Deep Back Flashcards
What regions of the back is thoracolumbar fascia found?
thoracic, lumbar, sacral
Thoracolumbar fascia is continuous with which two regions?
cervical and gluteal
The thoracolumbar fascia thickens inferiorly, and the thickening is prominent in the ___ region
lumbar
Medial attachments of which two muscles blend into the thoracolumbar fascia?
serratus posterior, latissimus dorsi
The posterior layer of the thoracolumbar fascia covers the rector spinal group with attachment medially to the ___ ____ of the ____ vertebrae, the median sacral crest, and supraspinous ligaments
spinous processes; lumbar
The middle layer of the thoracolumbar fascia attaches medially to the ___ ___ of the ___ vertebrae, superiorly to the lower border of rib XII, and inferiorly to the iliac crest
transverse processes; lumbar
The middle layer of the thoracolumbar fascia is the posterior surface of the ___ ___ muscle
quadratus lumborum
The anterior layer of the thoracolumbar fascia covers the quadratus lumborum on its anterior surface, attaches medially to the ___ ___ of the ___ and ___ vertebrae, superiorly to the lateral arcuate ligament of the diaphragm, and inferiorly to the iliac crest
transverse processes; thoracic; lumbar
All three layers of the thoracolumbar fascia unite laterally and attach to what?
angle of the ribs
Laterally, the thoracolumbar fascia is continuous with the aponeurosis of what muscle?
transversus abdominus
These muscles are broad and flat, lie deep to the trapezius and deep and medial to the levator scapulae. There are two muscles in this group.
Splenius group
What is the action of the splenius group?
extension of the head and neck when contracting bilaterally, rotation of the head and neck when contracting unilaterally (turns face to same side)
Splenius cervicis is the most inferior of the splenius group and is narrower than splenius capitis. What is its origin and insertion?
Origin: spinous processes of T3-T6
Insertion: transverse processes of C1-C3
Splenius capitis is the most superior of the splenius group. What is its origin and insertion?
Origin: spinous processes of C7-T4 and the lower half portion of the ligamentum nuchae
Insertion: lateral third of the superior nuchal line and the mastoid process
This group of muscles are the largest group of the intrinsic back muscles. They are deep to the posterior layer of the thoracolumbar fascia but superficial to the middle layer. Because they lie deep to the splenius muscles in the cervical and upper thoracic regions, these muscles are sometimes called the “intermediate group” of in the intrinsic back muscles. They lie between the spinous processes of the vertebrae medially and the angle of the ribs laterally.
erector spinae muscles
The individual fibers within the erector spinae group span 6-10 vertebral levels. All of the erector spinae muscles originate from what?
a broad common tendon attached to the spinous processes of lumbar vertebrae, and lower thoracic vertebrae, the sacrum, and the iliac crest
What is the most lateral of the erector spinae muscles?
Iliocostalis
Iliocostalis inserts where?
to the angle of the ribs and transverse processes of cervical vertebrae laterally
The Iliocostalis muscle can be divided into three sections,: Iliocostalis lumborum, thoracis, and cervicis. Give the origin and insertion for each one.
Iliocostalis lumborum
origin: the common tendon of the erector spinae
insertion: superolaterally to the angle of lower 6/7 ribs
Iliocostalis thoracis
origin: the angle of lower 6 ribs
insertion: the angle of upper 6 ribs, and the transverse processes of C7
Iliocostalis cervicis
origin: the angle of ribs 3-6
insertion: the transverse processes of vertebrae C4-C6
This erector spinae muscle is medial to iliocostalis and lateral to spinalis. It inserts onto the transverse processes of the thoracic and cervical vertebrae, the ribs lateral to the tubercle, and mastoid process.
Longissmus
The Longissmus can be divided into three sections: Longissmus thoracis, cervicis, and capitis. Give the origin and insertion for each one.
Longissmus thoracis
origin: common tendon of the erector spinae group and the transverse processes of all lumbar vertebrae
insertion: transverse processes of all thoracic vertebrae and ribs 2/3-12
Longissmus cervicis
origin: transverse processes of T1-4/5
insertion: transverse processes of C2-C6 superiorly
Longissmus capitis
origin: transverse processes of C4-T4/5 and articular processes of lower 3/4 cervical vertebrae
insertion: mastoid process
This muscle is the most medial of the erector spinae group
spinalis
Spinals can be divided into three sections: Spinals thoracis, cervicis, and capitis. Give the origin and insertion for each one.
Spinalis thoracis
origin: spinous processes of T10/11-L2
insertion: spinous processes of T1-T8
Spinalis cervicis
origin: lower portion of the ligamentum nuchal and the spinous process of C7
insertion: the spinous process of C2
Spinalis capitis
origin/insertion: not given in handout
What are the actions of the erector spinae group?
erector spinae muscles are extensors of the back when contracting bilaterally
and….
laterally flex the back when contracting unilaterally
This muscle group originates from transverse processes of inferior vertebrae and insert onto spinous processes of superior vertebrae. They are deep to the muscles of the erector spinae.
