Trunk POINA Flashcards
What nerve innervates the trapezius?
Cranial Nerve XI - Spinal Accessory Nerve
Ventral Rami of C3, C4 - (Pain/proprioceptive fibers)
What nerve innervates the Levator Scapulae
Dorsal scapular nerve (C4-C5)
Cervical C3 & C4
What nerve innervates the Rhomboid Major
Dorsal Scapular C4,C5
What nerve innervates the rhomboid minor
Dorsal scapular nerve C4,C5
What nerve innervates the latissimus Dorsi
Thoracodorsal C6-C8
(TD C6-C8)
Where does the rhomboid major and minor attach?
Medial border of the scapula
What action do the rhomboid major and minor create?
Adduction (Retraction) and downward rotation of scapula
Where do the rhomboid major and minor attach?
(PA)
Spinous process of T2-T5 (Major)
Ligamentum Nuchae; Spinous process C7-T1 (Minor)
What action does the latissimus dorsi create?
Extend Shoulder
Adduct Shoulder
Internally rotated the shoulder
Where does the latissimus dorsi attach?
(PA)
Inferior angle of scapula
Spinous process of inferior 6 thoracic vertebrae (T7-T12)
Throacolumbar fascia
Iliac crest
Ribs 9-12 or 10-12
Where does the latissimus dorsi attach?
(DA)
Floor of Intertubercular sulcus of humerus
What actions do the upper trapezius create?
Bilaterally:
- Head and neck extension
Unilaterally:
- Head/neck ipsilateral lateral flexion
- Head/neck contralateral rotation
- elevate scapulas
- upwardly rotates scapulas
What action does the middle trapezius create?
Adduct / Retract the scapula
Stabilize scapula
What action does the lower trapezius create?
Depress scapula
Upwardly rotate scapula
Where does the trapezius attach?
(PA)
External occipital protuberance
Superior nuchal line
Ligamentum nuchae
Spinous process C7-T12
Where does the trapezius attach?
(DA)
Lateral 1/3 of Clavical
Acromion
Spine of scapula
Where does the levator scapulae attach?
(PA)
Transverse process of C1-C4
Where does the levator scapulae attach?
(DA)
Medial border of scapula
What actions do the levator scapulae create?
Elevate the scapulae
Downwardly rotate the scapula
What muscle is the most superficial deep back muscle?
Splenius Capitis & Splenius Cervicis
What actions do the Splenius Capitis & Splenius cervicis create?
Unilaterally: Laterally flexes the neck and rotates the head ipsilaterally
Bilaterally : extend the head and neck
Where does the Splenius Capitis attach? (PA)
Nuchal ligament
Spinous Process C7-T6
Where does the Splenius Cervicis attach? (PA)
Nuchal ligament
Spinous Process C7-T6
Where does the splenius capitis attach (DA)
Mastoid Process
Superior nuchal line
Where does the splenius cervicis attatch?
Transverse process C1-C4
Bonus Q: what other muscle attaches here?
What nerve innervates all intrinsic back muscles?
Posterior rami of spinal nerves
What actions do the splenius capitis and splenius cervicis create?
unilaterally: lateral neck flexion, ipsilateral head rotation
Bilaterally: Head/ neck extension
What muscles make up the Erector spinae muscle group?
Illiocostalis
Longissimus
Spinalis
Where do the erector spinae muscles attach? (PA)
thoracolumbar fascia
- posterior surface of sacrum
- iliac crest
- Spinous process T11-L5
Where does the illiocostalis attatch (DA)?
Lower rib angles
Cervical TP
Where does the longissimus attach (DA)
between rib tubercles and angles to thoracic TP
where does the spinalis attach? (DA)
upper thoracic SP
cranium
What actions do the erector spinae create?
Unilaterally:
- vertebral column ipsilateral lateral flexion
Bilaterally:
- Vertebral column extension
What muscles make up the transversospinalis group?
Rotatores
Multifidus
Semispinalis capitis
Where do the rotatores attach? (IA)
TP of vertebrae
* best developed in the thoracic region
Where does the semispinalis attach? (IA)
What are the different regions?
TP C4-T12
Semispinalis capitis
semispinalis cervicis
Semispinalis Thoracis
Where do the rotatores attach (SA)
SP of lumbar vertebrae - C2
What are the segments that rotatores can span?
brevis- 1 vertebrae
longus- 2 vertebrae
where do the multifindus attach (SA)?
What are the segments that multifindus can span?
Entire length of the spinous process
2-4 vertebrae
Where do the semispinalis attach?
What are the segments that semispinalis can span?
capitis: occipital bone
cervicis: SP cervical
thoracis: SP thoracic
4-6 vertebrae
What nerve innervates the semispinalis cervicis?
cervical posterior rami of spinal cervical nerves
What actions do the rotatores create?
Unilaterally:
contralateral rotation of vertebral column
Bilaterally:
vertebral column local extension
stabilizes vertebrae during local movements of vertebral column
What actions do the multifidus create?
