Week 1 SAQs 1.docx PDF

# Cervical Vertebra ## Boundaries & Contents of the Cervical Transverse Foramina: - **Boundaries:** Surrounding transverse processes - **Contents:** Vertebral artery and vein (C6 to C1) and accompanying sympathetic plexus ## Movements Permitted at the Thoracic Vertebral Column: - **Sagittal Plane...

# Cervical Vertebra ## Boundaries & Contents of the Cervical Transverse Foramina: - **Boundaries:** Surrounding transverse processes - **Contents:** Vertebral artery and vein (C6 to C1) and accompanying sympathetic plexus ## Movements Permitted at the Thoracic Vertebral Column: - **Sagittal Plane:** Flexion occurs in the sagittal plane, limited by rib attachments - **Frontal Plane:** Extension occurs in the frontal plane ## Action of the Erector Spinae Muscles: - **Bilateral Action:** Bilateral contraction extends the thoracic vertebral column ## Most Distal Joint Influenced by the Sacral Vertebrae: - **Sacroiliac Joint:** The sacroiliac joint is the most distal joint influenced by the sacral vertebrae ## Joint that Does Not Allow Rotation: - **Costovertebral Joints:** The rotation in the thoracic region is restricted at the costovertebral joints due to rib attachments ## Movement Restricted by the Anterior Longitudinal Ligament: - **Cervical Spine:** The anterior longitudinal ligament limits hyperextension in the cervical spine ## Muscles Attaching to Thoracic Spinous Processes: - **Trapezius:** - **Rhomboid Major:** - **Latissimus Dorsi:** ## Movements Permitted at the Cervical Vertebrae: - **Sagittal Plane:** Flexion and extension - **Frontal Plane:** Lateral flexion - **Transverse Plane:** Rotation ## Type of Contraction Performed During Forward Flexion of the Thoracic Spine: - **Eccentric Contraction:** The erector spinae muscles perform eccentric contraction during forward flexion in the thoracic spine, controlling the descent of the vertebral column # Sacral Vertebra ## Segments in a Sacral Vertebra Before Fusion: - **5 Segments:** A sacral vertebra contains five segments before fusing into a single sacrum ## Vertebral Region Characterized by Ribs Articulating with Transverse Processes: - **Thoracic Vertebral Region:** Ribs articulate with the transverse processes in the thoracic vertebral region ## Dorsal or Ventral: Cervical Vertebra: - **Both Dorsal and Ventral:** The cervical vertebrae contain both dorsal (neural arch) and ventral (vertebral body) components ## Dorsal or Ventral: Thoracic Vertebra: - **Both Dorsal and Ventral:** The thoracic vertebrae contain both dorsal (neural arch) and ventral (vertebral body) components ## Dorsal or Ventral: Lumbar Vertebra: - **Both Dorsal and Ventral:** The lumbar vertebrae contain both dorsal (neural arch) and ventral (vertebral body) components ## Dorsal or Ventral: Sacral Vertebra: - **Both Dorsal and Ventral:** The sacral vertebrae contain both dorsal (neural arch) and ventral (vertebral body) components ## Pre-Axial or Post-Axial: Cervical Vertebra: - **Post-Axial:** The cervical vertebrae are post-axial, meaning they are positioned posterior to the notochord ## Pre-Axial or Post-Axial: Thoracic Vertebra: - **Post-Axial:** The thoracic vertebrae are post-axial, meaning they are positioned posterior to the notochord ## Pre-Axial or Post-Axial: Lumbar Vertebra: - **Post-Axial:** The lumbar vertebrae are post-axial, meaning they are positioned posterior to the notochord ## Pre-Axial or Post-Axial: Sacral Vertebra: - **Post-Axial:** The sacral vertebrae are post-axial, meaning they are positioned posterior to the notochord # Descriptions of Vertebrae ## Cervical Vertebra: - **Small, Oval Body:** The cervical vertebrae have a small, oval body - **Transverse Foramina:** - **Bifid Spinous Processes:** ## Thoracic Vertebra: - **Heart-Shaped Body:** - **Costal Facets:** The thoracic vertebrae contain costal facets for rib attachment - **Long, Downward-Sloping Spinous Processess:** ## Sacral Vertebra: - **Fused Vertebrae:** The sacral vertebrae are fused to form the sacrum - **Stable Base:** The sacrum provides a stable base for the spine and transmits weight to the pelvis # Nerve Supply ## Nerve Supply of the Intertransversarii Muscles in the Cervical Region: - **Ventral Rami of Spinal Nerves:** The