Anatomy of the Back - Unit 1 Flashcards
What are the types of ligaments associated with the vertebral column?
- supraspinous
- nuchal
Name the ligaments that connect the tips of spinous processes from C7 to sacrum.
supraspinous ligaments
Name the ligaments that extend from external occipital protuberance and posterior border of foramen magnum to spinous process of cervical vertebrae.
nuchal ligaments
What does the transverse cervical artery supply?
trapezius
What is the origination of the transverse cervical artery?
Thyrocervical Trunk off the subclavian artery
Which nerve travels with the transverse cervical artery?
CN XI
What are the branches of the transverse cervical artery?
- superficial cervical
- dorsal scapular (33% of the time)
What does the dorsal scapular artery supply?
- levator scapula
- Rhomboids
What is the origination of the dorsal scapular artery?
- 33% of the time it is a branch of the transverse cervical a.
- 66% of the time it is a branch of the subclavian a.
What nerve travels with the dorsal scapular artery?
dorsal scapular nerve
What is the origination of the vertebral artery?
subclavian artery
Where does the vertebral artery enter and exit the neck?
- enters at C6 and exits at C1 through transverse foramina
- enters foramen magnum to help form the Circle of Wills
What does the vertebral artery supply?
suboccipital muscles
What does the thoracodorsal artery supply?
latissimus dorsi
What nerve travels with the thoracodorsal artery?
thoracodorsal nerve
Where does the thoracodorsal artery originate?
it is one of two terminal branches of the sub scapular artery which comes off the subclavian
Where does the posterior intercostal artery originate?
descending thoracic aorta
What does the dorsal cutaneous branches of the posterior intercostal artery supply?
deep back muscles
Where does the occipital artery originate?
the external carotid artery
What does the occipital artery supply?
posterior scalp and sub occipital muscles
What does the Dorsal (posterior) rami of the spinal nerve supply?
- intrinsic back muscles
- zygopophyseal joints
- dermatomal cutaneous innervations of the skin
What are then “named” dorsal rami?
- suboccipital nerve
- greater occipital nerve
Where does the sub occipital nerve exit the vertebral column?
between occiput and C1
What does the sub occipital nerve supply?
suboccipital muscles
Where does the greater occipital nerve exit the vertebral column?
between C1 and C2
What is another name for CN XI?
spinal accessory nerve
What does CN XI supply?
trapezius muscle and sternocleidomastoid muscle
Where does the dorsal scapular nerve originate?
ventral (anterior) ramus of C5
Where and with what artery does the dorsal scapular nerve travel?
along the scapula with dorsal scapular artery
Where does the thoracodorsal nerve originate?
posterior cord of brachial plexus (C6-C8)
What does the thoracodorsal nerve supply?
latissimus dorsi
What is the deep fascia of the thoracic and lumbar regions?
thoracolumbar fascia
Describe thoracolumbar fascia
- extends laterally from spinous processes
- forms thin covering intrinsic thoracic back muscles
- forms thick covering over lumbar muscles
- continuous with deep fascia from cranium and pelvis
Major groups of Back Muscles
Extrinsic
Intrinsic
Subdivisions of extrinsic back muscles and how many muscles are in each subdivision.
- superficial, 5
- intermediate, 2
What is the function of the extrinsic back muscles?
produce and control upper limb and respiratory movements
Subdivisions of intrinsic back muscles and how many muscles are in each subdivision.
- superficial,2
- intermediate, 3
- deep, 4
- minor deep, 4
What is the function of the intrinsic back muscles?
produce vertebral movements and maintain posture
What are the 5 superficial extrinsic back muscles?
- trapezius
- latissimus dorsi
- levator scapulae
- rhomboid major
- rhomboid minor
What is the function of the superficial extrinsic back muscles?
- Connect axial skeleton to superior appendicular skeleton
- produce and control upper limb movements
Where do the superficial back muscles receive innervation? What is the exception?
- from the dorsal rami of cervical nerve
- trapezius receives innervation from CN XI
Describe the trapezius size and shape
it is a large muscles with three parts (superior, middle and inferior) that can act independently or together
Where do insertions tend to be located?
more distal
Where do origins tend to be located?
towards the midline
What are the origins of the trapezius?
- medial 1/3 of superior nuchal line
- external occipital protuberance
- nuchal ligament
- spinal processes of C7-T12
What are the insertions of the trapezius?
- lateral 1/3 of clavicle
- acromion
- spine of scapula
What are the actions of the trapezius?
- elevation of the scapula (by inferior trap)
- retraction of scapula (by middle trap)
- depression of scapula (by inferior trap)
- upward rotation (by inferior and superior trap)
What nerves innervated the trapezius?
- CN XI for motor
- C3,C4 for sensory
What artery supplies the trapezius?
transverse cervical
Describe the latissimus dorsi
covers large area of back from medial posterior trunk to anterior humerus
What are the origins of latissimus dorsi?
