Back Flashcards
The back runs from the ____ to the ____
Cervical spine to the sacrum
The superficial and deep back muscles are separated by ____
Thoracolumbar fascia
What is the main function of the superficial back muscles?
Upper extremity movement
What are the names of the deep back muscles from superficial to deep?
Spinotransversalis, erector spinae, transversospinalis, and segmental
What is the function of the deeper back muscles?
Spinal stability and mobility
What is the innervation of ALL of the deeper back muscles?
Dorsal Rami
What muscles are in the spinotransversalis group?
Splenius capitus
Splenius cervicis
What is the inferior attachment and superior attachment for the splenius capitus and splenius cervicis?
Inferior attachment:
They arise from the nuchal ligament and spinous processes of C7-T6
Superior attachment:
Splenius cervicis: Tubercles of the transverse processes of C1-C3 or C4
Splenius Capitis: Fibers run from spinous process to transverse process to the mastoid process of the temporal bone and the lateral 1/3 of the superior nuchal line of the occipital bone
What are the actions of the splenius capitus and splenius cervicis both alone and together?
Alone:
Laterally flexes the neck and rotates the head to the same side as the active muscles
Together:
Extend the head and neck
Where do the splenius capitus and splenius cervicis innervate ?
Dorsal Rami
What muscles are in the erector spinae group?
Iliocostalis, longissimus, and spinalis
What are the components (the regions) of the iliocostalis?
Cervicis, thoracis, and lumborum
Are the actions for each muscle in the erector spinae group the same?
Yes
What are the actions of the erector spinae group unilaterally and bilaterally
Unilaterally:
Laterally flex the vertebral column
Bilaterally:
Extend the head and vertebral column and as the back is flexed they help control movement by gradually lengthening the fibers
What is the origin and insertion of the iliocostalis?
The iliocostalis spans from the cervicis region to the lumborum region and as it enters the cervical spine it attaches to the transverse processes.
The superior attachment are the ribs.
What is the innervation of the iliocostalis ?
Dorsal rami
What are the components (the regions) of the longissimus?
Thoracis, cervicis, and capitus
What is the origin and insertion of the longissimus?
The longissimus spans the thoracis, cervicis, and capitus region and extends from transverse process to transverse process
What is the innervation of the longissimus ?
Dorsal rami
Out of all of the deep back muscles which is the largest and longest ?
Longissimus
What are the components (the regions) of the spinalis?
Thoracis, cervicis, and capitis
What is the origin and insertion of the spinalis?
The spinalis spans the thoracis, cervicis, and capitis regions and runs from spinous process to spinous process
What is the innervation of the spinalis ?
Dorsal rami
Out of the erector spinae group, which muscle is the thinnest ?
Spinalis
What muscles are included in the transversospinalis group?
Semispinalis, rotatores, and multifidi
What direction (medially to laterally, superior to inferior..) does the transversospinalis group run and from what process to what process ?
The transversospinalis group runs inferior to superior and from transverse process to spinous process
The transversospinalis group spans how many segments ?
They span a few segments and can go down to as little as one segment
Are the transversospinalis group oblique?
Yes
What is the action of the semispinalis?
Extend the head, thoracic, and cervical regions of the vertebral column and rotates them contralaterally
What is the origin/insertion for the semispinalis?
The semispinalis spans the thoracic, cervicis, and capitus regions, runs from inferior to superior, and from transverse process to spinous process.
What is the innervation of the semispinalis??
Dorsal rami
What region is the semispinalis most prominent?
Cervical region
How many segments do the multifidus span?
2-4 segments
What region is the multifidus most prominent?
Lumbar region
What is the origin and insertion of the multifidus?
The multifidus extends from the sacrum to the middle of the cervical region and runs from transverse process to spinous process.
What is the action of the multifidus?
Unilateral contraction rotates to the contralateral side and helps stabilize the vertebrae
What is the innervation of the multifidus?
Dorsal rami
How many segments do the rotatores span?
