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MSK EXAM I > Superficial and Deep Back musculature > Flashcards

Superficial and Deep Back musculature Flashcards

1
Q

What can the high mobility of the upper limb be attributed to

A

having only one bony attachment to the torso- the sternoclavicular articulation

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2
Q

What muscles attach the scapula to the vertebral column

A

Trapezius, Latissimus Dorsi, Levator Scapulae, Rhomboideus Minor and Major

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3
Q

What is the origin and insertion of Trapezius m

A

Origin- along midline posteriorly from occipital protuberance and sup nuchal line and all spinous processes till TV12
Insertion- Lateral superior border of clavicle, acromion and spine of the scapula

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4
Q

What are the actions of trapezius m

A

Superior- elevate scapula and assist in upward rotation of glenoid fossa
Middle fibers- retract the scapula(tense)
Inferior- upward rotation of the glenoid fossa

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5
Q

What innervates trapezius

A

CN XI spinal accessory- motor

Ventral rami of spinal nerves C3 and C4 (sensory)

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6
Q

What is in the subtrapezial plexus

A

CN XI and spinal nerves C3 and C4 network

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7
Q

How do we test the integrity of spinal accessory

A

Asking the patient to shrug his/her shoulders against resistance- any disparity on either side implies injury to CN XI

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8
Q

What is the origin of latissimus dorsi m

A

ORigin- spinous processes T6-T12 via thoracolumbar fascia to all lumbar ans sacral processes, posterior 1/3 crest of ilium and outer surfaces of 9-12 and inferior angle of scapula

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9
Q

What is the insertion of latissimus dorsi m

A

floor of the inter tubercular (bicipital) groove of humerus

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10
Q

What is the action of latissimus dorsi m

A

adducts, extends and medially rotates the humerus

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11
Q

What is the innervation for latissimus dorsi m

A

Thoracodorsal nerve

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12
Q

What is the origin and insertion for Levator Scapulae m

A

origin- transverse processes of cervical vertebrae 1-4

Insertion- Medial border of scapula from superior angle to root of spine

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13
Q

Action of levator scapulae m

A

elevates scapula and assists in downward rotation of glenoid fossa

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14
Q

What innervates legator scapulae m

A

Dorsal scapular nerve C5, third and 4th cervical nerve

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15
Q

What is the origin and insertion of rhomboid minor

A

Origin- spinous processes C7 and T1

Insertion- medial border of scapula at root of spine

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16
Q

What is the action of rhomboid minor

A

retracts scapula, and downwardly rotates glenoid fossa

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17
Q

What is the innervation to rhomboid minor

A

dorsal scapular nerve

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18
Q

What is the insertion and origin of rhomboid major?

A

origin- spinous processes T2-T5

insertion- medial border of scapula from root of spine to inferior angle

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19
Q

What is the action of rhomboid major

A

retracts scapula, downwardly rotates glenoid cavity

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20
Q

What innervates the rhomboid major

A

dorsal scap nerve

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21
Q

What is the triangle of auscultation

A

located superficial to posterior 6th intercostal space, devoid of overlying muscle

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22
Q

What are the borders for the triangle of auscultation

A

Medial- trapezius
lateral rhomboid major
inferior- latissimus dorsi

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23
Q

What vessels are found in superficial back

A

Transverse cervical artery
Dorsal Scapular
Thoracodorsal

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24
Q

Describe transverse cervical a

A

passes posteriorly within posterior triangle of neck and slips deep to trapezius
splits in 50% cases to superficial and deep

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25
Q

Where does the superficial branch of transverse cervical a go?

A

descends with CN XI on deep surface of trapezius

is aided by dorsal branches of posterior intercostal aa

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26
Q

Where does the deep branch of transverse cervical a go?

