Back and Vetebral Column Flashcards
The dorsal ramus of C2 is completely what?
Sensory
The dorsal ramus of C1 is completely what?
Motor
The Greater occipital nerve is completely what?
Sensory
Dorsal ramus of C2 comes from under the inferior oblique and pierces the semispinalis capitas and trapezius to supply the scalp.
The suboccipital nerve is completely what?
Purely motor from the dorsal ramus of C2
Trapezius
Nerve Innervation: CN XI
Artery Blood Supply: Superficial branch of the transverse cervical artery.
Origin: Medial third superior nuchal line, ligament nuchae, spinous process of C7-T12
Insertion: Lateral third of clavicle, acromion, spine of scapula
Function: Elevates, retracts, and rotates scapula; lower fibers depress scapula.
With the serratus anterior rotates the scapula from 90-180 degrees.
Latissimus Dorsi
Nerve Innervation: Thoracodorsal Nerve
Artery Blood Supply: Thoracodorsal artery
Origin: Last three ribs, iliac crest, thoracolumbar fascia, spinous of T7-L5
Insertion: Humerus
Function: Extends, adducts, and medially rotates humerus. Also plays a role in expiratory efforts such as coughing and sneezing.
Levator scapulae
Nerve Innervation: Dorsal Scapular Nerve
Artery Blood Supply:
Origin: posterior tubercles of transverse processes of C1-4
Insertion: Upper part of medial border of scapula
Function: Raises medial border of scapula
Rhomboid minor
Nerve Innervation: Dorsal Scapular Nerve
Artery Blood Supply:
Origin: Lower ligamentum nuchea. Spines of C7 and T1
Insertion: Medical border of scapula at spine pf scapula
Function: Retracts scapula. Roatates lower scapula back to rest position
Rhomboid major
Nerve Innervation: Dorsal Scapular Nerve
Artery Blood Supply:
Origin: Spines of T2- T5 vertebrae
Insertion: Medial border of scapula below base of spine of scapula
Function: Retracts scapula. Rotates scapula to rest position.
Serratus posterior superior
Nerve Innervation: Anterior Primary Rami
Artery Blood Supply:
Origin: Spinous process C7 - T2
Insertion: Posterior aspect of ribs 2-5
Function: Assist forced inspiration/ Elevate Ribs
Serratus posterior inferior
Nerve Innervation: Anterior Primary Rami
Artery Blood Supply:
Origin: Spinous process T11-L2
Insertion: Posterior aspect of ribs 9-12
Function: Assist forced expiration/ Depress Ribs
Splenius capitis
Nerve Innervation: Posterior primary Rami C3, 4
Artery Blood Supply:
Origin: Lower ligament nuchae, supraspinous ligaments T1-3
Insertion: Lateral occiput between superior and inferior nuchal lines
Function: Extend and rotate cervical spine
Semispinalis capitis
Nerve Innervation: Artery Blood Supply: Origin: Insertion: Function:
Serratus anterior
Nerve Innervation: Long Thoracic Nerve (note: the branch out of the roots of the brachial plexus C5,6,7).
Artery Blood Supply: Lateral Thoracic Artery
Origin: 8 upper ribs
Insertion: Ventral aspect of medial border of scapula
Function: Protracts the scapula FWD important for reaching and pushing movements
C.R. If nerve is injured will cause “winging” of the scapula. It moves laterally and posteriorly from the thoracic wall. Breast surgery can cuase this type of winging.
What muscle does the Greater Occipital nerve (C2) innervate?
It is sensory only no motor!
What muscle does the thoracodorsal nerve innervate?
Lattisimus Dorsi
What muscle does the Long thoracic nerve innervate?
Serratus anterior
What muscle does the transverse cervical artery (superficial branch) innevervate?
Trapezius
What muscle does the transverse cervical artery (superficial branch) innervate?
Trapezius
What muscle does the thoracodorsal artery innervate?
Lattisimus dorsi
What muscle does the lateral thoracic artery innervate?
Serratus anterior
Where is the Ligamentum Flavum?
d
Where is the Anterior longitudinal ligament?
d
Where is the Posterior longitudinal ligament?
s
What are they key surface landmarks of the back?
C7 : Vertebrae prominens
T1-T2: The superior angle of the scapula
T7: The inferior angle of the scapula
L4: Illiac crest
Note: The back extends from the base of the skull(occiput) to the iliac crest
Muscles of the back are divided into which two categories?
Extrinsic and Intrinsic
Extrinsic back muscles
Are the superficial and intermediate group of back muscles.
The Superficial group of back muscles are involved in the movement of the upper limbs.
The intermediate group of back muscles are involved in the movement of the thoracic wall.
Intrinsic back muscles
Are called the true muscles, they consist of the deepest layer of back muscles. They are involved in the support and movement of the vertebral column and they also participate in moving the head.
These muscles are extended from the pelvis to the cranium.
The ________ muscles are innervated by the anterior rami of the spinal nerves.
Extrinsic back muscles
The ________ muscles are innervated by the posterior rami of the spinal nerves.
Intrinsic back muscles
Extrinsic Muscles Superficial Group
Function of the Superficial Layer: control upper limb movements as it connects the upper limb to the trunk all inserted into the medial border of the scapula.
