Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
131 Cards in this Set
- Front
- Back
trapezius - Origin
|
External occipitar protuberance, medial third of superior nuchal line, nuchal ligament, SP of C7-T12
|
|
trapezious- insertion
|
lateral third of the clavicle; acromion and spine of the scapula
|
|
trpezious - action
|
elevates and depresses the scapula (descending/superior), rotates the scapula superiorly(middle); retracts scapula(ascending/inferior)
|
|
trapezious- innervation
|
motor: spinal accessory (XI), proprioception: C3-C4 (sensory)
|
|
trapezious-artery
|
transverse cervical artery
|
|
latissimus dorsi - Origin
|
Spinous processes of T7 to the sacrum, posterior third of the iliac crest, ribs 10-12, sometimes from the inferior angle of the
scapula |
|
latissimus dorsi - insertion
|
floor of the intertubercular groove of the humerous
|
|
latissimus dorsi-innervation
|
thoracodorsal nerve (C6, 7, 8) from the posterior chord of the brachial plexus.
|
|
latissimus dorsi - action
|
extends, adducts and medially rotates humerous.
Raises body during climbing |
|
latissimus dorsi-artery
|
thoracodorsal artery
|
|
trapezious- Clinical
|
Injury of spinal accessory nerve
1. the primary clinical manifestation of spinal accessory nerve palsy is a marked ipsilateral weakness when the shoulders are elevated ( shrugged ) against resistance |
|
latissimus dorsi - Clinical
|
Injury to thoracodorsal nerve
1. during surgery in the inferior part of the axilla, the thoracodorsal nerve supplying the latissimus dorsi at risk of injury |
|
Rhomboideus Major, Minor & Levator Scapulae - Clinical
|
Injury to dorsal scapular nerve
1. injury to the dorsal scapular nerve ( the nerve to rhomboids ) affects the actions of these muscles 2. if the rhomboids of one side are paralyzed, the scapula on the affected side is located farther from the midline than that on the other side |
|
Triangle of auscultation
Boundaries |
inferiorly- upper border of the latissimus dorsi
laterally- medial border of scapula medially - lateral borer of trapezious Floor is formed by the rhomboideus major |
|
Triangle of auscultation
Clinical importance |
This triangular gap in the thick back musculature is a good place to examine the posterior segments of the lungs with a stethoscope
|
|
Levator Scapulae-Origin
|
Transverse Process of C1-C4
|
|
Levator Scapulae-Inertion
|
Medial border of scapula superior root of scapular spine (dorsal surface)
|
|
Levator Scapulae-Innervation
|
dorsal scaula nerve (C5root)
C3-C4 nerves |
|
Rhomboideus minor-Origin
|
nuchal ligament
SP C7-T1 |
|
Rhomboideus minor-Insertion
|
the smooth triangular area at the medial end of scapular spine ( dorsal surface )
|
|
Rhomboideus minor-Innervation
|
Dorsal scapular nerve (C5 root)
|
|
Rhomboideus minor-Actions
|
. retracts the scapula
2. rotates it to depress the glenoid cavity 3. fixes the scapula to the thoracic wall |
|
Levator Scapulae-Actions
|
1. elevates the scapula
2. tilts its glenoid cavity inferiorly by rotating the scapula |
|
Rhombodieus major-Origin
|
spinous process of T2 - T5 vertebrae
|
|
Rhombodieus major-Insertion
|
into the medial border of scapula from the level of spine to inferior angle ( dorsal surface )
|
|
Rhombodieus major-Innervation
|
Dorsal scapular nerve (c5 root)
|
|
Rhombodieus major-Actions
|
1. retracts the scapula
2. rotates it to depress the glenoid cavity 3. fixes the scapula to the thoracic wall |
|
Injury to the dorsal scapular nerve
|
. if the rhomboids of one side are paralyzed, the scapula on the affected side is located farther from the midline than that on the other side
|
|
Serratus posterior superior-Origin
|
. ligamentum nuchae
2. spinous process of C7 - T3 vertebrae |
|
Serratus posterior superior- Insertion
|
the superior borders of 2nd to 4th ribs
|
|
Serratus posterior superior-innervation
|
the 2nd to 5th intercostal nerves
|
|
Serratus posterior superior-actions
|
elevate the ribs
|
|
Serratus posterior inferior -Origin
|
the spinous processes T11 to L2 vertebrae
|
|
Serratus posterior inferior-Origin
|
inferior borders of 8th to 12th ribs near the angles
|
|
Serratus posterior inferior-innervation
|
ventral rami of 9th to 12th thoracic spinal nerves
|
|
Serratus posterior inferior-insertion
|
the inferior borders of 8th to 12th ribs near the angles
|
|
Serratus posterior inferior-Actions
|
depresses the ribs
|
|
Splenius-Origin
|
. nuchal ligament ( ligamentum nuchae )
2. spinous processes of C7 - T3 ( T4 )vertebrae |
