unit1.8 deep back

Question 1

list the blood supply to the deep muscles of the back

Answer 1

1. branches of
   
   1. vertebral artery
   2. deep cervical arteris
   3. occipital arter
   4. transverse cervical artery
   5. posterior arteries

Question 2

list the structure and describe the three regions and list muscles that contribute/attach to this.

Answer 2

thoracolumbar fascia

• function
  
  • contributes to the overall organization and integrity of the region

1. superiorly
   
   1. passes anteriorly to serratus anterior muscle and is continuous with the deep fascia of the neck
2. thoracic region
   
   1. covers the deep muscle and separates them from the muscles in the superficial and intermediate layers
3. medially
   
   1. attaches to the spinous processes of the thoracic vertebrae and laterally ot the angles ofthe ribs

muscles- latissimus dorsi and serratus posterior inferior blend with the thoracolumbar fascia.

Question 3

list the group, structures, function, origin/insertion, blood supply, and innervation.

Answer 3

splenius (spinotransversalis muscles) muscles- first layer

Splenius capitis

1. function
   
   1. extend neck bilaterally draw head backwards
   2. rotate head, unilaterally draw and rotate head to same side
2. origin/insertion
   
   1. origin
      
      1. lower half of ligamentum nuchae
      2. spinous processes of C7-T4
   2. insertion
      
      1. mastoid process
      2. skull below lateral third of superior nuchal line
3. bloood flow
   
   1. 4. innervation
   2. posterior rami of middle cervical nerves

splenius cervicis

1. function
   
   1. together extend the neck
   2. individually draw an rotate the head to same side
2. origin/insertion
   
   1. origin
      
      1. spinous processes of T3-T6
   2. insertion
      
      1. transverse processes C1-C3
3. blood supply
4. innervation
   
   1. posterior rami of lower cervical nerves

Question 4

muscle group, names and function

Answer 4

second layer Erector spinae

1. muscle columns
   
   1. illiocostalis
   2. longissimus
   3. spinalis
2. function
   
   1. primary extensors of vertebral column and head
   2. unilaterally-bends the vertebral column to the ipsilateral
   3. bilaterally-extends the vertebral column and head

Question 5

name the group, labels, function, origin/insertion, blood supply, and innervation

Answer 5

three illiocostalis muscles of the deep back muscles

1. illiocostalis
   
   1. cervicic
   2. thoracis
   3. lumborum
2. function
   
   1. extends and laterally flexes vertebral column
3. origin/insertion
   
   1. origin
      
      1. 3rd -12th rib
      2. sacrum and medial iliac crest
   2. insertion
      
      1. transverse processes of C4-C6
      2. angles of 1st-12th ribs
4. blood supply
   
   1. posterior intercostal arteries
5. innervation
   
   1. dorsal primary rami of cervical, thoracic and lumbar spinal nerves

Question 6

list the group, labels, function, origin/insertion, blood supply, and innervation

Answer 6

longissimus column of erector spinae

1. longissimus
   
   1. capitis
   2. cervicis
   3. thoracis
2. function
   
   1. capitis
      
      1. extend and rotate head
   2. cervicis and thoracis
      
      1. extend and laterally flex the vertebral column
3. origin/insertion
   
   1. origin
      
      1. transverse process of C5-C7, T1-T5
      2. lumbar vertebrae
   2. insertion
      
      1. mastoid process
      2. transverse process of
         
         1. C2-C6
         2. thoracic vertebrae
         3. 3rd-12th ribs
4. blood supply
   
   1. posterior intercostal arteries

Question 7

list the group, labels, function, origin/insertion, blood supply and innervation

Answer 7

spinalis column of the erector spinae

1. spinalis
   
   1. capitis
   2. cervicis
   3. thoracis
2. function
   
   1. extends vertebral column
3. origin/insertion
   
   1. origin
      
      1. ligamentum nuchae
      2. spinouse processes of C7
      3. spinous processes of
         
