musculoskeletal anatomy exam 6 (spine and thorax)

oblique capitis inferior

A: rotate the head to the same side O: spinous process of the axis (C2) I: transverse process of the atlas (C1) N: suboccipital

intertransversarii

A: unilaterally: laterally flex the vertebral column to same side bilaterally: extend the vertebral column O/I: cervical: spanning the spinous processes of C2 to T3 lumbar: spanning the spinous processes of T12 to L5 N: spinal

external oblique

A: unilaterally: laterally flex vertebral column to the same side -rotate vertebral column to the opposite side bilaterally: flex the vertebral column -compress abdominal contents O: external surfaces of fifth to twelfth ribs I: anterior part of the iliac crest, rectus sheath to linea alba N: (T5-6), T7-11, T12

internal oblique

A: unilaterally: laterally flex vertebral column to the same side -rotate vertebral column to the same side bilaterally: flex the vertebral column -compress abdominal contents O: lateral inguinal ligament, iliac crest, and thoracolumbar fascia I: rectus sheath to linea alba N: T7-12, L1, iliohypogastric and ilioinguinal, ventral divisions

iliocostalis

A: unilaterally: laterally flex vertebral column to the same side bilaterally: extend the vertebral column O: common tendon (lumborum) posterior surface of ribs 1-12 (thoracis and cervicis) I: transverse processes of lumbar vertebrae 1-3 and posterior surface ribs 6-12 posterior surface of ribs 1-6 (thoracis) transverse processes of lower cervicals (cervicis)

longissimus

A: unilaterally: laterally flex vertebral column to the same side bilaterally: extend the vertebral column O: common tendon (thoracis) transverse processes of upper five thoracic vertebrae (cervicis and capitis) I: lower nine ribs and transverse processes of thoracic vertebrae (thoracis) transverse processes of cervical vertebrae (cervicis) mastoid process of temporal bone (capitis)

erector spinae group

A: unilaterally: laterally flex vertebral column to the same side bilaterally: extend the vertebral column O: common tendon (thorocolumbar fascia) that attaches to the posterior surface of sacrum, iliac crest, spinous processes of the lumbar, and last two thoracic vertabrae I: various attachments at the posterior ribs, spinous and transverse processes of thoracic and cervical vertebrae, and mastoid process of temporal bone N: spinal

spinalis

A: unilaterally: laterally flex vertebral column to the same side bilaterally: extend the vertebral column O: spinous processes of the upper lumbar and lower thoracic vertebrae (thoracis) ligamentum nuchae, spinous process of C-7 (cervicis) I: spinous processes of upper thoracic (thoracis) spinous processes of cervicals, except C-1 (cervicis)

quadratus lumborum

A: unilaterally: laterally tilt (elevate) the pelvis -laterally flex the vertebral column to the same side bilaterally: fix the last rib during forced inhalation and exhalation -assist to extend the vertebral column O: posterior iliac crest I: last rib and transverse processes of first through fourth lumbar vertebrae N: lumbar plexus T12, L1, 2, 3

splenius capitis and cervicis

A: unilaterally: rotate the head and neck to the same side laterally flex the head and neck to the same side bilaterally: extend the head and neck O: capitis: inferior one-half of ligamentum nuchae and spinous processes of C7 to T4 cervicis: spinous processes of T3 and T6 I: capitis: mastoid process and lateral portion of superior nuchal line cervicis: transverse processes of C1 to C3 N: cervical

multifidi and rotatores

A: unilaterally: rotate the vertebral column to the opposite side bilaterally: extend the vertebral column O: multifidi: sacrum and transverse processes of lumbar through cervical vertebrae rotatores: transverse processes of lumbar through cervical vertebrae I: spinous processes of lumbar vertebrae through second cervical vertebra (multifidi span two to four vertebrae; rotatores span one to two vertebrae) N: spinal

in which three directions are the ribs ideally designed to move?

anterior/posterior, lateral, superior

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.

body type, muscular contraction

Which section of the vertebral column is capable of the most movement?

cervical

the first rib is deep to which bone along the anterior thorax?

clavicle

As you palpate medially toward the spine, you may lose contact with the twelfth rib because it is deep to which muscle group?

erector spinae group

The thoracic transverse processes are located deep to the ____ muscles and superficial to the ____.

erector spinae; connecting aspects of the ribs

you are palpating lateral to the edge of rectus abdominis and the fibers you feel are superficial and running at an angle. What muscle is this?

external oblique

the ligamentum nuchae spans between which two bony landmarks?

external occipital protuberance, spinous process of C-7

To feel the ligamentum nuchae change tension underneath the fingers, what two passive movements can be performed at the head?

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 spinous processes?

flexion and extension

which muscles are located between the ribs?

intercostals

as a group, the transversospinalis muscles can be easily located along the ____ of the thoracic and lumbar vertebrae.

lamina grooves

Which edge of the quadratus lumborum is accessible from the side of the torso?

lateral edge (side)

what action could you ask your partner to perform to feel the quadratus lumborum contract?

laterally tilt (elevate) the hip

the thoracolumbar fascia serves as an attachment site for which two muscles?

latissimus dorsi, any branches of the erector spinae group

name two large muscles through which you would have to palpate to access various portions of the intercostals.

latissimus dorsi, pectoralis major, or external oblique

rotating the head to the left demands the contraction of which splenius capitis-the left or right?

left

Passive rotation of the spine to the same side would _______ the multifidi.

lengthen

passive flexion of the spine would ____ the iliocostalis.

lengthen

passive rotation of the head and neck to the opposite side would ___ splenius capitis.

lengthen

passive rotation of the head to the opposite side would ____ the oblique capitis inferior.

