Podcast
Questions and Answers
Damage to the dorsal rami of spinal nerves would MOST directly affect which group of back muscles?
Damage to the dorsal rami of spinal nerves would MOST directly affect which group of back muscles?
- Deep back muscles involved in posture and vertebral column movement (correct)
- Superficial back muscles responsible for limb movement
- Intermediate back muscles assisting in respiration
- The muscles of the anterior abdominal wall
A patient presents with weakness in shoulder adduction, extension, and internal rotation. Which nerve is MOST likely affected?
A patient presents with weakness in shoulder adduction, extension, and internal rotation. Which nerve is MOST likely affected?
- Thoracodorsal nerve (correct)
- Anterior rami
- Spinal accessory nerve (CN XI)
- Dorsal scapular nerve (C5 root)
What is the MOST significant consequence of damaging the spinal accessory nerve (CN XI)?
What is the MOST significant consequence of damaging the spinal accessory nerve (CN XI)?
- Inability to abduct the arm beyond 15 degrees
- Loss of sensation in the posterior neck
- Difficulty in elevating, retracting, and depressing the scapula (correct)
- Impaired function of the diaphragm affecting respiration
A surgeon needs access to the ribs for a thoracic procedure and identifies the triangle of auscultation. Which muscle's position is MOST crucial in defining this space?
A surgeon needs access to the ribs for a thoracic procedure and identifies the triangle of auscultation. Which muscle's position is MOST crucial in defining this space?
A patient reports lower back pain after lifting a heavy object. Examination reveals a palpable bulge in the lumbar region lateral to the latissimus dorsi. Which anatomical landmark is MOST likely compromised, leading to the hernia?
A patient reports lower back pain after lifting a heavy object. Examination reveals a palpable bulge in the lumbar region lateral to the latissimus dorsi. Which anatomical landmark is MOST likely compromised, leading to the hernia?
During a deep dissection of the back, the serratus posterior superior is identified. What is the MOST probable action when it contracts?
During a deep dissection of the back, the serratus posterior superior is identified. What is the MOST probable action when it contracts?
Which of the following actions would be MOST impaired by damage to the splenius capitis muscle?
Which of the following actions would be MOST impaired by damage to the splenius capitis muscle?
A patient is diagnosed with injury to the erector spinae muscles on one side of their back following a trauma. What is the MOST likely observable effect of this injury?
A patient is diagnosed with injury to the erector spinae muscles on one side of their back following a trauma. What is the MOST likely observable effect of this injury?
The iliocostalis lumborum is being examined in a patient with chronic back pain. Where would clinicians palpate to assess for tenderness?
The iliocostalis lumborum is being examined in a patient with chronic back pain. Where would clinicians palpate to assess for tenderness?
If transversospinalis muscles are active, what spinal movement is the MOST likely result?
If transversospinalis muscles are active, what spinal movement is the MOST likely result?
What is the MOST immediate risk if the vertebral artery is compromised within the suboccipital triangle?
What is the MOST immediate risk if the vertebral artery is compromised within the suboccipital triangle?
A patient presents with severe neck pain and limited range of motion after a whiplash injury. Imaging reveals damage to the ligamentum nuchae. Which of the superficial muscles is MOST likely affected?
A patient presents with severe neck pain and limited range of motion after a whiplash injury. Imaging reveals damage to the ligamentum nuchae. Which of the superficial muscles is MOST likely affected?
What is the MOST direct clinical implication of understanding the arrangement of back structures from superficial to deep?
What is the MOST direct clinical implication of understanding the arrangement of back structures from superficial to deep?
A patient with a C7 vertebra fracture experiences numbness and weakness in their little finger and ring finger. Which nerve root is likely compressed due to the proximity of the vertebral injury?
A patient with a C7 vertebra fracture experiences numbness and weakness in their little finger and ring finger. Which nerve root is likely compressed due to the proximity of the vertebral injury?
What is the MOST likely consequence of disrupting the anterior longitudinal ligament?
What is the MOST likely consequence of disrupting the anterior longitudinal ligament?
During a lumbar puncture, a physician aims to access the subarachnoid space. Which of the following structures MUST be pierced AFTER the dura mater to reach this space?
During a lumbar puncture, a physician aims to access the subarachnoid space. Which of the following structures MUST be pierced AFTER the dura mater to reach this space?
