Introduction to Spine, Back, and Abdomen Flashcards
QUADRATUS LUMBORUM
O: Iliac crest, iliolumbar ligament, tips of vertebrae L1-L5
I: 12th rib
A: Fix 12th rib during inspiration, depress 12th rib for forced inspiration, ipsilateral flexion of trunk
N: Lumbar plexus
PSOAS MAJOR
O: Bodies, transverse processes, IV discs of T12-L5
I: Lesser trochanter
A: Flexion of thigh at hip
N: Lumbar plexus
ILIACUS
O: Iliac fossa, sacral ala, anterior sacroiliac ligament
I: Lesser trochanter
A: Flexion of thigh at hip
N: Femoral nerve
TRANSVERSUS ABDOMINIS
O: Lower 6 ribs & costal cartilages, thoracolumbar fascia, iliac crest, inguinal ligament
I: Pubis and linea alba
A: Compression of abdomen
N: Lower 6 thoracic + LI (iliohypogastric & ilioinguinal) ns
RECTUS ABDOMINIS
O: Pubic symphysis and crest
I: Xiphoid process, 5th - 6th - 7th costal cartilages
A. Flexion and compression of abdomen
N: Lower 6 thoracic ns
EXTERNAL OBLIQUES
O: Lower 8 ribs
I: Anterior 1/2 of iliac crest, pubic tubercle, linea alba
A: Compression of abdomen, flexion of trunk, ipsilateral flexion of trunk, contralateral rotation
N: Lower 6 thoracic + LI (iliohypogastric & ilioinguinal) ns
INTERNAL OBLIQUES
O: Thoracolumbar fascia, iliac crest, inguinal ligaments
I: Lower 3 ribs, linea alba, pubis
A: Compression of abdomen, flexion of trunk, ipsilateral flexion of trunk, ipsilateral rotation
N: Lower 6 thoracic + LI (iliohypogastric & ilioinguinal) ns
Superior border of the Abdominopelvic Cavity
Diaphragm
Inferior border of the Abdominopelvic Cavity
Continuous with the pelvic cavity
Deep Layer (Intrinsic) - INTERTRANSVERSARII
O: Transverse process I: Transverse process of vertebra above A. Bilateral --> stabilize back Unilateral --> lateral flexion of back
Deep Layer (Intrinsic) - LEVATOR COSTARUM
O: Tips of transverse processes C7-T11
I: Ribs between tubercle & angle
A: Elevate ribs “inspiratory”
Deep Layer (Intrinsic) - ROTATORS
O: Transverse processes of vertebrae
I: Spinous process of 2nd vertebra above
A:
Bilateral –> back extension and stabilization
Unilateral –> contralateral rotation of back
Deep Layer (Intrinsic) - INTERSPINALES
O: Superior border of spinous process of cervical and lumbar vertebrae
I: Inferior border of spinous process of vertebra above
A: Back extension and stabilization
Deep Layer (Intrinsic) - MULTIFIDUS
O: Posterior sacrum, sacroiliac ligaments, iliac crest, posterior superior iliac spine, articular processes of lumbar vertebrae, transverse processes of thoracic & articular processes of cervical vertebrae C7 to C4
I: Whole length of spinous process of 2nd to 4th vertebra above
A:
Unilaterally –> contralateral rotation of spine
Bilaterally –> spine stabilization
Deep Layer (Intrinsic) - Transversospinales and Semispinalis
O. C4-T10 transverse processes
I. Spinous process of 4th - 6th vertebra above, occipital bone
A.
Bilaterally –> head extension
Unilaterally –> contralateral rotation of the head
Transversospinales is made up of?
Semispinalis + Multifidus + Rotators
Semispinalis is made up of?
Capitis (muscles attached to the head) + cervicis + thoracis
Intermediate Layer (Intrinsic) - ILIOCOSTALIS
O: Thoracolumbar fascia, sacroiliac ligament, posterior sacrum, posterior iliac crest, spines and supraspinous ligaments of lumbar vertebrae
I: Costal angles, transverse processes of cervical vertebrae
A. Chief back extensors
Bilateral –> back and head extension
Unilateral –> lateral flexion
Intermediate Layer (Instrinsic) - LONGISSIMUS
O: Thoracolumbar fascia, sacroiliac ligament, posterior sacrum, posterior iliac crest, spines and supraspinous ligaments of lumbar vertebrae
I: Ribs (between angle and tubercle) and transverse processes of thorax and cervix, mastoid process
A. Chief back extensors
Bilateral –> back and head extension
Unilateral –> lateral flexion
Intermediate Layer (Instrinsic) - SPINALIS
O: Thoracolumbar fascia, sacroiliac ligament, posterior sacrum, posterior iliac crest, spines and supraspinous ligaments of lumbar vertebrae I: Spines of thorax and cervix A. Chief back extensors Bilateral --> back and head extension Unilateral --> lateral flexion
Superficial Layer (Instrinsic) - SPLENIUS CERVICIS
O. T3-T6 spinous processes
I. CI-C4 transverse processes
A. Head extension bilaterally; ipsilateral rotation and flexion
Superficial Layer (Intrinsic) - SPLENIUS CAPITIS
O. Nuchal ligament, C7-T4 spinous processes
I. Mastoid process & occipital bone
A. Head extension bilaterally; ipsilateral rotation and flexion
What are EXTRINSIC muslces?
