Session 3 - Muscles of the back Flashcards
What is the muscle found in the picture?
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The trapezius
What nerve provides motor innervation of the trapezius?
The accessory nerve
What are the roots of the accessory nerve?
C1 - C6
What are the roots of the accessory nerve specific to sensory function?
C3 and C4
What are the actions of the trapezius?
The upper fibres of the trapezius elevate the scapula and rotate it during abduction of the arm. The middle fibres retract the scapula and the lower fibres pull the scapula inferiorly
How would you test the accessory nerve?
test how well the trapezius is functioning. You can do this by getting the patient to elevate the shoulder against resistance.
What is the muscle shown in the picture?
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Latissimus dorsi
What innervates latissimus dorsi?
Thoracodorsal nerve
What actions is the latissimus dorsi responsible for?
Extension of the arm at the shoulder, adduction at the shoulder and medial rotation of the arm
What is the muscle in the picture?
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Levator Scapulae
What does Levator Scapulae attach?
Medial border of the scapulae
Where does latissimus Dorsi attach?
attaches to the intertubecular sulcus of the humerus
Where does trapezius attach?
All fibres attach to the posterior surface of the scapula and the clavicle.
What innervates levator scapulae?
Dorsal Scapula nevere
What are the actions of the levator scapulae?
Elevates scapula. Rotates scapula to tilt glenohumeral joint inferiorly
What are the muscles shown in the picture?
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The Rhomboids major and minor
Where do the rhomboids attach?
The medial border of the scapula
What are the rhomboids innervated by?
Dorsal scapula nerve
What are the actions of the rhomboids?
Retracts scapula. Rotates scapula to tilt glenohumeral joint inferiorly. Can also fix the scapula to the thoracic wall.
What is the muscle shown in the picture?
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Deltoid
What three sections are the deltoids divided into?
Anterior, middle and posterior
What does the deltoid attach to?
The deltoid tuberosity on the l;ateral surface of the humerus
What are the deltoids innervated by?
The axillary nerve
PWhat is the function of the anterior fibres of the deltoids?
The anterior fibres flex the arm at the shoulder, the posterior fibres extend the arm at the shoulder
What is the function of the middle fibers of the deltoid?
The middle fibres are the major abductor of the arm – it takes over from the supraspinatus, which abducts the first 15 degrees.
What is the muscle shown in the picture?
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Teres major
What does teres major form?
The inferior border of the quadrangular space
What does teres major attach?
Intertubecular groove of humerus
What is the innervation of teres major?
Lower subscapular nerve
What are the actions of teres major?
Adducts at the shoulder and medially rotates the arm
What are the rotator cuff muscles?
A group of 4 muscles that originate from the scapula and attach to the humeral head, pulling it into the glenoid fossa.
What do rotator cuff muscles provide?
Stability to the glenohumeral joint
What is A?
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Supraspinatus
What is the origin and attachment of the supraspinatus?
Originates from the supraspinous fossa on the posterior surface of the scapula, attaches to the greater tuberosity of the humerus
What is the innervation of the supraspinatus?
Suprascapular nerve
What are the actions of the supraspinatus?
Responsible for first 15 degrees of abduction, assists deltoid for the rest.
What is B?
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Infraspinatus
What is the origin and attachments of the infraspinatus?
Originates from the infraspinous fossa, attaches to the greater tubercle of the humerus
What is the innervation of the infraspinatus?
Suprascapular nerve
What are the actions of the infraspinatus?
Lateral rotation of arm
What is C?
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Teres minor
What are the origins and attachments of teres minor?
Originates from midway down the medial border, attaches to the greater tubercle of the humeru
What is the innervation of teres minor?
Axillary nerve
What is the action of teres minor?
Lateral rotation of the arm
What is D?
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Subscapularis
What are the origins and attachments of the subscapularis?
Originates from the subscapular fossa, on the costal surface of the scapula. It attaches to the lesser tubercle of the humerus
What is the innervation of the subscapularis?
Upper and lower subscapular nerves
What is the action of the subscapularis?
Actions: Medially rotates arm
What is painful arc?
pain in the middle of abduction, where the affected area comes into contact with the acromion
What causes painful arc?
When the arm is abducted, the tendon of the supraspinatus muscle ‘rubs’ against the coraco-acromial arch. The friction is reduced by the subacromial bursa. Under repetitive use, there are degenerative changes in both the subacromial bursa and the supraspinatus tendon.
What causes rotator cuff tendonitis?
Repetitive use of the rotator cuff muscles can cause the head of the humerus and the muscles to irritate the coraco-acromial arch, which in turn causes inflammation of the rotator cuff