Proximal (origin) attachment for Trapezius

Innervation of Trapezius

Contraction of ascending part of trapezius (action)

Contraction of entire Trapezius (action)

• Superior nuchal line• External occipital

protuberance• Ligamentum nuchae• Spinous process of C7-T12

vertebrae

• Motor – spinal accessory (CNXI)

• C3 and C4 – pain and proprioceptive fibers

• Depresses scapula

• Retracts scapula

1

• Lateral 3rd of clavicle• Acromion• Spine of scapula

• Elevates scapula

• Retracts scapula

• Rotates glenoid cavity superiorly

Distal (insertion) attachment for Trapezius

Contraction of descending part of trapezius (action)

Contraction of middle part of trapezius (action)

Contraction of descending and ascending part of Trapezius

(action)

2

Proximal attachment (origin) for Latissimus dorsi

Innervation of Latissimus dorsi

Action of Latissimus Dorsi

• Spinous process of T6-T12• Thoracolumbar fascia• Iliac crest• Inferior 3 or 4 ribs

• Floor of intertubercular sulcus of humerus.

• Thoracodorsal nerve (C6, C7, C8)

• Extends, adducts and medially rotates humerus

• Raises body towards arms when climbing

Distal attachment (insertion) for Latissimus dorsi

3

Proximal attachment (origin) for Rhomboid minor

Innervation of Rhomboid major and

rhomboid minor

Action of rhomboid major and minor

• Ligamentum nuchae• Spinous processes of C7

and T1

• Dorsal scapular n. (C4-C5)

• Retraction and downward rotation of scapula

• Secure scapula to thoracic wall (in conjunction with serratus anterior)

Distal attachment (insertion) for Rhomboid minor • Vertebral border of

scapula from root of spine

4

Proximal attachment (origin) for Rhomboid major

• Spinous processes of T2-T5

Distal attachment (insertion) for Rhomboid major • Vertebral border of

scapula from root of spine

5

Proximal attachment (origin) for Levator scapulae

Innervation of levator scapulae

Action of levator scapulae

• Transverse processes of upper C1-C4

• Dorsal scapular n. (C4-C5)

• Assist rhomboids• Elevation of scapula

Distal attachment (insertion) for Levator scapulae • Vertebral border of

scapula from superior angle to root of spine

6

Proximal attachment (origin) for Serratus posterior superior

Innervation of serratus posterior superior and

inferior

• Spinous processes (of C7-T3)

• Inter costal nerves

• Assists in inspiration

Distal attachment (insertion) for Serratus posterior superior • To ribs (superior border of

ribs 2-4)

Action of serratus posterior superior

7

Proximal attachment (origin) for Serratus posterior inferior

Innervation of serratus posterior superior and

inferior

• Spinous processes of lower vertebrae (T11-L2)

• Inter costal nerves

• Assists in expiration

Distal attachment (insertion) for Serratus posterior inferior • Loswer ribs (Inferior

border of ribs 8-11)

Action of serratus posterior inferior

8

Proximal attachment (origin) for Splenius Capitis and Cervicis

Innervation of Splenius Capitis and Cervicis

Action of Splenius Capitis

• Nuchal ligament• Spinous processes of C7-

T3 vertebrae

• Mastoid process• Lateral third of superior

nuchal line of occipital bone.

• Posterior rami of spinal nerves

• extension of head (both sides); ipsilateral rotation of head and neck

Distal attachment (insertion) for Splenius Capitis and Cervicis

Capitis:

• Tubercles of transverse processes of C1-C3 or C4 vertebrae

Cervicis:

Capitis:

Cervicis:• Nuchal ligament• Spinous processes of T3-

T6 vertebrae

9

What are the erector spinae muscles (lateral to medial)

Distal attachment (insertion) for erector

spinae

• Iliocostalis, longissimus, spinalis

• Iliocostalis – ribs• Longissimus – transverse

process and eventually mastoid process

• Spinalis – spanning spinous processes of vertebrae on each side

• Both sides - Extension of vertebral column

• One side – ipsilateral rotation

Proximal attachment (origin) for erector spinae • Arise from common

inferior tendon that extends from the iliac crest to median sacral crest

Contraction of erector spinae (both sides or

one side)

10

Innervation of erector spinae

What are the proximal and distal attachments of transversospinalis

• Posterior primary rami of spinal nerves

What are the transversospinalis muscles • Semispinalis capitis,

cervcis and thoracis• Multifidis• Rotatores

Contraction of transversospinalis

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• Proximal – lower transverse process

• Distal – higher transverse process.

• Semispinalis – important in holding up head

• Multifidis – stabilize vertebrae

• Rotatores - stabilize vertebrae

Proximal attachment (origin) for rectus capitis posterior minor

Innervation of rectus capitis posterior minor

• Below medial end of inferior nuchal line.

• Suboccipital n.

• Stabilizes atlanto-occipital joint

Distal attachment (insertion) for rectus capitis posterior minor • Posterior tubercle of atlas

Action of rectus capitis posterior minor

12

Proximal attachment (origin) for rectus capitis posterior major

Innervation of rectus capitis posterior major

• Below inferior nuchal line, lateral to rectus capitis posterior minor

• Suboccipital n.

• Extend head• Rotate atlas and head to

same side

Distal attachment (insertion) for rectus capitis posterior major • Spine of axis

Action of rectus capitis posterior major

13

Proximal attachment (origin) for obliquus capitis superior

Innervation of obliquus capitis superior

• Transverse process of atlas

• Suboccipital n.

