Anatomy Pcket

8/12/2019 Anatomy Pcket

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Brm Bruckmeier

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Anatomy

Sander, Schwarz


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6. Dorsal Trunk Wall130

6.1 General Facts

6.1.1 Regions of Dorsal Trunk Wall

6. Dorsal Trunk Wall

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1 Occipital region (d16)

2 Nuchal region/ posteriorcervical region

3 Vertebral region

4 Lateral cervical region

5 This is an area that has nospecific name. Here therhomboid muscles arelocated.

6 Deltoid region

7 Scapular region

8 Infrascapular region

9 Lumbal region

10 Lumbar triangle

11 Sacral region

12 Anal region

13 Gluteal region


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131Muscles, Vessels, Nerves

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6.2 Muscles, Vessels, Nerves

6.2.1 Superficial Musculature of Back

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1 Trapezius muscleIN:Accessory nerve (XI)O: Occipital bone, spinous

processes of the cervical andthoracic vertebrae, nuchalligament

I: Clavicle, acromion, scapularspine

F: The muscle is divided intothree parts: The superior,middle and inferior part.Each part has a differentdirection of pull, dependingon the lever it acts upon

2 Deltoid muscleIN:Axillary nerveO: Clavicle, acromion and

scapular spineI: Deltoid tuberosity of

humerusF: Ad- and Abduction, medial

and lateral rotation,swinging of the arm; themuscular subdivisions exertdifferent actions, dependingon their location relative tothe pivoting point

3 Latissimus dorsi muscleIN:Thoracodorsal nerveO: Spinous processes of

thoracic and lumbarvertebrae, sacral bone, iliaccrest, thoracolumbal fascia

I: Minor tubercular crestF: Adduction, medial rotation

of humerus

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6.2.2 Deep Musculature of Back I

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1 Deltoid muscle (d131)

2 Minor rhomboid muscleIN:Dorsal scapular nerveO: Spinous processes of C6 and C7

vertebraeI: Medial border of scapulaF: Co-acts with the major

rhomboid muscle, to pull thescapula towards the vertebral

column, thereby fixing it to thethoracic wall

3 Major rhomboid muscleIN:Same as minor rhomboid muscleO: Spinous processes T1-T4

vertebraeI: Caudal to the minor rhomboid

muscle at the medial scapularmargin

F: Same as minor rhomboid muscle

4 Trapezius muscle (severed)

5 Serratus posterior inferior (muscle)

6 Teres major (muscle) (d218)

7 Lumbosacral aponeurosis

8 Latissimus dorsi (muscle) (d131)

9 External oblique muscle ofabdomen (d118)


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6.2.3 Deep Musculature of Back II

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1 Splenius capitis (muscle)

2 Levator scapulae (muscle)

3 Serratus posterior superior(muscle)IN:Ventral branches of C8-T4

O: Spinous processes ofC6-T2

I: Ribs II-VF: Elevates the ribs II-V,

inspiration

4 Teres major (muscle)IN:Subscapular nerves or

thoracodorsal nerveO: Inferior angle and lateral

caudal border of scapula

I: Minor tubercular crestF: Adduction andmedial rotation of arm

5 Serratus posterior inferior(muscle)IN:Branches of T11-L2O: Spinous processes of

caudal thoracic andcranial lumbar vertebrae

I: Ribs IX-XIIF: Depresses the ribs IX-XII,

antagonist of thediaphragm

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6.2.4 Serratus Anterior (Muscle)

.1 Serratus anterior (muscle)IN:Long thoracic nerveO: Ribs I-IX, divided into

superior, middle and inferiorpart

I: Superior angle, medial

border and inferior angle ofscapula; the muscle runsventral to the subscapularmuscle below the shoulderblade; seen from the backthe sequence thereforewould be: Scapula subscapular muscle serratus anterior (muscle)

F: Rotation of the scapula(important for armmovement!), fixation of thescapula, may also act asaccessory respiratorymuscle, together with therhomboid muscle it forms amuscular sling (stability ofthe trunk).

For better visualization, the figure shows the muscle insertions located on the ventralside of the scapula, projected onto the dorsal side of the shoulder blade. The scapulais quasi transparent.


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6.2.5 Autochthonous Musculature of Back

Straight system Angular system

Medial column Interspinal straightsystem (d137)

Interspinal muscles

Spinal muscleIntertransverse muscle

Transversospinal angularsystem (d138)

Rotatores muscles

Multifidus muscleSemispinal muscles

Lateral column Intertransversalstraight system (d139)

Longissimus muscleIliocostalis muscle

Spinotransversal angularsystem (d140)

Splenius muscle

Those muscles of the back that are not shifted dorsally from other

locations during embryonic development, but instead remain at the siteof origin, are called autochthonous back muscles.

