Muscles are named according to their shape, location, or a combination.

They are further categorized according function such as flexion,

extension, or rotation. Muscles and ligaments work together to support the spine, hold it upright, and control movement during rest and
activity.

Types of Vertebral Muscles General Location

Forward flexors Anterior
Lateral flexors Lateral
Rotators Lateral
Extensors Posterior
Skeletal muscle is striated (striped) in appearance. It is innervated, under voluntary control, and has the fastest contraction rate of all muscle.
Prior to a muscle contracting, a nerve impulse originates in the brain and travels through the spinal cord to the muscle.

Energy is needed for the muscle to contract (work). Mitochondria (cellular level) produce ATP (adenosine triphosphate), a chemical cells
need for energy. ATP is produced as the mitochondria burn glucose (sugar). Blood vessels deliver the oxygen and nutrients the mitochondria
needs to provide a steady supply of ATP.

Muscles of the Posterior Cervical and Upper Thoracic Spine

1. Semispinalis Capitus (head rotation/pulls backward) 
2. Iliocostalis Cervicis (extends cervical vertebrae) 
3. Longissimus Cervicus (extends cervical vertebrae) 
4. Longissimus Capitus (head rotation/pulls backward) 
5. Longissimus Thoracis (extension/lateral flexion vertebral column, rib
rotation) 
6. Iliocostalis Thoracis (extension/lateral flexion vertebral column, rib rotation) 
7. Semispinalis Thoracis (extends/rotates vertebral column)

Muscles of the Spinal Column

CERVICAL MUSCLES FUNCTION NERVE

Extends & rotates head, flexes
Sternocleidomastoid C2, C3
vertebral column
Scalenus Flexes & rotates neck Lower cervical
 Middle/lower
Spinalis Cervicis Extends & rotates head
cervical
Middle/lower
Spinalis Capitus Extends & rotates head
cervical
Middle/lower
Semispinalis Cervicis Extends & rotates vertebral column
cervical
Semispinalis Capitus Rotates head & pulls backward C1 – C5
Middle/lower
Splenius Cervicis Extends vertebral column
cervical
Longus Colli Cervicis Flexes cervical vertebrae C2 – C7
Longus Capitus Flexes head C1 – C3
Rectus Capitus Anterior Flexes head C2, C3
Rectus Capitus Lateralis Bends head laterally C2, C3
Middle/lower
Iliocostalis Cervicis Extends cervical vertebrae
cervical
Middle/lower
Longissimus Cervicis Extends cervical vertebrae
cervical
Middle/lower
Longissimus Capitus Rotates head & pulls backward
cervical
Rectus Capitus Posterior
Extends & rotates head Suboccipital
Major
Rectus Capitus Posterior
Extends head Suboccipital
Minor
Obliquus Capitus Inferior Rotates atlas Suboccipital
Obliquus Capitus Superior Extends & bends head laterally Suboccipital
 

THORACIC
FUNCTION NERVE
MUSCLES
Extension, lateral flexion of Dorsal primary divisions
Longissimus Thoracis
vertebral column, rib rotation of spinal nerves
Extension, lateral flexion of Dorsal primary divisions
Iliocostalis Thoracis
vertebral column, rib rotation of spinal nerves
Dorsal primary divisions
Spinalis Thoracis Extends vertebral column
of spinal nerves
Extends & rotates vertebral Dorsal primary divisions
Semispinalis Thoracis
column of spinal nerves
Extends & rotates vertebral Dorsal primary divisions
Rotatores Thoracis
column of spinal nerves
 

LUMBAR MUSCLES FUNCTION NERVE

 Flexes thigh
at hip joint & L2, L3,
Psoas Major vertebral sometimes
column L1 or L4

Ventral
Lateral flexion primary
Intertransversarii
of vertebral division of
Lateralis
column spinal
nerves
Lateral flexion
Quadratus Lumborum of vertebral T12, L1
column
Dorsal
Extends primary
Interspinales vertebral divisions of
column spinal
nerves
Dorsal
Lateral flexion primary
Intertransversarii
of vertebral divisions of
Mediales
column spinal
nerves
Dorsal
Extends &
primary
rotates
Multifidus divisions of
vertebral
spinal
column
nerves
Dorsal
Extends &
primary
Longissimus rotates
divisions of
Lumborum vertebral
spinal
column
nerves

