- Suboccipital triangle
- Borders
- Obliquus Capitis Superior (Superior)
- Obliquus Capitis Inferior (Inferior)
- Rectus Capitis Major (Medial)
- Contents
- Vertebral artery
- Suboccipital Nerve (C1) - Sensory and Motor
- Suboccipital Venous Plexus
- Borders
- Spine and Spinal Cord
- Vertebrae
- 7 Cervical
- 12 Thoracic
- 5 Lumbar
- 5 Sacral (fused)
- Coccyx
- Provides main support for the body
- Ligaments of the spine (P to A)
- Supraspinous ligament
- Interspinous ligament
- Ligamentum Flavum
- Posterior Longitudinal ligament
- Anterior Longitudinal ligament
- Spinal Cord
- Runs from the base of the brain until around L2
- Innervates most of the body below the level of the neck
- Exceptions:
- Trapezius and SCN (Accessory nerve),
- Intrinsic muscles of the larynx (Vagus),
- Parasympathetic innervation of various organs in the thorax and abdomen (Vagus)
- Exceptions:
- Surrounded by Dura mater, arachnoid mater, and Pia mater
- Lumbar puncture
- Done at the level of L3-L4 to avoid the spinal cord itself
- Performed to colect CSF, Measure pressure of CSF, Anesthesia, and inject dye for imaging
- Lumbar puncture
- Vertebrae
- Clinical Correlations
- Kyphosis
- Exaggerated forward rounding of the back
- Most common in women and related to Osteoporosis
- Lordosis
- Unusually large inward arch of the lowr back
- Can be inherited, or caused by conditions such as arthritis or muscular dystrophy
- Scoliosis
- Sideways curvature of the spine
- Most common of the three. Often occurs during growth spurts just before puberty
- Herniated intervertebral disc
- Nucleus pulposus pushes through annulus fibrosis
- Some are asymptomatic and require no treatment
- Others can result in pain, numbness, or weakness in the back/extremities
- Kyphosis
Back Muscles
Superficial Back Right
Muscle |
Origin (Fixed attachment) |
Insertion (moves with contractionIn |
Function/Action |
Blood Supply |
Innervation |
Spinous Processes C1-C7, Occipital Protuberance, Nuchal
Ligament |
Superior: lateral 1/3 of clavicle Middle: Acromion Inferior: Medial Spine of Scapula |
Scapula: Superior: Elevation Middle: Retraction Inferior: Depression and lateral rotation |
Transverse cervical aa) ·
Superficial Cervical aa |
Motor: CN XI Sensory: C3/C4 |
|
Spinous Processes of T7-T12, thoracodorsal
fascia, iliac crest, ribs 9-12 |
Humerus (bicipital groove) |
Arm: Extension, medial rotation, adduction |
Thoracodorsal a/v |
Thoracodorsal n. ·
Middle subscapular n. |
|
Vertebral column (T2-T5) |
Medial border of scapula (inferior to spine) |
Scapula: Medial rotation, retraction, elevation |
Dorsal scapular a/v |
Dorsal scapular n (C5) |
|
Vertebral column (C7-T1), nuchal ligament |
Spine of scapula |
Scapula: Medial rotation, retraction, elevation |
|||
Transverse Processes of C1-C4 |
Medial border of scapula, superior to spine of
scapula |
Scapula: Elevation |
Intermediate Back Left
Muscle |
Origin |
Insertion |
Function/Action |
Blood Supply |
Innervation |
Nuchal ligament; spinous processes of C7-T2 |
Ribs 2-5 |
Inspiration – elevate ribs |
Posterior Intercostal aa |
Ventral Primary Ramii (T1-T4) |
|
Spinous processes T11-L2 |
Ribs 9-12 |
Inspiration - lower ribs |
Posterior Intercostal aa |
Ventral Primary Ramii (T9-T12) |
Deep Back Right
Superficial/Spinotransverse
Group
Muscle |
Origin |
Insertion |
Function/Action |
Blood Supply |
Innervation |
Nuchal ligament and spinous processes of C3-T3 |
Mastoid Process and Superior Nuchal Line |
1) Ipsilateral rotation of head 2) Extension/Lateral Flexion of cervical spine and head |
Deep Cervical aa |
Dorsal Primary Ramii of C2-C6 |
|
Nichal Ligament and Spinous Processes of C7-T6 |
Transverse processes of C1-C3 |
1) Ipsilateral rotation of head 2) Extension/Lateral Flexion of cervical spine and head |
Deep Cervical aa |
Dorsal Primary Ramii of C2-C6 |
Intermediate/Sacrospinalis
Group (Erector Spinae) Left
Muscle |
Origin |
Insertion |
Function/Action |
Blood Supply |
Innervation |
Iliac
crest & sacrum |
Transverse
processes of upper lumbar vertebrae, ribs 1-12, thoracolumbar fascia |
Extension,
abduction and lateral rotation of spine |
Deep
Cervical aa |
Dorsal
Primary Ramii |
|
Iliac
crest, sacrum, spinous processes of lumbar vertebrae, transverse processes of
thoracic vertebrae |
Ribs
2-12 |
Extension
and lateral flexion of trunk and head |
Deep
Cervical aa |
||
Spinous
processes of T2-T8 |
Spinous
processes of T2-T8 and base of skull |
Support,
extension and lateral flexion of spine |
Deep
Cervical aa |
Deep/
Transversospinalis Group Right
Muscle |
Origin |
Insertion |
Function/Action |
Blood Supply |
Innervation |
Transverse processes of C3-T6 |
Posterior Occipital Bone |
Extension/Lateral Flexion of cervical/thoracic spine and head |
Deep Cervical aa |
Dorsal Primary Ramii of C3-T6 |
|
Transverse processes of T1-T6 |
Spinous Processes of C2-C5 |
Head inclination, extension and rotation of spine and head to
contralateral side |
Deep Cervical aa |
Dorsal Primary Ramii of T1-T6 |
|
Transverse processes of T1-T12 |
Spinous Processes of C6-T4 |
Contralateral rotation of trunk; bilateral lateral flexion and
extension of spine |
Deep Cervical aa |
Dorsal Primary Ramii of C6-T12 |