Muscles of the back Flashcards

1
Q

What are the 2 major groups of muscles in the back and what muscles compose these? What are the main functions of each group?

A

Extrinsic: superficial and intermediate muscles (produce and control limb and respiratory movements)
Intrinsic: deep back muscles (act on vertebral column, produce movements and maintain posture)

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2
Q

Which muscles compose the superficial extrinsic back muscle group?

A

Trapezius, latissimus dorsi, levator scapulae, and rhomboids; they attach the upper limbs to the trunk

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3
Q

What is the innervation of the extrinsic back muscles?

A

Anterior rami of cervical nerves; act on the upper limb
- Trapezius receives its motor fibers from the spinal accessory nerve (CNXI)

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4
Q

Which muscles compose the intermediate extrinsic back muscle group?

A

Serratus posterior superior and inferior; designated superficial respiratory muscles but are more likely proprioceptive rather than motor in function

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5
Q

Extension of intrinsic back muscles

A

From pelvis to cranium

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6
Q

Where does the deep fascia that encloses the intrinsic back muscles attach?

A
  • Medially to the nuchal ligament
  • Tips of spinous processes
  • Supraspinous ligament, and median crest of sacrum
    -Laterally to the cervical and lumbar transverse `processes and to the angle of the ribs
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7
Q

How are the deep back muscles grouped?

A

Superficial, intermediate, and deep layers (according to relationship to their surface)

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8
Q

Which muscles constitute the superficial layer of intrinsic back muscles?

A

Splenius muscles

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9
Q

What is the extension of the splenii muscles?

A

Midline and extend superolaterally to the cervical vertebrae and cranium

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10
Q

What types of splenii muscles are there and how can we differentiate them?

A

Cervicis and capitis; we can tell them apart, based on where they attach

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11
Q

Where are the splenius muscles located?

A

Lie on the lateral and posterior aspects of the neck, covering the vertical muscles (bandage)

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12
Q

Which muscles constitute the intermediate layer of the intrinsic back muscles?

A

Erector spinae muscles

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13
Q

Where are the erector spinae muscles located?

A

Lie in a groove on each side of the vertebral column, between spinous processes and the angles of the ribs

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14
Q

What is the erector spinae and how is this divided?

A

Chief extensor of the VC, divides into 3 muscle columns:
- Iliocostalis: lateral column
- Longissimus: intemediate column
- Spinalis: medial column

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15
Q

How are the columns of the erector spinae divided?

A

Divided regionally into 3 parts, named depending on their superior attachments.
- Lumborum, thoracis, and cervicis

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16
Q

What is the common origin of the three erector spinae columns?

A

Arise from a broad tendon that attaches inferiorly to:
- Posterior part of the iliac crest
- Posterior aspect of the sacrum
- Sacro-iliac ligaments
- Sacral and inferior lumbar spinous processes
- Supraspinous ligament

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17
Q

What is the origin of the splenius muscles?

A

Arises from nuchal ligament and spinous processes of C7-T6 vertebrae

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18
Q

What is the insertion of the splenius capitis?

A

Fibers run superolaterally to mastoid process of temporal bone and lateral third of superior nuchal line of occipital

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19
Q

What is the insertion of the splenius cervicis?

A

Tubercles of transverse processes of C1-C3 or C4 vertebrae

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20
Q

What is the nerve supply of the splenius muscles?

A

Posterior rami of spinal nerves

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21
Q

What are the main actions of the splenius muscles?

A

Acting alone: laterally flexes neck and rotates head to side of active muscles
Acting together: extend head and neck

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22
Q

What is the insertion of the iliocostalis (lumborum, thoracis, and cervicis) of the erector spinae?

A

Fibers run superiorly to angles of lower ribs and cervical tranverse processes

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23
Q

What is the insertion of the longissimus (lumborum, thoracis, and capitis) of the erector spinae?

A

Fibers run superiorly to ribs between tubercles and angles to transverse processes in thoracic and cervical regions and mastoid process of temporal

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24
Q

What is the insertion of the spinalis muscles (thoracis, cervicis, and capitis) of the erector spinae?

