2ObjectivesIdentify the superficial and deep muscles of the back in terms of their location, nerve supply and actions.Understand the muscle support of the trunk.Explain the mechanism of body weight transmission.
3Vertebral Column Cervical: 7 Thoracic: 12 Lumbar: 5 Sacral: 5 (fused to form 1 sacrum)Coccygeal: 4 (fused to form coccyx)Total= 33 (counted as 26 in the total bones of the body because of fusion.
5Movements at the Vertebral Column Flexion: bending forwardExtension: bending backwardsLateral flexion: bending side-wardsRotation: Twisting the trunkCircumduction:The axis of movement passes through the center of the vertebral bodies, so that the bodies do not move. Movements are mostly permitted by the cervical & lumbar spines. Thicker the intervertebral disc, greater the degree of movement
6Functions of the Vertebral Column Protects the spinal cord & spinal nerves.Supports the weight of the body superior to the level of the pelvis.Provides a partly rigid & flexible axis for the body & an extended base on which the head is placed and rotates.Plays an important role in posture & locomotion
7MUSCLES OF THE BACK They are organized into 3 groups: Deep group: attached to & involved in the movement of vertebral column & head.Intermediate group: attached to ribs & serve respiratory functions.Superficial group: attached to & involved in the movements of upper limb.Intrinsic muscles:Develop in the backSupplied by posterior rami of spinal nervesExtrinsic muscles:Not developed in the backSupplied by anterior rami of spinal nerves.
8Extrinsic Muscles of the Back 1. Superficial extrinsic back muscles:TrapeziusLatissimus dorsiLevator scapulaeRhomboids major & minorThey all connect the upper limb to the trunk.Supplied by anterior rami of spinal nerves
9Superficial Extrinsic Back Muscles TrapeziusLatissimus dorsiLevator scapulaeRhomboids major & minor
10TRAPEZIUS Origin: Spines of cervical & thoracic vertebrae Insertion: lateral 1/3 of clavicle + acromion & spine of scapula.Action: rotation of scapula during abduction of humerus above horizontal.Upper fibers: elevate scapula.Middle fibers: retract scapulaLower fibers: depress scapula.Nerve supply: Spinal part of accessory (11th cranial) nerve.InsertionActionOrigin
11LEVATOR SCAPULAE; RHOMBOID MINOR & MAJOR Origin:Levator scapulae: cervical transverse processesRhomboid minor & major: thoracic spinesInsertion: medial border of scapula.Nerve supply: dorsal scapular nerve.Actions:Levator scapulae: elevates scapula.Rhomboid minor & major: retract scapula.
12LATISSIMUS DORSI Origin: a. Spinous processes of T7 - L5 vertebrae. b. Iliac crest of sacrum.c. Thoracolumbar fascia.d. Inferior angle of the scapula.e. Lower three or four ribs.Insertion:bicipital groove of humerus.Nerve supply:thoracodorsal nerve.Actions:extension, adduction & medial rotation of humerus (arm, shoulder joint).
13Extrinsic Muscles of the Back 2. Intermediate extrinsic back muscles:Serratus posterior superiorSerratus posterior inferiorThey are superficial respiratory muscles andare supplied by intercostal nerves.
14Intermediate Extrinsic Back Muscles It is separated from the deep group by thoracolumbar fascia.It includes:Serratus posterior superior (rib elevator).Serratus posterior inferior (rib depressor).Nerve supply: anterior rami of thoracic spinal nerves.
15Intrinsic Muscles of the Back Called muscles of the back proper.Deep muscles of the back.All are supplied by the posterior primary rami of spinal nerves.Act to maintain posture and control movement of the vertebral column.
16Intrinsic Muscles of the Back 1. Superficial intrinsic back muscles: Splenius cervices & splenius capitis N.S: Posterior rami of spinal nerves. Actions: Acting alone; laterally flex neck & rotate head to side of active muscle. Acting together; extend head & neck.
17Superficial Intrinsic Back Muscles Splenius cervices&splenius capitis
192. Intermediate intrinsic back muscles: Erector spinae is the chief extensor of the vertebral column & is divided into three columns (also called as the long muscle of the back).Ilio-costalis (forms lateral column)Longissimus (forms intermediate column)Spinalis (forms medial column)
20They extend from sacrum to skull. They include extensors and rotators of head & vertebral column.Their tone is responsible for maintenance of normal curvature of vertebral column.
21Intrinsic Muscles of the Back N.S: Posterior rami of spinal nervesActions: Acting bilaterally, extend head & neckfrom a position of flexion.Acting unilaterally, laterally flex vertebralcolumn.
23Intrinsic Muscles of the Back 3. Deep intrinsic back muscles:This is a group of muscles that lie deep to erector Spinae.It can be divided into two groups:Major deep layerMinor deep layer
24Deep Intrinsic Muscles of the Back 1-Major deep layerTransversospinal group consist of semispinalis, multifidus & rotators.N.S:Posterior rami of spinal nerves.Actions: Extension and stabilization of vertebral column.
25Deep Intrinsic Back Muscles Transversospinal group(semispinalis, multifidus & rotators)
26Deep Intrinsic Muscles of the Back 2- Minor deep layerInterspinalesIntertransversariiLevatores costarumN.S: Posterior rami of spinal nervesActions: Extension, rotation, lateral flexion and stabilization of vertebral column.
29MUSCULAR TRIANGLES OF BACK Auscultatory Triangle:Boundaries: latissimus dorsi, trapezius, and medial border of scapula.Site where breath sounds are most easily heard with a stethoscope.Lumbar Triangle: (Triangle of Petit)Boundaries : latissimus dorsi, posterior border of external oblique muscle of the abdomen, and iliac crest.Site of an abdominal hernia; or where pus may emerge from the abdominal wall.
30Muscles of the back are organized in layers Extrinsic: Movements of upper limb and respiration.1st layer: TrapeziusLatissimus Dorsi2nd layer: Levator ScapulaeRhomboids (minor & major)3rd layer: Serratus posterior (superior & inferior)Intrinsic: Act on vertebral column and neck.1st layer: Splenius2nd layer: Erector Spinae: IliocostalisLongissimusSpinalis3rd layer: Transversospinal: MultifidusRotatoresSemispinalis