MSK_MT1_TBL6 (Back Muscles & Fasciae, Back Triangles, Suboccipital Triangle) Flashcards
Trapezius Muscles are made of (3)
- SUPERFICIAL* Extrinsic Muscle
1. Superior (descending) muscle
2. Middle (transverse) muscle
3. Inferior (ascending) muscle

Trapezius Superior Muscle Insertion
lateral 1/3 of the clavicle

Trapezius Middle Muscle Insertion (2)
- Acromion of Scapula
- Spine of Scapula

Trapezius Middle Muscle Origin
T1-T4

Trapezius Inferior Muscle Origin
T5 - T12

Trapezius Inferior Muscle Insertion
Medial Ends of spine of scapula

Trapezius Muscle Inervation
Cranial Nerve XI (11)
Spinal Nerves C3 & C4 (anterior rami, sensory fibers)

Traperzius Muscle Actions
- elevates scapula (shrugging motion)
- retracts and rotates scapula
- rotates the glenoid cavity

Traperzius Muscle Bilateral Action
- done by the superior descending muscle
- allows for the extension of the neck

Traperzius Muscle Unilateral Contraction
- flexion of the head to one side

Excercises for Trapezius
- upper portion developed through elevating shoulders
- middle portion developed bringing shoulder blades together (horizontal bar)
- lower portion developed by bringing shoulder blades down while keeping arms straight (parallel bars)
Latissimus dorsi Origin
Superficial Extrinsic Muscle

- posterior illiac crest
- sacral
- lumbar
- T7 - T12 (lower 6 thoracic)
Latissimus dorsi Insertion
Intertubericle (bicipital) groove of the humerous

Latissimus dorsi Functions
- extends
- adducts
- medially or internally rotates humerous

Latissimus dorsi Inervations
- Thoracodorsal nerve (C6-8 origin)

Excercises for Latissimus dorsi
- vericle pulling movements (pull ups and pull downs)
- horizontal pulling movements (rowing)
Levator scapulae muscle origin
Superficial Extrinsic Muscle
transverse process of C1-C4

Levator scapulae muscle insertion
upper portion of the medial border of the scapula

Levator scapulae muscle Innvervation
C3 & C4
dorsal scapular nerve (C5)

Levator scapulae muscle Functions
- Evevates scapula
- rotates the glenoic cavity inferiorly
Rhomboid Muscle Innervation
both the minor and major rhomboid muscles are innervated by the:
dorsal scapular nerve(C5)

Romboideus minor muscle Origin
originates at C7 + T1

Romboideus minor muscle Insertion
attaches at the medial border of the scapula (near the spine of the scapula)

Romboideus major muscle Origin
T2 - T5

Romboideus major muscle Insertion
Medial border of the scapula (the bottom half past the spine of the scapula)

Romboideus muscles Function
adducts scapula
inferior rotation of scapula
Excercises for Romboideus muscles
- pull ups and pull downs
- rowing
(same as Levator scapulae)
Serratus posterior superior Origin
Intermediate (Extrincic muscle)
- Nuchal Ligament
- C7 & T1-3

Serratus posterior superior Insertion
Intermediate Extrinsic muscle
Ribs 2-5

Serratus posterior superior Innervation
Intermidiate Extrinsic Muscle
Intercostal Nerves 2-5

Serratus posterior superior Functions
elevates the ribs = helps the lung to *inspire

Serratus posterior inferior Origins
Intermediate Extrinsic Muscle
T11-12 * L1-2

Serratus posterior inferior Insertions
Intermediate Extrinsic Muscle
- inferior borders
- ribs 8 - 12

Serratus posterior inferior Innervations
Intermediate Extrinsic Muscle
- intercostal nerves 9-12
- subcostal nerve
- anterior rami

Serratus posterior inferior Functions
Intermediate Extrinsic Muscle
depresses the ribs = *expiration of lungs = exhale

Triangle of Aculation
Where Dr. check your breating with Stethescope
borders of the empty triangle are:
- trapezious muscle
- medial border of scapula
- latissimus dorsi

Deep/Intrinsic Muscles (Overview)

Erector spinae muscle Overview
Intermediate Layer of Deep/Intrinsic Muscles
- Iliocostalis (cervicis, thoracis, lumborum)
- Longissimus (capitis, cervicis, thoracis)
- Spinalis (capitis, cervicis, thoracis)
INNERVATION
Dorsal rami of spinal nerves

Placements of the Erector spinae muscles

Illiocostalis Origins/Insertions
- attaches to angles of RIBS + CERVICAL transverse processes
Longissimus Origins/Insertions
attaches to:
- ribs
- thoracic
- cervical transverse process
- mastoid process
Spinalis thoracis
originates T10-L3
inserts T2-T8

Spinalis capitus
origin: spineous process at C7-T1
insertion: occipital bone @ midline
Spinalis cervitus
origin: spineous process at C6-T2
insertion: C2-4

Actions of the Erector Spinae
- bilateral contraction = extension
- unilateral contraction = lateral flexion to the same side of contracting msucle
Excercises:
Deadlift
Inferior Lumbar
Lumbar triangle (of Petit)
laterally completed by the external abdominal oblique muscle
inferiorly completed by the iliac crest
floor of this space = The internal abdominal oblique muscle
Petit’s hernia: less common

