脊柱内在稳定性肌群功能

Muscles-MusclesoftheBack(背部肌肉Superficiallaryer(moversofupperIntermediatelayer(musclesforDeeplayer(moversofSuperficialgroup(appendiculargroupmoversofupper6stabilizorsofscapula(6origin：脊柱、insertion：肩胛shoulderjointmoversorigin：肩胛骨、insertion：Intermediategroup(respiratorygroupmusclesforSerratusposteriorsuperior(Gray'sorigin：upperthoracicspineinsertion：2~5action：上提肋骨-->inspiration(innervation：ventralramusofT1~3intercostalSerratusposteriorinferiorO:lowerthoracic,lumbarspineI:8~12action：拉下肋骨-->expiration(innervation：ventralramusofT8~12intercostalLevatorcostarum(Gray'sO:C7~T10transverseI:action:elevatebrevis(提肋短肌)(连接相邻肋骨)、innervation:dorsalramusofintercostalnerves(肋间神经Deep最多的肌肉，移动数量最多的骨骼、关节不可动区：skull、pelvis、bony可动区：neck(7cervicalvertebrae)、waist(5lumbarmoversofvertebralupper1/2forcervicallower1/2forlumbarmovementsofvertebralvertebraglidingjoints，动作都是lineamovements但若视7C、5LA.angularmovements-->ErectorspinaeLateralbending(=B.Rotation-->TransversospinalesErectorspinaemuscles(竖脊肌群)(Gray'sposturemuscles(维持肌肉antigravity1~2minErectorspinaemm.sacrumspinousprocesscommontendonIliocostalisgroupiliocostalislumborum(腰髂肋肌)、iliocostalisthoracis(胸髂肋肌)、iliocostaliscervicis(颈髂肋位于最外侧costalangle角)、transverseprocessoflowerCspine(低位Longissimusgrouplongissimusthoracis(胸最长肌)、longissimuscervicis(颈最长肌)、longissimuscapitis(头最长transverseprocessofT,Cspine(胸、颈椎横突)上。Spinalisgroupspinalisthoracis(胸棘肌)、spinaliscervicis(颈棘肌)、spinaliscapitis(头棘肌)最靠近位置，起自棘突、终于棘突spinalistoracis到了颈部(spinaliscervicis)通常变得不明显或缺少。再往上spinaliscapitissemispinalis相混合，可不必特别加以区lateraldorsalramusofC,TLspinaln.Transversospinalesmuscles(横脊肌群你必须要移除竖棘肌群才能见到这些位于最的背部本体肌力-->rotation(旋转)力量-->转spinous/tranverseSemispinalis由深而浅依序是rotators、multifidus、愈肌肉愈短、愈浅层肌肉愈坏处是长肌收缩时需要对侧为数众多短力矩，常造成对侧肌不能放松，累积长Long&Shortrotators(1-->3)-这种最的短肌其实是最重要的posture[extendedRotators(旋转肌fromtransverseprocesstosipinousprocessInterspinalisfromspinousprocesstospinous细分a.Interspinaliscervicis(颈棘间肌)、b.Interspinalislumborum(腰棘fromtransverseprocesstotransverseprocess这三种肌肉都在相邻vertebrase3：extension,lateralbending、rotation伸直->侧弯Multifidusm.(1--semispinalis，双侧同时收缩，伸直腰／Semispinalism.(半棘肌)(1--transverseprocess(O)、终止于颈椎spinousprocess(I)semipinalisthoracis(胸半棘肌)、semispinalis单侧收缩转对semispinalisfamilylowerhalfofback-->splenius,semispinalis-------(m.thatrotatetheCspine)-----Spleniusm.细分为：Spleniuscapitis(头夹肌)、Spleniustrapezius(斜方肌)就可看见在颈部，如果切掉serratuspost.sup.(后上锯肌)会更清楚。originspinousprocess(O)，insertion椎transverseprocess(I)、枕骨superiornuchal半棘肌的origin,insertiondorsalramusofC4~8cervicalspinaln.同semispinalisvs.splenius成头部转动方向不同！(转同侧vs.转对侧)总的来说，transversospinalesmm.和erectorspinaemm.这反映出vertebralcolumnbackmusclesposturesmuscles需求-->持续收缩伸直脊柱，抵消脊柱前方所以，backmm.