1-2 segments
What is the origin/insertion of the rotatores?
The rotatores extend from the sacrum to the middle of the cervical region and run from transverse process to spinous process
What is the action of the rotatores?
May function as an organ of proprioception, possibly stabilize the vertebrae, assist extension and rotatory movements of the vertebral column
What is the innervation of the rotatores?
Dorsal rami
What muscles are included in the segmental group?
Interspinalis and intertransversarii
What is the origin/insertion of the interspinalis?
The interspinalis runs vertically in-between the spinous processes of the cervical and lumbar vertebrae
What is the action of the interspinalis?
Aid in extension and rotation of the vertebral column
What is the innervation of the interspinalis?
Dorsal rami
What is the origin/insertion of the intertransversarii?
The intertransversarii runs adjacently in between the transverse processes of the cervical and lumbar vertebrae.
What is the action of the intertransversarii (do not forget the bilateral component)?
Aids in lateral flexion of the vertebral column
Bilaterally: Stabilizes the vertebral column
What is the innervation of the intertransversarii?
Dorsal rami
What are the names of the suboccipital muscles?
Rectus capitis posterior major and minor / Obliquus capitis superior and inferior
Where do all of the suboccipital muscles innervate?
Posterior ramus of C1, the suboccipital nerve
What are the actions of the suboccipital group of muscles?
Extend the head on C1, rotate the head and rotate the C1 on C2 vertebrae.
What is the origin/insertion of the rectus capitis posterior major?
It arises from the spinous process of the C2 vertebra and inserts into the lateral part of the inferior nuchal line of the occipital bone.
What is the origin/insertion of the rectus capitis posterior minor?
It arises from the posterior tubercle on the posterior arch of the C1 vertebra and inserts into the medial third of the inferior nuchal line.
What is the origin/insertion of the obliquus capitis superior?
It arises from the transverse process of C1 and inserts into the occipital bone between the superior and inferior nuchal line.
What is the origin/insertion of the obliquus capitis inferior?
It arises from the spinous process of C2 and inserts into the transverse process of C1.
In the different regions of the vertebral column (cervical, thoracic, lumbar, sacral, and coccygeal) how many vertebrae are in each region?
Cervical - 7 Thoracic - 12 Lumbar - 5 Sacral - 5 fused Coccygeal - 4 fused
Which regions of the vertebral column are primary curvatures and in which cavity are they located?
Thoracic and sacral - anterior cavity
Which regions of the vertebral column are secondary curvatures and in which cavity are they located?
Cervical and lumbar - posterior cavity
When are primary curvatures developed?
Straight from the womb at birth
When are secondary curvatures developed?
Secondary curvatures occur between 0 and 1 and develop gradually after birth as the child learns to sit upright, stand, and walk.
What are the upper and lower regions of the cervical vertebrae?
Upper - C1 & C2
Lower - C3-C7
In which vertebral bodies can you find the uncinate process and where do they lie?
C3-C6 of the vertebra above
Example - superior portion of C4 rests on the inferior portion of C3
Why isn’t the joint of Lushka considered a real joint?
It lacks synovial lining
What is a massive indicator that you are looking at a cervical vertebrae?
The spinous process is bifid (‘Bifid’ means that the spinous process is divided into two ‘clefts’.)
What is the only region of the spine that has a transverse process with a transverse foramen?
Cervical region of the spine
What is the name of C1?
Atlas
Is it hard to side bend on occiput C1?
Yes
What allows for a lot of axial rotation on C1?
Flat facets
Describe C1
C1 has no spinous process or body. It has two lateral masses separated by anterior and posterior arches. It has a transverse foramen and the transverse process is really long.
What is the name of C2?
Axis
Which vertebrae is the strongest cervical vertebrae?
C2
What is the main distinguishing feature of C2?
It has an Odontoid process (Dens) that projects superiorly from its body
The axis (C2) articulates anteriorly with what?
