Lec 3

Question 1

Know the locations of the superior/inferior nuchal line, external occipital protuberance and mastoid process

Question 2

List the muscles of the Deep back Superficial layer

Answer 2

Splenius Cervicis and Splenius Capitis

Question 3

List the MA, PA, DA, N for splenius cervicis and capitis

Answer 3

MA:
- unilaterally laterally flexes head and ipsilateral rotation
- bilaterally extends head and neck

PA: nuchal ligament and SP of C7-T6

DA:
- capitis (goes to cap/head), mastoid process & lateral third of superior nuchal line (fibers go superolateral, slanted one)
- cervicis (straight one doesnt go to head) TP of C1-C4 (just like levator scap)

N: posterior rami of spinal nerves

Question 4

Describe the organization of spinal nerves

Answer 4

• Ventral nerve roots (motor/from CNS) to muscles
• dorsal nerve roots (sensory/from CNS to skin)

they cross over at spinal cord

• ventral rami, nerves leave spinal cord and innervate ventral body wall, superficial back and all limbs
• dorsal rami, innervate skin and deep muscles of back

Question 5

What muscles make up the intermediate layer of the deep back?

Answer 5

Erector spinae group

• iliocostalis
• longissimus
• spinalis

Question 6

MA, PA, DA, N for Erector Spinae group

Answer 6

MA:
- unilaterally; laterally flex vertebral column to the ipsilateral side
- bilaterally extend vertebral column (NO ROT)

PA: SP of last two thoracic and all lumbar vertebra, thoracolumbar fascia/tendon that attaches to scrum and iliac crest

DA:
- iliocostalis; lower rib ANGLES (the medial part where they start to curve i think) and cervical TP
- longissimus; between rib tubercles and angles to thoracic TP (closer medial to spine)
-spinal; upper thoracic SP and to the cranium

N: Dorsal rami of spinal nerves

Question 7

What muscles make up the deep group of deep back muscles?

What is another name for them

Primary movements?

Answer 7

Transversospinalis group

• multifidus
• rotators
• semispinalis

“gutter”

Extend and rotate

Question 8

Rotatores (brevis and longus) MA, IA, SA, N

Answer 8

MA;
- unilaterally; rotate vertebral cloumn to CONTRA side
- bilaterally; extend vertebral column locally

IA: TP of vertebrae (thoracic the best)

SA: SP of lumbar vertebrae all the way through 2nd cervical
(breivs spans 1 vertebrae, longus spans 2)

N: dorsal rami of spinal nerves

Question 9

Multidifi

Answer 9

MA:
- unilaterally; rotate vertebrae to contra side
-bilaterally; extend vertebral column and stabilize during local movements

IA:
- arises from posterior sacrum, TP of T1-3, aponeurosis of erector spinae and articular processes of C4-C7

SA:
- thickest in the lumbar region, SP, located 2-4 segments superior to proximal attachment

N: dorsal rami of spinal nerves

Question 10

Semispinalis

Answer 10

MA: extends the head, neck and thoracici spine, rotates contralaterally

IA: TP of C4-T12

SA: goes to occipital bones and SP in thoracic and cervical regions, spans 4-6 segments

N: *cervical dorsal rami

Question 11

Name the four deep suboccipital muscles

Answer 11

rectus capitis posterior major, rectus capitis posterior minor, oblique capitis inferior, oblique capitis superior

Question 12

Name the muscles that make up the boundaries of the triangle

Answer 12

Superiomedial boundry: rectus major

Superiorlateral boundry: obliquus superior

inferiorlateral boundary: obliquus inferior

Question 13

What is the MA of the suboccipitals

Answer 13

Rectus major, rectus minor and obliquus superior: rock and tilt head into extension (these three attach to the head)

Rectus major, rectus minor and obliquus inferior: rotate head to same side (these three run slightly laterally)

obliquus capitis superior: laterally flex the head to same side

Question 14

Rectus capitis posterior major

Origin and Insertion

Answer 14

Origin: spinous process of C2 (axis)

Insertion: lateral nuchal line

Question 15

Rectus capitis posterior minor

Origin and Insertion

Answer 15

Origin: Posterior tubercle of C1 (atlas)

Insertion: medical nuchal line

Question 16

Obliquus capitis inferior

Origin and Insertion

Answer 16

Origin: SP of C2 (axis)

Insertion: TP of C1 (atlas)

Question 17

Obliquus capitis superior

Origin and Insertion

Answer 17

Origin: TP of C1

Insertion: occipital bone between nuchal lines

Question 18

Important contents of subocciptial triangle

Answer 18

suboccipital nerve
vertebral artery

Question 19

another name for suboccipital nerve

Answer 19

posterior rami of C1

Question 20

what muscle does the greater occipital nerve innervate? C2

Answer 20

semispinalis capitis

Question 21

what muscle also does head rotation that isnt specifically listed under it

Answer 21

longissimus capitis does ipsilateral rotation

Question 22

Suboccipital neuralgia

Answer 22

pain in the upper neck or back of the head and back of eyes

compression or irritation of the greater occipital nerve (C2). least occipital nerve (c3) or other nerves

Question 23

Suboccipital nerves innervation big picture

Answer 23

C1 is the only one that goes to MUSCLEs of triangle

greater occipital, lesser occipital and anterior rami of nerve C3-C7 go to SKIN

Question 24

Suboccipital origin, course and distribution

Answer 24

posterior ramus of spinal nerve C1

runs between cranium and C1 to reach suboccipital triangle

distribution - muscles of triangle

Question 25

greater occipital origin, and distribution

Answer 25

posterior ramus of spinal nerve C2

skin over the neck and occipital bone

Question 26

lesser occipital nerve origin and distribution

Answer 26

anterior rami of spinal nerves C2-C3

skin of superior posterolateral neck and scalp posterior to the external ear

Question 27

posterior rami nerves C3-C7 origin and distribution

Answer 27

posterior rami of spinal nerves c3-c7

intrinsic muscles of back and overlying skin adjacent to vertebral column