Muscles of the Back (Maria) Flashcards Preview

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1

What is the organization of back muscles according to innervation? 

Which one is intrinsic? which one is extrinsic? 

  1. Hypaxial mucles:
  • extrinsic back musles
  • innervated by cranial nerves and ventral rami of spinal nerves. 
  • superficial muscles.

    2. Epaxial muscles: 

  • intrinsic back muscles
  • innervated by dorsal rami of spinal nerves.

2

1. What constitute the superficial group? 

2. To what muscle group do they belong?

1. Superficial muscles: muscles realted to and involved in movements of appendicular elements of  skeleton 

  • Clavicle, scapula, humerus

2. They belong to the hypaxial muscle group.

3

1. What constitute the intermediate muscle group?

2. To what muscle group to they belong?

1. intermediate group: muscles attached to costal elements and with possible respiratory functions.

2. they belong to the hypaxial muscle. 

4

1.Name the group of muscles that constitute the epaxial musles?

 

  1. spinotransversales group
  2. erector spinae group
  3. transversospinales group
  4. segmental group
  5. suboccipital group

5

What muscles are part of the superficial group of the hypaxial muscles? 

 

Superficial group:

1. Trapezius

2. Latissims dorsi

3. levator scapulae

4. rhomboid minor

5. rhomboid major

6

State the following for the Trapezius:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

Trapezius:

1. Origin:

  • Superior nuchal line
  •  ligamentum nuchae
  •  external occiipal protuberance
  •  thoracic vertebral spines. 

2. Insertion: lateral 1/3 clavicle + acromion and spinae of scapula

3. Funtion: 

  • Upper fibers: elevation of shoulder girdle (as in shrug and during arm elevation)
  • Middle fibers: retraction of scapula
  • Lower fibers: depression of scapula + participation in cranial rotation of glenoid during arm abduction

4. Innervation: 

  • Motor: Accessory n. (CN XI)
  • (Motion sensor) Proprioception: C3-C4 ventral rami

7

State the following for the Latissimus Dorsi:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

1. Origin: Iliac Crest + spinous process of T6-sacrum

2. Insertion: Floor of intertubercular sulcus of humerus. 

3. Function: 

  • Extension
  • adduction
  •  medial rotation of humerus

4. Innervation: Middle subscapular nerve ( C6-C8)

8

State the following about Levator Scapulae

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Transverse processes of C1-C4
  2. Insertion: Upper portion of vertebral border of scapula
  3. Function: Upward and anterior movement of superior angle of scapula --> as in reaching forward or extending arm. 
  4. Innervation: Dorsal scapular nerve (C4-C5)

 

9

State the following about the Rhomboid minor:

1. Origin

2. Insertion

3. Functions

4. Innervations

  1. Origin: Lower part of ligamentum nuchae + C7-T1 spines
  2. Insertion: Vertebral border of scapula at root of spine
  3. Function:
  • Retraction (adduction)
  •  elevation
  • caudal rotation of glenoid fossa of scapula

    4. Innervation: Dorsal scapular nerve (C4-C5)

10

State the following about the Rhomboid Major:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: T2-T5 spines
  2. Insertion: Vertebral border of scapula between spine and inferior angle.
  3. Function:  
  • Retraction (adduction)
  •  elevation
  • caudal rotation of glenoid fossa of scapula

    4. Innervation: Dorsal Scapular nerve (C4-C5)

11

Which mucles are part of the intermediate group of the Hypaxial Mucles?

 

  1. Serratus posterior inferior.
  2. Serratus posterior superior.

12

State the following about the Serratus Posterior Superior:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: 
  • Lower part of ligamentum nuchae
  • C7-T3
  • subraspinous

     2. Insertion: Upper border of ribs 2-5 just lateral to their angles 

     3. Function: elevate rib 2-5

     4. Innervation: ventral rami of spinal nn.

13

State the following about the Serratus posterior inferior:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

 

1. Origin:

  • T11-L3 spines
  • supraspinous ligament

2. Insertion: lower border of ribs 9-12 lateral to their ribs angles. 

3. Functions: 

  • Depression of ribs 9-12
  • possible prevention of elevation of lower ribs  during contraction of diaphragm

4. Innervation: Dorsal rami of spinal nn. 

14

1. Where is this located?

2. To what is this attached to?

 

1. The Thoracolumbar fascia is the separartion between the hypaxial and epaxial muscles in the thoracic region.

15

What does the posterior layer of the Thoracolumbar fascia covers?