A

Fibers run superiorly to spinous processes in upper thoracic region and cranium

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25
What is the nerve nerve supply of the three columns that compose the erector spinae?
Posterior rami of spinal nerves
26
What are the main functions of the columns of the erector spinae?
Acting bilaterally: extend vertebral column and head; as back is flexed, control movement by gradually lengthening their fibers Acting unilaterally: laterally flex vertebral column
27
Which muscles constitute the deep layer of the intrinsic back muscles?
Transversospinales muscle group
28
The transversospinales muscle group is composed of...
Semispinalis, multifidus, and rotatores
29
Where are the transversospinales muscle group located?
Deep to erector spinae; these obliquely disposed group of muscles, ocuppy the "gutter" between the transverse and spinous processes; these originate from transverse processes and pass to spinous processes of more superior vertebrae
30
Where are the semispinalis, multifidus, and rotatores located in relation to the other?
Semispinalis: superficial Multifidus: intermediate Rotatores: deepest
31
How many parts are the semispinalis divided into? Name them
Three parts; according to vertebral level of its superior attachments Capitis, thoracis, and cervicis
32
Where are the semispinalis capitis located? What is their extension?
This form the longitudinal bulge on each side in the back of the neck near the median plane - Extension: ascend from cervical and thoracic transverse processes to the occipital bone
33
What is the extension of the semispinalis thoracis and cervicis?
Pass superomedially from the transverse processes to the thoracic and cervical spinous processes of superior vertebrae
34
What are the characteristics of the multifidus muscles?
- Short, triangular muscular bundles - Thickest in lumbar region - Each bundle passes obliquely, superiorly, and medially and attaches along the whole length of the spinous process of adjacent superior vertebra
35
What are the characteristics of the rotatores?
- Best developed in thoracic region - Deepest of three layers of transversospinales muscles - Arise from transverse process of one vertebra and insert into the root of spinous processes of the next one or two vertebrae superiorly
36
Which are the smallest deep back muscles?
Interspinales (connect spinous), intertransversarii (connect transverse), and levatores costarum
37
What is the origin of the semispinalis muscles?
Arise from transverse processes of C4-T10
38
What is the insertion of the semispinalis muscles?
Fibers run superomedially to occipiral bone and spinous processesin upper thoracic and cervical regions, spanning 4-6 segments
39
What is the nerve supply of the semispinalis muscles?
Posterior rami of spinal nerves
40
What are the main actions of the semispinalis?
Extends head and thoracic and cervical regions of vertebral column and rotates them contralaterally
41
What is the origin of the multifidius?
Arises from: - Posterior sacrum - Posterior superior iliac spine of ilium - Aponeurosis of erector spinae - Sacro-iliac ligaments - Mammillary processes of lumbar vertebrae - Transverse processes of thoracic vertebrae - Articular processes of C4-C7
42
What is the insertion of the multifidius?
Fibers pass obliquely superomedially to entire length of spinous processes of vertebrae located 2 - 4 segments superior to origin
43
What is the nerve supply of the multifidus?
Posterior rami of spinal nerves
44
What are the main actions of multifidus?
Unilateral contraction rotates to contralateral side; stabilizes vertebrae during local movements of the vertebral column
45
What is the origin of the rotatores (brevis and longus)?
Arise from transverse proceses of vertebrae
46
What is the insertion of the rotatores?
Fibers pass superomedially to attach to junction of lamina and transverse process or spinous process of vertebra immediately (brevis) or 2 segments (longus) superior to the vertebra of origin
47
What is the nerve supply of the rotatores?
Posterior rami of spinal nerves
48
What are the main actions of the rotatores?
Mainly act as organs of proprioception; possible stabilize vertebrae and assist with local extension and rotatory movements of vertebral column
49
What does sensors of proprioception refer to?
Sense of one's position
50
What is the suboccipital region?
Superior part of the back of the neck; the triangular are inferior to the occipital region of the head, including posterior aspects of C1 and 2
51
Where is the suboccipital region located?
Loes deep to the trapezius and semispinalis capitis muscles
52
Which muscles can be found in the suboccipital region?
Rectus capitis posterior major and minor and obliquus capitis superior and inferior
53
What is the nerve supply for the 4 muscles in the suboccipital region?
Posterior ramus of C1 (suboccipital nerve)
54
What is the origin of the rectus capitis posterior major?
Arises from the spinous process of C2
55
What is the insertion of the rectus capitis posterior major?
Lateral part of the inferior nuchal line of occipital
56
What is the origin of the rectus capitis posterior minor?
Arises from posterior tubercle on the posterior arch of the C1
57
What is the insertion of the rectus capitis posterior minor?
Medial third of the inferior nuchal line
58
What is the origin of the obliquus capitis inferior?
Arises from the spinous process of C2
59
What is the insertion of the obliquus capitis inferior?
Transverse process of C1
60
What is the origin of the obliquus capitis superior?
Arises from the transverse process of C1
61
What is the insertion of the obliquus capitis superior?
Occipital bone beterrn the superior and inferior nuchal lines
