Back muscles, occipital muscles

Muscles, fasciae and movements of the neck

Semmelweis Egyetem ÁOK

Anatómiai Intézet
Dr. Csáki Ágnes
2017.10.19.
 Back muscles
The muscles of the back can be divided into three groups :
Superficial – associated with movements of the shoulder.
Spinohumeral muscles
M. trapezius
M. rhomboideus major et minor
M. levator scapulae
M. latissimus dorsi

Intermediate – associated with movements of the thoracic cage.

Serratus posterior superior
Serratus posterior inferior

Deep – associated with movements of the vertebral column

erector spinae m.
transversospinal muscles,
interspinal, intertransverse and
suboccipital muscles

The deep muscles develop embryologically in the back, and are thus described as intrinsic
muscles.
The superficial and intermediate muscles do not develop in the back, and are classified as
extrinsic muscles
differentiation of the myotome – development of the skeletal muscles

Epimere – muscles of the back

(segmental innervations from the
dorsal branch of the spinal nerve)
Hypomere – muscles of the neck,
thorax and abdomen, muscles of the
extremities
(innervated by ventral branches of
the spinal nerve - plexus)
A very similar layered organization at the thorax and abdomen
 -------------------- Mm. scaleni

M. erector spinae----------

------------ Mm obl. abd. ext. et int.

---------- M. rectus abdominis

 Back muscles
The muscles of the back can be divided into three groups :
Superficial – associated with movements of the shoulder.
Spinohumeral muscles migrate from the hypomere
M. trapezius
M. rhomboideus major et minor
M. levator scapulae
M. latissimus dorsi

Intermediate – associated with movements of the thoracic cage. Serratus

posterior superior
Serratus posterior inferior

Deep – associated with movements of the vertebral column epimere

erector spinae m.
transversospinal muscles,
interspinal, intertransverse and
suboccipital muscles
Superficial muscles – associated with movements of the shoulder.
Trapezius muscle
Originates from the skull(nuchal line), and the spinous processes of C1-T12.
The fibres attach to the clavicle, acromion and the scapula spine.
Innervation : XI. cranial nerve (accessory nerve)
Vertebra prominens,
M. trapezius proc. spinosus

M. latissimus
Proc. spinosus
dorsi

The upper fibres of the trapezius elevates the scapula and rotates it during abduction of the
arm. The middle fibres retract the scapula and the lower fibres pull the scapula inferiorly.
Latissimus dorsi
broad origin from the spinous processes of T6-T12, iliac crest, thoracolumbar fascia and the
inferior three ribs
attaches to the crest of lesser tubercule
Innervation: Thoracodorsal nerve (brachial plexus)
Actions: Extends, adducts and medially rotates the upper limb.
Vertebra prominens,
proc. spinosus

Proc. spinosus
M. latissimus dorsi
Levator scapulae
from the transverse processes of the C1-C4 vertebrae and attaches to the angle of the scapula.
Innervation: Dorsal scapular nerve (brachial plexus)
Elevates the scapula

M. levator scapulae

Rhomboid Major M. rhomboideus

from the spinous processes of minor
T2-T5 vertebrae, attaches to
M. rhomboideus
the medial border of the
major
scapula, between the spine
and inferior angle
Rhomboid Minor
from the spinous processes of
C7-T1 vertebrae, attaches to
the medial border of the
scapula,

Innervation: Dorsal scapular

nerve (brachial plexus)
Retract and rotate the scapula
Intermediate – associated with movements of the thoracic cage.
The serratus posterior superior is a thin, rectangular shaped muscle. It
lies deep to the rhomboid muscles on the upper back.
Attachments: Originates from the lower part of the ligamentum nuchae,
and the cervical and thoracic spines (usually C7 – T3). The fibres pass in
an inferolateral direction, attaching to ribs 2-5.
Innervation: Intercostal nerves
Actions: Elevates ribs 2-5

Serratus posterior
The serratus posterior inferior is superior m.
broad and strong. It lies underneath
the latissimus dorsi.
Attachments: Originates from the
thoracic and lumbar spines (usually
T11 – L3). The fibres pass in a
superolateral direction, attaching to
ribs 9-12. Serratus posterior
Innervation: Intercostal nerves inferior m.
Actions: Depresses ribs 9-12.
Deep – associated with movements of the vertebral column

Splenius capitis Originates from the M. splenius capitis

ligamentum nuchae, and the spinous
processes of C7 – T3vertebrae. The
fibres ascend, attaching to the the
M. splenius
occipital bone of the skull.
cervicis
Actions: Rotate head to the same
side.

Splenius cervicis Originates from the

spinous processes of T3-T6 vertebae.
The fibres ascend, attaching to the
transverse processes of C1-4.
Actions: Rotate head to the same side.

