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MUSCLES OF THE BACK: VIRTUAL LAB REVIEW 3 groups (in layers): A. SUPERFICIAL LAYER move upper extremity (arm) B. INTERMEDIATE LAYER- Respiratory muscles (insert to ribs) C. DEEP LAYER - move trunk and back TRAPEZIUS - superficial layer Insert: Clavicle (lateral 1/3) and Scapula (acromion and spine) Origin: 1) Skull - External occipital protuberance 2) Fascia Ligamentum nuchae 3) Vertebrae Spines of C7, T1-T12 Actions: 1) Elevates (upper fibers) and Depresses (lower fibers) Shoulder 2) Retracts scapula 3) Extends head Innervation: Accessory nerve (Cranial nerve XI) - Test - shrug shoulders LATISSIMUS DORSI Insertion: HumerusIntertubercular (bicipital) groove Origin: Vertebrae T6-T12 (spines) Fascia- Thoracolumbar fascia Pelvic Bone- Iliac crest; Actions: Adducts, extends, and medially rotates arm Innervation: Thoracodorsal Nerve (Posterior Cord of Brachial Plexus) LATISSIMUS DORSI RHOMBOID MINOR Origin: Vertebrae (C7, T1 spines) Insert: Scapula (med. border) RHOMBOID MAJOR Origin: Vertebrae T2-T5 spines; Insert: Scapula (med. Border) to Inferior Angle Orient to medial border of scapula Orient to medial border of scapula Spines of Vertebrae (C7 and T1; T2-T5) RHOMBOID MINOR RHOMBOID MAJOR LEVATOR SCAPULAE LEVATOR SCAPULAE Origin: Vertebrae (C1-C4 transverse processes) Insertion: Scapula (sup. angle and medial border) Note: Rhomboids and Lev. Scap. Action: All elevate and adduct scapula Innervation: All by Dorsal scapular nerve LEVATOR SCAPULAE LEVATOR SCAPULAE LEVATOR SCAPULAE - look for round (shaped like finger) of muscle disappearing toward neck (not toward vertebral spines) TRIANGLE OF AUSCULTATION Boundaries Inferior - Lat. Dorsi Superior - Trapezius Lateral - Rhomboid Major overlies 6th intercostal space; floor has no large muscles- good place for listening with stethoscope Intermediate Group- associated with Respiration All Origin - Vertebrae; All Insert - Ribs SERRATUS POSTERIOR SUPERIOR Origin: Vertebrae (cervical and upper thoracic spines) Action: Raise ribs in inspiration SERRATUS POSTERIOR INFERIOR Origin: Vertebrae (lumbar and lower thoracic spines) Action: Lower ribs in expiration Innervation: both muscles by Intercostal Nerves SERRATUS POSTERIOR SUPERIOR SERRATUS POSTERIOR INFERIOR SERRATUS MUSCLES - look for thin sheet of muscle insert onto RIBS (not scapula, arm) DEEP GROUP OF BACK MUSCLES divisible into three subgroups 1. SPLENIUS 2. ERECTOR SPINAE 3. TRANSVERSO-SPINALIS – deep to Erector Spinae ALL 1. Act to Extend trunk when act bilaterally 2. Located dorsal to vertebral column 3. Innervated by Dorsal primary rami of spinal nerves DORSAL AND VENTRAL RAMI OF SPINAL NERVES DORSAL ROOT DORSAL ROOTLETS DORSAL ROOT Dorsal Ramus Dorsal Ramus Spinal nerve Ventral Ramus Spinal nerve VENTRAL ROOTLETS Both Dorsal and Ventral Rami contain sensory and motor axons Ventral Ramus Dorsal Ramus Ventral Ramus Spinal nerves divide into Dorsal and Ventral Rami immediately after they leave the intervertebral foramen, Dorsal Ramus (also called Dorsal Primary Ramus) sensory and motor axons to region of back; sensory to skin of back and posterior neck, motor axons to deep muscles of back and neck. ERECTOR SPINAE- three columns of muscle lying in parallel SPINALIS- most medial spines to spines LONGISSIMUS- intermediate transverse process to transverse processes ILIOCOSTALIS- lateral - ilium and ribs to ribs or transverse processes ERECTOR SPINAE SPINALIS- most medial LONGISSIMUSintermediate ILIOCOSTALISlateral Identify muscles by location Look for midline row of vertebral spines Identify muscles by location SPINALIS- most medial LONGISSIMUSintermediate ILIOCOSTALISlateral TRANSVERSOSPINALIS - ALL: Origin: transverse processes Insert: spines of vertebrae above Parts differ in how many vertebrae they extend across a. Semispinalis- 5 or 6 b. Multifidus- 3 or 4 c. Rotatores- 1 or 2 Act: Extend trunk in bilateral action, rotate unilaterally Note: Orientation of muscle fibers: transversospinalis are angled up and in toward spines; erector spinae are parallel to vertebral column TRANSVERSOSPINALIS TRANSVERSOSPINALIS Orientation of muscle fibers: transversospinalis are angled up and in toward spines, deep to erector spinae Good luck!