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Anatomy > Superficial, Deep Back, SubOccipital Triangle > Flashcards

Superficial, Deep Back, SubOccipital Triangle Flashcards

1
Q

3 sides of the scapula

A

Medial, Lateral, Superior

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2
Q

Insertion/Innervation of Intermediate muscles

A

Insertion: Ribs distal to angle

Innervation: Spinal nerves, anterior rami

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3
Q

Superior angle of the scapula

A

Where superior and medial borders meet

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4
Q

Insertion/Innervation of Deep muscles

A

Insertion: vertebrae, skull, ribs (angle and proximal)

Innervation: Spinal nerves, posterior rami

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5
Q

Glenoid fossa

A

Articulating surface of the scapula to the humerus

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6
Q

Superficial fascia

A
  • Immediately deep to the skin
  • Contains branches of nerves/blood vessels/lymphatics
  • Loose network of connective tissue
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7
Q

Insertion/Innervation of superficial muscles

A

Insertion: Scapula

Innervation: Cranial nerve (XI), spinal nerves via plexus

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8
Q

Rhomboid Major and Minor Action

A

Retraction and downward rotation of scapula

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9
Q

Rhomboid Major: Origin, Insertion, Innervation, Arterial Supply

A
  • O: Nuchal and supraspinious ligaments, spinous process of T2-5
  • I: medial border of scapula, inferior to minor insertion
  • In: Dorsal scapular nerve (C5 branch of brachial plexus)
  • A: Dorsal scapular artery
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10
Q

Serratus Posterior Inferior: Origin, Insertion, Innervation, Arterial Supply

A
  • O: spinous process of T11-L2
  • I: Ribs 9-12, just distal to angle of the rib
  • In: anterior rami of T9-T12 (T9-T11 are intercostal nerves, T12 is subcostal nerve)
  • A: Posterior intercostal arteries (branches of aorta)
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11
Q

Hip-hitching

A

Ability of paraplegic to shift hips due to Lat connection to iliac crest, helps prevent bed sores

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12
Q

Levator Scapulae: Origin, Insertion, Innervation, Arterial supply

A
  • O: transverse process of C1-C4
  • I: Superior angle of the scapula
  • In: dorsal scapular nerve (C5 of brachial plexus)
  • A: Dorsal scapular artery (subclavian origin) or deep branch of transverse cervical artery
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13
Q

iatrogenic

A

Caused by a physician

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14
Q

Rhomboid Minor: Origin, Insertion, Innervation, Arterial Supply

A
  • O: Nuchal and Supraspinous ligaments, spinous process of C7-T2
  • I: superior portion of the medial border of the spine
  • In: Dorsal scapular nerve (C5 branch of brachial plexus)
  • A: dorsal scapular artery (subclavian origin) or deep branch of transverse cervical artery
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15
Q

Action of the Trapezuis

A
  • Acts on the pectoral girdle
    • Elevation (descending fibers)
    • Depression (ascending fibers)
    • Retraction (aka adduction, middle fibers)
    • Upward rotation of the scapula (descending/inferior fibers)
    • Extension of head/neck
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16
Q

Arteries off of the Subclavian artery that go to the back

A

Thyrocervical truck → Transverse cervical artery

Bifercates!

Deep Transverse cervical branch (aka dorsal scapular artery when directly comes off of the subclavian artery): medial border of scapula

Superficial Transverse cervical branch: run deep to the trapezius

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17
Q

Trapezuis: Origin, Insertion, Innervation, Arterial Supply

A
  • O: Superior nuchael line, external occipital protuberance, nuchael ligament, C7-T12
  • I: later 1/3 of clavicle, acromion process, spine of the scapula
  • Innervation: Accessory XI
  • A: Superficial branch of transverse cervical artery
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18
Q

Triangle of Auscultation

A

Medial: Inferior margin of trapezius

Inferior: Superior margin of latissimus Dorsai

Lateral: medical border of scapula

Floor: 6th/7th rib and external intercostal within the 6th space

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19
Q

Thoracodorsal artery pathway

A

Branches off axillary artery, through the axilla, to the deep surface of the lats

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20
Q

Posterior Intercostal Arteries Pathway

A

Branches off of descending aorta, runs along the thoracic wall within the intercostal spaces

Gives rise to dorsal branch artery

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21
Q

What innervated the subcutaneous tissue of the back?

