Spine and Thorax

hiccup

An involuntary contraction of the diaphragm will cause air to rush into the lungs and the vocal cords to snap shut. The audible result is a _________________.

12th

The ____________ rib can vary in length from 3 to 6 inches. Since anomalies are common in either the length of number of ribs, your partner's rib might not match this description

Coastal cartilage

It is identical in shape and size to the ribs and serves as a bridge between them and sternum

Cervical

The ____________ vertebrae are the most mobile and accessible of the twenty-four spinal bones

Abdominal aorta

Measuring nearly an inch in diameter, it is the chief artery for carrying blood to the abdominal organs and lower appendages. It lies on the anterior surfaces of the vertebrae, deep to the small intestines. Lateral to this is the psoas major

sternocleidomastoid

Many of the cervical transverse processes are deep to which neck muscle?

C-7

Match the bony landmark with the corresponding spinout process. Base of the neck

T-7

Match the bony landmark with the corresponding spinout process. Inferior angle of the scapula

T-2

Match the bony landmark with the corresponding spinout process. Superior angle of the scapula

L-4

Match the bony landmark with the corresponding spinout process. Top of iliac crest

T-12

Match the bony landmark with the corresponding spinout process. Twelfth rib

Brachial plexus and subclavian artery

The _____________ _______________ and ________________ _______________ pass between the first rib and clavicle

spinal

The _____________ muscles are composed of numerous bands of densely interwoven fibers that make it difficult to isolate a particular portion of muscle

11th

The _____________ rib is six to eight inches in length and extends halfway around the body.

Internal oblique

O: Lateral inguinal ligament, iliac crest and thoracolumbar fascia I: Internal surface of lower three ribs, abdominal aponeurosis to linea alba

Transverse Abdominis

O: Lateral inguinal ligament, iliac crest, thoracolumbar fascia and internal surface of lower six ribs I: Abdominal aponeurosis to linea alba

Quadratus Lumborum

O: Posterior iliac crest I: Last rib and transverse processes of the first through fourth lumbar vertebrae

Rectus Abdominis

O: Public crest, pubic symphysis I: Cartilage of fifth, sixth and seventh ribs and xiphoid process

Multifidi

O: Sacrum and transverse processes of lumbar through cervical vertebrae I: Spinous processes of lumbar vertebrae through second cervical vertebra (Span two to four vertebrae)

Rectum Capitis Posterior Major

O: Spinous process of the axis (C-2) I: Inferior nuchal line of the occiput

Oblique Capitis Inferior

O: Spinous process of the axis (C-2) I: Transverse process of the atlas (C-1)

Splenius Cervicis

O: Spinous processes of T-3 to T-6 I: Transverse processes of C-1 to C-3

Spinalis

O: Spinous processes of the upper lumbar and lower thoracic vertebrae (thoracic), ligamentum nuchae, spinous process of C-7 (cervicis) I: Spinous process of upper thoracic (thoracis) Spinous process of cervical, except C-1 (cervicis)

Oblique Capitis Superior

O: Transverse process of the atlas (C-1) I: Between the nuchal lines of the occiput

Semispinalis Capitis

O: Transverse processes of C-4 to T-5 I: Between the superior and inferior nuchal lines of the occiput

Rotatores

O: Transverse processes of lumbar through cervical vertebrae I: Spinous processes of lumbar vertebrae through second cervical vertebra (Span one to two vertebrae)

Rectum Capitis Posterior Minor

O: Tubercle of the posterior arch of the atlas (C-1) I: Inferior nuchal line of the occiput

Erector spinae group

The ______________ ________________ group runs from the scrum to the occiput along the posterior aspect of the vertebral column. Its musculature has a dense layered arrangement that can be difficult to visualize

brachial

The ______________ plexus, a large muscle group of the nerves that innervated the arm, exits between the TVPs.

Serratus posterior inferior

The _______________ is deep to the thoracolumbar aponeurosis and, during exhalation, can stabilize the ribs against the pull of the diaphragm

TVPs or transverse

The _______________ processes of the cervical vertebrae are located on the side of the neck. They extend inferiorly form the mastoid process and many are deep to the sternocleidomastoid muscle. They are all the same width except for the C-1, which are much wider. Old Hollywood films put Frankenstein's neck bolts in this

Body of the sternum

The _________________ of the ______________ is located inferior to the manubrium and forms the major portion of the sternum.

manubrium

The _________________, the superior portion of the sternum, articulates with the clavicle, the first rib and the second rib

scalene

The ___________________ muscles fan across the posterior triangle and attach to the first and second ribs. The first rib can be accessed by this muscle.

semispinalis capitis

The ____________________ _____________________ is located along the thoracic and cervical vertebrae and ultimately reaches the cranium

ribs

The ___________ articulate posteriorly with the thoracic vertebrae and then curve around the thorax to the anterior chest

Atlas

The ___________ is the only vertebra that does not have a spinous process

spinalis

The ___________ is the smallest of the 3 muscles and lies closest to the spine in the lamina groove

Flexion and extension

With your partner seated, what two movements at the spine could you ask your partner to perform to feel the movement of the spinout processes?