A

runs deep to the levator scapulae and rhomboid mm, runs with dorsal scap nerve

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27
Q

Describe dorsal scapular artery

A

present in approx 50%. arises from 2nd or 3rd portion of subclavian artery and courses posteriorly. follows path of deep transverse cervical a

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28
Q

Describe the thoracodorsal artery

A

branch of sub scapular artery (3rd portion of axillary a)

accompanies thoracodorsal nerve on ventral surface of latissimus dorsi m

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29
Q

excluding trapezius, what nerves innervate mm of upper limb and superficial back

A

derived from ventral rami of spinal nerves assoc with brachial plexus

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30
Q

What are the muscles from the intermediate layer of the back

A

Serratus posterior superior and inferior

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31
Q

What is the origin and insertion of serratus posterior superior

A

origin- nuchal ligament and spinous processes Cv7-TV3

insertion- posterior surface of ribs 2-5 lateral to angle

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32
Q

What is the action os serratus posterior superior

A

elevates ribs during inspiration

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33
Q

What nerves innervate serratus posterior superior

A

intercostal nerves T1-T4

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34
Q

What is the origin and insertion of serratus posterior inferior

A

origin- spinous process TV11-LV2 via thoracolumbar fascia

insertion- posterior surface of ribs 9-12 lateral to angle

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35
Q

what is the action of serratus posterior inferior

A

depresses lower 4 ribs to allow diaphragm to act during inspiration

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36
Q

What is the inntervation of serratus posterior inferior

A

intercostal nn T9-T11 and subcostal n (T12)

37
Q

What are the divisons of the deep back fascia

A

nuchal- cervical region

thorabolumbar- thorax and lumbar regions

38
Q

What are the attachments of the back fascia

A

superficial- medially to nuchal lig, supraspinal lig and tips of cervical and lumbar transverse processes, angles of ribs in thorax
deep- medially to base of skull and tups of cervical and lumbar transverse processes and angles of ribs in thorax

39
Q

Laterally, what does the anterior and posterior laminae of thoracolumbar fascia become

A

fuse with fascia of anterolateral abdominal musculature

40
Q

Laterally, what does the nuchal fascia become

A

blends with the prevertebral fascia

41
Q

What are the deep back muscles

A

Splenius Capitis et cervicis
Erector Spinae mm
Transversospinal group
Intersegmental deep back muscles

42
Q

What is the origin of splenius capitis

A

spinous processes CV7-TV6

43
Q

What are the insertions of the spelnius captiis et cervicis

A

Capitis- lateral portion of the superior nuchal line and mastoid process
Cervicis- posterior tubercles of transverse processes of CV1 to CV3

44
Q

What are the actions of Splenius capitis

A

extend the head, rotate and side bend the head an neck to the same side

45
Q

What are the actions of splenius cervicis

A

extend and rotate neck to same side, also bind to deeper musculature

46
Q

What nerves innervate splenius capitis et cervicis

A

dorsal rami of C2-C5

47
Q

Primarily the erector spinae m group has what function

A

extensor and side bender of the spine

48
Q

Describe the origin and insertion of iliocostalis

A

origin- crest of ilium and sacrum, posterior surface of ribs at angle
insertion- angle of ribs, traverse processes of lower cervical vertebrae

49
Q

Action of iliocostalis

A

extends vertebral column, laterally flexes(side beds) same side

50
Q

Nerve innervation of iliocostalis

A

dorsal rami of spinal nerves from vertebral segments covered by muscle

51
Q

What is the origin and insertion of longissimus

A

Origin- transverse processes beloe
Insertion- transverse processes aboce, capitis portion inserts on mastoid process deep to splenius and sternocleidomastoid m

52
Q

What is the action of longissimus

A

Extends vertebral column, lateral flexion to same side, capitis portion extends skull and rotates it to same side

53
Q

What is the innervation of longissimus

A

dorsal rami os spinal nerves from vertebral segments covered by mm

54
Q

What is the origin and insertion of spinalis

A

origin- spinous processes below

insertion- spinous processes above

55
Q

What are the actions of spinalis m

A

Extends vertebral column, lateral flexion to same side; capitis portion extends skull

56
Q

What innervates the spinalis m

A

dorsal rami of spinal nerves from vertebral segments covered by muscle

57
Q

What are the transversospinal muscles

A

Semispinalis
Multifidus
Rotatores

58
Q

Describe the divisions of semispinalis

A

semispinalis thoracis- continuous with with semispinalis cervicis
semispinalis cervicis- ends at spinous provess of CV2
semispinalis capitis- largest post neck, extends mid-thoracic and lower CV to skull, covers semispinalis cervicis