Erector Spinae

16

What does the anterior layer of the Thoracolumbar fascia covers?

 

Quadratus lumborum

18

1. Which muscles are part of the Spinotransversales group?

2. To which group of muscles do they belong?

3. Are the intrinsic or extrinsic?

1. Splenius capitis and Splenius cervisis

2. They belong to the epaxial muscle group

3. They are intrinsic muscles of the back

19

State the following about Splenius capitis:

  1. Origin
  2. Insertion
  3. Functions
  4. Innervation

1. Origin:

  • Ligamentum nuchae
  • C7-T4 spines

2. Insertion: 

  • Mastoid process
  • skull bellow superior nuchal line

3. Functions: 

  • Bilateral activation: Extension of head and neck. Extend the head to one side when activated.
  • Unilateral activation: Rotation of head toward ipsilateral side

4. Innervation: Dorsal Rami spinal nn. 

20

State the following about the Splenius Cervicis:

  1. Origin
  2. Insertion
  3. Functions
  4. Innervation

  1. Origin: T3-T6
  2. Insertion: Transverse processes of C1-C3
  3. Function: 
  • Bilateral activation: Extension of head and neck. Extend the head to one side when activated.
  • Unilateral activation: Rotation of head toward ipsilateral side

    4. Innervation: Dorsal rami spinal nn. 

21

1. Which muscles are part of the Erector spinae group?

2. To what muscle groups do they belong?

3. Are they intrinsic or extrinsic?

 

 

22

State the following about Spinalis:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1.  Origin: Vertebral spines
  2. Insertion: vertebral spines
  3. Function: 
  • Bilateral activation: Extension of vertebral column and head. Rate head to active side and the spine.
  • Unilateral activation: Lateral flexion of vertebral column + rotation of head to ipsilateral side. Rotate the spine

   4. Innervation: 

  • Dorsal Rami of spinal nerves

 

23

State the following about the Longissimus:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Aponeurotically from sacrum. More cranial fibers originate from transverse processes of pre-sacral vertebrae
  2. Insertion: transverse and costal elements of vertebrae near their junctions. Most cranial fibers insert onto mastoid process, and are called longissimus capitis.
  3. Function: 
  • Bilateral activation: Extension of vertebral column and head. Rate head to active side and the spine.
  • Unilateral activation: Lateral flexion of vertebral column + rotation of head to ipsilateral side. Rotate the spine

   4. Innervation: Dorsal rami of spinal nerves 

24

State the following for the Iliocostalis muscle:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Aponeurotically from sacrum and iliac crest. More cranial fibers originate near costal angles
  2. Insertion: ribs near their angles. Mores cranial fibers insert onto posterior tubercles of cervical vertebrae.
  3. Functions:
  • Bilateral activation: Extension of vertebral column and head. Rate head to active side and the spine.
  • Unilateral activation: Lateral flexion of vertebral column + rotation of head to ipsilateral side. Rotate the spine

    4. Innervation: Dorsal rami of spinal nerve.

25

1. What muscles are part of the Transversospinales muscle group?

2. To what group do they belong?

3. Are they intrinsic or extrinsic muscles?

1. Semispinalis capitis, semispinalis, rotatores, multifidus

2. They belong to the epaxial muscles

3. They are intrinsic muscles.

26

State the following for Semispinalis muscle group:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

 

  1. Origin: transverse process of vertebrae
  2. Insertion: vertebral spines
  3. Functions: 
  • Bilateral activation: Contribution to extension of vertebral column
  • Unilateral activation: Lateral flexion and (if intervertebral joints permit) axial rotation of vertebral column toward contralateral side

