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Trapezius
 Origin: medial third of superior nuchal line; EOP; ligamentum
nuchae, T1-T12 spinous process
 Insertion: spine of scapula; acromion; lateral third of clavicle
 Action: elevate and retract pectoral girdle; superioly rotate
scapula
 Innervation: Accessory Nerve
Latissimus Dorsi
 Origin: T7-L5 spinous process; thoracolumbar fascia; dorsal
sacrum; iliac crest
 Insertion: floor of intertubercular groove
 Action: extend, adduct, medially rotate humerus
 Innervation: thoracodorsal nerve
Levator Scapulae
 Origin: C1-C2 transverse process; C3-C4 posterior tubercles
 Insertion: superior angle of scapula
 Action: elevate, protract pectoral girdle; inferiorly rotate
scapula
 Innervation: C3-C4 ventral rami and dorsal scapular nerve
Rhomboid Major
 Origin: T2-T5 spinous process
 Insertion: medial border of scapula
 Action: retract, elevate pectoral girdle; inferiorly rotate
scapula
 Innervation: dorsal scapula nerve
Rhomboid Minor
 Origin: C7-T1 spinous process
 Insertion: medial border of scapula; superior to R. Major
 Action: retract, elevate pectoral girdle; inferiorly rotate
scapula
 Innervation: dorsal scapular nerve
Serratus Posterior Superior
 Origin: C7-T3 spinous process
 Insertion: superior border of ribs 2-5
 Action: weakly elevate ribs 2-5
 Innervation: ventral rami T2-5
Serratus Posterior Inferior
 Origin: T11-L3 spinous process
 Insertion: inferior border of ribs 9-12
 Action: weakly depress ribs 9-12
 Innervation: ventral rami T9-12
Teres Major
 Origin: posterior surface of inferior angle of scapula
 Insertion: medial lip of intertubercular groove
 Action: extend: adduct, medially rotate humerus
 Innervation: lower subscapular nerve
Deltoid
 Origin: spine of scapula; acromion; lateral third of clavicle
 Insertion: deltoid tuberosity
 Action:
 Ant—flex, medially rotate humerus
 Lat—abduct humerus
 Post—extend, laterally rotate humerus
 Innervation: axillary nerve
Supraspinatus
 Origin: supraspinous fossa
 Insertion: greater tubercle
 Action: abduct humerus
 Innervation: suprascapular nerve
Infraspinatus
 Origin: Infraspinous fossa
 Insertion: greater tubercle
 Action: laterally rotate humerus
 Innervation: suprascapular nerve
Subscapularis
 Origin: subscapular fossa
 Insertion: lesser tubercle
 Action: medially rotate humerus
 Innervation: upper and lower subscapular nerves
Teres Minor
 Origin: posterior surface, middle lateral border of scapula
 Insertion: greater tubercle
 Action: laterally rotate humerus
 Innervation: axillary nerve
Serratus Anterior
 Origin: ribs 1-8 laterally
 Insertion: anterior side of scapula along medial border
 Action: protract pectoral girdle; hold scapula to rib cage;
superiorly rotate scapula
 Innervation: long thoracic nerve
Splenius
 Origin: spinous process of C7 to T6 and supraspinous
ligament
 Insertion: transverse process of cervical vertebrae and
mastoid process
 Action:
 Bilaterally: extend spine
 Unilaterally: flex and ipsilateral rotation of cervical spine
Iliocostalis
 Origin: common tendon attached to iliac crest, posterior
sacrum, spinous process of lumbar vertebrae and
supraspinous ligament
 Insertion: ribs in thoracic region and transverse process in
lumbar and cervical region
 Action:
 Bilaterally: extend spinal column
 Unilaterally: flex spinal column ipsilaterally; minimally rotate spine
Longissimus
 Origin: common tendon with iliocostalis
 Insertion: ribs in thoracic region, transverse process in
thoracic and cervical regions and onto mastoid process
 Action:
 Bilaterally: extend spinal column
 Unilaterally: flex spinal column ipsilaterally
Spinalis
 Origin: spinous process and supraspinous ligament in lumbar
and thoracic region
