BACK AND SPINE

VERTEBRAL/NEURAL ARCH
VERTEBRAL COLUMN
▪ Continues to transmit forces to
✓ Central bony pillar of the body POSTERIOR STRUCTURES

✓ CONTENTS: spinal cord, the roots of ▪ PEDICLE

spinal nerves o Connects body to POSTERIOR

✓ Composed of 33 vertebrae divided into o Transmits BENDING FORCES

5 regions
▪ LAMINA
✓ CURVES: primary and secondary o ROOF/ CENTRRAL PORTION OF
NOTE: IT SUPPORTS THE SKULL, PECTORAL ARCH
GIRDLE, UPPER LIMBS, THORACIC CAGE
o Transmits FROM PEDICLE TO
ADULT = 26 VERTEBRAE IT FUSED TOGETHER PROCESSES
7 CERVICAL 12 THORACIC 5 LUMBAR 5 SACRAL
WHICH EVENTUALLY FUSED 4 COCCYGEAL PROCESSES
PRIMARY = curves present at birth KYPHOSIS ▪ Attachments for muscles and ligaments
ANTERIOR CONCAVITY, THORACIC AND ▪ 1 SPINOUS PROCESS
SACRAL, COCCYGEAL o POSTERIOR
o FROM LAMINAE
SECONDARY = LORDOSIS, POSTERIOR
CONCAVITY, ANTERIOR CONVEX, CERVICAL
▪ 2 TRANSVERSE PROCESS
AND LUMBAR
o LATERAL
RAISE HEAD PRONE SIT/STAND = CERVICAL o LAMINAE
LUMBAR
▪ 4 ARTICULAR PROCESS (2 SUP 2 INF)
Skeletally mature = can maintain his head
upright in cervical
o PARS INTERARTICULARIS
can stand and walk = lumbar
▪ Region between
superior and inferior
articular facet/process
VERTEBRAE ▪ MOST COMMON SITE
VERTEBRAL BODY OF FRACTURE IN
VERTEBRAL COLUMN
▪ ACCEPT BODY WEIGHT
▪ RESIST COMPRESSISON o ARTICULAR PILLAR
▪ Column formed by
superior and inferior
MOBILE SEGMENT: 2 ADJACENT VERTEBRAE, articular process
INTERPOSING INTERVERTEBRAL DISC

INTERVERTEBRAL DISC
▪ C2 TO SACRUM (L5-S1)
▪ 23 INTERVERTEBRAL DISCS
▪ 25% = 2CM IN HEIGHT (DAY AND
NIGHT)
NOTE:
RATIO OF DISC: VERTEBRAL BODY THICK
C>L>T
INTERVERTEBRAL FORAMEN= EXITS SPINAL
ROOTS, FORMED BY INF AND SUPERIOR
ARTICULAR RPRROCESSES

FUNCTIONS TRANSVERRSE FORMANEN = FORAMEN

TRANSVERSARIUM
▪ SEPARATE TWO VERTEBRAL BODIES

▪ INCREASING AVAILABLE MOTION

CERVICAL VERTEBRAE
BETWEEN 2 VERTEBRAE
ATLAS (C1)
▪ TRANSMIT LOAD
▪ Ring-like bone that cradles the occiput
and transmit forces to the lower
DISC THICKNESS cervical vertebrae
▪ CERVICAL: 3mm
▪ THORACIC: 6mm ▪ (-) vertebral body or spinous processes
▪ LUMBAR: 9mm
▪ (+) lateral mass = connected by
anterior and posterior arch; articular
PARTS facets
▪ ANNULUS FIBROSUS
o TYPE I COLLAGEN FIBERS
ATLANTO-OCCIPITAL JOINT
o OUTER = RESIST TENSION ▪ SYNOVIAL CONDYLOID
o VASCULAR = INNERVATED ▪ 2 DOF
OUTER 1/3 OR 1/2 ▪ F/E, LATERAL FLEXION

▪ NUCLEUS PULPOSUS ▪ Superior articular facets of atlas

o TYPE II COLLAGEN FIBERS
o INNER = RESIST COMPRESSION
o GEL-LIKE
o AVASCULAR
(CONCAVE) + occipital condyles of the
occipital bone (CONVEX)
▪ YES JOINT

