Back Lecture 1 : Muscles Flashcards

1
Q

What does the back provide?

A

The Back provides musculoskeletal axis of

support for the trunk

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2
Q

What do the bony elements of the back consist of?

A

The Bony elements consist mainly of vertebrae

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3
Q

What does the back contain?

A

The Back contains the spinal cord and proximal

parts of the spinal nerves

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4
Q

List the functions of the back.

A

The back :
o supports the body’s weight

o transmits forces through the pelvis
to the lower limbs

o carries and positions the head

o braces and helps maneuver upper
limbs

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5
Q

The vertebral column consists of :

A

33 vertebrae

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6
Q

The 33 vertebrae consist of :

A
▪ 7 cervical
▪ 12 thoracic
▪ 5 lumbar
▪ 5 sacral
▪ 3-4 coccygeal vertebrae
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7
Q

What does the sacral vertebrae fuse into?

A

The Sacral vertebrae fuse into a single bony

element, the sacrum

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8
Q

What do the coccygeal vertebrae vary in? What do they often fuse into?

A

Coccygeal vertebrae vary in number
from three to four, and often fuse into
a single coccyx

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9
Q

What groups do the muscles of the back consist of?

A

Muscles of the back consist of extrinsic and intrinsic groups

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10
Q

What does each group of muscles do?

A
  • Extrinsic muscles - move the upper limbs and ribs

* Intrinsic muscles - maintain posture and move vertebral column

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11
Q

The movements of the muscles include :

A

Movements include flexion (anterior bending), extension, lateral flexion, and rotation

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12
Q

What are the extrinsic muscles involved in? What are they innervated by?

A

EXTRINSIC MUSCLES: involved in
movement of the Upper Limb (UL)
and thoracic wall and are innervated
by the anterior rami of spinal nerves or cranial nerve XI(trapezius).

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13
Q

What is the superficial group(of the extrinsic muscles) related to and involved in?

A

The Superficial group is related to and involved in the movement of the upper limb

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14
Q

What is the intermediate group(of the extrinsic muscles) related to and what does it serve as?

A

Intermediate group - is related to the
thoracic wall and serve as a
respiratory function.

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15
Q

Describe the position of the intrinsic muscles.

A

INTRINSIC MUSCLES: are deep in

position

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16
Q

What are intrinsic muscles innervated by?

A

The intrinsic muscles are innervated by the posterior rami

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17
Q

Name the superficial muscles of the back.

A
  • Latissimus dorsi
  • Levator scapulae
  • Rhomboid major
  • Rhomboid minor
  • Trapezius
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18
Q

What are the superficial muscles of the back generally involved in?

A

These muscles are generally involved in movements of the shoulder

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19
Q

Describe each trapezius.

A

Each trapezius is flat and triangular with the base
situated along the vertebral column and the
apex pointing towards the tip of the shoulder

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20
Q

Origin of the trapezius :

A
  • Superior nuchal line
  • External occipital protuberance
  • Ligamentum nuchae
  • Spinous processes of C7 to T12
  • Corresponding supraspinous ligaments
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21
Q

Insertion of the trapezius :

A

Insertion: Lateral 1/3 of clavicle;

acromion and spine of scapula

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22
Q

The action performed by the trapezius :

A
Assist in rotating scapula during abduction
of humerus
❑upper fibers elevate scapula
❑middle fibers adduct scapula
❑lower fibers depress scapula
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23
Q

Which nerve is responsible for the innervation of the trapezius?

A

Accessory nerve (motor) [CNXI]

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24
Q

Describe the Latissimus Dorsi.

A

The Latissimus Dorsi is large, flat and triangular at lower
portion of back and ends in tendon that
attaches to the humerus.

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25
Q

Origin of the Latissimus Dorsi :

A
  • Spinous processes of T7 to T12
  • Posterior layer of lumbar fascia
  • Outer lip of iliac crest
  • Ribs (lower 4 – rib 8-12)
  • Inferior angle of the scapula
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26
Q

Insertion of the Latissimus Dorsi :

A

Floor of the intertubercular sulcus

of the humerus

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27
Q

The action performed by the Latissimus Dorsi :

A

Extends, adducts, medially

rotates humerus

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28
Q

Which nerve is responsible for the innervation of the Latissimus Dorsi?

A

Thoracodorsal nerve (motor)

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29
Q

Describe the Levator scapulae.

A

The Levator scapulae is a slender muscle

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30
Q

Origin of the Levator scapulae :

A

Origin:
• Transverse processes of C1 &C2
• Posterior tubercles of the transverse
processes of C3 & C4

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31
Q

Insertion of the Levator scapulae :

A

Superior angle and upper part of

medial border of the scapula

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32
Q

The action performed by the Levator scapulae :

A

Elevates scapula

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33
Q

Which structures are responsible for the innervation of the Levator scapulae?

A

Innervation: dorsal scapular nerve (C5) and

C3-C4 anterior rami (motor)

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34
Q

Describe the Rhomboid Minor and state what it arises.

