Muscles of the back

D. Mumba BSc Hb. Unza

 Skin & fasciae of the back
• The skin is thick & fixed to the
underlying fasciae
• Superficial fascia contain variable
amount of fat, is thick & strong &
connected to the overlying skin by C.T
• Deep fascia is dense in texture
• Sensory supply to the skin of the back
is the posterior rami of the spinal
nerves
• 1st & 8th cervical nerves don’t supply the
skin
 Muscles
• Muscles connecting the upper limb to
the back are
1. Trapezius
2. latissimus dorsi
3. Levator scapulae
4. Rhomboideus major (rhomboid major)
5. Rhomboideus minor (rhomboid Minor)
1. Trapezius
• Origin
I. medial 1/3 of superior nuchal line
II.External protuberance
III. ligamentum nuchae
IV. C7
V. T1-T12 spines
VI.Corresponding supraspinous lig
• Insertion
I. Upper fibers into the posterior border
of the lateral 1/3 of the clavicle
II.Middle fibers- into the acromion & the
upper border of the spine of the
scapular
III.Lower fibers- into the medial end of
the spine of scapula
• Nerve supply
I. Motor fibers from spinal part of the
accessory nerve (CN 11)
II.Sensory from cervical nerves 3 &4
• Action
I. Upper fibers act with the levator scapulae &
elevate the scapula
II.Middle fibers act with rhomboideus & retract
the scapula
III.Upper & lower fibers act with the serratus
ant. & rotate the scapula forward round the
chest wall. This is important in abduction of
the arm beyond 90º
IV.Stead's the scapula
2. Latissimus dorsi
• Origin
I. Posterior 1/3 of the outer lip of iliac
crest
II.Posterior layer of the lumbar fascia
III.Spines of T7- T12
IV.Lower 4 ribs
V. Inferior angle of the scapula
• Insertion
I. Muscle winds around the lower border
of the teres major & forms the post
fold of the axilla.
II.The tendon is twisted upside down & is
inserted into the floor of the
interbercular sulcus
• Nerve supply
I. Thoracodorsal nerve (C6, C7, C8)
• Action
I. Adduction, extension & medial rotation
of the shoulder as in swimming, rowing,
climbing, pulling, folding the arms behind
the back
II.Helps in violent expiration efforts-
coughing, sneezing
III.Essentially a climbing muscle
IV.Hold inferior angle of scapula in place
3. levator scapulae
• Origin
I. Transverse processes of C1,C2
II.Posterior tubercle of the transverse
processes of C3, C4
• Insertion
I. Superior angle & upper part of the
medial border of the scapula

• Nerve supply
I. A branch from the dorsal scapular
nerve (C5)
II.C3,C4 branches are proprioceptive
• Action
I. Helps in the elevation of the scapula
II.Steadies the scapula during movements
of the arm
4. Rhomboid minor
• Origin
I. Lower part of the ligamentum nachae
II.C7 & T1

• Insertion
 base of the triangular area at the
root of the spine of the scapula
• Nerve supply
 Dorsal scapular nerve

• Action
 Retract the scapular & steady it
5. Rhomboid major
• Origin
I. Spines of T2,T3,T4,T5
II.Supraspinous lig

• Insertion
 Medial border of the scapular below
the root of the spine
• Nerve supply
 Dorsal scapular nerve (C5)

• Action
 Retracts the scapula & steady it
• Triangle of auscultation
 Small interval bounded
i. medially by the lateral border of the
trapezius
ii. Laterally by the medial border of the scapula
iii. Inferiorly the upper border of the latissimus
dorsi
iv. The floor is formed by the 7th rib, 6th & 7
intercostal space & rhomboid major
v. The only part of the back not covered
by muscle
vi. Clinical importance- resp sounds are
better heard over this triangle on the
back
• Lumbar Triangle or petit
Another small triangle bounded
i. medially by the lateral border of the
latissimus dorsi
ii. Laterally by ,the posterior border of the
external oblique
iii. Inferiorly by the iliac crest
iv. Clinical importance- hernias occur here-
lumbar hernias