Anatomy of Muscles of the back

Dr David KAKIZIMANA
 Muscles of the back
• There are two major groups : Extrinsic and
intrinsic
• The extrinsic back muscles: superficial muscles
(control limbs mvt) and intermediate muscles
(respiratory movements)
• The intrinsic (deep) back muscles: specifically
act on the vertebral column, producing its
movements and maintaining posture.
 Extrinsic Back Muscles
• The superficial extrinsic back muscles:
 trapezius,
 latissimus dorsi,
 levator scapulae,
 rhomboids majaor and minor

• connect the upper limbs to the trunk and produce and control

limb movements

• nerve supply: anterior rami of cervical spinal nerves

• Trapezius m. : spinal accessory nerve (CN XI).

 SUPERFICIAL EXTRINSIC BACK MUSCLES
MUSCLE PROXIMAL DISTAL ATTACHMENT INNERVATION MAIN ACTIONS
ATTACHMENT (ORIGIN) (INSERTION)
Trapezius Medial third of superior Lateral third of clavicle, Spinal root of accessory Elevates, retracts, and
nuchal line; external acromion, and spine of nerve (cranial nerve XI) rotates scapula;
occipital protuberance, scapula and cervical nerves (C3 superior fibers elevate,
ligamentum nuchae, and C4) middle fibers retract,
and spinous processes and inferior fibers
of C7-T12 depress scapula
Latissimus dorsi Spinous processes of Intertubercular groove Thoracodorsal nerve Extends, adducts, and
T7-T12, thoracolumbar of humerus branch of brachial medially rotates
fascia, iliac crest, and plexus humerus at shoulder
inferior three or four
ribs
Levator scapulae Transverse processes of Superior part of medial Dorsal scapular and Elevates scapula and
C1-C4 border of scapula cervical (C4, C5) nerves, tilts its glenoid cavity
branch of brachial inferiorly by rotating
plexus scapula
Rhomboid minor Minor: ligamentum Medial border of Dorsal scapular Retracts scapula and
and major nuchae and spinous scapula from level of nerve, branch of rotates it to depress
processes of C7 and spine to inferior brachial plexus glenoid cavity; fixes
T1 angle scapula to thoracic
Major: spinous wall
processes of T2-T5
SUPERFICIAL EXTRINSIC
BACK MUSCLES
INTERMEDIATE EXTRINSIC BACK MUSCLES

• serratus posterior (superior and inferior)

• thin muscles

• commonly designated superficial respiratory muscles, but

are more likely proprioceptive rather than motor in function

• The serratus posterior superior lies deep to the rhomboids,

• The serratus posterior inferior lies deep to the latissimus

dorsi
INTERMEDIATE
EXTRINSIC BACK
MUSCLES
 INTERMEDIATE EXTRINSIC BACK MUSCLES

MUSCLE PROXIMAL DISTAL INNERVATION MAIN ACTIONS

ATTACHMENT ATTACHMENT
(ORIGIN) (INSERTION)
Serratus Ligamentum Superior border T1-T4 posterior Elevates ribs
posterior nuchae and ribs 2–4 rami
superior spinous processes
of C7-T3
Serratus Spinous processes Inferior border T9-T12 posterior Depresses ribs
posterior of T11-L2 ribs 9–12 rami
inferior
 INTRINSIC BACK MUSCLES
• muscles of back proper

• grouped into superficial, intermediate, and deep layers

• extend from the pelvis to the cranium

• enclosed by deep fascia

• The thoracic and lumbar parts of the deep fascia constitute the

thoracolumbar fascia. thiner in the thoracic region and stronger and

thicker in the lumbar region

• innervated by the posterior rami of spinal nerves

• act to maintain posture and control movements of the vertebral column

 SUPERFICIAL LAYER OF INTRINSIC BACK
MUSCLES
• The splenius muscles: (captis and cervicis)

• thick and flat

• lie on the lateral and posterior aspects of the neck, covering the vertical

muscles somewhat like a bandage

• splenius capitis: arise from the midline extend superolaterally to and

cranium

• splenius cervicis: arise from the midline and extend superolaterally to the

cervical vertebrae

• The splenii cover and hold the deep neck muscles in position.
 SUPERFICIAL LAYER OF INTRINSIC BACK
MUSCLES
MUSCLE PROXIMAL DISTAL INNERVATION MAIN ACTIONS
ATTACHMENT ATTACHMENT
(ORIGIN) (INSERTION)
Splenius capitis Nuchal ligament Mastoid process Posterior rami of Bilaterally:
and spinous of temporal bone the Middle extends head
process C7-T3 and lateral third cervical nerves Unilaterally:
of superior nuchal laterally bends
line (flexes) and
rotates face to
same side
Splenius cervicis Spinous process Transverse Posterior ramis of Bilaterally:
T3-T6 process (C1-C3) the Lower cervical extends neck
nerves Unilaterally:
laterally bends
(flexes) and
rotates neck
toward same side
SUPERFICIAL LAYER OF
INTRINSIC BACK
MUSCLES
 INTERMEDIATE LAYER OF INTRINSIC BACK
MUSCLES
• erector spinae muscle a.k.a long muscles of the back

• lie in a “groove” between the spinous processes centrally and

the angles of the ribs laterally .

• is the chief extensor of the vertebral column and is divided

into three columns:

• the spinalis forms the medial column,

• the longissimus forms the intermediate column,

• The iliocostalis forms the lateral column.

