympathetic preganglionic cell bodies located within the spinal cord?

A

lateral horn (gray matter)

75
Q

sympathetic innervation to VENTRAL body wall

A

lateral horn
ventral root / rami
down white communicans (preganglionic)
synapse in paravertebral ganglion
up gray communicans (postganglionic)
out ventral rami towards hypaxial dermatome

76
Q

sympathetic innervation to dorsal body wall

A

lateral horn
ventral root / rami
down white communicans (preganglionic)
synapse in paravertebral ganglion
up gray communicans (postganglionic)
backtrack to dorsal rami towards expaxial dermatome

77
Q

sympathetic innervation for thoracic organs

A

lateral horn
ventral root / rami
down white communicans (preganglionic)
synapse in paravertebral ganglion
postganglionic (splanchnic nerve) extends to organ
NOTE - never use gray ramus as part of pathway

78
Q

sympathetic innervation for abdominal and pelvic organs

A

lateral horn
ventral root / rami
down white communicans (preganglionic)
DO NOT synapse in paravertebral ganglion
elongated preganglionic axon extends through diaphragm
SYNAPSE in prevertebral ganglion (close to organ)
innervates organ

79
Q

parasympathetic innervation to thoracic and upper abdominal organs

A

vagus nerve extends and synapses within organ wall
preganglionic cell bodies - CNS
postganglionic cell bodies - organ wall

80
Q

parasympathetic innervation to lower abdominal and pelvic organs

A

lateral horn
ventral root / ramus
becomes pelvic splanchnic nerve
(all preganglionic)

81
Q

what are the two types of visceral sensory innervation?

A

visceral pain - pain from internal organs
visceral afferents - visceral sensory other than pain

82
Q

how is visceral pain described?

A

dull, diffuse, poorly localized

83
Q

what can cause visceral pain?

A

ischemia, prolonged smooth muscle contraction, distention

84
Q

how do visceral pain axons for the thorax and abdomen send signals back to the body?

A

follow sympathetic pathways backward (no matter how complicated) as far as spinal nerve proper then pass through the dorsal root (cell bodies found in dorsal root ganglia)

85
Q

how do visceral pain axons from the pelvis send signals back to the body?

A

follow parasympathetic pathways backward to spinal nerve proper and then pass through dorsal root (cell bodies found in dorsal root ganglia)

86
Q

how are visceral afferents (other than pain) carried back to body to be perceived?

A

from thorax and abdomen - carried by vagus nerve
lower abdomen and pelvis - pelvic splanchnic nerves

87
Q

what part of the skeleton is made up of the cranium, mandible, spine, ribs, and sternum?

A

axial skeleton

88
Q

what are the two main roles of the vertebral column?

A

protect the spinal cord and transfer loads (allow movement of body)

89
Q

how many vertebrae are there in the 5 different segments of the spine?

A

cervical (n=7)
thoracic (n=12)
lumbar (n=5)
sacral (n=5)
coccyx (n=3/4)

90
Q

what segments of the vertebral column make up the the primary curvatures?

A

thoracic and sacral

91
Q

what are segments of the vertebral column make up the the secondary curvatures?

A

cervical and lumbar

92
Q

what segments of the spinal cord are convex?

A

thoracic and sacral

93
Q

what segments of the spinal cord are concave?

A

cervical and lumbar

94
Q

what are the 5 palpable skeletal landmarks and points of reference for the back and spinal column?

A

cervicothoracic junction (C7)
scapular spine (T3)
inferior scapular angle (T7)
12th rib (T12) - last set of floating ribs
iliac crest (L4) - supracristal line

95
Q

what are the relative degrees of flexion and extension within the cervical spine?

A

flexion - 45-50 degrees
extension - 85 degrees

96
Q

what is the degree of axial rotation within the cervical spine?

A

90 degrees

97
Q

what is the degree of lateral flexion within the cervical spine?

A

40 degrees

98
Q

what artery does the vertebral arteries give rise to that can be impinged on during rotational movement and cause vertigo / dizziness, syncope, and visual disturbance?

A

basilar artery

99
Q

what is the relationship between flexion and extension within the thoracic and lumbar regions?

A

thoracic - flexion and extension is relatively limited (articular facets flat and against each other)
lumbar - flexion and extension are relatively free (articular facets are turned slightly lateral)

100
Q

what is the relationship between lateral flexion and bending within the thoracic and lumbar regions?

A

thoracic - lateral flexion and bending is somewhat limited (articular processes and ligaments)
lumbar - lateral flexion and bending is somewhat minimal in lumbar region

101
Q

what type of movement is an important aspect of human bipedal locomotion?