Transversospinalis group
What are the three muscles that make of the Transversospinalis group and what is their joint action?
semispinalis, multifidis, rotatores
action: bilateral contraction causes extension of the back, while unilateral contraction causes rotation of the torso in the opposite direction
Semispinalis spans 4-6 vertebral levels and is subdivided based on the vertebral region where each section inserts. These subdivisions are thoracis, cervicis, and capitis. Give the origin and insertion for each one.
Semispinalis thoracis
origin: transverse processes T6-T10 inferiorly
insertion: spinous processes of C5-T4 superiorly
Semispinalis cervices
origin: transverse process of T1-T6 inferiorly
insertion: spinous process of C2-C5 superiorly
Semispinalis capitis
origin: transverse processes of T1-T6, C7, and the articular process of C4-C6 inferiorly
insertion: occipital bone between the inferior and superior nuchal lines
What is the unique action of the semispinalis muscles?
bilateral contraction: extension of the neck, and unilateral contraction: rotation of the head
These muscles are deep to the semispinalis muscles. They span two to four vertebral levels, from transverse process inferiorly to spinous process superiorly. They run the entire length of the vertebral column from the sacrum inferiorly to C2 superiorly, but are most pronounced in the lumbar region.
multifidus muscles
Give the Origin, insertion, and action of the multifidus muscles.
origin: sacrum, mamillary processes of lumbar vertabrae, transverse processes of thoracic vertebrae
insertion: base of spinous processes of all vertebrae from L5-C2
action: stabilizer of the vertebral column
These muscles are the deepest of the transversospinal group. They extend form the sacrum to C2, but are most pronounced at the thoracic level. Like multifidus, these muscles are most likely involved in stabilization of the vertebral column.
Rotatores
The rotatores muscles are divided into Rotatores longi and braves. Give the attachments of each one.
Rotatores longi: spans 2 vertebral levels, attaching to the transverse process of one vertebrae and the spinous process of a vertebra 2 levels higher
Rotatores brevis: spans one vertebral level, attaching to the transverse process of one vertebrae and the spinous process of the vertebra above it
There are three segmental back muscles: levatores costarum, interspinales, and intertransversarii. Give the action and attachments for each one.
Levatores costarum
action: elevate ribs
origin: transverse processes of C7-T11
insertion: onto ribs below
interspinales: attach to the spinous process of adjacent vertebrae with the interspinous ligaments
action: stabilize vertebrae during movement
Intertransversarii: attach to the transverse processes of adjacent vertebrae.
action: stabilize vertebrae during movement
Which of the three segmental back muscles are considered “true back muscles”?
interspinales and intertransversarii
In regards to deep back muscles, where does the cervical region receive blood from?
vertebral artery, deep cervical artery, occipital artery, transverse cervical artery, ascending cervical artery
In regards to deep back muscles, where does the thoracic region receive blood from?
posterior intercostal arteries
In regards to deep back muscles, where does the lumbar region receive blood from?
subcostal artery, dorsal branches of lumbar arteries
In regards to deep back muscles, where does the sacral region receive blood from?
lateral sacral arteries
The muscles of the deep back, as well as the skin of the back, are innervated in a segmental pattern by the ___ ____ of spinal nerves.
posterior rami
The ____ _____ is a bilateral structure that lies deep to the simspinalis capitis/spinalis capitis muscles. It is formed by four small muscles which each have a role in extension and rotation of the head and also function to stabilize the upper cervical occipital region
suboccipital triangle
Muscles of the suboccipital region are innervated by dorsal rami C1, usually called the ____ nerve
suboccipital
In regards to muscles of the suboccipital region, give the origin, insertion, and action of obliquus capitis inferior
origin: spinous process of C2
insertion: transverse process of C1
action: unilateral contraction rotates the head to the same side
In regards to muscles of the suboccipital region, give the origin, insertion, and action of obliquus capitis superior
origin: transverse process of C1
insertion: the occipital bone above the inferior nuchal line
action: bilateral contraction extends the head, and unilateral contraction bends the head to the same side
In regards to muscles of the suboccipital region, give the origin, insertion, and action of rectus capitis posterior major
origin: spinous process of C2
insertion: occipital bone below the inferior nuchal line
action: bilateral contraction extends the head, and unilateral contraction rotates the head to the same side
In regards to muscles of the suboccipital region, give the origin, insertion, and action of ectus capitis posterior minor
origin: posterior tubercle of C1 inferomedially
insertion: the occipital bone below the inferior nuchal line superolaterally
action: bilateral contraction contributes to the extension of the head
The blood supply for the muscles of suboccipital triangle is from branches of the ____ and ___ arteries and they are drained by associated veins
vertebral; occipital
Give the contents of the suboccipital triangle:
floor and walls
floor: posterior arch of C1
walls: muscles of the suboccipital triangle
The vertebral artery passes through the suboccipital triangle after exiting the ___ ___ as it travels into the foramen magnum
transverse foramen
The ___ ___ nerve is the medial branch of the dorsal rams of cervical spinal C2 and innervates skin along the posterior part of the scalp to the top of the head
greater occipital
___ is microscopic tearing or overstitching of the muscle fibers
strain
