Lecture 5: Muscles of back Flashcards
Name the 2 categories of back muscles
Extrinsic
Intrinsic
Describe extrinsic muscles of back
Superficial muscles
Describe extrinsic muscles of back - general proximal attachments
On axial Skeleton
But distal attachments may be in upper limb = move into limb
Leave axial skel
Describe extrinsic muscles of back - primary function
Movement of upper limb
Describe extrinsic muscles of back - motor innervation
Ant rami of spinal nerves and CN XI
Describe intrinsic muscles of back
Deeper layers
Deep to extrinsics
Describe intrinsic muscles of back - general attachments
On vertebrae and or ribs
= attachments limited to axial Skeleton
Describe intrinsic muscles of back - primary functions
Movement and support fo vertebral column
Describe intrinsic muscles of back - motor innervation
Post rami of spinal nerves
Describe first layer of extrinsic = name layers
Most superficial= trapezius, latissimus dorsi
What do traps look like
diamond shape
Proximal attachments trapezius
Axial = from skull = external occipital protuberance (bump on skull)
nuchal ligament and
supraspinous ligament along spinous processes of c7 to t12
distal attachments trapezius
Scapula and lateral 1/3 of clavicle (wraps around)
Innervation trap
Cranial nerve xi = spinal accessory nerve
Function as trap
Primarily upper limb mover
When axial skel and skull fixed = trap moves scapula relative to rib cage
Trap function as back/neck muscle = when scapula fixed
Bilateral = next extension (head and neck bc crosses Altanto occipital joint)
Unilateral = isplateral flexion and contra lateral axial rotation of head and neck
What does lat mean
Broadest of the back
Is whole of lat completely visible
NOOO
Superior portion covered by trapezius
Proximal axial attachments of latissimus Dorsi
T7-t12 spinous processes
Thoracolumabr fascia - via aponeurosis
Ilium attachment by aponeurosis
Distal limb attachments of latissimus Dorsi
Intertubercular groove of humerus = crosses shoulder joint
Describe function of lat as back muscle
Bilateral = thoracic spine extension
Unilateral = ipsilateral lateral flexion of lumbar spine primarily
What is thoracolumbar fascia
Complex multi layered ct structure composed to fascia and aponeuroses of back muscles = epimysium, deep fascia and aponeurosis of external muscles
Where does tlf extend
Ilium/sacrum to neck
What is tlf composed of
Deep fascia surrounding intrinsic back muscles and aponeuroses of some extrinsic muscles - including lats
What happens to tlf in lumbar region
Separates intrinsic back muscles from posterior abd wall muscles = psoas and quadratus lumborum
Generally describe tlf
Continuous with abd wall muscles
Posterior layer wraps erector spinae
Origins of aponeurosis serratus posterior inferior and latissimus dorsi
What makes up extrinsic second layer
Levator scapulae
Rhomboid major and minor
Axial attachment levator scapulae
Transverse processes of c1-c4
Limb attachments levator scapulae
Superior angle of scapula
Functions of levator scapulae
Primary = movement of scapula = elevation, shrug muscle
Secondary = bilateral= extension of cervical spine, unlateral = ispilateral lateral flexion fo cervical spine
Innervation lats
Thoracodorsal nerve = c6-c8
Innervation levator scapulae
Ant rami c3-c5
What is rhomboid major and minor shaped like
Rhomboids
Are rhomboids covered
Yes by traps
Entirely
Axial attachments rhomboids
Spinous processes c6-t4
limb attachments rhomboids
Medial border of scapula
functions rhomboids
None in back
Only movement of scapula = elevate and move medically
Innervation rhomboids
Dorsal scapular nerve = c5
What makes up extrinsic deepest layer = 3rd layer
Serratus posterior superior and inferior
Proximal vertebral attachments of serratus posterior superior
Nuchal ligament
Spinous processes c7-t3 (4 slips covered by rhomboids)
Distal rib attachments of serratus posterior superior
Superior border of ribs 1-4
Slips across costotransverse joints
Function of serratus posterior superior
Elevation of upper ribs = accessory muscles of respiration
innervation of serratus posterior superior
T2-t5 ant rami
vertebral proximal attachments of serratus posterior inferior
Tlf = contributes aponeurosis to tlf
Spinous processes t11-l2 = around 5 slips sometimes
distal limb attachments of serratus posterior inferior
Inferior border ribs 8/9-12
Function of serratus posterior inferior
Depression fo lower ribs = accessory muscles of respiration = forceful expiration
Innervation of serratus posterior inferior
T9-t12 ant rami
Name intrinsic intermediate layer muscles
Erector spinae
