Superficial and Deep back Flashcards Preview

MSK exam 1 AP > Superficial and Deep back > Flashcards

Flashcards in Superficial and Deep back Deck (111):
1

how many back layers

6

superficial 1, 2
intermediate 4
deep back 4,5,6

2

layer 1 of back

trapezius
latissimus dorsi

3

layer 2 of back

rhomboideus major
rhomboideus minor
levator scapulae

4

layer 3 of back

serratous posterior superior
serratous posterior inferior

5

layer 4 of back

erector spinae which includes:
iliocostalis
longissimus
spinalis

splenius capitis AND cervicis

6

layer 5 of back

Transversospinalis which includes:
semispinalis
multifidus
rotatores

7

intersegmental muscles

interspinales
Intertransversarii

8

subocciptial muscles

rectus capitis posterior major
rectus capitis posterior minor
obliquus capitis superior
obliquus capitis inferior

9

what 5 muscles attach the scapula to the vertebral column

trapezius
latissimus dorsi
levator scapulae
rhomboideus minor
rhomboideus major

10

triangle of ausculation borders

medial- trapezius
lateral- rhomboideus major
inferior- latissimus dorsi

11

trapezius

Origin--> external occiptial protuberance, superior nuchal line
via the nuchal ligment to the cervical/upper thoracic spinous processes to TV12

Insertion- lateral superior border of the clavicle
acromion and spine of the scapula

12

action of trapezius

superior fibers--> elevate scapula, assists in upward rotation of the glenoid cavity

middle fibers--> retraction of the scapula

inferior fibers--> upward rotation of glenoid cavity

13

innervation of trapezius

spinal accessory nerve (cranial nerv XI)
ventral rami of spinal nerves C3 to C4 (sensory)

14

what artery is found in the trapezius

transverse cervical artery

15

CN X( (spinal accessory nerve) and spinal nerves C3 and C4 form a network of nerves on the ventral surface of the trapezius known as...

subtrapezial plexus

16

how do you test the integrity of the spinal accessory nerve?

ask pt to shrug their shoulders against resistance

any change in strength on either side implied injury to spinal nerve (accessory) (CN XI)

17

latissimus dorsi (o )

o--> spinous processes T6-T12

via thoracolumbar fascia to all lumbar and sacral spinous processes

posterior one third of the crest of the ilium

outer surfaces of the ribs 9-12

inferior angle of the scapula

18

latissimus dorsi insertion

floor of the intertubercular groove of humerus

19

action of latissimus dorsi

adducts, extends, and medially rotates the humerus (swimmer doing the butterfly)

20

innervation of latissimus dorsi

thoracolumbar nerve

21

levator scapulae

Origin- transverse process of cervical vertebrae 1-4

insertion--> medial border of scapula from superior angle to root of spine

22

action of levator scapulae

elevates scapula

assists in downward roation of the glenoid cavity

23

innervation of the levator scapulae

dorsal scapular nerve (c5)

3rd and 4th cervical nerves

24

rhomboideus minor

superor the the rhomb. majory

origin--> spinous processes of C7 to T1

insertion--> medial border of scapula at root of scapular spine

25

rhomboideus minor action and innervation

action--> retracts scapula, downwardly rotaes the glenoid cavity

innervation--> dorsal scapular nerve

26

rhomboideus major

origin --> spinous process T2-T5

insertion--> medial border of scapula from root of spine to inferior angle

27

rhomboideus major action and innervation

retracts scapula, downwardly rotates glenoid cavity

innervation --> dorsal scapular nerve

28

what is the transverse cervical artery a branch of?

thyrocervical trunk (1st portion of the subclavian artery)

divides into superficial and deep branch

29

where is the superficial branch of the transverse cervical artery?

descends in company with the spinal accessory nerve on the deep surface of the trapezius

30

where is the deep branch of the transverse cervical artery?

run deep to the levator scapulae and the rhomboid muscles

accompanies the dorsal scapular nerve and participates in the scapular anastomosis

31

from what does the dorsal scapular artery arise from?

arises from the 2nd or 3rd portion of the subclavian artery and courses posteriorly between portions of the brachial plexus and neck musculature

this artery then follows the path described above by the deep branch of the transverse cervical artery

32

thoracodorsal artery

a branch of the subscapular artery (3rd portion of the axillary artery)

accompanies the thoracodorsal nerve on the ventral surface of the latissimus dorsi muscle

33

what do some texts also refer the deep branch of the transverse cervicalartery as?

descending or dorsal scapular nerve

see buck book pg 30

34

nerves that innervate the muscles of the upper limb and superficial back are derived from what?

ventral rami of spinal nerves associated with the brachial plexus

35

what innervates the superficial muscles of the back?

