Back Flashcards
The back is defined as the ______ part of the trunk, that os inferior to the ____and superior to the ____ ___.
The back forms the ___ of the human body; it consists of the ____ ____, _____ ____, ____ ____ and _____ ____ (skin, connective tissue, vessels and nerves).
posterior part
neck
gluteal region
axis
vertebral column
supporting muscles
spinal cord
associated tissue
The _____ formed the longitudinal axis of the body during development, but only remnants of it are left in the form of the ____ ____.
notocord
intervetebral disks
1-6?
- transverse process
- spinal process
- lamina
- Pedicle
- Vetebral Body
- Vetebral Canal
The Vetebral column has two different types of ____. What are they? Describe each.
Joints
Synovial(diarthroidal)- a moveable joint
Cartilaginous- cartlidge is between bones so that the bones don’ t damage each other.
Synovial Joints in the back are located between ____ of ___ ___ and specifically where a _____ ____ ____ meets an ___ ____ ___. This joint is called a ____ joint or a _____ joint
processes of adjacent vertebrae
superior articulating process
inferior articulating process
Zygapophysial
facet joint
What are the processies in red and what forms between them?
- The top is the superior articulating process
- The bottom is inferior articulating process
- The joint between them is a zygopophysial synovial joint
How are joints innervated?
Any nerve that crosses a joint sends off tiny sensory branches to the joint and innervate it
(this is Hiltons law but dont worry about the name)
Intervetebral discs are ___ ___ and aren’t very moveable. They are meant to ____ the adjacent vetebrae.
Cartilaginous joints
cushion
The intervetebral discs consist of the __ __ and the __ __.
Nucleus pulposus
annulus fibrosus
The nuclues pulposus is __% water and is the remnant of the ____.
90
notocord
The outer lamellar part of the intervetebral disc is called the ___ ___.
Annulus fibrosus
When a ____ ____ or (prolapsed disc) occurs due to trauma or hyperextenstion, the _____ ____ could come out. The nuclues pulposus almost always come out _____ or ___ and this is because there is a very strong ____ (called the ___ __ ___) that runs along the front of the vetebral bodies that prevents them from herniating forward. However, since it herniates backwards, it can push back on the ____ ___ ____ and cause ____.
herniated disc
nucleus pulposus
posteriorly
laterally
ligament
Anterior Longitudinal Ligament
true spinal nerve (clinical nerve root)
radiculopathy
You can herniate discs in the ____ region and the radiculopathy pain takes the form of ____. The ____ nerve is the largest nerve in the body, so when you press on nerves in the lower back it affects it and the_____ will have pain. The pain radiates down the lower ___to the ____ and down the back of the ____ to the ___.
lumbar
sciatica
sciatic
dermatome
back
hip
thigh
leg
More caudal spinal nerve roots descend as cauda equina to the ____ ____ where they join as a _____ ____ ___ and exit the vertebral column; a spinal nerve exits through the ____ half of the intervertebral foramen. Because of this, the spinal nerve lies above the intervertebral disc at that level, so it won’t be affected by a herniated disc at that level. Instead, the spinal nerve ____ the herniated would be affected.
SO usually if the L4/L5 disc herniated, the ___ spinal nerve would most likely be compressed.
intervertebral foramen
true spinal nerve
superior
below
L5
L5 radiculopathy causes weak _____ of ___ and ___
dorsiflexion
foot and toes
S1 radiculopathy causes depressed ___ ___ and weakness of ____ ____ in the ___
depressed ankle reflex
plantar flexion in the foot
The ___-___ joints allow you to nod and shake your head. The two we need to know are the _____ joint and the ____ joint.
Atlas is the ___ ___; Axis is the ____ ___; Occipital is a part of the ___.
Cranio-veterbral joints
atlanto-occipital joint
atlanto-axial joint
Atlas- C1 vertebrae
Axis- C2 vertebrae
Occipital- part of skull
Atlanto-occipital joints are _____ ____ that lie between the ____ ____ ____ of the C1 vertebrae (atlas) and the _____ ____of the skull. What do these joints allow?
synovial joints
superior articulating processes
occipital condyles
“Nodding” of the head to indicate “yes” occurs at this joint.
_____ loints are ____ joints that lie between C1 (atlas) and C2 (axis). What do these allow?
Atlanto-axial
synovial
“Shaking the head to indicate no” occurs here
Anterior Longitudinal Ligament checks the ____ of the _____ ____. It continues superiorly as the (aka renamed superiorly) ____ _____ ____ and then the ___ ______ ____ as you continue more.
Checks extension
vertebral column
anterior atlanto-axial ligament
•anterior atlanto-occipital ligament
The ____ ____Ligament is found on the back of the vetebral bodies. This is going to check the ____ of the _____ _____. It will continue superiorly as the___ ___ at the level of vertebra __.
Posterior Longitudinal
flexion of the vertebral column
tectorial ligament
C2
What is the red?
Posterior longitudinal ligament
What is in the yellow?
What is #1 representing?
yellow -Ligamentum Flavum
anterior long. lig.
_____ ____ connects adjacent laminae and checks _____ of the ____ ___. It will be renamed as it moves superiorly and called the ____ ___ ____ and then the
____ ___ ____
Ligamentum Flavum
flexion of vertebral column
posterior atlanto-occipital ligament
posterior atlanto-axial ligament (C1 & C2)
Interspinous Ligaments check ____ of the _____ ____ and are directionally _____
flexion of vertebral column
posterior
What is in purple and what is in yellow?
