Transcript Gross Anatomy: Deep Back

Gross Anatomy:
Deep Back
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
Thoracolumbar Fascia
Deep Back Muscles and Innervation
Rotation of Vertebrae
Spinotransversales
Splenius Cervicis:
Attachments:
Splenius Capitis:
Attachments:
What is the action of these muscles?
Innervation?
Patient of yours has tightness in left splenius capitus. How do you
“stretch” the muscle?
Spinotransversales
Erector Spinae
Spinalis- attached to just spinous processes
(red)
thoracis
cervicis
capitis
Longissimus- begins at sacrum and attaches to
transverse processes (blue) some go to
mastoid on skull
thoracis
cervicis
capitis
Iliocostalis- arises from iliac crest. Second
attachment is two ribs and goes up ribs.
Connects to cervical transverse processes
lumborum
thoracis
cervicis
What is the collective action of both
erector spinae acting together?
A. Extension
B. Flexion
C. Rotation
D. Side bending
Erector Spinae
A 35-year-old male presents with the main complaint of
upper back discomfort. Physical exam reveals that T3 –
T8 vertebra are SL [side-bent left] and RR [rotated right].
How can you tell?
What muscle is most likely responsible for this finding?
***This is an example of Type 1 Somatic Dysfunction***
Transversospinal Group
Rotatores-shortest muscles. Span only 1-2
segments. Extend the entire vertebral
column and are most developed in the
thoracic region. Start on a transverse
process and go up to the spinous process
above it. Probably for proprioception.
Multifidus- 2 to 4 segments. Goes up entire
column but best developed in lumbar
region
Semispinalis- 3 to 5 segments. In thoracic and
cervical. Also capitis. Some go to skull
Transversospinal Group
Transversospinal Group
Intersegmental Muscles
Interspinales:
Intertransversarii:
Intersegmental Muscles
Intertransversarii: in the thoracic region
intertransversarii are modified to form
the levator costarum
A 47-year-old male presents with the main complaint of
lower back pain. Physical exam reveals that L1 – L2
vertebra are SL [side-bent left] and RL [rotated left].
What muscle is most likely responsible for this finding?
***This is an example of Type 2 Somatic Dysfunction***
Suboccipital Muscles
• situated deep to semispinalis
capitis
Rectus capitis posterior major
Rectus capitis posterior minor
Obliquus capitis inferior
Obliquus capitis superior
A 25-year-old female presents
with the chief complaint of
tightness in her neck and pain
in the area indicated to the left.
What nerve is most likely
affected?
A. C1, posterior ramus
B. C2, posterior ramus
C. C1 spinal nerve
D. C1, anterior ramus
E. C2, anterior ramus
Contents of the Suboccipital Triangle