ventral primary rami of cervical spinal nerves

AND for the trapezius only the spinal accessory nerve which is cranial nerve XI

36

what innervates the intermediate muscles of the back? and what are the intermediate muscles of the back?

ventral primary rami of thoracic spinal nerves
(intercostal nerves)

serratous posterior superior and inferior

37

what is the primary function of the deep muscles of the back?

extend, sidebend, and rotate the spine

38

what are the muscles groups of the deep muscles of the back?

splenius
erector spinae (no rotation)
transversospinal group
intersegmental muscles
muscles of the subocciptial triangle

39

serratous posterior superior (intermediate)

origin--> nuchal ligament and spinous processes of CV7-TV3

Insertion--> posterior surface of ribs 2-5 lateral to the angle

40

action of serratous posterior superior

elevates ribs during inspiration

41

innervation of serratous posterior superior

intercostal nerves T1-T4

42

origin of serratous posterior inferior

spinous process TV11-LV2 via thoracolumbar fascia

43

insertion of serratous posterior inferior

posterior surface of ribs 9-12 lateral to the angle
SAME INSERTION AS latissimus dorsi

44

action of serratous posterior inferior

depresses lower four ribs allowing diaphragm to act during inspiration (stabilizes the diaphragm)

45

innervation of the serratous posterior inferior

intercostal nerves T9-T11 AND subcostal nerve (underneath last rib)

46

fascia

continuous layer extending from skull to the sacrum

possesses regionally named divisions
-nuchal
-throacolumbar fascia (thorax and lumbar regions)

47

superficial lamina (fascia) attachments

attachaed medially to the nuchal ligament, supraspinal ligament, tips of all spinous processes, median crest of the sacrum

48

deep (anterior) (fascia) lamina attachment

attached medially to the base of the skull below the superior nuchal line, to the tips of cervical and lumbar transverse processes and in the thoracic region to the angles of the ribs

49

NOTE about fascia

laterally the two layers of the nuchal fascia blend to become continuous with the prevertebral fascia

laterally the anterior and posterior laminae of the thoracolumbar fascia blend with the fascias of the anterolateral abdominal musculature

50

splenius capitis et cervicis origin

spinous process of CV7 - TV6

51

insertion of splenius capitis

lateral portion of the superior nuchal line and mastoid process

52

insertion of splenius cervicis

posterior tubercles of transverse processes of CV1 to CV3

53

action of capitis splenius

extends head
rotates and side bends the head and neck to the same side

54

action of cervicis splenius

extends and rotates neck to the same side

also binds deeper musculature

55

innervation of splenius capitis and cervicis

dorsal rami of C2-C5

56

erector spinae muscle group

occupies vertebral costal groove

extends the full length of the vertebral column

inferiorly it attaches via a strong aponeurotic tendon to the iliac crest, sacrum, lumbar spinous process and supraspinal ligament

***primarily an EXTENSORS and side bender of the spine AND POSTURAL Muscles NOT FOR ROTATION

57

iliocostalis divisions

lumborum
thoracis
cervicis

part of erector spinae muscle

58

origin of iliocostalis

crest of ilium and sacrum

posterior surface of ribs at angle

59

insertion of ilocostalis

angle of ribs

transverse processes lower cervical vertebrae

60

proximal attachment versus distal attachment

proximal--> usually the origin

distal --> usually the insertion

61

innervation of ilocostalis AND spinalis

dorsal rami of spinal nerves from vertebral segments covered by muscle

62

division of longissimus

thoracis, cervicis, capitis

63

origin of longissimus

transverse process below

64

insertion of longissimus

transverse process above

capitis portion inserts on mastoid process deep to splenius and sternocleidomastoid muscles

65

action of longissimus

extends vertebral column

lateral flexion to same side

capitis portion*** extends skull and rotates it to the same side

66

origin of spinalis

part of erector spinae muscles

divided into thoracis, cervicis, capitis

***the capitis portion is usually blended/fused with a deeper muscle, the semispinalis capitis

origin--->spinous process below

67

insertion of spinalis

spinous processes above

68

action of spinalis

extends vertebral column, lateral flexion to same side

capitis portion extends the skull

69

general movements of transversospinal group (5th layer) if acting on one side

rotate vertebrae above to opposite side
side bend the vertebral column to the same side

70

general movements of transversospinal group (5th layer) if acting with both sides

extends the vertebral column

71

origins of transversospinal groups

on transverse process below

72

insertions of transversospinal groups

on spinous process one to six segments above depending on specific subdivision

73

innervation of transversospinal groups

dorsal rami of spinal nerves of vertebral segments covered by muscle

74

divisions of transversospinal group

semispinalis-- subdivision spanning 4-6 vertebrae

multifidus- subdivisions spanning 2-4 vertebrae

rotatores-subdivisions spanning 1-2 vertebrae

75

semispinalis thoracis

continuous with semispinalis cervicis

76

semispinalis cerviscis

ends at spinous process of CV2 (first bifid spinous process)

