Unit 3

What is the origin of the Splenius Capitis?

• Lower ½ Ligamentum Nuchae

• Spinous Processes C7-T4

What is the origin of the Splenius Cervicis?

• Spinous processes T3 - T6

What is the origin of the Iliocostalis?

• Spinous processes

• Ribs

• Ilium

What is the origin of the Longissimus?

• Transverse processes

What is the origin of the Spinalis?

• Spinous processes

What is the origin of the Semispinalis (Thoracis,Cervicis and Capitus)?

• Lower Thoracic Transverse Processes

* Crosses 4-6 vertebral levels to insertion *

What is the origin of the Multifidus?

Crosses 2-4 vertebral levels to insertion

• Erector Spinae muscles

• Mamillary Processes of Lumbar Vertebrae

• Transverse Processes Thoracic Vertebrae

• Articular Processes Cervical Vertebrae

What is the origin of the Rotatores?

• Mammillary processes (L)

• Transverse processes (T)

• Articular processes (C)

What is the origin of the Levator Costorum?

• Transverse Processes C7-T11

What is the origin of the Interspinales?

• Spinous Processes

What is the origin of the Intertransversarii?

• Transverse Processes

What is the origin of the Rectus Capitis Posterior Major?

• Spinous Process C2 (Axis)

What is the origin of the Rectus Capitis Posterior Minor?

• Posterior Tubercle C1 (Atlas)

What is the origin of the Obliquus Capitis Superior?

• Transverse Process C1 (Atlas)

What is the origin of the Obliquus Capitis Inferior?

• Spinous Process C2 (Axis)

What is the insertion of the Splenius Capitis?

• Mastoid Process

• Lateral 1/3 Superior Nuchal Line

What is the insertion of the Splenius Cervicis?

• Transverse Processes C1-C3

What is the insertion of the Iliocostalis?

• Ribs (Thoracic and Lumbar)

• Transverse Processes (Cervical)

What is the insertion of the Longissimus?

• Transverse Processes

What is the insertion of the Spinalis?

• Spinous Processes

What is the insertion of the Semispinalis (Thoracis, Cervicis and Capitus)?

• Spinous Processes

• Occiput (Capitis)

What is the insertion of the Multifidus?

• Base of Spinous Processes

What is the insertion of the Rotatores?

• Spinous Processes

What is the insertion of the Levator Costorum?

• Rib below origin near Tubercle

What is the insertion of the Interspinales?

• Spinous Process Above

What is the insertion of the Intertransversarii?

• Transverse Process

What is the insertion of the Rectus Capitis Posterior Major?

• Lateral portion of Occipital Bone, below Inferior Nuchal Line

What is the insertion of the Rectus Capitis Posterior Minor?

• Medial Portion of Occipital Bone, below Inferior Nuchal Line

What is the insertion of the Obliquus Capitis Superior?

• Occiput, between Superior and Inferior Nuchal Lines

What is the insertion of the Obliquus Capitis Inferior?

• Transverse Process C1

What is the action of the Splenius Capitis?

• Bilateral: extend head and neck

• Unilateral: rotate head ipsilaterally

What is the action of the Splenius Cervicis?

• Bilateral: extend neck

• Unilateral: lateral flexion, rotate neck ipsilaterally

What is the action of the Iliocostalis?

Primary extensors of vertebral column and head

• Bilateral: extend vertebral column, control flexion of vertebral column

• Unilateral: laterally flex vertebral column, ipsilateral rotation of head

What is the action of the Longissimus?

Primary extensors of vertebral column and head

• Bilateral: extend vertebral column, control flexion of vertebral column

• Unilateral: laterally flex vertebral column, ipsilateral rotation of head

What is the action of the Spinalis?

Primary extensors of vertebral column and head

• Bilateral: extend vertebral column, control flexion of vertebral column

• Unilateral: laterally flex vertebral column, ipsilateral rotation of head

What is the action of the Semispinalis (Thoracis, Cervicis and Capitus)?

• Bilateral: extension of the vertebral column

• Unilateral: rotate the vertebral column to opposite side

• Semispinalis Capitis:

• Extends head (Bi)

• Extends and upward rotates chin to ipsilateral side

(Uni)

What is the action of the Multifidus?

• Bilateral: extension of the vertebral column

• Unilateral: rotate the vertebral column to opposite side

What is the action of the Rotatores?

• Unilateral: rotate the vertebral column to opposite side

What is the action of the Levator Costorum?

• Elevates Ribs

What is the action of the Interspinales?

• Stabilize adjoining vertebrae during movement

What is the action of the Intertransversarii?

