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Clinical Anatomy > Module 1: Superficial Back, Sub-occipital, Deep Back, Spinal Cord, Scapular Region > Flashcards

Module 1: Superficial Back, Sub-occipital, Deep Back, Spinal Cord, Scapular Region Flashcards

1
Q

What are the proximal(trunk) attachments of the trapezius?

A

superior nuchal line, external occipital protuberance, ligamentum niche, cervical and thoracic spinous processes (C7-T12)

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2
Q

What are the distal(extremity) attachments of the trapezius?

A

clavicle, acromion, scapular spine

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3
Q

What is the proximal(trunk) attachments of the latissimus dorsi?

A

SP of T7-L5, thoracolumbar fascia, iliac crest

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4
Q

What is the distal(extremity) attachment of the latissimus dorsi?

A

floor of the inter tubercular sulcus of the humerus

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5
Q

What is the proximal(trunk) attachment of the levator scapulae?

A

transverse process of c1-c4

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6
Q

What is the distal(extremity) attachment of the levator scapulae?

A

superior angle + superomedial border of the scapula

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7
Q

What is the proximal(trunk) attachment of the rhomboids?

A

major: spinous process t2-t5
minor: ligamentum niche + spinous process C7-T1

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8
Q

What are the distal(extremity) attachments of the rhomboids?

A

medial border of the scapula

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9
Q

What are the muscle actions of the trapezius?

A

upper = scapular elevation
lower = depression
middle = retraction
upper + lower = upward rotation

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10
Q

What is the innervation of the trapezius?

A

accessory nerve (
(CN XI: motor)
(CN 3-4: sensory)

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11
Q

What are the muscle actions of latissimus dorsi?

A

adduction, external, medial rotation of humerus, ext humerus

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12
Q

What is the innervation of the latissimus dorsi?

A

thoracodorsal nerve (C6-8)

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13
Q

What are the muscle actions of the levator scapulae?

A

elevation + downward rotation of the scapula

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14
Q

What is the innervation of the levator scapulae?

A

dorsal scapular nerve (C4-5)
(sensory: C3-4)

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15
Q

What are the muscle actions of the rhomboids?

A

scapular retraction
elevation (upper)
downward rotation of scapula

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16
Q

What is the innervation of the rhomboids?

A

dorsal scapular nerve (C4-5)
sensory = C3-4

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17
Q

What is the key difference between the extrinsic and intrinsic back muscles?

A

Extrinsic
- superficial = limb movement
- intermediate = respiration/proprioception
Intrinsic
- vertebral column stabilization/movement

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18
Q

What rami innervate the extrinsic back muscles?

A

ventral rami of spinal nerve

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19
Q

What rami innervate the intrinsic back muscles?

A

dorsal rami of spinal nerve

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20
Q

What are the 4 extrinsic superficial back muscles?

A

latissimus dorsi
trapezius
levator scapulae
rhomboids

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21
Q

What are the 2 extrinsic intermediate back muscles?

A

serratus posterior superior
serratus posterior inferior

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22
Q

What are the two intrinsic superficial back muscles?

A

splenius capitis
splenius cervicis

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23
Q

What are the 3 intrinsic intermediate muscles?

A

erector spinae:
- spinalis
- longissimus
-iliocostalis

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24
Q

What are the 3 intrinsic deep muscles of the back?

A

Transversospinalis:
- semispinalis
- multifidis
- rotatores

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25
Q

What is a dermatome?

A

An area of skin supplied by a single spinal nerve

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26
Q

What is the triangle of auscultation?

A

Auscultation = examining body through sound with stethoscope

Borders:
- upper border of latissimus dorsi
- lower lateral border of trapezius
- medial border of scapula

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27
Q

Where is most of the body’s weight distributed?

A

anterior to the vertebral column

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28
Q

What are the unique features of cervical vertebrae?

A

Bifid spinous processes
Uncinate process
Transverse foramen
Atlas = no body
Axis = dens

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29
Q

What are the suboccipital muscles of the neck? their innervation, and function?