62
What are the boundaries of the suboccipital region?
Superomedially: rectus capitis posterior major Superolaterally: obliquus capitis superior Inferolaterally: obliquus capitis inferior Floor: posterior atlanto-occipital membrane and posterior arch of C1 Roof: semispinalis capitis
63
What are the main functions of the suboccipital group of muscles?
Extend the head on C1 and rotate the head and the C1 on C2
64
What are the movements that can be produced at the cervical intervertebral joints?
Flexion, extension, lateral bending, rotation
65
Which are the principal muscles producing "flexion" of the cervical intervertebral joints?
Bilateral action of: - Longus colli - Scalene - Sternocleidomastoid
66
Which are the principal structures limiting/opposing "flexion" of the cervical intervertebral joints?
Ligaments - Posterior atlanto-axial - Posterior longitudinal - Ligamenta flava - Tectorial membrane Posterior neck nuscles Anulus fibrosus (tension posteriorly)
67
Which are the principal muscles producing "extension" of the cervical intervertebral joints?
Bilateral action of deep neck muscles - Semispinalis cervicis and iliocostalis cervicis - Splenius cervicis and levator scapulae - Splenius capitis - Multifidus - Longissimus capitis - Semispinalis capitis - Trapezius
67
Which are the principal structures limiting/opposing "extension" of the cervical intervertebral joints?
Ligaments - Anterior longitudinal ligament - Anterior atlanto-axial Anterior neck muscles Anulus fibrosus (tension anteriorly) Spinous processes (contact between adjacent processes)
68
Which are the principle muscles producing "lateral bending" of the cervical intervertebral joints?
Unilateral action of: - Iliocostalis cervicis - Longissimus capitis and cervicis - Splenius capitis - Splenius cervicis - Intertransversarii and scalenes
69
Which are the main structures limiting/opposing movement of the cervical interverteral joints
Ligaments - Alar ligaments tension limits movement to contralateral side Anulus fibrosus (tension anteriorly) Zygapophysial (facet) joints
70
Which are the principle muscles producing "rotation" of the cervical intervertebral joints?
Ipsilateral action of: - Rotatores - Semispinalis capitis and cervicis - Multifidus - Splenius cervicis Contralateral action of - Sternocleidomastoid
71
Which are the main structures limiting/opposing movement of the cervical intevertebral joints?
Ligaments - Alar ligaments tension limits movement to ipsilateral side Anulus fibrosus
72
What are the movements that can be produced at the thoracic and lumbar intervertebral joints?
Flexion, extension, lateral bending, and rotation
73
Which are the principle muscles that produce "flexion" of the thoracic and lumbar intervertebral joints?
Bilateral action of: - Rectus abdominis - Psoas major - Gravity
74
Which are the principle structures limiting/opposing "flexion" of the thoracic and lumbar intervertebral joints?
Ligaments - Supraspinous - Interspinous - Ligamenta flava Capsule of zygapophysial (facet) joints Extensor muscles Vertebral bodies (apposition anteriorly) IV disc (compression anteriorly) Annulus fibrosus (tension posteriorly)
75
Which are the principle muscles that produce "extension" of the thoracic and lumbar intervertebral joints?
Bilateral action of: - Erector spinae - Multifidus - Semispinalis thoracis
76
Which are the principle structures limiting/opposing "extension" of the thoracic and lumbar intervertebral joints?
Ligaments - Anterior longitudinal ligament Capsule of zygapophysial joints Abdominal muscles Spinous processes (contact between adjacent processes) Anulus fibrosus (tension anteriorly) IV discs (compression posteriorly)
77
Which are the principle muscles that produce "lateral bending" of the thoracic and lumbar intervertebral joints?
Unilateral action of: - Iliocostalis thoracis and lumborum - Longissimus thoracis - Multifidus - External and internal oblique - Quadratus lumborum - Rhomboids - Serratus anterior
78
Which are the principle structures limiting/opposing "lateral bending" of the thoracic and lumbar intervertebral joints?
Ligaments - Contralateral side Contralateral muscles that laterally bend trunk Contact between iliac crest and thorax Anulus fibrosus (tension of contralateral fibers) IV discs (compression ipsilaterally)
79
Which are the principle muscles that produce "rotation" of the thoracic and lumbar intervertebral joints?
Unilateral action of: - Rotatores - Multifidus - Iliocostalis -Longissimus - External oblique acting synchronously with opposite internal oblique - Splenius thoracis
80
Which are the principle structures limiting/opposing "rotation" of the thoracic and lumbar intervertebral joints?
Ligaments - Costovertebral Ipsilateral external oblique, contralateral internal oblique Articular facets (apposition) Anulus fibrosus
81
Which are the principle muscles that produce "flexion" of the atlanto-occipital joint?
- Longus capitis - Rectus capitis anterior - Anterior fibers of sternochleidomastoid - Suprahyoid and infrahyoid muscles
82
Which are the principle muscles that produce "extension" of the atlanto-occipital joint?
- Rectus capitis posterior major and minor - Obliquus capitis superior - Splenius capitis - Longissimus capitis - Trapezius (ascending part)
83
Which are the principle muscles that produce "lateral bending" of the atlanto-occipital joint?
- Sternocleidomastoid - Rectus capitis lateralis - Longissimus capitis - Splenius capitis
84
Which are the principle muscles that produce "rotation" of the atlanto-axial joint?
Right: - Sternocleidomastoid - Semispinalis capitis Left: - Obliquus capitis inerior - Rectus capitis posterior, major and minor - Longissumus capitis - Splenius capitis