Back and Neck Muscles Flashcards
What are the attachments of sternocleidomastoid (SCM)?
- S: mastoid process
- I: sternum (sternal head)
- I: clavicle (clavicular head)
What are the actions of sternocleidomastoid?
- contralateral rotation of the head and neck
- ipsilateral lateral flexion of the head and neck
- flexion of the neck (if the head/neck is in neutral or flexed)
- extension of the head (if the head is already extended)
- assists with inspiration
- anterior translation of head on neck
What are the borders and contents of the Anterior Cervical Triangle
- base: mandible
- lateral border: SCM
- medial border: midsagittal plane of the neck
- contents: muscles, arteries, veins, lymph nodes, viscera, thyroid and parathyroid glands
What are the borders, floor and contents of the Posterior Cervical Triangle?
- base: clavicle
- anterior: SCM (posterior aspect)
- posterior border: trapezius
- floor:
- splenius capitis
- levator scapula
- middle scalenes
- posterior scalenes
- omohyoid
- brachial plexus
- subclavian artery and vein
- contents: blood vessels and nerves
Where is the larynx located and what does it do?
- location: just inferior to where the pharynx splits into the trachea and the esophagus
- does voice production (Adam’s apple is formed by the thyroid cartilage)
What are the suprahyoid muscles?
- mylohyoid
- geniohyoid
- stylohyoid
- digastric (anterior and posterior bellies)
What are the general actions of the suprahyoid muscles?
- superior attachments fixed: elevate the hyoid bone
- hyoid fixed: assist in depressing (lowering) the mandible
What are the infrahyoid muscles?
- sternohyoid
- sternothyroid
- thyrohyoid
- omohyoid
What are the general actions of the infrahyoid muscles?
depress the hyoid bone
What are the two-headed muscles of the hyoids?
- digastric (anterior and posterior bellies)
- omohyoid (superior and inferior bellies)
Which muscle group attaches the hyoid to the skull?
suprahyoids
The prefix “omo” refers to:
the shoulder (inferior belly of omohyoid attaches to superior border of he scapula near the suprascapular notch)
What’s between the muscle bellies of each of the two-headed hyoid muscles?
intermediate tendons
What are the muscles of the superficial layer of the back?
- trapezius
- latissimus dorsi
- levator scapula
- rhomboid major (and minor)
What are the intermediate muscles of the back, and what do they do?
accessory muscles of respiration
- serratus posterior superior
- serratus posterior inferior
What muscles are in the superficial layer of the deep back muscles?
- splenius capitis
- splenius cervicis
What muscles are in the intermediate layer of the deep back muscles?
3 columns of muscles collectively called the erector spinae (aka paraspinals). Medial to lateral, they are:
- spinalis
- longissimus
- iliocostalis
What muscles are in the deep layer of the deep back muscles and have a superomedial fibre direction?
(collectively called the transversospinalis muscles) from superficial to deep:
- semispinalis (capitis, cervicis, thoracis)
- multifidus
- rotatores
What muscles are in the deep layer of the deep back muscles and have a vertical fibre direction?
- interspinales
- intertransversarii
Where are the muscles in the deep layer of the deep back muscles, and generally where do they attach?
superomedial or vertical fibre direction
- found in the groove between the spinous and transverse processes (the laminar groove)
- some (SMR) attach from the TVP to the SP of a superior vertebrae
- some (inters) attach from SP-SP or TVP-TVP
What are the attachments of serratus posterior superior? What is it deep to? Superficial to?
- M: SPs of C7-T3
- L: superior borders of ribs 2-5
- deep to rhomboids
- superficial to erector spinae
What are the attachments of serratus posterior inferior? What is it deep to? Superficial to?
- M: SPs of T11-L2
- L: lower 4 ribs
- deep to latissiumus/thoracolumbar fascia
- superficial to the erector spinae
What are the actions of serratus posterior superior?
elevates ribs 2-5 (supports breathing – forced inspiration)
What are the actions of serratus posterior inferior?
draws ribs down and back (with forced expiration – coughing, sneezing, blowing nose…)
What does splenium mean?
bandage (gr.)
What are the attachments and actions of splenius capitis?
- I: SPs of C4-T2
- S: mastoid process and lateral superior nuchal line
- unilateral contraction: ipsilateral rotation
- bilateral contraction: extension of the neck
What are the attachments and actions of splenius cervicis?
- S: C1-C4 TVPs (posterior tubercles)
- I: SPs of T3-T5
- unilateral contraction: ipsilateral rotation
- bilateral contraction: extension of the neck
What’s the general location, structure and direction of the intermediate back muscles?
- arise inferiorly from the thoracolumbar fascia and spread out in a superolateral direction
- are subdivided into 3 columns of muscles on either side of the spine and each column has 3 segments
What are the shortest and longest columns of the paraspinals (aka erector spinae)?
- shortest: spinalis
- longest: longissimus
What are the divisions of spinalis, generally where are they located and generally where to they attach?
(very thin)
- sit in the laminar groove
- thoracis, cervicis, capitis
- attach to the SPs
What are the divisions of longissimus and generally where to they attach?
- all attach to TVPs
- thoracis, cervicis, capitis (also attaches to mastoid process superiorly)
What are the divisions of iliocostalis and generally where do they attach?
- lumborum (angle of ribs 8-12)
- thoracis (angle of ribs 1-7)
- cervicis (ribs 4-7 just medial to thoracis; also TVPs of C3-6)
What are the actions of erector spinae (aka paraspinals)?
- unilateral: lateral flexion of the vertebral column
- bilateral: extension of the vertebral column
Generally where are semispinalis muscles, what are their divisions, and generally where do they attach?