intertransversarii muscles in the cervical region are innervated by the ventral rami of the cervical spinal nerves ## Nerve Supply of the Intertransversarii Muscles in the Lumbar Region: - **Dorsal and Ventral Rami of Spinal Nerves:** The intertransversarii muscles in the lumbar region are innervated by the dorsal and ventral rami of the lumbar spinal nerves # Lesion to the Cervical Spinal Nerves ## Possible Clinical Signs: - **Weakness:** - **Sensory Deficits:** Sensory deficits may occur at intervertebral joints between cervical vertebrae ## Lesion to the Lumbar Spinal Nerves ## Possible Clinical Signs: - **Motor Deficits:** - **Sensory Deficits:** Motor and sensory deficits may occur at intervertebral joints between lumbar vertebrae # Common Injury Mechanisms ## Cervical Vertebrae: - **Hyperextension Injuries:** Hyperextension injuries, such as whiplash, are common in the cervical region ## Lumbar Vertebrae: - **Repetitive Axial Loading:** - **Improper Lifting:** Repetitive axial loading or improper lifting can lead to disc herniation in the lumbar vertebrae # Multifidus & Erector Spinae Muscles ## Common Action: - **Stabilize Spine:** Both the multifidus and erector spinae muscles stabilize the spine - **Assist in Extension:** # Intertransversarii & Interspinales Muscles ## Common Action: - **Stabilize Vertebrae:** Both the intertransversarii and interspinales muscles stabilize the vertebrae - **Fine-Tune Movement:** # Sclerotome ## Segment Contributing to the Cervical Vertebrae: - **Cervical Somites:** The sclerotome of cervical somites contributes to the cervical vertebrae ## Segment Contributing to the Lumbar Vertebrae: - **Lumbar Somites:** The sclerotome of lumbar somites contributes to the lumbar vertebrae # Spinal Nerve Exit ## Cervical Vertebral Column: - **Intervertebral Foramen:** The spinal nerves exit the cervical vertebral column through the intervertebral foramen ## Lumbar Vertebral Column: - **Intervertebral Foramen:** The spinal nerves exit the lumbar vertebral column through the intervertebral foramen # Transverse Foramen ## Boundaries & Contents: - **Boundaries:** Transverse processes - **Contents:** Vertebral artery and vein, and sympathetic plexus # Intervertebral Foramen (Thoracic Region) ## Boundaries & Contents: - **Boundaries:** Superior and inferior notches, vertebral body, and zygapophyseal joints - **Contents:** Spinal nerves and dorsal root ganglia # Sagittal Plane Movement ## Cervical Vertebrae: - **Flexion and Extension:** Flexion and extension occur in the sagittal plane of the cervical vertebrae ## Lumbar Vertebrae: - **Flexion and Extension:** Flexion and extension occur in the sagittal plane of the lumbar vertebrae # Unilateral Action of the Erector Spinae Muscles ## Thoracic Region: - **Lateral Flexion:** Unilateral action of the erector spinae muscles produces lateral flexion of the thoracic vertebrae # Bilateral Action of the Multifidus Muscles ## Lumbar Region: - **Extension** Bilateral action of the multifidus muscles produces extension of the lumbar vertebrae # Most Distal Joint Influenced by the Sacral Vertebrae: - **Sacroiliac Joint:** The sacroiliac joint is the most distal joint influenced by the sacral vertebrae # Anterior Longitudinal Ligament ## Joint that Does Not Allow Action: - **Atlanto-Occipital Joint:** The anterior longitudinal ligament has no action on the atlanto-occipital joint # Posterior Longitudinal Ligament ## Movement Restricted: - **Hyperflexion:** The posterior longitudinal ligament limits hyperflexion of the vertebral column # Multifidus ## Most Likely to Be Challenged: - **Active/Passive Insufficiency During Rotation:** The multifidus muscles are the most likely to be challenged during active/passive insufficiency while rotating # Muscles that Attach to Thoracic Transverse Processes: - **Levator Costarum:** - **Longissimus:** - **Intertransversarii:** # Movements Permitted at Cervical Vertebrae: - **Sagittal Plane:** Flexion and extension - **Frontal Plane:** Lateral flexion - **Transverse Plane:** Rotation # Thoracic Vertebrae: - **Flexion:** During flexion, the angle between vertebrae reduces # Multifidus: Muscle Contraction During Extension: - **Concentric Contraction:** The multifidus