▪ VERTEBRAL END PLATE

o HYLAINE CARTILAGE (PLATES)
o ONLY WEAKLY ATTACHED TO
BONE
o MERGED WITH ANNULUS
FIBROSUS
 AXIS (C2) C7 (VERTEBRA PROMINENS)

▪ VERTEBRAL BODY: peglike process ▪ SPINOUS PROCESS

(DENS OR ODONTOID PROCESS) o NON-BIFID

▪ Bifid spinous process ▪ TRANSITIONAL = C, T

ATLANTO-AXIAL JOINT
THORACIC VERTEBRAE
▪ FLEXION/EXTENSIOM, ROTATION
VERTEBRAL BODY
▪ 2DOF

▪ INFERIOR ARTICULAR PROCESSES OF ▪ DEMIFACETS = superior, inferior (T2-T8)

THE ATLAS (C1) + SUPERIOR
ARTICULAR PROCESSES OF THE AXIS o Inferior demifacet and 1 full
(C2) (2 LATERAL ARTICULATION) = costal facet (T1)
SYNOVIAL PLANE
o (+) superior demifacet, (-)
▪ DENS OF THE AXIS + ANTERIOR ARCH inferior demifacet (T9)
OF THE ATLAS + TRANSVERSE
LIGAMENT OF ATLAS (MEDIAN) = o Full costal facets (T10-12)
SYNOVIAL PIVOT

TRANSVERSE PROCESS
TYPICAL CERVICAL VERTREBRAE (C3-C6)
▪ Costal/costotubercular facet (T1-T10)
▪ BIFID SPINOUS PROCESS ▪ (-) costal facet (T11-T12)

▪ TRANSVERSE FORAMEN NOTE: COSTAL FACETS = ATTACHMENT ON

o VERTEBRAL ARTERY (C1-C6)
o VERTEBRAL VEIN (C1-C6)
NOTE: C7 = VEIN CVEIN
▪ (+) uncinate process
o Posterolateral prominences on
body
RIBS
TRANSITIONAL VERTEBERAE = T12
LUMBAR: SPINOUS PROCESSES T11 AND T12 =
SHORTER AND BROADER

▪ UNCOVERTEBRAL JOINT
o “JOINT OF LUSHKA”

o Limits LATERAL FLEXION

o PROTECTS IVD
POSTEROLATERALLY
SUPERIOR Face Thin and Face
ZYGOPOPHYSEAL superiorly flat; face superiorly,
JOINTS
FACETS and posteriorly, medially (+)
posteriorly laterally, mamillary
MOBILE SEGMENTS = 6 JOINTS
superiorly processes
INTERBODY JOINTS

▪ 6 DOF
INFERIOR Face Face Face ▪ SLIDING = ANTEEROPOSTERIORLY, ML,
ZYGAPOPHYSEAL inferiorly inferiorly, laterally and
FACETS and anteriorly, inferiorly TORSIONAL
anteriorly medially ▪ DISTRACTION = COMPRESSION,
ROTATION (TILTING, ROCKING)

▪ Cartilaginous symphysis joint

NOTE: SHAPE OF VERTEBRAL BODY
CERVICAL = CIRCULAR
THORACIC = HEART SHAPED ▪ Between VERTEBRAL BODIES and
INTERPOSED DISCS
LUMBAR = KIDNEY SHAPED/ BEAN SHAPED

LARGEST VERTEBRAL FORAMEN = CERVICAL

ZYGAPOPHYSEAL/APOPHYSEAL/Z JOINTS/
SMALLEST = THORACIC
FACET JOINTS ARTICULATIONS
PLANES
▪ SYNOVIAL PLANE (RIGHT AND LEFT)
CERVICAL
▪ SUPERIOR ARRTICULAR PROCESSES OF
▪ OBLIQUE
CAUDAL VERTEBRAE (BELOW) +
▪ 450
INFERIOR ARTICULAR RPROCESSES
CRANIAL VERTEBRAE (ABOVE)
THORACIC