Unilaterally:
- contralateral rotation of vertebral column
Bilaterally:
- vertebral column local extension
stabilizes vertebrae during local movements of vertebral column
What actions do the semispinalis create?
head/neck/thoracic spine extension
head/neck/thoracic spine contralateral rotation
What are the four suboccipital muscles
Rectus Capitis Posterior Minor
Rectus Capitis Posterior Major
Obliquus Capitis Inferior
Obliquus Capitis Superior
What is the proximal attachment of Rectus Capitis Posterior Minor
Posterior tubercle of C1
What is the proximal attachment of the Rectus Capitis Posterior Major
Spinous Process of C2
What is the proximal attachment of the Obliquus Capitis Inferior?
Posterior tubercle of C2
What is the proximal attachment of Obliquus Capitis Superior?
Transverse Process of C1
What is the distal attachment of Rectus Capitis Posterior Minor
Medial inferior nuchal line
What is distal attachment of the Rectus Capitis Posterior Major
Lateral inferior nuchal line
What is the distal attachment of the Obliquus capitis Inferior?
Transverse Process of C1
What is the distal attachment of the Obliquus capitis superior
Occipital bone between superior and inferior nuchal line
What nerve innervates the suboccipital muscles?
Suboccipital Nerve
(Dorsal Rami of C1)
Which suboccipital muscles Rock and tilt head back into extension?
Rectus capitis posterior Major
Rectus capitis posterior Minor
Obliquus Capitis Superior
Which suboccipital muscles rotate the head ipsilaterally?
Rectus Capitis Posterior Major
Rectus Capitis Posterior Minor
Obliquus Capitis Inferior
What suboccipital muscle/muscles ipsilaterally lateral flexion head
Obliquus capitis superior
What is the Proximal attachment of the Deltoid
Clavicle
Acromion
Spine of scapula
What is the distal attachment of the Deltoid
Deltoid tuberosity of humerus
What nerve innervates the deltoid
Axillary nerve C5-C6
What actions do the Anterior deltoid (clavicular part) do
Arm flexion
Arm IR - internal rotation
What actions does the middle deltoid (Acromial part) do?
Arm ABduction
What action does the posterior (spinal part) deltoid do?
Arm Extension
Arm ER- External rotation
What is the proximal attachment of the Pectoralis major?
Clavicular head (clavicle)
Sternocostal head ( sternum, costal cartilages 1-6, External oblique muscle)
What is the distal attachment of the Pectoralis Major
Lateral lip of intertubercular sulcus of humerus
What nerve innervates Pectoralis Major
Lateral and medial pectoral nerves:
Clavicular head C5,C6
Sternal Costal head C7,C8,T1
What are the actions of the Pectoralis Major (lateral and medial nerves)
Humerus ADDuction
Humerus IR - internal rotation
Scapular Protraction
Arm Horizontal Adduction
What are the actions of the Pectoralis Major ( sternocostal head)
Humerus extension from flexed position
What are the actions of the Pectoralis Major? (clavicular head C5-C6)
Humerus flexion
What is the proximal attachment of the pectoralis minor?
Ribs 3-5
What is the distal attachment of the pectoralis minor?
Coracoid process
What nerve innervates the pectoralis minor
medial pectoral nerve C8,T1
Lateral Pectoral nerve (variable)
What are the actions of the Pectoralis minor
Scapular protraction
with the scapula fixed- assist to elevate the thorax during forced inhalation
What is the proximal attachment of the Teres Major?
Posterior scapula
what is the distal attachment of the Teres Major
Medial lip of the intertubercular sulcus of humerus
What nerve innervates the teres major
Lower scapular nerve C5,C6
What actions does the teres major perform
Shoulder ADDuction
Shoulder IR- internal rotation
What muscles make up the rotator cuff
supraspinatus
infraspinatus
subscapularis
teres minor
What is the proximal attachment of the supraspinatus?
Supraspinous fossa
What is the distal attachment of the supraspinatus?
greater tubercle of the humerus
What nerve innervates the supraspinatus
Suprascapular nerve C4-C6
What action does the supraspinatus perform?
stabilizes head of humerus in glenoid cavity
initiates and assists deltoid in ABduction of arm
What is the proximal attachment of the infraspinatus
infraspinous fossa
What is the distal attachment of the infraspinatus
greater tubercle of the humerus
What nerve innervates the infraspinatus
Suprascapular nerve C5-C6
What action does the infraspinatus perform?
stabilizes head of humerus in glenoid cavity
Shoulder ER- external rotation
What is the Proximal attachment of the Teres Minor
Lateral border of the scapula
What is the distal attachment of the Teres Minor
Greater tubercle of humerus
What nerve innervates Teres Minor
Axillary nerve C5,C6
What action does the teres minor perform
Shoulder ER- external rotation
What is the proximal attachment of the subscapularis
Subscapular fossa
What is the distal attachment of the Subscapularis
lesser tubercule of humerus
What nerves innervate the subscapularis
Upper and Lower subscapular nerves C5-C7
What action does the subscapularis perform?
