Spine And Thorax 1
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This document provides an overview of the muscles of the spine and thorax, including bony landmarks and three groups of deep back muscles - the spinalis, longissimus, and iliocostalis muscles. It describes the actions, origins, insertions, and innervations of muscles within each group, including the spinalis cervicis, spinalis thoracis, longissimus thoracis, longissimus cervicis, and iliocostalis lumborum. The document also outlines tests to locate the erector spinae group and assess back extensor strength.
Spine And Thorax 1
- 3. Bony landmark trail Trail 1. Midline Ridge Explore the spinous processes of the vertebrae and the spaces between them Trail 2. Crossing Paths Describe surrounding bony landmarks that intersect with specific spinous processes
- 4. Bony landmark trail Trail 3. Cervical vertebrae Trail 4. Thoracic and Lumbar vertebrae
- 5. Bony landmark trail Trail 5. sternum Trail 6. Ribs, rib cage and costal cartilage
- 6. Muscles of the spine and thorax Superficial muscles of the back
- 7. Muscles of the spine and thorax Intermediate muscles of the back Deep muscles of the back
- 8. Muscles of the spine and thorax Schematic cross section view of the muscles of the spine
- 9. Muscle layers of the post. neck
- 10. Erector spinae group Spinalis Longissimus Iliocostalis As a group, easily palpated along the entire length of the back and neck
- 11. Spinalis cervicis Action Bilateral contraction extends the cervical and thoracic spine Unilateral contraction bends the cervical and thoracic spine to the same side Origin SP of the T1-T2 and C5-C7 vertebrae Insertion SP of the C2-C5 vertebrae Innervation Dorsal rami of the spinal nerve
- 12. Spinalis thoracis Action Bilateral contraction extends the cervical and thoracic spine Unilateral contraction bends the cervical and thoracic spine to the same side Origin Lateral surface of the SP of the T10-T12 and L1-L3 vertebrae Insertion Lateral surface of the spinous processes of the T2-T8 vertebra Innervation Dorsal rami of the spinal nerve
- 13. Longissimus muscle 4. Longissimus thoracis 5. Longissimus cervicis 6. Longissimus capitis
- 14. Longissimus thoracis Action Bilateral contraction extends the spine, unilateral contraction bends the spine laterally to the spine Origin Sacrum, iliac crest(common tendon of origin with iliocostalis), SP of lumbar vertebrae, TP of lower thoracic vertebrae Insertion 2 nd -12 th ribs, costal processes of lumbar vertebrae, TP of thoracic vertebrae Innervation Lateral branches of dorsal rami of spinal nerve
- 15. Longissimus Cervicis Action Bilateral contraction extends the spine, unilateral contraction bends the spine laterally to the spine Origin TP of T1-T6 vertebrae Insertion TP of C2-C5 vertebrae Innervation Lateral branches of dorsal rami of spinal nerve
- 16. Longissimus capitis Action Bilateral contraction extends the head, unilateral contraction flexes and rotates the head to the same side Origin TP of T1-T3 vertebrae and TP and articular process of C4-C7 vertebrae Insertion Mastoid process of occipital bone Innervation Lateral branches of dorsal rami of spinal nerve
- 17. Iliocostalis muscle 1. Iliocostalis lumborum 2. Iliocostalis thoracis 3. Iliocostalis cervicis Action Entire muscle; bilateral contraction extends the spine, unilateral contraction bends the spine laterally to the same side
- 18. Iliocostalis muscle Origin Iliocostalis lumborum: sacrum, iliac crest, thoracolumbar fascia Iliocostalis thoracis: 7 th -12 th ribs Iliocostalis cervicis: 3 rd -7 th ribs Insertion Iliocostalis lumborum: 6 th -12 th ribs, deep layer of thoracolumba fascia, TP of upper lumbar vertebrae Iliocostalis thoracis: 1 st -6 th ribs Iliocostalis cervicis: TP of C4-C6 vertebrae Innervation Lateral branches of dorsal rami of C8-L1
- 19. Erector spinae group Prone position Locate the region of lower erectors by asking to alternatively raise and lower feet slightly (contract in order to stabilize the pelvis)
- 20. Erector spinae group Palpate inferiorly onto the sacrum and then superiorly along the thoracic vertebrae Ask the patient to extend his spine and neck slightly in order to contract the erectors in the thoracic region
- 21. Erector spinae group Follow the ropy fibers of the erectors between the scapulae and along the back of the neck
- 22. Test for back extensors
- 23. Test for back extensors Patient: Prone Fixation: Hip extensors must give fixation of the pelvis to the thigh. The examiner stabilizes the legs firmly on the table Test: Trunk extension to the subject’s full range of motion
- 24. Back extensors Strong back extensor and strong hip extensor Strong back extensor and weak or paralyzed hip extensor Weak or paralyzed back extensor and strong hip extensor