Superficial back

Question 1

Superficial Back Surface Landmarks (9 landmarks)

Answer 1

• External occipital protuberance
• Vertebral prominens (C7)
• Fold of Trapezius
• Spine fo Scapula
• Medial Border of Scapula
• Intrinsic back Muscles
• L4 vertebra
• Iliac Crest
• Posterior Superior Iliac Spines

Question 2

Axial Skeleton

Answer 2

• Skull
• Sternum
• Ribs
• Vertebral column

Question 3

Appendicular Skeleton

Answer 3

• Upper limb and Pectoral Girdle
• Lower Limb and Pelvic Girdle

Question 4

How many vertebra are there

Answer 4

• 33
  
  • 7 cervical
  • 12 Thoracic
  • 5 Lumbar
  • 5 Sacrum

Question 5

Typical Vertebra structure

Answer 5

Question 6

____ is the only bone attachment of the upper appendicular skeleton to the axial skeleton

Answer 6

Clavicle

Question 7

Question 8

Superficial Back muscle attachements to the Scapula

Answer 8

• Superior angle
  
  • Levator Scapulae
• Medial Border
  
  • Rhomboids
    
    • Minor
      
      • Inserts on median border slighlty above or at the level of the spinous process
    • Major
      
      • Inserts on median border slighlty at or below the spinous process of the Scapula
• Inferior angle
  
  • Latissimus Dorsi
• Spine and Acromion
  
  • Trapezius

Question 9

Posterior View of Scapula

Answer 9

• Pectoral girdle
• Only bone attachment is clavicle
• Superifcial back muscle attachments
  
  • Superior angle
    
    • levator scapulae
  • Medial Border
    
    • Rhomboids
  • Inferior angle
    
    • latissimus dorsi
  • Spine and Acromion
    
    • Trapezious

Question 10

Osteological features of the Humerus

Answer 10

Question 11

Superficial Back Fascia

Answer 11

• Vertebral Arch Ligaments
  
  • Supraspinous ligmanent
  • Interspinuous ligaments
  • Liagmentum flavum
• Ligamentum nuchae
  
  • Occipital protuberance
  • Spinous process C7
  • Role
    
    • Postural (aids extensors)
    • Keeps trapezius from bowing during contraction
• Thoracolumbar fascia
  
  • Deep fascia of the back
  • Invests the intrinsic back muscle
  • Separates the intrinsic and extrinsic back muscles

Question 12

Ligamentum Nuchae

Answer 12

• Superfiscial Fascia of the back
• Attachements
  
  • from the occipital protuberance
  • to the spinous process C7
• Role
  
  • Postural (aids extensors)
  • Keeps trapezius from bowing during contraction

Question 13

Thoracolumbar Fascia (TFL)

Answer 13

• Deep Fascia of the back
• Invest the intrinsic back muscle
• Separates the intrinsic and extrinsic back muscles

Question 14

What is the difference between the intrinsic and extrinsic back muscles

Answer 14

• Intrinsic
  
  • Function
    
    • Postural movement of spine
  • Innervation
    
    • Dorsal rami
• Extrinsic
  
  • Attachment
    
    • Attach pectoral girdle to the axial skeleton
  • Function
    
    • Movement of scapula or humerus
  • Innervation
    
    • Ventral rami

Question 17

Dorsal rami vs. Ventral rami innervate

Answer 17

• Dorsal Rami
  
  • Innervate
    
    • Vertebrae and joints
    • “True” or intrinsic back muscles (only muscles deep to thoracolumbar fascia)
    • Skin of back
• Ventral Rami
  
  • Innervate
    
    • All other skeletal muscles
    • Dermatome segments

Question 18

Trapezius

Answer 18

• Origin
  
  • Descending:
    
    • the external occipital protuberance
    • Ligamentum nuchae
    • Spinous process of the C7 Vertebra
  • Transverse:
    
    • The aponeurosis of the Spinous processes at the T1-T4 vertebrae
  • Ascending:
    
    • The spinous process of the T5-T12 vertebrae
• Insertion
  
  • Descending:
    
    • The lateral one-third of the clavicle
  • Transverse:
    
    • The medial side of the acromion
  • Ascending:
    
    • The upper crest and tubercle of the scapular spine
• Innervation:
  
  • Accessory Nerve (CN XI)
  • C2-C6
• Arterial Supply:
  
  • Transverse Cervical Artery
• Action
  
  • Retraction
  • Superior rotation
  • elevation and depression of scapula

Question 19

Spinal portion of CN XI (composed of, enters skull at, and exits skull at?)