A patient exhibits signs of spinal cord compression. Which structure provides the MOST immediate protection surrounding the spinal cord?
A patient exhibits signs of spinal cord compression. Which structure provides the MOST immediate protection surrounding the spinal cord?
A patient is diagnosed with thoracic kyphosis. What curvature of the vertebral column is affected?
A patient is diagnosed with thoracic kyphosis. What curvature of the vertebral column is affected?
A patient is diagnosed with scoliosis. What curvature of the vertebral column is affected?
A patient is diagnosed with scoliosis. What curvature of the vertebral column is affected?
A patient experiencing pain due to cervical disc herniation at the C5-C6 level. Which nerve root is MOST likely affected?
A patient experiencing pain due to cervical disc herniation at the C5-C6 level. Which nerve root is MOST likely affected?
A patient experiencing pain due to thoracic disc herniation at the T5-T6 level. Which nerve root is MOST likely affected?
A patient experiencing pain due to thoracic disc herniation at the T5-T6 level. Which nerve root is MOST likely affected?
A patient experiencing pain due to lumbar disc herniation at the L3-L4 level. Which nerve root is MOST likely affected?
A patient experiencing pain due to lumbar disc herniation at the L3-L4 level. Which nerve root is MOST likely affected?
Which of the following is NOT a normal curvature of the adult vertebral column?
Which of the following is NOT a normal curvature of the adult vertebral column?
What is the main functional significance of the anterior longitudinal ligament?
What is the main functional significance of the anterior longitudinal ligament?
Which feature is unique to cervical vertebrae compared to thoracic and lumbar vertebrae?
Which feature is unique to cervical vertebrae compared to thoracic and lumbar vertebrae?
What is the MOST important function of the annulus fibrosus within an intervertebral disc?
What is the MOST important function of the annulus fibrosus within an intervertebral disc?
Which motion is MOST enabled by the unique structure of the atlanto-axial joint?
Which motion is MOST enabled by the unique structure of the atlanto-axial joint?
After a spinal injury, a patient has lost sensation of pain and temperature on their left side, but motor function and proprioception are intact. Where is the MOST LIKELY location of the injury?
After a spinal injury, a patient has lost sensation of pain and temperature on their left side, but motor function and proprioception are intact. Where is the MOST LIKELY location of the injury?
Which action is MOST directly enabled by the serratus posterior inferior?
Which action is MOST directly enabled by the serratus posterior inferior?
Which of the following joints does not have an intervertebral disc?
Which of the following joints does not have an intervertebral disc?
Which of these innervates the semispinalis capitis?
Which of these innervates the semispinalis capitis?
Which of these passes through the foramen transversarium?
Which of these passes through the foramen transversarium?
If there is injury to the lumbar plexus, there could be difficulty with?
If there is injury to the lumbar plexus, there could be difficulty with?
If a patient has a injury to the dorsal scapular nerve. What does that MOST directly influence the function of?
If a patient has a injury to the dorsal scapular nerve. What does that MOST directly influence the function of?
Where does the conus medullaris terminate?
Where does the conus medullaris terminate?
What does the filum terminale consist of?
What does the filum terminale consist of?
A surgeon is planning an approach to the spinal cord and needs to understand the meningeal layers. Which of the following sequences accurately lists the meningeal layers from superficial to deep?
A surgeon is planning an approach to the spinal cord and needs to understand the meningeal layers. Which of the following sequences accurately lists the meningeal layers from superficial to deep?
Which ligament connects the laminae of adjacent vertebrae, assisting in returning the vertebral column to an erect position after flexion?
Which ligament connects the laminae of adjacent vertebrae, assisting in returning the vertebral column to an erect position after flexion?
Which of the following statements BEST describes the origin of the erector spinae muscles?
Which of the following statements BEST describes the origin of the erector spinae muscles?
A patient has a lesion affected the dorsal columns of the spinal cord. MOST accurately anticipate?
A patient has a lesion affected the dorsal columns of the spinal cord. MOST accurately anticipate?
A patient exhibits increased lumbar lordosis and a forward tilting of the pelvis. What compensatory change is MOST likely observed in the thoracic spine?
A patient exhibits increased lumbar lordosis and a forward tilting of the pelvis. What compensatory change is MOST likely observed in the thoracic spine?
