Download Back muscles

Muscles of thorax and abdomen.
Muscle groups of the back.
Vessels and nerves of the abdominal wall
• Ivo Klepáček
muscles
inguina
mm. epaxiales
hypaxiales
autochtonní heterochtonní
autochtonic heterochtonic
Ep
Hyp
muscles
inguina
Thoracic
muscles
muscles
inguina
• M.pectoralis major
n.pectoralis lat.+med.
• M.pectoralis minor
n.pectoralis med.
• M.subclavius n.subclavius
• M.serratus anterior
n.thoracicus longus
• Mm.intercostales externi,
interni, intimi
nn.intercostales I-XI
• M.transversus thoracis
nn.intercostales
• Musculus diaphragma
n.phrenicus
M.pectoralis major
muscles
inguina
Clavicular part
Sternal part
Abdominal part
adduction,
rotation,
accessory
inspiratory
muscle
Muscles of the anterior axillar fold
Thoracohumeral system
Innervation:
pectoral nerves C5-Th1
muscles
inguina
M.pectoralis
minor
What compress subclavian or
axillary artery
A) Costa cervicalis
B) mm. scaleni (m.scalenus
minimus)
C) Tumor inside spatium
costoclaviculare
D) Insertion of the m.pectoralis
minor
Intercostal muscles
muscles
inguina
 external intercostal m.
M. intercostalis externus
membrana intercostalis externa
fascia thoracica superficialis (externa)
 internal intercostal m.
M. intercostalis internus
membrana intercostalis interna
 innermost intercostal m.
M. intercostalis intimus
fascia intercostalis interna
(endothoracica)

Transverse thoracic m.
M. transversus thoracis
fascia intercostalis interna
(endothoracica)
Internal intercostal muscles + transversus
ventral thoracic wall
(dorsal view)
muscles
inguina
m.
transversus
thoracis
Internal and external intercostal muscles
dorsal thoracic wall
muscles
inguina
Angulus costae (II)
Intercostalis externus
Intercostalis internus
Membrana
intercostalis interna
Mm. intercostalis externus, internus, intimus
a transversus (transversalis)
muscles
inguina
IE
muscles
inguina
II
Mm. intercostalis externus, internus, intimus
transversus (transversalis) thoracis et fasciae
muscles
inguina
muscles
inguina
Intercostal aa. et vv.
muscles
inguina
muscles
inguina
Vein, Artery, Nerve, nerve, artery
Spatium
intercostale obsah
muscles
inguina
Punctio
Punction
Vessels and nerves
of the dorsal
thoracic wall
muscles
inguina
Superior intercostal vein
v. intercostalis superior
Azygos vein
v. azygos
Sympathetic trunk
Truncus sympathicus
Thoracic duct
Ductus thoracicus
Splanchnic nerves
nn. splanchnici
Ao
v. jugularis
Ductus
thoracicus
muscles
inguina
v. subclavia
v.cava superior
v.hemiazygos
accesoria
v.azygos
v.hemiazygos
Vena cava inferior
Žilní systém
trupu
v.lumbalis
ascendens
Venous system
of the trunk
Lymphatic vessels
of the trunk
muscles
inguina
Preparace a.
et v. thoracica
interna
muscles
inguina
Dissection
of the internal
thoracic a.
and v.
Muscles of anterior abdominal wall
muscles
inguina
Function:
Flexion
Lateroflexion
Rotation
Increase of
intraabdominal
pressure
Forced
expiration
innervation: intercostal nerves,
iliohypogastric, ilioinguinal
muscles
inguina
Superficial mm. (ventral abdominal wall)
mm. obliquus externus, internus, transversus
external oblique, internal transverse abdominal muscles
OE
OI
T
muscles
inguina
M.rectus
abdominis
hluboké
svaly břicha
deep
abdominal
muscle group
(iliopsoas,
quadratus
lumborum mm.)
m. rectus abdominis
muscles
inguina
vagina musculorum
rectorum
rectus abdominis muscle
and its
sheath
muscles
inguina
Linea arcuata
Douglas line
(arcuate line)
Linea
semilunaris
Spiegel line
Semilunar line
Vagina musculorum rectorum
Rectus sheath, vagina
James Douglas 1675-1742 Engl. anatomist
Adrian van den Spieghel /Adrianus
Spigelius) 1578-1625 Belgian anatomist
muscles
inguina
muscles
inguina
Hlavní funkce břišních svalů
Main function of the abdominal muscles
Abdominal
wall –
ventral view
muscles
inguina
•
•
•
Skin
Fascia abdominalis
subcutanea
et superficialis
Muscles
Antonio Scarpa (1752 –
1832) Italian anatomist
Petrus Camper (17221789), Dutch
Anthropologist
muscles
inguina
Caput Medusae
muscles
inguina
muscles
inguina
Abdominal
wall - dorsal
view
•
•
•
Peritoneum
Fascia transversalis
(endoabdominalis)
Muscles
muscles
inguina
muscles
inguina
Canalis inguinalis
Inguinal canal
Stěny
Walls
????
