The Back Flashcards
What are the posterior-axis-appendicular muscles (back muscles)?
Made up of intrinsic and extrinsic back muscles
What are the scapulohumeral muscles?
Deltoid muscles Teres major Rotator cuff muscles (SITS)
What are the the extrinsic back muscles (layer 1 )
Trapezius Latissimus dorsi
What are the 2nd layer of the extrinsic back muscles?
- Levetor scapulae 2. Rhomboid minor 3. Rhomboid major
What are the muscles of the 3rd layer of the extrinsic back muscles?
Serratus posterior group: Superior and inferior
Where do the extrinsic muscles of the back develop?
The ventral body wall (hypomere)
What innervates the extrinsic muscles?
Ventral primary rami
Where do intrinsic back muscles develop?
In situ ( isn’t he original place) from epimere
What innervates the intrinsic back muscles?
Dorsal primary rami of spinal nerves
Where does the intercrestal plane lie?
Between the two iliac crest across to the spinous process of L4.
What is the intercrestal line used for ?
Lumbar puncture to draw Csf or for anesthesia
What is the foramen magnum for?
Exit of the spinal cord
What are the anterior axis-appendicular muscle? (Thoraco-appendicular pectoral)
Pect. Major and minor Subclavius Serratus anterior
Origin of trapezius
Occipital bone Ligamentum nuchae The spinous processes of T1-12
Innvervation of trapezius
Spinal Accessory spinal nerve
Overhead abduction is done by
Serratus anterior and trapezius
Latissimus Dorsi Origin
Inferior 6 spinous processes thoracic process Inferior 4 ribs Inferior angle of scapulae Thoracic lumbar fasciae Iliac crest
Insertion of Latissimus Dorsi
Intertubucular grove of humerus
Innveration of Latissimus Dorsi and Vessel
Thorcodorsal nerve (long scapular) V: Thoracodorsal artery
Action of latissimus dorsi
EAM ( Extend, Adductor and medically rotate) *swimming muscle
What muscles are in the rhomboid group? Innervation? Blood supply?
Name:Levator Scapulae, Rhomboid minor, Rhomboid Major N:dorsal scapular nerve Blood: deep branch of transverse cervical artery
What are the 5 muscles attached to c2 nerve (suboccipital)
Obliq. Capitis sup. + inf. Rectus capitis major + minor Semispsinalis capitis
What are the 8 pairs of muscles attached to c2?
?
Where does the inter-cristal plane pass over?
Spinous process of L4
What do you pass during. Lumbar puncture?
Interspinous ligament Supraspinous ligament Dura mater Arachnoid mater Stop at subarachnoid space
In a caudal epidural anesthesia, the needle is inserted into where?
The epidural
What part of the spine is especially prone to herniation?
Lumber spine due to the entire weight of the axis resting on it
What is the most common place where herniation or prolapse will occur?
The lumber region at the 5 & 7 o’clock positions where the annulus fibrosis is unsupported
Where does the ALL reinforce the IVD?
From the 9 to 3 o’clock position
Where does the Pll reinforce the disc at?
6 o’clock position
Where is dislocation most common in the spine?
The cervical region
What nerve will herniation compress?
The nerve below it Ex: l4 herniation will defect l5 nerve
What does occulta mean for rural tube defects?
The spina bífida is not obvious I.e tuft of hair in the back
What is the O/I of the Trapezius?
O: superior nuchal line, External occipital protuberance, Nuchal ligament, Spinous process of C7-T12 I: Clavicle, acromion and spine of scapula
Innervation and vessels of trapezius?
Spinal accessory (motor), cervical spinal never c3-c4 Vessels: superficial branch of transverse cervical artery
Actions of Trapezius?
Elevation, Retraction and Rotation of Scapula
O/I of Latissimus dorsi?
O: spinous processes of T7-T12 (lower 6), thoracolumbar fascia, iliac crest, inferior 3-4 ribs I: intertubercular groove of humerus
Innervation and vessel of Latissimus dorsi?
I: thoracodorsal nerve V: thorcodorsal artery
Action of latissimus dorsi?
EAM- (Extend, adducts and medically rotates) Note: it’s the swimming muscle
Innervation and blood supply of rhomboid group (includes levator scapulae)?
I: dorsal scapular nerve B: deep branch of transverse cervical artery
O/I of rhomboid minor?
O:ligamentum nuchae, c7 and T1 spinous processes I: base of spine of scapula
O/i of rhomboid major?
O: T2-T5 spinous processes I: below base of scapula dorsally
Action of rhomboid group?
Major/minor: retraction of scapula (push up muscle) Levator scapulae: elevates scapula and tilts glenoid cavity down
O/I of levator scapulae?