A patient has a condition that leads to the ossification of the anterior longitudinal ligament. Which movement of the vertebral column will be MOST restricted?
A patient has a condition that leads to the ossification of the anterior longitudinal ligament. Which movement of the vertebral column will be MOST restricted?
Following a motor vehicle accident, a patient is diagnosed with a spinal cord injury that selectively damages the spinothalamic tract. Which sensory function would be MOST affected?
Following a motor vehicle accident, a patient is diagnosed with a spinal cord injury that selectively damages the spinothalamic tract. Which sensory function would be MOST affected?
A patient is undergoing a procedure requiring access to the vertebral canal. If the needle passes through the ligamentum flavum, what space will it enter immediately after?
A patient is undergoing a procedure requiring access to the vertebral canal. If the needle passes through the ligamentum flavum, what space will it enter immediately after?
A patient presents with a spinal tumor that is compressing the anterior horn cells in the lumbar region. Which motor function would be MOST affected?
A patient presents with a spinal tumor that is compressing the anterior horn cells in the lumbar region. Which motor function would be MOST affected?
In a patient undergoing spinal anesthesia, the anesthetic is injected into the subarachnoid space. Which of the meningeal layers is NOT penetrated by the needle in this procedure?
In a patient undergoing spinal anesthesia, the anesthetic is injected into the subarachnoid space. Which of the meningeal layers is NOT penetrated by the needle in this procedure?
A patient is diagnosed with stenosis of the intervertebral foramen at the L4-L5 level. Which structure is MOST likely to be compressed by this condition?
A patient is diagnosed with stenosis of the intervertebral foramen at the L4-L5 level. Which structure is MOST likely to be compressed by this condition?
A patient sustains a whiplash injury, resulting in hyperextension of the neck. Which ligament is MOST likely to be damaged initially?
A patient sustains a whiplash injury, resulting in hyperextension of the neck. Which ligament is MOST likely to be damaged initially?
A surgeon is performing a laminectomy to access the spinal cord. What specific part of the vertebra is removed during this procedure?
A surgeon is performing a laminectomy to access the spinal cord. What specific part of the vertebra is removed during this procedure?
During a spinal tap procedure, an inexperienced clinician punctures through the dura mater, but stops before puncturing the arachnoid mater. Which space has the needle entered?
During a spinal tap procedure, an inexperienced clinician punctures through the dura mater, but stops before puncturing the arachnoid mater. Which space has the needle entered?
A patient is diagnosed with a tumor within the vertebral foramen. This tumor is exerting pressure directly on the spinal cord. Which structure provides the MOST immediate protection to the spinal cord in this scenario?
A patient is diagnosed with a tumor within the vertebral foramen. This tumor is exerting pressure directly on the spinal cord. Which structure provides the MOST immediate protection to the spinal cord in this scenario?
A patient is diagnosed with ankylosing spondylitis, an inflammatory condition leading to fusion of the vertebrae. This primarily affects which type of joint?
A patient is diagnosed with ankylosing spondylitis, an inflammatory condition leading to fusion of the vertebrae. This primarily affects which type of joint?
A patient reports numbness along the medial side of their forearm and weakness in intrinsic hand muscles. A herniated disc is suspected. At which level is this disc herniation MOST likely located?
A patient reports numbness along the medial side of their forearm and weakness in intrinsic hand muscles. A herniated disc is suspected. At which level is this disc herniation MOST likely located?
During a forensic examination of a skeleton, the forensic anthropologist notes the presence of a bifid spinous process. This finding would MOST strongly suggest that the vertebra in question is from which region of the vertebral column?
During a forensic examination of a skeleton, the forensic anthropologist notes the presence of a bifid spinous process. This finding would MOST strongly suggest that the vertebra in question is from which region of the vertebral column?
A patient is diagnosed with a schwannoma, a type of nerve sheath tumor, affecting the dorsal root ganglion of a spinal nerve. What sensory deficit would MOST likely result from this condition?
A patient is diagnosed with a schwannoma, a type of nerve sheath tumor, affecting the dorsal root ganglion of a spinal nerve. What sensory deficit would MOST likely result from this condition?
A patient with severe facet joint arthritis undergoes a procedure to denervate the medial branch of the dorsal ramus. What is the intended outcome of this procedure?
