PRIORITY: OAINs Exam 1

What are the cervical prevertebral muscles?

• scalenes (ant/mid/lat)

• SCM- divide ant/lat

• Splenius capitus

• rectus capitus lateralis

Interspinal muscles (unisegmental)

• connect adjacent SP

• aid extension

• Best in Cervical/Lumbar

Intertransverse (unisegmental)

• Connect consecutive TP

• Side bending (lat flex)

• Bilaterally stabilize spine

All uniseg best in cervical + lumbar

What muscles are considered homologues of interversaeii?

Rectus capitis anterior + lateralis

What are the postvertebreal cervical muscles?

• suboccipitals: RCPm/M; Obliquus capisus sup/inf

• splenius capitis

• splenius cervicis

What is another term for the deep intrinsic muscles?

transversospinal (deep dive)

What are the transversospinal muscles?

“A”yyy SeMR (deep dive- deep intrinsic)

• semispinalis

• multifidis

• rotators

What is another name for the erector spinae?

intrinsic back muscles

What are the intrinsic back muscles?

erector spinae: I love spaghetti (spin that spaghetti)

• iliocostalis- Cap no L

• longissimus

• spinalis

What are the minor intrinsic back muscles?

• interspinae (ext)

• intertransvere (lat flex)

• levators costarum

Anterior Scalene

Origin

TP C3-C6

Anterior Scalene

Insertion

1st rib

Anterior Scalene

Action

“all” scalene

• Lat Flex neck

• elevate 1st rib (insp)

Anterior Scalene

Innervation

ventral rami C4-C6

Sternocleidomastoid

Origin

• mastoid proccess

• lat ½ sup nuchal line

Sternocleidomastoid

insertion

• sternal head > ant manubrium

• clavicular head > sup / med 1/3 clavicle

Sternocleidomastoid

action

unilat

• ispilat lat flex neck

• contralat rot

bilat

• ext neck at OA joint

• cervical flex

• chin to chest

Sternocleidomastoid

innervation

Spinal accessory nerve- CN XI

O: Middle Scalene

post TP C4-C7

I: Middle Scalene

sup surface 1st rib

(post to subclavian groove)

A: Middle Scalene

• lat neck flex

• elevate 1st rib

N: Middle Scalene

ventral rami cervical Ns

O: Posterior Scalene

(post) TP C4-C6

I: Posterior Scalene

external boarder 2nd rib

A: Posterior Scalene

• lat neck flex

• 2nd rib elevation

N: Posterior Scalene

Ventral rami C7-C8

O: Rectus Capitus Lateralis

jugular process of occipital bone

I: Rectus Capitus Lateralis

ant surface lat mass C1

A: Rectus Capitus Lateralis

flex head!

N: Rectus Capitus Lateralis

• Ventral rami C1

• C2 spinal nerve

O: Rectus capitus posterior minor

medial 1/3 inf nuchal line

I: Rectus capitus posterior minor

post tubercle post arch C1

A: Rectus capitus posterior minor

• Extend head on C1

• ASSIST in rotate C1 on C2

N: Rectus capitus posterior minor

Dorsal Rami C1

What do “ALL” suboccipital muscles do?

• extend head on C1

• rotate C1 on C2 (RCPm only assists)

What innervates ALL suboccipital muscles?

dorsal rami C1

O: Rectus capitus posterior Major

lat inf nuchal line

I: Rectus capitus posterior Major

spinous process C2

A: Rectus capitus posterior Major

• rotate C1 on C2

• extend head on C1

N: Rectus capitus posterior Major

dorsal rami C1

O: Obliquus capitus superior

occipital bone between inf/sup nuchal line

I: Obliquus capitus superior

TP C1

A: Obliquus capitus superior

• extend head on C1

• rotate C1 oon C2

N: Obliquus capitus superior

dorsal rami C1

O: Obliquus capitus inferior

TP C1

I: Obliquus capitus inferior

Post tubercle post arch C2

A: Obliquus capitus inferior

• extend head on C1

• rotate C1 on C2

N: Obliquus capitus inferior

dorsal rami C1

O: Splenius Capitis

• mastoid process

• lat 1/3 superior nuchal line

I: Splenius Capitis

• nuchal lig

• SP C7-T6

A: Splenius Capitis

uni:

• ipsilat side bend

• ipsilat rot

bi:

• extend head/neck

N: Splenius Capitis

dorsal rami middle cerical spinal nerves

O: splenius cervicis

TP C1-C4

I: splenius cervicis

• nuchal lig

• SP C7-T6

A: splenius cervicis

uni:

• ipsilat side bend

• ipsilat rot

bi:

• extend neck

N: splenius cervicis

dorsal rami spinal nerves

O: semispinalis

• sup med occipital bone

• SP lower T vert 4-6 segments

I: semispinalis

• TP C4-T10

A: semispinalis

cap; cerc; thoracis —respectively

• extension

• contralat rot

What do all of the transversospinal / deep intrinsic muscles do?

(A SeMR deep dive swim)

• extension

• contralat rot

What innervates all transversospinal / deep intrinsic muscles?

dorsal rami of spinal nerves

What is the largest/strongest post neck muscle?

semispinalis (cap/cerv)

Where is the multifidus best developed?

lumbar spine

Where are the rotatoes best developed?

thoracic spine

O: Multifidus

• SP 2-4 segments above oblique fibers

I: Multifidus

• TP 2-4 levels inf

• mamillary processes

• L, T, C4-7

• erector spinae aponeurosis in lumbar spine

A: Multifidus

• ext

• contralat rot

N: Multifidus

dorsal rami spinal nerves

O: Rotatoes (brevis/longus)

• SP 1-2 levels above (brev vs long)

I: Rotatoes (brevis/longus)

• junction of TP + laminae

(1-2 levels inf brev/long)

A/N: Rotatoes (brevis/longus)

• A: extension / contralat rot

• N: dorsal rami spinal nerves

What do *all’’ erector spinae do?

• extension

• ipsilateral lat flex (sidebending) *spinalis only in trunk; rest in prospective areas

Where do ALL the erector spinae insert?

erector spinae aponeurosis

O: Iliocostalis

• angle on lower ribs

• cervical TP

I: Iliocostalis

• erector spinae aponeurosis AND

• post ilium / sacrum

What innervates ALL erector spinae?

dorsal rami of spinal nerves

O: Longissimus

• mastoid process

• cervical / thoracic TP

• ribs

I/N: Longissimus

• erector spinae aponeurosis

• dorsal rami spinal nerves

A: Longissimus

• extension

• ipsilat side bending

O: Spinalis

• occiput

• toracic SP

I/N: Spinalis

• erector spinae aponeurosis

• dorsal rami spinal nerves

A: Spinalis

• extension

• ipsilat side bend in trunk only (thoracic SP)

OAIN: External Intercostals

O: lover boarder rib above > I: upper boarder rib below

*hand in pocket- curl fingers up to grab

• elevate ribs- inspiration

OAIN: Internal Intercostals

O: lover boarder rib above > I: upper boarder rib below

*hands of prayer- pull along fingers

• rib depression (expiration)

OAIN: Inermost Intercostals

O: inner surface lower boarder rib above >

I: upper boarder rib below

Rib depression (expiration)

O: Transversus Thoracis

post xiphoid process / lower sternum

I: Transversus Thoracis

inner surface costal cart 2-6

A: Transversus Thoracis

rib depression (expiration)

O: Serratus posterior superior

• nuchal lig

• SP C7-T3

I: Serratus posterior superior

• ribs 2-5 (lat to post angles)

A: Serratus posterior superior

• elevate ribs (insp)

O: Serratus posterior inferior

• SP T11-L2

I: Serratus posterior inferior

• inf boarder ribs 8-12 (lat to post anle)

A: Serratus posterior inferior

• depress ribs (expiration)

O: Rectus Abdominis

• pubic crest/symphysis

I: Rectus Abdominis

• xiphoid process

• costal cart 5-7

A: Rectus Abdominis

• flex vertebral column

O: Transversis abdominis

• costal cart 7-12

• thoracolumbar fascia

• iliac crest

• connective tissue deep to inguinal lig

I: Transversis abdominis

• linea alba with aponeurosis of internal oblique

• pubic crest

• pubis

A: Transversis abdominis

• compress abdominal viscera

• assist forced expiration

• lumbar stabilization