|
Splenius (Capitis & Cervicis have same)-Origin
|
. nuchal ligament ( ligamentum nuchae )
2. spinous processes of C7 - T3 ( T4 )vertebrae |
|
Splenius capitis - Insertion
|
1. to the mastoid process of the temporal bone
2. lateral third of the superior nuchal line of the occipital bone |
|
Splenius capitis- direction of fibers
|
fibers run superolaterally
|
|
Splenius cervicis - Insertion
|
into the tubercles of transverse processes of C1 - C3 (C4 ) vertebrae
|
|
Splenius (Capitis & Cervicis have same)-Innervation
|
by the posterior / dorsal rami of spinal nerves
|
|
Actions of Splenius - acting alone
|
, laterally flex neck and rotate head to side of active muscles
|
|
Actions of Splenius - acting together
|
they extend head and neck
|
|
Erector spinae - Origin
|
. from the posterior part of the iliac crest
2. posterior surface of sacrum 3. lower lumbar and sacral spinous processes 4. supraspinous ligaments |
|
Erector spinae-
Iliocostalis - lumborum, thoracis and cervicis - Insertion |
1. to the angles of the lower ribs
2. cervical transverse processes |
|
Erector spinae- Longissimus - thoracis, cervicis and capitis -
Insertion |
1. to the ribs between the tubercles and angles
2. to the transverse processes of thoracic and cervical regions 3. mastoid process of temporal bone |
|
Erector Spinae - Spinalis - thoracis, cervicis and capitis
Insertion |
1. to the spinous processes in the upper thoracic region
2. to the cranium |
|
Erector Spinae - Innervation (ALL)
|
Nerve supply by the posterior / dorsal rami of spinal nerves
|
|
Erector Spinae- Actions - Bilaterally
|
they extend vertebral column and head
|
|
Erector Spinae- Actions - Unilatterally
|
laterally flex vertebral column
|
|
Transversospinalis - Semispinalis -Origin
|
from the transverse processes of C4 - T12 vertebrae
|
|
Transversospinalis- Semispinalis - thoracis, cervicis and capitis - Insertion
|
1. to the occipital bone
2. spinous processes of thoracic and cervical regions |
|
Transversospinalis- Semispinalis - innervation
|
by the posterior / dorsal rami of spinal nerves
|
|
Transversospinalis- Semispinalis - Actions
|
1. extends the head, thoracic and cervical regions of the vertebral column
2. rotate them contralaterally |
|
Multifidus - Origin
|
1. posterior sacrum
2. posterior superior iliac spine of ilium 3. aponeurosis of erector spinae 4. sacroiliac ligaments 5. mamillary processes of lumbar vertebrae 6. transverse processes of T1 - T3 7. articular processes of C4 - C7 |
|
Multifidus - Insertion
|
the spinous processes of vertebrae above, 2 to 4 segments
|
|
Multifidus - Innervation
|
the posterior / dorsal rami of spinal nerves
|
|
Multifidus - Action
|
Action is to stabilize the vertebrae during local movements of the vertebral column
|
|
Rotatores -
Origin |
the transverse processes of vertebrae ( best developed in the thoracic region )
|
|
Rotatores -
Insertion |
into the junction of lamina and transverse process or spinous process of vertebra above their origin, 1 to 2 segments
|
|
Rotatores - Innervation
|
the posterior / dorsal rami of spinal nerves
|
|
Rotatores - Actions
|
1. stabilize the vertebrae and assists with the local extension and rotatory movements of
vertebral column 2. may function as organs of proprioception |
|
Interspinalis - Origin
|
the superior surfaces of spinous processes of cervical and lumbar vertebrae
|
|
Interspinalis - Insertion
|
into the inferior surface of the spinous processes of the vertebrae above the origin
|
|
Interspinalis - Innervation
|
the posterior / dorsal and anterior / ventral rami of spinal nerves
|
|
Interspinalis - Actions
|
to aid in extension and rotation of the vertebral column
|
|
Intertransversarii - Origin
|
from the transverse processes of cervical and lumbar vertebrae
|
|
Intertransversarii - Insertion
|
into the transverse processes of adjacent vertebrae
|
|
Levatores costorum- Origin
|
the transverse processes of C7 and T1 - T11 vertebrae
|
|
Levatores costorum-Insertion
|
on the rib between the tubercle and angle
|
|
Levatores costorum-Innervation
|
the posterior / dorsal rami of C8 - T11 spinal nerves
|
|
Levatores costorum-actions
|
. elevate the ribs
2. assists respiration 3. assists with the lateral flexion of vertebral column |
|
Back strains
|
is a common injury in people who participate in sports, results from
|
|
Back strain results from
|
involves some degree of stretching or microscopic tearing of muscle fibers
3. the muscle usually involved is the erector spinae |
