Anatomy I: Back and Suboccipital Myology PDF

ANATOMY I TOPIC 3. MYOLOGY OF THE BACK AND SUBOCCIPITAL REGION Equipo docente anatomía del sistema musculoesquelético Departamento de Fisioterapia Ve más allá  MUSCLES...

ANATOMY I TOPIC 3. MYOLOGY OF THE BACK AND SUBOCCIPITAL REGION Equipo docente anatomía del sistema musculoesquelético Departamento de Fisioterapia Ve más allá  MUSCLES GENERAL CONCEPTS ▪ Origin (proximal insertion) or head: Muscle termination attached to the stationary bone ▪ Insertion (distal insertion): Muscle termination attached to the bone with greater movement ▪ Belly: Widest portion between origin and insertion ▪ Action: Main movements that occur when a muscle contracts © Copyright Universidad Europea. Todos los derechos reservados  UNI- OR BILATERAL MUSCLE CONTRACTION ▪ When a muscle is even, it can cause different movements if the contraction is uni or bilateral. ▪ Example: Contraction of the intertransverse muscles causes lateral tilting of the spine if the contraction is unilateral, while causing extension of the spine if the contraction is bilateral. ▪ Contraction of a muscle on one side of the given body (right or left) can cause movement on the same side where the muscle is (movement homolateral) or to the other side (movement contralateral). © Copyright Universidad Europea. Todos los derechos reservados  TRUNK MUSCLES ▪ POSTERIOR REGION OF THE TRUNK ▪ CHEST WALL MUSCLES ▪ ABDOMEN WALL ▪ DIAPHRAGM ▪ PERINEUM AND PELVIC FLOOR © Copyright Universidad Europea. Todos los derechos reservados  MUSCLES OF THE BACK AND SUBOCCIPITAL REGION They differ according to their location and insertion: - Extrinsic muscles (thoracobrachial muscles) are the most superficial muscles (trapezius, latissimus dorsi, rhomboid and levator scapula), They are muscles that join the upper extremity with the trunk. - Intermediate muscle: The muscles in the intermediate group of back muscles consist of two thin muscular sheets in the superior and inferior regions of the back, immediately deep to the muscles in the superficial group (serratus posterior superior and serratus posterior inferior) - Intrinsic muscles, that are fixed on the vertebrae and/or ribs. They perform movements of the spine. They are located in three layers: superficial, medium and deep layers. © Copyright Universidad Europea. Todos los derechos reservados Músculos intrínsecos del dorso /C.G.  EXTRINSIC MUSCLES OF THE DORSUM –SUPERFICIAL: Thoracobraquiales (They attach the upper extremity to the trunk: trapezius, latissimus dorsi, levator scapula and rhomboid) © Copyright Universidad Europea. Todos los derechos reservados  EXTRINSIC MUSCLES OF THE DORSUM –INTERMEDIATE (Respiratory muscles): SERRATUS POSTERIOR SUPERIOR AND SERRATUS POSTERIOR INFERIOR © Copyright Universidad Europea. Todos los derechos reservados  EXTRINSIC MUSCLES OF THE DORSUM © Copyright Universidad Europea. Todos los derechos reservados  INTERMEDIATE MUSCLES OF THE DORSUM © Copyright Universidad Europea. Todos los derechos reservados  EXTRINSIC AND INTERMEDIATE LAYER © Copyright Universidad Europea. Todos los derechos reservados  THORACOLUMBAR FASCIA It lines the muscles of the vertebral canals in the chest and lumbar region. Medially it is fixed in the thoracochal lumbar spinous processes and laterally in the angle of the ribs. © Copyright Universidad Europea. Todos los derechos reservados  THORACOLUMBAR FASCIA In the lumbar region it is formed by three leaves: - posterior layer, - middle layer, - anterior layer © Copyright Universidad Europea. Todos los derechos reservados  THORACOLUMBAR FASCIA In the lumbar region it is formed by three leaves: - posterior layer, - middle layer, - anterior layer © Copyright Universidad Europea. Todos los derechos reservados  - POSTERIOR LAYER, Superficially covers the erector of the column. It lends insertion to the latissimus dorsi muscle. © Copyright Universidad Europea. Todos los derechos reservados  MUSCLES OF THE BACK AND SUBOCCIPITAL REGION INTRINSIC MUSCLE GROUP OF THE POSTERIOR REGION OF THE TRUNK It is organized in three plane: - SUPERFICIAL: Transverse-spinous (splenius) - INTERMEDIATE: Erector of the spine - DEEP: Muscles of the vertebral canals (interspinous, intertransverse, transverse). MUSCLES OF THE POSTERIOR REGION OF THE NECK: SUBOCCIPITAL REGION Posterior rectus major of the head Minor posterior rectus of the head Upper oblique of the head Lower oblique of the head © Copyright Universidad Europea. Todos los derechos reservados  1.