• Extends head

Distal attachment (insertion) for obliquus capitis superior • Inferior nuchal line

(lateral to rectus capitis major)

Action of obliquus capitis superior

14

Proximal attachment (origin) for obliquus capitis inferior

Innervation of obliquus capitis inferior

• Spinous process of axis

• Suboccipital n.

• Rotates atlas and head to same side

Distal attachment (insertion) for obliquus capitis inferior • Transverse process of

atlas

Action of obliquus capitis inferior

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Proximal attachment (origin) for Deltoid

Innervation of Deltoid

• Clavicle,• Scapular spine• Acromion

• Axillary n.

• Abduction of arm (middle part; w/ supraspinatus)

• Flexion and medial rotation of humerus (anterior part)

• Extension and lateral rotation of humerus (posterior part)

Distal attachment (insertion) for Deltoid • Deltoid tuberosity

Action of Deltoid

Proximal attachment (origin) for Supraspinatus

Innervation of Supraspinatus

• Supraspinous fossa

• Suprascapular n.

• Abducts humerus

Distal attachment (insertion) for Supraspinatus • Greater tubercle of

humerus

Action of Supraspinatus

Proximal attachment (origin) for Infraspinatus

Innervation of Infraspinatus

• Infraspinous fossa

• Suprascapular n.

• Laterally rotates humerus

Distal attachment (insertion) for Infraspinatus • Greater tubercle of

humerus

Action of Infraspinatus

Proximal attachment (origin) for Teres minor

Innervation of Teres minor

• Axillary border of scapula

• Axillary n.

• Laterally rotates humerus

Distal attachment (insertion) for Teres minor • Greater tubercle of

humerus

Action of Teres minor

Proximal attachment (origin) for Subscapularis

Innervation of Subscapularis

• Subscapular fossa

• Upper subscapular n.• Lower subscapular n.

• Adducts and medially rotates humerus

Distal attachment (insertion) for Subscapularis • Lesser tubercle of

humerus

Action of Subscapularis

Proximal attachment (origin) for Teres major

Innervation of Teres major

• Axillary border of scapula

• Lower subscapular n.

• Secures humerus at shoulder

• Adducts and medially rotates humerus

Distal attachment (insertion) for Teres major • Medial edge of

intertubercular sulcus

Action of Teres major

Location of Platysma

Innervation of Platsyma

• Superficial fascia of anterior and posterior cervical triangle

• Facial n.

Proximal attachment (origin) for Sternocleidomastoid

Innervation of Sternocleidomastoid

• Sternum• Medial end of clavicle

• Spinal accessory n.

• Flexion of head• Ipsilateral flexion,• Contralateral rotation

Distal attachment (insertion) for Sternocleidomastoid

• Mastoid process of temporal bone

Action of Sternocleidomastoid

Proximal attachment (origin) for Omohyoid

Innervation of Omohyoid

• Superior border of scapula• Intermediate tendon• Clavicle

• Ansa cervicalis

• Depression of hyoid bone• Aid in swallowing

Distal attachment (insertion) for Omohyoid

• Hyoid

Action of Omohyoid

Proximal attachment (origin) for Scalenus anterior, medius, and

posterior

Innervation of Scalenus anterior, medius, and

posterior

• Transverse process of cervical vertebrae

• Anterior primary rami of cervical nn.

• Accessory respitory• Flexor of neck• Contralateral rotator of neck

Distal attachment (insertion) for Scalenus anterior, medius, and

posterior

• First and second rib

Action of Scalenus anterior, medius, and

posterior

Innervations of thoracodorsal nerve

• Latissimus dorsi

• Rhomboid major • Rhomboid minor• Levator scapulae

Innervations of dorsal scapular nerve

Innervations of spinal accessory nerve

• Trapezius• Sternocleidomastoid

Innervation of suboccipital nerve

• Rectus capitis posterior major

• Rectus capitis posterior minor

• Obliquus capitis superior• Obliquus capitis inferior26

Innervations of greater occipital nerve

• Posterior surface of scalp (cutaneous)

Innervations of axillary nerve

• Deltoid• Teres minor• Triceps brachi, long

head

Innervations of suprascapular nerve

• Supraspinatus • Infraspinatus

Innervations of upper subscapular nerve

• Subscapularis

Innervations of lower subscapular nerve

• Subscapularis• Teres major

Innervations of greater auricular nerve

Innervations of transverse cervical nerve

Innervations of supraclavicular nerve

• Skin around ear (cutaneous)

• Skin of anterior neck (cutaneous)

• Skin inferior to clavicle (cutaneous)

• Scalp behind ear (cutaneous)

Innervations of lesser occipital nerve

Innervations of ansa cervicalis • Omohyoid• Sternohyoid• Sternothyroid

• DiaphragmInnervations of phrenic nerve

30

Spinal roots of thoracodorsal nerve

• C6, C7, C8

• C4-C5Spinal roots of dorsal scapular

nerve

Spinal roots of suboccipital n.

Spinal roots of greater occipital n.

• C1 (motor only)

• C2

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Spinal roots of axillary nerve • C5, C6

Spinal roots of suprascapular nerve

• C4, C5, C6

Spinal roots of upper subscapular nerve

• C5, C6, C7

Spinal roots of lower subscapular nerve

• C5, C6, C7

32

Spinal roots of lesser occipital nerve

• C2

Spinal roots of greater auricular nerve

• C2, C3

Spinal roots of transverse cervical nerve

• C2, C3

Spinal roots of supraclavicular nerve • C3, C4