 Insertion: spinous process in upper thoracic and cervical
regions
 Action: same as other erector spinae
Semispinalis
 Origin: transverse process of thoracic and cervical vertebrae
 Insertion: spinous process 4-6 segemtns superior to origin
and occipital bone between nuchal lines
 Action: extend and contralaterally rotate spine
Multifidus
 Origin: suprrior iliac spine, sacrum, aponeurosis of erector
spinae
 Insertion: spinous process 2-4 segments superior to origin
 Action: stabilize spine during movement
Rotatores
 Origin: transverse process all along spine
 Insertion: spinous process 1-2 segments superior to origin
 Action: mostly likely proprioceptive
Levator Costarum
 Origin: transverse process of C7-T11
 Insertion: ribs inferior to vertebrae
 Action: assist in elevating ribs during deep respiration; lateral
flexion
Interspinales
 Origin: spinous process
 Insertion: superior spinous process
 Action: extend and rotate spine
Intertransversarii
 Origin: transverse process
 Insertion: superior transverse process
 Action: laterally flex and stabilize spine
Rectus Capitis Posterior Minor
 Origin: posterior tubercle of C1
 Insertion: inferior nuchal line
 Action: extend and rotate atlanto-occipital joint
Rectus Capitis Posterior Major
 Origin: spinous process of C2
 Insertion: inferior nuchal line
 Action: extend and rotate atlanto-occipital joint
Obliquus Capitis Superior
 Origin: transverse process of C1
 Insertion: between nuchal lines
 Action: extend head and flex head to ipsilateral side
Obliquus Capitis Inferior
 Origin: posterior tubercle of C2
 Insertion: transverse process of C1
 Action: extend head and flex head to ipsilateral side
Pectoralis Major
 Origin: medial third of clavicle; sternum and costal cartilage
 Insertion: lateral lip of intertubercular groove
 Action: adduct, medially rotate, flex humerus;
depress/protract shoulder
 Innervation: medial and lateral pectoral nerves
Pectoralis Minor
 Origin: ribs 3,4,5 near costochondral junction
 Insertion: coracoid process
 Action: deepresss and protract pectoral girdle; inferiorly
rotate scapula
 Insertion: medial pectoral nerve
Subclavius
 Origin: 1st costal cartilage
 Insertion: inferior side of clavicle
 Action: depress clavicle; resist lateral dislocation of clavicle
 Innervation: subclavius
Sternocleidomastoid
 Origin: sternum and medial third of clavicle
 Insertion: mastoid process
 Action: rotate head to opposite side; elevate chin
 Innervation: accessory nerve
Anterior Scalene
 Origin: transverse process of C4-C6
 Insertion: scalene tubercle of rib 1
 Action: elevate rib 1; laterally flex and rotate neck
 Innervation: C40C6 ventral rami
Middle Scalene
 Origin: transverse process C2-C7
 Insertion: superior rib 1
 Action: elevate rib 1; laterally flex neck
 Innervation: C3-C8 ventral rami
Posterior Scalene
 Origin: transverse process C5-C7
 Insertion: superior rib 2
 Action: elevate rib 2; laterally flex neck
 Innervation: C7-C8 ventral rami
Omohyoid
 Origin: intermediate tendon held to clavicle
 Insertion: inferior border of hyoid
 Action: depress, retract, and steady hyoid
 Innervation: Ansa cervicalis
Triangle of Auscultation
2
3
1
1. Superior Latissimus Dorsi
2. Medial Border of Scapula
3. Lateral Trapezius
Quadrangular Space
3
1
2
4
Quadrangular Space
 Contains: posterior circumflex humeral artery and axillary
nerve
1.
2.
3.
4.
Teres minor
Teres major
Surgical neck of humerus
Long head of tricep
Triangular Space
1
3
2
Triangular Space
 Contains circumflex scapular artery
1. Teres minor
2. Teres major
3. Long head of tricep
1
2
3
Posterior Triangle of Neck
 Contains cervical plexus C1-C4
1. Trapezius
2. Sternocleidomastoid
3. Middle third of clavicle
 Roof: investing fascia
 Floor: prevertebral fascia