Superficial and Deep Back Flashcards
Supraspinous Ligament
Connects tips of adjacent spinous processes
Ligamentum Nuchae
Nuchal Ligament, connects tips of spinous processes at cervical levels.
Extrinsic Superficial Muscles
Trapezius, Latissimus Dorsi, Levator Scapulae, Rhomboid Major and Minor
Extrinsic Intermediate Muscles
Serratus Posterior Superior and Inferior
Proximal Attachments of Trapezius
Superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes of C7-T12
Distal Attachments of Trapezius
Clavicle, acromion, scapular spine
Actions of Trapezius
Elevation, rotation, depression, of scapula; rotation of glenoid fossa superiorly.
Innervation of Trapezius
Cranial Nerve XI, Spinal Accessory Nerve
Blood Supply of Trapezius
Transverse Cervical Artery
Proximal Attachments of Latissimus Dorsi
Spinous processes T7-T12, thoracolumbar fascia, iliac crest
Distal Attachments of Latissimus Dorsi
Floor of intertubercular sulcus of humerus
Actions of Latissimus Dorsi
Extension, adduction, medial/internal rotation of humerus; lifts body toward arm in climbing
Levator Scapulae Proximal Attachment
Transverse Processes, C1-C4
Levator Scapulae Distal Attachments
Superior angle of scapula
Levator Scapulae Innervation
Dorsal Scapular Nerve
Levator Scapulae Blood Supply
Dorsal Scapular Artery
Rhomboid Minor Proximal Attachments
Nuchal Ligament, Spinous processes of C7 and T1
Rhomboid Major Proximal Attachments
Spinous processes of T2-T5
Distal attachment of Rhomboid Major
Medial border of scapula below spine
Distal attachment of Rhomboid Minor
Medial border of scapular above spine
Action of Serratus Posterior Superior
Elevation of Ribs
Action of Serratus Posterior Inferior
Depression of Ribs
Border of Triangle of Auscultation
Trapezius, Latissimus Dorsi, Scapula
Border of Lumbar Triangle of Petit
Latissimus Dorsi, External Obliques, Iliac Crest
Spinotransverse Muscles
Splenius Capitus and Splenius Cervicis
Action of Spinotransverse muscles
Unilateral produces lateral flexion of neck and rotation of head to side of contraction. Bilateral produces head and neck extension.
Erector Spinae Muscles
Iliocostalis, Longissimus, Spinalis
Action of Erector Spinae Muscles
Unilateral contraction produces lateral flexion, bilateral contraction produces extension.
Transverso-Spinal Muscles
Semispinalis, Multifidus, Rotators
Semispinalis
Spans 4-6 vertebrae, most developed in cervical, attaches to C2
Multifidus
Spans 2-4 vertebrae, most developed in lumbar. Deep to erector spina muscle mass
Rotators
Spans 1-2 vertebrae, most developed in thoracic region.
Action of semispinalis
extension of vertebral column (semispinalis cervicis) and head (semispinalis captius)
Action of Multifidus
Unilateral contraction rotates to contralateral side; stabilizes vertebrae
Action of Rotators
Extension and rotation of vertebral column
Innervation of intrinsic back muscles
Dorsal/Posterior Rami of Spinal Nerves
Innervation of extrinsic back muscles
Ventral/Anterior rami of Spinal Nerves
Borders of suboccipital triangle
rectus capitus posterior major, obliquus captius superior, obliquus capitus inferior.
Floor of suboccipital triangle
Formed by posterior arch of C1 and posterior atlanto occipital membrane
Vertebral Artery
Contained in suboccipital triangle. Also contains suboccipital nerve
What are the 8 wrist bones?
Scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
Primary arterial supply of upper limb
Subclavian artery
Branch of subclavian artery that supplies muscles of scapula via suprascapular and transverse cervical arteries
Thyrocervical trunk
What does the subclavian artery become after crossing the lateral body of the first rib?
Axillary Artery
What does the axillary artery become when it crosses the lower border of teres major?
Brachial artery
What does the brachial artery give rise to?
Deep brachial artery, superior and inferior ulnar collateral arteries
What does the brachial artery split into? Where does it split?
Anterior to the elbow the brachial artery becomes the radial and ulnar arteries.
What joins the basilic and cephalic veins?
Median cubital vein
Innervation of pectoralis major?
Medial and lateral pectoral nerves
Action of pectoralis major
Adducts medically rotates humerus, flexes humerus
Innervation of pectoralis minor
Medial pectoral nerve
Action of pectoralis minor
Protracts, depresses, and stabilizes scapula.
Innervation of serratus anterior
Long thoracic nerve
Action of serratus anterior
Protracts scapula, rotates scapula laterally/upward
Innervation of subclavius
Nerve to subclavius
Action of subclavius
Anchors and depresses clavicle
Innervation of deltoid
Axillary nerve
Action of deltoid
Flexes and medially rotates arm, abducts arm, extends and laterally rotates arm.