A

Rectus Capitis Posterior Minor/Major
Obliques Capitis Superior/Inferior
- C1 spinal n.
- suboccipital n. (dorsal ramus)
- postural support, extension, lateral flexion, rotation

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30
Q

What are the structural components of a typical vertebra?

A

Spinous Process and Transverse Process
- muscle attachment and movement
Articular Processes
- restrict movement
Vertebral Arch (pedicle + lamina)
- protect spinal cord
Vertebral Body
- support body weight

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31
Q

What changes happen to vertebrae as you age?

A
  • bone density decreases
  • articular surfaces bow inward
  • compression at the periphery
  • oesteophytes form
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32
Q

What is the normal development of spinal curvatures?

A

Primary
- thoracic and sacral kyphosis
Secondary
- cervical lordosis = begin to lift/stabilize head
- lumbar lordosis = begin to walk/ support body weight

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33
Q

What are the abnormal curvatures of the spine?

A
  • Excessive Kyphosis – thoracic (old people)
  • Excessive Lordosis – lumbar (pregnant women)
  • scoliosis – lateral shift normal to curvature
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34
Q

What are the components of the intervertebral disc?

A
  • nucleus pulposus – 88% water
  • annulus fibrosis – crossing fibers limit rotation, strong bond of bodies)
  • hyaline cartilage end plate
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35
Q

What is a posterolateral herniation of the intervertebral disc?

A

protruded nucleus pulposus, compresses lower spinal nerve

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36
Q

What are the 6 ligaments of the spine and the motions they limit?

A
  • Anterior Longitudinal – ext and reinforce front annulus fibrosus
  • Posterior Longitudinal – flex + reinforce back annulus fibrosis
  • Interspinous – flexion
  • supraspinous – flexion
  • ligamentum flavum – flexion
  • intertransverse – lateral flexion
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37
Q

What is the structure of the ligamentum nuchae and its function?

A
  • median fibroelastic septum
  • splenius capitis attachment
  • supports C spine, allow flexion limiting excessive movement
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38
Q

What are the 6 primary movements of the spine?

A
  • flexion
  • extension
  • neck + head rotation
  • upper trunk rotation
  • lateral flexion
  • lateral extension
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39
Q

What regions of the spine have more flexion/extension?

A

C > L > T

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40
Q

What regions of the spine have more lateral flexion/extension?

A

C > L > T

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41
Q

What regions of the spine have more rotation?

A

C > T > L

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42
Q

What is the facet joint angle of the 3 types of vertebrae?

A
  • C = 45 deg
  • T = 60 deg
  • L = 90 deg
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43
Q

What is the order of meningeal covering of the spinal cord from superficial to deep?

A

dura mater –> arachnoid mater –> pia mater

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44
Q

What are the structural changes of spinal stenosis?

A
  • decrease in vertebral canal
  • compression of spinal nerve roots
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45
Q

What are the attachments and innervations of serratus posterior superior?

A
  • spinous process of C7-T3 to rib 2-5
  • intercostal n. (T1-4)
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46
Q

What are the attachments and innervations of serratus posterior inferior?

A
  • sp of T11-L2 to rib 9-12
  • intercostal n. (T9-12)
47
Q

What are the attachments and innervations of the splenius cervicis?

A
  • sp of T3-T6 to post tubercles of TP C1-C3
  • dorsal rami
48
Q

What are the attachments and innervation of the splenius capitis?

A
  • nuchal ligament and sp of C7-T4 to mastoid process
  • dorsal rami
49
Q

What are the attachments and innervations of erector spinae?

A
  • TLF attached to sacrum, iliac crest, sp of L5-T11, supraspinous ligaments, angles of ribs to:
    – spinalis = sp
    – longissimus = ribs
    – iliocostalis = TP costal angles
50
Q

What are the different sections of the erector spinae muscles?

A
  • spinalis = thoracis, cervicis, capitis
  • longissimus = capitis, cervicis, thoracis
  • iliocostalis = cervicis, thoracics, lumborum
51
Q

What are the attachments of the transversospinales muscles?