????
Inguinal canal
muscles
inguina
(Canalis inguinalis – latin)
weakness of the abdominal wall
4 -5 cm long tube-like gap in the lower margin of
the anterior abdominal wall above inguinal (groin)
ligament
It is the passage connecting inner and outer
surface of the muscular layers of the anterior
abdominal wall
It serves as communicating canal between
subcutaneous and intra-abdominal structures
female
muscles
inguina
c
male
muscles
inguina
Transverse section
muscles
inguina
Anulus inguinalis profundus
Internal inguinal ring
c
Anulus inguinalis superficialis
External inguinal ring
muscles
inguina
APONEUROSIS
c
Přední stěna
Ventral wall
muscles
inguina
Dolní okraje plochých šlach OI aT
Distal margine of OI and T aponeuroses
Tříselný kanál Canalis inguinalis
Groin canal, inguinal canal
2.vrstva 2nd layer
Strop dno
Roof bottom
FASCIA
TRANSVERSALIS
muscles
inguina
c
Tříselný kanál Canalis
inguinalis
Groin canal, inguinal
canal
3.vrstva 3rd layer
Zadní stěna
Dorsal wall
muscles
inguina
muscles
inguina
Zadní stěna tříselného kanálu
Dorsal wall of the inguinal canal (intraabdominal view)
muscles
inguina
Ligamentum
interfoveolare
Aponeurosis
m.transv.abdom.
m.transversus
abdominalis
Inferior epigastric
vessels
Vasa
testicularia
Falx inguinalis
Trigonum
Hesselbachi
Ligamentum
inguinale
n. femoralis
a. femoralis
v. femoralis
Ductus deferentialis
vas deferens
muscles
inguina
Fascia transversalis
„fascia“ cremasterica
aa. testicularis, cremasterica, deferentialis
Plexus pampiniformis
Ductus deferens
muscles
inguina
c
muscles
inguina
muscles
inguina
Anulus
inguinalis
superficialis
canalis inguinalis – příčný řez
1- fossa supravesicals
2- fossa medialis inguinalis
3- fossa lateralis inguinalis
Přímá hernie HERNIA DIRECTA
muscles
inguina
Nepřímá hernie HERNIA INDIRECTA
Fascia transversalis
peritoneum
TA
IOA
EOA
Superficial
abd.fascia
cremaster
Fascia
spermatica
externa
Ifascia spermatica interna
muscles
inguina
Diaphragma
structure
muscles
inguina
Vertebral part – from ligaments which surround
deep abdominal muscles (arcuate mediale, laterale
and mediana ligg.).
Lumbar part – right side - from first three lumbar
vertebrae
Lumbar part – left side - from first two lumbar
vertebrae
Sternal part - from xiphoid process and from false ribs
muscles
inguina
Diaphragm
phren
formation
muscles
inguina
Inferior view
muscles
inguina
muscles
inguina
Diaphragm
openings
Aortic hiatus (aorta a ductus)
Esophageal hiatus (jícen a vagus)
Hiatus venae cava inferioris (vein and
right phrenic nerve)
Arcades (muscles and splanchnic nerves
and connections between ascending lumbar veins
and azygos and hemiazygos veins)
muscles
inguina
Superior view
Sternocostal triangle
Lumbocostal triangle
(Bochdaleki)
Hiatus
esophageus
Medial
arcuate
lig.
Lig. arcuatum medianum
Lateral arcuate lig.
PM
Crus dextrum et sin
QL
Hiatus aorticus
muscles
inguina
4
5
muscles
inguina
Diaphragm - innervation
Nerves – motor
fibres from
phrenic nerves (C3,4,5).
Sensitive fibers supply parietal and
visceral pleurae + middle part is
supplied from the sensitive fibers of
phrenic nerve
sensoric fibers are from the intercostal
nerve.
muscles
inguina
Diaphragm and its function
Muscle of abdominal straining:
The diaphragm
contraction aids that of the muscles of the anterior abdominal wall
in raising the intra-abdominal pressure to evacuate the pelvic
contents (micturition, defecation, parturition).
Weight-lifting muscle:
The diaphragm contraction
support the vertebral column and prevent flexion. It assists the
postvertebral muscles in the lifting of heavy weights.
Thoracoabdominal pump:
The descent of the
diaphragm decreases the intrathoracic pressure and increases the
intra-abdominal pressure. This pressures change compresses the
blood in the inferior vena cava and forces it upward into the right
atrium of the heart. Lymph can be passed faster to the thoracic
duct, too.