A

axial rotation

102
Q

what helps to promote rotation in the thoracic region?

A

orientation of articular processes
NOTE - attachment of ribs somewhat limited the range of rotation that would be possible
NOTE - trunk rotation in the lumbar region is relatively limited due to shape and orientation of lumbar articular processes

103
Q

general anatomical features of typical vertebral segments (see picture in notes)

A

vertebral body - weight bearing parts of vertebrae
vertebral arch - made of up pedicle and lamina
inferior / superior articular process
transverse process
spinous process

104
Q

which vertebrae within the vertebral column does NOT have a vertebral body?

A

atlas (C1)

105
Q

which vertebrae within the vertebral column has the dens?

A

axis (C2)
NOTE - dens of C2 used to be the body of C1

106
Q

what segment of vertebrae have a bifid spinous process and what does it accomodate?

A

cervical vertebrae (7) and nuchal ligament

107
Q

what segment of vertebrae have demi-facets and the vertebral bodies resemble a heart shape?

A

thoracic vertebrae (12)

108
Q

what segment of vertebrae are under the greatest amount of strain because they transmit weight to the pelvis (have the largest vertebral body)?

A

lumbar vertebrae (5)

109
Q

what segment of vertebrae is comprised of 5 fused vertebrae, provides strength and stability to the pelvis, and serves as sites of attachment for ligaments that hold the sacrum and pelvis together posteriorly?

A

sacrum (5)

110
Q

what part of the sacrum tends to correspond to the center of gravity?

A

promontory (articulates with L5 vertebrae)

111
Q

name the parts of the thoracolumbar fascia (tendon sheet)

A

anterior layer
middle layer
posterior layer

112
Q

what are the two components of intervertebral discs?

A

nucleus pulposus - jelly like spongy middle (remnant of notochord)
annulus fibrosus - fibrous tough outer layer that provides joint connection between vertebral bodies

113
Q

where are intervertebral discs the thickest and thinnest?

A

thickest - lumbar region (where they bear the most weight)
thinnest - cervical region

114
Q

ligaments of the vertebral column to know (see picture in notes)

A

nuchal ligament (cervical region). -attaches to bifid spinous process
supraspinous ligament
interspinous ligaments
ligamentum flava (has a lot of collagen - yellow color)
intertransverse ligaments
anterior longitudinal ligament
posterior longitudinal ligament

115
Q

describe kyphosis (hyperkyphois) and what it can result from

A
  • abnormal or exaggerated thoracic curvature (convexity)
  • can result from developmental abnormalities, trauma, or degenerative disease
116
Q

describe lordosis (hyperlordosis) and what it can result from

A
  • abnormal or exaggerated lumbar curvature (concavity)
  • associated with congenital abnormalities, musculoskeletal problems, degenerative disease
117
Q

describe scoliosis and what it can result from

A
  • abnormal or exaggerated lateral curvature of spine
  • can be congenital, neuromuscular, or idiopathic in origin
    NOTE - usually manifests in thoracic region
118
Q

describe what a herniated intervertebral disc is and what it can result from

A
  • weakened spot where nucleus pulposus can burst and rupture and thus compress spinal nerves
    NOTE - usually occurs in lumbar region and in posterolateral direction
119
Q

notes on thoracic region disc herniation

A
  • usually a result of wear and tear (disc degeneration)
  • sudden and forceful twisting of the mid-back region
  • other conditions that predispose individual such as abnormal kyphosis
120
Q

notes on lumbar region disc herniation

A
  • lumbar region bears the most weight
  • frequent bending, twisting, and improper lifting increases load on tendons that reinforce this region as well as intervertebral discs
  • acute or sudden injury
121
Q

describe spondylolisthesis and what it can result from

A
  • anterior / central displacement of one vertebrae on adjacent
  • common progression from spondylolysis (fracture of posterior aspect of vertebrae), can also be congenital
122
Q

in what direction do intrinsic back muscles run?

A

run longitudinally

123
Q

what area that is used clinically to hear breathing sounds is made up by the lateral border of trapezius and the superior border of latissimus dorsi?

A

triangle of auscultation

124
Q

what area of clinical significance is prone to herniation due to a slight weakening in the lateral abdominal wall?

A

lumbar triangle

125
Q

are extrinsic back muscles hypaxial or expaxial and what are they innervated by (dorsal or ventral rami)?