▪ FRONTAL UNCONVERTEBRAL JOINTS

▪ 600
▪ “JOINTS OF LUSHKA”
▪ UNCINATE PROCESS (cervical region)
LUMBAR

▪ SAGITTAL
▪ 900
 VERTEBRAL MOTIONS
UPPER CEERVICAL SPINE (ATLANTO-OCCIPITAL
JOINT)
UPPER CERVICAL SPINE (ATLANTO-AXIAL
JOINT MOTION OF INTERVERTEBRAL JOINT)
MOTION SUPERIOR FORAMINA SIZE
JOINT MOTION OF INTERVERTEBRAL
VERTEBRAE
MOTION SUPERIOR FORAMINA SIZE
VERTEBRAE
FLEXION OCCIPITAL
(C0-C1) CONDYLE (AO)
FLEXION C1 → ANT SLIDE MINIMAL
ON C2
ROLL:
ANT MINIMAL
EXTENSION C1 → POST MINIMAL
SLIDE: POST SLIDE ON C2

ATLAS (AA) ROTATION ATLAS (ON AXIS)

SLIDE: (C1-C2)
FORWARD/ ANT SYNOVIAL IPSILATERAL
ON AXIS (C2) PLANE FACET:
POST
EXTENSION OCCIPITAL
(C0-C1) CONDYLE CONTRALATERAL
(AO) FACET:
ANT
ROLL:
POST MINIMAL

SLIDE:
ANT

ATLAS
SLIDE:
BACKWARD/POST
ON AXIS
SIDE OCCIPUT (AO)
BENDING
IPSILATERAL:
MEDIAL,
INFERIOR, MINIMAL
ANTERIOR

CONTRALATERAL:
LATERAL,
SUPERIOR,
POSTERIOR
 CERVICAL ZYGAPOPHYSEAL FACET JOINTS c/L INFERIOR
FACETS:
▪ SYNOVIAL PLANE SUP, ANT
▪ 450, OBLIQUE (FORWARD)
▪ SUP ARTICULAR FACET = S, P
▪ INF ARRTICULAR FACET = I, A

JOINT MOTION OF INTERVERTEBRAL CERVICAL AND THORACIC SPINE

MOTION SUPERIOR FORAMINA SIZE
VERTEBRAE BONES OF THE THORAX
(DICTATED BY PLANE
ORIENTATION) STERNUM
(C3 TO C7)
DIVIDED INTO THREE PARTS
FLEXION ANT TILTING
AND GLIDING MANUBRIUM STERNI (T3-T4)
(right and left
facets of BILATERAL OPENING ▪ ARTICULATES WITH: RIGHT AND LEFT
vertebrae (more space for STERRNOCLAVICULAR + BODY OF
ABOVE) nerve roots to exit)
MANUBRIUM + STERRNOCHONDRAL 1
INF FACETS &2
SLIDE:
SUP, ANT ▪ BODY STARTS AT: T5-T9

EXTENSION POST TILTING

AND GLIDING BODY OF STERNUM
BILATERAL CLOSING
▪ T5-T9
INF FACETS ▪ ARTICULATES WITH:
SLIDE:
INF, POST
XIPHOID PROCESS
ROTATION i/L INFERIOR
FACETS: ▪ T10
INF, POST i/L SEPERATION ▪ ARTICULATES WITH: BODY OF
(BACKWARD) STERNUM
c/L APPROXIMATION
c/L INFERIOR
FACETS: STERNAL ANGLE
SUP, ANT
(FORWARD) ▪ B/W T4-T5
▪ “ANGLE OF LOUIS”
SIDE BENDING i/L INFERIOR
FACETS: i/L APPROXIMATION
INF, POST
(BACKWARD) c/L SEPERATION NOTE: 1ST TO 7TH RIB HAVE COSTAL CARTILAGE
(opening) 8TH RIB = SHARE

FLOATING = NO ANTERIOR ATTACHMENT

RIBS (12 PAIRS) ANGLE

TRUE RIBS ▪ Shaft of the rib BENDS SHARPLY

FORWARD
▪ VERTEBROSTERNAL
▪ RIB 1-7
▪ STERNUM -- > COSTAL CARTILAGES
JOINTS OF THE THORAX
MANUBRIOSTERNAL JOINT
FALSE RIBS
▪ CARTILAGINOUS SYMPHYSIS
▪ VERTEBROCHONDRAL
▪ MANUBRIUM + BODY OF STERNUM
▪ RIBS 8-10
▪ STERNAL → SHARRE CARTILAGE OF RIB
7 XIPHISTERNAL JOINT