A patient with severe facet joint arthritis undergoes a procedure to denervate the medial branch of the dorsal ramus. What is the intended outcome of this procedure?
A previously healthy individual experiences a sudden onset of bilateral lower extremity weakness and urinary retention. MRI reveals compression of the spinal cord. What is the MOST likely location of the compression?
A previously healthy individual experiences a sudden onset of bilateral lower extremity weakness and urinary retention. MRI reveals compression of the spinal cord. What is the MOST likely location of the compression?
A patient is noted to have winging of the scapula and weakness in shoulder abduction above 90 degrees. These findings suggest injury to which specific nerve and muscle group?
A patient is noted to have winging of the scapula and weakness in shoulder abduction above 90 degrees. These findings suggest injury to which specific nerve and muscle group?
A patient presents with chronic lower back pain radiating down the posterior thigh and leg. Straight leg raise test is positive. What is MOST likely the cause of this patient's pain?
A patient presents with chronic lower back pain radiating down the posterior thigh and leg. Straight leg raise test is positive. What is MOST likely the cause of this patient's pain?
A person performing a handstand relies heavily on what spinal curvature to maintain balance and prevent excessive backward sway?
A person performing a handstand relies heavily on what spinal curvature to maintain balance and prevent excessive backward sway?
A patient is asked to abduct their arm past 90 degrees. Which muscle would be MOST responsible for completing that action?
A patient is asked to abduct their arm past 90 degrees. Which muscle would be MOST responsible for completing that action?
Which of the following muscles is LEAST directly involved in forced expiration?
Which of the following muscles is LEAST directly involved in forced expiration?
If a patient is having difficulty with retraction of the scapula, which muscle group is LEAST likely involved?
If a patient is having difficulty with retraction of the scapula, which muscle group is LEAST likely involved?
A weightlifter strains their longissimus thoracis muscle during a deadlift. Where is the MOST likely location of pain?
A weightlifter strains their longissimus thoracis muscle during a deadlift. Where is the MOST likely location of pain?
What spinal ligament is MOST directly involved in limiting hyperflexion of the vertebral column?
What spinal ligament is MOST directly involved in limiting hyperflexion of the vertebral column?
A transection of the spinal cord at which level would MOST likely result in quadriplegia?
A transection of the spinal cord at which level would MOST likely result in quadriplegia?
A patient exhibits an abnormal lateral curvature of the spine. This is MOST accurately described as?
A patient exhibits an abnormal lateral curvature of the spine. This is MOST accurately described as?
Which characteristic is LEAST descriptive of lumbar vertebrae compared to cervical or thoracic vertebrae?
Which characteristic is LEAST descriptive of lumbar vertebrae compared to cervical or thoracic vertebrae?
The anterior longitudinal ligament extends from the base of the skull to the sacrum and is the ONLY ligament that limits excessive hyperextension of the posterior column. If damaged in a fall, which spinal level could the clinician use to confirm ligament location?
The anterior longitudinal ligament extends from the base of the skull to the sacrum and is the ONLY ligament that limits excessive hyperextension of the posterior column. If damaged in a fall, which spinal level could the clinician use to confirm ligament location?
Given that a patient's occupation involves constant overhead movements with their arms, which scapular movement will be MOST important to evaluate regarding potential pathology?
Given that a patient's occupation involves constant overhead movements with their arms, which scapular movement will be MOST important to evaluate regarding potential pathology?
A geriatric patient presents to the clinic. The clinical notes indicate Dowagers Hump. Clinically, there is excessive flexion at the level of the thoracic region. MOST accurately, the therapist should document the patient has what?
A geriatric patient presents to the clinic. The clinical notes indicate Dowagers Hump. Clinically, there is excessive flexion at the level of the thoracic region. MOST accurately, the therapist should document the patient has what?
Following repetitive overhead motions at work, a patient struggles with flexion and lateral rotation at the shoulder. This is due to the trapezius not properly upwardly rotating causing issues beyond 90 degrees of abduction. MOST accurately, which nerve is responsible for this movement pattern?
Following repetitive overhead motions at work, a patient struggles with flexion and lateral rotation at the shoulder. This is due to the trapezius not properly upwardly rotating causing issues beyond 90 degrees of abduction. MOST accurately, which nerve is responsible for this movement pattern?
There has been damage to the vertebral artery around the suboccipital triangle. What impact will that present to MOST accurately?