是不能休息(posturesmm.基本特色)的(unlesssleeponthebed!)所以，上请坐好-->坐有坐相、站有站良好的才能避免脊柱变形-->产生左右不配平力量-->posturemm.不能放松-->颈、背痛[learningSpinalisfromspinousprocess(棘突)tospinousprocessSemispinalisfromtransversetospinousSpleniusorigin(O)insertion(I)semispinalis不同：转同侧vs.Suboccipitalregion内容物：dorsalramusof1stcervicalspinalnerve(第一颈神经背枝)、vertebralartery(椎动脉)ObliquecapitisinferiorO:轴椎(axis；C2)棘突；I:寰椎(atlas；C1)ObliquecapitissuperiorO:C1；I:RectuscapitisposteriormajorO:C2；I:RectuscapitisposteriorminorO:C1(post.tubercle)；I:nerve1stcervicalspinalnerve[extended[recallspinalis是不是很像[recallsemispinalisoblique[recallspleniusoblique[Summary]musclesthatmovethesemispinaliscapitis、succipitaltriangleprevertebralsuperficalneck[learning起：背部本体肌肉(竖脊肌、横脊肌合：神经解剖的光反射、反射MusclesofthethoracicMusclesforrespirationCostalcage(肋架)上提／呼气用肌肉能动肋骨(e.g.：Pectoralisminor、前锯肌Serratusanteior)Inspiration(吸气用肌肉Diapharagm(横膈(Nerveinnervation)：C3~C5Spinalnerve->phrenic横膈是最重要吸气肌，you'lldiewithoutitsintercostaln.支配，而是大老远由上方cervicaln.来支配？横膈，因为phrenicnervemadeofC3~5Eercostal(ribcostaltubercle骨相接处，肌肉变为Eercostalssternumcostalangle(肋角)肌肉变为Iercostalsintercostalsvs.abdominalwallSternalis(胸骨肌)同InternalintercostalsinterchondralScalenes(斜角肌ant.、mid.scalenes1strib、post.scalenem.上提2ndribSternocleidomastoid(胸锁乳突肌clavicle、1stribcostoclavicularligament(SCM1stribBack-->intermediatelayer-->respiratorySerratusposteriorsuperior(后上锯肌)、Serratusposteriorinferior(后下锯肌)serratusanterior运动用)vs.后锯肌serratusposterior(-->呼吸用)Levatorcostarum(提肋肌costalpartofPectoralismajor(肋骨部Expiration(呼气用肌肉Internalintercostalscostalpart(硬骨4Innercomplex(复合体Transversesthoracis将之下拉。由2~6Inermostintercostalsm.3~4Intercostalmm.(肋间肌Eercostalm.由后向前，腱膜(aponeurosis)('ercostalIercostalm.肌纤维和肋间外间呈"X"Innermostintercostalsm.Diaphragm(横膈centraltendonportion(腱性部muscularportionSternalpartCostalpart(肋骨部)、后方Lumbarpart(腰部)diaphragmichiatusAorta、Esophagus、IVC[review]3)：3SternalpartCostalpart：胚胎期横膈下降时被拉进的腹壁肌肉，位于边缘。与后方腰部间有Lumbocostal[clinicPhrenicherniapoststernalhernia(胸骨后疝thoracoabdominalpleuralLumbarLat.arcuateligament(外弓状韧带)(跨腰方肌)、Intarcuateligament(内弓状韧带)(跨Rightcrus、Lefttcrushiatus(fromant.toInferiorvenaEsophagus、Vagusn.esophgealbranchofleftgastricartery(左胃动脉食道Aorta、Thoracicduct(胸管)、Splanchnicn.ofsympatheticnerve(交感内脏神经)、Azygosvein(奇神经：Phrenicn.(膈神经)是直接进入横膈内(右侧入腱性部、左侧入肌性部)。musculophrenica.(肌膈动脉)、pericardiacalartery(心包膜动脉)、superiorphrenicartery(膈上动脉)inferiorphrenicartery(MusclesoftheabdominalAnteriorabdominal呼吸用、排便及排尿、腰部动作中的Externalobliqueabdominis向上覆盖住5~10ribs锯肌(Serratusant.)、阔背肌(Latissimusdorsi)交错共9~12ribs。纤维方向是由外上方(腋下区)斜向内下方(近部郊-->手插进长裤口袋时的方向Inguinalligament(韧带)：(LigamentofASIS(Ant.sup.iliacspinePubictubercle(耻骨结节)间Superficialinguinalring(浅环Spermaticcord(：男)／Roundlig.