Back Muscles and Ligaments Flashcards
Ligament fxns
- strengthen joints
2. limit vertebral movement
Anterior and posterior altanto-occipital membrane
ligament around occiput and C1
a. around vertebral arches and foramen magnum
b. resists rotation
Cruciate ligament
supports atlanto-axial joint
- 3 parts
a. superior longitudinal band
b. transverse lig of atlas (sling for dens process)
c. inferior longitudinal band - prevents post. displacement of dens and ant displacement of atlas
alar ligament
attaches dens to foramen magnum
1. prevents excessive rotation
Anterior longitudinal ligament
C1 to sacrum
- strong and fibrous
- ant aspect of vert bodies and IVD
- well dev in lordotic regions
- resists (hyper)extension
Posterior longitudinal ligament
C2 to sacrum
- narrow, weaker band
- post aspect of vert bodies and IVD
- less dev in lumbar
- weakly resists hyperflexion, prevents herniation
Ligamentum flavum
- adjacent lamina in post vert canal
- strongest in thoracolumbar region
- weakest in med cervical
- limits flexion, prevents separation of laminae
interspinous ligaments
- between spinous processes
- weak and membranous
- limits flexion
Supraspinous ligaments
C7 to sacrum
- tips of spinous processes
- merges w/ nuchal ligament
- inc. SA for muscle attachment
Nuchal Ligament
Skull to C6
- tips of spinous processes
- merges w/ supraspinous lig.
- inc. SA for muscle attachment
Intertransverse ligaments
- connect transverse processes
2. limits lateral flexion
Superficial extrinsic muscles
- Trapezius
- latissmus dorsi
- levator scapulae
- rhomboid major
- rhomboid minor
* Fxn: motor to limbs
Trapezius
- Fxn: moves shoulder all direction, steadies shoulder, unilateral flexion
- Prox: medial 1/2 nuchal line, ext. occip protuberance, C7 - T12 spinous processes
- Distal: lat 1/3 clavical, acromion, scapular spine
- Innervation: cranial XI (accessory n.), C3 and C4 sensory
- supply: transverse cervical artery
Latissmus dorsi
- Fxn: shoulder (extend, adduct, rotate), pulls body toward arms
- Prox: T7-T12 spinous processes, thoracolumbar fascia, inf. scapular angle, ribs 9-12
- Distal: floor of intertubercular groove (humerus)
- Innervation: Thoracodorsal n. (C6-C8)
- supply: thoracodorsal a.
Levator scapulae
- Fxn: elevates scapula, inf rotation, unilat flexes neck
- Prox: C1-C4 transverse processes
- Distal: superior angle scapula
- Innervation: dorsal scapular (C5) and C3 and C4
- Supply: dorsal scapular a.
Rhomboid minor
- Fxn: retract scapula, inf, rotation, steadies scapula, unilat flexion
- Prox: C7-T1 sp. process
- Distal: medial border scapula
- Innervation: dorsal scapular (C5)
- Supply: dorsal scapular a.
Rhomboid major
- Fxn: retract scapula, inf, rotation, steadies scapula
- Prox: T2-T5 sp. process
- Distal: medial border scapula
- Innervation: dorsal scapular (C5)
- Supply: dorsal scapular a.
Intermediate Muscles
- Serratus posterior superior
- serratus posterior inferior
* Fxn: proprioception
serratus posterior superior
- Fxn: proprioception
- Prox: ligamentum nuchae, C7-T3 sp. processes
- Distal: ribs 2-4
- innervation: ant. rami T2-T5
- supply: imtercostal a.
Serratus posterior inferior
- Fxn: proprioception
- Prox: T11-L2 sp. processes
- Distal: ribs 8-12
- innervation: ant. rami T9-T12
- supply: imtercostal a., subcostal, and lumbar a.
Deep Back Muscles
- spinotansversales
- erector spinae
- Transversospinales
Spinotransversales
- splenius cervicis
2. splenius capitis
Splenius cervicis
- bilateral extension head, unilateral flex and rotate neck
- Prox: T3-T6 sp. process
- Distal: C1-C3 transverse process
- innervation: post. rami spinal n.
- supply: occipital, transverse cervical, intercostal
Splenius capitis
- bilateral extension head, unilateral flex and rotate neck
- Prox: C7-T4 sp. process, ligamentum nuchae
- Distal: mastoid process, lateral 1/2: sup. nuchal line
- innervation: post. rami spinal n.
- supply: occipital, transverse cervical
Iliocostalis
(lumborum, thoracis, cervicis)
- Fxn: bilateral extension, unilateral flexion
- Prox: broad tendon from iliac, sacrum, lumbar sp. process, lower thoracic sp. process
- Distal: angle of lower ribs, cervical transverse process
- Innervation: segmental post. rami spinal n.
