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The Back Region: Regional and Clinical Anatomy For Physical Therapy Students

This document provides an overview of the back region and its muscles. It begins by defining the back and dividing it into six regions. It then discusses reasons for studying the back, including the presence of the spinal cord. The document outlines the extrinsic and intrinsic muscles of the back. For the extrinsic muscles, it describes the trapezius, latissimus dorsi, levator scapulae, rhomboid major, and rhomboid minor muscles. For the intrinsic muscles, it discusses the erector spinae group including the longissimus and iliocostalis muscles and the transversospinalis group including the semispinalis, multifidus, and rotatores muscles

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28 views47 pages

The Back Region: Regional and Clinical Anatomy For Physical Therapy Students

This document provides an overview of the back region and its muscles. It begins by defining the back and dividing it into six regions. It then discusses reasons for studying the back, including the presence of the spinal cord. The document outlines the extrinsic and intrinsic muscles of the back. For the extrinsic muscles, it describes the trapezius, latissimus dorsi, levator scapulae, rhomboid major, and rhomboid minor muscles. For the intrinsic muscles, it discusses the erector spinae group including the longissimus and iliocostalis muscles and the transversospinalis group including the semispinalis, multifidus, and rotatores muscles

Uploaded by

유한민
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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THE BACK REGION

REGIONAL AND CLINICAL ANATOMY FOR


PHYSICAL THERAPY STUDENTS
CLINICAL
ANATOMY: THE
BACK
 THE BACK
 DEFINITION:
- Posterior aspect of
the trunk inferior to
the neck and superior
to the gluteal region
(buttocks)
-region of the body to
which the head, neck
and limbs are
attached.
CLINICAL ANATOMY: THE BACK

REGIONS OF THE
BACK:
1. Posterior
cervical region
2. Scapular region
3. Vertebral region
4. Subscapular
region
5. Lumbar region
6. Sacral region
CLINICAL ANATOMY: THE BACK
CLINICAL ANATOMY:
THE BACK

 REASONS FOR
STUDYING THE BACK
 PRESENCE OF THE
SPINAL CORD
 BACK: A SOLID
MUSCULO-OSSEOUS
SHIELD
CLINICAL ANATOMY: THE BACK
 REASONS FOR STUDYING
THE BACK
 SPINAL CORD: AUTONOMIC
NERVOUS SYSTEM
CLINICAL
ANATOMY: THE
BACK
 REASONS FOR
STUDYING THE BACK
 BACK PAIN
CLINICAL
ANATOMY: THE
BACK

 REASONS FOR STUDYING


THE BACK
-LOW BACK PAIN
CLINICAL ANATOMY: THE
BACK
CLINICAL ANATOMY:
THE BACK
COURSE
INTRODUCTION
CLINICAL ANATOMY: THE
BACK
COURSE INTRODUCTION
CLINICAL ANATOMY
THE BACK
MUSCLES OF THE BACK
CLINICAL ANATOMY: THE BACK
MUSCLES OF THE BACK
 MUSCLES OF THE BACK
1. Types/Groupings
-Extrinsic muscles
-Intrinsic muscles
2. Muscle group arrangement
- acdg. to functions
Extrinsic muscles- for the upper limbs
for respiratory functions
Intrinsic muscles- for stability and support of
vertebral column
CLINICAL ANATOMY: THE BACK
MUSCLES OF THE BACK
 EXTRINSIC MUSCLES
-Arranged in Layers
1. First layer
-Trapezius muscle
-Latissimus Dorsi
2. Second layer
-Levator scapulae
-Rhomboid major
-Rhomboid minor
3. Third layer
-Serratus posterior superior
-Serratus posterior inferior
CLINICAL ANATOMY: THE BACK
MUSCLES OF THE BACK
 MUSCLES OF THE BACK
-INNERVATIONS
a. Extrinsic Muscles: from the anterior (or
ventral) rami of the cervical nerves
b. Intrinsic Muscles: from posterior rami
(or dorsal) rami of the cervical and thoracic
nerves.
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES
 THE FIRST LAYER SUPERFICIAL
EXTRINSIC BACK MUSCLES
 1. TRAPEZIUS MUSCLE:
a. Description
b. Origin
c. Insertion
d. Function
-Acting with the Levator
scapula
-Acting with Serratus anterior
muscle
-Acting with the Rhomboids
-With shoulder fixed
e. Relationship to other
structures
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES
 LATISSIMUS DORSI
A. Description
-flat, broad muscle
B. Origin
-6 inferior thoracic vertebrae
-posterior layer of lumbar fascia
-spines of lumbar and thoracic
vertebrae and supraspinous ligament
-external lip of iliac crest
-lower 4 ribs
C. Insertion- humerus
D. Actions: 1. On humerus
2. Acting with the sternocostal part
of Pectoralis major muscle and Teres
major muscle
3. Acting on violent expiratory
movement
-Triangle of Auscultation
-triangle of Petit
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES
 STRUCTURES
VISUALIZED:
 1. lumbodorsal
(thoracolumbar fascia)
 Iliac Crest

 External Oblique
muscle
 Triangle of Petit
LEVATOR SCAPULA:
A. Origin:
-transverse process of
the Atlas
- tubercles of the
transverse process of C2,
C3, C4
B. Insertion : Posterior
border of the scapula
C. Innervation:
-Directly by anterior
rami C3-C4 cervical nerves
-Indirectly by nerves
from C5 through the Dorsal
scapular nerve
D. Action: together with
Trapezius and the
rhomboids