(圆Med.cruspubicsymphysis)、Lat.cruspubictubercle)，中间有Intercrurallig.(脚间韧带)强化防止裂Reflectedligament(返折韧带)：(LigamentofColles)方止于腹直肌鞘。位于浅环开口内下方(Lacunarligament(陷窝韧带)：(LigamentofGimbernat)(=LigamentofHesselbach)由靠近耻骨结节的韧带纤维形成，它管内缘)附着于pectinpubis(=pectinealPectinealligamentInternalobliqueabdominis向上附着于7~10ribs边缘，下方附着于韧带外2/3(内1/3变为表面的提睪肌)及iliaccrest，内侧10~12ribsThoracolumbarfascia。TransversusabdominisCremasterm.腹内斜肌、腹横肌下缘部份肌纤维跟随进入管，成为外的提睪肌。支配Genitabr.ofGenitofemoraln.(Inguinalfalx(镰)=Conjointtendon(结合由上方跨过向内、向后，附着于耻骨梳Inguinaltriangle肌肉的薄弱区(仅有Transveralisfascia腹横筋膜)-->Directhernia(直接氙气)Rectusabdominis向上附着于5~7ribspubictubercle4Tendinousintersections3Lineaalba(白线)，外侧和三腹壁相接处形成纵向弧线称Lineasemilunaris(半月9thribpubictubercle。出现肌肉内的肌腱－Tendinousinscription脊柱运动中最重要的flexor(和脊柱后方背部本体肌肉互为拮抗肌(-->flexorvs.extensor)Rectussheath(aponeurosis)分为前后两层，Ant.Layer横肌腱膜形成，肚脐下方arcuateline(弓状Endoabdominalfascia(浅)Transversalisfascia、Extraperitonealfacia(脂肪)、 Transversalisfascia

腹横肌内表面，属腹腔内筋膜，亦是前腹壁deep最的部分肚脐以下的post.layerofRectussheath进入下肢大腿的Ant.wallofFemoralc 管前壁)(股管内有femorala.,v.,lymphDeepinguinalring(深环位于Inguinaltriangle外，是穿出前入后成为Int.spermaticfascia(Interfoveolarligament位于前腹壁内表面，紧邻深环内缘，横筋膜延伸带(Inf.epigastrica.v.紧贴其PyramidalisPosteriorabdominalquadratuslumborumPsoasmajor(腰大肌)、Psoasminor(腰小肌)、iliacus(髂hipjoint(髋关节)前方通过，是髋关节强有力的形成共同肌腱(iliopsoaslessortrochanter([extendedpsoas、iliacuspelvicgirdle运动肌，影响到下肢近端的动作，以及静态平衡、动参考m.ofplevicA.主要集中在ant.abdominal肌肌纤维字母的X在腹壁围成一袋状物，用以内脏来辅助B.post.abdominalwall，lumbarHead,Thorax,PelvisNeck,WaistWaistFlexion/ExtensionLateralflexion：想象成发生在中轴上的Circumduction：由组合出的循序组合动lumbarvertebraegliding(vertebraeglidingjoint)只有背部本体肌肉中的横脊肌群(Transversospinalis之横突、棘突)-->见背部肌肉(Semispinalis,Multifidus,Rotators)、脊神经背枝(dorsalramus)Musclesofthe[learningobject]：Pelvic了解骨盆下口(pelvicoutlet)由于缺乏骨骼为底板，是故存在内 形成隔膜的肌肉有内、外两层，外层是三角形在部官周围，称为隔膜。内部在小骨盆内形成，称为骨盆[review]truetruepelvicPelvic即真骨盆，它是真、假骨盆的分界，称为骨盆缘(pelvicbrim)它是横向椭圆形(女性)或是心脏形()pelvicbrimPelvicbrimsacralpromontarymarginofala(骨氐翼缘)]＋弓状线(Arcuatelineofilium)＋[耻骨梳(Pectenpubis)＋耻骨联合(Symphysispubis)]Iliopectinealline线、耻骨梳合称为髂耻骨梳线(Iliopectinealline)，它Iliopectinealline＝Arcuateline(iliacpart)＋Pectenpubic(pubicpart)(Gray'sLineaterminalis(终线)＝Arcuateline＋[Pectenpubis＋pubiccrest]真骨 边缘＝骨氐骨岬＋骨盆缘＋耻骨联pubiccrest(pecten真骨 边缘＝骨氐骨岬＋骨盆缘＋耻骨联Pelvic就是指小骨盆(lesserpelvis=truepelvis前：Pubicsymphysis后 A.Perinealdiaphragm(隔膜diaphragm(膈膜)，做为挡Pelvicoutlet前：Urogenitaltriangle无论男、女性，只有此层才有双层膈膜-->位于泌尿生殖 后： 三角externalsphinctor(外括约肌Perinealdiaphragm(膈膜)=urogenitaldiaphragm(泌尿生殖隔o：Deeptransverseperineus(深横肌)＋Externalurethralsphinctor(外括约肌) 深横肌)(较不明显)、外括约肌＋Compressor 压肌)、Sphincterurethrovaginalis(括约深横肌是三角形的肌肉，两侧稳定附着于pubis(耻骨)，是隔膜中最的肌肉(-