Superficial Back Flashcards by Mary Nguyen

External occipital protuberance

Midline bony prominence in the occipital bone.
Same level as superficial nuchal line.

Attachments:

1) Nuchal ligament
2) Trapezius muscle

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Mastoid process

Pyramidal bony projection from the posterior section of the temporal bone.

4 attachments (all neck muscles):

1) SCM
2) Splenius capitus
3) Posterior belly of digastric muscle
4) Longissimus capitis

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Superior nuchal line

Marks superior limit of neck.
Upper ridge.
Extends on either side of EOP.

Attachments:

1) Trapezius
2) Transversospinalis (splenius, erector spinae, transversospinalis)

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Spinous processes of vertebrae

Median posterior projections of spine

absent C1
C3-C5 = bifid
C7 = vertebra prominence
Long + sloping T-spine
Hatchet-shaped in L-spine

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Iliac crest

Superior edge of ilium

*Landmark for L4

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Scapula

Shoulder blade

*Inferior angle = landmark for T7

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Spine of scapula

Ridge dividing posterior of scapula into:

1) Supraspinous fossa
2) Infraspinous fossa

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Acromion process

Subcutaneous lateral point of scapula (palpable)

*Forms AC joint

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Occipital artery

Origin: External carotid artery, emerges cranial border of splenius capitus

Course: Passes to posterior belly of digastric + mastoid processes; follows occipital nerve

Supplies: Scalp on back of head, as far as vertex

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Greater occipital nerve

Origin: Medial branch of posterior ramus of spinal nerve C2

Course: Emerges btwn axis + obliquus capitis inferior; then pierces trapezius

Innervates: scalp region of occipital

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Posterior cutaneous nerves + vessels

Superior neurovasculature supplying skin/cutaneous aspects posteriorly
*changes planes

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Lateral cutaneous nerves + vessels

Superior neurovasculature supplying skin/cutaneous aspects laterally
*changes planes

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Thoracolumbar fascia

Deep fascia - thoracic + lumbar

Medial attachment: nuchal ligament, tips of SPs, supraspinous ligament, median crest of sacrum

Lateral attachment: cervical + lumbar TPs, angles of ribs

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Trapezius (origin + insertion)

Origin:

1) SNL
2) EOP
3) Nuchal ligament
4) SPs of C7-T12

Insertion:

1) Spine of scapula
2) Acromion
3) Lateral 1/3 clavicle

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Latissimus dorsi (origin + insertion)

Origin:

1) SPs of T6-T12
2) Thoracolumbar fascia
3) Iliac crest
4) Ribs 9/10-12

Insertion:
Floor of intertubercular groove of humerus

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Teres major (origin + insertion)

Origin:

1) Inferior part of lateral border of scapula
2) Posterior surface of inferior angle of scapula

Insertion:
Medial lip of intertubercular sulcus of humerus

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Trapezius (function + innervation + vascularization)

Function:

1) Upper = elevate scapula + clavicle
2) Middle = retract scapula
3) Lower = depress scapula
4) Upper + Lower = rotate scapula up
* **Helps hold scapula on ribcage

Innervation:

1) Motor = spinal accessory nerve (CN XI)
2) Sensory = C3, C4 (pain + proprioception)

Vascularization:

1) Occipital artery (descending part)
2) Superficial or transverse cervical artery (transverse part)
3) Dorsal scapular artery (ascending part)

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Latissimus dorsi (function + innervation + vascularization)

Function:

1) Adduct humerus
2) Extend humerus
3) Medial (internal) rotation of humerus
4) Raises body towards arms (pull-up)

Innervation:
Thoracodorsal (C6, C7) (C8)
*Found near lateral tendon

Vascularization:

1) Thoracodorsal artery
2) Perforating arteries of the 9th-11th posterior intercostal arteries
3) 1st-3rd lumbar arteries

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Teres major (function + innervation)

Function:

1) Adduct shoulder joint
2) Medial (internal) rotation of shoulder joint

Innervation:
Lower subscapular nerve (C5) (C6)

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Rhomboid major (origin + insertion)

Origin:
SP of T2-T5

Insertion:
Medial border of the scapula from spine to inferior angle

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Rhomboid major (function + innervation + vascularization)

Function:

1) Retract scapula
2) Rotate GH cavity inferiorly
3) Fix scapula to thoracic wall

Innervation:
Dorsal scapular nerve (C5) (C4)

Vascularization:

1) Dorsal scapular artery
2) Deep branch of transverse cervical artery
3) Dorsal branch of upper 5 or 6 posterior intercostal arteries

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Rhomboid minor (origin + insertion)

Origin:

1) Nuchal ligament
2) Spinous process of C7 and T1

Insertion:
Medial border of the scapula, down to the spine

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Rhomboid minor (function + innervation + vascularization)

