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Gross Anatomy 2:Superficial Back
Kulesza
Readings:Snell, Clinical Anatomy by Regions (8th edition)• The Superficial Part of the Back and the Scapular
Region: p. 454 –458; table 9-2• Page 63; table 2-1 [serratus posterior muscles]
Objectives:1. Identify the superficial landmarks associated with the
back.2. Describe the structure, function and support of the
superficial muscles of the back (arterial supply, venous drainage and innervation).
3. Identify the borders and functional significance of the triangle of auscultation and the lumbar triangle.
Superficial Landmarks
• Median Vertebral Furrow• Erector Spinae• External occipital protuberance• Spinous Processes, vertebra
prominens (C7)• Cervical border of trapezius• Acromion• Deltoid• Scapula and its spine• Posterior axillary fold• Iliac crest
Dermatomes
Sternoclavicular and Scapulothoracic
Articulations
An 18-year-old male presents following a mountain biking accident. History reveals he was thrown from the bike and landed on the side of his head (he was wearing a helmet). Physical exam reveals a fracture clavicle.
On a follow-up visit, the fracture has healed but he has weakness in shrugging his shoulder and in retracting the scapula. Physical exam reveals atrophy of the trapezius.
What nerve was most likely damaged in the accident? ---Spinal accessory nerve
Trapezius
Proximal attachment: superior nuccal ligament
Distal attachment:
Action:
Innervation: CN XI (& contributions from CN’s II, III, IV)
Latissimus Dorsi
Proximal attachment:
Distal attachment:
Action:
Innervation:
Trapezius & Latissimus Dorsi
Trapezius & Latissimus Dorsi
Innervation of the Trapezius
Innervation of the Trapezius
2nd Layer of Superficial Back Muscles
Levator Scapulae
Proximal attachment:
Distal attachment:
Action:
Innervation:
Rhomboids
Proximal attachment:
Distal attachment:
Action:
Innervation:
Superficial Back Triangles
Triangle of Auscultation:
Lumbar Triangle:
• Inferior Lumbar Hernia (Petit’s Hernia)
Superior Lumbar Hernia (Grynfeltt’s Hernia)
Intermediate Back Muscles*respiratory muscles*Serratus Posterior Superior:Proximal attachment:
Distal attachment:
Action:
Innervation:
Serratus Posterior Inferior:Proximal attachment:
Distal attachment:
Action:
Innervation:
Common Variations of the Transverse/Superficial Cervical Artery
Common Variations of the Transverse/Superficial Cervical Artery