A

hypaxial
ventral rami of spinal nerves
NOTE - trapezius is innervated by cranial nerve 11

126
Q

are intrinsic back muscles hypaxial or expaxial and what are they innervated by (dorsal or ventral rami)?

A

epaxial
dorsal rami of spinal nerves
NOTE- have a lot of proprioception function

127
Q

extrinsic back muscles - HYPAXIAL and VENTRAL RAMI

A

trapezius
latissimus dorsi
levator scapulae
rhomboid minor
rhomboid major
serratus posterior superior
serratus posterior inferior

128
Q

intrinsic back muscles - EPAXIAL and DORSAL RAMI

A

erector spinae group
- iliocostalis
- longissimus
- spinalis

transversospinalis group
- multifidus
- semispinalis
- rotatores

129
Q

what three muscles make up the erector spinae group (superficial to deep)?

A

ilocostalis
longissimus
spinalis

130
Q

what three muscles make up the transversospinalis group (superficial to deep)?

A

semispinalis
multifidus
rotatores

131
Q

what rami innervates the intrinsic back muscles and skin of the back?

A

dorsal ramus

132
Q

what rami innervates extrinsic back muscles, anterior / lateral trunk, and limbs…. makes up the cervical and brachial plexus and intercostal nerves?

A

ventral rami

133
Q

what group of back muscles moves the shoulder and arm (extrinsic or intrinsic)?

A

extrinsic back muscles

134
Q

where does trapezius receive its motor and sensory innervation from?

A

motor - spinal accessory nerve (CN11)
sensory - cervical plexus (C3 and C4)

135
Q

where does latissimus dorsi receive its motor and sensory innervation from?

A

motor and sensory - thoracodorsal nerve (brachial plexus)

136
Q

where does levator scapulae receive its motor and sensory innervation from?

A

motor and sensory - cervical plexus (C3 and C4)

137
Q

where does rhomboid minor receive its motor and sensory innervation from?

A

motor and sensory - branchial plexus (dorsal scapular nerve)

138
Q

where does rhomboid major receive its motor and sensory innervation from?

A

motor and sensory - branchial plexus (dorsal scapular nerve)

139
Q

where does serratus posterior superior receive its motor innervation from?

A

intercostal nerve branches

140
Q

where does serratus posterior inferior receive its motor innervation from?

A

intercostal nerve branches

141
Q

what muscle connects from vertebral column out to scapula and clavicle (axial skeleton to shoulder)

A

trapezius

142
Q

what muscle originates on vertebral column and thoracolumbar fascia… coming around and attaching to humerus?

A

latissimus dorsi

143
Q

what three muscles connect from scapula to vertebral column?

A

levator scapulae
rhomboid minor
rhomboid major

144
Q

where do extrinsic back muscles (posterior axioappendicular muscles) attach?

A

attach to scapula and humerus (upper arm bone) to the spine and/or ribs (axial skeleton)

145
Q

what group of muscles move the vertebral column (extrinsic or intrinsic)?

A

intrinsic back muscles

146
Q

what area does capitis denote?

A

connection to cranium

147
Q

what area does cervicis denote?

A

connection to cervical vertebrae

148
Q

what area does thoracis denote?

A

connectio to thoracic region

149
Q

what area does lumborum denote?

A

connection to lumbar region

150
Q

in what areas does the splenius muscle exist?

A

capitus and cervicis

151
Q

in what areas does the iliocostalis muscle exist?

A

cervicis, thoracis, and lumborum

152
Q

in what areas does the longissimus muscle exist?

A

capitus, cervicis, and thoracis

153
Q

in what areas does the spinalis muscle exist?

A

cervicis and thoracis

154
Q

in what areas does the multifidus muscle exist?

A

expands entire vertebral column

155
Q

what are the two parts of the rotatores muscle (bi-fid muscle)?

A

brevis and longus

156
Q

in what areas does the semispinalis muscle exist?

A

capitus and cervicus

157
Q

what group of muscles functions to extend the trunk when working bilaterally and laterally flexes the trunk when active unilaterally?

A

erector spinae group

158
Q

where does iliocostalis have attachments?

A

attaches to sacrum / ilium and ribs

159
Q

where does longissimus have attachments?

A

has rib attachments and can extend to cranial region

160
Q

where does spinalis have attachments?

A

inserts and originates in spinous processes

161
Q

what muscle that is a part of the transversospinalis group skips 2 or more levels?

A

multifidus

162
Q

what muscle that is a part of the transversospinalis group skips 2 levels?

A

rotatores longus

163
Q

what muscle that is a part of the transversospinalis group skips 1 level?

A

rotatores brevis