Anatomy - Spine Flashcards
Muscles of Erector Spinae group
iliocostalis, longissimus, spinalis
Innervation and action of erector spine
Dorsal rami of each region; extension and lateral bending of vertebral column and head
Origin of erector spinae
spinous process of lower lumbar and sacral vertebrae, posterior sacrum, iliac crest, sacrospinous and sacrotuberous lig
Insertion of iliocostalis muscle
angles of lower ribs, cervical transverse processes
Insertion of longissimus muscle
b/w tubercles and angles of ribs, transverse processes of thoracic and cervical vertebrae, mastoid process
Insertion of spinalis muscle
spinous processes of upper thoracic and midcervical vertebrae
Action, innervation, and blood supply of latissimus dorsi
A: Extend, adduct, and internally rotate humerus I: thoracodorsal nerve (C6, C7, C8 nerve roots) BS: thoracodorsal artery
Origin and insertion of latissimus dorsi
O: spinous processes of T7-L5, thoracolumbar fascia, iliac crest and last 3 ribs
I: humerus (intertubercular sulcus)
Action, innervation, and blood supply of levator scapulae
A: elevates scapula medially, inferiorly rotates glenoid fossa
I: dorsal scapular nerve (C5) cervical spinal (C3-C4)
BS: Dorsal scapular artery
Action, innervation, and blood supply of multifidus
A: stabilizes spine I: dorsal primary rami BS: Cervical portion; occipital, deep cervical, vertebral arteries
Thoracic portion; dorsal branches of post. intercostal, subcostal, & lumbar arteries Sacral portions: dorsal branches of lateral sacral arteries
Origin of multifidus
Sacrum, ilium, transverse processes of T1-T12 and articular processes of C4-C7
Insertion of multifidus
Spinous processes of vertebrae above, spanning 2-4 segments
Action and innervation of rotatores
A: stabilize, extend, rotate spine I: dorsal primary rami
3 portions of iliocostalis muscle
Iliocostalis Cervicus, Thoracis, and Lumborum
3 portions of longissimus muscle
Longissimus Capitus, Cervicus, and thoracis
2 portions of spinalis
Spinalis Cervicus and Thoracis
Action, innervation, blood supply of trapezius
A: Descending portion: Elevation, retraction, upward rotation. Transverse portion: Retraction. Ascending portion: Depression and upward rotation. I: CN XI, accessory n. B. supply: Transverse cervical a.
Origin and insertion of levator scapulae
O: Transverse processes of C1-C4. I: Superior angle of scapula
Origin and insertion of trapezius
D.O.: Occipital bone and C1-C4. T.O.: Aponeurosis @ T1-T4. A.O. T5-T12. D.I.: Clavicle. T.I: Acromion A.I.: Scapular spine
Triangle of auscultation borders
trapezius, latissimus dorsi, rhomboid major. Within this is intercostal space 6
action, innervation, blood supply of rhomboid major
A: retraction and downward rotation of scap I: dorsal scapular n. (C4-C5). BS: dorsal scapular a.
Origin and insertion of rhomboid major
O: spinous process of T1-T4 I: medial border of scapula inferior to spine of scapula
Lumbar triangle borders and significance
latissimus dorsi, external oblique, iliac crest. The floor of triangle is the internal oblique. Rarely, a lumbar hernia occurs here.
Action, innervation, and blood supply of rhomboid minor
A: retraction and downward rotation. I: Dorsal scapular n. (C4-C6). BS: dorsal scapular a.
Origin and insertion of rhomboid minor
O: spinous process of C6-C7. I: medial border of scapula superior to spine of scapula.
Origin and insertion of interspinales
O: Superior surfaces of cervical and lumbar spinous processes I: inferior surfaces of spinous processes to vertebra of attachment
Origin and insertion of serratus posterior superior
O: nuchal ligament and spinous processes of C7-T3 I: 2nd-4th rib
Action, innervation, and blood supply of serrates posterior superior
A: superficial respiratory assist (elevates ribs) I: Ventral rami of upper thoracic n. BS: posterior intercostal a.
Origin and insertion of serratus posterior inferior
O: Spinous processes of T11-L2 I: inferior part of ribs 9-12
Action, innervation, and blood supply of serratus posterior inferior
A: superficial respiratory assist (depresses ribs) I: ventral rami of upper thoracic n. BS: posterior intercostal a.
Origin and insertion of semispinalis
O: C4-T12 transverse processes I: occipital bone, C2-T4 spinous processes
Action and innervation of semispinalis
A: extends head, cervical and thoracic regions I: dorsal primary rami
3 portions of semispinalis
Semispinalis Capitis, Cervicis, and Thoracis
Origin and insertion of rotatores
O: transverse processes of vertebrae I: superomedially on lamina and transverse process of vertebra 1-2 segments above
action and innervation of interspinales cervicis
A: aid in extension and rotation of column I: dorsal primary rami
Origin and insertion of intertransversarii
O: transverse processes of cervical and lumbar vertebrae I: transverse processes of adjacent vertebrae
Action, innervation, and blood supply of splenius capitis
A: bilat - extend head. Unilaterally - laterally bend and rotate to same side I: dorsal rami of MIDDLE cervical nerves BS: descending branch of occipital a.