Answer 19

• Somatomotor fibers
• C2-C6 ventral Rami
• Enters Cranium through the foramen magnum
• Extis the skull via the Jugular forament

Question 20

Damage to the spinal branch XI clinical correlation

Answer 20

• Damage to spinal branch XI
  
  • Partial paralysis of the trapezius
    
    • shoulder drop
    • Weakness in shoulder
    • Difficulty lifting upper limb > 90 degrees
  • Flaccid paralysis of Sternocleidomastoid (SCM)
    
    • Torticollis
    • Contraction/Fibrosis

Question 21

Latissimus Dorsi

Answer 21

• Origin:
  
  • inferior angle of scapula
  • 9th-12th ribs
  • Spinous process of T7-T12 vertebrae
  • Thoracolumbar fascia
  • Posterior one-third of iliac crest
• Insertion
  
  • Intertubercular sulcus of humerus
• Action
  
  • Extension
  • adduction and internal rotation of the arm
  • aids in respiration
• Innervation:
  
  • Thoracodorsal nerve (C6-C8)
• Arterial Supply:
  
  • Thoracodorsal artery
  • posterior intercostal arteries
  • subcostal artery
  • lumbar arteries

Question 22

What attaches at the intertubercular groove

Answer 22

• Tendon long head Biceps Branchii
• Attachments
  
  • Latissums Dorsi
  • Pectoralis Major
  • Teres Major

Question 23

Thoracodorsal Nerve

Answer 23

• Ventral Rami (C6,C7,C8)
• Innervates
  
  • Latissimus
• Path:
  
  • Located at the deep side of the Latissimus
  • will enter the muscle in the middle

Question 24

Levator Scapulae

Answer 24

• Origin
  
  • Transverse Processes of C1-C4 vertebrae
• Insertion
  
  • Part of medial margin of scapula that lies superior to spine of scapula
• Action
  
  • Involved in flexing the head and neck laterally
  • elevation and inferior rotation of the scapula
• Innervation:
  
  • Dorsal Scapular nerve (C5)
  • C3 spinal nerve
  • C4 spinal nerve
• Arterial supply
  
  • Ascending cervical artery
  • Transverse cervical artery
  • Dorsal scapular artery

Question 25

Rhomboid Major

Answer 25

• Origin
  
  • Spinous Processes of T2-T5 vertebrae
• Insertion
  
  • Part of medial margin of scapula that lies inferior to spine of scapula
• Action
  
  • Stabilization, retraction (adduction), elevation, and interal rotation of the scapula
• Innervation:
  
  • Dorsal Scapular nerve (C5)
• Arterial Supply:
  
  • Dorsal Scapular artery

Question 26

Rhomboid Minor

Answer 26

• Origin
  
  • Spinous processes of C7 and T1 vertebra
  • inferior part of ligamentum nuchae
• Insertion
  
  • Part of medial margin of scapula that lies adjacent to spine of scapula
• Action
  
  • Stabilization, retraction (adduction), elevation, and interal rotation of the scapula
• Innervation
  
  • Dorsal Scapular nerve (C5)
• Arterial Supply
  
  • Dorsal Scapular artery

Question 27

What are the three muscles that make up the 2nd layer of the superficial extrinsic back muscles

Answer 27

• Levator Scapulae
• Rhomboid Minor
• Rhomboid Major

Question 28

What does the dorsal scapular nerve innervate

Answer 28

• Innervates the 3 muscles of the 2nd layer of the superficial back muscles
  
  • Levator Scapulae
  • Rhomboid Minor
  • Rhomboid Major

Question 29

Intermediate layer (3rd) of extrinsic back muscles

Answer 29

• Serratus Posterior
  
  • Superior
  • Inferior
• Both attach to ribs
• Aid in respiration