Floating ribs

11th and 12th ribs are considered the __________________, as they do not attach to the sternum or coastal cartilage at all

Pyramidalis

A: Tenses the linea alba O: Pubic symphysis I: Linea alba

Intertransversarii

Action: Unilaterally: Laterally flex the vertebral column to the same side Bilaterally: Extend the vertebral column

Serratus posterior inferior

Action: Depress the ribs during exhalation O: Spinous processes of T-12 to L-3 I: Posterior surface of ninth through twelfth ribs

Internal Intercostals

Action: Draw the ribs inferiorly (decreasing the space of thoracic cavity) to assist with exhalation

External Intercostals

Action: Draw the ribs superiorly (increasing the space of the thoracic cavity) to assist with inhalation

Serratus posterior superior

Action: Elevate the ribs during inhalation O: Spinous processes of C-7 to T-3 I: Posterior surface of second through fifth ribs

Interspinalis

Action: Extend the vertebral column O and I: Cervical: Spanning the spinous processes of C-2 to T-3 Lumbar: Spanning the spinous processes of T-12 to L-5

Scalenes and levator scapulae

All of the TVPs serve as attachment sites for various muscles, including the _____________ and __________________ _______________.

Intertransversarii

As their name suggests, these small, short muscles span between the transverse processes. They are the deepest muscles in the cervical and lumbar regions and for this reason are nearly impossible to detect, let alone access

Jugular notch

At the top of the sternum, the ____________ _____________ is between the sternal heads of the clavicle. It may be flat or bowl-shaped, and although no muscles attach directly to it, the sternocleidomastoids pass superficially to it while the infrahyoids attach deep to it

Intercostals

Better known to carnivores as the meat on spare ribs. They are small, slender muscles between the ribs. They are divided into two groups: the external and internal. The fibers of these two groups run perpendicular to each other and can be visualized as extensions of the external and internal oblique muscles They help stabilize the rib cage and assist in respiration, but their specific role is detailed. It is not possible to distinguish internal and external from one another.

transversospinalis

Consist of many short, diagonal, fibers. These fibers form an intricate stitch like design that links the vertebrae together. The name refers to the fact that the fibers of this muscle group extend at varying lengths from the transverse and spinous processes of the vertebrae

Rib cage

Consists of coastal cartilage and 12 pairs of ribs

Interspinalis

Extending from the spinous processes in the cervical and lumbar regions, these short muscles help extend the spine. The cervical muscles are deep to the ligamentum nuchal while the lumbar muscles are deep to the interspinous ligament . These muscles are deep to isolate

Coastal cartilage

Extending of the ribs is the _______________ ______________ that attaches them to the sternum

xiphoid process

Extending off the bottom of the sternum, the _________________ _______________ can be an inch in length or completely absent. It is an attachment site for the abdominal aponeurosis.

Thoracolumbar aponeurosis

In the lumbar region, the erector lie deep to the thin but dense ___________________ ___________________

Ligamentum Nuchae

Is a finalize sheet of connective tissue that runs along the sagittal plane from the external occipital protuberance to the spinous process of C-7 in the neck. Chief function is to help stabilize the head and neck. It is also an attachment site for the superficial muscles of the posterior neck, such as trapezius and splenius capitis. Posterior edge is superficial

Splenius cervicis

Is deep to the splenius cavities and not as easily isolated; however, its general location can be outlined in the lamina groove of the upper thoracic and cervical spine

Splenius Capitis

Is deep to the trapezius and rhomboids. Its fibers angle toward the mastoid process and are superficial between the trapezius and sternocleidomastoid

Thoracolumbar aponeurosis

It is a broad, flat tendon stretching across the thorax and lumbar regions. More accurately, it is thick, diamond-shaped tendon that lies superficially across the posterior thorax, stretches across the Sacrum to the posterior iliac crest and runs upward to the lower thoracic vertebrae It is an anchor for several muscles, it has a flat dense texture that is difficult to distinguish from the deeper

Spinous process

It is a vertebra's posterior projection, as a group they form a visible row of bumps that run down the center of the back. They are designed as attachment sites for layers of muscle ligaments and fasciae

First rib

It is difficult to isolate along the anterior thorax. It lies directly beneath the clavicle and ten quickly curves towards the back. It can, however, be accessed in the posterior triangle of the neck.