There has been damage to the vertebral artery around the suboccipital triangle. What impact will that present to MOST accurately?
Following clinical observation. It is determined a patient needs work completed on forced exhalation for respiratory dysfunction. Clinically, which muscle will be MOST appropriate to treat?
Following clinical observation. It is determined a patient needs work completed on forced exhalation for respiratory dysfunction. Clinically, which muscle will be MOST appropriate to treat?
While palpating a posterior back, the practitioner touches the spinous process. MOST accurately, which area of the vertebrae is being touched?
While palpating a posterior back, the practitioner touches the spinous process. MOST accurately, which area of the vertebrae is being touched?
While completing a spinal tap, there has been entry into the dura mater. Name ONE structure that has NOT been affected.
While completing a spinal tap, there has been entry into the dura mater. Name ONE structure that has NOT been affected.
A clinic is having a discussion of the filum terminale. Which is MOST accurate to indicate?
A clinic is having a discussion of the filum terminale. Which is MOST accurate to indicate?
During development, there are structural changes with the level of the spinal cord. MOST accurately at birth, which is the approximate level of termination?
During development, there are structural changes with the level of the spinal cord. MOST accurately at birth, which is the approximate level of termination?
Due to structural changes within the development of the spinal cord, which structures are oblique around the spinal cord?
Due to structural changes within the development of the spinal cord, which structures are oblique around the spinal cord?
If a patient has structural damage at the C1-C2 level, what amount of cervical rotation will MOST likely be affected?
If a patient has structural damage at the C1-C2 level, what amount of cervical rotation will MOST likely be affected?
Flashcards
Superficial back muscles function
Superficial back muscles function
Anchors upper limb to axial skeleton & extends from skull to pelvis.
Deep back muscles
Deep back muscles
Consists of intrinsic or native muscles of the back (dorsum).
Trapezius actions and innervation
Trapezius actions and innervation
Elevates, retracts, and depresses the scapula; spinal accessory nerve (CN 11), C34
Latissimus Dorsi action and nerve
Latissimus Dorsi action and nerve
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Rhomboid Minor action and nerve
Rhomboid Minor action and nerve
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Rhomboid Major action and nerve
Rhomboid Major action and nerve
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Levator Scapulae action and nerve
Levator Scapulae action and nerve
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Triangle of Auscultation boundaries
Triangle of Auscultation boundaries
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Lumbar Triangle of Petit boundaries
Lumbar Triangle of Petit boundaries
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Serratus posterior superior action and nerve
Serratus posterior superior action and nerve
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Serratus posterior inferior action and nerve
Serratus posterior inferior action and nerve
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Splenius muscles
Splenius muscles
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Erector Spinae Muscle action
Erector Spinae Muscle action
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Iliocostalis muscle
Iliocostalis muscle
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Longissimus muscle
Longissimus muscle
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spinalis muscle
spinalis muscle
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Transversospinalis Muscles
Transversospinalis Muscles
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Sub-Occipital Triangle contents
Sub-Occipital Triangle contents
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Origin of Obliquus capitis inferior
Origin of Obliquus capitis inferior
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Origin of Obliquus capitis superior
Origin of Obliquus capitis superior
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Origin of Rectus capitis posterior major
Origin of Rectus capitis posterior major
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Function of the bony anatomy of the spine
Function of the bony anatomy of the spine
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Lordosis
Lordosis
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Kyphosis
Kyphosis
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Normal anatomy of a vertebrae component
Normal anatomy of a vertebrae component
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Atlas vertebrae characteristic?
Atlas vertebrae characteristic?
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Axis (C2) vertebrae characteristic?
Axis (C2) vertebrae characteristic?
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Sub-Axial Cervical Vertebrae (C3-C7) distinctive characteristics
Sub-Axial Cervical Vertebrae (C3-C7) distinctive characteristics
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Thoracic Vertebrae: Transverse process (TP) distinctive?
Thoracic Vertebrae: Transverse process (TP) distinctive?
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Lumbar Vertebrae: Body distinctive characteristics?
Lumbar Vertebrae: Body distinctive characteristics?