Purple- interspinous ligaments
Yellow supraspinous ligaments
_____ _____ connects tips of adjacent spinous processes (This area thickens at cervial levels and called the ___ ____ ). These are usde to check _____ of the ____ ____.
Supraspinous Ligaments
(ligamentum nuchae
flexion of vertebral column
- Dura mater
- spinous process
- subcutaneous tissue
- skin
- interspinous ligament
- supraspinous ligament
- ligamentum flavum
- vetebral body
- intervetebral disc (it is the skinny one if you switched it with 9 while you were making it )
Superficial extrinsic back muscles are associated with the ___ ____
is associated with the upper extremity
What are the superficial back muscles? (4)
- Trapezius
- Latissimus Dorsi
- Levator scapulae
- Rhomboid major and minor
____ ____ muscles assists in holding the ____ back muscles in place and are accessory muscles of ____. What are they? (2)
Intermediate group
deep
respiration
Serratus posterior superior
Serratus posterior inferior
What are the proximal attachments of the trapezius? (4)
What are the sistal attachments(3)?
Superior nuchal line, external occipital protruberance, nuchal ligament, spinous processes C7-T12
Clavicle, acromion, scapular spine
USUALLY, Proximal attachments of muscles are also called the ____ while distal attachments are also called the ____.
origin
insertion
What muscle is in blue? What mactions is it responsible for?
Trapezius
Actions: Elevation, retraction, depression of scapula; rotation of glenoid fossa superiorly
What innverates the trapzius?
what kind of fiber does this nerve serve?
what is the arterial supply?
Cranial nerve XI (spinal accessory nerve)
Somatic Motor
Transverse cervical artery
What is being pointed to in the yellow?
In the white?
Latissimus Dorsi
thoracolumbar fascia
Latissimus dorsi Proximal attachments?
Distal attachment?
PROX:
Spinous processes T7-12,
thoracolumbar fascia
iliac crest
DISTAL
Floor of intertubercular sulcus of humerus
What are the actions of Latissimus Dorsi?
Actions:
Extension, adduction, medial/internal rotation of humerus;
lifts body toward arm in climbing
Purple?
Black?
Green?
Purp Rhomboid major
Black rhomboid minor
Green Levator Scapulae
For Levator scapulae, what are the following:
Proximal attachments:
Distal attachment:
Innervation:
Blood supply:
Proximal attachments: Transverse processes, C1-4
Distal attachment: Superior angle of scapula
Innervation: Dorsal scapular nerve (C5)
Blood supply: Dorsal scapular artery
For Rhomboid major and minor, what are the following for each:
Proximal attachments:
Distal attachment:
Proximal attachments:
- Minor: nuchal ligament, spinous processes of C7, T1
- Major: spinous processes of T2-T5
Distal attachment:
Medial border of scapula (minor superior to scapular spine, major below scapular spine)
What are the Intermediate extrinsic back muscles and name the action of each.
Serratus posterior superior
Actions: Elevation of ribs
Serratus posterior inferior
Actions: Depression of ribs
Usually, nerves and blood vessels supply their muscles on the muscles?
This allows for?
deep surface
protection
What are these two triangles?
The Superior one?
Triangle of auscultation
Inferior one?
Lumbar triangle of Petit
The what is a back landmark that allows lung sounds to be heard clearly because no muscle intervenes between skin and rib cage?
Triangle of auscultation
What is often the site for hernias of retroperitoneal contents through posterior abdominal wall?
Lumbar triangle of Petit
Deep back muscles Act to maintain _____ and control movements of the ____ ____ (flexion, extension, lateral flexion, rotation). They are found deep to the ____ ____ of cervical regions (_____ ____/____) and thoracic/lumbar regions (______ ___).
posture
vertebral column
investing fascia
nuchal fascia/ligament
thoracolumbar fascia
purple
pink?
Purple: Splenius cervicis
pink- Splenius capitus
What are the actions of the spenius cervicis and splenius capitus?
- Unilateral contraction yields lateral flexion of neck and rotation of head to side of contraction
- Bilateral contraction yields head and neck extension
What is the origin and insertion for the splenius capitus and splenius cervicis?
Origin: Lower cervical and upper thoracic spinous processes
Insertion: Capitus: Mastoid process, superior nuchal line
Cervicis: Upper cervical transverse processes
In the Deep back, you can find the ____ ____ muscles that exist as a common muscle mass that splits into three parts. What are the three parts from later to medial?
\Erector spinae
Iliocostalis:
Longissimus
Spinalis
What are the erector spinae muscle insertions and orgins?
Origins: Iliac crest, sacrum
Insertions:
Iliocostalis: angles of lower ribs, cervical transverse processes
Longissimus: angles of ribs, cervical/thoracic transverse processes, mastoid process
Spinalis: spinous processes
Green
yellow
both blues?
What do they span before inserting distally?
Green
GREEN Semispinalis spans 4-6 vertebrae before inserting distally
YELLOW Multifidus spans 2-4 vertebrae before inserting distally
BLUE Rotators span 1-2 vertebrae before inserting distally
What’s in the green? what’s poking out behind it?
semispinalis capitus
greater occipital nerves
Purple?
being pointed at?
semispinalis cervicis
C2
What is this?
What action does it do?
Multifidus
Actions: Unilateral contraction rotates to contralateral side; stabilizes vertebrae
