anatomy 3 - irenes.edu

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5/20/21 1 Irene’s Myomassology Institute Anatomy 3 Lecture Posterior Torso 1 © 2019 Books of Discovery, booksofdiscovery.com Spine & Thorax Bony Landmarks to Know Spinous processes of the vertebrae Transverse processes of the vertebrae Superior nuchal line of the occiput External occipital protuberance Ligamentum nuchae Mastoid process of the temporal bone Thoracolumbar fascia (aponeurosis) Iliac crest 2 © 2019 Books of Discovery, booksofdiscovery.com Spine & Thorax Joint Movements to Know Flexion of the vertebral column Extension of the vertebral column Lateral flexion of the vertebral column Rotation of the vertebral column 3 © 2019 Books of Discovery, booksofdiscovery.com Spine & Thorax Surface Features Visible on Spine and Thorax Anterior View (p. 168) 4 © 2019 Books of Discovery, booksofdiscovery.com Spine & Thorax Surface Features Visible on Spine and Thorax Posterior View (p. 168) 5 © 2019 Books of Discovery, booksofdiscovery.com Spine & Thorax Bones of Spine and Thorax Posterior View (p. 170) 6

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Page 1: Anatomy 3 - irenes.edu

5/20/21

1

Irene’s Myomassology InstituteAnatomy 3 Lecture

Posterior Torso

1© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Bony Landmarks to Know

• Spinous processes of the vertebrae• Transverse processes of the vertebrae• Superior nuchal line of the occiput • External occipital protuberance • Ligamentum nuchae • Mastoid process of the temporal bone• Thoracolumbar fascia (aponeurosis)• Iliac crest

2

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Joint Movements to Know

• Flexion of the vertebral column• Extension of the vertebral column • Lateral flexion of the vertebral column • Rotation of the vertebral column

3© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Surface Features Visible on Spine and Thorax

Anterior View

(p. 168)

4

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Surface Features Visible on Spine and Thorax

Posterior View

(p. 168)

5© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Bones of Spine and Thorax

Posterior View

(p. 170)

6

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2

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Cervical Vertebrae

Atlas and Axis

(p. 171)

7© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

C3 − C7

(p. 172)

8

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Thoracic Vertebrae

(p. 172)

9© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Lumbar Vertebrae

(p. 172)

10

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Thorax

Anterior and posterior view

(p. 173)

11© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Sternum

Anterior view

(p. 173)

12

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© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Rib bones

First rib and other rib

(p. 173)

13© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Spine Curvatures

(p. 174)

14

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

(p. 174)

Abnormal Curves

This Photo by Unknown Author is licensed under CC BY

This Photo by Unknown Author is licensed under CC BY-NC-ND

15© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Overview

Muscles that move vertebral column and ribs/thorax

(pp. 188-190)

16

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Muscle layers of the posterior neck

(pp. 191-192)

17© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Cross section of the neck

(p. 192)

18

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4

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Cross section of the thorax

(p. 193)

19© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

(p. 194)

Vertebral column flexion

(antagonists on extension) Rectus abdominisExternal oblique (bilaterally) Internal oblique (bilaterally) Psoas major (with the insertion fixed) Iliacus (with the insertion fixed)

20

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

(p. 194)

Vertebral column extension

(antagonists on flexion)Longissimus (bilaterally)Iliocostalis (bilaterally)Multifidi (bilaterally)Rotatores (bilaterally)*Semispinalis capitisSpinalis (bilaterally)Quadratus lumborum (assists) Interspinalis*Intertransversarii (bilaterally)*Latissimus dorsi (assists, when arm is fixed)*

21© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

(pp. 194-195)

Vertebral column rotation

(all unilaterally)External oblique (to the opposite side) Internal oblique (to the same side) Multifidi (to the opposite side) Rotatores (to the opposite side)

22

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

(pp. 194-195)

Vertebral column lateral flexion

(unilaterally to the same side)

External oblique Internal oblique LongissimusQuadratus lumborum Psoas major (assists)* Intertransversarii* SpinalisLatissimus dorsi (assists)

23© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Spine and Thorax Muscle Group

Erector Spinae groupTransversospiinalis group

(pp. 196-202)

24

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© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Erector Spinae GroupSpinalisLongissimus Iliocostalis

(pp. 196-199)

A Unilaterally: Laterally flex vertebral column to the same sideBilaterally: Extend the vertebral column

O Common tendon (thoracolumbar fascia) that attaches to the posterior surface of sacrum, 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

N Spinal

25© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Spinalis

(pp. 196-199)

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)

26

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Longissimus

(pp. 196-199)

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)

27© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Iliocostalis

(pp. 196-199)

O Common tendon (lumborum)Posterior surface of ribs 1–12 (thoracis and cervicis)

I Transverse processes of lumbar vertebrae 1–3 and posterior surface of ribs 6–12 (lumborum)Posterior surface of ribs 1–6 (thoracis)Transverse processes of lower cervicals (cervicis)

28

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Transversopinalis Group

MultifidiRotatoresSemispinalis Capitis

(pp. 200-202)

29© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Multifidi

(pp. 200-202)

A Unilaterally: Rotate the vertebral column to the opposite sideBilaterally: Extend the vertebral column

O Multifidi: Sacrum and 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

30

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© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Rotatores

(pp. 200-202)

A Unilaterally: Rotate the vertebral column to the opposite sideBilaterally: Extend the vertebral column

O Rotatores: Transverse processes of lumbar through cervical vertebrae

I Spinous processes of lumbar vertebrae through second cervical vertebra(Multifidi span two to four vertebrae; rotatoresspan one to two vertebrae)

N Spinal

31© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Semispinalis Capitis

(pp. 200-202)

A Extend the vertebral column and head

O Transverse processes of C-4 to T-5

I Between the superior and inferior nuchal lines of the occiput

N Cervical

32

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Splenius Capitis and Cervicis

(pp. 203-204)

A Unilaterally:Rotate the head and neck to the same sideLaterally flex the head and neck to the same sideBilaterally:Extend the head and neck

O Capitis: Inferior one-half of ligamentum nuchae and spinous processes of C-7 to T-4

Cervicis: Spinous processes of T-3 to T-6

I Capitis: Mastoid process and lateral portion of superior nuchal line

Cervicis: Transverse processes of C-1 to C-3

N Cervical

33© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Suboccipitals

Rectus Capitis Posterior MajorRectus Capitis Posterior MinorOblique Capitis SuperiorOblique Capitis Inferior

(pp. 205-206)

34

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Rectus Capitis Posterior Major

(pp. 205-206)

A Rock and tilt the head back into extension

Rotate the head to the same sideO Spinous process of the axis (C-2)

I Inferior nuchal line of the occiput

N Suboccipital

35© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Rectus Capitis Posterior Minor

(pp. 205-206)

A Rock and tilt the head back into extension

O Tubercle of the posterior arch of the atlas (C-1)

I Inferior nuchal line of the occiput

N Suboccipital

36

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© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Oblique Capitis Superior

(pp. 205-206)

A Rock and tilt the head back into extension

Laterally flex the head to the same sideO Transverse process of the atlas (C-1)

I Between the nuchal lines of the occiput

N Suboccipital

37© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Oblique Capitis Inferior

(pp. 205-206)

A Rotate the head to the same side

O Spinous process of the axis (C-2)

I Transverse process of the atlas (C-1)

N Suboccipital

38

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Cross section

(pp. 207-215)

39© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Quadratus Lumborum

(pp. 207-208)

A Unilaterally:Laterally tilt (elevate) the pelvisLaterally flex the vertebral column to the same sideAssist to extend the vertebral column

Bilaterally:Fix the last rib during forced inhalation and exhalation

O Posterior iliac crest

I Last rib and transverse processes of first through fourth lumbar vertebrae

N Lumbar plexus T12, L1, 2, 3

40

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Serratus Posterior Superior

(p. 216)

A Elevate the ribs during inhalation

O Spinous processes of C-7 to T-3

I Posterior surface of second through fifth ribs

N T1, 2, 3, 4

41© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Serratus Posterior Inferior

(p. 216)

A Depress the ribs during exhalation

O Spinous processes of T-12 to L-3

I Posterior surface of ninth through twelfth ribs

N T9, 10, 11, (12)

42

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© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Ligaments of the Spine and Thorax

Ligamentum NuchaeSupraspinous Ligament

(pp. 218-219)

43© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Thoracolumbar Fascia

(p. 220)

44

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Craniovertebral Joints

Atlantooccipital and atlantoaxial joints

(p. 221)

45© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Intervertebral Joints

(p. 222)

46

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Intervertebral Joints

(p. 222)

47© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Intervertebral Joints

(p. 222)

This Photoby Unknown Author is licensed under CC BY-SA-NC

§ Make up 25% of the height of the spine.

§ Cervical discs make up 40% of the height of the neck.

§ They bear 80% of the weight placed on the spine, the facet joints get the other 20%

§ Function for weight bearing and shock absorption

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© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Intervertebral Joints

(p. 222)

§ Nucleus pulposus is 80% water

§ Annulus fibrosis is 10 to 20 layers of fibrocartilage

§ The discs are designed to resist§ Distraction – vertical

movement§ Shear – horizontal

sliding§ Torsion - rotation

49© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Herniated Disk

(p. 222)

50

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Costovertebral Joints

(p. 223)

51© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Sternocostal Joints

(p. 223)

52

© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Bony Landmarks to Know

• Spinous processes of the vertebrae• Transverse processes of the vertebrae• Superior nuchal line of the occiput • External occipital protuberance • Ligamentum nuchae • Mastoid process of the temporal bone• Thoracolumbar fascia (aponeurosis)• Iliac crest

53© 2019 Books of Discovery, booksofdiscovery.com

Spine & Thorax

Joint Movements to Know

• Flexion of the vertebral column• Extension of the vertebral column • Lateral flexion of the vertebral column • Rotation of the vertebral column

54