▪ FIBROCARTILAGINOUS JOINT
FLOATING RIB ▪ XIPHOID PROCESS + BODY OF
STERNUM
▪ VERTEBRAL
▪ RIB 11 AND 12 NOTE: MANUBRIOSTERNAL AND
XIPHISTERNAL JOINT ARE OFTEN FUSED
TOGETHER
TYPICAL RIB
HEAD
COSTOVERTEBRAL JOINT
▪ 2 FACETS: SUPERIOR DEMIFACET OF
▪ HEAD OF RIB + DEMIFACETS OF 2
VERTEBRAE BELOW, INFERIOR
ADJACENT THORACIC VERTEBRAE
DEMIFACET OF VERTEBRAE ABOVE
▪ SYNOVIAL PLANE

▪ FORM CONTRAVERTEBRAL JOINT RADIATE LIGAMENT

▪ SUPERIOR BAND = JOINT TO SUP

NECK VERTEBRAE

▪ Between the HEAD AND TUBERCLE

▪ INTERMEDIATE BAND = JOINT TO
IVD
TUBERCLE
▪ INFERIOR BAND = JOINT TO
▪ At the JUNCTION OF THE NECK WITH INFEERIOR VERTEBRAE
THE SHAFT

▪ FORM COSTOTRANSVERSE JOINT

SHAFT

▪ (+) COSTAL GROOVE

 MOTION OF THORAX
COSTOTRANSVERSE JOINT
INCREASE IN VERTICAL DIAMETER
▪ SYNOVIAL PLANE
▪ T1 TO T10 ▪ PISTON ACTION: diaphragm DESCENDS
by pulling central tendon DOWNWARD
▪ TUBERCLE OF RIB + COSTAL FACET ON DURING CONTRACTION
THE TRRANSVERSE PROCESS

LIGAMENTS INCREASE IN AP DIAMETER

LATERAL COSTOTRANSVERSE LIGAMENT ▪ PUMP HANDLE MOTION: STERNUM

and UPPER 6 RIBS project FORWARD
▪ COSTAL TUBERCLE + TIP OF and UPWARD
TRANSVERSE PROCESS ▪ EXTENSION OF THORACIC SPINE

COSTOTRANSVERSE LIGAMENT INCREASE IN TRANSVERSE DIAMETER

▪ NECK OF RIB + TRANSVERSE PROCESSS
SUPERIOR COSTOTRANSVERSE LIGAMENT
▪ NECK OF RIB + TRANSVERSE PROCESS
OF VERTEBRAE ABOVE
▪ BUCKET HANDLE MOTION: 7TH TO 10TH
ribs move UP and OUT
▪ CALIPER MOTION: 11TH TO 12TH ribs
FLARRE OUTWARD

COSTOCHONDRAL JOINT
LUMBAR VERTEBRAE

▪ SYNCHONDROSES ▪ (+) MAMILLARY PROCESSES = small

▪ CARTILAGE + RIB bumps on the posterior edge of each
superior ZYGAPOPHYSEAL PROCESS

CHONDROSTERNAL JOINT ▪ (+) ACCESSORY PROCESSES =

prominences on the posterior surface
▪ CARTILAGE + STERNUM
of each TRANSVERSE PROCESS
▪ 1ST COSTAL CARTILAGE + MANUBRIUM

PART CERVICAL THORACIC LUMBAR

▪ 2ND COSTAL CARTILAGE + DEMIFACETS VERTEBRAE VERTEBRAE VERTEBRAE
AT THE MANUBRIOSTERNAL JUNCTION SUPERIOR Face Thin and Face
ZYGOPOPHYSEAL superiorly flat; face superiorly,
FACETS and posteriorly, medially
▪ 3RD – 7TH COSTAL CARTILAGE + BODYY posteriorly laterally, (+)
OF STERNUM superiorly mamillary
processes