Layer 1
- Trapezius
- Lattisimus Dorsi
Layer 2 1. Rhomboid Major 2. Rhomboid Minor 3. Levator scapulae Note: All of layer two inserts into the medial border of the scapula
Extrinsic Muscle Intermediate Group
Function: associate with thoracic wall and control respiratory movements:
- Serratus Posterior Superior (function is to elevate ribs)
- Serratus Posterior Inferior (function is to depress ribs)
Intrinsic muscles
Intrinsic muscles are called the “True Muscles” They function to support and move the vertebral column and participate in moving the head
Superficial Layer
- Splenius capitas
- Splenius cervices
Intermediate Layer
1. Erector Spinae
(iliocostalis, longissimus, spinalis)
Deep Layer
- Semispinalis
- Multifidus
- Rotatores
Triangle of auscultation
The trapezius, latissimus dorsi, and medial edge of scapula form a triangle that is absent of muscle and bone which allows us to hear lung sounds.
Body
Weight bearing portion of vertebra that tends to increase in size as we descend down the spine.
What is an articular process (facets)?
Facets are used for articulation with adjacent vertebra. There are TWO SUPERIOR and TWO INFERIOR facets.
Intervetebral foramen
Opening formed by vertebral notches that is transversed by spinal nerve roots and associated vessels
What is the name of the foramen created by the vertebrae?
Intervertebral foramen and vertebral foramen. The vertebral foramen eventually becomes the vertebral canal.
What characterizes the a cervical vertebrae?
There are seven cervical vertebrae. They are characterized by their small size and by the presence of the intervertebral foramen (foramen that exist in the transverse process) called the foramen transversarium.
What is the function of the foramen transversarium? (present in the cervical vertebrae only)
To transmit the vertebral vessles
Structure of Atlas (C1)
DOES NOT HAVE A VERTEBRAL COLUMN or SPINOUS PROCESS but it does contain the transverse process.
It look like a ring composed of two lateral masses interconnected by an anterior and posterior arch.
Each lateral mass articulates above with the occipital condyle to form the (atlanto-occipital joint) and below with the superior articular process of the axis to form the (atlanto-axial joint)
Structure of Axis (C2)
contains an odontoid process(Dens)
What is the odontoid process aka the Dens
The odontoid process is a portion of Axis which becomes the body of the atlas. During development the body of C1 fuses into the body of C2.
C7 (vertebral prominens)
has a long non-bifid spinous process. You can feel it and see it!
Atlanto - occipital joint
Yes-Yes joint (Flexion & Extension)
Atlanto - axial joint
No-No joint (Rotation)
The DENS acts as a pivot that allows the atlas and attached head to rotate on the axis side to side
What are the suboccipital muscles and where do the lie?
These muscles lie to deep to the semispinalis capitas
- Recti Major
- Recti Minor
- Superior Oblique
- Inferior Oblique
What nerve innervates all four suboccipital muscles
The suboccipital nerve of dorsal ramus of C1. That is purely MOTOR
What can you find inside of the suboccipital triangle
- The vertebral artery ( a branch of the subclavian artery)
- The suboccipital nerve C1
- Arch of C1
What two structures artery and nerve are at the floor of the suboccipital traingle
- Vertebral artery ( a branch of the subclavian artery)
2. Suboccipital nerve
What two structures artery and nerve are at the roof of the suboccipital traingle
- Occipital artery (branch of the external carotid artery ECA)
- Greater occipital nerve
What are the key surface landmarks of the back
C7- Vertebral Prominence
T1-T2 The Superior angle of the scapula
T7 The inferior angle of the scapula
L4 Iliac Crest
Cranial nerve X1 innervates what two muscles
SCM
Trapezius
Pedicle vs. Lamina
Lamina is between transverse process and the spinous process.
Pedicle is between the body and the transverse process.
Intervertebral Foramen
Foramina where spinal nerve roots and associated nerve vessels traverse
This is not the same as Foramen transversarium
Verterbral Arch
Vertebral Body and Vertebral Arch make up the whole length of the vertebrae.
Foramen Transversarium
foramen that exist in the transverse processes of cervical vertebrae ONLY and transmit the vertebral vessels.
Lateral Masses of C1
Exist superiorly and inferiorly to articulate with the occipital condyle of the skull (antlanto-occipital joint) and with the superior articular process of the axis (atlanto-axial joint) respectively.
What do the cervical C2-C6 vertebrae have in common
They all have a bifid spinous process!
The C7 spinous process is long! It is our landmark Vertebrae prominence.
Arrangement of muscles in the back of the neck
- Trapezius and SCM
2.Splenius Capitas - Semispinalis Capitas
- Suboccipital muscles
Rectus minor
Rectus major
Superior Oblique (attaches to transverse process)
Inferior Oblique
Everything about the Suboccipital triangle.
Medial- Rectus Major
Lateral- Superior Oblique
Inferior- Inferior Oblique
Roof- Semispinalis capitas
Floor- Posterior Arch of the Atlas
Artery and Nerve of the Floor- Vertebral Artery and Suboccipital nerve
Artery and Nerve of the Roof- Occipital Artery and Greater Occipital Nerve