    4. Innervation: Dorsal rami spinal nerve.

27

State the following for the Semispinalis capitis:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Transverse process of upper thoracic and lower cervial vertebrae.
  2. Insertion: Nuchal plane of occipital bone near midline.
  3. Function: 
  • Bilateral activation: Powerful extension of head/skull
  • Unilateral activation: Rotation of head to ipsilateral side

    4. Innervation: Dorsal rami spinal nerves.

28

State the following for the Multifidus muscle:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin:
  • Transverse processes of vertebrae
  • Iliac crest 

    2. Insertion: vertebral spines

    3. Functions: same as semispinalis

    4. Innervation: dorsal rami spinal nerves

29

State the following for the Rotatores muscles:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

***SAME AS SEMISPINALIS MUSCLES*** 

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

30

What muscles are part of the segmental group?

To what muscle group do they belong to?

Are the intrinsic or extrinsic?

  1. Levatores costarum, interspinales and intertransversarius
  2. They belong to the epaxial muscle group
  3. They are intrinsic muscle.

31

State the following for the Levator Costarum:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Transverse processes of C7-T11
  2. Insertion: Rib below vertebra of origin near costal tubercle
  3. Function: Elevate of rib
  4. Innervation: Dorsal rami spinal nerve

32

State the following about the Interspinales:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Spinous process of a more caudally located vertebra.
  2. Insertion: Spinous process of the vertebra located immediately cranial to the vertebra of origin
  3. Funtion: Stabilization of adjacent vertebrae during trunk movements
  4. Innervation: Dorsal Rami spinal nerve

33

State the following about the Intertransversari muscle:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: Transverse process of a more caudally located vertebra
  2. Insertion: Transverse process of the vertebra located immediately cranial to the vertebra of origin
  3. Funtion: Stabilization of adjacent vertebrae during trunk movements
  4. Innervation: Dorsal Rami spinal nerve

34

What muscles are located in the Suboccipital muscle group?

To what muscle group do they belong?

Are they intrinsic or extrinsic?

  1. Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior.
  2. They belong to the epaxial muscle
  3. They are intrinsic muscles

35

State the following about the rectus capitis posterior major:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: C2 spine
  2. Insertion: Occipital bone bellow inferior nuchal line
  3. Function: Extension + ipsilateral rotation of head 
  4. Innervation: Suboccipital nerver C1

36

State the following about the Rectus capitis posterior minor muscles:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: C1 spine
  2. Insertion: Occipital bone below inferior nuchal line
  3. Function: Extension of head
  4. Innervation: Suboccipital nerve C1

37

State the following about the Obliquus capitis superior muscle:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: C1 transverse process
  2. Insertion: Occipital bone between superior and inferior nuchal lines
  3. Function: Extension + ipsilateral flexion of head
  4. Innervation: Suboccipital nerve C1

38

State the following about the Obliquus capitis inferior muscle:

  1. Origin
  2. Insertion
  3. Function
  4. Innervation

  1. Origin: C2 spine
  2. Insertion: C1 transverse
  3. Function Ipsilateral rotation of head
  4. Innervation: Suboccipital nerve C1

39

1. What are the boundaries of the Suboccipital triangle?

2. What are the contents of the suboccipital triangle?

  1.   Boundaries:

  • Medial → Rectus capitis posterior major
  •   —  Lateral → Obliquus capitis superior
  •   —  Inferior → Obliquus capitis inferior
  1.   Contents:

  • Suboccipital n. (dorsal ramus of C1)
  •   Vertebral a.

40

 

What happens when you do forward flexion of the trunk while keeping your knees straight?

 

  • There is a cessation of activity in spinal extensor muscles at the terminal phase of toe-touch posture. 
  • Prevention of hyper-flexion of lumbar region by tension within flexion-resistant (dorsal) ligaments of vertebral column. 