The muscle tracts that jointly form the erector muscle of spine,areinnervated by the dorsal branches of the spinal nerves (d95).

The remaining back muscles are innervated by the ventral branches.The autochthonous back musclessupport the vertebral columnthrough contraction, which builds up pressure within the osseofibroustunnel resulting in the stiffening of the skeletal axis. In addition itparticipates in all vertebral column movements.

A classification of the autochthonous back muscles follows below:

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6.2.6 Osseofibrous Tunnel

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1 Thoracolumbar fascia(posterior layer)

2 Erector muscle of spinewith medial and lateralcolumn

3 Quadrate lumbar muscle(d206)

4 Transverse muscleof abdomen (d120)

5 Psoas muscle (d206)

6 Thoracolumbar fascia(middle layer)

Shown above is a transverse section depicting the autochthonous back musculaturewithin the osseofibrous tunnel.This tunnel is formed by thethoracolumbar fascia,in conjunction with the spinous processes and ribs of the vertebrae. However, withinthe thoracic area of the spine, the autochthonous muscle fiber tracts are also incontact with the ribs.

The middle layer of the thoracolumbar fascia arises from the costal processes of thelumbar vertebrae. It extends between the ventrolateral and autochthonousmusculature. From this layer the internal oblique and transverse muscle of abdomenarise.

The posterior layer of the thoracolumbal fascia arises from the spinous processes, theiliac crest and from the costal angles. It projects cranially and continues into thenuchal fascia. The posterior and inferior serratus muscle and latissimus dorsi muscleproject from the posterior layer to reach their particular insertion points.


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xxzMedial Column Straight System

6.2.7 Medial Column Straight System

2a

1b3a

3b

1c

1a

2b3c

1 Spinalis (muscle) (skips at least 1 vertebra)- Spinalis capitis (muscle) (1a): Runs from

the spinous processes of the caudalcervical vertebrae to the superior nuchalline

- Spinalis cervicis (muscle) (1b): Runs fromthe spinous processes of the cranialthoracic vertebrae to the spinousprocesses of the medial cervicalvertebrae

- Spinalis thoracis (muscle) (1c): Runs fromthe spinous processes of the cranial

lumbar vertebrae to the spinousprocesses of the medial thoracicvertebrae

2 Intertransverse musclePosterior cervical intertransversemuscles(2a): Run between thetransverseprocesses of adjacent cervical vertebrae

Medial lumbar intertransverse muscles(2b): Run from the accessory processes ofa lumbar vertebra to the mamillaryprocesses of the next lumbar vertebrabelow

3 Interspinal muscleA distinction is drawn between: Cervical(3a), thoracic(3b) andlumbar (3c)interspinal muscles.

They run in pairs from the spinousprocesses of a vertebra to the spinousprocesses of the next adjacent vertebrawithout skipping a segment. Thesemuscles are not present in the medialthoracic area of the spine

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6.2.8 Medial Column Angular System

1a

1b

2

3

1c

1c 1c

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2

1 Semispinalis muscle(skips approximately 5 segments)- Semispinalis capitis (muscle)(1a):

Runs from the transverse processes ofthe caudal cervical and cranialthoracic vertebrae to the superior andinferior nuchal line

- Semispinalis cervicis (muscle)(1b):Runs from the transverse processes ofthe thoracic vertebrae to the spinousprocesses of higher lying thoracic and

cervical vertebrae- Semispinalis thoracis (muscle)(1c):Runs from the transverse processes ofthe lower thoracic vertebrae to thespineous processes of the upperthoracic vertebrae; 1b and 1c cannotbe distinguished from each other

2 Rotatores (muscles)The rotatores muscles are located inthe cervical, thoracic and lumbarareas. Distinguished are:Rotatores brevis muscles, which runbetween adjacent vertebrae, androtatores longus muscles, which skip1 segment each time. Originatingfrom transverse processes, therotatores muscles project to higherspinous processes

3 Multifidi muscles(skip up to 3 segments)

The multifidi muscles run just as therotatores muscles, but skip a largernumber of vertebrae.


