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FOM Week 2 > Anatomy Lecture 5: Deep Back Muscles > Flashcards

Anatomy Lecture 5: Deep Back Muscles Flashcards

0
Q

What are two classifications of deep back muscles?

A

Intersegmental and multisegmental

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1
Q

What are characteristics of intrinsic (deep) back muscles?

A
  1. Derived from dorsal muscle mass
  2. Innervated by dorsal primary rami
  3. Blood supply from branches of segmental arteries
  4. Movements of trunk, head, and neck, maintenance of posture
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2
Q

What are characteristics of intersegmental back muscles?

A
  1. Short muscles that span a single IV joint (segment)
  2. Contribute to fine control of vertebral movement
  3. Have a high proportion of muscles spindles
  4. Important role in proprioception
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3
Q

What are muscle spindles?

A

Specialized sensory fibers that register muscle length and velocity

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4
Q

Due to intersegmental muscle fibers being very short, what are they more susceptible to?

A

They are more susceptible to strain and are implicated in many cases of back and neck pain.

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5
Q

What are characteristics of multisegmental muscles and what are their movements?

A
  1. Span multiple intervertebral joints
  2. Formed by fusion of intersegmental muscles during development
  3. Multisegmental m. provide forceful extension of vertebral column, maintain posture, and contribute to rotation/lateral flexion of torso, head, and neck
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6
Q

What are intrinsic muscle actions?

A
  1. Flexion/extension
  2. Lateral flexion
  3. Rotation
  4. Unilateral vs bilateral contraction
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7
Q

Which deep back muscles produce flexion?

A

No deep back muscle produces flexion.

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8
Q

Which deep back muscles lateral flex to the right and and which deep back muscles lateral flex to the left?

A

Right sided deep back muscles flex toward the right

Left sided deep back muscles flex toward the left

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9
Q

What are the two types of rotational movements of deep back muscles?

A

Ipsilateral rotation and Contralateral rotation

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10
Q

Define bilateral contraction and unilateral contraction

A
  1. Bilateral contraction: right and left side muscles contract simultaneously and, if symmetrically, does pure extension
  2. Unilateral contraction: muscles contract on one side only resulting in primarily lateral flexion and rotation.
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11
Q

What are the intrinsic back muscles?

A
  1. Splenius capitis and cervicis m.
  2. Erector spinae muscle group
  3. Transversospinalis group
  4. Levator costae m.
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12
Q

List the origin, insertion, and actions of the splenius capitis and cervicis muscles

A
  1. Origin: ligamentum nuchae, T1-T4 spinous processes
  2. Insertion: (capitis) mastiod process and superior nuchal line
    (cervicis) C1-C4 transverse processes
  3. Unilateral Actions: lateral flexion, Ipsilateral rotation of head/neck
  4. Bilateral Actions: extension of head/neck
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13
Q

Which muscles are in the erector spinae muscle group?

A

3 longitudinal columns

  1. Iliocostalis m.
  2. Longissimus m.
  3. Spinalis m.
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14
Q

List the origin and actions of the erector spinae muscle group.

A
  1. Origin: common tendon of origin from posterior iliac crest, dorsal sacrum, and lumbar spinous processes; additional slips originate along axial skeleton
  2. Unilateral Actions: lateral flexion and Ipsilateral rotation of trunk, head, and neck
  3. Bilateral Actions: extension of trunk and head/neck
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15
Q

Where is the insertion of the iliocostalis m.?

A

Angles of the ribs (lumborum and thoracis) and cervical transverse processes (cervicis)

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16
Q

Where are the insertions of the longissimus m.?

A

Thoracic transverse processes and adjacent ribs (thoracis), cervical transverse processes (cervicis), mastoid process (capitis)

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17
Q

Where are the attachments of the spinalis m.?