NOTE: RIB 11 AND 12 DOES NOT HAVE INFERIOR Face Face Face
ZYGAPOPHYSEAL inferiorly inferiorly, laterally
COSTOCHONDRAL JOINT
FACETS and anteriorly, and
anteriorly medially inferiorly
TRANSVERSE (+) Large, Long, SIDE i/L INFERIOR
PROCESSES transverse thickened slender,
BENDING FACETS (L T3): LEFT i/L CLOSING
foramen ends; (+) horizontal;
to LEFT INF, POST (approximation)
costal facet; (+) accessory
caudal processes
decrease in RIGHT c/L
length OPENING
c/L INFERIOR (seperation)
SPINOUS Short, T1-T10 slope Broad, thick, FACETS (R T3):
PROCESSES slender, inferiorly; and SUP, ANT
horizontal, T11 and T12 horizontal
bifid tips are
triangular
and
horizontal;tip JOINT SUPERIOR RIBS
lies at the
MOTION VERTEBRRAE
level of the
caudal
FLEXION ANTERIOR UPPER 6
vertebral TILTING AND (ROTATE):
body GLIDING ANTERIORLY
ROTATE
VERTEBRAL Large and Small and Triangular,
FORAMEN triangular circular small
LOWER 6
(GLIDE):
SUPERIORLY
VERTEBRAL MOTIONS GLIDE

CERVICAL AND THORACIC ZYGAPOPHYSEAL EXTENSION POSTERIOR UPPER 6:

JOINTS (1 MOBILE SEGMENT) TILTING AND ROTATE
GLIDING POSTERIORLY
JOINT MOTION OF INTERVERTEBRAL
MOTION SUPERIOR FORAMINA SIZE LOWER 6:
VERTEBRAE GLIDE
INFERIORLY
FLEXION ANT TILTING AND
GLIDING BILATERAL
OPENING
INF FACETS SLIDE: (separation) NOTE: FRYETE’S LAW “COUPLING” MULTIPLE
SUP, ANT SEGMENTS
EXTENSION POST TILTING AND THORACIC SPINE
GLIDING
BILATERAL UPPER THORACIC
CLOSING
INF FACETS SLIDE: (approximation) ▪ LATERAL FLEXION TO (R) ROTATION TO
INF, POST (R) = i/L
ROTATION i/L INFERIOR
to RIGHT FACETS (R T3): LOWER THORACIC
INF, POST RIGHT i/L OPEN
▪ LATERAL FLEXION TO (R) ROTATION TO
c/L INFERIOR LEFT c/L CLOSE
(L) = c/L
FACETS (L T3):
SUP, ANT
THORACIC AND LUMBAR SPINE
LUMBAR
▪ IF LATERAL FLEXION FIRST = ROTATION
IS i/L
▪ IF ROTATION FIRST = LATERAL FLEXION
IS c/L
LIGAMENTS
TRANSVERSE ATLANTAL LIGAMENT
▪ Secure attachment on AXIS
▪ RESISTS ANTERIOR DISPLACEMENT OF
C1 ON C2
ATLANTAL CRUCIFORM LIGAMENT
▪ SUPERIOR AND INFERIOR
LONGITUDINAL FIBERS + TRANSVERSE
PORTION
▪ RESISTS ANTERIOR DISPLACEMENT OF
C1 ON C2
ALAR LIGAMENT
▪ Axis on EITHER SIDE OF THE DENS +
OCCIPITAL CONDYLES
APICAL LIGAMENT
▪ APEX OF THE DENS + THE ANTERIOR
MARGIN OF THE FORAMEN MAGNUM
ANTERIOR LONGITUDINAL LIGAMENT
▪ TRIANGULAR (BECOMES THINNER ON
SACRUM)
▪ C2 to sacrum
▪ ANTERIOR AND LATERAL SURFACES OF
THE VERTEBRAL BODIES
▪ CERVICAL = C2 TO OCCIPUT
▪ CERVICAL = C2 TO OCCIPUT
o C1 TO OCCIPUT = “ANTERIOR
ATLANTOOCCIPITAL
LIGAMENT”
o C1 TO C2 = ATLANTOAXIAL
LIGAMENT
▪ DEEP = 1 SEGMENT, SUPERFICIAL =
LAHAT
▪ WELL DEVELOPED IN LORDOTIC
REGIONS (CERVICAL, LUMBAR)
▪ TENSILE STRENGTH: LUMBAR >
CERVICAL > THORACIC
▪ THIS LIGAMENT IS 2X STRONGER THAN
PLL
▪ LIMITS EXTENSION:
o STRETCHED IN EXTENSION
o COMPRESSED IN FLEXION
POSTERIOR LONGITUDINAL LIGAMENT
▪ C2 TO SACRUM
▪ POSTERIOR ASPECT OF THE VERTEBRAL
BODIES
▪ CERVICAL = C2 TO OCCIPUT
“TECTORIAL MEMBRANE”
▪ LIMIT FLEXION
o TAUT IN FLEXION
o COMPRESSED IN FLEXION
▪ IMPORTANCE: maintaining IVD =
TRAPPING FLUID INSIDE
LIGAMENTUM FLAVA INTERTRANSVERSE LIGAMENT