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Function:

1) Retract scapula
2) Rotate GH cavity inf
3) Fix scapula to thoracic wall

Innervation:
Dorsal scapular nerve (C5) (C4)

Vascularization:

1) Dorsal scapular artery
2) Deep branch of transverse cervical artery
3) Dorsal branch of upper 5 or 6 posterior intercostal arteries

Levator scapulae (origin + insertion)

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Origin:
Posterior tubercles of TPs of C1-C4

Insertion:
Superior angle of the scapula

Levator scapulae (function + innervation + vascularization)

Function: Elevate scapula, rotate scapula down, rotate GH cavity inf Innervation: Dorsal scapular nerve (C4, C5) + C3, C4 spinal nerves Vascularization: Transverse cervical and ascending cervical arteries (branches of the thyrocervical trunk)

Serratus posterior inferior muscles (origin + insertion)

Origin: Spinous processes of T11-L2 Insertion: Inferior borders of ribs 8-12 near angles

Serratus posterior superior muscles (function + innervation)

Function: Elevate ribs *Serves as retinacula (keeps deep back muscles in place) Innervation: Intercostal nerves 2-5

Serratus posterior superior muscles (origin + insertion)

Origin: 1) Nuchal ligament 2) Spinous processes of C7-T3 vertebrae Insertion: Superior borders of ribs 2-4

Serratus posterior inferior muscles (function + innervation + vascularization)

Function: - Depress ribs * Serves as retinacula (keeps deep back muscles in place) Innervation: 1) Intercostal nerves 9-11 2) T12 subcostal nerve Vascularization: 1) Posterior intercostal arteries 2) Subcostal artery & upper lumbar arteries

What common symptom will present if nerves supplying the scapulothoracic stabilizer muscles are injured? What muscles are those?

- Winging scapula - Involves serratus anterior, trapezius, rhomboids * Primary - due to dysfunction in scapulothoracic stabilizer muscles * Secondary - in association w/ other pathologies (subacromial bursitis, GH joint disorders) * Trapezius helps keep scapula against ribcage * Typically injured in posterior triangle of the neck (e.g., lymph node dissection, or iatrogenic [surgical] injury)

Types of spinal curvature abnormalities

1) Scoliosis 2) Kyphosis (thoracic) 3) Lordosis (lumbar)

Vertebral body

Round osseous part with flat ends sup + inf. Separated by IV discs.

Pedicle

"Arms" reaching out from VB. *Screws go through this to secure VBs.

Articular process

Sup + inf processes that articulate with adjacent VBs

Lamina

Top of arch forming posterior end of vertebral arch, extends from pedicles

Transverse process

Bilateral projections on either side of neural arch that serve as attachment points for muscles

Vertebral notches

Sup + inf, form the IV foramina when joined

Annulus fibrosis

Fibrocartilage rings around circumference of IV disc

Nucleus pulposus

Central core of IV disc that is soft and malleable *Can herniate into VC + compress SC/nerve roots

Uncovertebral joints

Synovial joints btwn uncus of VB of C3-C6 *Frequent sites of spur formation

C7 landmark

Vertebra prominence *Most easily palpated

T7 landmark

Inferior angles of scapula

L4 landmark

Iliac crest

Sacral promontory

Sacral landmark on radiographs *L5 right above

Layers of back

1) Skin 2) Superficial (subcutaneous) fascia - Aka tela cubcutanea, hypodermis 3) Deep (investing) fascia 4) Muscle 5) Bone

Function of superficial (extrinsic) back muscles

1) Connect upper limb to the trunk | 2) Control limb movement

Function of intermediate (extrinsic) back muscles

Serve as retinacula (help hold deeper muscles in place) *Minor role in respiration

Function of deep (intrinsic) back muscles

1) Control posture | 2) Control movements of vertebral column

Scapulohumeral rhythm

Ratio of the glenohumeral movement to the scapulothoracic movement during arm elevation

Superficial fascia

Thin layer of loose fatty connective tissue underlying the dermis and binding it to the parts beneath

Name the superficial (extrinsic) back muscles

1) Trapezius 2) Latissimus dorsi 3) Rhomboid major 4) Rhomboid minor 5) Levator scapulae

What muscle does the spinal accessory nerve innervate?

- Trapezius | - SCM

What muscles does the dorsal scapular nerve innervate?

1) Rhomboid major 2) Rhomboid minor 3) Levator scapulae

What muscle does the thoracodorsal nerve innervate?

- Latissimus dorsi

What muscle helps abduct shoulder joint to 15 degrees?

- Supraspinatus

Name the intermediate extrinsic back muscles

- Serratus posterior superior | - Serratus posterior inferior

Superficial Back Flashcards

(56 cards)