Innervation of teres major
Lower subscapular nerve
Action of teres major
Adducts and medially rotates arm
Innervation of supraspinatus muscle
Suprascapular nerve
Action of supraspinatus
Initiates and assists deltoid in arm abduction
Innervation of infraspinatus
Suprascapular nerve
Action of infraspinatus
Lateral rotation of arm
Innervation of teres minor
Axillary nerve
Action of teres minor
Lateral rotation of arm
Innervation of subscapularis
Upper and lower scapular nerves
Action of subscapularis
Medially rotates and adducts arm
Contents of quadrangular space
Axillary nerve and posterior humeral circumflex artery/vein
What composes the pectoral girdle?
Scapula, clavicle, Manubrium
What bones are in the antebrachium and what connects them?
Radius and ulna connected by the interosseous membrane
What muscles make up the rotator cuff
Supraspinatus, infraspinatus, teres minor, subscapularis
How many phalanges per hand?
14
define intermuscular septum
Fascia surrounds large arms muscles. Septum divides it into anterior and posterior compartments.
When does the subclavian artery become the axillary artery?
When it crosses the lateral border of the first rib
When does the axillary artery become the brachial artery?
When it crosses the lower border of teres major
What are vena comitantes?
Deep veins that travel alongside an artery in the upper limb. They are named for the artery.
Where do superficial veins in the upper limb originate?
The dorsal venous network
Where do deep lymphatics terminate?
Humeral (lateral) axillary lymph nodes
Movements of the pectoral girdle
Elevation, depression, protraction, retraction, lateral rotation, medial rotation
Anterior thoraco-appendicular muscles
Pectoralis major, pectoralis minor, serratus anterior, subclavius
Posterior thoraco-appendicular muscles
Trapezius, latissimus dorsi, levator scapulae, rhomboid major and minor
Proximal attachment of pectoralis major
???
What does the medial pectoral nerve innervate?
Pectoralis major and minor
What does the lateral pectoral nerve innervate?
Pectoralis major
What does the long thoracic nerve innervate?
The serratus anterior
Scapulo-humeral (intrinsic shoulder) muscles
Deltoid, teres major, rotator cuff
What are the borders of the quadrangular space
Inferior: teres major
Superior: teres minor
Lateral: surgical neck of humerus
Medial: long head of triceps brachii
Contents of quadrangular space
Axillary nerve, posterior circumflex humoral artery/vein
What are the 4 regions of the upper limb?
Shoulder (pectoral girdle), arm, forearm, hand
What is the medial and lateral intermuscular septae
Part of brachial fascia that extends deep to attach to humerus and compartmentalize the arm.
What is the flexor and extensor retinaculum?
A thickened part of antebrachial fascia that is attaches anterior and posteriorly at the wrist
What are the two types of innervation that occur in the upper limb?
Segmental innervation by spinal nerves, and multi segmental innervation by peripheral nerves from the brachial plexus.
What muscles elevate the pectoral girdle?
Levator scapulae and trapezius
What muscles depress the pectoral girdle?
Pectoralis minor and trapezius
What muscles protract the pectoral girdle?
Pectoralis minor, serratus anterior
What muscles retract the pectoral girdle?
Trapezius, Rhomboid major and minor
What muscles laterally rotate the pectoral girdle?
Serratus anterior and trapezius
What muscles medially rotate the pectoral girdle?
Levator scapulae, rhomboid major and rhomboid minor
Proximal attachments of pectoralis major
Clavicle head, medial clavicle, sternocostal head, sternum, upper costal cartilage
Distal attachments of pectoralis major
Lateral lip of inter tubercular sulcus of humerus
Proximal attachments of pectoralis minor
Ribs 3-5
Distal attachments of pectoralis minor
Coracoid process of scapula
Proximal attachments of serratus anterior
Ribs 1-8
Distal attachments of serratus anterior
Anterior surface of medial border of scapula
Proximal attachments of subclavius
Inferior surface of middle third of clavicle
Distal attachments of subclavius
Junction of 1st rib and its costal cartilage
Scapulo-humeral (intrinsic shoulder) muscles
Deltoid, teres major, rotator cuff (supra, infra, subclav, and t. Minor)
Proximal attachments of deltoid
Lateral clavicle, acromion, spine of scapula
Distal attachments of deltoid
Deltoid tuberosity of humerus
Proximal attachments of teres major
Inferior angle of scapula
Distal attachment of teres major
Medial lip of intertubercular sulcus of humerus
Proximal attachments of supraspinatus
Supraspinous fossa of scapula
Distal attachment of supraspinatus
Great tubercle of humerus
Proximal attachment of infraspinatus
Infraspinous fossa of scapula
Distal attachments of infraspinatus
Greater tubercle of humerus
Proximal attachments of teres minor
Lateral border of scapula
Distal attachment of teres minor
Greater tubercle of humerus
Proximal attachment of subscapularis
Subscapular fossa of scapula
Distal attachment of subscapularis
Lesser tubercle of humerus
What muscle is interested on its superficial surface and by what?
Serratus anterior by the long thoracic nerve
What are the lateral rotators of the rotator cuff?
Infraspinatus and teres minor