Shoulder IR- internal rotation
What is the proximal attachment of the serratus Anterior
Lateral ribs 1-9
What is the distal attachment of the Serratus Anterior
Medical border of the scapula
What nerve innervate the serratus anterior
Long thoracic nerve C5-C7
What actions does the serratus anterior perform?
Scapular protraction
Scapular upward rotation
Holds scapula to thoracic wall
What is the superior/medial attachment of the Sternocleirdomastoid
Mastoid process
Superior nuchal line
What is the inferior/lateral attachment of the sternocleidomastoid
Sternal head- Manubrium
Clavicular head- medial 1/3 of clavicle
What nerve innervates the sternocleidomastoid
Spinal accessory nerve (CNXI)
Ventral Rami C3,C4 (pain/proprioceptive fibers)
What muscle actions does the sternocleidomastoid perform?
Unilaterally: sternal head
- Neck ipsilateral lateral flexion
- Neck contralateral rotation
Bilaterally:
- Neck extension @OA joints
- Cervical vertebrae flexion
- Superior cervical vertebrae extension
- inferior cervical vertebrae flexion
With cervical vertebrae fixed:
- manubrium & medial clavicle elevation
(deep respiration)
What is the origin of the Intercostals
Inferior border of the rib above
What is the insertion of the intercostals
Superior border of the rib below
What nerve innervates the intercostals
Thoracic intercostals nerves T1-T11
What are the actions of the external intercostals
Draws the ribs superiorly to assist inhalation
Increases thoracic space
What is the muscle action of the internal intercostals
Draw the ribs inferiorly to assist with exhalation
Decreases thoracic space
What is the origin of the diaphragm
Costal attachment: inner surface of lower 6 ribs
Lumbar attachment: Upper 2 or 3 lumbar vertebrae
Sternal attachment: Inner part of the xiphoid process
What is the insertion of the diaphragm
Central tendon
What is the action of the diaphragm
Draw down the central tendon of the diaphragm
What nerve innervates the diaphragm
Phrenic Nerve (C3-C5)
What is the superior attachment of the Quadratus Lumborum
12 rib
Tips of lumbar transverse processes
What is the inferior attachment of the quadratus lumborum
Iliolumbar ligament and iliac crest
What nerve innervates the quadratus lumborum
Ventral Branches of T12, L1-L4
What is the superior attachment of the psoas major
TP of T 12- L5 vertebrae, sides of L bodies, discs between them
What is the inferior attachment of the psoas major
Lesser trochanter
What nerve innervates the psoas major
Ventral rami L1-L3
What is the action of the quadratus lumborum
Unilaterally:
- laterally tilt/hike/elevate the pelvis
- laterally flex the vertebral column (ipsi)
- Extend vertebral column
Bilaterally:
Fix the last rib during forced inspiration
What is the action of the psoas major
Flexes the hip (acting inferiorly with iliacus)
Flexes the vertebral column laterally ( acting superiorly with illiacus)
Balances trunk
When sitting- acts inferiorly with iliacus to flex trunk
What is the superior attachment of the iliacus
Iliac fossa, sacrum, anterior sacroiliac ligament
What is the inferior attachment of the iliacus
Lesser trochanter & psoas tendon
What nerve innervates the iliacus
Femoral L2-L4
What is the action of the iliacus
Flexes thigh and stabilizes hip joint; acts with psoas major
What is the origin of the rectus abdominis
Pubic crest & pubic symphysis
What is the insertion of the rectus abdominis
Cartilage of 5-7 ribs & xiphoid process
What is the nerve innervation of the rectus abdominis
Thoraco-abdominal nerves ( anterior rami T6-T12)
What is the action of the rectus abdominis
Flex the vertebral column
Compress abdominal viscera
Posterior pelvic tilt
What is the origin of the external obliques
External surfaces of 5-12 ribs
What is the insertion of the external obliques
Linea alba
Pubic tubercle
Anterior half of iliac crest
What is the nerve innervation of the external oblique
Thoracoabdominal nerve T7-T11
Subcostal N
What is the action of the external obliques
Unilaterally:
Laterally flex vertebral column (ipsi)
Rotate vertebral column (contra)
Bilaterally:
Flex the vertebral column
Compress abdominal contents
What is the origin of the internal obliques
Thoracolumbar fascia
Iliac crest
Inguinal ligament
What is the insertion of the internal obliques
Inferior border ribs 10-12, linea alba, patten pubis via conjoint tendon
What is the Nerve innervation of the internal oblique
THoraco- abdominal nerves T6-T12
First lumbar nerve
What is the action of the internal obliques
Unilaterally:
Laterally flex vertebral column (ipsi)
Rotate vertebral column (ipsi)
Bilaterally:
Flex the vertebral column
Compress abdominal contents
What is the origin of the transverse abdominis
Internal surfaces of 7th-12th costal cartilages
Thoracolumbar fascia
Iliac crest
What is the insertion of the transversus abdominis
Linea alba with apopneurosis of internal oblique
Pubic crest
Pecten pubis via conjoint tendon