77

semispinalis capitis

largest muscle of the posterior neck

extends from mid thoracic and lower cervical vertebrae to the skull

covers semispinalis cervicis

78

multifidus

extends the length of the vertebral column from sacrum to CV2

most well developed in lumbar area

***important in extension and minimal rotatory component

79

semispinalis general info

extends one half of vertebral column from lower thoracic to upper cervical levels

80

rotatores

each subdivision spans one to two vertebrae

81

note on movement of rotatores and multifidus

since these span fewer vertebral segments compared to semispinalis they function more as stabilizers between individual vertebral segments than as prime movers

82

intersegmental deep back muscles 6th layer general info

lcoated deep to transversospinal muscles

consists of short muscles that span one vertebral segment

stabilizers***

high concentration of stretch receptors allow them to feedback on postural spinal muscles

innervated by dorsal rami of regional spinal nerves EXCEPT for levatores costarum

83

interspinales

paired muscles (left and right) that span adjacent spinous processes of cervical and lumbar vertebrae


local adjustors*** constantly keeping spine straight b/c they are filled with proprioceptor fibers

84

intertransversarii

paired muscles (anterior and posterior)

span adjacent transverse processes of cervical and lumbar vertebrae

85

what is the anterior portion of the intertransversarri innervated by ?

anterior innervated by ventral rami

86

what is the posterior intransversarri divided into and what innervates each part?

divided into medial and lateral portions

medial innervated by dorsal rami

lateral innervated by ventral rami

87

what is the lateral muscle group (of the 6th layer) that is located in the thoracic region only

the lateral posterior intertransversarri which are called the LEVATOR COSTARUM

88

levator costarum general info

extend from transverse processes ABOVE to ribs (medial to angle) one and two segments BELOW

89

function of levator cost arum??

elevate ribs during inspiration

90

what innervates the levator costarum?

innervated by corresponding VENTRAL RAMI of spinal nerves

91

location of subocciptial triangle

deep to semispinalis capitis

92

function of subocciptial triangle

extend the skull and rotate the skull and atlas to the same side

93

innervation of suboccipital muscles

dorsal ramus of cervical nerve C1 (suboccipital nerve)

94

rectus capitis posterior major

origin spinous process of CV2

insertion inferior nuchal line and occipital bone below

95

action of rectus capitis posterior major (x3)

extension and lateral flexion of the skull

minimal rotation to the same side

96

rectus capitis posterior minor

more medial than the rectus capitis posterior major

origin--> posterior tubercle of atlas

97

insertion of rectis capitis posterior minor

medial portion of inferior nuchal line and occipital bone between inferior nuchal line and foramen magnum

may also attach to dura between CV1 and occiput

98

obliquus capitis inferior

origin --> spinous process of CV2

insertion--> transverse proces of atlas

***only muscle that turns the head but does not attach to the head

99

action of obliquus capitis inferior

rotates skull and atlas on odontoid process to the same side

100

obliquus capitis superior

origin--> transverse process of atlas

insertion--> occipital bone between super and inferior nuchal lines

101

action of obliquus capitis superior

extends and sidebends the skull to the same side

102

lateral superior border of the suboccipital triangle

obliquus capitis superior

103

lateral inferior border of the suboccipital triangle

obliquus capitis inferior

104

medial border of the suboccipital triangle

rectus capitis posterior major

105

roof and floor of the suboccipital triangle

roof--> semispinalis capitis


floor--> posterior atlantooccipital membrane and the posterior arch of the atlas

106

vertebral artery

traverses the transverse cervical foramen of atlas and turns medially along the groove in the posterior arch of the atlas and pierces the posterior atlantoccipital membrane to gain the foramen magnum

107

suboccipital nerve (C1-dorsal ramus)

pierces the atlantoocciptal (posterior) membrane between the posterior arch of the atlas and the vertebral artery

passes through the sub occ triangle and distributes to all sub occ muscles

108

greater occiptial nerve (C2-dorsal ramus)

emerges from beneath the obliquus capitis inferior

turns upward to cross that muscle and the subocc triangle and pierces the semispinalis capitis and trapezius

innervates the posterior scalp as far forward as the vertex of the skull

109

what is the cause of tension headaches?

passage of the greater occipital nerve through the substance of the semispinalis capitis places the nerve in a position where after prolonged extension of the neck CONTINUED TRACTION of the nerve results in the headache

110

vessels of deep back usually are what ?

dorsal branches of specific arteries

111

how is venous return accomplished in the deep back ?

venae comitantes of the arterial supply

tributaries to occipital, ascending cervical, vertebral, posterior intercostal, lumbar, iliolumbar, lateral sacral veins, most of which have continuity with the vertebral venous plexus