muscles perform concentric contraction during extension of the vertebral column # Multifidus: Vertebral Segments Crossed: - **Lumbar Vertebrae:** 3-4 vertebral segments # Semispinalis: Vertebral Segments Crossed: - **Cervical Vertebrae:** 5-6 vertebral segments # Vertebral Region Most Prone to Degeneration: - **Lumbar Vertebrae:** The lumbar vertebrae are most prone to degeneration # Vertebral Region Most Affected by Trauma: - **Cervical Vertebrae:** The cervical vertebrae are the most affected region during trauma # Elements of Vertebrae ## Transverse Foramen: - **Costal Element of Cervical Vertebrae:** The transverse foramen is derived from the costal element of cervical vertebrae ## Spinous Process: - **Neural Arch:** The spinous process is derived from the neural arch # Movements of the Vertebrae ## Cervical Vertebrae: - **Favored:** Flexion, extension, lateral flexion, and rotation - **Not Possible:** All movements are possible in the cervical region ## Thoracic Vertebrae: - **Favored:** Rotation - **Not Possible:** Significant lateral flexion, which is prevented due to rib attachments ## Evolution of the Lumbar Vertebrae - **Mammals:** The development of true lumbar vertebrae in mammals allowed for galloping due to the rotation of limbs under the body - **Amphibians and Reptiles:** Amphibians and reptiles rely on lateral undulation, limiting their movement capabilities ## Vertebral Body Shapes: - **Cervical:** Small, oval shaped for flexibility - **Thoracic:** Heart-shaped with rib facets for stability - **Lumbar:** Large, kidney shaped for weight-bearing ## Zygapophyseal Joints: - **Prevent Rotation:** Zygapophyseal joints in the lumbar spine prevent rotation - **Permit Flexion and Extension:** Zygapophyseal joints permit flexion and extension due to their interlocked radial orientation # Thoracic Articular Facets: ## Rotational Movement: - **Tangential Facets:** The tangential orientation of the thoracic articular facets allows for rotation - **Limited Lateral Flexion:** Lateral flexion is limited due to the attachment of ribs # Motion Segment - **Anterior Component:** Vertebral bodies and intervertebral discs, responsible for load-bearing - **Posterior Component:** Neural arch and ligaments, responsible for motion control # Intervertebral Disc ## Axial Compression: - **Nucleus Pulposus:** The nucleus pulposus is responsible for pressure transmission under load - **Annulus Fibrosus:** The annulus fibrosus is responsible for tension resistance ## Consequences of AnnulusFibrosus Weakening: - **Disc Herniation:** - **Bulging:** Weakening of the annulus fibrosus can lead to disc herniation or bulging # Coupled Movements in the Cervical Vertebrae ## Features that Enable Coupled Movements: - **Oblique Facet Angles (45°):** Allow for coupled lateral flexion and rotation # Hox Genes ## Morphological Differences: - **Regional Specific Features:** Hox genes regulate the development of regional specific features, including transverse foramina in the cervical vertebrae and rib facets in the thoracic vertebrae # Intervertebral Disc Changes with Age: - **Water Content:** Water content within the intervertebral disc decreases with age - **Disc Elasticity:** Reduced water content leads to reduced disc elasticity and height - **Reduced Shock Absorption** # Vertebrae Identification ## Cervical Vertebrae: - **Transverse Foramina:** ## Thoracic Vertebrae: - **Rib Facets:** ## Lumbar Vertebrae: - **Absence of Transverse Foramina and Rib Facets:** ## Sacral Vertebrae: - **Fused Vertebrae** # Vertebral Injuries ## Mechanisms Leading to Injuries: - **Disc Herniation:** Caused by axial loading in the lumbar spine - **Spondylolisthesis:** Occurs in the lumbar or cervical spine due to hyperextension injuries # Vertebral Column Curvature: ## Development: - **Lordosis and Kyphosis:** Develop postnatally for shock absorption and weight distribution ## Functional Advantages: - **Shock Absorption:** - **Weight Distribution:** # Vertebral Morphology & Injuries ## Cervical Spine: - **Whiplash:** Mobile facets in the cervical spine predispose it to whiplash injuries ## Lumbar Spine: - **Hyperextension Injuries:** Load-bearing facets in the lumbar spine predispose it to hyperextension