         1. lumbarvertebrae
         2. thoracis vertebrae
   2. insertion
      
      1. spinous processes of
         
         1. C2
         2. T1-T8
      2. spinalis capitis muscle usually blends with semispinalis capitis muscle
4. blood supply
   
   1. posterior intercostal arteris
5. innervation
   
   1. dorsal primary rami of cervical and thoracic spinal nerves

Question 8

list this muscle group, function and three layers

Answer 8

third layer-two groups :transversospinalis muscles and segmental

Shown in picture: transversospinalis muscles

1. function
   
   1. unilaterally-rotate the vertebral column and head toward the contralateral side
   2. bilaterally-extend the vertebral column and head
2. layers-superficial to deep
   
   1. semispinalis- inthe upper half of the vertebral column
   2. multifidus-2-4 segments
   3. rotatores-1-2 segements

Question 9

List the muscle group, function, origin/insertion, blood supply and nerve supply

Answer 9

semispinalis of the intermediate intrinsic back muscles

1. Semispinalis
   
   1. capitis
   2. cervicic
   3. thoracis
2. function
   
   1. extends vertebral column
   2. rotates head and vertebral column to contralateral side
   3. semispinalis capitis has unique action
      
      1. bilaterally-pulls head posteriorly
      2. unilaterally-pulls head posteriorly and turns it, causing chin to move superiorly and to ipsilareral side
3. origin/insertion
   
   1. origin
      
      1. C4-C7
      2. T1-T6
      3. transverse processes of T7-T12
   2. insertion
      
      1. occipital bone
      2. C2-C5 spinous processes
      3. T1-T4 vertebrae
4. blood supply
   
   1. posterior intercostal arteries
5. innervation
   
   1. posterior rami

Question 10

name the muscle group, muscle name, location, function and origin/insertion

Answer 10

multifidus, middle layer of the transversospinalis

1. function
   
   1. bilaterally-extend the vertebral column
   2. unilaterally-rotates the trunk to the opposite side
2. origin/insertin
   
   1. origin
      
      1. posterior sacrum
      2. posterior superior iliac spine
      3. aponeurosis of erector spinae
      4. sacroiliac ligaments
      5. mammillary precesses of lumbar vertebrae
      6. transverse processes of T1-T3
      7. articular processes of C4-C7
   2. insertion
      
      1. entire length of spinous processes
         
         1. 2-4 spinal segments
3. best developed in the lumbar region
4. innervation
   
   1. posterior rami

Question 11

list the group, name, location in layer, function, origin/insertion, blood supply, innervation

Answer 11

rotatores of the transversospinalis muscles- deepest

1. function
   
   1. bilateral-extends thoracic spine
   2. unilaters-rotates spine to opposite side
2. origin/insertion
   
   1. origin
      
      1. T1-T12 between transverse and spinous processes of adjacent vertebrae
      2. or skipping one vertebra
   2. insertion
3. blood vessel
4. innervation
   
   1. spinal nerve of posterior rami

Question 12

list muscle name, group, location in layers, function, origin/insertion, blood supply, innervation

Answer 12

levatores costarum of the segmental muscles

1. function
   
   1. elevate ribs
2. origin/insertion
   
   1. origin
      
      1. transverse processes of C7-T11
   2. insertion
      
      1. rib below vertebra of origin near tubercle
3. blood supply
   
   1. posterior intercostal artery
4. innervation
   
   1. dorsal rami of C8-C11

Question 13

muscle group, name, location in layers, function, location in body, blood supply, innervation

Answer 13

interspinalis muscles of the segmental deep muscle

1. function
   
   1. postural muscles stabilize the adjoining vertebrae during movements of vertebral column
2. short paired muscles attached to the spinous processes of contiguous vertebrae, one on each side of interspinous ligament.
3. blood supply
   
   1. posterior intercostal artery
4. innervation
   
   1. dorsal primary rami of spinal nerves

Question 14

muscle group, name, location in layers, function, location in body, blood supply, innervation

Answer 14

intertransversarii’s of the segmental deep muscles

1. function
   
   1. postrural muscles that stabilize adjoining vertebrae during movements of vertebral column
2. small muscles between the transverse processes of contiguous vertebrae
3. blood supply
   
   1. posterior intercostal artery
4. innervation
   
   1. dorsal rami of spinal nerves

Question 15

jerry is having back pain. He was lifting a refrigerator up 13 stories. his doctor thinks it could be a back sprain but will run a few tests.

what is a back sprain, how could it have been caused, what would the doctor try to rule out, and what can be done to avoid it?