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6.2.9 Lateral Column Straight System

1a

2a1b

2b

1c

2c

1 Longissimus muscle (medial from 2)- Longissimus capitis (muscle)(1a):

Projects from the transverseprocesses of the cervical andthoracic vertebrae to the mastoidprocess

- Longissimus cervicis (muscle)(1b): Projects from the transverseprocesses of the thoracic vertebrae

to the transverse processes of thecervical vertebrae

- Longissimus thoracis (muscle)(1c): Projects from the sacral boneand transverse processes of thelumbar vertebrae to all ribs and tothe transverse processes of thehigher lying lumbar and thoracicvertebrae

2 Iliocostalis (muscles)- Iliocostalis cervicis (muscle)(2a):

Projects from the cranial ribs to thetransverse processes of the medialcervical vertebrae

- Iliocostalis thoracis (muscle)(2b):Projects from the lower ribs to theupper ribs

- Iliocostalis lumborum (muscle)(2c): Projects from the sacral boneand the iliac crest to the caudal ribs

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6.2.10 Lateral Column Angular System

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1 Splenius capitis (muscle)Runs from the spinousprocesses of the cranialthoracic and cervicalvertebrae to the mastoid

process. Bends and rotatesthe head.

2 Splenius cervicis (muscle)Runs from the spinousprocesses of the cranialthoracic vertebrae to thetransverse processes of theatlas and axis. Bends androtates the cervical spine.


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6.2.11 Musculature of Back of Neck I

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1 Longissimus capitis(muscle)

2 Splenius capitis (muscle)(d140)

3 Greater occipital nerve(d143)

4 Lesser occipital nerve

(d

40)

5 Trapezius muscle (d131)

6 External jugular vein (d17)

7 Levator muscle of scapulaIN:Dorsal nerve of scapulaO: Transverse processes of the four cranial

cervical vertebraeI: Superior angle of

scapulaF: Pulls the scapula

toward medial andcranial

8 Lesser rhomboid muscle(d132)

9 Greater rhomboid muscle(d132)

10 Dorsal nerve of scapula(d35)

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6.2.12 Musculature of Back of Neck II

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1 Splenius capitis (muscle) (d140)2 Longissimus capitis (muscle) (d139)

3 Semispinalis capitis (muscle)(d138)

4 Rectus capitis posterior minor(muscle)IN:Suboccipital nerveO: Posterior tubercle of atlasI: Inferior nuchal lineF: Rotation and extension of the

head

5 Rectus capitis posterior major(muscle)IN:Suboccipital nerveO: Spinous processes of axisI: Inferior nuchal lineF: Same as No. 4

6 Longissimus capitis (muscle)

7 Semispinalis capitis (muscle)

8 Multifidi (muscles) (d138)

9 Interspinales cervicis (muscles)(d137)

10 Semispinalis cervicis (muscles)

11 Supraspinal ligaments

12 Semispinalis thoracis (muscle)

13 Longissimus cervicis (muscle)

14 Iliocostalis cervicis (muscle)

The short muscles of back of neck consist of: Superior oblique muscle of head,inferior oblique muscle of head, rectus capitis posterior minor (muscle), rectus capitisposterior major (muscle) and rectus capitis lateralis (muscle).


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6.2.13 Musculature of Back of Neck III /Nerves of Back of Neck

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1 Greater occipital nerve2 Superior oblique muscle of

headIN:Suboccipital nerveO: Lateral mass of atlasI: Inferior nuchal lineF: Rotation and extension

of the head

3 Nervus occipitalis tertius

4 Suboccipital nerve

5 Inferior oblique muscle ofheadIN:Suboccipital nerveO: Spinous processes of axisI: Lateral mass of atlasF: Same as No. 2

6 Vertebral artery (d63)

7 Rectus capitis posteriorminor (muscle)

8 Rectus capitis posteriormajor (muscle)

9 Interspinalis cervicis (muscle)

10 Cervical plexus (d42)It is formed, as is true for allother plexuses, by the ventralbranches of the spinalnerves. The cervical plexusoriginates from the segmentsC1-C4/5. Its branches are thecervical ansa, the phrenicnerve, the lesser occipitalnerve, the great auricularnerve, the transverse cervicalnerve and thesupraclavicular nerve.

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6.2.14 Vertebral Artery

The vertebral artery (d143)is the first departing branch of the subclavian arteryand projects, surrounded by the anterior scalenus muscles (d36) and longus collimuscle, in a cranial direction. It traverses the foramen of the transverse process at the6th cervical vertebra and projects towards the atlas.

After leaving the transverse foramen at the most superior cervical vertebra, it makesa turn and projects in a medial direction along the vertebral groove of atlas.It traverses the atlantooccipital membrane and then enters the subarachnoid space.After entering the interior of the cranium through the great foramen, it joins with thevertebral artery from the opposite side, to form the basilar artery. Via the posteriorcerebral arteries, the basilar artery is interconnected with the arterious circle ofcerebrum (circle of Willis) (d63)

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