injuries # Nucleus Pulposus & Annulus Fibrosus - **Nucleus Pulposus:** Absorbs pressure under load - **Annulus Fibrosus:** Resists tension under load # Range of Motion in Lumbar Vertebrae: - **Flexion and Extension:** The lumbar vertebrae have a greater range of flexion and extension - **Rotation:** Lumbar facets prevent rotation due to their interlocked radial orientation, while their shape facilitates flexion-extension movements. # Sacral Vertebrae Fusion: - **Pelvic Stability:** Fusion stabilises the pelvis - **Lower Limb Biomechanics:** Fusion enables force transfer to the lower limbs # Coupled Movement Between Vertebral Regions ## Cervical: - **Obligue Facets:** The oblique facets in the cervical vertebrae allow for coupled movement ## Thoracic: - **Ribs:** Ribs limit coupled movement in the thoracic vertebrae ## Lumbar: - **Interlocked Facets:** Interlocked facets in the lumbar vertebrae limit coupled movement # Anterior and Posterior Longitudinal Ligaments: ## Function: - **Anterior Longitudinal Ligament:** Resists hyperextension - **Posterior Longitudinal Ligament:** Resists hyperflexion # Aquatic vs Terrestrial Mammals ## Adaptations: - **Flattened Cervical Vertebrae:** - **Retained Lumbar Regions:** These features are adapted for aquatic locomotion # Load-Bearing Capacities ## Cervical: - **Lightweight:** The cervical vertebrae are lightweight for flexibility ## Thoracic: - **Rib Attachments:** Rib attachments provide stability in the thoracic region ## Lumbar: - **Large Vertebral Bodies:** Large vertebral bodies are adapted for weight-bearing # Ligamentum Flavum: ## Dorsal or Ventral? - **Dorsal:** Posterior to the spinal cord # Anterior Longitudinal Ligament ## Dorsal or Ventral? - **Ventral:** Located along the anterior surface of the vertebral bodies # Posterior Longitudinal Ligament ## Dorsal or Ventral? - **Dorsal:** Located on the posterior aspect of the vertebral bodies within the vertebral canal # Supraspinous Ligament ## Dorsal or Ventral? - **Dorsal:** Located along the tips of the spinous processes # Ligamentum Flavum ## Pre-Axial or Post-Axial? - **Post-Axial** # Anterior Longitudinal Ligament ## Pre-Axial or Post-Axial? - **Pre-Axial** # Posterior Longitudinal Ligament ## Pre-Axial or Post-Axial? - **Pre-Axial** # Supraspinous Ligament ## Pre-Axial or Post-Axial? - **Post-Axial** # Ligamentum Flavum ## Description: - Elastic ligament connecting the laminae between vertebrae # Anterior Longitudinal Ligament - **Description:** Broad, strong ligament along the anterior vertebral bodies, preventing hyperextension # Posterior Longitudinal Ligament - **Description:** Narrow ligament along the posterior vertebral bodies, preventing hyperflexion # Supraspinous Ligament - **Description:** Connects the tips of spinous processes, continuing as the ligamentum nuchae in the cervical region # Nerve Supply of the Erector Spinae Muscles: - **Dorsal Rami of Spinal Nerves:** # Nerve Supply of the Semispinalis Capitis: - **Dorsal Rami of Spinal Nerves:** # Nerve Supply of the Rectus Capitis Posterior Major: - **Dorsal Ramus of C1 (Suboccipital Nerve):** # Nerve Supply of the Obliquus Capitis Inferior: - **Dorsal Ramus of C1 (Suboccipital Nerve):** # Lesion to the Ligamentum Flavum ## Possible Clinical Signs: - **Radiculopathy:** Buckling of the ligamentum flavum can cause radiculopathy at the corresponding intervertebral foramen # Lesion to the Rectus Capitis Posterior Major ## Possible Clinical Signs: - **Extension Deficiency:** Weakens extension at the atlanto-occipital and atlantoaxial joints - **Ipsilateral Rotation Deficiency:** Weakens ipsilateral rotation at the atlanto-occipital and atlantoaxial joints # Common Injury Mechanism for the Posterior Longitudinal Ligament: ## Chronic Hyperflexion: - **Herniated Intervertebral Discs:** Compression of the posterior longitudinal ligament can occur due to chronic hyperflexion or herniated intervertebral discs # Common Injury Mechanism for the Ligamentum Flavum: - **Degenerative Thickening:** Degenerative thickening of the ligamentum flavum can compress the spinal nerve roots, leading to radiculopathy # Rotatores & Multifidus Muscles ## Common Action: - **Resist Rotation:** Both muscles resist rotation - **Stabilize