 INTERMEDIATE LAYER OF INTRINSIC BACK
MUSCLES
• Each column is divided regionally into three parts according to

the superior attachments (e.g: iliocostalis lumborum, iliocostalis thoracis,

and iliocostalis cervicis)

• The common origin is through a broad tendon that attaches

inferiorly to the posterior part of the iliac crest, the posterior

aspect of the sacrum, the sacroiliac ligaments, and the sacral

and inferior lumbar spinous processes.

• They act bilaterally to extend the flexed trunk

INTERMEDIATE LAYER
OF INTRINSIC BACK
MUSCLES
 INTERMEDIATE LAYER OF INTRINSIC BACK
MUSCLES

MUSCLE PROXIMAL DISTAL INNERVATION MAIN ACTIONS

ATTACHMENT ATTACHMENT
(ORIGIN) (INSERTION)
Erector spinae Posterior sacrum, iliac Ilicostalis: angles of Respective spinal Extend and laterally
crest, sacros-pinous lower ribs and cervical nerves of each region bend vertebral column
ligament, supra-spinous transverse processes and head
ligament, and spinous Longissimus: between
processes of lower tubercles and angles of
lumbar and median ribs, transverse
crests of sacrum -- processes of thoracic
broad thoraco-lumbar and cervical vertebrae,
fascia mastoid process
Spinalis: spinous
processes of upper
thoracic and
midcervical vertebrae
 Deep Layer of Intrinsic Back Muscles

• transversospinal muscle group: consisting of the semispinalis,

multifidus, and rotatores.
• These muscles originate from transverse processes of
vertebrae and pass to spinous processes of more superior
vertebrae.
• They occupy the “gutter” between the transverse and the
spinous processes and are attached to these processes, the
laminae between them, and the ligaments linking them
together
 Deep Layer of Intrinsic Back Muscles
• The Semispinalis m.: the superficial member of the transversospinal mm

group.

• arises from approximately half of the vertebral column

• It is divided into three parts according to the superior attachments:

semispinalis capitis, semispinalis cervicis, and semispinalis thoracis.

• The multifidus m.: the middle layer of the transversospinal mm group

• consists of short, triangular muscular bundles that are thickest in the

lumbar region

• The rotatores, or rotator muscles: the deepest layer of transversospinal

 DEEP LAYER OF INTRINSIC BACK MUSCLES

Transversospinal muscle group

PROXIMAL DISTAL
ATTACHMENT ATTACHMENT
MUSCLE (ORIGIN) (INSERTION) INNERVATION * MAIN ACTIONS
Semispinalis Transverse processes Spinous processes of Respective spinal Extends head, neck,
C4-T12 cervical and thoracic nerves of each and thorax and
regions region rotates them to
opposite side
Multifidi Sacrum, ilium, and Spinous processes of Respective spinal Stabilizes spine
transverse processes vertebrae above, nerves of each during local
of T1-T12 and spanning two to four region movements
articular processes segments
of C4-C7
Rotatores Transverse processes Lamina and Respective spinal Stabilize, extend,
transverse process nerves of each and rotate spine
or spine above, region
spanning one or two
segments
DEEP LAYER OF INTRINSIC BACK MUSCLES

• minor deep back muscles: the interspinal,

intertransverse and elevators of ribs
• poorly developed in the thoracic region.

• The interspinal and intertransverse muscles connect

spinous and transverse processes, respectively.
• The elevators of the ribs represent the posterior
intertransverse muscles of the neck.
 DEEP LAYER OF INTRINSIC BACK MUSCLES

Minor deep back muscles

PROXIMAL DISTAL ATTACHMENT
MUSCLE ATTACHMENT (ORIGIN) (INSERTION) INNERVATION MAIN ACTIONS
Interspinales Superior surfaces of Inferior surfaces of Posterior rami of Aid in extension and
spinous processes of spinous processes of spinal nerves rotation of vertebral
cervical and lumbar vertebra superior to column
vertebrae vertebra of origin
Intertransversarii Transverse processes Transverse processes Posterior and Aid in lateral flexion
of cervical and of adjacent anterior rami of of vertebral column;
lumbar vertebrae vertebrae spinal nerves acting bilaterally,
stabilize vertebral
column
Levatores Tips of transverse Pass inferolaterally Posterior rami of C8- Elevate ribs, assisting
costarum processes of C7 and and insert on rib T11 spinal nerves respiration; assist
T1-T11 vertebrae between tubercle with lateral flexion of
and angle vertebral column
DEEP LAYERS OF INTRINSIC BACK
MUSCLES
 Suboccipital and Deep Neck Muscles

• The suboccipital region: the superior part of the posterior cervical

region, is the triangular area inferior to the occipital region of the
head, including the posterior aspects of vertebrae C1 and C2.

• 4 small muscles of the suboccipital region lie deep to the

trapezius and semispinalis capitis muscles

• major and minor rectus capitis posterior

• Superior and inferior obliquus capitis muscles.

• Innervation: suboccipital nerve (the posterior ramus of C1).

 SUBOCCIPITAL MUSCLES

Muscle Origin Insertion

Rectus capitis posterior Spinous process of vertebra Lateral part of inferior nuchal
major C2 line of occipital bone

Rectus capitis posterior Posterior tubercle of Medial part of inferior nuchal

minor posterior arch of vertebra C1 line of occipital bone

Inferior oblique of head (L. Spinous process of vertebra Transverse process of

m. obliquus capitis inferior) C2 vertebra C1

Superior oblique of head (L. Transverse process of Occipital bone between

m. obliquus capitis superior) vertebra C1 superior and inferior nuchal
lines
SUBOCCIPITAL
MUSCLES
SUBOCCIPITAL MUSCLES
 1

11 2
3
4

12 7
8
9
13

10