Intrinsic back muscles and vasculature

Question 1

Proximal attachments of splenius capitus?

Answer 1

Spinous processes of vertebrae C7-T3, nuchal ligament

Question 2

Distal attachments of splenius capitus?

Answer 2

Mastoid process

Question 3

Proximal attachments of splenius cervicis?

Answer 3

Spinous processes of T3 – T6 vertebrae

Question 4

Distal attachments of splenius cervicis?

Answer 4

Transverse processes of C1 – C3 vertebrae

Question 5

What are intrinsic back muscles innervated by?

Answer 5

Dorsal rami

Question 6

Main actions of splenius capitis and cervicis?

Answer 6

Bilateral: Extends head/neck

Unilateral: Lateral flexion and rotation of head (ipsilateral)

Question 7

Erector spinae is made up of what three muscles?

Answer 7

1. Spinalis
   
   • Spinalis thoracis, cervicis, capitis
     2. Longissimus
   • Longissimus thoracis, cervicis, capitis
     3. Iliocostalis
     Iliocostalis lumborum, thoracis and cervicis

Question 8

Proximal attach for spinalis?

Answer 8

c7-L2 approx

Question 9

Proximal attach for longissimus?

Answer 9

C4 - posterior iliac crest

Question 10

Iliocostalis proximal attach?

Answer 10

ribs 3-12 down to medial end of iliac crest

Question 11

Distal attach for spinalis?

Answer 11

Occipital bone to spinous process of t8

Question 12

Distal attach for longissimuss?

Answer 12

mastoid process to L5, ribs 7-12 also

Question 13

Distal attach for Iliocostalis?

Answer 13

Transverse process of C4 to L4, also ribs 5-12

Question 14

Main actions of spinalis?

Answer 14

Extends trunk concentrically

Question 15

Main actions of longissimus?

Answer 15

Extends trunk, head and neck

Question 16

Main actions of Iliocostalis?

Answer 16

Extends and ipsilaterally laterally flexes trunk and neck

Question 17

Muscles that make up transversospinalis?

Answer 17

Semispinalis, multifidus and rotatores

Question 18

What direction do the fibres of transversopspinalis muscles go in?

Answer 18

Oblique angle from inferior TP to superior SP

Question 19

How many vertebral segments do semispinalis span?

Answer 19

5-7

Question 20

Proximal attachments of semispinalis?

Answer 20

1. Articular processes of vertebrae C4-C7, transverse processes of vertebrae T1-T6

Question 21

Distal attachments of semispinalis?

Answer 21

Between superior and inferior nuchal lines of occipital bone

Spinous processes of vertebrae C2-C5

Question 22

Main actions of semispinalis?

Answer 22

Extend and contralaterally rotates trunk, neck and head

Question 23

How many spinal segments do multifidus cross?

Answer 23

2-5 vertebral column

Question 24

proximal attachments of multifidus?

Answer 24

Transverse processes of cervical, thoracic, and lumbar vertebrae

Question 25

Distal attachments of multifidus?

Answer 25

Lateral aspect and tips of the spinous processes of vertebrae 2-5 levels above origin

Question 26

Action of multifidus?

Answer 26

Extends, contralaterally rotates and ipsilaterally laterally flexes trunk and neck

Question 27

How many spinal segments to rotatores span?

Answer 27

1

Question 28

Proximal attach of rotatores

Answer 28

Transverse processes of thoracic vertebrae

Question 29

Distal attachments of rotatores

Answer 29

Laminae/Spinous process of vertebra 1 or two levels above origin

Question 30

Actions of rotatores?

Answer 30

Stabilizer, local extension, rotation

Question 31

Interspinales actions?

Answer 31

Extension of cervical and lumbar spine

Question 32

Intertransversarii proximal and distal attachments?

Answer 32

Lumbar region

Question 33

Actions of Intertransversarii?

Answer 33

Assists lateral flexion of the spine; Stabilizes spine

Question 34

Levatores costarum proximal and distal attachments?

Answer 34

Proximal: Transverse processes of the C7 – T11 Distal: Superior border/external surface of rib one level below origin

Question 35

Actions of levatores costarum?

