Deep Back and Suboccipital Triangle

Question 1

function of extrinsic muscles of back

Answer 1

move limbs and perform thoracic proprioception

Question 2

Function of intrinsic muscles of back

Answer 2

support upright posture and allow movements of the vertebral column, also perform proprioception

Question 3

Intermediate extrinsic muscles include

Answer 3

serratus posterior and serratus inferior

Question 4

serratus posterior and inferior function as

Answer 4

either superficial respiratory muscles or proprioceptive

Question 5

extrinsic back muscles are innervated by

Answer 5

CNXI (accessory nerve)

branches of brachial plexus (anterior rami)

Question 6

intrinsic back muscles are innervated gby

Answer 6

posterior rami of spinal nerves

Question 7

function of spenius capitis and splenius cerfvicis

Answer 7

unilaterally flex neck and rotate head to ipsilateral side

bilaterally extend head

Question 8

categories of intrinsic muscles of the back

Answer 8

splenius muscles
erector spinae group
transversospinalis group

Question 9

function of erector spinae m

Answer 9

bilaterally: extend vertebral column and head
unilaterally: laterally flex vertebral column - sidebending

Question 10

muscles considered erector spinae m

Answer 10

iliocostalis (lomburum, thoracis, cervicis)
Longissimus (thoracis, servicis, capitis)
Spinalis (thoracis, cervicis, capitis)

Question 11

transversospinalis m function

Answer 11

extend, rotate, stabilize segments of the spinal column

deepest layer - occupy trench between transverse and spinous processes

Question 12

transversopinalis muscle include

Answer 12

semispinalis (most superficial, thoracis, cervicis, capitis)
multifidus (middle, lumbar)
rotatores (deepest, thoracic)

Question 13

multifidus m

Answer 13

middle layer of transversospinalis m
short, triangular bundles
stabilize vertebrae during location movements of vertebral column

Question 14

Roratores m

Answer 14

deepest layer of rotator muscles
stabilize vertebrae and assist with local extension and rotatory movements
might be involved in proprioception

Question 15

minor deep layer/ segmental muscles include

Answer 15

interspinalis m - aid in extension/rotation
intertransversarii m - aid in lateral flexion, bilateral stabilizers
levatores costarum m - elevate ribs, assist in respiration/lateral flexion

Question 16

posterior rami of spinal nerves innervate

Answer 16

deep back muscles

Question 17

back sprain definition

Answer 17

injury to ligamentous tissue, or ligament attachment to bone
no dislocation or fracture
excessive extension or rotatio n

Question 18

back strain definition

Answer 18

common injury due to overly strong contraction
stretching/tearing of fibers
typically erector spinae muscles

Question 19

dislocation of cervical vertebrae

Answer 19

less tightly interlocked than other vertebrae making them more prone to dislocation - if severe enough can cause damage to spinal cord

Question 20

suboccipital region refers to

Answer 20

muscle compartment deep to superior part of posterior cervical region
deep to trapezius, splenius, semispinalis m
pyramidal space inferior to external occipital prominence

Question 21

atlas

Answer 21

c1 - contributes its body to C2 (or axis) as dens (therefore it lacks a vertebral body)

Question 22

joints of C1 and C2

Answer 22

superior/articular facets
lateral atlantoaxial joint
median atlantoaxial joint (the one that allows you to say no)

Question 23

ligament that holds the dens in place

Answer 23

the transverse ligament

Question 24

contents of suboccipital triangle

Answer 24

rectus capitis posterior major m
rectus capitis posterior minor m
obliquus capitis superior m
obliquus capitis inferior m

(Vertebral a and/or occipital a
Posterior rami of C1 (suboccipital nerve) innervation )

Question 25

obliquus capitis inferior m is unique to the other muscles of the suboccipital triangle in that

Answer 25

it does not directly contact the occipital bone | it makes contact with the atlas

Question 26

suboccipital muscles perform what function

Answer 26

extension (and one does lateral rotation)

Question 27

suboccipital n serves

Answer 27

muscles of the suboccipital triangle | branch of psoterior ramus of spinal nerve C1

Question 28

greater occipital n supplies

Answer 28

skin over neck and occipital bone | branch of posterior ramus of spinal nerve C2

Question 29

Lesser occipital nerve supplies

Answer 29

Skin of superior posterolateral neck and scalp posterior to external ear (Branch of anterior rami of spinal nerves C2-C3)

Question 30

posterior rami nerves C3-C7 supplies

Answer 30

intrinsic muscles of back and overlying skin adjacent to vertebral column

Question 31

vascular supply to suboccipital region

Answer 31

vertebral artery first branch off of the subclavian a. ascends through the transverse foramina of C7->C2 perforate the dura and pass through the foramen magnum will ultimately join together to form basilar arteries

Question 32

Soft tissue injury characteristics

Answer 32

acceleration/deceleration syndrome - head is forced forward then snaps back - whiplash injury typically involves damage to soft tissue, may also involve fractures

Question 33

Vertebral artery impingement

Answer 33

reduced blood supply to brainstem when vertebral a is blocked/narrowed with movement at atlantoaxial joint caused by trauma, cervical spine abnormalities, CV disease Patients present with dizziness/vertigo, confusion

Question 34

Fracture of atlas

Answer 34

caused by sudden, forceful compression of C1 diving accidents, roll-over car accidents) may result in quadraplegia

Question 35

Hangman's fracture (C2 fracture)

Answer 35

fracture of pars interarticularis (where are inferior and posterior articular facet comes together) caused by hyperextension of the neck (being hanged) severe cases of acceleration/deceleration syndrome can completely sever the spinal cord

Question 36

fracture of dens (C2 fracture) 3 types

Answer 36

most common at base - caused by horizontal blow to the head type 1 - fracture of upper odontoid process type 2 - fracture of base of odontoid process type 3 - through odontoid process and into lateral masses of C2

Question 37

Occipital neuralgia

Answer 37

irritation of greater occipital and lesser occipital nerves caused by osteoarthirtis of cervical vertebrae, neck injury, muscle spasms in neck, tumors, infection, gout, diabetes patients present with burning/stabbing pain triggered by neck movement, scalp tenderness, pain behind eyes, headache

Question 38

muscles responsible for flexion of head (5)

Answer 38

longus capitis, rectus capitis anterior, anterior portion of sternocleidomastoid, suprahyoid and infrahyoid

Question 39

muscles responsible for extension of head (6)

Answer 39

``` rectus capitis posterior major obliquus capitis superior minor obliquus capitis superior splenius capitis longissimus capitis trapezius ```

Question 40

muscles responsible for lateral flexion of head (5)

Answer 40

``` sternocleidomastoid obliquus capitis superior rectus capitis lateralis longissimus capitis splenius capitis ```