A

Upper thoracic spinous processes (thoracis), cervical spinous processes and ligamentum nuchae (cervicis), occipital bone between nuchal lines (capitis, usually fused with semispinalis capitis)

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18
Q

List the origin, insertions, and actions of the transversospinalis group

A
  1. Origin: dorsal sacrum and posterior iliac crest, lumbar mamillary processes, cervical and thoracic transverse processes
  2. Insertion: spinous processes and occipital bone
  3. Unilateral Actions: lateral flexion, Contralateral rotation of trunk, head, and neck
  4. Bilateral Actions: extension of trunk and head/neck
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19
Q

What are the 3 groups within the transversospinalis group and what are the muscles?

A
  1. Semispinalis m: semispinalis cervicis and semispinalis capitis
  2. Multifidus m: multifidus lumborum
  3. Rotator m: rotator longus and rotator brevis
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20
Q

How are the subgroups of the transversospinalis group defined?

A

Defined by the number of vertebral segments spanned

21
Q

How many segments do the semispinalis m. span and where are they located?

A
  1. Spans 5-6 segments, best defined in cervical region
  2. Semispinalis cervicis: upper thoracic transverse processes to upper cervical spinous process as far as C2
  3. Semispinalis capitis: cervical transverse processes to occipital bone
22
Q

What muscle is a major extensor of the head?

A

Semispinalis capitis m.

23
Q

How many segments does the multifidus m. span and where is it located?

A
  1. Spans 3-4 segments, best defined in the lumbar region

2. Multifidus lumborum: dorsal sacrum and lumbar mamillary processes to lumbar and lower thoracic spinous processes

24
Q

How many segments do the rotator m. span and where are they located?

A
  1. Span 1-2 segments, best defined in the thoracic region
  2. Rotator longus: spans 2 segments
  3. Rotator brevis: spans 1 segment
25
Q

List the origin, insertion, and actions of the levator costae m.

A
  1. Origin: transverse processes of thoracic vertebrae
  2. Insertion: superior boarders of the ribs (1 or 2 segments inferior)
  3. Actions: elevate ribs, assist lateral flexion
26
Q

What are the intersegmental muscles, where are they found, and what is their primary function?

A
  1. Interspinalis m: between adjacent spinous processes in cervical and lumbar region
  2. Intertransverse m: between adjacent transverse processes in cervical and lumbar region
  3. Primary function: proprioception due to high proportion of muscle spindles
27
Q

What separates the anterior and posterior intertransversarii in the cervical region?

A

The cervical spinal nerves

28
Q

What occurs with flexion-extension syndrome (whiplash)?

A

Rapid movement of head from hyperextension to hyperflexion can tear cervical intersegmental muscles and sprain cervical ligaments causing inflammation, stiffness, and pain.

29
Q

What is the thoracolumbar fascia and what are the layers?

A

Investing fascia of the intrinsic back muscles in the thoracic and lumbar regions.

  1. Posterior layer
  2. Middle layer
  3. Anterior layer
30
Q

What are characteristics of the posterior layer of the thoracolumbar fascia?

A
  1. Attaches to the vertebral spinous processes
  2. Thin layer in the thoracic region
  3. Dense aponeurosis in lumbar region
31
Q

What are characteristics of the middle layer of the thoracolumbar fascia?

A
  1. Attaches to lumbar transverse processes, iliac crest, and rib 12
  2. Continuous laterally with the aponeurosis of transverse abdominis m
32
Q

What are the characteristics of the anterior layer of the thoracolumbar fascia.

A
  1. Anterior fascia of quadratus lumborum m.

2. Historically not considered part of the thoracolumbar fascia

33
Q

What region of vertebrae and thoracolumbar fascia layers from an osseofascial compartment that encloses the intrinsic back muscles?

A

Lumbar vertebrae and posterior and middle layers of the thoracolumbar fascia

34
Q

What is paraspinal compartment syndrome and what does it affect?

A
  1. Swelling of the intrinsic back muscles due to overuse of trauma
  2. Increased intracompartmemtal pressure may interrupt blood supply leading to muscle death
35
Q

What is the suboccipital region?