• Stabilize adjoining vertebrae during movement

What is the action of the Rectus Capitis Posterior Major?

• Bilateral: Extension of head

• Unilateral: Ipsilateral rotation of head

What is the action of the Rectus Capitis Posterior Minor?

• Extension of head

What is the action of the Obliquus Capitis Superior?

• Bilateral: Extension of head

• Unilateral: lateral flexion of the head

What is the action of the Obliquus Capitis Inferior?

• Ipsilateral head rotation

Which nerve(s) innervate Splenius Capitis?

• Posterior Rami of Middle Cervical Nerves

Which nerve(s) innervate Splenius Cervicis?

• Posterior Rami of Lower Cervical Nerves

Which nerve(s) innervate Iliocostalis?

• Posterior Rami

Which nerve(s) innervate Longissimus?

• Posterior Rami

Which nerve(s) innervate Spinalis?

• Posterior Rami

Which nerve(s) innervate Semispinalis (Thoracis, Cervicis and Capitus)?

• Posterior Rami

Which nerve(s) innervate Multifidus?

• Posterior Rami

Which nerve(s) innervate Rotatores?

• Posterior Rami

Which nerve(s) innervate Levator Costorum?

• Posterior Rami

Which nerve(s) innervate Interspinales?

• Posterior Rami

Which nerve(s) innervate Intertransversarii?

• Posterior Rami

Which nerve(s) innervate Rectus Capitis Posterior Major?

• Posterior Rami, C1

Which nerve(s) innervate Rectus Capitis Posterior Minor?

• Posterior Rami, C1

Which nerve(s) innervate Obliquus Capitis Superior?

• Posterior Rami, C1

Which nerve(s) innervate Obliquus Capitis Inferior?

• Posterior Rami, C1

What is the origin of the Temporalis muscle?

• Temporal fossa

• Temporal fascia

What is the origin of the Masseter muscle?

• Zygomatic arch

• Zygomatic process

What is the origin of the Medial Pterygoid muscle?

• Deep head: medial surface of the lateral pterygoid plate

• Superficial head: tuberosity of maxilla

What is the origin of the Lateral Pterygoid muscle?

• Upper head: infratemporal surface (greater wing) of sphenoid

• Lower head: lateral surface of lateral pterygoid plate

What is the insertion of the Temporalis muscle?

• Coronoid process and the anterior border ramus of mandible

What is the insertion of the Masseter muscle?

• Ramus and the lateral surface of the mandible

What is the insertion of the Medial Pterygoid muscle?

• Internal surface of Ramus of the Mandible

• Angle of the Mandible

What is the insertion of the Lateral Pterygoid muscle?

• Articular disc, joint capsule

• Fovea of mandibular condyle

What is the action of the Temporalis muscle?

• Elevate and retract the mandible

What is the action of the Masseter muscle?

Elevate mandible

• Superficial fibers protrude the mandible

• Deep fibers retract the mandible

What is the action of the Medial Pterygoid muscle?

• Elevate mandible

• Assist with mandible protrusion

What is the action of the Lateral Pterygoid muscle?

• (Bilateral) Protrude mandible when opening mouth, depress the mandible

• (Unilateral) Deviate mandible contralaterally (grinding)

What is the nerve innervation of the Temporalis muscle?

• Trigeminal nerve V3, Mandibular Branch

What is the nerve innervation of the Masseter muscle?

• Trigeminal nerve V3

What is the nerve innervation of the Medial Pterygoid muscle?

• Trigeminal nerve V3

What is the nerve innervation of the Lateral Pterygoid muscle?

• Trigeminal nerve V3

What are the Primary and Secondary curvature of the Spine?

• Primary is the anterior concave curvature.

* Kyphosis, Thoracic and Sacral portions of Spine

• Secondary is the anterior convex curvature

* Lordosis, Cervical and Lumbar portions of Spine

What is the Spinous Process of a typical vertebrae?

• Junction of the two Lamina

What is the Transverse Process of a typical vertebrae?

• Junction of Pedicle and Lamina on each side

• Articulation with ribs in Thoracic region

What is unique about the Atlas (C1)?

• No vertebral body or disc

• Has anterior arch

• Has Anterior Arch Facet for Dens

What are the unique features of Cervical Vertebrae?

• Laterally they have Foramen Transversarium for vessels to travel to skull

• Triangular Vertebral Canal

• C2 - C6 have Bipid Spinous Process

Describe the Ligaments of the Axis (C2)

• Transverse Ligament that holds dens in contact with C1

• Posterior and Transverse Ligaments together for Cruciform Ligament, which is a key stabilizer of Atlantoaxial Joint

What is the Atlantoaxial joint responsible for?