A
  • Posterior rami of spinal nerves C4 to L3 bifurcate to form posterior cutaneous branch.
  • Medial branch forms the posterior branch in mid-thoracic
  • Lateral branch of rami froms posterior branch in lower-thoracic/Lumber
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22
Q

Clinical test for Accessory nerve function

A

Elevation of shoulder girdle against resistance (since clavicle supports shoulder, not the trapezius)

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23
Q

Plexus

A
  • Anterior rami of multiple spinal nerves combined
  • Cervical, brachial, lumbar, sacral
  • T1 anterior ramus connects to brachial plexus
  • T12 anterior ramus connects to lumbar plexus
24
Q

Thoracolumbar fascia

A
  • Extensive sheet extending to sacrum and iliac crest superiorly to the neck, from the spinous process laterally to the angle of the ribs
  • 3 distinct layers
  • Helps with lumbar stability
  • Ultrasound can show reduced mobility often associated with lower back pain
25
Q

Cervical nerve block placement

A

Posterior triangle

26
Q

Accessory nerve

A
  • Cranial nerve XI
  • Motor nerve
  • Enters via foramen magnum, exits jugular foramen, crosses internal jugular vein, runs into posterior triangle of the neck
  • High iatrogenic injury rate
27
Q

Acromion

A

Large-flattened, anteriorly-directed process off of the lateral tip of the scapula spine

28
Q

Deep Fascia

A
  • Compact sheet dominated by collagen
  • Surrounds or encases other structures, particularly muscle
29
Q

Inferior angle of the scapula

A

Where the lateral and medial angles meet

30
Q

Serratus Posterior Superior: Origin, Insertion, Innervation, Arterial Supply

A
  • O: Nuchal ligament, spinous process of C7-T3
  • I: ribs 2-5, Just distal to the angle of the rib
  • In: Anterior rami T2-T5 (intercostal nerves)
  • A: Posterior intercostal arteries (branches of aorta)
31
Q

Latissimus Dorsi: Origin, Insertion, Innervation, Arterial Supply

A
  • O: C7-T12 spinous processes, ribs 9-12, thoracolumbar fascia, iliac crest
  • I: Floor of intertubercular sulcus on anterior humerus
  • In: Thoradorsal nerve (C6-8 branch of brachial plexus)
  • A: Thoradorsal artery (branch of axillary)
32
Q

Investing fascia

A

Continuous with the epimysium of the muscle

33
Q

Back muscles drain into what major veins?

A

Brachiochephalic or Azygous veins

34
Q

Cause of mild scapular winging

A

Dorsal scapular nerve being entrapped in scalenus muscle

35
Q

Septum

A

Deep fascia extending from superficial fascia to skeletal features, defining compartments

36
Q

Thoracolumbar fascia: Shape/thickness, Area, Layers

A
  • Covers thoracic, lumbar, and sacral regions, blending into the serrated posterior inferior, lats, transverse abdominis
  • Posterior, middle, anterior layers
  • Thickens inferiorly
37
Q

Posterior Layer of Thoracolumbar fascia: Attachements, what it covers

A
  • Attachments: spinous process of lumbar, median sacral crest, supraspinous ligaments
  • Covers the erector spinae muscles
38
Q

Middle layer of thoracolumbar fascia: Attachments, role in anatomy borders

A
  • Attachments: transverse processes of lumbar, lower boarder of rib 12, iliac crest
  • Divides the back from the posterior abdominal wall (covers posterior portion of quadratus lumborum and anterior portion of erector spinae)
39
Q

Splenius cervicis: Origin, Insertion, Action

A
  • O: Spinous process of T3-T6
  • I: Transverse process of C1-C3
  • Action: extends the head/neck, lateral flex/rotates head toward contracting muscle
40
Q

Splenius Capitis: Origin, Insertion, Action

A
  • O: Spinous process of C7-T4, inferior ligamentum nuchae
  • I: Lateral 1/3 of superior nuchal line/mastiod process
  • A: Extends head/neck, lateral flex/rotate the head towards the contracting mucsle
41
Q

Erector Spinae: Origin, Subdivisions, Actions

A
  • O: Common Tendon of origin (attaches to the spinous process of lumbar/lower thoracic, sacrum, iliac crests)
  • Divisions: Iliocostalis, Longissimus, Spinalis
  • Extends the back/neck, laterally flexes the back/neck (ipsilateral contraction)
42
Q