They are located posterior to the vertebral column and are innervated by anterior rami of spinal nerves.
What are INTRINSIC muscles?
They are located posterior to the vertebral column and innervated by posterior rami of spinal nerves.
What are the functions of INTRINSIC muscles?
To maintain posture and move the vertebral column.
List Superficial Extrinsic muscles and what they do.
Trapezius (CN-11) Latissimus dorsi Rhomboid major Rhomboid minor Levator scapulae
Move upper limb (mainly)
Name the Intermediate Extrinsic muscles and what they are.
Serratus posterior superior
Serratus posterior inferior
Respiratory muscles
What is a dermatome?
The area of the skin that provides sensory input to the CNS via one pair of spinal nerves or the trigeminal (V).
What is a myotome?
The group of muscles supplied by a single nerve root. Map of general somatic motor fibers.
SOMATIC NERVOUS SYSTEM - Motor innervation
Skeletal muscles
SOMATIC NERVOUS SYSTEM - Sensory innervation
Skin, joints, and muscles
Somatic vs. Autonomic
Somatic
Motor –> Skeletal muscle (voluntary nervous system)
Sensory –> Sensations from skin/joints
Autonomic
Motor –> Smooth & cardiac muscles, and glands (involuntary NS)
Sensory –> Viscera & blood vessels
Central vs. Peripheral
CNS = Brain and spinal cord
- Integrate, coordinate incoming/outgoing signals; higher mental functions
PNS = Nerve fibers and nerve cell bodies outside spinal cord
- 12 pairs of cranial nerve + 31 pairs of spinal nerves
- Conduct impulses to/from CNS
What makes up a long bone?
Epiphysis, Diaphysis, and Metaphysis
Describe the Epiphysis.
Enlarged end, strengthen joints, attachment site for tendons and ligaments
Describe the Diaphysis.
Elongated, cylindrical shaft
Describe the Metaphysis.
Region between diaphysis and epiphysis. Contains epiphyseal (growth) plate.
Endosteum
- Covers most internal surfaces of bones
- Contains osteoprogenitor cells, osteoblasts, and osteoclasts
- Active in bone remodeling, growth, fracture repair
Periosteum
- Covers external surfaces of bones, except where articular cartilage does
- Dense irregular connective tissue
- Acts as anchor for blood vessels and nerves
- Contains osteoprogenitor cells and osteoblasts
- Active in remodeling, growth, fracture repair
Articular cartilage
Thin layer of hyaline cartilage covering the epiphysis and reduces friction and absorbs shock in moveable joints.
Medullary Cavity
Hollow, cylindrical space in diaphysis. In adults, it contains yellow bone marrow.
*Medullary cavity in infants contains spongy bone and filled with red bone marrow.
Osteoprogenitor cells
Mesenchymal stem cells in endosteum and periosteum. Produce more stem cells and osteoblasts.
Osteoblasts
Form bone matrix (secrete as organic osteoid)
Osteocytes
Reside in lacunae. Maintains matrix and detect mechanical stress on a bone.
Osteoclasts
Large, multinuclear cells that dissolve bone matrix (osteolysis), releasing CALCIUM
- Have ruffled border
- Often located in a resorption “Howship” lacuna
- Secrete hydrochloric acid and enzymes that dissolve matrix
Two Patterns of Bone Development
Intramembranous and Endochondral ossification
Intramembranous ossification
“Inside membrane”
Develops from mesenchymal membrane and produces flat bones of the skull, some facial bones, mandible, and center of clavicle
Endochondral ossification
“Within the cartilage”
Begins with hyaline cartilage model and produces majority of bones in the body.
Functions of Bone Tissues
- Support and protection of more delicate organs
- Movement: attachment site for muscles
- Hemopoiesis: blood cell production in red bone marrow (to make blood)
- Storage of mineral and energy reserves: calcium and phosphate; lipids stored in yellow marrow
What are joints?
Where a bone meets another bone, cartilage, or teeth
What are the 3 classification of joints by function?
Synarthrosis (immobile joint), amphiarthrosis (slightly mobile), diarthrosis (freely moveable)
What are the 3 classification of joints by structure?
Fibrous, cartilaginous, and synovial
Types of Synovial Joints (Diarthrosis)
Plane joints, ball-and-socket joints, saddle joints, hinge joints, condylar (ellipsoid) joints, and pivot joints
Types of Muscle Tissues
Skeletal, cardiac striated, and smooth
Skeletal muscle tissue
- Moves bones and other structures
Cardiac striated muscle tissues
Forms walls of the heart and adjacent parts of the great vessels
Smooth muscle tissues
Forms part of the walls of most vessels and hollow organs, moves substances through viscera, controls movement through blood vessels
How are muscles named?
