1. External occipital protuberance Ligamentum nuchae
Superior nuchal line
External occipital protuberance
Ligamentum nuchae
Spinous process of C7-T12 vertebrae
Proximal (origin) attachment for Trapezius
Motor – spinal accessory (CNXI)
C3 and C4 – pain and proprioceptive fibers
Innervation of Trapezius
Depresses scapula
Contraction of ascending part of trapezius (action)
Retracts scapula
Contraction of entire Trapezius (action)

2. Distal (insertion) attachment for Trapezius Lateral 3rd of clavicle
Acromion
Spine of scapula
Elevates scapula
Contraction of descending part of trapezius (action)
Retracts scapula
Contraction of middle part of trapezius (action)
Rotates glenoid cavity superiorly
Contraction of descending and ascending part of Trapezius (action)

3. Proximal attachment (origin) for Latissimus dorsi
Spinous process of T6-T12
Thoracolumbar fascia
Iliac crest
Inferior 3 or 4 ribs
Distal attachment (insertion) for Latissimus dorsi
Floor of intertubercular sulcus of humerus.
Innervation of Latissimus dorsi
Thoracodorsal nerve (C6, C7, C8)
Extends, adducts and medially rotates humerus
Raises body towards arms when climbing
Action of Latissimus Dorsi

4. Proximal attachment (origin) for Rhomboid minor Ligamentum nuchae
Spinous processes of C7 and T1
Distal attachment (insertion) for Rhomboid minor
Vertebral border of scapula from root of spine
Innervation of Rhomboid major and rhomboid minor
Dorsal scapular n. (C4-C5)
Retraction and downward rotation of scapula
Secure scapula to thoracic wall (in conjunction with serratus anterior)
Action of rhomboid major and minor

5. Proximal attachment (origin) for Rhomboid major
Spinous processes of T2-T5
Distal attachment (insertion) for Rhomboid major
Vertebral border of scapula from root of spine

6. Proximal attachment (origin) for Levator scapulae
Transverse processes of upper C1-C4
Distal attachment (insertion) for Levator scapulae
Vertebral border of scapula from superior angle to root of spine
Innervation of levator scapulae
Dorsal scapular n. (C4-C5)
Assist rhomboids
Elevation of scapula
Action of levator scapulae

7. Proximal attachment (origin) for Serratus posterior superior
Spinous processes (of C7-T3)
Distal attachment (insertion) for Serratus posterior superior
To ribs (superior border of ribs 2-4)
Innervation of serratus posterior superior and inferior
Inter costal nerves
Assists in inspiration
Action of serratus posterior superior

8. Proximal attachment (origin) for Serratus posterior inferior
Spinous processes of lower vertebrae (T11-L2)
Distal attachment (insertion) for Serratus posterior inferior
Loswer ribs (Inferior border of ribs 8-11)
Innervation of serratus posterior superior and inferior
Inter costal nerves
Assists in expiration
Action of serratus posterior inferior

9. Proximal attachment (origin) for Splenius Capitis and Cervicis
Nuchal ligament
Spinous processes of C7-T3 vertebrae
Cervicis:
Nuchal ligament
Spinous processes of T3-T6 vertebrae
Capitis:
Mastoid process
Lateral third of superior nuchal line of occipital bone.
Distal attachment (insertion) for Splenius Capitis and Cervicis
Cervicis:
Tubercles of transverse processes of C1-C3 or C4 vertebrae
Innervation of Splenius Capitis and Cervicis
Posterior rami of spinal nerves
extension of head (both sides); ipsilateral rotation of head and neck
Action of Splenius Capitis

10. What are the erector spinae muscles (lateral to medial)
Iliocostalis, longissimus, spinalis
Proximal attachment (origin) for erector spinae
Arise from common inferior tendon that extends from the iliac crest to median sacral crest
Iliocostalis – ribs
Longissimus – transverse process and eventually mastoid process
Spinalis – spanning spinous processes of vertebrae on each side
Distal attachment (insertion) for erector spinae
Both sides - Extension of vertebral column
One side – ipsilateral rotation
Contraction of erector spinae (both sides or one side)

11. Innervation of erector spinae Posterior primary rami of spinal nerves
What are the transversospinalis muscles
Semispinalis capitis, cervcis and thoracis
Multifidis
Rotatores
What are the proximal and distal attachments of transversospinalis
Proximal – lower transverse process
Distal – higher transverse process.
Semispinalis – important in holding up head
Multifidis – stabilize vertebrae
Rotatores - stabilize vertebrae
Contraction of transversospinalis

12. Proximal attachment (origin) for rectus capitis posterior minor
Below medial end of inferior nuchal line.
Distal attachment (insertion) for rectus capitis posterior minor
Posterior tubercle of atlas
Innervation of rectus capitis posterior minor
Suboccipital n.
Stabilizes atlanto-occipital joint
Action of rectus capitis posterior minor

13. Proximal attachment (origin) for rectus capitis posterior major
Below inferior nuchal line, lateral to rectus capitis posterior minor
Distal attachment (insertion) for rectus capitis posterior major
Spine of axis
Innervation of rectus capitis posterior major
Suboccipital n.
Extend head
Rotate atlas and head to same side
Action of rectus capitis posterior major

14. Proximal attachment (origin) for obliquus capitis superior
Transverse process of atlas
Distal attachment (insertion) for obliquus capitis superior
Inferior nuchal line (lateral to rectus capitis major)
Innervation of obliquus capitis superior
Suboccipital n.
Extends head
Action of obliquus capitis superior

