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?