Vertebral Column:** # Semispinalis Capitis & Erector Spinae Muscles - **Common Action:** Both muscles extend the vertebral column # Rectus Capitis Posterior Major & Obliquus Capitis Inferior Muscles: ## Common Action: - **Ipsilateral Rotation of the Head and Neck:** Both muscles perform ipsilateral rotation of the head and neck # Anterior Longitudinal Ligament ## Space Traversed: - **Anterior Surface of Vertebral Bodies:** # Posterior Longitudinal Ligament ## Space Traversed: - **Vertebral Canal:** The posterior longitudinal ligament runs within the vertebral canal along the posterior vertebral bodies # Suboccipital Triangle ## Boundaries & Contents: - **Boundaries:** Rectus capitis posterior major; _obliquus capitis superior; obliquus capitis inferior_ - **Contents:** Vertebral artery, and dorsal ramus of C1 # Intervertebral Foramen ## Boundaries & Contents: - **Boundaries:** Adjacent pedicles; vertebral bodies; zygapophyseal joint - **Contents:** Spinal nerve roots, and dorsal root ganglia # Movements Permitted at Thoracic Vertebrae: - **Sagittal Plane:** Flexion and extension - **Frontal Plane:** Lateral flexion - **Transverse Plane:** Rotation # Movements Permitted at Cervical Vertebrae: - **Sagittal Plane:** Flexion and extension - **Frontal Plane:** Lateral flexion - **Transverse Plane:** Rotation # Erector Spinae Muscle Contraction During Flexion: - **Eccentric Contraction:** # Semispinalis Capitis Muscle Contraction During Extension: - **Concentric Contraction:** # Multifidus: Vertebral Segments Crossed: - **Lumbar Vertebrae:** 3–4 vertebral segments # Semispinalis: Vertebral Segments Crossed: - **Thoracic Vertebrae:** 5–6 vertebral segments # Semispinalis: Primarily Located in:  - **Cervical and Thoracic Regions:** # Multifidus: Most Developed in: - **Lumbar Region:** # Movements Permitted at Thoracic Vertebrae: - **Favored:** Rotation - **Not Possible:** Significant lateral flexion due to rib constraints # Movements Permitted at Lumbar Vertebrae: - **Favored:** Flexion and extension - **Not Possible:** Significant rotation due to interlocking facet joints # Multi-Segmental Ligaments of the Vertebral Column: - **Anterior Longitudinal Ligament:** - **Posterior Longitudinal Ligament:** - **Supraspinous Ligament:** # Ligamentum Flavum ## Unique Feature: - **Elasticity:** Highly elastic, preventing buckling during flexion and compression of the spinal cord # Zygapophyseal Joint: - **Capsular Ligaments:** Capsular ligaments stabilize the facet joints, limit excessive movement, and protect the joint capsule # Intrinsic Muscles are Most Sensitive to Length Changes: - **Intertransversarii:** - **Interspinales:** Contain a high density of muscle spindles, increasing sensitivity to length changes # Transversospinales Muscle Group ## Primary Function: - **Resist Rotation:** - **Stabilize Vertebral Column:** # Muscles: - **Rotatores** - **Multifidus** - **Semispinalis** # Multifidus Muscles: ## Most Prominent in the Lumbar Region: - **Stabilize Lumbar Spine:** Stabilize the lumbar spine during weight-bearing, preventing excessive movement # Suboccipital Triangle ## Clinical Relevance: - **Structures:** Contains the vertebral artery and the dorsal ramus of C1, crucial for head movement, proprioception, and circulation. # Rectus Capitis Posterior Major & Minor ## Function: - **Rectus Capitis Posterior Major:** Extension of the head, ipsilateral rotation of the head at the atlanto-occipital and atlantoaxial joints - **Rectus Capitis Posterior Minor:** Extension of the head # Thoracolumbar Fascia: ## Function: - **Stabilize Lumbar Spine:** The thoracolumbar fascia reinforces the lumbar spine - **Weight-Bearing:** ## Layers of the Thoracolumbar Fascia: - **Anterior Layer:** Covers the quadratus lumborum - **Middle Layer:** Lies between the quadratus lumborum and erector spinae - **Posterior Layer:** Covers the erector spinae and transversospinales, providing the most structural support # Intrinsic Back Muscles ## Function: - **Stabilize and Move Spine:** - **Innervation:** Dorsal rami of spinal nerves # Extrinsic Back Muscles ## Function: - **Limb Associated:** - **Innervation:** Ventral rami of spinal nerves ## Muscles Associated with the Thoracolumbar Fascia: - **Serratus Posterior Superior:** - **Serratus Posterior Inferior:** # Erector Spinae Muscles ## Lateral Flexion: - **Ipsilateral Lateral Flexion:** The erector spinae muscles perform ipsilateral lateral flexion of the vertebral column during lateral flexion # Ligamentum Nuchae ## Differences from Supraspinous Ligament: - **Cervical Region:** The ligamentum nuchae is specific to the cervical region - **Attachment:** The ligamentum nuchae attaches to the trapezius muscle, unlike the supraspinous ligament # Obliquus Capitis Inferior ## Function: - **Ipsilateral Rotation:** Performs ipsilateral rotation of the head at the atlanto-axial joint # Interspinous Ligament ## Function: - **Limit Excessive Flexion:** Connects adjacent spinous processes, preventing excessive flexion # Ligament Strength: - **Thoracic Region:** Thinner ligaments for greater flexibility in this region - **Lumbar Region:** Thicker ligaments for greater stability # Greater Occipital Nerve (C2) ## Clinical Significance: - **Neuralgia:** - **Headaches:** Associated with headaches and neuralgia due to the location of the nerve close to the suboccipital region # Erector Spinae Group: Postural Stability - **Tonic Contraction:** Maintains postural stability during prolonged standing # Radiate Ligaments: - **Costovertebral Joint:** Stabilize the costovertebral joint by anchoring the rib heads to the vertebral bodies # Multi-Segmental Ligaments of the Vertebral Column: - **Anterior Longitudinal Ligament:** - **Posterior Longitudinal Ligament:** - **Supraspinous Ligament:** # Ligamentum Flavum: ## Function: - **Prevent Buckling:** Highly elastic, prevents buckling during flexion and protects the spinal cord from compression # Zygapophyseal Joint Capsular Ligaments: - **Stabilize Facet Joints:** - **Restrict Excessive Movement:** - **Protect Joint Capsules:** # Muscles Most Sensitive to Length Changes: - **Intertransversarii:** - **Interspinales:** # Transversospinales Muscle Group: - **Function:** Resist rotational movement - **Stabilize Vertebral Column:** ## Muscles: - **Rotatores:** - **Multifidus:** - **Semispinalis:** # Multifidus Muscles: ## Prominent in the Lumbar Region: - **Stabilize Lumbar Spine:** - **Prevent Excessive Movement:** # Suboccipital Triangle: ## Clinical Relevance: - **Structures:** Contains the vertebral artery and the dorsal ramus of C1, crucial for head movement, proprioception, and circulation. # Rectus Capitis Posterior Major & Minor - **Rectus Capitis Posterior Major:** Extension of the head, ipsilateral rotation of the head at the atlanto-occipital and atlantoaxial joints. - **Rectus Capitis Posterior Minor:** Extension of the head # Thoracolumbar Fascia: - **Stabilize Lumbar Spine:** - **Weight-Bearing:** ## Layers of the Thoracolumbar Fascia: - **Anterior Layer:** Covers the quadratus lumborum - **Middle Layer:** Lies between the quadratus lumborum and erector spinae - **Posterior Layer:** Covers the erector spinae and transversospinales, providing the most structural support # Intrinsic Back Muscles: - **Stabilize and Move Spine:** - **Innervation:** Dorsal rami of spinal nerves # Extrinsic Back Muscles: - **Limb Associated:** - **Innervation:** Ventral rami of spinal nerves ## Muscles Associated with the Thoracolumbar Fascia: - **Serratus Posterior Superior:** - **Serratus Posterior Inferior:** # Erector Spinae Muscles ## Lateral Flexion: - **Ipsilateral Lateral Flexion:** The erector spinae muscles perform ipsilateral lateral flexion of the vertebral column during lateral flexion # Ligamentum Nuchae ## Differences from Supraspinous Ligament: - **Cervical Region:** The ligamentum nuchae is specific to the cervical region - **Attachment:** The ligamentum nuchae attaches to the trapezius muscle, unlike the supraspinous ligament # Obliquus Capitis Inferior ## Function: - **Ipsilateral Rotation:** Performs ipsilateral rotation of the head at the atlanto-axial joint # Interspinous Ligament - **Limit Excessive Flexion:** Connects adjacent spinous processes, preventing excessive flexion # Ligament Strength: - **Thoracic Region:** Thinner ligaments for greater flexibility in this region - **Lumbar Region:** Thicker ligaments for greater stability # Greater Occipital Nerve (C2) - **Neuralgia:** - **Headaches:** Associated with headaches and neuralgia due to the location of the nerve close to the suboccipital region # Erector Spinae Group: Postural Stability - **Tonic Contraction:** Maintains postural stability during prolonged standing # Radiate Ligaments: - **Costovertebral Joint:** Stabilize the costovertebral joint by anchoring the rib heads to the vertebral bodies # Multi-Segmental Ligaments of the Vertebral Column: - **Anterior Longitudinal Ligament:** - **Posterior Longitudinal Ligament:** - **Supraspinous Ligament:** # Ligamentum Flavum: ## Function: - **Prevent Buckling:** Highly elastic, prevents buckling during flexion and protects the spinal cord from compression # Zygapophyseal Joint Capsular Ligaments: - **Stabilize Facet Joints:** - **Restrict Excessive Movement:** - **Protect Joint Capsules:** # Intrinsic Muscles are Most Sensitive to Length Changes: - **Intertransversarii:** - **Interspinales:** # Transversospinales Muscle Group: - **Function:** Resist rotational movement - **Stabilize Vertebral Column:** - **Rotatores** - **Multifidus** - **Semispinalis** # Multifidus Muscles - **Stabilize Lumbar Spine:** - **Prevent Excessive Movement:** # Suboccipital Triangle - **Clinical Relevance:** Contains the vertebral artery and the dorsal ramus of C1, crucial for head movement, proprioception, and circulation. # Rectus Capitis Posterior Major & Minor - **Rectus Capitis Posterior Major:** Extension of the head, ipsilateral rotation of the head at the atlanto-occipital and atlantoaxial joints. - **Rectus Capitis Posterior Minor:** Extension of the head # Thoracolumbar Fascia: - **Stabilize Lumbar Spine:** - **Weight-Bearing:** ## Layers of the Thoracolumbar Fascia: - **Anterior Layer:** Covers the quadratus lumborum - **Middle Layer:** Lies between the quadratus lumborum and erector spinae - **Posterior Layer:** Covers the erector spinae and transversospinales, providing the most structural support # Intrinsic Back Muscles: - **Stabilize and Move Spine:** - **Innervation:** Dorsal rami of spinal nerves # Extrinsic Back Muscles: - **Limb Associated:** - **Innervation:** Ventral rami of spinal nerves ## Muscles Associated with the Thoracolumbar Fascia: - **Serratus Posterior Superior:** - **Serratus Posterior Inferior:** # Erector Spinae Muscles - **Ipsilateral Lateral Flexion:** The erector spinae muscles perform ipsilateral lateral flexion of the vertebral column during lateral flexion # Ligamentum Nuchae ## Differences from Supraspinous Ligament: - **Cervical Region:** The ligamentum nuchae is specific to the cervical region - **Attachment:** The ligamentum nuchae attaches to the trapezius muscle, unlike the supraspinous ligament # Obliquus Capitis Inferior ## Function: - **Ipsilateral Rotation:** Performs ipsilateral rotation of the head at the atlanto-axial joint # Interspinous Ligament ## Function: - **Limit Excessive Flexion:** Connects adjacent spinous processes, preventing excessive flexion # Ligament Strength: - **Thoracic Region:** Thinner ligaments for greater flexibility in this region - **Lumbar Region:** Thicker ligaments for greater stability # Greater Occipital Nerve (C2) - **Neuralgia:** - **Headaches:** Associated with headaches and neuralgia due to the location of the nerve close to the suboccipital region # Erector Spinae Group: Postural Stability - **Tonic Contraction:** Maintains postural stability during prolonged standing # Radiate Ligaments: - **Costovertebral Joint:** Stabilize the costovertebral joint by anchoring the rib heads to the vertebral bodies # Multi-Segmental Ligaments of the Vertebral Column: - **Anterior Longitudinal Ligament:** - **Posterior Longitudinal Ligament:** - **Supraspinous Ligament:** # Ligamentum Flavum: ## Function: - **Prevent Buckling:** Highly elastic, prevents buckling during flexion and protects the spinal cord from compression # Zygapophyseal Joint Capsular Ligaments: - **Stabilize Facet Joints:** - **Restrict Excessive Movement:** - **Protect Joint Capsules:** # Intrinsic Muscles are Most Sensitive to Length Changes: - **Intertransversarii:** - **Interspinales:** # Transversospinales Muscle Group: - **Function:** Resist rotational movement - **Stabilize Vertebral