Describe erector spinae - gen
Extensors of back
Group of 3 parallel columns on either side of spinous processes
Extend from pelvis to neck (all 3 muscles insert on neck too)
Describe erector spinae - the muscles
Named from lateral to medial = iliocostalis, longissimus, spinalis
Where is erector spinae
In thorax and lumbar region
Covered by tlf (their own deep fascia)
What is erector spinae surrounded by
Own epimysium = contributes to tlf
Attachments iliocostalis and longissimus
Sacrum/ilium and vertebral processes to ribs
Attachments spinalis
Inferior to superior spinous processes
Functions of erector spinae
Bilateral = spine extension
Unilateral = spinal ispilateral lateral flexion = especially iliocostalis (greater distance, to centre of rotation = better at this motion bc of this)
Innervation of erector spinae
Post rami of adjacent spinal nerves = smaller
Trick to remember erector spinae muscles
I LIKE STANDING = (iliocostalis, longissimus, spinalis)helps you stand and good posture
Describe erector spinae functions - explain more
Gliding movement at zygophophyseal joints = very small at each joint but sum of all actions across vertebrae= create motion
Intervertebral joint becomes more wedge shaped = haas to move
Sup slides onto inf
Describe evolutionary fun fact = erector spinae
Spinous processes are longer in species that run like horses, or whose heads/trunks generate large pitching torques = more spine extensor muscle mass with better ability to generate Counter torque = bc gravity acting on head
What makes up intrinsic deeper layers
Various muscles = multifidus, levatores costarum, rotattores longus and brevis, medial and lateral intertransversarius, interspinales
Describe general function of deepest layer intrinsics
Spine stabilization and fine movement (posture, contribute to extension, rotation)
Describe innevration of deepest layer intrinsic
Posterior rami of spinal nerves at same level
Describe mutifidus
Not lats bc lats more superficial, but same area
Good at extending spine
Describe levatores costarum
Rib elevators
Accessory muscle of resp = increase volume of cage, bucket handle movement
Describe rotatores longus and brevis
Skip vertebrae and go to one above it
Axial rotation
Describe medial and lateral intertransversarius
Between transverse processes
Describe interspinales
Between spinous processes
Describe general invention of extrinsics
Ant rami
Trap = spinal accessory
Lats = c6-c8
Rhomboids = c3-c5
Serratus posterior sup = t2-t5
Serratus posterior inf = t9-t12
Describe general invention of intrinsics
Posterior rami
Describe back innervation - sensory
Posterior ram are also mixed = areas overlapping location of erector spinae will form dermatomes
Form dermatoems = continuous with ant rami at same level in terms of skin
Pierce through extrinsics of back
Describe arterial supply to instinsic and deep extrinsic muscles - gen
Deep extrinsic = serratus posterior
Comes from dorsal branches of segmental Arteries of aorta = posterior intercostal, lumbar arteries and of internal iliac (lateral sacral)
Describe lateral sacral a
Gives off little branches that goes back throug ant sacral foramina —> towards back and provide blood o whole column of intrinsic back muscles
Describe dorsal branches
To back muscles, skin, vertebral Columns and spinal cord
Off post intercostal and lumbar
What is given blood supply by dorsal branches
Spinal cord
Dorsal root ganglion
Spinal nerve beginnings
Describe arterial supply to extrinsic back muscles and TLF
Terminal branches of same dorsal branches that supply intrinsic muscles
And individual arteries branching off subclavian/axillary system to neck and upper limb (mostly to upper limbs)
What goes through muscles
Terminal branches of POSTERIOR INTERCOSTAL AND LUMBAR arteries, veins and posterior ramus of spinal nerves
= go through to skin
Describe dorsal scapular artery
To rhomboids
Trapezius
Levator scapuale
Describe transverse cervical artery
To trapezius
Rhomboids
(between these 2)
Describe thoracodorsal artery
To latissimus/tlf
Describe branching of extrinsic supply to back muscles
Subclavian —> axillary (under clavicle)
Axillary gives = transverse cervical, dorsal scapular and thoracodorsal
Describe function fo lats
Primarily Shoulder mover when scapula fixed
Abducts = medically rotates shoulder (same orientation as teres major)
What is curious about serratus posterior
Attachments stay in axial skel but still apart of extrinsic group bc innervation is by ant rami
Why is serratus posterior named this
Comes from serrated appearance of rib attachments