Origin and insertion of splenius capitis
O: nuchal lig, spinous process of C7-T3 I: Mastoid process, lateral 1/3 of superior nuchal line
Origin and insertion of splenius cervicis
O: Spinous process of T3-T6 I: transverse process of C1-C3
Action, innervation, and blood supply of splenius cervicis
A: bilat - extend head. Unilaterally - laterally bend and rotate to same side I: dorsal rami of LOWER cervical nerves BS: descending branch of occipital a.
Origin and insertion of rectus capitis posterior major
O: Spine of C2 I: inferior nuchal line
action and innervation of intertransversarii
A: aid in lateral bending and stabilization I: dorsal primary rami AND ventral primary rami
Action, innervation, and blood supply of rectus capitis posterior major
A: extends and rotates head to same side I: suboccipital n. (C1) BS: vertebral a.
Origin and insertion of rectus capitis posterior minor
O: tubercle of posterior arch of atlas I: median inferior nuchal line
Action, innervation, and blood supply of rectus capitis posterior minor
A: extends head I: suboccipital n. (C1) BS: vertebral a.
Origin and insertion of obliquus capitis inferior
O: spinous process of axis I: transverse process of atlas
Action, innervation, and blood supply of obliquus capitis inferior
A: rotates atlas to turn face to same side I: suboccipital n. (C1) BS: vertebral a.
Origin and insertion of obliquus capitis superior
O: transverse process of atlas I: occipital bone
Action, innervation, and blood supply of obliquus capitis superior
A: extends and bends head laterally I: suboccipital n. (C1) BS: vertebral a.
Boundaries of suboccipital triangle and what comes through it
medially = RCPMajor inferiorly = OQI laterally = OQS roof = semispinalis capitis floor = posterior arch of atlas contents: suboccipital n. and vertebral a.
Ligaments that limit spinal flexion (4)
Interspinous lig.
supraspinous lig.
posterior longitudinal lig.
ligamentum flavum
Ligament that limits lateral bending
intertransverse lig.
Ligament that limits spinal extension
anterior longitudinal lig.
Primary curvatures of spine
thoracic and sacral kyphoses (concave anteriorly)
Secondary curvatures of spine
Cervical and lumbar lordoses (concave posteriorly)
What is scoliosis?
Abnormal lateral curvature and vertebral rotation
What’s special about C1 (atlas)?
No body or spinous process Ant and Post arches Posterior tubercle Lateral masses produces "yes" mvmt with atlanto-occipital jt No IV disc below this
What’s special about C2 (axis)
Dens
strongest cervical vertebrae
produces “no” mvmc with atlanto-axial joint
What part of cruciate ligament prevents what injury?
Transverse lig. portion of cruciate ligament prevents atlanto-occipital subluxation -> spinal cord compression
Cervical hyperflexion causes what damage?
tear in interspinous and supraspinous ligs. and poss. IV disc rupture posteriorly s fx of vertebral body
“whiplash”
cervical hyperextension of the head AND neck
resulting in damage to posterior parts of vertebrae
fracture by crush or compression of vertebral arches, tear of anterior longitudinal lig.
Clefts of Luschka?
synovial joint like, found in C3-C6, uncinate processes and superior vert. bodies, develops after 10 y/o
pars interarticularis
part of the lamina and is the neck of the scottie dog (column of bones connection sup. and inf. articular facets)
Fracture of pars interarticularis
Also called spondylolysis
Spondylolisthesis
A forward translation of one vertebral body over the adjacent vertebrae from fx of the pars interarticularis fx
“Hangman’s” fracture
Traumatic spondylolysis of C2.
hyperextension of head ON the neck
One of the most common cervical fx.
Fracture of both pars interarticularis of C2.
Results in quadriplegia or death (from brainstem injury)
Jefferson’s fracture
AKA burst fx caused from axial loading to head (diving in shallow pool)
Fracture of posterior and anterior arch
may not have spinal cord damage since vertebral canal size actually increases from fx
Layers of meninges from outer to inner
DURA- forms dural sac (epidural space)
ARACHNOID-delicate and avascular, lines dural sac.
subarachnoid space - where CSF is
PIA-thin, transparent. Suspends spinal cord in dural sac. Has filum terminale and denticulate lig.
Lumbar cistern
L2-S2, CSF + cauda equina
Lumbar puncture
diagnostic tool - CNS disorders, meningitis
@ L3-L4 or L4-L5 levels
Conus medullaris stops at what level?
~ L1-L2
herniation of nucleus pulposus occurs which direction?
posterolaterally b/c no supporting ligaments this way and thinner anulus fibrosus.
Herniation of NP mostly occurs where?
95% at L4-L5 and L5-SI
Disc herniation and radiculopathy in cervical region
will compress the roots of a spinal nerve @ same level
Disc herniation and radiculopathy in lumbar region
will affect the roots of the subsequent spinal nerve