Answer 35

Elevation of the ribs Rotation of thoracic spine

Question 36

Proximal attachments of Rectus capitis posterior major?

Answer 36

Spinous process of C2 (Axis)

Question 37

Distal attachments of Rectus capitis posterior major?

Answer 37

Lateral part of occipital bone (inferior nuchal line)

Question 38

Actions of Rectus capitis posterior major?

Answer 38

Extends and rotates head to the ipsilateral side

Question 39

Proximal attach of Rectus capitis Posterior minor

Answer 39

Posterior tubercle of C1 (Atlas)

Question 40

Distal attach of Rectus capitis Posterior minor

Answer 40

Medial part of occipital bone (inferior nuchal line)

Question 41

Action of Rectus capitis Posterior minor

Answer 41

Extends head (stabilizes atlanto-occipital joint)

Question 42

Proximal attachments of Oblique capitis Inferior

Answer 42

Spinous process of C2 (Axis)

Question 43

Distal attachments of Oblique capitis Inferior

Answer 43

Transverse process of C1 (Atlas)

Question 44

Action of Oblique capitis Inferior

Answer 44

Rotates atlas (C1) and head to the ipsilateral side

Question 45

Proximal attachments Oblique capitis Superior

Answer 45

Transverse process of C1 (Atlas)

Question 46

Distal attachments Oblique capitis Superior

Answer 46

Occipital bone (between superior/inferior nuchal lines)

Question 47

Actions of Oblique capitis Superior

Answer 47

Extends head and lateral flexion to ipsilateral side

Question 48

What makes the suboccipital triangle?

Answer 48

Rectus capitis posterior major, oblique capitis superior and oblique capitis inferior

Question 49

Intrinsic back muscles (unisegmental group) is msotly for?

Answer 49

stabilise one segment, postural purposes

Question 50

extensors of neck or head from superficial to deep

Answer 50

1. Trapezius 2. Splenius and levator scapulae 3. semispinalis 4. Suboccipital muscles x 4

Question 51

What nerve and arteries is visible from suboccipital triangle?

Answer 51

Vertebral artery and suboccipital nerve (c1 posterior ramus)

Question 52

What's the two nerves below the suboccipital triangle in order?

Answer 52

Greater occipital nerve (c2 posterior ramus) very close to obliquus capitis inferior and 3rd occipital nerve very close to semispinalis cervicis and capitis.

Question 53

Thoracolumbar fascia

Answer 53

- 3 layers of fascia - connection between vertebral bodies, abdominal muscles, upper and lower limbs - dynamic stability of lumbar spine and sacroiliac joint

Question 54

What makes up the abdominal cavity?

Answer 54

diaphragm top, abdominal muscles side, gluteal muscles at back, pelvic floor and hip girdle below.

Question 55

How is lumbar stiffened and prevented from bucking under compressive loads?

Answer 55

Intraabdominal pressure in abdominal cavity

Question 56

Dorsal rami has two branches, medial supplies almost all muscles except two. This is supplied by the lateral branch. Which two muscles is it?

Answer 56

Iliocostalis and longissimus

Question 57

Blood supply hierarchy for spinal cord?

Answer 57

1. Segmental spinal arteries, exist at every spinal level 2. Anterior and posterior radicular arteries - branch off segmental at every vertebral level, supply nerve roots 3. Segmental medullary arteries: - branches from segmental spinal - appear one some levels - Reinforce spinal arteries to supply spinal cord (booster arteries)

Question 58

Vertebral venous plexuses

Answer 58

Internal and external vertebral venous plexuses are valveless IVVP inside vertebral canal, EVVP outside Both drain via intervertebral vein, exits out of intervertebral foramen and drain into segmental veins IVVP and EVVP communicates with each other

Question 59

If disc protrusion occurs between L5 and S1, what nerve root will be affected?

Answer 59

S1 (the nerve root one level lower will be affected)

Question 60

If IV disc protrudes at c3/c4, which nerve affected?

Answer 60

C3, for cervical it is one level higher (nerve roots exist above their respective vertebrae)