Sternum

It is superficial and is located along the midline of the chest; the breastbone

Quadratus Lumborum

It would seem to be the deepest muscle of the low back, it is strangely enough the deepest muscle of the abdomen. Stretching from the posterior ilium to the transverse processes of the lumbar vertebrae and 12th ribs, this squat muscle is simply an abdominal muscle located on the posterior surface of the thorax

External oblique

Lateral to the rectus abdominis is the ________________ _________________. They are broad, superficial muscle best pleated at its attachments to the lower ribs.

Pyramidalis

Located superficial to the rectus abdominis, this small muscle is absent in roughly 20% of the population

Supraspinous Ligament

Long, thin extends inferiorly from the ligamentum nuchae. As it continues down the spine, it attaches to the spinout processes of the thoracic and lumbar vertebrae. It is superficial and easily accessed in the spaces between the spinous processes

Intertransversarii

O and I: Cervical: Spanning the transverse processes of vertebrae C-2 to C-7 Lumbar: Spanning the transverse processes of vertebrae L-1 to L-5

Diaphragm

O: Coastal attachment: Inner surface of lower six ribs Lumbar attachment: Upper two or three lumbar vertebrae Sternal attachment: Inner part of xiphoid process I: Central tendon

Iliocostalis

O: Common tendon (lumborum), posterior surface of ribs 1-12 (thoracic and cervicis) I: Transverse processes of lumbar vertebrae 1-3 and posterior surface of ribs 6-12 (lumborum), posterior surface of ribs 1-6 (thoracic), transverse processes of lower cervical (crevices)

Longissimus

O: Common tendon (thoracic), transverse processes of upper five thoracic vertebrae (crevices and cavities) I: Lower nine ribs and transverse processes of thoracic vertebrae (thoracis), transverse processes of cervical vertebrae (crevices) and mastoid process of temporal bone (cavities)

Erector Spinae group

O: Common tendon (thoracolumbar aponeruosis) that attaches to the posterior surface of scrum, iliac crest, spinous processes of the lumbar and last two thoracic vertebrae I: Various attachments at the posterior ribs, spinous and transverse processes of thoracic and cervical vertebrae and mastoid process of temporal bone

External oblique

O: External surfaces of fifth to twelfth ribs I: Anterior part of the iliac crest, abdominal aponeurosis to linea alba

Intercostals

O: Inferior border of the rib above I: Superior border of the rib below

Splenius Capitis

O: Inferior one-half of ligamentum nuchae and spinous processes of C-7 to T-4 I: Mastoid process and lateral portion of superior nuchal line

Exhalation

On _____________________, the muscle fibers of the diaphragm relax, releasing the central tendon and allowing the lungs to deflate

True ribs

Ribs "1-7" are known as the ______________, because they attach directly to the sternum

False ribs

Ribs "8-12" are referred to as ____________________ , because they attach indirectly to the sternum by means of the coastal cartilage

Rectus abdominis

Round bellies, The reversed "washboard belly" is formed by the multiple superficial bellies of the ______________ __________________

Lamina groove

The ________________________ is the tough space between the spinous and transverse processes of the vertebrae. Although sizable on a skeleton, the one on your partner is filled with layers of muscles which render it almost inaccessible. It is best thought of as a helpful region for locating muscle bellies

Body type and muscular contraction

The angles of the scapula and the corresponding spinous processes do not always line up. Name two factors that might affect the position of the scapula

Serratus posterior Superior

The belly of the ______________ is partially deep to the scapula and has fibers that parallel the superficial rhomboids

Transverse abdominis

The deepest muscle of the group, plays a major role in forced exhalation. It cannot be specifically palpated

Inspiration (inhalation)

The diaphragm creates ________________(_____________) when its muscles fibers contract and pull the central tendon inferiorly. Because the central tendon is attached to the connective tissue that surrounds the lungs, a vacuum is created in the upper thoracic cavity, pulling air into the lungs

suboccipitals

The eight short ____________________ are the deepest muscles. They are located at the base of the head

sternal angle

The junction between the manubrium and body of the sternum is called the _____________________ __________________. Stretching horizontally, it might feel like a small speed bump or a dip.

