Back Triangles, Misc. Flashcards
(4 cards)
Triangle of auscultation
boundaries-trapezius, latissimus dorsi, medial border of scapula
floor- 6th & 7th ribs and the 6th intercostal space
func-can hear wet sound better; posterior segments of the lung are examined using a stethoscope
• When the arms are folded across the front of the chest and the trunk is flexed, the scapulae are drawn anteriorly so that auscultatory triangle enlarges.
Lumbar triangle (of Petit)
boundaries- latissimus dorsi, external oblique abdominus, iliac crest
floor- internal oblique abdominal muscle
func- if ab muscles weak, herniation of lumbar triangle > abdominal hernia
Suboccipital triangle
(2: L, R); C1 atlas, C2 axis
cut, reflect semispinalis capitis m. to reveal suboccipital triangle
Lobo
• Is bound medially by the rectus capitis posterior major muscle, laterally by the obliquus capitis superior muscle, and inferiorly by the obliquus capitis inferior muscle.
• Has a roof formed by the semispinalis capitis and longissimus capitis.
• Has a floor formed by the posterior arch of the atlas and posterior atlanto-occipital membrane.
• Contains the vertebral artery and suboccipital nerve and vessels.
L- Boundaries (all blood supply by occipital a. and innervated by suboccipital n. (DPR of C1)):
Medially (hypotenuse)-Rectus capitis posterior major and minor
-rectus capitis posterior minor (C1-posterior tubule of atlas to occipital bone (inferior nuchal line)) (more medial, away from triangle)
-major (from C2 axis to occipital bone(inferior nuchal line)) (border of triangle)
rectus- straight, capitis-to head, minor-short, major-long
Laterally (Vertical triangle leg)- Obliquus capitis superior muscle
-from transverse process of C1 to occipital bone (above inferior nuchal line)
Inferiorly (Horiz triangle leg)-Obliquus capitis inferior muscle
not attached to head but still capitis, from spine of C2 to transverse process of C1 (can’t call inferior oblique bc that’s muscle in eyeball)
Roof-Semispinalis capitis
Floor-Posterior arch of C1 and posterior atlantooccipital membrane
Content:
3rd part of vertebral artery, suboccipital nerve (dorsal rami of C1), suboccipital venous plexus
Dorsal rami of 1st cervical nerve – aka suboccipital nerve- innervate muscles making up triangle
Third part of vertebral artery in triangle
vertebral artery enters at C6-does NOT only supply brain
traverses transverse foramina of cervical vertebrae
traverses groove on posterior arch of atlas
if partly occluded > dizziness
Asuboccipital punctureorcisternal punctureis a diagnostic procedure that can be performed in order to collect a sample ofcerebrospinal fluid.
When CSF cannot be obtained from the lumbar space, a cisternal tap may be required.
If the needle is advanced too far it can enter the medulla, sometimes causing sudden respiratory arrest and death.
Sometimes can’t do lumbar puncture for CSF. Before lumbar puncture, must do fundoscopy (watch fundus of patient)
Ophthalmoscopy (aka fundoscopy) is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or funduscope), part of an eye examination and may be done as part of a routine physical examination.
fundusof the eye = interior surface of the eye opposite the lens; includes the retina, optic disc, macula, fovea, and posterior pole.
part of the eyeball opposite the pupil.
Spondylosis vs Spondylolisthesis
Spondylosis aka “scotty dog sign”- Fracture of column of bones connecting superior & inferior articular processes (pars interarticularis / interarticular part/ neck of “scotty dog”) occurs, interlocking mechanism is broken
note- Zygapophysial joints aka facet joints separate - synovial, plane (gliding) joints btwn articular processes of vertebrae (not btwn bodies of vertebrae)–close to IV foramina through which spinal nerves emerge from vertebral canal
Spondylolisthesis-
Failure or fracture of interarticular parts of vertebral laminae of L5 -spondylolysis of L5 especially may result in spondylolisthesis (anterior displacement) of L5 vertebral body relative to sacrum - S1 vertebra due to downward tilt of L5/S1 IV joint
Spondylolisthesis at L5-S1 IV joint may result in pressure on spinal nerves of cauda equina as they pass into superior part of sacrum, causing lower back & lower limb pain
Spondylo (A)-fracture, thesis (B) L5 moving front (displacement)-compress nerve, severe pain
