Anatomy - Superficial & Intermediate Back Muscles 1

Front 1

What are the superficial muscles of the back?

Where do they originate from in development?

Back 1

trapezius, latissimus dorsi, rhomboid minor, rhomboid major, levator scapulae

locations other than the back

Front 2

Where do the superficial (extrinsic) muscles of the back generally recieve their innervations from?

What is the exception?

Back 2

anterior rami of spinal nerves

trapezius receives innervation from CNXI that comes from the posterior rami

Front 3

What is the general function of the superficial back muscles? AKA?

What is the general function of the intermediate back muscles? AKA?

Back 3

move the upper limbs

appendicular group

move the ribs

respiratory group

Front 4

What does the first layer of the back consist of?

Back 4

Trapezius & Latissimus Dorsi

Front 5

What does the second layer of the back consist of?

Back 5

levator scapulae, rhomboid minor, rhomboid major

Front 6

Where is the attachment of the Trapezius?

Back 6

Proximal - external occipital protuberance, superior nucheal line, ligamentum nuchae, C7-T12 spinous processes

Distal - spine of scapula, acromion, lateral 1/3 or clavicle

Front 7

TRAPEZIUS:

What is the action?

Back 7

adduct scapula, upwards & outward scapular rotation, elevates scapula, depresses scapula

Front 8

TRAPEZIUS:

What is the motor innervation?

What is the sensory/proprioceptive innervation?

Back 8

spinal accessory nerve (CN XI)

C3 & C4

Front 9

TRAPEZIUS:

What is the blood supply?

Back 9

MAJOR: superficial branch of the transverse cervical artery

Front 10

What could damage to the spinal accessory nerve (CN XI) cause?

Back 10

trapezius muscle atrophy --> shoulder droop, weakness/inability to shrug shoulder, difficulty raising upper limb above head (no upward/outward rotation)

Front 11

What is the majority of the causes of spinal accessory nerve (CN XI) damage?

Back 11

penetrating trauma (stab/bullet)

surgery in the lateral cervical region - cervical lymph node biopsy/removal of cancerous nodes

Front 12

What are physical signs of CN XI damage or trapezius atrophy?

Back 12

shoulder droop

diminished shoulder elevation, inability to shrug shoulders against resistance

inability to raise arm above head

Front 13

Where is the acromion and spine of scapula?

Back 13

Front 14

What landmarks of the scapula are easily palpable?

Back 14

spine of scapula, acromial angle, medial border, inferior angle

Front 15

Damage to which nerve causes a winged scapula?

What can cause this?

Back 15

long thoracic nerve

removal of axillary lymph nodes, mastectomy

*atrophy of serratus anterior muscle

Front 16

LATISSIMUS DORSI:

Attachment?

Back 16

Proximal - T7-T12 & lumbar spinous processes, sacrum, iliac crest, ribs 10-12

Distal - floor of bicipital groove (intertubercular groove)

Front 17

LATISSIMUS DORSI:

Innervation?

Where does this nerve originate from?

Back 17

Thoracodorsal nerve (C6-8)

posterior cord of brachial plexus

Front 18

LATISSIMUS DORSI:

What is the blood supply?

What is the derivation of that artery?

Back 18

thoracodorsal artery

(subclavian --> axillary --> subscapular --> thoracodorsal)

Front 19

Where is the intertubercular (bicipital) groove of the humerus?

Back 19

between the greater and lesser tubercles of the proximal humerus

*medial to insertion of pectoralis major

Front 20

LATISSIMUS DORSI:

What is the action?

Back 20

extend, medially rotates, adduct THE HUMERUS

pulls body toward arm in climbing and chin exercise

* HANDCUFF MUSCLE

Front 21

What can cause damage to the thoracodorsal nerve?

Back 21

surgery involving the axilla - breast cancer surgery

Front 22

What are the physical signs of thoracodorsal nerve injury? (C6-C8)

Back 22

difficulty in adducting arm, rotation of humerus, extension of humerus

inability to adduct against resistence, inability to do chin up, inability to pull body toward arm in climbing

Front 23

LEVATOR SCAPULAE:

Attachment?

Back 23

Proximal - C1-C4

Distal - medial border of scapula superior to scapular spine

Front 24

LEVATOR SCAPULAE:

Innervation?

Back 24

C4,C4 anterior rami (from cervical plexus)

lower portion recieves dorsal scapular nerve (C4-C5)

Front 25

LEVATOR SCAPULAE:

What is the action?

