Spine And Thorax 1

1. Spine and Thorax

2. Topographical views

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:Patient: Prone
•Fixation:Fixation: Hip extensors must give fixation of
the pelvis to the thigh. The examiner
stabilizes the legs firmly on the table
•Test: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