Function, bones which they are attached to, position (location), length, relative size, number of attachments, and shape
Prime mover (agonist)
Main muscles producing a specific movement
Fixator
Provide proximal fixation
Synergist
Complement the action of the agonists by preventing movements at unwanted joints
Antagonist
Oppose the agonists
Isotonic (Phasic)
Length change
Concentric vs. Eccentric (Phasic)
Concentric = shortening Eccentric = lengthening
Isometric (Phasic)
Same length with muscle tension above the regular muscle tone
Tonic
Slight contraction to produce muscle tone to maintain body postures
Reflexive (involuntary)
Respiratory movement and muscle reflex
Vertebral column is composed of ____ bones.
26
How many individual vertebrae are there?
24
What are the 3 sections of the vertebral column?
Cervical (7), Thoracic (12), and Lumbar (5)
Two inferior bones that are fusions of several vertebrae
Sacrum (5 fused vertebrae) and Coccyx (4 fused vertebrae - tailbone)
Functions of Vertebral Column
Protection, Support, Axis of movement, and Posture and locomotion
Four spinal curvatures present in adult
Cervical, Thoracic, Lumbar, and Sacral
Primary curves that appear in fetal development
Thoracic and sacral curvatures
Secondary curves appear at 3-4 months of age
Cervical and lumbar curvatures (help shift trunk’s weight over the legs)
What are the causes of an abnormal curvature?
Congenital, trauma, behavioral, and age-related causes
What are the impacts on occupational performance?
Balance and ROM
Vertebral body
Supports body weight, muscle, and ligament attachments
Vertebral arch
Protection of spinal cord, muscle, and ligament attachments
What makes up the vertebral arch?
2 pedicles, 2 laminae, superior and inferior articular processes, spinous process, transverse process
Vertebral foramen
Vertebral canal houses: Spinal cord and meninges, fat, spinal nerve roots, and vessels
Intervertebral foramen
Exit the spinal
Which region of the vertebrae allows the most movement?
Cervical - allows for most mobility/degrees of movement
What region in the vertebrae allows the least movement?
Thoracic - stabilization to protect vital organs, least movement
Describe Atlas C1.
No body, no spinous process, articulates w/ skull at antlanto-axial joint
Describe Axis C2.
“Dens” projected superiorly from the body antlanto-axial and articulates with C1 at atlanto-axial joint
What is the prominent difference between the male and female coccyx?
Females have a flatter coccyx to allow for passage of the baby through birth canal. Females also have wider sacrums than males.
Atlanto-occipital (Condyloid synovial)
Bones: superior articular process of CI with occipital condyles
Movement: mainly head flexion/extension, limited side to side flexion and rotation
Ligaments (Ligs): anterior and posterior atlanto-occipital membranes
Atlanto-axial
2 lateral atlanto-axial joints –> plane synovial
1 median atlanto-axial joints –> pivot synovial
Bones: C1 and C2
Movement: Rotation side-to-side
Ligaments:
Cruciate ligament: transverse band (acts as an annular ligament); longitudinal band
Alar ligaments R/L, Apical ligament, Tectorial membrane (the upper part of the posterior longitudinal ligament. It covers the cruciate, alar, and apical ligaments.
Intervertebral Joints (IV)
Cartilaginous/symphysis
Structure:
a. Anulus fibrosis –> fibrocartilage
b. Nucleus pulposus –> 85% water at birth, dehydrates as we age
Ligs:
a. Anterior longitudinal ligament
b. Posterior longitudinal ligament
Functions: act as shock absorbers and permit movement between vertebral bodies
Uncovertebral “Luschka’s” Joint
C3-C6
Between uncus and inferiorlateral surface of the superior vertebral body
Covered with cartilage, filled with fluid
Limit lateral flexion
Zygapophysial “Facet” Joints
Bones: articular processes
Synovial plane joints
Articular joint capsule
Allow for spinal movement
Ligaments of the Spine
Anterior longitudinal Posterior longitudinal Ligamenta flava Interspinous Supraspinous Nuchal Intertransverse
Function of the Anterior Longitudinal Ligament
Maintains the stability of the IV joints and limits extension of the vertebral column
Function of the Posterior Longitudinal Ligament
Helps prevent hyperflexion of the vertebral column and posterior herniation of the IV discs
Function of the Ligamenta flava
Help preserve posture and assist with straightening the column after flexing
Function of the Interspinous ligament
To limit flexion (bending forwards) through restricting separation of the spinous processes of the vertebral column.
Function of the Supraspinous ligament
Helps maintain the upright position of the head.
Function of the Nuchal ligament
Limits forward flexion of the head and the cervical spine
Function of the Intertransverse ligament
To limit lateral flexion of the spine.