The anterior arch of the atlas
The C1 and C2 articulations are (flat/round)
Flat
In the C1-C2, and C2-C3 facet orientation, the facet joints going down are ____ degrees and have _____ types of motion
45 and similar
What makes a cervical vertebra unique?
A bifid spinous process, a transverse foramen, joints of lushka, and the transverse processes being directly lateral and short are what makes the cervical vertebrae unique.
What creates the joints of lushka?
The uncinate process
At what angle does the cervical spine orient itself?
45 degrees (the angle is important to decide how movement occurs in that area of the spine)
Describe C1 and a difference between C1 and the rest of the cervical vertebra
C1 Consists of two lateral masses connected by anterior and posterior arches. It has the same transverse process with a transverse foramen in it like the rest of the lower cervical vertebrae (C3-C7), but the transverse process is really long.
Is it hard side bend on occiput C1?
Yes
What two cervical vertebra produce up to 50% of the axial rotation of the head?
C1/C2 due to the 45 degree orientation
What is the only vertebra that has a Dens (odontoid process)?
C2
The odontoid process is on the most (anterior/posterior) portion of C2
Anterior
The anterior articular surface of the dens articulates with the posterior surface of the anterior arch of C1.
True Or False?
True
Is the C1/C2 articulation flat or round?
Flat
Describe the thoracic vertebra
• Thoracic vertebra have bodies that are intermediate in size, articular facets on the transverse processes and bodies for the ribs, there is a superior and inferior costal facet on the posterior aspect of the vertebral body, and there is a costal facet on the transverse process
Where do the ribs articulate on the thoracic spine?
The costal facet on the transverse process is where ribs articulate.
The thoracic spine is long and oblique going inferiorly. The spinous process that you palpate in this region is actually 1-2 levels below the actual vertebral level.
True Or False?
True
Is there a lot of space between thoracic vertebra?
• Not a whole lot of space between the thoracic vertebra, they clutch down on each other and block motion.
What is the orientation of the facet joints in the thoracic region in terms of angles off of the horizontal and frontal plane?
60 degrees off of the horizontal
30 degrees off of the frontal
Which plane are the thoracic and cervical spine in?
Frontal
Do the vertebral bodies stand taller in the thoracic or cervical spine?
Thoracic
Does the thoracic spine have a transverse foramen?
No
In which direction do the transverse processes point in the thoracic spine?
Posterolateral
Which vertebra between the cervical, thoracic, and lumbar have articulations with the ribs?
Thoracic
Between the thoracic and lumbar vertebra, which vertebra are wider?
Lumbar
The articular processes in the lumbar vertebra are moving towards which plane?
Sagittal
Describe the size and direction of the transverse processes in the lumbar region?
Short and go directly lateral
Describe the spinous process in the lumbar region
They angle down a little bit, go mostly posterior, and are very tall
As we go from cervical to lumbar, the vertebral bodies get (smaller/larger)
Larger due to the lumbar spine needing to hold more weight
What plane orientation does L1-L3 have?
What plane orientation does L4-L5 have?
L1-L3 - Sagittal
L4-L5 - Frontal
The vertebral bodies get (bigger/smaller) from L1-L5
Bigger
What is the Intervertebral Joint made of?
The intervertebral joint is made up of the adjacent vertebra connected by the intervertebral disc (IV disc) and the associated ligaments.
What is the outer layer of the intervertebral disc called?
Annulus fibrosus
What is the annulus fibrosus made up of? And what do they allow for?
The annulus fibrosus is made up of the concentric rings, and these concentric rings have different orientation of collagen fibers which allow for tensile forces in multiple directions to be resisted as we move our spine.
The annulus fibrosus is fibrocartilaginous
T OR F
True
The nucleus pulposus is an amorphous gel that is surrounded by what?
Hyaline cartilage end plates and the annulus fibrosus
At birth the nucleus pulposus is made up of 85% _____ that decreases as we age and becomes _________
Water; fibrocartilaginous