Lecture 5: Muscles of back Flashcards

1
Q

Name the 2 categories of back muscles

A

Extrinsic
Intrinsic

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2
Q

Describe extrinsic muscles of back

A

Superficial muscles

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3
Q

Describe extrinsic muscles of back - general proximal attachments

A

On axial Skeleton
But distal attachments may be in upper limb = move into limb
Leave axial skel

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4
Q

Describe extrinsic muscles of back - primary function

A

Movement of upper limb

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5
Q

Describe extrinsic muscles of back - motor innervation

A

Ant rami of spinal nerves and CN XI

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6
Q

Describe intrinsic muscles of back

A

Deeper layers
Deep to extrinsics

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7
Q

Describe intrinsic muscles of back - general attachments

A

On vertebrae and or ribs
= attachments limited to axial Skeleton

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8
Q

Describe intrinsic muscles of back - primary functions

A

Movement and support fo vertebral column

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9
Q

Describe intrinsic muscles of back - motor innervation

A

Post rami of spinal nerves

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10
Q

Describe first layer of extrinsic = name layers

A

Most superficial= trapezius, latissimus dorsi

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11
Q

What do traps look like

A

diamond shape

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12
Q

Proximal attachments trapezius

A

Axial = from skull = external occipital protuberance (bump on skull)
nuchal ligament and
supraspinous ligament along spinous processes of c7 to t12

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13
Q

distal attachments trapezius

A

Scapula and lateral 1/3 of clavicle (wraps around)

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14
Q

Innervation trap

A

Cranial nerve xi = spinal accessory nerve

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15
Q

Function as trap

A

Primarily upper limb mover
When axial skel and skull fixed = trap moves scapula relative to rib cage

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16
Q

Trap function as back/neck muscle = when scapula fixed

A

Bilateral = next extension (head and neck bc crosses Altanto occipital joint)
Unilateral = isplateral flexion and contra lateral axial rotation of head and neck

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17
Q

What does lat mean

A

Broadest of the back

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18
Q

Is whole of lat completely visible

A

NOOO
Superior portion covered by trapezius

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19
Q

Proximal axial attachments of latissimus Dorsi

A

T7-t12 spinous processes
Thoracolumabr fascia - via aponeurosis
Ilium attachment by aponeurosis

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20
Q

Distal limb attachments of latissimus Dorsi

A

Intertubercular groove of humerus = crosses shoulder joint

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21
Q

Describe function of lat as back muscle

A

Bilateral = thoracic spine extension
Unilateral = ipsilateral lateral flexion of lumbar spine primarily

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22
Q

What is thoracolumbar fascia

A

Complex multi layered ct structure composed to fascia and aponeuroses of back muscles = epimysium, deep fascia and aponeurosis of external muscles

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23
Q

Where does tlf extend

A

Ilium/sacrum to neck

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24
Q

What is tlf composed of

A

Deep fascia surrounding intrinsic back muscles and aponeuroses of some extrinsic muscles - including lats

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25
Q

What happens to tlf in lumbar region

A

Separates intrinsic back muscles from posterior abd wall muscles = psoas and quadratus lumborum

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26
Q

Generally describe tlf

A

Continuous with abd wall muscles
Posterior layer wraps erector spinae
Origins of aponeurosis serratus posterior inferior and latissimus dorsi

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27
Q

What makes up extrinsic second layer

A

Levator scapulae
Rhomboid major and minor

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28
Q

Axial attachment levator scapulae

A

Transverse processes of c1-c4

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29
Q

Limb attachments levator scapulae

A

Superior angle of scapula

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30
Q

Functions of levator scapulae

A

Primary = movement of scapula = elevation, shrug muscle
Secondary = bilateral= extension of cervical spine, unlateral = ispilateral lateral flexion fo cervical spine

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31
Q

Innervation lats

A

Thoracodorsal nerve = c6-c8

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32
Q

Innervation levator scapulae

A

Ant rami c3-c5

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33
Q

What is rhomboid major and minor shaped like

A

Rhomboids

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34
Q

Are rhomboids covered

A

Yes by traps
Entirely

35
Q

Axial attachments rhomboids

A

Spinous processes c6-t4

36
Q

limb attachments rhomboids

A

Medial border of scapula

37
Q

functions rhomboids

A

None in back
Only movement of scapula = elevate and move medically

38
Q

Innervation rhomboids

A

Dorsal scapular nerve = c5

39
Q

What makes up extrinsic deepest layer = 3rd layer

A

Serratus posterior superior and inferior

40
Q

Proximal vertebral attachments of serratus posterior superior

A

Nuchal ligament
Spinous processes c7-t3 (4 slips covered by rhomboids)

41
Q

Distal rib attachments of serratus posterior superior

A

Superior border of ribs 1-4
Slips across costotransverse joints

42
Q

Function of serratus posterior superior

A

Elevation of upper ribs = accessory muscles of respiration

43
Q

innervation of serratus posterior superior

A

T2-t5 ant rami

44
Q

vertebral proximal attachments of serratus posterior inferior

A

Tlf = contributes aponeurosis to tlf
Spinous processes t11-l2 = around 5 slips sometimes