Superior Lumbar
Lumbar triangle (of Grynfeltt)
- medially completed by sacrospinalis
- laterally completed by internal abdominal oblique muscle
- superiorly completed by the 12th rib
- floor of this space = tranversalis fascia
- roof of this space = tranversus abdominus muscle
Grynfeltt hernia: MORE COMMON

suboccipital region
deepest region of the back of the neck
underneath the trapezius, splenius capitis, and semispinalis capitis muscles.
suboccipital triangle. borders
HELPFUL TO ORIENT SURGEONS
- Floor : posterior atlanto-occipital membrane and posterior arch of C1 vertebra
- Roof: semispinalis capitis muscle
Superomedial border: rectus capitis posterior major muscle
Superolateral border: obliquus capitis superior muscle
Inferolateral border: obliquus capitis inferior muscle
Contains:
- vertebral artery & greater occipital nerve (dorsal ramus of C2)

Superficial Back Muscles are..
associated with movements of the shoulder.
Intermediate Back Muscles are…
associated with movements of the thoracic cage.
Deep/Intrinsic Back Muscles are…
associated with movements of the vertebral column & control of posture
Splenius Capitis Insertion
Deep Superficial Back Muscle
insertion: lateral part of the superior nuchal line (found between occipital bone and the mastoid process of the temporal bone)

Splenius Capitis Origin
Deep/Intrinsic Superficial Back Muscle
Origin: spinous processes of the C7 to T3 & nuchal ligament.

Splenius Capitis Innervation
Deep/Intrinsic Superficial Back Muscle
the posterior rami of C1 - C6

Splenius Capitis Function
Deep Superficial back muscles
bilateral contraction = EXTENTION of back of head
unilateral contraction = FLEX & ROTATES head to the SAME side

Splenius Cervicis Origin
Deep Superficial Back Muscle
originates form the spinous processes of T3 - T6

Splenius Cervicis Innsertion
Deep Superficial Back Muscles
inserts on the transverse processes of C1 - C3

Splenius Cervicis Innervation
Deep Superior Back Muscles
(same as splenius Capitis) = the posterior rami of C1 - C6

Splenius Cervicis Funcation
Deep Superior Back Muscles
(same as Funcation of splenius cervicis) =
biltaeral contraction = extension of the head
unilateral contraction = Flex & Rotate to one side

Illiocostalis Cervicis Attachments
Lateral Er. Spinae Deep Intermediate
Origin: Ribs 3-6
Insertion: Cervical Vertabrae C4- C6

Illiocostalis thoracis Attachments
Er. Spinae Deep Intermediate
Origin: Ribs 7- 12
Insertion: Ribs 1 - 6

Illiocostalis Lumborum Attachments
Er. Spinae, Deep Intermediate
Origin: lateral sacral, medial illiac crest, thoracofascia
Insertion: L1 -L4 & R 6 - R 12, thoracofasia

Illiocostalis Innervation
Lateral Erector Spinae Deep Intermediate
posterior rami of C8 - L1

Illiocostalis Functions
bilateral = extension of the spine
unilateral = bending of the spine ipsilaterally (same side)
Longisimus Capitis Attachments
Medial Er. Spinae Deep Intermediate
Origin: C4 - T5
Insertion: Mastoid

Longisimus Cervicis Attachments
Medial Er. SPinae, Deep Intermediate
Origin: T1-T5
Insertion: C2 - C6

Longisimus Thoracis Attachments
Medial Er. Spinae, Deep Intermediate
- origin: sacrum and iliac crest via:
- iliocostalis lumborum tendon & lumbosacral aponeurosis
- L1-5
- Insertion: T1 – T12; lower Ribs R5-R12

Longisimus Muscle Innervation
posterior rami of C1-L5

Longissimus Capatus Function
bilateral = EXTENDS head + neck
unilateral = Flexes/Rotates head + neck
for rest of Longissimus = same rules but for SPINE
Spinalis Capatus Attachments
Most internal Er. Spinae, Deep Intermediate
Origin: C7 & T1
Insertion: Occipital Bone @ Midline

Spinalis cervicis Attachments
Most internal Er. Spinae, Deep Intermediate
Origin: C7 & T1 & Nuchal Ligament
Insertion C2-C4

Spinalis Muscle Innervation
Posterior rami along whole of muscle
Spinalis Muscle Function
bilateral contraction = EXTENSION of CERVICAL* & *THORACIC spine
unilater contraction = SIDE BEND of CERVICAL* & *THORACIC spinec ipsolaterally
Semispinalis Function
Deep Layer of Deep/Intrinsic Muscle
bilateral contraction = EXTENSION of the head + cervical & thoracic spine
unilateral contraction = LATERAL FLEXION of the head, cervical and thoracic spine on the ipsilateral
ROTATION CONTRALATERALLY

Semispinalis Innervation
capitalis = via the Greater Occipital nerve + C3
cervisis & thoracis = via posterior rami (medial branches)

Multifidus Function
Deep Deep Back
triangle bunches of muscle
bilateral contration = extenion of the spine
unilateral = lateral flexion of the spine ipsolaterally
contralateral roatation

Rotatores Function
Deep Deep back
zig zag muscles, thoracically developed
bilateral = Extension of the thoracic
unilateral = rotation of the thoracic contralaterally