REGIONAL AND CLINICAL ANATOMY: THE BACK MUSCLES


REGIONAL AND
CLINICAL ANATOMY:
THE BACK MUSCLES
THE RHOMBOIDS:
A. Rhomboid minor
1. Origin:
-Ligamentum nuchae
-Spinous processes of C7
and T1.
2. Insertion: Triangular
smooth surface area at
the root of the spine of the
scapula.
3. Innervation: Same as the
Levator scapulae:
-directly:C3 and C4
- indirectly: C5 through the
Dorsal scapular nerve.
4. Actions: 1, Position and
movement of scapula
RHOMBOID MAJOR
MUSCLE
A. Origin:
1 Spinous processes
of T4 and T5
2. Corresponding
supraspinous ligament
B. Insertion: just below
the Rhomboid minor
insertion; along the
vertebral border to the
inferior angle of the
scapula.

REGIONAL AND CLINICAL ANATOMY: THE BACK MUSCLES


 SECOND LAYER OF SUPERFICIAL
EXTRINSIC BACK MUSCLES
LEVATOR SCAPULAE
-RHOMBOIDEUS MAJOR
-RHOMBOIDEUS MINOR

ACTIONS:
> Acting with other muscles that attach
to the scapula: help to control the position
And movement of the shoulder
> Acting with Pectoralis minor
> Acting with the Trapezius
> When the cervical part of the vertebral
Column is fixed, and acting with the Trapezius
As in carrying weight on the shouder
REGIONAL AND
CLINICAL ANATOMY
THE BACK MUSCLES

MUSCLE
ATTACHMENTS TO
THE SCAPULA
-Areas in red: Origin
-Areas in blue:
Insertion
A. Areas of insertion
for the ff. muscles:
-Levator scapulae
-Rhomboid minor
-Rhomboid major
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES

 3RD LAYER OF
SUPERFICIAL
EXTRINSIC MUSCLES
OF THE BACK
-SERRATUS POSTERIOR
SUPERIOR
-SERRATUS POSTERIOR
INFERIOR
THIRD LAYER OF EXTRINSIC
MUSCLES OF THE BACK
A. Serratus Posterior Superior
1. Origin:
a. Ligamentum nuchae
b. Spinous processes of C7
and the T1 to T3
2. Insertion: ribs 2-5
B. Serratus Posterior Inferior
1. Origin: by aponeurosis from
the spinous process of T12 to L3
and the corresponding
supraspinous ligaments
2. Insertion: by fleshy digitations
to the lower borders of the lower 4
ribs
REGIONAL AND
CLINICAL ANATOMY: THE
BACK MUSCLES
OTHER CHARACTERISTICS OF THE
INTRINSIC BACK MUSCLES.
1. Extend from the pelvis to the
cranium
2. Each muscle is invested
individually by the deep fascia
3. Medial attachments:
a. Ligamentum nuchae
b. tips of the spinous processes of
the vertebral column
c. Supraspinous ligament
d. Median crest of the sacrum
4. Lateral attachments:
a. Transverse processes of the
vertebrae
b. Angles of the ribs
REGIONAL AND CLINICAL
ANATOMY
THE BACK MUSCLES

LIGAMENTUM
NUCHAE
-Extension of the
supraspinous
ligament in the
cervical region
-Provides
attachment to the
ff. muscles: the
Trapezius, THE LIGAMENTUM NUCHAE
Splenius
CLINICAL ANATOMY: THE BACK
THE INTRINSIC BACK MUSCLES
CLINICAL ANATOMY: THE BACK
THE INTRINSIC BACK MUSCLES
ERECTOR SPINAE MUSCLES LONGISSIMUS

 LONGISSIMUS MUSCLE

CLINICAL ANATOMY: THE BACK


INTRINSIC BACK MUSCLES
CLINICAL ANATOMY: THE BACK
THE BACK MUSCLES
THE TRANSVERSO-SPINALIS MUSCLES IN
RELATION TO THE ERECTOR SPINAE TRANSVERSO-SPINAL MUSCLES

 Arranged in layers
1st layer: Semispinalis
2nd layer: Multifidus
3rd layer: Rotatores
-known as “gutter muscles”
-Obliquely oriented muscles
- Origin: transverse processes of
the inferior vertebra
- Insertion: Spinous processes of
the superior vertebra

CLINICAL ANATOMY: THE BACK


INTRINSIC BACK MUSCLES
CLINICAL ANATOMY: THE BACK
INTRINSIC BACK MUSCLES
 TRANSVERSO-SPINALIS
MUSCLES
 The Semispinalis muscles
-Semispinalis capitis
Responsible for the
bulge at each side of the
posterior neck near the
median plane
-Semispinalis cervicis
-Semispinalis thoracis
CLINICAL ANATOMY: THE BACK
INTRINSIC BACK MUSCLES
TRANSVERSO-SPINAL MUSCLES THE ROTATORES

THE ROTATORES
-Deepest of the transverso-
spinal muscles
- Consist of two bundles: the
Rotatores longus and Rotatores
brevis
-Best developed in thoracic
vertebrae
-Originate from the transverse
process of one vertebra below
- Insertion: root of the spinous
process of the vertebra above.
CLINICAL ANATOMY: THE BACK
THE INTRINSIC BACK MUSCLES
THANK YOU FOR YOUR
KIND ATTENTION!!!
CLINICAL ANATOMY: THE BACK
MUSCLES OF THE BACK

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