- superior 1/2 of spinal column
- thoracis, cervicis, capitis (capitis attaches superiorly between the superior and inferior nuchal lines; it’s the largest mass in the posterior neck)
- attaches to a TVP laterally then SP of a superior vertebrae (skips 3-6 vertebrae)
What are the actions of semispinalis?
- bilateral: extension of the head and neck
- unilateral: contralateral rotation of the neck
Generally where do multifidus muscles attach and what are their actions?
- attaches from S4-C2 (skipping 1-3 vertebrae) (only “intrinsic” back muscle to cross the sacrum)
- bilateral: extension of the spine, stabilization
- unilateral: lateral flexion, contralateral rotation
Generally where do rotatores muscles attach and what are their actions?
- attaches to a TVP laterally then SP of a superior vertebrae
- bilateral: stabilization
- unilateral: contralateral rotation
Generally where do interspinales muscles attach and what are their actions?
- paired muscles on either side of cervical and lumbar SPs
- extension
Generally where do intertransversarii muscles attach and what are their actions?
- attach TVPs of adjacent vertebrae of cervical and lumbar spine
- lateral flexion
What are the suboccipital muscles, and what are they deep to?
deep to semispinalis capitis
- rectus capitis posterior major
- rectus capitis posterior minor
- obliquus capitis inferior
- obliquus capitis superior
What are the attachments and actions of rectus capitis posterior major?
- I: SP of C2
- S: inferior nuchal line
- unilateral contraction: ipsilateral rotation of the head
- bilateral contraction: extend the head on the neck
What are the attachments and actions of rectus capitis posterior minor?
- I: posterior arch of C1 (posterior tubercle)
- S: inferior nuchal line (also to dura mater)
- bilateral contraction: extend the head on the neck
What are the attachments and actions of obliquus capitis inferior?
- I: SP of C2
- S: TVP of C1
- unilateral contraction: ipsilateral rotation of the head
What are the attachments and actions of obliquus capitis superior?
- I: TVP of C1
- S: between superior and inferior nuchal lines
- unilateral contraction: lateral flexion of the head on the neck
- bilateral contraction: extend the head on the neck
Why might rectus capitis posterior minor cause headaches?
it attaches to the dura mater and can disrupt normal CSF flow
What are the boundaries (incl. floor and roof) of the suboccipital triangle?
the most lateral 3 suboccipital muscles define the triangle:
- inferolateral border: obliquus capitis inferior
- superolateral border: obliquus capitis superior
- superomedial border: rectus capitis posterior major
- floor: posterior atlanto-occipital membrane
- roof: semispinalis
What are the contents of the suboccipital triangle?
- vertebral artery
- suboccipital nerve
What are the anterior/lateral neck muscles?
they’re prevertebral
- rectus capitis anterior
- rectus capitis lateralis
- longus colli (aka longus cervis)
- longus capitis
What are the attachment points and actions of rectus capitis anterior?
- I: lateral mass of C1
- S: occiput
- flexes head on the neck
What are the attachments and actions of rectus capitis lateralis?
- I: TVP of C1
- S: occiput
- flexes head on the neck
- laterally flexes head on neck
What are the attachments and actions of longus colli (aka longus cervicis)?
- I: body of T3
- S: anterior tubercle of C1
- additional attachments to the bodies and TVPs of the cervical spine
- flexion of the neck
What are the attachments and actions of longus capitis?
- I: TVPs of C3-C6
- S: occiput
- flexion of the head and neck
What are the lateral neck muscles?
- anterior scalene
- middle scalene
- posterior scalene
- sternocleidomastoid
What are the attachments and actions of anterior scalene?
- S: anterior tubercles of C3-C6 TVPs
- I: rib 1 (scalene tubercle)
- bilateral contraction: flexion of the neck
- unilateral contraction: ipsilateral lateral flexion of the neck
- elevates 1st rib during forced inhalation
- unilateral contraction: contralateral rotation of the neck (weak)
What are the attachments and actions of middle scalene?
- S: posterior tubercles of C2-C7 TVPs
- I: rib 1 (posterior to subclavian artery)
- unilateral contraction: ipsilateral lateral flexion
- elevates 1st rib during forced inhalation
- unilateral contraction: contralateral rotation of the neck (weak)
What are the attachments and actions of posterior scalene?
- S: posterior tubercles of C4-C6 TVPs
- I: rib 2
- unilateral contraction: ipsilateral lateral flexion
- elevates rib 2 during forced inhalation
In chart form, how would I lay out attachments of the scalenes?
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What do mylo and genio mean?
mill; chin
What are the attachments of mylohyoid?
- S: mandible
- I: hyoid bone
What are the attachments of geniohyoid?
- S: mandible
- I: hyoid bone
What are the attachments of stylohyoid?
- S: styloid process of the temporal bone
- I: hyoid bone
What are the attachments of the anterior belly of digastric?
- S: inferior border of the mandible
- I: intermediate tendon to hyoid (via a connective tissue loop)
What’s a good way to remember the suprahyoid muscles?
My gen(eration’s) styl(e) is digastric
What are the attachments of sternohyoid?
- S: hyoid bone
- I: manubrium
What are the attachments of sternothyroid?
- S: thyroid cartilage
- I: manubrium
What are the attachments of thyrohyoid?
- S: hyoid bone
- I: thyroid cartilage
What are the attachments of the superior belly of omohyoid?
- S: hyoid bone
- I: intermediate tendon
What are the attachments of the inferior belly of omohyoid?
- S: intermediate tendon
- I: superior border of the scapula near the suprascapular notch
What are the divisions of iliocostalis and generally where do they attach?
- lumborum (angle of ribs 8-12)
- thoracis (angle of ribs 1-7)
- cervicis (ribs 4-7 just medial to thoracis; also TVPs of C3-6)