DEEP BACK MUSCLES

Deep Back Muscles

Epaxial muscles. Hypaxial muscles. Pharyngeal arch muscles.

Cutaneous Nerves of the Back

Along either side of the midline of the back:

Innervated by dorsal (posterior) rami of thoracic spinal nerves.

More laterally:
Innervated by lateral cutaneous branches of the intercostal nerves.

Thoracolumbar Fascia
Triangular-shaped sheet of tough connective tissue. Partial site of origin of latissimus dorsi and abdominal oblique muscles.

Thoracolumbar Fascia Laminae

Posterior lamina to lumbar spinous processes. Middle lamina to lumbar transverse processes. Anterior lamina (deepest) to lumbar transverse processes.

Arrangement of Back Muscles

Three groups:
Superficial:
Extrinsic.

Intermediate:
Extrinsic.

Deep:
Intrinsic.

Superficial Extrinsic Muscles

Connect limb to axial skeleton. Innervated by ventral rami or CN XI. Include:

Trapezius. Latissimus dorsi. Levator scapulae. Rhomboideus major. Rhomboideus minor.

Intermediate Extrinsic Muscles

Respiratory muscles. Innervated by ventral (anterior) rami. Serratus posterior group:

Serratus posterior superior. Serratus posterior inferior.

Refer to Syllabus: Table II, p. 71.

INTRINSIC (DEEP) BACK MUSCLES

Intrinsic Back Muscles

True intrinsic muscles of the back are innervated by dorsal (posterior) rami. Three groups:

Superficial Intermediate Deep

Refer to Table III, p 73 of Syllabus.

Spinotransversalis System
Consists of the Splenius group: Long muscles. Originate from ligamentum nuchae and spinous processes.

Spinotransversalis System
Run laterally upward to transverse processes and skull. Run laterally and upward to insertion. Two parts:

Splenius capitis. Splenius cervicis.

Superficial Intrinsic Muscles

Splenius capitis:
O: I:

spinous processes of C7 and T1-4. superior nuchal line and mastoid.

spinous processes of T3-6. C1-C4 transverse processes with levator scapulae.

Splenius cervicis:
O: I:

Spinotransversalis System

Intermediate Intrinsic

Sacrospinalis system:
Erector spinae. Run longitudinally upward:
Transverse processes to rib. Rib to rib. Rib to cervical transverse processes. Spinous processes to spinous processes.

Intermediate Layer of Intrinsic Deep Back Muscles

Components:
Iliocostalis. Longissimus. Spinalis.

Refer to Syllabus:
Table III. P 73.

Intermediate Intrinsic

Iliocostalis:
Origin = ilium and sacrum. Insertion = most of the ribs. Lateral part of the erector spinae group. Extends back; keeps erect posture. Components:
Lumborum. Thoracis. Cervicis.

Intermediate Intrinsic

Longissimus:
Origin = transversus processes and sacrum. Insertion = most of ribs. Middle portion of erector spinae group. Components:
Thoracis. Cervicis. Capitis.

Intermediate Intrinsic

Spinalis:
Origin = spinous processes of T11-L2. Insertion = spinous processes of thoracic and lower cervical vertebrae. Components:
Thoracis. Cervicis:
Usually absent.

Capitis:
Part of semispinalis capitis.

Deep Intrinsic Muscles

Transversospinalis system:
From transverse processes to transverse processes. Concealed by erector spinae. Muscles arise laterally and insert medially. Components:
Semispinalis. Multifidus. Rotatores.

Semispinalis
Traverse a couple of vertebral levels. Components:

Thoracis. Cervicis.
Origin = T1-4. Insertion = C3-5. Largely covered by semispinalis capitis.

Semispinalis

Components:
Capitis:
Origin = Insertion = T1-6 and C4-7. between superior and inferior nuchal lines.

Multifidus
Thick muscle mass. Arises from sacrum and surrounding structures and from transverse processes up to C4.

Including mammillary processes of lumbar vertebrae.

Traverses 3 segments. Inserts on spinous processes C2-L5.

Rotatores
Pass from root of transverse process to root of superior spinous process. Long:

Span two segments.

Short:
Span one segment.

Intrinsic Segmental Muscles

Interspinales. Intertransversarii.