- SUPERFICIAL LAYER: SPLENIUS MUSCLES They differ: splenium of the head and splenium of the neck (splenium means bandage, in reference to its orientation) They extend from: Origin: spinous process of the lower cervical vertebrae and first thoracic and ligamentum Nuchae. Until: Insertion: Occipital bone and mastoid process of the temporal (splenium of the head) Transverse processes of the 1st and 2nd cervical vertebra (splenium of the neck) © Copyright Universidad Europea. Todos los derechos reservados  INTERMEDIATE LAYER: SERRATUS MUSCLE GROUP (THORAX MUSCLES) (is part of the muscles of the vertebral canals) Fibers from these two serratus posterior muscles (serratus posterior superior and serratus posterior inferior) pass obliquely outward from the vertebral column to attach to the ribs. This positioning suggests a respiratory function, and at times, these muscles have been referred to as the respiratory group. Serratus posterior superior is deep to the rhomboid muscles, whereas serratus posterior inferior is deep to the latissimus dorsi. Both serratus posterior muscles are attached to the vertebral column and associated structures medially, and either descend (the fibers of the serratus posterior superior) or ascend (the fibers of the serratus posterior inferior) to attach to the ribs. These two muscles therefore elevate and depress the ribs. © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  ERECTOR SPINAE GROUP It is located on each side of the spine, it is the main extensor of the spine. It consists of three fasciculate muscles, from lateral to medial: iliocostal, longissimus and spinous. © Copyright Universidad Europea. Todos los derechos reservados  COMMON MASS EIPS Iliac crest Iliac tuberosity. Middle sacral crest. Apof. Lumbar spiny © Copyright Universidad Europea. Todos los derechos reservados  ERECTOR SPINAE GROUP Iliocostalis It originates in a common mass with fixations in EIPS, iliac crest, iliac tuberosity and lumbar spinous process and ascends by attaching to the ribs and transverse processes of the last cervical vertebrae. Three parts are described: lumbar iliocostal, thoracic and cervical. © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  ERECTOR SPINAE GROUP Iliocostalis cervicis Iliocostal thoracis Iliocostalis lumborum © Copyright Universidad Europea. Todos los derechos reservados  ERECTOR SPINAE GROUP Longissimus capitis Longissimus Longissimus cervicis Medial to iliocostal. Ascends from the common tendon to the skull (mastoid process of the temporal bone) Longissimus thoracis Its fascicles (thoracic, cervical and head) ascend by inserting into transverse processes and ribs until ending in the skull. © Copyright Universidad Europea. Todos los derechos reservados  ERECTOR SPINAE GROUP Spinalis It is the most medial component of the erector of the spine, it is poorly developed, it is usually only recognizable at the thoracic level. It extends between the spinous processes of the cervical and thoracic vertebrae © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  Longissimus thoracis Spinalis Iliocostalis thoracis © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  INNERVATION OF THE INTRINSIC OR DEEP MUSCLES OF THE DORSUM The innervation of the intrinsic dorsum muscles comes from dorsal branches of the spinal nerves, with the exception of the intertransverse muscles which are innervated by ventral branches. ROLE OF THE ERECTOR OF THE COLUMN - Back extension - Unilateral contraction collaborates in inclinations and rotations. © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  3. DEEP LAYER: Interspinous, intertransverse, transverse. Formed by short muscles located along the entire spine, they are named as: 1.- Interspinous (SHORT SEGMENTAL GROUP) 2.- Intertransversarius (SHORT SEGMENTAL GROUP) 3.- “Levatores costarum” (SHORT SEGMENTAL GROUP/THORAX MUSCLES (RESPIRATORY)) 4.- Transverspinous group: - Short rotators (jump 1 vertebra) - Long rotators (jump 2 vertebrae) - Multifidus (jump 3-4 vertebrae) - Semispinatus (jump 6-8 vertebrae or more) (Semispinatus of the head or larger complex) © Copyright Universidad Europea. Todos los derechos reservados  DEEP LAYER: Muscles of the vertebral canals. Muscles of the vertebral canals The muscles of the vertebral canals occupy the space between the spinous processes, the transverse processes and the posterior angle of the ribs. They are covered by the thoracolumbar fascia. © Copyright Universidad Europea. Todos los derechos reservados  DEEP LAYER: Muscles of the vertebral canals. They extend from the pelvis to the skull. They are organized in 4 vertical columns or 2 medial and 2 lateral tracts. This muscle group is responsible for the extension movement of the spine. They also intervene as active ligaments giving stability to the spine. Except for the intertransverse muscles, all are innervated by dorsal branches of the spinal nerves. © Copyright Universidad Europea. Todos los derechos reservados  1.