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Anterior longitudinal ligament
Anterior longitudinal ligament
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Posterior Longitudinal Ligament
Posterior Longitudinal Ligament
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Tectorial membrane
Tectorial membrane
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Supraspinous ligament
Supraspinous ligament
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Ligament Flavum (yellow ligament)
Ligament Flavum (yellow ligament)
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What covers the spinal cord
What covers the spinal cord
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Spinal Cord :gestation?
Spinal Cord :gestation?
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Dura Mater
Dura Mater
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Denticulate ligaments
Denticulate ligaments
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Conus medullaris
Conus medullaris
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Formation of a Spinal nerve
Formation of a Spinal nerve
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Nerve Roots
Nerve Roots
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Study Notes
Back Muscles
- Back muscles are categorized into three groups: superficial, intermediate, and deep.
Superficial Back Muscles
- Superficial muscles anchor the upper limb to the axial skeleton and extend from the skull to the pelvis.
- These muscles receive nerve supply from ventral (anterior) nerve rami.
Intermediate Back Muscles
- Intermediate muscles function in respiration and receive innervation from ventral (anterior) nerve rami.
Deep Back Muscles
- Deep muscles consist of intrinsic or native muscles of the back and receives innervation from dorsal nerve rami.
Trapezius
- The trapezius originates from the medial 1/3 of the superior nuchal line, external occipital protuberance, ligament nuchae, spine of C7, and supraspinous ligament of all T-vertebrae.
- Trapezius inserts the upper fibers into the lateral 1/3 of the clavicle, the middle fibers into the acromion process and upper border of the scapula, and the lowest fibers into the medial end of the spine of the scapula.
- The spinal accessory nerve (CN 11) and C3/C4 innervate the trapezius.
- Trapezius upper fibers elevate the scapula, the middle fibers retract it, and the lowest fibers depress the medial border of the scapula
Latissimus Dorsi
- Latissimus Dorsi originates from the posterior part of the iliac crest, lumbar fascia, lower 6-7 T-vertebrae, and fibers from the inferior angle of the scapula
- Latissimus Dorsi inserts onto the floor of the bicipital groove of the humerus.
- This muscle receives innervation from the thoracodorsal nerve and adducts, extends, and internally rotates the shoulder.
Rhomboid Minor
- Rhomboid Minor originates from the lower part of ligamentum nuchae, spines of C7-T1 vertebrae and inserts on the medial border of the scapula opposite the root of the spine.
- The dorsal scapular nerve (C5 root) innervates this muscle
- Action is retraction of scapula and position of attention
Rhomboid Major
- Originates from T2-T5 spines & corresponding supraspinous ligament
- Inserts on Medial border of scapular opposite infraspinous fossa
- Dorsal scapular nerve (C5 root)
- Action is retraction of scapula and position of attention
Levator Scapulae
- Originates from transverse process of upper 4 C-vertebrae and inserts on the medial border of the scapula opposite supraspinous fossa
- Dorsal scapular nerve (C5 root)
- Action is elevation of the scapula
Triangle of Auscultation
- Inferior border is the latissimus dorsi
- Medial border is the trapezius
- Lateral border is medial border of scapula
- Ribs 6 & 7 lie within the triangle, so this area is suited for auscultation
Lumbar Triangle of Petit
- Medial border is the latissimus dorsi
- Lateral border is the external abdominal oblique muscle
- Inferior border is the iliac crest
- Lumbar hernias can develop here that contain fat and intestinal contents.
Serratus Posterior Superior
- The serratus posterior superior originates from the supraspinous ligament, ligament nuchae, C7-T3 spinous process.
- Inserts to the upper border of ribs 2-5.
- The serratus posterior superior is innervated by anterior rami and intercostal nerves 2-5, elevating the upper ribs during inhalation.
Serratus Posterior Inferior
- Serratus posterior inferior originates from the supraspinous ligament, spinous process of T11-L3 vert
- Insertion: Lower border of ribs 9-12.
- Anterior rami and intercostal nerves 9-12 innervate it
- Draws the lower ribs down & backward during exhalation
Splenius Muscles
- The splenius muscles cover the other deep muscles in the cervical region.
- These muscles originate from the nuchal ligament and upper thoracic spinous processes.
- They insert onto the mastoid process, lateral aspect of superior nuchal line, and transverse processes of C1-C3.