A

Semispinalis
- TP to superior spinous process
– capitis, cervicis, thoracis

Multifidis
- sacrum/ posterior SI ligament, posterior iliac spine, transverse process to superior spinous process
– sacral, lumbar, thoracic, cervical

Rotatores(Longus + Brevis)
- TP to SP above (1-2 levels)

52
Q

What are the attachments of the interspinales?

A

-between SP of adjacent vertebrae
– C(6), T(2-3), L (4)

53
Q

What are the attachments of the intertranvesarii muscle?

A

between TP of adjacent vertebra

54
Q

What makes the trapezius different from the other extrinsic back muscles?

A

It is the only one innervated by a cranial nerve (others are ventral rami of SN)

55
Q

What are the extensions of the Pia mater?

A

denticulate ligaments

56
Q

What is the arachnoid mater bonded to?

A

inner dura mater in vivo

57
Q

What are the attachments and innervation of Longus Colli?

A

ant tubercles and bodies C3-T3 to ant tubercles and bodies of C1-C6
ventral rami SN C2-C7

58
Q

What are the actions of Longus Colli?

A

flexion, lateral flexion, ipsilateral rotation

59
Q

What are the attachments and innervation of Longus capitis?

A

ant tubercles C3-C6 to basilar portion of occipital bone
ventral rami SN C1-C3

60
Q

What are the actions of Longus capitis?

A

flexion, ipsalateral rotation

61
Q

What are the attachments of rectus capitis posterior major?

A

SP of axis&raquo_space;> inferior nuchal line

62
Q

What are the attachments of rectus capitis posterior minor?

A

posterior tubercle of atlas&raquo_space;» inferior nuchal line

63
Q

What are the attachments of obliquus capitis inferior?

A

SP of axis&raquo_space;» TP of atlas

64
Q

What are the attachments of obliquus capitis superior?

A

TP of atlas&raquo_space;» superior and inferior nuchal line

65
Q

What muscles make up the suboccipital triangle?

A

rectus capitis posterior major
obliquus capitis inferior
obliques capitis superior

66
Q

What structure loops into the suboccipital triangle before making its way to the skull?

A

vertebral artery

67
Q

What are the actions of splenius capitis?

A

Extension
Lateral flexion
Ipsalateral rotation

68
Q

What are the actions of semisplenius capitis?

A

Extension
Contralateral rotation

69
Q

What are the attachments of serratus anterior?

A

outer/superior borders of upper 8 ribs to costal surface of medial border of scapula

70
Q

What are the actions of serratus anterior?

A

scapular protraction + upward rotation

71
Q

What is the innervation of serratus anterior?

A

long thoracic nerve

72
Q

What are the attachments of subclavius?

A

1st rib + cartilage to undersurface of clavicle

73
Q

What are the actions of the subclavius?

A

depress + stabilize clavicle

74
Q

What is the innveration of the subclavius?

A

subclavian nerve

75
Q

What is the function of bursae found in joints?

A

Bursae act as a bag (synovial membrane) that secretes synovial fluid to provide lubrication and padding for joint capsules

76
Q

What is the location of bursae found in a joint?

A

tendon + bone interface

77
Q

Where are bursa located in the scapular region?

A

subacromial
sub deltoid
subtendinous
subscapularis

78
Q

What neurovascular structures would be injured if there was a bone fracture located at the medial border of the scapula?

A

dorsal scapular nerve and artery

79
Q

What is the location of the subacromial space?

A

below the coracoacromial notch (acromion, coracoacromial ligament, and coracoid process)

80
Q

What are the contents of the subacromial space?

A

suprspinatus muscle and subacromial bursa

81
Q

How is the shoulder susceptible to dislocation?

A
  • no inferior reinforcement by rotator cuff muscles or ligaments
  • increase in probability if humerus is abducted
  • 95% anterior dislocations (inferior)
82
Q

How do shoulder dislocations harm structures in the shoulder region?