- INTERSPINOUS ▪They join the adjacent spinous processes. ▪At the thoracic level they are replaced by connective tissue. © Copyright Universidad Europea. Todos los derechos reservados  1. INTERSPINOUS ▪They join spinous processes of two neighboring vertebrae. They are located on the sides of the interspinous ligaments. ▪They can intervene in the extension of the spine. © Copyright Universidad Europea. Todos los derechos reservados  2.- INTERTRANSVERSARIUS They join the adjacent transverse processes. © Copyright Universidad Europea. Todos los derechos reservados  2.- INTERTRANSVERSARIUS ▪ Located between the transverse processes. They belong to the lateral tract. ▪ At the cervical level there are two intertransverse muscles on each side. ▪ Poorly developed in the dorsal segment. ▪ Innervated by anterior branches of spinal nerves. ▪ They can participate in the lateral inclinations of the spine. © Copyright Universidad Europea. Todos los derechos reservados  2.- LEVATORES COSTARUM Arise from the tranverse processes of vertebrae CVII and TI to TXI. They have an oblique lateral and downward direction and insert into the rib below the vertebra of origin in the area of the tubercle. Contraction elevates the ribs. © Copyright Universidad Europea. Todos los derechos reservados  3.- LEVATORES COSTARUM © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  Function of interspinous and intertransverse These interspinous and intertransverse muscles stabilize the vertebrae during spinal movements. In addition, the interspinalis can intervene in the extension and the intertransversarius in the lateral inclinations. The highly segmented nature of the interspinalis and intertransversarius muscles is ideal for fine motor control of the axial skeleton. Because these unisegmental muscles possess a relatively high density of muscle spindles, they likely provide the nervous system (and therefore other muscles) a rich source of sensory feedback, especially in the craniocervical region. © Copyright Universidad Europea. Todos los derechos reservados  4.- TRANSVERSPINOUS GROUP Extend from the head to the sacrum Between transverse process and lamina or spinous process of another overlying vertebra © Copyright Universidad Europea. Todos los derechos reservados  4.- TRANSVERSPINOUS GROUP Short rotator: Transverse process > lamina of the upper vertebra Long rotator: Transverse process > lamina of the 2nd upper vertebra Multifidus: Transverse process > base of the Spinous process of the 3rd or 4th upper vertebra Semispinalis Transverse process > vertex of the spinous process separated by more than 4 vertebrae © Copyright Universidad Europea. Todos los derechos reservados  Short rotator: Transverse process > lamina of the upper vertebra Long rotator: Transverse process > lamina of the 2nd upper vertebra © Copyright Universidad Europea. Todos los derechos reservados  Multifidus: Transverse process > base of the Spinous process of the 3rd or 4th upper vertebra © Copyright Universidad Europea. Todos los derechos reservados  Seminspinalis: Transverse process > vertex Spinous process separated by more than 4 vertebrae (6-8) © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  SUMMARY OF THE TRANSVERSE-SPINOUS GROUP MUSCLES AND VERTEBRAL INSERTIONS © Copyright Universidad Europea. Todos los derechos reservados  SUMMARY OF THE INTRINSIC MUSCLE GROUP © Copyright Universidad Europea. Todos los derechos reservados © Copyright Universidad Europea. Todos los derechos reservados  MUSCLES OF THE SUBOCCIPITAL REGION ▪ RECTUS CAPITIS POSTERIOR MAJOR ▪ RECTUS CAPITIS POSTERIOR MINOR ▪ OBLIQUUS CAPITIS SUPERIOR ▪ OBLIQUUS CAPITIS SUPERIOR © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP RECTUS CAPITIS POSTERIOR MAJOR © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP RECTUS CAPITIS POSTERIOR MINOR © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP OBLIQUUS CAPITIS SUPERIOR © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP OBLIQUUS CAPITIS INFERIOR © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP: SENSITIVE BRANCHES © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP © Copyright Universidad Europea. Todos los derechos reservados  SUBOCCIPITAL GROUP RAMOS OCCIPITALES: RAMOS CERIVCALES POSTERIORES (C1, C2 Y C3) RAMA SENSITIVA C2 (NERVIO OCCIPITAL MAYOR = NERVIO DE ARNOLD) © Copyright Universidad Europea. Todos los derechos reservados  SUMMARY OF THE POSTERIOR NERVE ROOT DIVISION INNERVATION OF THE INTRINSIC OR DEEP MUSCLES OF THE BACK The innervation of the intrinsic muscles of the back comes from dorsal branches of the spinal nerves, with the exception of the intertransverse muscles, which are innervated by ventral branches (intervertebral). © Copyright Universidad Europea. Todos los derechos reservados  THANK YOU [email protected] © Copyright Universidad Europea. Todos los derechos reservados