Semispinalis
- Transverse processes of the upper thoracic vertebrae serve as its origin
- Inserts onto the occipital bone between the nuchal lines
- Traversed by the greater occipital nerve
- The thickest muscle of the posterior neck region
Semispinalis cervicis & thoracis
- All the T-transverse processes serve as the origin and inserts on the spinous process 4-6 segments higher than their origin
Erector Spinae Muscles
- Formed by long vertically running muscle bundles on each side of the vertebral column.
- Action is to enable the whole spine to extend and bends column laterally when only one side is active
Erector Spinae Columns
- Iliocostalis (lateral), Longissimus (middle), and Spinalis (medial).
- Dorsal rami of spinal nerves innervate these muscles.
Iliocostalis
- Most lateral column of the Erector Spinae Muscles
- Originates from the iliac crest and inserts on the ribs
- The 3 parts are:
-Iliocostalis cervicis, originates from the Upper 6 ribs
- Iliocostalis thoracis, originates from the lower 6 ribs -Iliocostalis lumborum: the origin is the iliac crest
Longissimus
- Middle column of the Erector Spinae Muscles
- Insertion: mastoid process of skull
- There are 3 parts:
- Longissimus capitis
- Longissimus cervicis
- Longissimus thoracis
Spinalis
- The medial column of the erector spinae muscles
- Connects to the spinous processes of the lumbar, thoracic & cervical vertebrae
- 3 parts: Spinalis capitis, Spinalis cervicis, Spinalis thoracic
Transversospinalis Muscles
- Located under the erector Spinae muscles
- Fills the groove between the transverse processes & spinous processes
- Origin is from the transverse process
- Insertion is the spinous process
- The muscles include:
- Semispinalis -Multifidus
- Rotatores:
- 3 segments: Cervices, thoracis, lumborum
- Interspinales
3 segments: Cervices, thoracis, lumborum
-Intertransversarii
- 3 segments: Cervices, thoracis, lumborum
Sub-Occipital Triangle Muscles
- Splenius Capitus
- Semispinalis Capitis
- Semispinalis cervicis
Sub-Occipital Triangle: Boundaries
- Obliqus capitis inferior (inferior oblique): Spinal process C2
- the transverse process C1 serves as insertion
- Action to stabilize, extend, and rotate head
- Suboccipital nerve innervates
- Obliquus capitis superior (superior oblique): the Transverse process of C1 serves as the Origin and inserts onto Occipital bone Action is to extend the head Suboccipital nerve innervates
Sub-Occipital Triangle: Rectus Capitis Muscles
- Rectus capitis posterior major: Located medially
- Origin: Spinous process of C2
- Insertion: Inferior nuchal line of occipital bone
- Action: Stabilizes, extends, and rotates the head
- Innervation: Suboccipital Nerve
- Rectus Capitis Posterior Minor - Origin: Spinous process of C1 vertebrae -Supports and acts to extend the head
- Innervation: Suboccipital nerve
Bony Anatomy of the Spine
- Functions to support soft tissues
- Protect vital organs
- helps with movement
Vertebral Regions
- 7 Cervical vertebrae
- 12 Thoracic vertebrae
- 5 Lumbar vertebrae
- 5 sacral fused vertebrae
- 2 coccyx (fused) vertebrae
Curves of the Vertebral Column
- Cervical & Lumbar regions: Lordosis that is Convex anterior
- Thoracic & sacral regions: Kyphosis that is Concave anterior
- Spinal Curvature: Scoliosis with females that are more often in adult
- Spinal Curvature: Lordosis caused by Osteoporosis, Pregnancy, or Obesity
Anatomy of Vertebrae
- The body of the vertebra is anterior, and the neural arch is posterior
- Spinous process protrudes from the posterior aspect
- Transverse process protrudes from the lateral edges
- Articular facets are laminates and pedicles located at the point
Cervical Vertebrae
- The cervical vertebrae are located in the SUPERIOR position
- Includes vertebral artery and first cervical spinal nerve
Atlas (C1)
- Ring-like; somewhat kidney-shaped
- No spinous process or body; consists of two lateral masses connected by anterior and posterior arches
- Concave superior articular facets form atlanto-occipital joints with the occipital condyles
Axis (C2)
- The strongest cervical vertebra
- Distinguishing feature is the dens, which projects superiorly from its body and provides provides a pivot around which the atlas turns and carries the cranium. Articulates anteriorly with the anterior arch of the atlas and posteriorly with the transverse ligament of the atlas
Sub-Axial Cervical Vertebrae (C3-C7)
- Bodies are small
- Transverse processes: small or absent in C7
- Articular processes directs superoposteriorly
- Spinous process bifurcation
Thoracic Vertebrae
- Heart-shaped and the vertebral foramen is circular
- Transverse processes is long while the spinous process slopes
- Superior articular facets directed posteriorly and slightly laterally with Demi-facets where superior and lower
- Contains facet on the transverse process where the ribs articulate
Lumbar Vertebrae
- Massive kidney shaped
- Triangular foramen with long slender transverse processes and directed posteromedial and lateral
- The spinous process is short and sturdy, and hatchet-shaped.
