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)

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)

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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