Week 4 - spine non-contractile Flashcards
Extrinsic Superficial layer of back & function
Trapezius
Latissimus dorsi
Levator scapulae
Rhomboids
Movements
of the upper limbs
Extrinsic Intermediate layer of back & innervation function
Serratus posterior superior
Serratus posterior inferior
Intercostal nerves
Associated with respiration
Intrinsic back muscles superficial & intermediate
Splenius capitus + cervicis
Erector Spinae
Overall function of intrinsic superficial and
intermediate muscles
- Span many vertebral layers
- Don’t even touch some vertebrae
- Responsible for angular movements
- Produce power
- Resist gravity
- Prime movers
- Can apply a compressive force to IVJs
and facets
Splenius Capitis & Cervicis Att., Action & NS
Distal (Superior)
Capitis: mastoid process, occiput
Cervicis: transverse processes C1-C3/4
Proximal (Inferior)
Capitis: lower ½ nuchal ligament, spinous
processes C7-T3/4, supraspinous ligament
Cervicis: spinous processes T3/4-T6
Action:
Unilateral: lateral flexion, ipsilateral rotation
Bilateral: neck extension
NS: posterior rami of spinal nerves
Erector spinae muscles (medial to lateral)
Spinalis, longissimus, iliocostalis
Erector Spinae (most medial) Spinalis Att., Action, NS & regions
Regions; capitis, cervicis, thoracis, spans several vertebral segments
Attachments:
Distal (Superior) upper thoracic spinous processes & cranium
Proximal (Inferior): supraspinous ligament, lumbar & thoracic
spinous processes
Action:
Unilateral: lateral flexion, Bilateral: back + neck extension
NS: posterior rami of spinal nerves
Erector Spinae (middle) Longissimus Att., Action, NS & regions
Regions; capitis, cervicis, thoracis, spans many vertebral segments
Attachments:
Distal (Superior) ribs, mastoid process
Proximal (Inferior): broad tendon, supraspinous ligament,
sacroiliac ligaments, median sacral crest, posterior iliac crest,
lumbar & thoracic spinous processes
Action:
Unilateral: lateral flexion, Bilateral: back + neck extension
NS: posterior rami of spinal nerves
Erector Spinae (most lateral) Iliocostalis Att., Action, NS & regions
Regions; cervicis, thoracis, lumborum spans many vertebral segments
Attachments:
Distal (Superior) angles of ribs, cervical thoracic processes
Proximal (Inferior): broad tendon, supraspinous ligament,
sacroiliac ligaments, median sacral crest, posterior iliac crest,
lumbar & thoracic spinous processes
Action:
Unilateral: lateral flexion, rotation
Bilateral: back + neck extension
NS: posterior rami of spinal nerves
You get Paul from supine to sitting over the edge of the bed. He says he feels very weak and you find that you have to keep gently pushing his shoulders posteriorly.
What muscles seem to be weak in relation to what you have to do?
A. Transverse abdominus
B. Iliocostalis
C. Splenius capitus
D. Diaphragm
E. Internal intercostals
B. Iliocostalis is posterior and lateral on the rib cage. Which would be involved in pulling the the ribs posteriorly, therefore shoulders posterior.
Transversospinalis muscles (deep to superficial)
Rotatores, multifidus, semispinalis
Semispinalis Att., Action, NS & regions
Regions; capitis, cervicis (well developed), thoracis, spans 4-6 segments
Attachments:
Distal (superior): Occiput, nuchal ligament
Proximal (inferior): transverse processes of C4-T12
Action:
Unilateral: rotation of cervical region
Bilateral: extension of vertebral column
NS: posterior rami of spinal nerves
Multifidus Att., Action, NS & regions
Regions; cervical, thoracic, lumbar (well developed), spans 2-4 segments
Attachments:
Distal (superior): whole length of the spinous processes of the vertebrae
Proximal (inferior)
Lumbar: posterior sacrum, PSIS, erector spinae aponeurosis, sacroiliac ligaments
Thoracic: all thoracic transverse processes
Cervical: articular processes
Action: stabilise vertebrae during local movements of vertebral column and trunk
NS: posterior rami of spinal nerves
Rotatores Att., Action, NS & regions
Regions; thoracic (well developed), spans 1-2
segments
Attachments:
Distal (superior): lamina of vertebrae
Proximal (inferior): transverse process of vertebrae below
Action: stabilise vertebrae during local movements of vertebral column and trunk. Proprioceptive.
NS: posterior rami of spinal nerves
Intrinsic - Minor deep muscles of the back names, Action, NS
Interspinalis & intertransversarii
Action: stabilise vertebrae (postural)
NS: posterior rami of spinal nerves
Superficial, intermediate, deep layers of back muscle functions (and name them)
The superficial layer of
intrinsic back muscles
acts on the head and
neck (splenius captitis, splenius cervicus)
The intermediate layer
is responsible for global
movements of the
vertebral column (erector spinae - spinalis, longissimus, iliocostalis)
The deep layer is
responsible for local
movements and
postural support (semispinalis, multifidus, rotatores, intertransversarii, interspinalis)
Paul has disuse atrophy from not moving whilst intubated. After getting Paul up from supine to sitting over the edge of the bed, you decide to give Paul exercises to strengthen his intrinsic deep back muscles. Which exercises do you think would be most appropriate?
A= Provide Paul with simple touch toes and stand up
exercises
B= Take Paul to the gym and get him to do weighted
extension exercises
C= Prescribe Paul with sit ups
D= Get Paul to gradually increase his walking distance
E= Teach Paul diaphragmatic breathing exercises
D. Intrinsic deep muscles are involved in postural support for the vertebrae. Walking is a good way to focus on engaging these muscles.
Quadratus Lumborum Att., Action & function, NS
Attachments:
Distal (superior): lower border of 12th rib &
lumbar transverse processes L1 to L4
Proximal (inferior): transverse process of L5
& posterior iliac crest
Action & Function: lateral flexion of spine &
fixator of 12th rib during respiration (lateral pelvic tilt also)
NS: anterior rami of spinal nerves T12-L3/L4
Neck muscles superficial
Platysma (don’t need to know)
Sternocleido-mastoid
STERNOCLEIDOMASTOID Att., Action & function, NS
Attachments
Superior: mastoid process and
occiput
Inferior: anterior-superior
sternum (manubrium) and medial
1/3 of clavicle
NS: accessory nerve
Action & Function:
Unilateral: neck lateral flexion and contralateral rotation
Bilateral:
Neck extension in upright
position; neck flexion in supine;
accessory muscle of inspiration
Torticollis
A contraction or shortening of the sternocleidomastoid
Many different types of torticollis, but can develop in utero due to the baby’s sustained head position
Prevertebral anterior muscles (4) & action
Rectus capitis
anterior
Rectus capitus
lateralis
Longus capitis (to head)
Longus colli (collar)
Action & function - flection of head and neck “yes”
Prevertebral lateral muscles
Scalene posterior
Scalene middle
Scalene anterior
ANTERIOR SCALENE att., action & function, NS
Anterior to the brachial plexus, posterior to SCM and clavicle
Attachments
Superior: transverse processes of C3-C6
Inferior: 1st rib
Action & Function: flex head; accessory
muscle of inspiration
Innervation: anterior rami of cervical spinal nerves