Spinous process and transverse process

The lamina groove is located between which two bony landmarks of the vertebrae?

Erector spinae group

The large ______________ _________________ ________________ is the most superficial of the spinal muscles and has three major branches

Abdominal column and rib cage

The muscles of the spine and thorax are situated along the posterior and abdominal regions and create movement of the ____________________ _________________ and ____________________ ______________

C-2

The process of _______________is larger and more distinct

Rotatores

The shorter, smaller ________________ lie deep to the multifidi

transversospinalis group

The smaller ____________________________ ___________________ also has three branches but lies deep to the erector. Its name reefs to its muscles fibers, which extend at varying lengths from the transverse and spinous processes of the vertebraes

intercostal

The spaces between the ribs are filled with thin ______________________ muscles that can be easily palpated

lumbar

The spinous process of the __________________ vertebrae are much longer, tall and stocky, the tips may feel more like short strips than points. The bodies of these vertebrae are quite massive and tall; they may have a finger's width of space between the processes.

Cervical

The spinous process of the ____________________ are shorter and smaller, because of lordotic curve in the cervical spine and the overlying ligamentum nuchae, they are actually deeper than the other two.

Thoracic

The spinous process of the ______________________ are smaller and closer together than their lumbar counterparts and angle downward

longissimus and iliocostalis

The thick _________________ and lateral ___________________ form a visible mound alongside the lumbar and thoracic spine

Sternum and rib cage

The thorax is comprised of which two structures?

splenii

The two ______________ muscles are located alone the posterior neck, deep to the trapezius

Suboccipitals

There are eight of these, they are small and are the deepest muscles of the upper posterior neck. They are involved in stabilizing the axis and atlas and in creating intrinsic movements such as rocking and tilting of the head. To outline the location, find the spinous process of C-2, the transverse processes of C-1 and the space between the superior nuchal line of the occiput and C-2

Abdominals

There are four of these muscles and they expand far beyond the "stomach" region. In fact, they form a muscular girdle that reaches around the sides of the thorax to the thoracolumbar aponeurosis, superiorly to the middle ribs and inferiorly to the inguinal ligament. The immense span of these muscles, with its unique overlapping arrangement and varying fiber direction, helps to stabilize the entire abdominal region

Multifidi

They are thick and directly accessible in the lumbar spine. They are the only muscles with fibers that lie across the posterior surface of the sacrum

Internal oblique

Thin fibers, are deep and perpendicular to the external oblique fibers and can be difficult to distinguish

Thoracic

This vertebrae is designed for minimal movement, they help stabilize and protect the internal organs

Lumbar

This vertebrae is larger and stickier, it is located between the 12th rib and posterior iliac crest, are designed to support the weight of the upper body

ligamentum nuchae

Which band of connective tissue lies superficial to the cervical spinous processes?

C-2 and C-7

Which two cervical vertebrae have spinous processes that protrude further posteriorly and are more distinct than the other cervical vertebrae?

Manubrium, body, and xiphoid process

What 3 components are part of the sternum that are superficial and covered only by fascia and the pectorals major tendon?

Anterior/posterior, lateral and superior

What 3 directions are the ribs designed to expand during inhalation?

latissimus doris and erector spinae group

What are some of the muscles the thoracolumbar aponeurosis anchors?

The spinalis, longissimus dorsi and iliocostalis

What are the 3 main branches of the erector spinae group?

Rock and tilt the head back in extension Rotate the head to the same side Laterally flex the head to the same side

What are the three actions of the oblique capitis inferior?

Mutifidi, Rotatores, and semispinalis and extends length of vertebral column

What are the three branches of the transversospinalis group?

Laterally flex the head to the same side

What is the action of the oblique capitis superior?

Rock and tilt the head back into extension

What is the action of the rectum capitis posterior major?

Rock and tilt the head back into extension

What is the action of the rectum capitis posterior minor?

Thoracolumbar aponeurosis and erector spinae

What is the medial portion of the Quadratus Lumborum buried beneath?

Clavicle, sternocleidomastoid, and trapezius

What muscles forms the posterior triangle of neck?

The upper back and posterior neck; run obliquely

Where are the long splenius cavities and splenius crevices muscles located along?

Side of the torso

Where is the lateral edge accessible form in the Quadratus Lumborum?

Mastoid process and shaft of clavicle

Your partner is supine and you passively rotate the head 45 degrees away from the side you are palpations. This position places the cervical transverse processes in a line running between which two bony landmarks?