59
Q

What portion of the erector spinae mm fuses medially with semispinalis capitis

A

spinalis capitis

60
Q

Describe multifidus mm

A

extends length of vertebral column from sacrum to CV2, each subdivision spanning 2-4 vertebrae

61
Q

Where are the multifidus mm most developed

A

lumbar region

62
Q

what is the function of multifidus mm

A

extension, minimal rotatory component

63
Q

how are the rotatores mm different than multifidus

A

spans 1-2 vertebrae instead of 2-4

64
Q

What is the main function of rotatores and multifidus

A

stabilizers between vertebral segments than as prime movers

65
Q

What are the intersegmental deep back muscles

A

interspinales and intertransversarii and levator costarum

66
Q

Describe the interspinales mm

A

paired mm (left & right) between spinous processes of cervical and lumbar vertebrae

67
Q

Describe intertransversarri

A

paired (anterior and posterior) mm between transverse processes of cervical and lumbar vertebrae

68
Q

What division of intertransversarri are innervated by ventral rami

A

anterior mm and the lateral portion of posterior

69
Q

What innervates medial portion of posterior intertransversarri

A

dorsal rami

70
Q

What is the name of the lateral posterior intertrasnversarri in the thoracic region

A

levator costarum mm

71
Q

Where is the insertion of the levator costorum mm and its function

A 
insert on ribs 1-2 segments below on superior surface
function is to elevate the ribs during inspiration
72
Q

What innervates the levator costorum mm

A

ventral rami of spinal nerves

73
Q

Where is the suboccipital triangle located

A

deep to semispinalis capitis

74
Q

What innervates ALL sub occipital mm

A

dorsal ramus of cervical spinal nerve C1 (suboccipital nerve)

75
Q

What muscles are in the sub occipital triangle area

A

Rectus capitis posterior major and minor

obliquus capitis inferior and superior

76
Q

Origin and insertion of rectus capitis posterior major

A

origin- spinous process of C2 axis

inserts- inferior nuchal line and occipital bone

77
Q

action of rectus capitis posterior major

A

extension and lateral flexion of the skull; minimal rotation to same side

78
Q

Origin and insertion of rectus capitis posterior minor

A

origin- posterior tubercle of C1 atlas

inserts- medial portion of the inferior nuchal line- may attach to dura between CV1 and occiput

79
Q

What is the action of rectus capitis posterior minor

A

extension and some lateral flexion of the skull

80
Q

What rectus capitis posterior mm can maybe be attributed with dural headache

A

rectus capitis posterior minor because of possible attachment to dura

81
Q

what is the origin and insertion of obliquus capitis inferior

A

origin- spinous process of CV2

inserts- transverse process of atlas

82
Q

Action of obliquus capitis inferior

A

rotates skull and atlas on odontoid process(dens) to same side

83
Q

Origin and insertion of obliquus capitis superior

A

origin- transverse process of atlas

insertion- occipital bone between superior and nuchal lines

84
Q

Action of obliquus capitis superior

A

extends and side beds the skull to same side

85
Q

5 boundaries of suboccipital triangle

A

lateral superior- obliquus capitis superior
lateral inferior- obliquus capitis inferior
medial- rectus capitis posterior major
roof- semispinalis capitis
floor- posterior atlanto-occipital membrane and posterior arch of atlas CV1

86
Q

Where does vertebral artery pass through in subocciptal area

A

turns along its groove on the posterior arch of the atlas and pierces the posterior atlantooccipital membrane to enter foramen magnum

87
Q

Where does the sub occipital nerve pass through

A

pierces posterior atlanooccippital membrane between posterior arch of atlas CV1 and vertebral a.

88
Q

Where does the greater occipital nerve pass through

A

emerges from beneath the obliquus capitis inferior and turns upward to cross the muscle and the triangle.
Pierces semispinalis capitis and trapezius to innervate posterior scalp as far as the vertex of skull

89
Q

Describe the veins of the deep back

A

venae commitantes.(occipital, ascending cervical, vertebral, posterior intercostal, lumbar, iliolumbar, and lateral sacral vv) final common path of venous drainage for deep back as well as spinal cord and vertebral column

MSK EXAM I (9 decks)

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