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Muscles Of Back Extrinsic muscles: • Move the upper limbs and the ribs. • Innervated by anterior rami of spinal nerves. Intrinsic muscles: • Maintain posture and move the vertebral column. • Innervated by the posterior rami of spinal nerves. Deep muscles Back • The intrinsic muscles are also arranged in layers. • Superficial layers splenius muscles , erector spinae. • Deeper layers spinotransverse group, semispinalis, multifidus the rotatores, and the suboccipital muscles. • Deepest interspinal and intertransverse muscles. Extrinsic (Superficial ) muscles: • • • • • Trapezius Latissimus dorsi Levator scapulae Rhomboid minor Rhomboid major Trapezius - Origin: • External occipital protuberance • Nuchal ligament • Spinous processes of vertebrae C7 to T12 • Supraspinous ligaments. Trapezius Insertion & Actions: • Superior part -the lateral onethird of the clavicle (Elevates the scapula). • Middle part - the acromion and spine of the scapula (Retracts the scapula). • Inferior part - the medial end of the spine of the scapula (Depresses the scapula). inferior Spinal part of accessory , C3, C4 Latissimus dorsi Origin: Iliac crest • Thoracolumbar fascia • Spinous process of T7 T12 • Lower 4 Ribs • Inferior angle of scapula. Insertion: Floor of the intertubercular sulcus Latissimus dorsi Action: • Adduction, extension and medial rotation of shoulder • Violent expiratory effort • Hold inferior angle of scapula Thoraco Dorsal Nerve Levator scapulae Levator scapulae m. • Origin: Transverse processes of C1, C2. • Posterior tubercles of transverse processes of C3, C4. • Insertion: Superior angle & medial border of the scapula. Levator scapulae Action: • Elevates the scapula • Rotates the scapula to depress the glenoid cavity. Dorsal scapular nerve, C3, C4 Rhomboid • Rhomboid minor: Rhomboid minor m. Rhomboid major m. Origin: • Nuchal ligament • Spinous processes of vertebrae C7 and T1. Insertion: • Root of the spine of the scapula near the spine. Rhomboid • Rhomboid major : Rhomboid minor m. Rhomboid major m. Origin: • Spinous processes of vertebrae T2 to T5. • Supraspinous Ligaments. Insertion: • Medial border of the scapula inferior to the spine. Rhomboid Action: • Retract the scapula. • Steady the scapula. Dorsal Scapular Nerve Triangles of the Back • The triangle of auscultation bounded by the latissimus dorsi muscle, the trapezius muscle, and the scapula. • The lumbar triangle bounded by the latissimus dorsi muscle, the external oblique muscle, and the iliac crest. Scapular spaces 1. Quadrangular space 2. Upper triangular space. 3. Lower triangular space. Quadrangular spaces Boundaries • Above(from before backwards) Subscapularies, capsule of shoulder joint, & teres minor. • BelowTeres major. • Medially -Long head of triceps. • Laterallysurgical neck of Structures passing: Axillary humerus. nerve & posterior circumflex humeral vessels. Upper Triangular spaces Boundaries: • AboveTeres minor • BelowTeres major • LaterallyLong head of triceps Apexlateral border of scapula where teres major & minor muscles converge Structures passing: Circumflex scapular vessels Lower triangular spaces • Boundaries: • AboveTeres major • MediallyLong head of triceps • Laterallyshaft of humerus. Structures passing: Radial nerve & profunda brachii vessels ��������������������������������������������������������������������������� ��������������������������������������������������������������������������������� �����������������������������������������������������