Extension, Dorsal
lateral flexion primary
Iliocostalis Lumborum of vertebral divisions of
column, rib spinal
rotation nerves

Muscle Fascia
Fascia is thickened connective tissue that envelops a muscle or a group of muscles. Superficial fascia is found directly under the skin.
 Epimysium is the fascia closest to the muscle. Perimysium divides the muscle into facicles – muscle fibers. Endomysium is another type of
connective tissue that covers each muscle fiber.

Ligaments
Ligaments are fibrous bands or sheets of connective tissue linking two or more bones, cartilages, or structures together. One or more
ligaments provide stability to a joint during rest and movement. Excessive movements such as hyper–extension or hyper–flexion, may be
restricted by ligaments. Further, some ligaments prevent movement in certain directions.

Three of the more important ligaments in the spine are the Ligamentum Flavum, Anterior Longitudinal Ligament and the Posterior
Longitudinal Ligament.

 The Ligamentum Flavum forms a cover over the dura mater: a layer of tissue that protects the spinal cord. This ligament connects
under the facet joints to create a small curtain over the posterior openings between the vertebrae.
 The Anterior Longitudinal Ligament attaches to the front (anterior) of each vertebra. This ligament runs up and down the spine
(vertical or longitudinal).
 The Posterior Longitudinal Ligament runs up and down behind (posterior) the spine and inside the spinal canal.

Primary Spinal Ligaments Include:

Ligament Spinal Region Limits…

Alar Axis – skull Head rotation & lateral flexion
Anterior Atlantoaxial Axis & Atlas Extension
Posterior
Axis & Atlas Flexion
Atlantoaxial
Ligamentum Nuchae Cervical Flexion
Extension & reinforces front of annulus
Anterior Longitudinal Axis – Sacrum
fibrosis
Posterior
Axis – Sacrum Flexion & reinforces back of annulus fibrosis
Longitudinal
Ligamentum Flavum Axis – Sacrum Flexion
Supraspinous Thoracic & Flexion
 Lumbar
Interspinous Lumbar Flexion
Intertransverse Lumbar Lateral flexion
Iliolumbar Sacroiliac joints Stability & some motion
Sacroiliac Sacroiliac joints Stability & some motion
Sacrospinous Sacroiliac joints Stability & some motion
Sacrotuberous Sacroiliac joints Stability & some motion
 

Ligaments of the Back of the Cervical and Upper Thoracic Spine 

1. Supraspinous Ligament (flexion) 
2. Ligamentum Nuchae (fibrous membrane)
Ligament Systems – Atlas and Axis
As mentioned in the Vertebral Column, the Atlas (C1) and Axis (C2) are different from the other spinal vertebrae. The upper cervical ligament
system is especially important in stabilizing the upper cervical spine from the skull to C2. Although the cervical vertebrae are the smallest, the
neck has the greatest range of motion. 

Occipitoatlantal Ligament Complex (Atlas)

These four ligaments run between the Occiput and the Atlas:

 Anterior Occipitoatlantal Ligament

 Posterior Occipitoatlantal Ligament
 Lateral Occipitoatlantal Ligaments (2)
Occipitoaxial Ligament Complex (Axis)
These four ligaments connect the Occiput to the Axis:

 Occipitoaxial Ligament
 Alar Ligaments (2)
 Apical Ligament
Altantoaxial Ligament Complex (Axis)
These four ligaments extend from the Atlas to the Axis:

 Anterior Atlantoaxial Ligament

 Posterior Atlantoaxial Ligament
 Lateral Ligaments (2)
 Cruciate Ligament Complex
These ligaments help to stabilize the Atlantoaxial (Axis) complex:

 Transverse Ligaments
 Superior Longitudinal Fascicles
 Inferior Longitudinal Fascicles

Nerves
Nerves control the body’s functions including the vital organs, sensation, and movement. The nervous system receives information and
initiates an appropriate response. It is affected by internal and external factors (i.e. stimulus).