Back 25

elevate & draw medially scapula

tilt gelnoid fossa inferiorly

laterally flex neck

Front 26

LEVATOR SCAPULAE:

What is the blood supply?

Back 26

transverse cervical artery (deep branch) [subclavian --> thyrocervical trunk --> TCA --> deep/superficial]

Front 27

RHOMBOID MINOR:

Attachment?

RHOMBOID MAJOR:

Attachment

Back 27

Proximal - C7-T1 spinous processes

Distal - Root of scapular spine

Proximal - T2-T5

Distal - medial border of scapula

Front 28

RHOMBOID MINOR:

Innervation?

RHOMBOID MAJOR:

Innervation?

Back 28

dorsal scapular nerve (C4-C5)

dorsal scapular nerve (C4-C5)

Front 29

RHOMBOID MINOR & RHOMBOID MAJOR:

Action?

Back 29

retracts & elevates scapula

w/ assistance from other muscles, rotates the lateral aspect of the scapula inferiorly

Front 30

RHOMBOID MINOR AND RHOMBOID MAJOR:

Blood supply?

Back 30

Deep branch of transverse cervical artery

Front 31

What is a common variation of the blood supply of the rhomboids?

Back 31

the descending scapular artery, coming right off of the subclavian, will supply this area

there is no TCA - the artery arising from the thyrocervical trunk and following the path similar to the TCA (w/o a deep branch) is named the superficial cervical artery

Front 32

What is a physical sign of dorsal scapular nerve damage?

Back 32

affected scapula will be further from the midline than the unaffected scapula

weakness in retraction/adduction/elevation of scapula

*weakness bc the function is not completely lost due to functioning trapezius

**Rhomboids AND levator scapulae are affected

Front 33

Derivation of transverse cervical artery?

Derivation of thoracodorsal artery?

Back 33

subclavian artery --> thyrocervical trunk --> transverse cervical artery --> deep & superficial branches

** deep is sometimes called dorsal scapular artery

subclavian --> axillary --> subscapular --> thoracodorsal

Front 34

Where is the superficial transverse cervical artery located?

Where is the deep transverse cervical artery located?

Back 34

beneath the trapezius with the spinal accessory nerve

beneath the rhomboids to supply them and levator scapulae

Front 35

What is the vertebrae level of:

root of the spine of the scapula

inferior angle of scpaula

iliac crest

Back 35

T3 spinous sprocess

T7 spinous process

L4 spinous process - L4/L5 intervertrbral disc

Front 36

What are the borders of the triangle of auscultation?

Back 36

Floor - rhomboid major

Medial border of scapula

Superior border of latissimus dorsi

lateral border of trapezius

Front 37

What is heard in the triangle of auscultation?

What intercostal space is located deep to the traingle of auscultation?

Back 37

breath sounds from the posterior lung segments

6th intercostal space

Front 38

What does the thoracolumbar fascia cover?

What does the thoracolumbar fascia provide attachment for?

Back 38

deep muscles of the back

attachment for latissimus dorsi

Front 39

What is aponeurosis?

What is fascia?

What is its function?

Back 39

a fibrous sheet or flat expanded tendon, giving attachment to muscular fibers and serving as the means of origin or insertion of a flat muscle, it sometimes serves as fascia for other muscles

connective tissue

wrap, insulate and support deep structures of the body; permit passage for nerves and vessels ; limit the spread infection or malignancy to a fascial compartment

Front 40

Describe superficial fascia

Describe deep fascia

Back 40

mostly fatty tissue; attached to the dermis of the skin

dense, more organized, connective tissue

Front 41

What are the intermediate back muscles?

Back 41

serratus posterior superior

serratus posterior inferior

Front 42

What is the attachment of serratus posterior superior?

What is the attachment of serratus posterior inferior?

Back 42

C7-T3 to ribs 2/3/4/5

T11-L3 to lower 3 or 4 ribs

Front 43

What is the function of serratus posterior superior?

What is the function of serratus posterior inferior?

Back 43

elevate ribs during forced inspiration

depress & stabilize ribs against diaphragm contraction

Front 44

What is the innervation of serratus posterior superior and serratus posterior inferior?

Back 44

intercostal nerves T2-T5

last 4 intercostal nerves (T9/T10/T11/T12)

Front 45

Dorsal rami nerves pass through the superficial back muscles to innervate ____

Back 45

the overlying skin

**do not innervate the superficial back muscles

Front 46

Each spinal nerve innervates a region of skin called a _____

Back 46

dermatome