15. Proximal attachment (origin) for obliquus capitis inferior
Spinous process of axis
Distal attachment (insertion) for obliquus capitis inferior
Transverse process of atlas
Innervation of obliquus capitis inferior
Suboccipital n.
Rotates atlas and head to same side
Action of obliquus capitis inferior

16. Proximal attachment (origin) for Deltoid Clavicle, Scapular spine
Acromion
Distal attachment (insertion) for Deltoid
Deltoid tuberosity
Innervation of Deltoid
Axillary n.
Abduction of arm (middle part; w/ supraspinatus)
Flexion and medial rotation of humerus (anterior part)
Extension and lateral rotation of humerus (posterior part)
Action of Deltoid

17. Proximal attachment (origin) for Supraspinatus Supraspinous fossa
Distal attachment (insertion) for Supraspinatus
Greater tubercle of humerus
Innervation of Supraspinatus
Suprascapular n.
Abducts humerus
Action of Supraspinatus

18. Proximal attachment (origin) for Infraspinatus Infraspinous fossa
Distal attachment (insertion) for Infraspinatus
Greater tubercle of humerus
Innervation of Infraspinatus
Suprascapular n.
Laterally rotates humerus
Action of Infraspinatus

19. Proximal attachment (origin) for Teres minor
Axillary border of scapula
Distal attachment (insertion) for Teres minor
Greater tubercle of humerus
Innervation of Teres minor
Axillary n.
Laterally rotates humerus
Action of Teres minor

20. Proximal attachment (origin) for Subscapularis Subscapular fossa
Distal attachment (insertion) for Subscapularis
Lesser tubercle of humerus
Innervation of Subscapularis
Upper subscapular n.
Lower subscapular n.
Adducts and medially rotates humerus
Action of Subscapularis

21. Proximal attachment (origin) for Teres major
Axillary border of scapula
Distal attachment (insertion) for Teres major
Medial edge of intertubercular sulcus
Innervation of Teres major
Lower subscapular n.
Secures humerus at shoulder
Adducts and medially rotates humerus
Action of Teres major

22. Innervation of Platsyma
Location of Platysma
Superficial fascia of anterior and posterior cervical triangle
Innervation of Platsyma
Facial n.

23. Proximal attachment (origin) for Sternocleidomastoid
Sternum
Medial end of clavicle
Distal attachment (insertion) for Sternocleidomastoid
Mastoid process of temporal bone
Innervation of Sternocleidomastoid
Spinal accessory n.
Flexion of head
Ipsilateral flexion,
Contralateral rotation
Action of Sternocleidomastoid

24. Proximal attachment (origin) for Omohyoid
Superior border of scapula
Intermediate tendon
Clavicle
Distal attachment (insertion) for Omohyoid
Hyoid
Innervation of Omohyoid
Ansa cervicalis
Depression of hyoid bone
Aid in swallowing
Action of Omohyoid

25. Innervation of Scalenus anterior, medius, and posterior
Proximal attachment (origin) for Scalenus anterior, medius, and posterior
Transverse process of cervical vertebrae
Distal attachment (insertion) for Scalenus anterior, medius, and posterior
First and second rib
Innervation of Scalenus anterior, medius, and posterior
Anterior primary rami of cervical nn.
Accessory respitory
Flexor of neck
Contralateral rotator of neck
Action of Scalenus anterior, medius, and posterior

26. Innervations of thoracodorsal nerve Latissimus dorsi
Rhomboid major
Rhomboid minor
Levator scapulae
Innervations of dorsal scapular nerve
Innervations of spinal accessory nerve
Trapezius
Sternocleidomastoid
Rectus capitis posterior major
Rectus capitis posterior minor
Obliquus capitis superior
Obliquus capitis inferior
Innervation of suboccipital nerve

27. Posterior surface of scalp (cutaneous)
Innervations of greater occipital nerve
Posterior surface of scalp (cutaneous)
Innervations of axillary nerve
Deltoid
Teres minor
Triceps brachi, long head
Supraspinatus
Infraspinatus
Innervations of suprascapular nerve
Subscapularis
Innervations of upper subscapular nerve

28. Innervations of lower subscapular nerve
Subscapularis
Teres major
Innervations of lower subscapular nerve
Innervations of greater auricular nerve
Skin around ear (cutaneous)
Innervations of transverse cervical nerve
Skin of anterior neck (cutaneous)
Innervations of supraclavicular nerve
Skin inferior to clavicle (cutaneous)

29. Scalp behind ear (cutaneous)
Innervations of lesser occipital nerve
Innervations of ansa cervicalis
Omohyoid
Sternohyoid
Sternothyroid
Innervations of phrenic nerve
Diaphragm

30. Spinal roots of thoracodorsal nerve
C6, C7, C8
C4-C5
Spinal roots of dorsal scapular nerve
Spinal roots of suboccipital n.
C1 (motor only)
Spinal roots of greater occipital n. C2

31. Spinal roots of axillary nerve
C5, C6
Spinal roots of suprascapular nerve
C4, C5, C6
Spinal roots of upper subscapular nerve
C5, C6, C7
Spinal roots of lower subscapular nerve
C5, C6, C7

32. Spinal roots of lesser occipital nerve
Spinal roots of greater auricular nerve
C2, C3
Spinal roots of transverse cervical nerve
C2, C3
Spinal roots of supraclavicular nerve
C3, C4