- spinal processes of T6-T12
- thoracolumbar fascia
- iliac crest
- inferior 3-4 ribs
What is the insertion of the latissimus dorsi?
-floor of the inter tubercular groove of the humerus
What are the actions of the latissimus dorsi?
- extension
- adduction
- medial rotation of the humerus
- downward rotation of the scapula
- raise body to arms when climbing
What nerve innervates the latissimus dorsi?
thoracodorsal nerve (C6-C8)
What artery supplies the latissimus dorsi?
thoracodorsal artery
Describe levator scapulae fibers and their location
- fibers pass inferiorly from origin to insertion
- located deep to sternocleidomastoid and trapezius
What is the insertion of levator scapulae?
Medial border of scapula superior to root of scapular spine
What is the origin of levator scapulae?
posterior tubercles of transverse processes of C1-C4
What nerve innervates the levator scapulae?
dorsal scapular nerve
What artery supplies the levator scapulae?
dorsal scapular artery
What are the actions of the levator scapulae?
- unilaterally, elevation and downward rotation of scapula
- bilaterally, extension of neck
Describe rhomboid major location
deep to trapezius, inferior to rhomboid minor
What is the origin of rhomboid major?
spinal processes of T2-T5
What is the insertion of rhomboid major?
medial border of scapula from level of spine to inferior angle
What artery supplies rhomboid major?
dorsal scapular artery
What nerve supplies rhomboid major?
dorsal scapular artery
What are the actions of rhomboid major?
retraction and downward rotation of scapula
fix scapula to thoracic wall
Describe rhomboid minor location
lies deep to trapezius, superior to rhomboid major
What is the origin of rhomboid minor?
spinal processes of C7-T1
What is the insertion of rhomboid minor?
smooth triangular area at base of scapular spine
What are the actions of rhomboid minor?
retractions and downward rotation of scapula
What artery supplies rhomboid minor?
dorsal scapular nerve
What nerve supplies rhomboid minor?
dorsal scapular artery
What is the triangle of auscultation?
a small triangular gap in the musculature of the back that provides a good area to listen to posterior segments of the lungs with a stethoscope
What are the borders of the triangle of auscultation?
- laterally, medial border of the scapula
- medially, trapezius
- inferiorly, latissimus dorsi
- floor, erector spinae and possibly rhomboid major
What is the lumbar triangle of petit?
small triangle in the lumbar region where herniations can commonly occur
What are the borders of the lumbar triangle?
- laterally, external oblique
- medially, latissimus dorsi
- inferiorly, iliac crest
- floor, internal oblique
What are the intermediate extrinsic back muscles?
- serratus posterior superior
- serratus posterior inferior
What are the superficial intrinsic back muscles?
- splenius crevicis
- splenius capitis
What is the function of the superficial extrinsic back muscles?
respiration and proprioception
What are the origins of serratus posterior superior?
- nuchal ligament
- spinal processes of C7-T3
What are the insertions of the serratus posterior superior?
superior borders of the 2nd - 4th ribs
What is the action of the serratus posterior superior?
elevation of ribs in respiration and proprioception
What innervates the serratus posterior superior?
ventral rami of the 2nd - 5th thoracic spinal nerves
What are the origins of the serratus posterior inferior?
spinal processes of T11-L2
What are the insertions of the serratus posterior inferior?
inferior borders of the 8th - 12th ribs near their angles
What is the action of the serratus posterior inferior?
depress the ribs for proprioception and respiration
What innervates the serratus posterior inferior?
Ventral rami of the 9th - 12th thoracic spinal nerves
What are the origins of the splenius cervicis?
the spinal processes of T3-T6
What are the insertions of the splenius cervicis?
tubercles of the transverse processes of C1-C3
What are the actions of the splenius cervicis?
- ipsilateral: rotation and lateral flexion
- bilateral: extension of the neck
What innervates the splenius cervicis?
dorsal rami of the spinal nerve
What are the origins of the splenius capitis?
nuchal ligament and spinal processes of C7-T3
What are the insertions of the splenius capitis?
mastoid process and lateral 1/3 of superior nuchal line
What are the actions of the splenius capitis?
- ipsilateral: rotation and lateral flexion
- bilateral: extension of the head
What innervates the splenius capitis?
dorsal rami of spinal nerves
What are the intermediate intrinsic back muscle groups?
the collective group of erector spinae muscles
- ilicostalis
- longissimus
- spinales
Where are the erector spinae muscles located?
in a groove between the spinal processes of the vertebral column and the angles of the ribs
What is the action of the erector spinae muscles?
- bilateral: extend the vertebral column
- unilateral: lateral flexion of the vertebral column
What innervates the erector spinae muscles?
dorsal rami of the spinal nerves
What are the origins of the erector spinae muscles?