41

 

1A. When you have extension of the trunk from toe-toch to normal erect posture, which muscles innitiate the movement?

B. Which muscles have delayed activation?

C. Which muscles are at risk?

 

1A. Movement initated by hip extensor muscles, not spinal extensor.

B. There is a delayedd activation of spinal extensor muscles.

C. Stress on Dorsal ligament, therefore, high risk of injury in this ligaments.

42

 

What are the components of the CNS and where do they come from? (embriological origin)

  1. Brain and spinal cord
  2. The development of the brain and spinal cord come from neural tube in embryo

43

 

The spinal cord is a continuation of which structure?

 

Medula oblongota

44

 

True or False:

The spinal cord grows faster than the vertebral column?

 

False.

45

 

How does the adult spinal cord differ from the neonates spinal cord? 

Why is that?

1. The adult spinal cord have extensions from foramen magnun to intervertebral disk between L1 and L2

2. The neonates spinal cord has extensions to L4/L5 vertebral levels

**This is due to the fact that bone grows at a faster rate than the spinal cord because there is more energy expenditure for neural tube than for bone.

46

 

Where is the Conus medullaris located?

 

Distal end of spinal cord, between L4-L5

47

What is the Filum Terminale?

What are the two parts of Filum terminale and what kind of covering do they have?

 

Filium terminale is a continuation of spinal cord from apex of conus medullaris.

  1. Filium terminale internum
  •  pia matter, within a dural sac

    2. Filium terminale externum:  

  • dural matter
  • passage through sacral hiatus
  • attaches to dorsum coccyx

48

 

How many spinal cord enlargements do we have, where are they located, and what is their function?

 

There are two spinal cord enlargemnets: Cervical and Lumbar

  1. Cervical: origin of spinal nerves C5-T1
  • Function: to provide upper limb innervation

    2. Lumbosacral enlargement: origins of spinal nerves L1-S3

  • Function: lower limb innveration

49

 

Name the external features of the spinal cord? (3)

 

  1. Anterior median fissure on anterior surface
  2. Posterior median sulcus on posterior surface
  3. Posterolateral sulcus on each side of posterior surface. Entrance for rootlets.

50

 

How is the gray matter different from the white matter?

 

  • Gray matter is unmyelinated and is rich in nerve cell bodies
  • White matter is myelinated and is rich on nerve cell processes.

51

 

How many longitudinal arteries does the spinal cord contains?

Where are these arteries branching from?

Along what structure of the spinal cord do they descend?

 

  1. Anterior spinal artery
  • originates from union of branches of vertebral aa.
  • passes through the anterior median surface of spinal cor

    2. Posterior spinal artery (R/L)

  • branches of vertebral (posterior inferior cerebellar) aa.
  • Descends along the spinal cord

52

 

The Sulcal arteries are a branch of the ____________ 

They entre through the ___________

The Sulcal arteries are a branch of the anterior spinal aa.

They entre through the anterior median fissure.

53

 

Where does the segmental medullary arteries originate from?

The segmental medullary arteries entry into the vertebral cana through __________

 

1. Segmental arteries originate from: 

  • segmental spinal aa. ( spinal branches  of ascending cervical, deep cervical, vertebral,   posterior intercostal, and lumbar aa.)

2. The segmental medullary arrteries enter through the intervertebral foramina at entry level.

54

 

  1. What is the largest segmental medullary artery?
  2. Where does it originate from? 
  3. True or False: These arteries reinforce the anterior and posterior spinal aa.

 

  1. The largest segmental medullary arteries are the Arteria radicularis magna (of Adamkiewics)
  2. They originate in lower thoracic or upper lumbar region from intercostal/lumbar aa. Usually on left side (65%)
  3. False, this arteries reinforce the arterial supply of 2/3 of spinal cord. 

    ****The segmental medullary aa are the ones that reinforce the anterior and posterior spinal aa.

55

 

A. Where does the Radicular aa branch from?

B. This artery provides blood supply to where?

 

  1. The radicular artery is a branch of the segmental spinal artery.
  2. This provides blood supplu to the ventral and dorsal roots o spinal nn. + superficial part of gray matter.