Illiocostalis Divisions: Origins and Insertions

A
  • Lumborum: Common tendon of origin ►angle of lower 7 ribs
  • Thoracis: Angle of lower 6 ribs ►Angle of upper 6 ribs/transverse process of C7
  • Cervicis: Angle of ribs 3-6 ►Transverse process of C4-C6
  • Note: Inferior muscles are more lateral than superior, origin of superior overlaps insertion of inferior
43
Q

Longissimus Divisions: Origins ►Insertions

A
  • Thoracis: Common tendon of origin/transverse processes of the lumbar ► transverse processes of thoracic/ ribs 2-12
  • Cervicis: Transverse process of T1-T6 ► Transverse process of C2-C6
  • Capitis: Transverse process of C4-T4/articular process of C4-C7 ►mastiod process
  • Note: Capitis must extend laterally to meet mastiod process
44
Q

Spinalis Divisions: Origin ► Insertion

A
  • Thoracis: spinous process of T10-L3 ►spinous process of T2-T8
  • Cervicis: spinous process of C5-T2 ► spinous process of C2-C5
  • Capitis: Indistinguishable from semispinalis in most people
45
Q

Transversospinalis Divisions, general origins/insertions, and Action

A
  • Divisions: Semipinalis, Multifudus Rotatores
  • O/I: originate from transverse process and insert onto a superior spinous process
  • Action: extend the back, trunk flexion (ipsilateral contration), rotation of trunk (contralateral contraction
46
Q

Semipinalis Divisions: Origin ► Insertions

A
  • Thoracis: Transverse process of T6-T10 ► Spinous process of C6-T4
  • Cervicis: TP of T1-T6 ► SP of C1-C5
  • Capitis: TP of C7-T6 ► Articular process of C4-C6
  • Note: semispinalis extend the neck and rotate the head ipsilaterally
47
Q

Multifundus: Origin, Insertion, Action

A
  • O: Sacrum, common tendon of origin, PSIS, mammillary processes (lumbar), TP of thoracic, articular process of lower 4 cervical
  • I: Base of spinous process of a veterbrae from L5 to C2
  • Stabilizer of vertebral column
  • Deep to semipsinalis and are individual muscles that run up the spine
48
Q

Rotators Divisions: general origin/insertion and action

A
  • Longus: 2 vertebrae levels, transverse process to spinous process 2 levels up
  • Brevis: 1 vertebral level, transverse process to spinous process 1 level up
  • Proprioception organs/Stabilizes the column
49
Q

Segmental muscles

A

Levatores Costarum

Intertransversarii

Interspinales

50
Q

Lavatores costarum: divisions, general origins/insertions, action

A
  • Oblique fibers that run laterally and inferiorly
  • O: transverse processes of C7-T11
  • I: near tubercle of the rib
  • Bravis: crosses 1 vertebral joint
  • Longus: crosses 2 vertebral joints
  • Elevates the ribs
51
Q

Intertransverssarii

A

Span between adjacent transverse processes

52
Q

Interspinales

A

Span between adjacent spinous processes

53
Q

Muscles of the sub occipital triangle

A
  • Obliquus capitis: superior/inferior
  • Rectus capitis: superior/inferior
54
Q

Obliquus Capitis divisions, origin/insertion, action

A
  • Inferior: Sp of C2 ►TP of C1, ipsilateral rotation of the head
  • Superior: TP of C1 ► Occipital bone between nuchal lines, extends head/ipsilateral head bend
55
Q

Rectus Capitis: division, origin/insertion, action

A
  • Major: SP of C2 ►Occipital bone below inferior nuchal line, Extends head/ipsilateral rotation
  • Minor: Posterior tubercle of C1 ► Occipital bone below inferior nuchal line, Contributes to extension of the head
56
Q

Neural nerves to suboccipital triangle

A
  • C1: Suboccipital nerve
  • C2: Greater/Lesser occipital nerve
57
Q

Arteries that serve the suboccipital triangle

A
  • Vertebral artery (through the transverse foramina and pierces the posterior atlanto-occipital membrane)
  • Occipital artery from the external carotid artery

Anatomy (35 decks)

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