▪ C2 TO SACRUM ▪ PASS BETWEEN THE TRANSVERSE

▪ LAMINA OF 2 ADJACENT VERTEBRAE
▪ CONTINUOUS WITH INTERSPINOUS
LIGAMENT
▪ STRONG: LOWER THORACIC
▪ WEAK: MIDCERVICAL
▪ ELASTIC → YELLOW → TAUT EVEN IN
NEUTRAL (maintain disc pressure)
ILIOLUMBAR LIGAMENTS
▪ LIMIT FLEXION
INTERSPINOUS LIGAMENT
PRIMARY BANDS
▪ C2/C3 TO SACRUM
▪ C1 (-) spinous process
▪ Attach between adjacent spinous
process
▪ Continuous with SUPRASPINOUS + 1st
to be DAMAGED IN EXCESSIVE FLEXION
▪ LIMIT FLEXION
SUPRASPINOUS LIGAMENT
▪ TIPS OF SPINOUS PROCESS FROM THE
C7 TO L3/L4
PROCESSES AND ATTACH TO THE DEEP
MUSCLES OF THE BACK
▪ LUMBAR > THORACIC > CERVICAL
o Alternately STRRECTHED and
COMPRESSED in LATERALL
FLEXION
▪ Tips and borders of the transverse
processes of L5 to attach bilaterally
on the iliac crest
▪ VENTRAL (anterior) = attached from
anterior aspect of transverse
process of L5 and anterior aspect
ILIUM
▪ DORSAL (posterior)
▪ SACRAL BAND (lumbosacral
ligament) = attached on anterior
aspect of L5 to the ALA of sacrum,
prevents dislocation of L5, lumbar
vertebra,

NOTE: LIMIT ANTERIOR DISPLACEMENT OF L5

▪ CERVICAL = C7 TO OCCIPUT
ON SACRUM
“LIGAMENTUM NUCHAE” = maintain
important MECHANORECEPTORS

▪ LIMIT FLEXION
MUSCLES OF THE BACK AND SPINE DEEEP ERECTOR SPINAE

ANTERIOR GROUP ▪ ECCENTRIC during FORWARD BENDING

from STANDING POSITION
DEEP CERVICAL FLEXORS

▪ ANTIGRAVITY posture (HEAD AND ▪ CONCENTRIC from FORWARD BENDING

NECK)
▪ Control CERVICAL LORDOSIS
▪ RECTUS CAPITIS ANTERIOR AND
LATERALIS, LONGUS CAPITIS, LONGUS
COLLI (OBLIQUE, VENTRAL)
ABDOMINALS
▪ INCREASE SPINAL STABILITY
to STANDING POSITION
▪ ELECTRICALLY SILENT during FORWARD
FLEXION @ >2/3 OF MAXIMAL
AVAILABLE MOTION
NOTE:
TRAPEZIUS, SUPERFICIAL MUSCLES, HIP
MUSCULATURE = CONTRACT FROM 900 TO 450

ERECTOR SPINAE CONTRACTING = 450 TO

▪ CONTROL the HEAD and TRUNK in STANDING
HYPEREXTENSION and LATERAL
FLEXION EREECTOR RSPINAE ELLECTRICALLY SILENT
BEYOND FORWARD FLEXION OF BEYOND 450

POSTERIOR GROUP MAGIGING ACTIVE LANG ES = WHEN 450 →

UPWARD STANDING
SUBOCCIPITALS
900 → 450 → 1800
▪ “FINE TUNING” of the HEAD and NECK
▪ PROPRIOCEPTIVE

INTERMEDIATE TRANSVERSOSPINALES

▪ SEMISPINALIS: SPAN 6 SEGMENTS

o EXTENSOR
o MAINTAIN CERVICAL LORDOSIS

▪ MULTIFIDUS: SPAN 3-5 SEGMENTS

o RESIST FORWARD FLEXION
o HOLD 3-5 SPINOUS PROCESS

▪ ROTATORS
o Small muscle