A

Inferior to the occipital bone and deep to the semispinalis capitis m.

36
Q

What are the suboccipital muscles?

A
  1. Rectus capitis posterior major m.
  2. Rectus capitis posterior minor m.
  3. Obliquus capitis superior m.
  4. Obliquus capitis inferior m.
37
Q

What do the suboccipital muscles constitute, what are their primary functions, and what is their innervation?

A
  1. Suboccipital muscles constitute the deepest layer of dorsal cervical muscles
  2. Primary functions are posture (fine adjustments) and proprioceptive
  3. Innervated by the dorsal ramus of C1, the suboccipital nerve
38
Q

List the origin, insertion, and actions of the Rectus capitis posterior major m.

A
  1. Origin: spinous process of axis (C2)
  2. Insertion: inferior nuchal line
  3. Actions: extension (bilateral) and Ipsilateral rotation (unilateral) of head
39
Q

List the origin, insertion, and actions of the Rectus capitis posterior minor m.

A
  1. Origin: posterior tubercle of the atlas (C1)
  2. Insertion: inferior nuchal line medial to Rectus capitis posterior major m.
  3. Actions: extension of head (bilateral)
40
Q

List the origin, insertion, and actions of the obliquus capitis superior m.

A
  1. Origin: transverse process of the atlas (C1)
  2. Insertion: occipital bone between nuchal lines
  3. Actions: extension of head (bilateral); lateral flexion of head (unilateral)
41
Q

List the origin, insertion, and actions of the obliquus capitis inferior m.

A
  1. Origin: spinous process of axis (C2)
  2. Insertion: transverse process of atlas (C1)
  3. Actions: Ipsilateral rotation of head (unilateral)
42
Q

What defines the boundaries of the suboccipital triangle?

A
  1. Borders: Rectus capitis posterior major m.
    Obliquus capitis superior m.
    Obliquus capitis inferior m.
  2. Floor: posterior atlanto-occipital membrane and posterior arch of atlas
  3. Roof: semispinalis capitis m.
43
Q

What are the contents of the suboccipital triangle and what are two important, closely related structures?

A
  1. Contents: vertebral artery and suboccipital nerve

2. Closely related structures: occipital artery and greater occipital nerve

44
Q

What is the course of the vertebral artery in the suboccipital triangle?

A
  1. Exits transverse foramen of C1
  2. Curves medially around posterior aspect of lateral mass of atlas
  3. Pierces posterior atlanto-occipital membrane to enter foramen magnum
45
Q

What is the course if the suboccipital nerve through the suboccipital triangle?

A
  1. Emerges from center of suboccipital triangle
  2. Gives muscular branches of suboccipital muscles
  3. Suboccipital nerve has few (if any) sensory fibers and no cutaneous distrubution
46
Q

What is the course of the occipital artery?

A

Emerges lateral to obliquus capitis superior m. and courses superiorly to supply posterior scalp

47
Q

What is the course of the greater occipital nerve?

A

Emerges inferior to obliquus capitis inferior m. and pierces semispinalis capitis m. to innervate skin of posterior scalp.

48
Q

What are the innervations of the intrinsic back muscles?

A

Innervated segmentally by muscular branches of the dorsal primary rami, which terminates as posterior cutaneous nerves

49
Q

What vessels supply blood to the intrinsic back muscles?

A
  1. Segmental arteries accompanying the dorsal primary rami
  2. Deep cervical artery: courses deep to semispinalis capitis m.
  3. Vertebral artery: gives muscular branches to cervical muscles
50
Q

What vessels supply blood to skin overlying intrinsic back muscles?

A

Posterior cutaneous arteries and branches of segmental artery

51
Q

What vessels provide blood to skin of lateral back?

A

Lateral cutaneous arteries and lateral branches of posterior intercostal arteries.

FOM Week 2 (13 decks)

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