A

Rhomboid minor - small,
cylindrical and arises from
ligamentum nuchae, spinous
processes of C7-T1

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35
Q

Origin of the Rhomboid Major :

A

T2 to T5 spinous

processes and supraspinous ligaments

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36
Q

Insertion of the Rhomboid Minor :

A

•Rhomboid minor - Medial scapula

border

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37
Q

Insertion of the Rhomboid Major :

A

•Rhomboid major - Medial scapula

border below rhomboid minor

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38
Q

The action performed by the Rhomboid major and minor :

A

Work together to retract the

scapula to the vertebral column

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39
Q

Which nerve is responsible for the innervation of the Rhomboid major and minor?

A

Dorsal scapular nerve

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40
Q

Name the intermediate muscles.

A
  • Serratus Posterior Superior

* Serratus Posterior Inferior

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41
Q

What is the Serratus Posterior Superior?

A

❑ Two flat muscular sheets that lie in the superior and inferior aspects of the back

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42
Q

Where do the fibres from the Serratus posterior superior and inferior?

A

❑The fibres from Serratus posterior superior and inferior pass outwards from the
vertebral column to attach to the ribs. Referred to as the respiratory group

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43
Q

Origin of the Serratus posterior superior :

A

• Deep to the rhomboid muscles
• Nuchal ligament & spinous process of
C7 to T3
• Fibres descend from vertebral column

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44
Q

Insertion of the Serratus posterior superior :

A

Upper borders of the 2-5 ribs

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45
Q

Action performed by the Serratus posterior superior :

A

Elevates ribs 2-5 and aids deep

Inspiration

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46
Q

Which structure is responsible for the innervation of the Serratus posterior superior?

A

Anterior rami of T2-T5

47
Q

Origin of the Serratus posterior inferior :

A
  • Deep to Lattisimus dorsi
  • Spinous processes of T11 to L2
  • Fibres ascend from vertebral column
48
Q

Insertion of the Serratus posterior inferior :

A

Inferior borders of the 9-12 ribs

49
Q

Action performed by the Serratus posterior inferior :

A

Depresses ribs 9-12 & aid in expiration

50
Q

Which structure is responsible for the innervation of the Serratus posterior inferior?

A

Anterior rami of T9-T12

51
Q

What is the action of a muscle based on?

A

Action of a muscle is based on its origin and
insertion – contraction of the muscle will
pull towards the origin point

52
Q

What do deep muscles include?

A

➢ Extensors and rotators of the head and neck – SPINOTRANSVERSALES: splenius capitus and
splenius cervicis
➢ Extensors and rotators of the vertebral column - erector spinae and transversospinales
➢ Short segmental muscles – interspinales and intertransversarii

53
Q

Which structures are responsible for the innervation of the deep muscles?

A

Posterior rami of spinal nerves

54
Q

What are the deep muscles of the back responsible for?

A

Deep muscles of the back are responsible for keeping the body in the erect
position

55
Q

The erector spinae is the…

A

strongest muscles in the back and take on most of the work.

56
Q

What are the spinotransversales?

A

The spinotransversales are 2 muscles that run from the spinous processes and
ligamentum nuchae vertically upwards and laterally

57
Q

Actions performed the Spinotransversales -Splenius capitus and splenius cervicus :

A

o Together: Extend neck

o Individually: rotate head to one side

58
Q

Origin of the Splenius capitus :

A

Lower ½ Ligmentum Nuchae & spinous

processes of C7 to T3/4

59
Q

Insertion of the Splenius capitus :

A

Mastoid process and

occipital bone of the skull

60
Q

The structures responsible for the innervation of the Splenius capitus :

A

Posterior primary rami of middle cervical nerves (C3-C4)

61
Q

Origin of the Splenius cervicus :

A

Spinous process of T3 to T6

62
Q

Insertion of the Splenius cervicus :

A

Transverse process of C1-C3

63
Q

The structures responsible for the innervation of the Splenius cervicus :

A

Posterior rami of lower cervical nerves

64
Q

What are the Erector Spinae covered by? What are they inferior to?

A

The Erector Spinae are covered by thoracolumbar fascia and serratus post and are inferior to the rhomboids and splenius muscles

65
Q

Where is the iliocostalis located?

A

❑Iliocostalis is the Outermost/laterally placed column of muscles

66
Q

The Longissimus is the…

A

Middle/intermediate column

67
Q

Describe the Longissimus.

A

The longissimus is the Largest of the subdivisions of erector spinae

68
Q

The Spinalis is the…

A

Most medial column

69
Q

Describe the Spinalis.

A

The spinalis is the Smallest of the subdivision

70
Q

ERECTOR SPINAE : Where is the iliocostalis muscle located?

A

The iliocostalis muscle is located laterally within the

erector spinae

71
Q

What is the iliocostalis muscle associated with?

A

It is associated with the ribs, and can be divided into three
parts – lumborum, thoracis, and cervicis

72
Q

What does the Spinalis interconnects?

