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Muscles of back
• Introduction• Cutaneous nerve supply• Development of muscles• Muscles of back Introduction Classification• Nerve supply of muscles of back• Action of muscles of back
Cutaneous Nerves
• Dorsal primary rami of spinal nerves.
• Each dorsal primary ramus divides into medial and lateral branches.
Muscles of back
Development:• Epaxial muscles: Extensors
of the neck and vertebral column
• Hypaxial muscles: Thoracic myotome form lateral and ventral flexor muscles of the vertabral column,lumbar myotome form quadratus lumborum.
Arrangement of Back Muscles
• Three groups:Superficial:
Extrinsic.Intermediate:
Extrinsic.Deep:
Intrinsic.
Ligamentum nuchae
•Consist of dorsal raphae and medial fascial septum
•Attachment
•extension
Thoracolumbar Fascia
• Deep fascia on the back of trunk.
• It binds long exetonsors of vertabral column to posterolateral surfaces of vertabral bodies.
• Two parts :Lumbar Thoracic
Thoracolumbar Fascia Laminae
• Posterior lamina to lumbar spinous processes.
• Middle lamina to lumbar transverse processes.
• Anterior lamina (deepest) to lumbar transverse processes.
Superficial Extrinsic Muscles
• Connect limb to axial skeleton.• Innervated by ventral rami or CN XI.• Include:
Trapezius.Latissimus dorsi.Levator scapulae.Rhomboideus major.
Rhomboideus minor.
Trapezius:• Diamond shaped• Origin:• Insertion:• Innervation:• Action:
Lattissimus dorsi:• Origin:• Insertion: • Innervation:• Action:
Levator scapulae:• Origin :• Insertion:• Innervation :• Action:
Rhomboid major:• Origin:• Insertion:Rhomboid minor:• Origin:• Insertion:
• Innervation:• Action:
Intermediate Extrinsic Muscles
• Serratus posterior group:
Serratus posterior superior.
Serratus posterior inferior
• Innervated by ventral rami of spinal nerves.
Intrinsic Back Muscles
• True intrinsic muscles of the back are innervated by dorsal (posterior) rami.
• Three groups:SuperficialIntermediateDeep.
INTRINSIC (DEEP) BACK MUSCLES
• Superficial :Splenius , Erector spinae• Deeper layer : Spinotransverse
group, Suboccipitals
• Deepest layer: Interspinous, Intertranseverse
.
Superficial muscles
• Consists of the Splenius group:• Long muscles.
• Originate from ligamentum nuchae and spinous processes.• Cover neck and upper part of thorax.• Two parts: Splenius capitis Splenius cervicis
Splenius capitis:• Attachments:• Relations: • Innervation:• Action:Splenius cervicis:• Attachments:• Relations:• Innervation:• Action:
Superficial IntrinsicErector spinae: Three muscles each
with three regional parts.1.Spinalis:Spinalis thoracis Spinalis cervicis Spinalis capitis2.Longissimus:Longi capitis Longi cervicis Longi thoracis3.Iliocostalis:Iliocost cervicis Iliocost thoracis Iliocost capitis
Spinalis: Components: Thoracis: Attachments: Cervicis: Attachments:
poorely developed Capitis:
Attachments:
Intermediate Intrinsic
• Longissimus:Central component of erector spinae
Longissimus capitis: Attachments Longissimus cervicis:
Attachments: Longissimus thoracis:Largest
component Has lumbar and
thoracic part. Attachments:
.
• Iliocostalis:most lateral component of erector spinae
Components: Iliocostalis cervicis: Attachments Iliocostalis thoracis: Attachment Iliocostalis lumborum: Attachments Has lumbar and
thoracic part
Erector spinae aponeurosis:• Formation:• Attachments:• Relations: • Innervation: • Action:
Deep Intrinsic Muscles• Spinotransverse group:
Present between spinous process and transverse elements of vertebrae.
Components: Rotators: Rotators thoracis Rotators cervicis Rotators capitis Multifidus Semispinalis: Semi cervicis Semi thoracis Semi capitis Suboccipital muscle
Rotatores• Deepest and shortest muscle• 11 pairs of small
quadrilateral muscle• Attachments:• Components: Rotator brevis: Attachments Rotator longus: Attachments
Multifidus
• Thick muscle mass.• Present at
cervical,thoracic,upper lumbar levels lies lateral to spinous process and also expands to cover posterior surface of sacrum.
• Multifidus arises from lateral surface and tip of trnsverse process and insert into transverse elements of vertebrae.
Semispinalis
• Longest fibres of spinotransverse group
• Components: Cervicis:
Attachments Thoracis: Attachments Capitis: Attachments• Relations:• Innervation:• Action:
Suboccipital muscle:
• 4 small muscles that connect occipital bone,atlas and axis.
• Suboccipital triangle• Components: Rectus capitis posterior major: Attachments Rectus capitis posterior minor: Attachments Obliquus capitis inferior: Obliquus capitis superior:• Innervation:• Actions:
Intrinsic Segmental Muscles
• Interspinales: Attachments. • Intertransversarii Attachments.
Applied:
• Low bachache: Lumbar strain Lumbar radiculopathy• Lumbar triangle:
– Superior(Grynfeltt)– Inferior(Petit) • Renal angle