- supply: segmentally - deep cervical, intercostal, subcostal, lumbar
Erector Spinae
- Iliocostalis
- Longissmiss
- Spinalis
Longissmiss
(thoracis, cervicis, capitis)
- Fxn: bilateral extension, Unilateral flex spine
- Prox: broad tendon iliac, sacrum, lumbar sp. processes
- Distal: thoracic and cervical transverse processes, mastoid process
- Innervation: segmental post rami spinal n
- Supply: segmentally- intercostal, deep cervical, subcostal, lumbar
Spinalis
(Thoracis and cervicis)
- Fxn: bilateral extension, unilateral flexion spine
- Prox: broad tendon iliac, sacrum, lumbar sp. process, Lower thoracic sp. process
- Distal: thoracic and cervical sp. process
- Innervation: segmental post. Rami spinal n.
- Supply: segmentally- deep cervical, intercostal, subcostal, lumbar
Transversospinales
- Semispinales
- Multifidus
- Rotatores
Semispinales
(Thoracis, cervicis, capitis)
- Fxn: bilateral extension, unilateral flexion same side, unilateral rotation opp side
- Prox: C4-C6 articulatory process, T7-T12 transverse processes
- Distal: occipital, sp. process of superior vertebrae (4-6 segments)
- Innervation: segmental post. Rami spinal n.
- Supply: segmentally - deep cervical, intercostal, subcostal, lumbar
Multifidus
- Fxn: bilateral spine extension, unilateral flexion same side and rotate opp side
- Prox: sacrum, ilium, mammillary, transverse and articulatory processes
- Distal: C2 sp. process, sp. processes superior vertebrae (2-4 segments)
- Innervation: segmental post. Rami sp. n
- Supply: segmentally - deep cervical, intercostal, subcostal, lumbar
Suboccipital muscles
- Obliquus capitis superior
- Obliquus capitis inferior
- Rectus capitis posterior major
- Rectus capitis posterior minor
Obliquus capitis inferior
- Fxn: bitaleral extension head, unilateral rotation same side
- Prox: C2 sp. process
- Distal: C1 transverse process
- Innervation: suboccipital n. (Post. Rami C1)
- Supply: vertebral and occipital a.
Deep segmental muscles
- Interspinales
- Intertansversarii
- Elevators costarum
Interspinales
(Cervicis, Thoracis, lumborum)
- fxn: extend spine
- Prox and distal: sp. processes adjacent vertebrae C1-L5
- Innervation: post. Rami sp. n.
- Supply: segmentally - deep cervical, intercostal, subcostal, lumbar
Intertranservsarii
(Cervicis, thoracis, lumborum)
- Fxn: bilateral stability, unilateral bending same side
- Prox and distal: transverse processes adjacent vertebrae C2-L5
- Innervation: post. And ant. Rami spinal n.
- Supply: segmentally - deep cervical, intercostal, subcostal, lumbar
Levatores costarum
(Longus and brevis)
- Fxn: bilateral extension and elevates ribs, unilateral rotation flex same side, rotation
- Prox: C7-T11 transverse processes
- Distal: 2 ribs below
- Innervation: post. Rami sp. n.
- Supply: deep cervical, intercostal, subcostal, lumbar
Rectus capitis posterior minor
- Fxn: bilateral extend head, unilateral rotate same side
- Prox: C1 post. Tubercle
- Distal: medial inferior nuchal line
- Innervation: suboccipital n. (Post. Rami C1)
- Supply: vertebral and occipital a.
Rectus capitis posterior major
- Fxn: bilateral head extension, unilateral rotation same side
- Prox: C2 sp. process
- Distal: lateral inferior nuchal line
- Innervation: suboccipital (post. Rami. C1)
- Supply: vertebral and occipital a.
Obliquus capitis superior
- Fxn: bilateral head extension, unilateral tilts same side and rotates opp side
- Prox: C1 transverse process
- Distal: lateral inferior nuchal line
- Innervation: suboccipital n. (Post. Rami C1)
- Supply: vertebral and occipital a.
Rotatores
(Longus and brevis)
- Fxn: bilateral extension, unilateral flex same side and rotate opp side
- Prox: T1-T12 transverse processes
- Distal: between laminate and sp. process of superior vertebrae (1-2 segments)
- Innervation: segmental post. Rami spinal n.
- Supply: segmentally- deep cervical, intercostal, subcostal, lumbar
Back sprains
Ligament injury w/o fracture or dislocation
Back strains
Tendon/muscle injury w/o fracture or dislocation
1. Erector Spinae muscles
Back spasms
Response to injury or inflammation
1. Sudden, involuntary contractions
Occipital neuralgia
Headache w/ throbbing, electric pain
- Radiates from upper cervical region -> posterolateral scalp
- Irritation/compression of nerves