Diaphragma
Diaphragm
- absorbér peritoneální tekutiny
muscles
inguina
- absorber of the peritoneal fluid
muscles
inguina
Diaphragma - herniation
Hernia congenitalis
Proniká skrze
congenital herniation –
penetrates through:
Canalis pleuroparietalis (častěji vlevo; v důsledku nespojení
septum transversum s pleuroperitoneální řasou
Pleuroperitoneal canal (more on left side, because of non fusion
between pleuroperitoneal fold and septum transversum
Hernia traumatica
traumatic herniation –
Proniká skrze
penetrates through:
hiatus oesophageus - para-esophageální typ
oesophageal opening - paraesophageal type
muscles
inguina
muscles
inguina
muscles
inguina
Svaly zad
Musculi dorsi
Back muscles
muscles
inguina
muscles
inguina
Zádové svaly
Back muscles
Superficial layer
Middle layer
Deep layer
Spinotransversal system
Spinospinal system
Transversospinal system
Suboccipital muscles
muscles
inguina
Mm. intermediales
Intermediate muscles
muscles
inguina
spinocostal system
• Serratus posterior superior
• Serratus posterior inferior
• Levatores costarum
muscles
inguina
mm. serrati
serratus
superior
serratus
inferior
Mm. dorsales profundi
Deep back muscles (erector trunci systems)
muscles
inguina
•
Superficial and obliquely
directed
•
Erector spinae (trunci):
iliocostalis, longissimus and
spinalis parts
Its separated continuation – splenius
capitis and cervicis
•
Intermediate and obliquely
directed
Transversospinalis: semispinalis,
multifidi and mm.rotatores
•
•
Deeply arranged
Mm. interspinales,
intertransversarii
muscles
inguina
muscles
inguina
Superficial
and obliquely
directed
Spino-transversal
system
Derivatives
of the
Fascia
thoracolumbalis+
Fascia nuchae
arrangement
muscles
inguina
m.splenius
m.iliocostalis
m.longissimus
muscles
inguina
m.longissimus
capitis, cervicis,
thoracis
L
m.iliocostalis
I
cervicis, thoracis et
lumborum
Vertically directed
muscles
inguina
Spino-spinal system
mm.interspinales
m.spinalis
Intermediate and
obliquely directed
muscles
inguina
Transverso-spinal
system
mm.rotatores breves
et longi
m.multifidus
m.semispinalis
Mm. prevertebrales
Prevertebral muscles
muscles
inguina
mm. longus capitis et colli
mm. rectus capitis et lateralis
Spinospinální m.spinalis - extension
Spinotransversální m.iliocostalis , m.longissimus,
m.splenius –rotation to the same side
Transversospinální m.semispinalis, mm.rotatores,
m multifidus - rotation to the oposite side
muscles
inguina
hluboké svaly zádové
Inervace: Dorsální větve nn.spinales
Innervation: dorsal branches of spinal nn.
M.serratus
M.latissimus
post. sup.
dorsi
M.trapezius
Petrovický lecture
muscles
inguina
Fascia thoracolumbalis
• It is between iliac crest and crista 12th
• Outer layer: aponeurosis m. latissimus dorsi
• Inner layer: Laterally proceeds to mm. transversi a
obliqui interni
Medially is splitted into three layers(lamellae):
posterior lamella – covers deep muscles
media lamella– dorsally from m. quadratus lumborum
anterior lamella– ventrally from m. quadratus lumborum
muscles
inguina
muscles
inguina
Movements in the regions
• Thoracic region – rotation is produced by the
semispinalis and rotatores muscles and less by
the oblique abdominal muscles
• Lumbar region – flexion is produced by the
rectus abdominis and psoas muscles
Lateral flexion is produced by the postvertebral
muscles, the quadratus lumborum and the
oblique abdominal muscles
Rotation is produced by the rotatores muscles and
by the oblique abdominal muscles
muscles
inguina
muscles
inguina
Hernia lumbalis
Lateroventrally
Costa XII.
Trigonum lumbale
Petiti
anulus superficialis
PETIT Jean Louis 1674-1760
GRYNFELT Kazimierz 1840-1913
KRAUSE Wilhelm 1833-1909
Tetragonum Krausei (Trigonum
Grynfelti - spatium tendineum Anulus
profundus
lumbale)
muscles
inguina
muscles
inguina
muscles
inguina
muscles
inguina
Trigonum
suboccipitale
muscles
inguina
Where you can get more
information
muscles
inguina
R.S.Snell : Clinical Anatomy for Medical Students
Lippincott, Williams & Wilkins, 6th edition
pp.: 46-55; 57-58; 59-72
A.Dykes : Anatomy
Mosby Publications
pp.: 41-47
A.M.R.Agur
and M.J.Lee : Grant`s Atlas of Anatomy
Williams & Wilkins
pp.: 2-28
K.L.Moore
and A.M.R.Agur : Essential Clinical Anatomy
Williams & Wilkins
pp.: 32-47
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