1. Deep Back and Suboccipital Triangle

2. Objectives:
Describe the structure, attachments, function and support of:
splenius capitus and cervicis
erector spinae
transversospinal group
intersegmental group
Describe the attachments, actions and support of the suboccipital muscles.
Describe the boundaries, contents and relationships of the suboccipital triangle.

3. Thoracolumbar Fascia The thoracolumbar fascia:
surrounds the deep muscles of the back
superiorly, continuous with deep fascia of the neck
“deep” to serratus posterior muscles
medially, attaches to the spines of the vertebrae
laterally, attaches to the transverse processes
inferiorly, attaches to lower border of 12th rib and iliac crest
Deep back muscles do not move limbs. They are intrinsic muscles, only move the vertebral column.

4. Thoracolumbar Fascia
(trans. Section through trunk)

5. Deep Back Muscles and Innervation

6. Rotation of Vertebrae
Rotation refers to the direction the body is moving.

8. Splenius Cervicis: Splenius Capitis: Attachments: Action: Innervation:
Splenius= bandage (flat)

9. Splenius Cervicis & Capitis

10. Erector Spinae Spinalis Longissimus Iliocostalis
Mnemonic: “ I Love Spaghetti”... Spinalis- attachment is spine to spine for spinalis muscles. Depending where muscles attach, get named specifically (i.e. spinalis thoracis)… Longissimus muscles-think transverse process. Starts at saccrum, attach at trans. Processes. Attaches in diff. regions, and named as such. Iliocostalis- comes off ileum and attaches to the ribs. Lumborum muscles attaches to the ribs in the lumbar region of the spine….thoracis muscles attach to the ribs in the thoracis region of the spine. No ribs in the cervical region…so no iliocostalis cervicis muscles.

11. Erector Spinae

12. (SBL = side bend to the left…Rr = rotated to the right side)…
A 35-year-old male presents with the main complaint of lower back discomfort. Physical exam reveals that L1 – L4 are SBL and RR.
Dysfunction of what muscle is most likely responsible for this finding?
(SBL = side bend to the left…Rr = rotated to the right side)…
(SBL = side bend to the left…Rr = rotated to the right side)…

13. Transversospinal Group
Rotatores
Multifidus
Semispinalis

14. Transversospinal Group

16. Transversospinal Group

17. Intersegmental Muscles
Interspinales:
Intertransversarii:

18. Intersegmental Muscles
Intertransversarii: in the thoracic region intertransversarii are modified to form the levator costarum

19. Suboccipital Muscles situated deep to semispinalis capitis
Rectus capitis posterior major
Rectus capitis posterior minor
Obliquus capitis inferior
Obliquus capitis superior

20. Contents of the Suboccipital Triangle

21. Contents of the Suboccipital Triangle
Left side: note the Greater Occipital Nerve piercing the spinalis capitis nerve.

22. Greater occipital nerve (C2) runs through the semispinalis capitis muscle and underneath the inferior oblique muscle. Greater occipital nerve terminates over the scalp.