A

The spinalis interconnects the spinous processes of adjacent vertebrae.

73
Q

Action performed by the Erector Spinae :

A

PRIMARY EXTENSORS of the vertebral column and head.

Acting unilaterally: they bend the vertebral column laterally

74
Q

ERECTOR SPINAE - Origin of the iliocostalis :

A

Common tendinous origin

75
Q

Insertion of the iliocostalis :

A
  • Costal angle of the ribs

* cervical transverse processes

76
Q

The structures responsible for the innervation of the iliocostalis :

A

Posterior rami of the spinal nerves

77
Q

Actions performed by the iliocostalis muscle :

A

o Acts unilaterally to laterally flex the vertebral column.

o Acts bilaterally to extend the vertebral column and head.

78
Q

Erector Spinae :Where is the Longissimus situated?

A

The longissimus is situated between the iliocostalis and spinalis

79
Q

The Longissimus is the…

A

largest of the three columns

80
Q

The longissimus can be divided into three parts, namely :

A

thoracic,

cervicis and capitis.

81
Q

Origin of the Longissimus :

A

Common tendinous origin

82
Q

Insertion of the Longissimus :

A

❑to the lower ribs
❑transverse processes of C2–T12
❑mastoid process of the skull

83
Q

Innervation of the Longissimus :

A

Posterior rami of the spinal nerves

84
Q

Actions performed by the Longissimus :

A

o Acts unilaterally to laterally flex the vertebral
column.
o Acts bilaterally to extend the vertebral column
and head.

85
Q

Where are the transversospinales located?

A

The transversospinales are deep intrinsic muscles are located underneath the erector spinae.

86
Q

The transversospinales are a…

A

Group of short muscles, run obliquely upward and medially from transverse
process to spinous process.

87
Q

There are three major muscles in the transversospinales group, namely :

A

the semispinalis, multifidus and

rotatores.

88
Q

What is the Semispinalis?

A

The semispinalis is the most superficial of the deep intrinsic muscles

89
Q

Origin of the Semispinalis :

A

Transverse processes of C4-T10

90
Q

Insertion of the Semispinalis :

A

❑Spinous processes of C2-T4

❑Occipital bone of the skull

91
Q

The structures responsible for the innervation of the Semispinalis :

A

Posterior rami of the spinal nerves

92
Q

Actions performed by the Semispinalis :

A

Extends and contralaterally rotates the

head and vertebral column.

93
Q

Where is the multifidus situated? Where is it best developed?

A

❑ Beneath semispinalis muscle. Best developed in the

lumbar area.

94
Q

Origin of the multifidus :

A

Sacrum, posterior iliac spine, common
tendinous origin of the erector spinae, mamillary
processes of lumbar vertebrae, transverse processes of
T1-T3 and articular processes of C4-C7.

95
Q

Insertion of the multifidus :

A

Spinous processes of the vertebrae

96
Q

The structures responsible for the innervation of the multifidus :

A

Posterior rami of the spinal nerves

97
Q

The action performed by the multifidus :

A

Stabilises the vertebral column

98
Q

The Rotatores are the…

A

Most prominent in the thoracic region

99
Q

Origin of the Rotatores :

A

Vertebral transverse processes

100
Q

Insertion of the Rotatores :

A

Lamina and spinous processes of the

immediately superior vertebrae

101
Q

The structures responsible for the innervation of the Rotatores :

A

Posterior rami of the spinal nerves

102
Q

The action performed by the Rotatores :

A

Stablises the vertebral column & has a

proprioceptive function

103
Q

What are the 2 groups of segmental muscles innervated by?

A

TWO GROUPS OF SEGMENTAL
MUSCLES - INNERVATED BY THE
POSTERIOR RAMI

104
Q

Origin of the Levatores Costarum :

A

Transverse processes of vertebra C7 - T11

105
Q

Insertion of the Levatores Costarum :

A

The rib below the vertebra of origin.

106
Q

The action performed by the Levatores Costarum :

A

Contraction elevates the ribs

107
Q

Where do the Interspinales pass?

A

Interspinales pass beween adjacent spinous

processes.

108
Q

Where do the Intertransversarius pass?

A

Intertransversarius pass between adjacent

transverse processes.

109
Q

The action performed by the Interspinales and the Intertransversarius :

A

They stabilize the vertebrae during

movements of the vertebral column.

110
Q

Where does muscle strain occur?

A

Low back pain/muscle strain or ruptures
can occur in the back just like they can
anywhere else in the body.

111
Q

What is a muscle strain in the back usually caused by?

A

A muscle strain
(or tear) in the back is usually caused by a
sudden movement or trying to lift
something that is too heavy.

112
Q

Why is low back pain a long time coming?

A

The low back pain however is often a long
time coming on as the muscles in the back
gradually tighten up due to bad posture
and overuse.

113
Q

Why do the muscles of the back become weak?

A

These muscles go into spasm and do not
get enough blood through them resulting
in weakness.