45
Q

distal limb attachments of serratus posterior inferior

A

Inferior border ribs 8/9-12

46
Q

Function of serratus posterior inferior

A

Depression fo lower ribs = accessory muscles of respiration = forceful expiration

47
Q

Innervation of serratus posterior inferior

A

T9-t12 ant rami

48
Q

Name intrinsic intermediate layer muscles

A

Erector spinae

49
Q

Describe erector spinae - gen

A

Extensors of back
Group of 3 parallel columns on either side of spinous processes
Extend from pelvis to neck (all 3 muscles insert on neck too)

50
Q

Describe erector spinae - the muscles

A

Named from lateral to medial = iliocostalis, longissimus, spinalis

51
Q

Where is erector spinae

A

In thorax and lumbar region
Covered by tlf (their own deep fascia)

52
Q

What is erector spinae surrounded by

A

Own epimysium = contributes to tlf

53
Q

Attachments iliocostalis and longissimus

A

Sacrum/ilium and vertebral processes to ribs

54
Q

Attachments spinalis

A

Inferior to superior spinous processes

55
Q

Functions of erector spinae

A

Bilateral = spine extension
Unilateral = spinal ispilateral lateral flexion = especially iliocostalis (greater distance, to centre of rotation = better at this motion bc of this)

56
Q

Innervation of erector spinae

A

Post rami of adjacent spinal nerves = smaller

57
Q

Trick to remember erector spinae muscles

A

I LIKE STANDING = (iliocostalis, longissimus, spinalis)helps you stand and good posture

58
Q

Describe erector spinae functions - explain more

A

Gliding movement at zygophophyseal joints = very small at each joint but sum of all actions across vertebrae= create motion
Intervertebral joint becomes more wedge shaped = haas to move
Sup slides onto inf

59
Q

Describe evolutionary fun fact = erector spinae

A

Spinous processes are longer in species that run like horses, or whose heads/trunks generate large pitching torques = more spine extensor muscle mass with better ability to generate Counter torque = bc gravity acting on head

60
Q

What makes up intrinsic deeper layers

A

Various muscles = multifidus, levatores costarum, rotattores longus and brevis, medial and lateral intertransversarius, interspinales

61
Q

Describe general function of deepest layer intrinsics

A

Spine stabilization and fine movement (posture, contribute to extension, rotation)

62
Q

Describe innevration of deepest layer intrinsic

A

Posterior rami of spinal nerves at same level

63
Q

Describe mutifidus

A

Not lats bc lats more superficial, but same area
Good at extending spine

64
Q

Describe levatores costarum

A

Rib elevators
Accessory muscle of resp = increase volume of cage, bucket handle movement

65
Q

Describe rotatores longus and brevis

A

Skip vertebrae and go to one above it
Axial rotation

66
Q

Describe medial and lateral intertransversarius

A

Between transverse processes

67
Q

Describe interspinales

A

Between spinous processes

68
Q

Describe general invention of extrinsics

A

Ant rami
Trap = spinal accessory
Lats = c6-c8
Rhomboids = c3-c5
Serratus posterior sup = t2-t5
Serratus posterior inf = t9-t12

69
Q

Describe general invention of intrinsics

A

Posterior rami

70
Q

Describe back innervation - sensory

A

Posterior ram are also mixed = areas overlapping location of erector spinae will form dermatomes
Form dermatoems = continuous with ant rami at same level in terms of skin
Pierce through extrinsics of back

71
Q

Describe arterial supply to instinsic and deep extrinsic muscles - gen

A

Deep extrinsic = serratus posterior
Comes from dorsal branches of segmental Arteries of aorta = posterior intercostal, lumbar arteries and of internal iliac (lateral sacral)

72
Q

Describe lateral sacral a

A

Gives off little branches that goes back throug ant sacral foramina —> towards back and provide blood o whole column of intrinsic back muscles

73
Q

Describe dorsal branches

A

To back muscles, skin, vertebral Columns and spinal cord
Off post intercostal and lumbar

74
Q

What is given blood supply by dorsal branches

A

Spinal cord
Dorsal root ganglion
Spinal nerve beginnings

75
Q

Describe arterial supply to extrinsic back muscles and TLF

A

Terminal branches of same dorsal branches that supply intrinsic muscles
And individual arteries branching off subclavian/axillary system to neck and upper limb (mostly to upper limbs)

76
Q

What goes through muscles

A

Terminal branches of POSTERIOR INTERCOSTAL AND LUMBAR arteries, veins and posterior ramus of spinal nerves
= go through to skin

77
Q

Describe dorsal scapular artery

A

To rhomboids
Trapezius
Levator scapuale

78
Q

Describe transverse cervical artery

A

To trapezius
Rhomboids
(between these 2)

79
Q

Describe thoracodorsal artery

A

To latissimus/tlf

80
Q

Describe branching of extrinsic supply to back muscles

A

Subclavian —> axillary (under clavicle)
Axillary gives = transverse cervical, dorsal scapular and thoracodorsal

81
Q

Describe function fo lats

A

Primarily Shoulder mover when scapula fixed
Abducts = medically rotates shoulder (same orientation as teres major)

82
Q

What is curious about serratus posterior

A

Attachments stay in axial skel but still apart of extrinsic group bc innervation is by ant rami

83
Q

Why is serratus posterior named this

A

Comes from serrated appearance of rib attachments