O: posterior tubercles of transverse processes of c1-c4 I: medial border of scapula (superior angle)
Action of Levator Scapulae?
Elevates scapula & tilts glenoid process inferior lay by rotation
What is the innervation and blood supply of the serratus posterior muscles?
Intercostal nerve B: intercostal arteries
O/I of serratus posterior superior ?
O: mucho ligament, c7-t1 spines I: superior borders of ribs 2-4
O/I of serratus posterior inferior?
O: spinous processes of T11-L3 I: Inferior borders of ribs 8/9-12
Where do the two rectus capitis minor muscles meet?
At the posterior tubercle of atlas
What two muscles meet at the transverse proces of axis in the suboccipital triangle?
Obliquus capitis superior and inferior
What muscles define the suboccipital triangle?
The two obliquus (sup/inf) Rectus capitis posterior major
What emerges from the suboccipital triangle?
Vertebral artery Suboccipital nerve
What is the Myodural bridge?
The connection between the suboccipital muscles and the dura matter
What is the significance of the myodural bridge MDB?
Plays a role in sensory and motor control. -stabilization and potency of the spinal cord -monitoring and modulation of tension in the region and prevention of the dura from fold in
What can happen if there is an imbalance in the myodural bridge MDB?
Intractable headaches
Name the nerve and blood supply of the suboccipital muscles and what other muscle these innervates.
Suboccipital nerve -nourished by vertebral and occipital arteries (Branches) Muscle: semispinalis capitis
What is the origin and insertion of the Rectus capitis posterior major?
O: spinous process of axis (c2) I: lateral portion of occipital bone below inferior nuchal line
What is the function of Rectus capitis posterior major?
Extension of head Rotation of face to same side as muscle
What is the origin and insertion of rectus capitis posterior minor?
O: posterior tubercle of atlas I: medial portion of occipital bone below inferior nuchal line
What is the action of the rectus capitis posterior minor?
Extension of head
What is the origin and insertion of obliquus capitis superior?
O: Transverse process of atlas (c1) I: Occipital bone between superior and inferior nuchal lines
What is the function of obliquus capitis superior?
Extension of head an bends to same side
What is the origin and insertion of obliquus capitis inferior?
O: spinous process of axis I: transverse process of atlas (c1)
What is the function of obliquus capitis inferior?
Rotation of face to same side
What are the borders of the auscultation triangle?
Medial border of scapula Lateral border of trapezius Superior border of latissimus dorsi muscle
What is the site of a lumbar hernia?
Triangle of petit (lumbar triangle)
What are the borders of the lumbar triangle?
Superior ridge of iliac crest Lateral border of latissimus dorsi muscle Lateral border of external oblique muscle
What are the branches of the thoracic aorta?
Bronchial Esophageal Subcostal Tracheal Pericardial Intercostal Medialstinal Phrenic
What is the artery of sudden death?
Left anterior descending artery
What does the right atrium have?
Pectinate muscle
What does the right ventricle have?
Tubercular carnae
What are the 8 vessels of the heart?
- Superior vena cava (SVC) 2. Inferior vena cava (IVC) 3. Pulmonary artery 4. Pulmonary veins (4 total) 5. Aorta
What arteries are used for coronary artery bypass?
First: great saphenous vein Now: internal thoracic artery
What is periocardiocentesis?
A procedure were you drain fluid from the pericardium
Mediastinum (place holder)
A- arches (azygous veins and ascending aorta) B- Bifurcations (trachea and pulmonary arteries) C- Change of direction ( esophagus and thoracic duct) -The thoracic duct drains into the left subclavian vein
What is the innervation to the diaphragm??
C3,c4,c5 “keep the diaphragm alive”
What structures pass through the diaphragm and at what level?
T8- inferior vena cava T10- esophagus with Vagus nerve T12- Descending thoracic aorta
What is a sliding hernia?
When part of the lower stomach rises above lower esophageal sphincter
What is a paraesophageal hernia?
When the fundus of the stomach rises above the Lower esophageal sphincter
What stomach hernia is a medical emergency?
Congenital diephragmatic hernia
What is a congenital diaphragmatic hernia?
A congenital disorder of the diaphragm where the abdominal contents rupture through the left (MC) side thus impeding the function of the left lung
Which lung has 3 lobes?
The right lung “Tri to be right”
Why does the left lung have only two lobes?
To make room for the heart
Where can you find the arch of the aorta?
Left lung
Where can you find the arch of azygous?
Right lung
Where do solids go when they enter the lungs?
The right lung in the lower lobe when sitting or standing
Where do liquids go when they enter the lungs?
Superior segmental bronchus of lower lobes (SuLL)
What is Mendelson syndrome?
A chemical pneumonitis or aspiration pneumonitis caused by aspiration during anaesthesia, especially during pregnancy.