|
Back Spasm
|
1. a sudden involuntary contraction one or more muscle groups
|
|
Back Sprain
|
1. is an injury in which only ligamentous tissue, or the attachment of ligament to the bone is
involved without dislocation or fracture 2. it results from excessively strong contractions related to movements of the vertebral column, such as excessive extension or rotation |
|
Suboccipital region
|
Located in the upper back part of the neck, inferior to the occipital region of the head, including the posterior aspects of C1 and C2 vertebrae
|
|
Suboccipital triangle
|
Lies deep to the trapezius and semispinalis capitis
|
|
Four muscles in the suboccipital region
|
1. rectus capitis posterior major
2. rectus posterior minor 3. superior oblique 4. inferior oblique These are mainly postural muscles and all the above four muscles are innervated by subooccipital nerve ( posterior / dorsal ramus of C1 ) |
|
Rectus capitis posterior major - Origin
|
from the spinous process of C2 ( axis )
|
|
Rectus capitis posterior major-Insertion
|
into lateral part of the inferior nuchal line of occipital bone
|
|
Rectus capitis posterior major-Innervation
|
are innervated by subooccipital nerve ( posterior / dorsal ramus of C1 )
|
|
Rectus capitis posterior minor-
Origin |
from the posterior tubercle of the posterior arch of C1 ( atlas )
|
|
Rectus capitis posterior minor - Insertion
|
into the medial part of the inferior nuchal line of occipital bone
|
|
Inferior oblique of the head ( obliquus capitis inferior )-Origin
|
from the posterior tubercle of the posterior arch of C2 ( axis )
|
|
Inferior oblique of the head ( obliquus capitis inferior )-Insertion
|
into the transverse process of C1 ( atlas )
|
|
Superior oblique of the head ( obliquus capitis superior )-Origin
|
from the transverse process of C1 ( atlas
|
|
Superior oblique of the head ( obliquus capitis superior )- Insertion
|
into occipital bone between the superior and inferior nuchal lines
|
|
Suboccipital triangle
|
Boundaries
Superomedially by the rectus capitis posterior major Superolaterally by the superior oblique Inferolaterally by the inferior oblique Floor 1. posterior arch of the atlas 2. posterior atlanto - occipital membrane Roof by the semispinalis capitis |
|
Contents of the Suboccipital triangle
|
1. vertebral artery
2. suboccipital nerve ( posterior / dorsal ramus of C1 ) |
|
Suboccipital triangle -Clinical
Reduced blood supply to the brain stem |
. when blood flow through these arteries is reduced, as occurs with arteriosclerosis
3. under these conditions, prolonged turning of the head, as occurs when backing up a motor vehicle, may cause light - headedness, dizziness and other symptoms from the interference with the blood supply to the brainstem |
|
Spinal Cord
|
. it begins as the continuation of the medulla oblongata, the caudal part of the brain stem
3. in the adult, the length of the cord is 42 - 45 cm long, extends from the foramen magnum in the occipital bone to the L1 or L2 vertebra 4. its tapering inferior end is the conus medullaris, may terminate as high as T12 and as low as L3 vertebra |
|
Spinal cord enlargements
|
It is enlarged in two regions in relationship to innervation of the limbs
|
|
Cervical enlargement
|
1. extends from C4 through T1 segments of the cord
2. most of the anterior / ventral rami of the spinal nerves arising from it form the brachial plexus of nerves that innervates the upper limb |
|
Lumbosacral ( Lumbar ) enlargement
|
1. extends from T11 through S1 segments of the cord
2. the anterior / ventral rami of the spinal nerves arising from this enlargement make up the lumbar and sacral plexuses of nerves, that innervate the lower limb |
|
Spinal nerve roots
|
1. the portion of the spinal cord giving rise to the rootlets and roots that ultimately form one
bilateral pair of spinal nerves 2. it is designated as a spinal cord segment |
|
Spinal nerves
|
1. 31 pairs are attached to the spinal cord
2. they exit the vertebral canal through the intervetebral foramina 3. in 50% of the people, the first cervical nerve ( C1 ) lacks posterior roots and coccygeal nerve be absent Cervical 8 Thoracic 5 Lumbar 5 Sacral 5 Coccygeal 1 |
|
Cauda equine -
|
1. formed by the loose bundle of spinal roots arising from the lumbosacral enlargement and
the conus medullaris – both dorsal and ventral root together. 2. they course within the lumbar cistern of CSF, caudal to the termination of the spinal cord 3. resembles a horse’s tail |