Column:** - **Rotatores** - **Multifidus** - **Semispinalis** # Multifidus Muscles - **Stabilize Lumbar Spine:** - **Prevent Excessive Movement:** # Suboccipital Triangle - **Clinical Relevance:** Contains the vertebral artery and the dorsal ramus of C1, crucial for head movement, proprioception, and circulation. # Rectus Capitis Posterior Major & Minor - **Rectus Capitis Posterior Major:** Extension of the head, ipsilateral rotation of the head at the atlanto-occipital and atlantoaxial joints. - **Rectus Capitis Posterior Minor:** Extension of the head # Thoracolumbar Fascia: - **Stabilize Lumbar Spine:** - **Weight-Bearing:** ## Layers of the Thoracolumbar Fascia: - **Anterior Layer:** Covers the quadratus lumborum - **Middle Layer:** Lies between the quadratus lumborum and erector spinae - **Posterior Layer:** Covers the erector spinae and transversospinales, providing the most structural support # Intrinsic Back Muscles: - **Stabilize and Move Spine:** - **Innervation:** Dorsal rami of spinal nerves # Extrinsic Back Muscles: - **Limb Associated:** - **Innervation:** Ventral rami of spinal nerves ## Muscles Associated with the Thoracolumbar Fascia: - **Serratus Posterior Superior:** - **Serratus Posterior Inferior:** # Erector Spinae Muscles - **Ipsilateral Lateral Flexion:** The erector spinae muscles perform ipsilateral lateral flexion of the vertebral column during lateral flexion # Ligamentum Nuchae ## Differences from Supraspinous Ligament: - **Cervical Region:** The ligamentum nuchae is specific to the cervical region - **Attachment:** The ligamentum nuchae attaches to the trapezius muscle, unlike the supraspinous ligament # Obliquus Capitis Inferior - **Ipsilateral Rotation:** Performs ipsilateral rotation of the head at the atlanto-axial joint # Interspinous Ligament - **Limit Excessive Flexion:** Connects adjacent spinous processes, preventing excessive flexion # Ligament Strength: - **Thoracic Region:** Thinner ligaments for greater flexibility in this region - **Lumbar Region:** Thicker ligaments for greater stability # Greater Occipital Nerve (C2) - **Neuralgia:** - **Headaches:** Associated with headaches and neuralgia due to the location of the nerve close to the suboccipital region # Erector Spinae Group: Postural Stability - **Tonic Contraction:** Maintains postural stability during prolonged standing # Radiate Ligaments: - **Costovertebral Joint:** Stabilize the costovertebral joint by anchoring the rib heads to the vertebral bodies # Multi-Segmental Ligaments of the Vertebral Column: - **Anterior Longitudinal Ligament:** - **Posterior Longitudinal Ligament:** - **Supraspinous Ligament:** # Ligamentum Flavum: - **Prevent Buckling:** Highly elastic, prevents buckling during flexion and protects the spinal cord from compression # Zygapophyseal Joint Capsular Ligaments: - **Stabilize Facet Joints:** - **Restrict Excessive Movement:** - **Protect Joint Capsules:** # Intrinsic Muscles are Most Sensitive to Length Changes: - **Intertransversarii:** - **Interspinales:** # Transversospinales Muscle Group: - **Function:** Resist rotational movement - **Stabilize Vertebral Column:** - **Rotatores** - **Multifidus** - **Semispinalis** # Multifidus Muscles - **Stabilize Lumbar Spine:** - **Prevent Excessive Movement:** # Suboccipital Triangle - **Clinical Relevance:** Contains the vertebral artery and the dorsal ramus of C1, crucial for head movement, proprioception, and circulation. # Rectus Capitis Posterior Major & Minor - **Rectus Capitis Posterior Major:** Extension of the head, ipsilateral rotation of the head at the atlanto-occipital and atlantoaxial joints. - **Rectus Capitis Posterior Minor:** Extension of the head # Thoracolumbar Fascia: - **Stabilize Lumbar Spine:** - **Weight-Bearing:** ## Layers of the Thoracolumbar Fascia: - **Anterior Layer:** Covers the quadratus lumborum - **Middle Layer:** Lies between the quadratus lumborum and erector spinae - **Posterior Layer:** Covers the erector spinae and transversospinales, providing the most structural support # Intrinsic Back Muscles: - **Stabilize and Move Spine:** - **Innervation:** Dorsal rami of spinal nerves # Extrinsic Back Muscles: - **Limb Associated:** - **Innervation:** Ventral rami of spinal