• Articulation between Atlas (C1) and Dens of Axis (C2)

• Cervical Rotation

What shapes are the vertebral canals and bodies of the thoracic and Lumbar vertebrae?

Thoracic

• Heart shaped body

• Circular canal

Lumbar

• Cylindrical body

• Triangular Canal

What are the differences of the costal facets on the Thoracic Vertebrae?

• Superior (larger) articulates with rib at same level.

• Inferior (smaller) articulate with rib inferior.

• Transverse costal facet articulates with tubercle of rib at same level.

What are the unique features of the Transverse Process on the Lumbar Vertebrae?

• Thin and long (except L5)

• Very broad

• Accessory process on the posterior portion of the base

Where is the Mamillary Process?

• Superior facet of the Lumbar Vertebrae

• Multifidus and Intertransversarii attach here

Describe the Superior and Inferior Facets of the Lumbar Vertebrae

• They project upward and downward

• Superior is concave and faces medially

• Inferior is convex and face laterally

* They fit together with vertebrae above and below

• Allow for stability and motion

What is the pattern in the size of vertebrae?

• They get larger from Cervical to Lumbar

What is the pattern in the size of the foramen of the vertebrae?

• Largest in Cervical

→ Decreases in Thoracic

→ Then increases in Lumbar around L1/L2

• Due to enlargements of grey matter

• increased neural input/output of afferent(sensory) and efferent(motor) signals to/from limbs

What is the make up of the Intervertebral Discs of the Vertebral Bodies?

• Outer ring is the Annulus Fibrosus that contain the Nucleus Pulposus

Where are the Uncovertebral Joints and what motions occur there?

• Synovial joints formed between the Uncinate Process inferior and Uncus superior on C3-C7

• Flexion, Extension

* Limits lateral flexion

Where are the Apophyseal Joints?

• Where the superior and inferior facets articulate

• Thin articular capsule attached to margins of the articular facets surround joint

What are the facet joint angle orientations from the transverse plane for the different spinal regions?

Cervical

• 45 degrees. Allows Flex/Ext, Rot, and Lat Flex

Thoracic

• 60 degrees. Allows small amounts of Lat Flex, Rot, and Flex/Ext

Lumbar

• 90 degrees. Primarily Flex/Ext

What are the major ligaments of the spine?

• Anterior Longitudinal Ligament

• Posterior Longitudinal Ligament

• Ligamentum Flava

• Ligamentum Nuchae and Supraspinous Ligament

• Interspinous Ligaments

• Intertransverse Ligaments

Where is the Anterior Longitudinal Ligament (A.L.L.), and what is it's primary responsibility?

Location

• It's superior attachment is on the base of the skull.

• It travels inferiorly on the anterior aspect of the spine, attaching to vertebral bodies and discs along the way.

• It's inferior attachment is on the anterior surface of the Sacrum

Responsibility

• Prevents hyperextension of the vertebral column

• Strong and broad fibrous band

Where is the Posterior Longitudinal Ligament (P.L.L.), and what is it's primary responsibility?

Location

• Superiorly, connects C2 to the intracranial aspect of the base of the skull (aka Tectorial Membrane)

• Travels inferiorly inside the vertebral canal, along the posterior surface of the vertebral bodies.

• Goes from Atlas to Sacrum.

• Like A.L.L., attaches to vertebral bodies and discs along its length.

Responsibility

• Prevents hyperflexion of the vertebral column

Where is the Ligamentum Flava, and what is it's primary responsibility?

Location

• Connects between the Lamina of adjacent vertebrae on the posterior surface of the Vertebral Canal.

• Posterior surface of Lamina below to anterior surface of Lamina above.

• Found from Axis (C1) to Sacrum

Responsibility

• Restores the spinal column to neutral position after flexion

• Resists separation of lamina

Where are the Ligamentum Nuchae and the Supraspinous Ligaments, and what are their primary responsibility?

Location

• Ligamentum Nuchae just goes from the Occipital Protuberance to the Spinous Process of C7. It's an expansion of the Supraspinous Ligament, but thicker.

• Supraspinous Ligament passes along the Spinous Processes of C7 to the Sacrum.

Responsibility

• Ligamentum Nuchae; provides attachment sites for muscles, resists flexion, and facilitates returning the head to anatomical position.

Where are the Interspinous Ligaments, and what are their primary responsibility?

Location

• Between the Spinous Processes.

• Blend with Supraspinous Ligament posteriorly and Ligamentum Flavum anteriorly.

Responsibility

• Prevent hyperflexion