|
Filum terminale – L1-Coccyx 1 –
|
connective tissue, no neural tissue, forms coccyx ligament where it attaches to the coccyx, anchors the spinal chord
|
|
Filum terminale arises from
|
the tip of the conus medullaris
|
|
Filum terminale descends among
|
the spinal nerve roots in the cauda equina
|
|
Filum terminale is the reminant of
|
the caudal part of the spinal cord
|
|
Pial part of the filum terminale
|
its proximal end - filum terminale internum )
|
|
Filum terminale consists of
|
vestiges of neural tissue, connective tissue and neurological tissue covered by pia mater
|
|
Filum terminale perforates
|
the inferior end of the dural sac, gaining a layer of dura
|
|
filum terminale externum
|
it continues through the sacral hiatus as the dural part of the filum terminale to attach to the dorsum of the coccyx
|
|
Function of the filum terminale
|
Is an anchor for the inferior end of the spinal cord and spinal meninges
|
|
Structure of spinal nerve
|
31 pairs of spinal nerves are attached to the spinal cord
|
|
Dorsal root of the spinal nerve
|
Arises from the dorsal surface of the cord, contains afferent ( sensory ) fibers from the skin, subcutaneous and deep tissues and often from the viscera
|
|
The cell bodies of somatic axons making up the ventral root are in
|
the ventral gray horns
|
|
Ventral root of the spinal nerve
|
Arises from the ventral surface of the cord, contains efferent ( motor ) fibers to skeletal muscle and many contain presynaptic autonomic fibers
|
|
Location of
Filum Intraduale Filum Extradurale |
Filum Intraduale L1-S2
Filum Extradurale S2-Coccyx 1 |
|
( dorsal root ganglion )
|
The cell bodies of axons making up the dorsal roots are in the spinal ganglion
|
|
The dorsal ramus
|
supplies the skin and true muscles of the back
|
|
The ventral ramus
|
supplies the limbs and the rest of the trunk
|
|
Ischemia spinal cord
|
. deficient blood supply to ( ischemia of ) the spinal cord, affects its function and can lead to
muscle weakness and paralysis 3. patients undergoing surgeries, those with ruptured aneurysms of the aorta or occlusion of anterior segmental medullary artery, may lose all sensation and voluntary movement inferior to the level of impaired blood supply to the spinal cord ( paraplegia ) |
|
Paraplegia
|
is the loss of all sensation and voluntary movements inferior to the level of impaired blood supply to the spinal cord
|
|
Spinal cord shock is,
|
the protrusion of a cervical IV intervetebral disc into the vertebral canal after a neck injury, associated with the paralysis inferior to the site of the lesion
|
|
Lumbar spondylosis (
|
degenerative joint disease )
1. causes localized pain and stiffness 2. pressure may produce sensory and motor symptoms in the area of distribution of the involved spinal nerve |
|
Lumbar spondylosis
The causes are |
1. encroachment of the vertebral canal by a protruding IV intervetebral disc
2. by swollen ligamentum flava 3. resulting from osteoarthritis of the zygapophyseal joints |
|
Cervical spondylosis is often accompanied by
|
1. swollen ligamtum flava
2. osteoarthritis of the zygapophyseal joints 3. this may cause pressure on the cervical spinal nerve roots and / or the spinal cord 4. resulting in various neurological signs and symptoms |
|
Osteophytes
|
1. in some olderly people, the nucleus pulposus of the intervertebral disc degenerate
2. leading to formation of bony outgrowth, with mostly asymptomatic 3. but may produce pressure on the spinal nerve roots and cause sensory and motor symptoms |
|
Transection of the spinal cord results in
|
loss of all sensation and voluntary movement inferior to the lesion
|
|
Transection at level C1 - C3
|
1. no function below head level
2. a ventilator is required to maintain respiration |
|
Transection at level C4 - C5 ( Quadriplegia )
|
1. no function of upper and lower limbs
2. respiration occurs |
|
Transection at level C6 - C8
|
1. loss of lower limb function combined with a loss of hand and a variable amount of upper limb
function 2. the individual may be able to self - feed or propel a wheelchair |
|
Transection at level T1 - T9 ( Paraplegia )
|
1. paralysis of both lower limbs
2. the amount of trunk control varies with the height of the lesion |
|
Transection at level T10 - L1
|
1. some thigh muscles function
2. may allow walking with long leg braces |
|
Transection at level L2 - L3
|
1. retention of most leg muscle function
2. short leg braces may be required for walking |