lengthen

passive rotation of the vertebral column to the opposite side would ___ internal oblique.

lengthen

passive rotation of the vertebral column to the same side would ____ the external oblique.

lengthen

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

ligamentum nuchae

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

mastoid process and center of shaft of clavicle

the abdominal aorta is located where in relationship to the psoas major?

medial

when is it best to move your fingers as you curl them underneath the rib cage to feel the diaphragm?

only as your partner exhales

drawing the ventral part of the ribs upward would ___ the external intercostals.

shorten

increasing the volume of the thoracic cavity would ___ the diaphragm's fibers.

shorten

passive extension of the head and neck would ___ the splenius capitis

shorten

passive lateral flexion of the head and neck would ___ the splenius cervicis.

shorten

passive lateral flexion of the spine to the same side would ___ the longissimus.

shorten

passive rotation of the head to the same side would ____ the rectus capitis posterior major.

shorten

passive rotation of the spine to the opposite side would ____ the rotatores.

shorten

what action could you ask your partner to perform to feel the first rib move?

slow, deep breath into upper chest

the most medial branch of the erector spinae group is the ____, while the most lateral is the ____.

spinalis; iliocostalis

What two bony landmarks and one region can be helpful to isolate the location of the suboccipitals?

spinous process of C-2, TVPs of C-1, and the space between the superior nuchal line of the occiput and C-2

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

spinous processes and transverse processes

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

sternocleidomastoid

The thorax is composed of which two structures?

sternum and rib cage

what superficial ligament can be felt between the spinous processes of the thoracic and lumbar vertebrae?

supraspinous

when the diaphragm muscle fibers contract, what connective tissue structure is pulled inferiorly?

the central tendon

How can the upper fibers of the trapezius be helpful in locating the suboccipitals?

the lateral edge is the same width as the suboccipitals

Although the entire rib cage is deep to muscle tissue, which portion is easily accessed?

the sides of the trunk

In the lumbar region, the erectors lie deep to what connective tissue structure?

thoracolumbar fascia

the eleventh and twelfth ribs lie at approximately what angle on the body?

45 degrees

serratus posterior inferior

A: depress the ribs during exhalation O: spinous processes of T12 to L3 I: posterior surface of ninth through twelfth ribs N: T9, 10, 11, (12)

diaphragm

A: draw down the central tendon of the diaphragm increase the volume of the thoracic cavity during inhalation O: costal 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 N: phrenic C3, 4, 5

serratus posterior superior

A: elevate the ribs during inhalation O: spinous processes of C7 to T3 I: posterior surface of second through fifth ribs N: T1, 2, 3, 4

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

C-2 and C-7

Please match the bony landmark with the corresponding spinous process. T-12 T-2 L-4 C-7 T-7

T-12 : twelfth rib T-2 : superior angle of the scapula L-4 : top of the iliac crest C-7 : base of the neck T-7 : inferior angle of the scapula

what is the structure that extends off the ribs and attaches to the sternum?

costal cartilage

what is the primary muscle of respiration?

diaphragm

to contract the lower fibers of the erector spinae group in a prone position, you could ask your partner to perform what action?

raise and lower his feet slightly

which abdominal muscle runs vertically from the rib cage to the pubic crest?

rectus abdominis

rotating your trunk to the right would engage your left or right internal oblique muscle?

right

to distinguish the trapezius fibers from the splenius capitis fibers, you could ask your partner to perform what action?

rotate his head slightly toward the side you are palpating

Exploring just posterior to the clavicle, through which muscle group must you palpate to access the first rib?

scalenes

Which rib attaches to the sternum at the level of the sternal angle?

second

unlike the long, vertical erector fibers, the branches of the transversospinalis group consist of many ____ fibers.

short, diagonal

compression of the abdominal contents would ___ the transverse abdominis.

shorten

The visible row of bumps running down the center of the back are the...

spinous processes

the splenius capitis is a deep muscle except on the lateral side of the neck where it is superficial between which two muscles?

trapezius and sternocleidomastoid

When exploring between the scapulae, can you name two muscles through which you will have to palpate to access the deeper erector spinae fibers?

trapezius, rhomboids or serratus posterior superior

which three bony landmarks can help you to isolate the borders of the quadratus lumborum?

twelfth rib, posterior iliac crest, and transverse process of lumbar vertebrae

To avoid the thick erector spinae muscles overlying the lumbar transverse processes, it is best to slide your fingers roughly how far laterally from the spinous processes?

two inches

rectus capitis posterior minor

A: rock and tilt the head back into extension O: tubercle of the posterior arch of the atlas (C1) I: inferior nuchal line of the occiput N: suboccipital

semispinalis capitis

A: extend the vertebral column and head O: transverse processes of C4 to T5 I: between the superior and inferior nuchal lines of the occiput N: cervical

intercostals

A: external intercostals: draw the ribs superiorly (increasing the space of the thoracic cavity) to assist with inhalation internal intercostals: draw the ribs inferiorly (decreasing the space of the thoracic cavity) to assist with exhalation O: inferior border of the rib above I: superior border of the rib below N: thoracic

rectus abdominis

A: flex the vertebral column -tilt the pelvis posteriorly O: pubic crest, pubic symphysis I: cartilage of fifth, sixth, and seventh ribs and xiphoid process N: T5, 6, T7-11, T12, ventral rami

oblique capitis superior

A: rock and tilt the head back into extension laterally flex the head to the same side O: transverse process of the atlas (C1) I: between the nuchal lines of the occiput N: suboccipital

rectus capitis posterior major

A: rock and tilt the head back into extension rotate the head to the same side O: spinous process of the axis C2 I: inferior nuchal line of the occiput N: suboccipital