Answer 15

1. back sprain
   
   1. injury only involving the ligamentous tissue or the attachment of liagament to the bone w/o dislocation or fracture.
2. cause
   
   1. excessive extension or rotation and wrong posture while lifting objects.
   2. most commonly involves the erector spinae
3. rule out
   
   1. any reffered pain from other organs
      
      1. kidneys
      2. spleen
      3. lymph nodes
      4. abdominal aortic aneurism
4. avoid
   
   1. keeping the back as straight as possible and by using the muscles of buttocks and lower limbs to assist in lifting

Question 16

describe this region

1. muscles
   
   1. insertion/origin
2. innervatin
3. blood flow
4. function

Answer 16

suboccipital region

1. 4 small intrinsic muscles
   
   1. rectus capitis posterior major
      
      1. insertion:occipital bone, inferior of nuccal line
      2. origin:C2 spinous process
   2. rectus capitis minor
      
      1. insertion:occipital bone inferior of nuccal line
      2. origin:C1 posterior tubercle
   3. obliquus captis superior
      
      1. inertion:occipital bone inferior of the nuccal line
      2. origin:C1 transverse process
   4. obliquus capitis inferior
      
      1. insertion:C1 transverse process
      2. origin:C2 spinous process
2. innervation
   
   1. C1 posterior rami, suboccipital
3. blood flow
   
   1. suboccipital artery
4. function
   
   1. extends the head at atlanto-axial joint

Question 17

name the muscle, innervation and origin of nerve.

Answer 17

rectus capitus major

obliquus capitus inferior

obliquus capitus superior

nerve=suboccipital, origin from dorsal rami of the spinal C1

Question 18

list the sub occipital traingle boundaries

1. superomedially
2. superolaterally
3. inferolaterally
4. floor
5. roof

Answer 18

1. superomedially
   
   1. rectus capitis posterior major
2. superolaterally
   
   1. obliquus capitis superior
3. inferolaterally
   
   1. obliquus capitis inferior
4. floor
   
   1. posterior antlantoocipital membrane
   2. posterior arch of atlas
5. roof
   
   1. semispinalis capitis

Question 19

list the nerve, artery and part of C1 vertebra contained by the sub occipital triangle

Answer 19

1. suboccipital nerve
2. vertebral artery
3. posterior arch of atlas

Question 20

list the names and innervation sites of the Dorsal rami of C1-C3

Answer 20

1. D1 ramus=suboccipital
   
   1. emerges from the spinal canal superior the posterior arch of the atlas and inferior to the vertebral artery where it enters the suboccipital triangle
   2. innervating
      
      1. rectus capitus major
      2. rectus capitus minor
      3. obliquus capitus superior
      4. obliquus cpitus inferior
2. D2 ramus= greater occipital nerve
   
   1. posterior ramus of C2 passes inferior to obliquus capitis inferior muscles and pierces semispinalis capitis muscle to supply the posterior scalp
3. D3=occipital nerve
   
   1. posterior of ramus of C3 supplies scalp over the occiput

Question 21

describe the arterial blood flow to the suboccipital region.

what is clinically significant about this and vertebral artery?

Answer 21

two blood flows

1. left ventric->, aortic arch,
   
   1. rightside
      
      1. brachiocephalic trunk-> R.common carotid->external carotid->occipital artery
   2. leftside
      
      1. left common coratid->external carotid->occipital artery

contains the vertbral artery

1. branches from the first part of the subclavian artery, to ascend through the tranverse foramina of C6–>C1
   
   1. bends 90 degrees medially to occupy a groove on the superior surface of the posterior arch of the atlas
      
      1. turns superiorly and pierces the posterior atlantooccipital membrane to enter the cranial cavity where it merges with the opposite vertebral artery to form the basilar artery

clinial significance

1. when arteries become stenotic due to ateriosclerosis
   
   1. prolonged turning of the head may cause light headedness and dizziness

Question 22

make a flow chart from left ventricle to the following structures

1. right
   
   1. vertebral arteries
   2. deep cervical arteris
   3. occipital arteries
   4. occipital artery
   5. transverse cervical artery
   6. posterior intercostal arteries

Answer 22