56

 

The spinal veins are drain by what?

 

Medullary/radicular veins (anterior and posterior)

57

 

The veins of the spinal cord unite with ___________

 

They unite with the internal vertebral venous plexus in epidural space

58

 

The internal vertebral plexus communicated with?

  • Dural sinus and vertebral veins in cranium
  • External vertebral venous plexus

59

 

What can you find in the anterior wall of vertebral canal?

  • vertebral bodies
  • intervertebral discs
  • posterior longitudinal ligament

60

 

What can you find in the lateral borders of the vertebral canal?

  • Pedicles
  • Intervertebral foramina

61

 

What can you find in the posterior border of vertebral canal?

  • Laminae
  • Ligamenta flava
  • Roots of interspinous ligaments
  • Spinous processes. 

62

 

What can you find in the extradural space?

 

Fat, veins, loose connective tissue

Location for epidural anesthesia

63

 

A. What is the most superficial and strongest meningeal surface of the spinal cord called?

B. This is continous with what layer at the foramen magnum?

C. Where does the narrowing of the dural sac occurs?

 

 

A. Dura matter

B. Cranial dura matter

C. lower border of S2 vertebra

64

 

What is the Epineurium?

 

—  tubular sleeve of dura mater surrounding  spinal nerves and roots

65

 

The subarachnoid matter is separated from pia matter by what and what is contained here?

 

Subarchnoid space. This contains the CSF.

66

 

Bellow what level of the spinal column is the subarachnoid space largest?

 

Bellow L2

67

 

A. The pia matter and arachnoid space are connected by what?

 

 

 

Arachnoid trabeculae

68

 

Innermost meningeal layer covering the spinal cord with extensions into the anterior median fissure?

 

Pia matter

69

 

How is the spinal cord positioned in the center of the subarachnoid space?

 

Denticulate ligament

70

 

1. What kind of fibers can be found in the dorsal root?

2. What kind of fibers can be founf in the ventral root?

 

1. Processes of sensory neurons in dorsal root

2. Motor nerve fibers in ventral root.

71

 

What does the dorsal root ganglion contain and where is it located?

 

It contains sensory neurons and is located in the intervertebral foramen

72

 

What forms the Recurrent meningeal nerve?

 

  • Dura
  • ligaments
  • intervertebral discs
  • blood vessels

73

 

Where would you find more obliquely oriented roots of spinal nerves?

 

In the more caudal (lower) regions of spinal cord

74

 

Where is the cauda equina starts and stops?

 

Starts with lumbar, sacral and coccygeal spinal nerves (L2-Co2) and stops at the sacral canal

75

 

Where is a spinal tap puncture done and for what purpose?

 

Done in the lumbar region, between spinous process of L4-L5 vertebrae, to withdraw CSF

76

 

What is a spinal cord shock and what does it cause?

 

  • This is a protrusion of cervical intervertebral disc into vertebral canal
  • Paralysis inferior to site of lesion.

77

 

What is a transection of the spinal cord?

 

This is a loss of sensation and voluntary movement inferior to lession site.

78

 

What happens if you have a transection in the C1-C3 vertebral level?

 

Complete loss of function bellow head level and respiration through a ventilator

79

 

What happens if you have a transection of the C4-C5?

 

Quadriplegia (upper/lower limbs)

possible respratory dysfuntion

Hypotension (low blood pressure)

80

 

What happens if you have a transection of the C6-C8?

 

Loss of lower limb function combined with loss of hand and variable amount of upper limb function

81

 

What happens if you have a T1-T9 transection?

 

Paraplegia (lower limbs) with trunk control dependent on height of lesion

82

 

What happens if you have a T10-L1 transection?

 

Retention of some thigh muscle function (walking with long leg braces possible)

83

 

What happens if you have a L2-L3 transection?

 

Retention of most leg muscle function (walking with short leg braces)

84