A

interrupts/ applies pressure on axillary structures

83
Q

What is the acronym for shoulder separations?

A

Falling On Outstretched Hand (FOOSH)

84
Q

What anatomical structures are affected by shoulder separation?

A
  • Acromioclavicular joint
  • acromioclavicular + coracoclavicular ligaments
  • now free acromion may move inferior damaging glenohumeral joint
85
Q

What are the contents of the quadrangular space?

A
  • axillary nerve
  • posterior circumflex humeral artery
86
Q

What muscles border the quadrangular space?

A
  • teres minor
  • teres major
  • humerus
  • long head triceps brachii
87
Q

What neurovascular structures run along the medial border of the scapula?

A
  • dorsal scapular nerve
  • dorsal scapular artery
88
Q

What are the contents of the scapular notch?

A
  • suprascapular artery (army over)
  • suprascapular nerve (navy)
89
Q

What is the location of the scapular notch?

A

transverse scapular ligament

90
Q

What is collateral circulation of the scapula?

A

Blood is allowed to continue flow if the subclavian artery is obstructed

91
Q

What are the rotator cuff muscles and their actions?

A
  • supraspinatus (abduction + lateral rotation)
  • infraspinatus (lateral rotation)
  • teres minor (lateral rotation)
  • subscapularis (medial rotation)
92
Q

What are the actions of the deltoid at the shoulder?

A
  • flexion + medial rotation
  • abduction
  • extension + lateral rotation + horizontal extension of humerus
93
Q

What nerve innervates the deltoid?

A

axillary nerve (C5-6)

94
Q

What nerve innervates supraspinatus?

A

suprascapular nerve (C4-6)

95
Q

What nerve innervates infraspinatus?

A

suprascapular nerve (C5-6)

96
Q

What nerve innervates teres minor?

A

axillary nerve (C5-6)

97
Q

What nerve innervates subscapularis?

A

upper + lower subscapular nerves (C5-6)

98
Q

What are the actions of teres major?

A
  • humeral adduction
  • medial rotation
  • extension
99
Q

What nerve innervates the teres major?

A

lower subscapular nerve (C5-6)

100
Q

What are the attachments of teres major?

A
  • inferior angle of scapula + lower lateral surface
  • to medial intertubercular sulcus of humerus
101
Q

What are the attachment sites of subscapularis?

A
  • subscapular fossa
  • lesser tubercle of humerus
102
Q

What are the attachment sites of teres minor?

A
  • upper 2/3 dorsal surface of lateral border
  • inferior facet of greater tubercle of humerus + shoulder joint capsule
103
Q

What are the attachments of infraspinatus?

A
  • medial 2/3 of infraspinous fossa
  • superior facet of greater tubercle of humerus + shoulder joint capsule
104
Q

What are the attachments supraspinatus?

A
  • medial 2/3 of supraspinous fossa
  • superior facet of the greater tubercle of humerus + shoulder joint capsule
105
Q

What are the attachments of the deltoid?

A
  • clavicle + acromion + spine of scapula
  • deltoid tuberosity of humerus
106
Q

What are the scapulohumeral muscles?

A
  • deltoid
  • supraspinatus
  • infraspinatus
  • teres minor
  • teres major
  • subscapularis
107
Q

What is the path of lymph drainage of the axilla?

A

Humeral + pectoral + subscapular > central > apical > right subclavian trunk

108
Q

Where does the supratrochlear lymph dump into?

A

Humeral lymph

109
Q

What does the infraclavicular lymph dump into?

A

Apical lymph

110
Q

What are part of the Humeral lymph?

A
  • hand
  • FA
  • medial arm
  • deep FA/A
111
Q

What does the pectoral lymph drain?

A

Anterior thorax and breast

112
Q

What does the subscapular lymp drain?

A
  • Posterior shoulder
  • posterior thorax
  • scapula
113
Q

What does the infraclavicular lymph drain?

A

Lateral arm and shoulder

Clinical Anatomy (12 decks)

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