Nerves follow tracts and cross over junctions called Synapses. Simplified, it is a complex communicative process between nerves conducted
by chemical and/or electrical changes.

 
Central Nervous System (CNS)
The Central Nervous System is composed of the brain and spinal cord. The brain has 12 Cranial Nerves. The spinal cord, which originates
immediately below the brain stem, extends to the first lumbar vertebra (L1). Beyond L1 the spinal cord becomes the Cauda Equina (see
below). The spinal cord provides a means of communication between the brain and peripheral nerves.

BRAIN 12 Cranial Nerves

Motor: 5 nerves
Sensory: 3 Nerves
Motor/Sensory: 4 nerves
 

SPINAL CORD 31 Pairs – Spinal Nerves

Cervical 8 pair
Thoracic 12 pair
Lumbar 5 pair
Sacral 5 pair
Coccyx 1 pair

Just below the last Thoracic (T12) and first Lumbar (L1) vertebra the spinal cord ends at the Conus Medullaris. From this point the spinal
nerves, resembling a horse’s tail become known as the Cauda Equina extending to the coccyx. These nerves are suspended in spinal fluid.
The nerve roots pass out of the spinal canal through the intervertebral foramen, where they feed the body either anteriorly (motor) or
posteriorly (sensory). The anterior divisions supply the front of the spine including the limbs. The posterior divisions are distributed to the
muscles behind the spine.

Spinal Nerves  
Anterior Roots
Motor
Ventral Roots
Posterior Roots
Sensory
Dorsal Roots
Other Spinal Cord and Nerve Structures

Cerebrospinal Fluid (CSF) 

Cerebrospinal fluid is a clear fluid found in the brain chambers (Ventricles), spinal canal, and spinal cord. This fluid is secreted from the
Choroids Plexus, a vascular part in the ventricles of the brain. CSF bathes and circulates among these tissues and acts as a shock absorber
to protect against injury. The fluid contains different electrolytes, proteins, and glucose. In an average adult the total volume of CSF is about
150 milliliters.

Meninges
Meninges are membranes that cover and protect the brain and spinal cord. There are three primary types: (1) Dura Mater, (2) Arachnoid
Mater, and (3) Pia Mater. 

(1) The dura mater, or dura, is the gray outer layer of the spinal cord and nerve roots. It is made of strong connective tissue. 
(2) The arachnoid mater resembles a loosely woven fabric of arteries and veins. This layer is thinner than the dura mater. The Subarachnoid
space is filled with cerebrospinal fluid.
(3) The pia mater is the innermost layer and is a delicate and highly vascular membrane providing blood to the neural structures. 

Dermatomes
A Dermatome is an area of skin supplied by fibers from a single spinal nerve root.

The intervertebral discs make up one fourth of the spinal column's length. There are no discs between the Atlas (C1), Axis (C2), and Coccyx.
Discs are not vascular and therefore depend on the end plates to diffuse needed nutrients. The cartilaginous layers of the end plates anchor
the discs in place.
The intervertebral discs are fibrocartilaginous cushions serving as the spine's shock absorbing system, which protect the vertebrae, brain,
and other structures (i.e. nerves). The discs allow some vertebral motion: extension and flexion. Individual disc movement is very limited –
however considerable motion is possible when several discs combine forces. 

Annulus Fibrosus and Nucleus Pulposus 

Intervertebral discs are composed of an annulus fibrosus and a nucleus pulposus.

The annulus fibrosus is a strong radial tire–like structure made up of lamellae; concentric sheets of collagen fibers connected to the vertebral
end plates. The sheets are orientated at various angles. The annulus fibrosus encloses the nucleus pulposus. 

Although both the annulus fibrosus and nucleus pulposus are composed of water, collagen, and proteoglycans (PGs), the amount of fluid
(water and PGs) is greatest in the nucleus pulposus. PG molecules are important because they attract and retain water. The nucleus
pulposus contains a hydrated gel–like matter that resists compression. The amount of water in the nucleus varies throughout the day
depending on activity.