Back, Spine, Thorax

What are the distinguishing features of cervical vertebrae?

Small body, bifid spinous process (except C7), transverse foramina, large vertebral foramen

What are the distinguishing features of thoracic vertebrae?

Heart-shaped body, long downward spinous processes, costal facets for ribs

What are the distinguishing features of lumbar vertebrae?

Large kidney-shaped body, short thick spinous process, massive vertebral body for weight bearing

Which vertebra is the vertebra prominens?

C7

What landmark is typically at the level of T2?

Superior angle of scapula

What landmark is typically at the level of T7?

Inferior angle of scapula

What landmark is typically at the level of T12?

Last thoracic vertebra; transition to lumbar region

What landmark is typically at the level of L4?

Iliac crest

What is the pars interarticularis?

Region between superior and inferior articular processes of vertebrae

Why is the pars interarticularis clinically important?

Common site of spondylolysis and spondylolisthesis

What structures form the vertebral lamina?

Posterior portion of vertebral arch connecting spinous and transverse processes

What is the superior border depression of the sternum called?

Jugular notch

What is the manubriosternal junction called?

Sternal angle (Angle of Louis)

What rib articulates at the sternal angle?

2nd rib

What are the parts of the sternum?

Manubrium, body, xiphoid process

Which ribs are floating ribs?

Ribs 11 and 12

Which ribs attach directly to the sternum?

True ribs (1–7)

Which ribs attach indirectly to the sternum?

False ribs (8–10)

What is costal cartilage?

Hyaline cartilage connecting ribs to sternum

What is the sacrum formed from?

Fusion of 5 sacral vertebrae

What is the coccyx formed from?

Fusion of coccygeal vertebrae (typically 4)

Trapezius — Action

Elevates, retracts, depresses, upwardly rotates scapula; extends neck

Trapezius — Origin

External occipital protuberance, ligamentum nuchae, C7–T12 spinous processes

Trapezius — Insertion

Lateral clavicle, acromion, spine of scapula

Trapezius — Innervation

Spinal accessory nerve (CN XI)

Trapezius — Blood supply

Transverse cervical artery

Latissimus dorsi — Action

Extends, adducts, medially rotates humerus

Latissimus dorsi — Origin

T7–L5 spinous processes, thoracolumbar fascia, iliac crest

Latissimus dorsi — Insertion

Intertubercular groove of humerus

Latissimus dorsi — Innervation

Thoracodorsal nerve

Latissimus dorsi — Blood supply

Thoracodorsal artery

Rhomboid major/minor — Action

Retract and downwardly rotate scapula

Rhomboid major/minor — Innervation

Dorsal scapular nerve

Rhomboid major/minor — Blood supply

Dorsal scapular artery

Levator scapulae — Action

Elevates scapula; ipsilateral neck flexion

Levator scapulae — Innervation

Dorsal scapular nerve

What are the three erector spinae muscles?

Iliocostalis, longissimus, spinalis

Erector spinae group — Action

Extend and laterally flex vertebral column

Erector spinae group — Innervation

Posterior rami of spinal nerves

What muscles make up the transversospinalis group?

Multifidus, semispinalis, rotatoresTransversospinalis group — Action

Transversospinalis group — Action

Stabilization, extension, contralateral rotation of spine

Which transversospinalis muscle is most palpable?

Multifidus

Splenius capitis/cervicis — Action

Extend head/neck; ipsilateral rotation

Splenius muscles — Innervation

Posterior rami of spinal nerves

What muscles make up the suboccipital group?

Rectus capitis posterior major/minor, obliquus capitis superior/inferior

Suboccipital muscles — Function

Fine movements of head; extension and rotation

Suboccipital muscles — Innervation

Suboccipital nerve (C1)

Suboccipital muscles — Blood supply

Occipital artery

External intercostals — Action

Elevate ribs during inspiration

Internal intercostals — Action

Depress ribs during forced expiration

Intercostals — Innervation

Intercostal nerves

Serratus posterior superior — Action

Elevates ribs

Serratus posterior inferior — Action

Depresses ribs

Diaphragm — Primary action

Main muscle of inspiration

Diaphragm — Innervation

Phrenic nerve (C3–C5)

What happens to the diaphragm during inspiration?

Contracts and flattens

Rectus abdominis — Action

Flexes trunk; compresses abdomen

Rectus abdominis — Innervation

Thoracoabdominal nerves

External oblique — Action

Contralateral trunk rotation; trunk flexion

Internal oblique — Action

Ipsilateral trunk rotation; trunk flexion

Transversus abdominis — Action

Compresses abdominal contents

What is the ligamentum nuchae?

Midline elastic ligament in posterior neck

What does the supraspinous ligament connect?

Tips of spinous processes

What is the thoracolumbar fascia?

Deep fascia of lower back enclosing intrinsic back muscles

What type of joint is an intervertebral disc joint?

Cartilaginous symphysis

What type of joint are zygapophyseal (facet) joints?

Synovial plane joints

What type of joint is the atlanto-occipital joint?

Synovial ellipsoid joint

What type of joint is the atlantoaxial joint?

Synovial pivot joint

What are the two parts of an intervertebral disc?

Annulus fibrosus and nucleus pulposus

What structures are part of the upper respiratory tract?

Nose, nasal cavity, pharynx, larynx

What structures are part of the lower respiratory tract?

Trachea, bronchi, lungs

What is the mediastinum?

Central compartment of thoracic cavity between lungs

What structures are found in the mediastinum?

Heart, great vessels, trachea, esophagus, thymus

What spinal nerve roots form the phrenic nerve?

C3, C4, C5

What rib is used to count ribs clinically?

2nd rib at the sternal angle

What vertebral level aligns with the iliac crest?

L4

Which intrinsic back muscles are responsible for posture?

Erector spinae group

Which deep back muscles are major spinal stabilizers?

Multifidi

What artery supplies trapezius?

Transverse cervical artery

What nerve innervates latissimus dorsi?

Thoracodorsal nerve

What nerve innervates rhomboids?

Dorsal scapular nerve

What is the main muscle of inspiration?

Diaphragm