- posterior iliac crest
- scarum
- sacral and inferior lumbar spinal processes
- sacrospinous ligament
- supraspinous ligament
What is the lateral column of the erector spinae muscles?
iliocostalis
What is the intermediate column of the erector spinae muscles?
longissimus
What is the medial column of the erector spinae muscles?
spinalis
What are the insertions for the iliocostalis column of the erector spinae muscles?
- lumborum: angles of the lower ribs
- thoracis: angles of the upper ribs
- cervicis: cervical transverse processes
What are the insertions of the longissimus column of the erector spinae muscles?
- thoracis: ribs (between tubercles and angles) and transverse processes in the thoracic region
- cervicis: cervical transverse processes
- capitis: mastoid process
What are the insertions of the spinals column of the erector spinae muscles?
- thoracis: spinal processes in thoracic region
- cervicis: spinal processes in cervical region
- capitis: cranium
Sometimes the capitis spinalis of the erector spinae column fuses with the semispinalis capitis to form what?
biventer captitis muscle
What are the deeper intrinsic back muscles?
- interspinalis
- intertransversarii
- levatores costarum
What are the origins of interspinalis muscles?
superior surfaces of spinal processes of the cervical and lumbar vertebrae
What are the insertions of interspinalis muscles?
inferior surfaces of spinal processes of the cervical and lumbar vertebrae
What is the action of interspinalis muscles?
connect the spinal processes to aid in extension and rotation of the vertebral column
What innervates the interspinalis muscles?
dorsal rami of the spinal nerves
What are the origins of intertransversarii muscles?
transverse processes of cervical and lumbar region
What are the insertions of intertransversarii muscles?
transverse processes of adjacent vertebrae in the cervical and lumbar region
What is the action of intertransversarii muscles?
connect transverse processe to
- unilateral: aid in lateral flexion of the vertebral column
- bilateral: stabilization of the vertebral column
What are the origins of levator costarum muscles?
transverse processes of C7-T11
What are the insertions of levator costarum muscles?
rib, between tubercle and angle
What are the actions of levator costarum muscles?
- elevate ribs in inspiration
- assist with lateral flexion of the vertebral column
What innervates levator costarum muscles?
dorsal rami of C8-T11 spinal nerves
What are the sub occipital/deep neck muscles?
- rectus capitis posterior major
- rectus capitis posterior minor
- obliquus capitis inferior
- obliquus capitis superior
Describe the subocciptal region of muscles
- lies under trapezius, sternocleidomastoid, splenius and semispinalis
- is a pyramidal space inferior to external occipital protuberance
- includes aspects of C1 and C2
What is the origin of rectus capitis posterior major muscles?
spinal process of C2
What is the insertion of rectus capitis posterior major muscles?
lateral part of inferior nuchal line
What are the actions of rectus capitis posterior major muscles?
- extension of head
- ipsilateral rotation
What innervates the rectus capitis posterior major muscles?
suboccipital nerve
What arteries supply the rectus capitis posterior major muscles?
vertebral and occipital artery
What is the origin of rectus capitis posterior minor muscles?
posterior tubercle of posterior arch of C1
What is the insertion of rectus capitis posterior minor muscles?
medial part of inferior nuchal line
What are the actions of rectus capitis posterior minor muscles?
- extension of head
- ipsilateral rotation
What innervates the rectus capitis posterior minor muscles?
suboccipital nerve
What arteries supply thecapitis posterior minor muscles?
vertebral and occipital artery
What innervates all the muscles of the deep neck/suboccipital region?
suboccipital nerve
What arteries supply all the muscles of the deep neck/suboccipital region?
vertebral and occipital artery
What is the origin of obliquus capitis inferior muscles?
spinal process of C2
What is the insertion of obliquus capitis inferior muscles?
transverse processes of C1
What is the action of obliquus capitis inferior muscles?
rotation of atlas, turn head to face same side as muscle
What innervates obliquus capitis inferior muscles?
suboccipital nerve
What artery supplies obliquus capitis inferior muscles?
vertebral and occipital artery
What is the origin of obliquus capitis superior muscles?
transverse processes of C1
What is the insertion of obliquus capitis superior muscles?
occipital bone between superior and inferior nuchal lines
What are the action of obliquus capitis superior muscles?
- extension of the head
- lateral flexion of head and neck
What innervates obliquus capitis superior muscles?
suboccipital nerve
What arteries supply obliquus capitis superior muscles?
vertebral and occipital artery
What are the borders of the sub occipital triangle?
- superomedial: rectus capitis posterior major
- superolateral: obliquus capitis superior
- inferolateral: obliquus capitis inferior
- floor: posterior Atlanta-occipital membrane and posterior arch of C1
- roof: semispinalis capitis
What is found in the sub occipital triangle?
vertebral artery and sub occipital nerve