Sacral Vertebrae
- Consists of 5 fused vertebrae
- Articulates with L5 and the coccyx Consists of Sacral tuberosity, auricular surface, Sacral cornu
- Contains both anterior and posterior foramina
Ligaments
- Anterior Longitudinal ligament
- Posterior longitudinal ligament
- Ligamentum flavum or Yellow Ligament
- Interspinous ligament and Supraspinous ligament
Anterior Longitudinal Ligament (ALL)
- Extends vertically on the anterior surface of the discs & bodies
- Extends from the axis (C2) to the sacrum and limits hyperextension
Posterior Longitudinal Ligament (PLL)
- Extends vertically on the posterior surface of the discs & bodies
- Extends from the axis (C2) to the sacrum and limits flexion and intervertebral disc herniation
Tectorial Membrane
- Broad extension of the posterior longitudinal ligament attaching the axis to the occipital bone
Supraspinous Ligament
- Attaches the tips of the spinous processes together, becoming the nuchal ligament in the cervical area
Ligament Flavum (Yellow)
- Connects the laminae of the adjacent vertebrae, bounds to the foramen and assists with extension to column
Spinal Cord
- At 6 months of gestation, the spinal cord ends at S1 level
- At birth, the spinal cord lies at the level of L3
- In adults, it ends at L1-L2 (never below L2)
- It tapers to a cone shaped ending called the conus medullaris
Spinal Cord Nerves
- All of the roots of the spinal nerves from L2 to the coccygeal pass caudal to the conus medullaris
- This mass is called the cauda equina which begins at the foramen magnum & ends at L1-2
Filum terminale
- Stalk of pia mater that reaches spinal cord and attaches to the end
- Dura mater which is the tough fiberous sheath
Spinal cord meninges
- 3 membranes covers the spinal cord with and Epidural space between dura and bone
- Dura Mater is continuous in the skull and is a tough fiborous sheath
- The arachnoid mater beneath the dura mater and is continuous with the arachnoid of brain
- Subarachnoid Space located in between arachnoid and pia mater contains the cord
Spinal nerve Components
- Rootlets, Roots, Dorsal root ganglion, Spinal nerve, Dorsal rami, Ventral rami
- Spinal cord protected by 3 membrane surrounding each side between the dorsal nerve
Nerve Roots
- Dorsal roots transmit only sensory fibers with cell bodies in dorsal root ganglion
- Anterior roots transmit motor neuron and located in the anterior horn of the spinal cord
- Unite to form the spinal nerve.
Disc Herniation
- C1-C2 are where there are No discs between them
- C4-C5 Involves the C5 Nerve Root
- C5-C6 Nerve Root Involves C6
- C6-C7 Nerve Root Involves C7
- C7-T1 Nerve Root Involves C8
Thoracic and Lumbar Disc Herniation
- T1-T2 Nerve Root Involves T1, T2-T3 Nerve Root Involves T2, T3-T4 Nerve Root Involves T3, T4-T5 Nerve Root Involves T4, T5-T6 Nerve Root Involves T5, T6-T7 Nerve Root Involves T6, T7-T8 Nerve Root Involves T7, T8-T9 Nerve Root Involves T8
- LUMBAR: L3-L4 Nerve Root Involves L4
- L4-L5 Nerve Root Involves L5, L5-S1 Nerve Root Involves S1, and S234 contains NO disc from vertebrae
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Overview of back muscles, categorized into superficial, intermediate, and deep layers. Includes origin, insertion, and innervation of muscles, such as the trapezius, and their function in respiration and skeletal movement. Focus on anatomical structure and nerve supply.