Innervation: Posterior rami of the spinal

nerves
The two splenius muscles can also act
together to extend the head and neck.
M. erector spinae:The erector spinae is situated posterolaterally to spinal column, between the vertebral
spinous processes and the costal angle of the ribs. It has three columns

m. iliocostalis
m. longissimus
m. spinalis

The iliocostalis muscle is located

laterally within the erector spinae. It
is associated with the ribs, and can
be divided into three parts – M. iliocostalis
lumborum, thoracis, and cervicis.
Attachments: Arises from the
common tendinous origin, and
attaches to the costal angle of the
ribs and the cervical transverse
processes.
Innervation: Posterior rami of the
spinal nerves
Actions: Acts unilaterally to laterally
flex the vertebral column.
The longissimus muscle is
situated between the iliocostalis
and spinalis. It is the largest of
the three columns. It can be
divided into three parts –
thoracic, cervicis and capitis.
Attachments: Arises from the
common tendinous origin, and
attaches to the lower ribs, the
transverse processes of C2 – T12,
and the mastoid process of the
skull.
Innervation: Posterior rami of M. longissimus
the spinal nerves
Actions: Acts unilaterally to
laterally flex the vertebral column
The spinalis muscle is located
medially within the erector
spinae. It is the smallest of the
three muscle columns. It can be
divided into the thoracic,
cervicis
Attachments: Arises from the
spinous processes and attaches
to the spinous processes
Innervation: Posterior rami of
the spinal nerves
Actions: Acts unilaterally to
laterally flex the vertebral
column.

M. spinalis
 Semispinalis capitis

M. longissimus capitis

M. Spinalis
Lumborum, thoracis, cervicis

M. Longissimus
Thoracis, cervicis, capitis

M. Iliocostalis
Lumborum, thoracis, cervicis
Transversospinalis muscles are located underneath the erector spinae. They are a group of short
muscles, associated with the transverse and spinous processes of the vertebral column

There are three types of muscles in this group –

the semispinalis, multifidus and rotatores.

M. Semispinalis
capitis

M. Semispinalis
cervicis

Semispinalis m.
Originates from the transverse processes of C4-T10. The
fibres ascend 5-6 vertebral segments, attaching to the
spinous processes of C2-T4: semispinalis cervicis

and to the occipital bone of the skull: semispinalis capitis

 Multifidus m.
Originates from the transverse processes
The fibres ascend 2-4 vertebral segments,
attaching the spinous processes of the
vertebrae.

Mm. multifidi

Mm. rotatores
Rotatores m.
Originates from the vertebral transverse
processes. The fibres ascend, and attach to
the lamina and spinous processes of the
immediately superior vertebrae.
Minor Deep Intrinsic Muscles:
Levatores costarum – Originates from
the transverse processes of C7-T11, and
attaches to the rib immediately below.
Acts to elevate the ribs.

Interspinales: Spans between adjacent

spinous processes. Acts to stablise the
vertebral column.

Intertranversarii– Spans between

adjacent transverse processes. Acts to
stablise the vertebral column.
Erector spinae

Only the semispinalis is shown

Muscular layers on the neck

Suboccipital muscles-
 Suboccipital muscles- suboccipital trigone

M. rectus capitis Obliquus capitis

post. Minor superior
from the posterior rom the transverse
tubercle of the C1 process of C1 and
vertebra (atlas) to the attaches into the
medial part of the occipital bone
inferior nuchal line (between the superior
of the occipital bone. and inferior nuchal
lines).
M. rectus capitis
post. Major M. obliquus capitis
from the spinous inferior
process of the C2 from the posterior
vertebrae (axis), and tubercle of the C2
inserts into the lateral vertebra, and
part of the inferior attaches into the
nuchal line of the transverse process of
occipital bone. C1.

Actions: Extension and rotation of the head. Innervation: Suboccipital nerve (post. ramus of C1)
Prevertebral muscles of the neck

M. rectus capitis anterior

M. rectus capitis lateralis

M. longus capitis

M. longus
colli

Scalenus muscles

Actions: flex the head and neck anteriorly Innervation: ventral rami of spinal nerves
 Scalenus muscles

posterior

anterior

Name Origin Insertion Function

m. anterior scalene tubercle on anterior tubercles of The three muscles:
scalene the 1. rib the transverse ipsilateral contraction causes ipsilateral lateral
processes of C3-C6 flexion of the neck,
m. middle behind posterior tubercles of and bilateral contraction causes anterior flexion
scalene the subclavian groove the transverse of the neck
on the 1. rib processes of C2-C7 in case of forced respiration act as accessory
muscles of respiration
m. posterior 2. rib posterior tubercles of
innervation : anterior rami of spinal nerves
scalene the transverse
C3-C8
processes of C5-C7
Supra- and infrahyoid muscles
The suprahyoid muscles are a group of four
muscles, located superiorly to the hyoid bone
of the neck. They all act to elevate the hyoid
bone – an action involved in swallowing

The infrahyoid muscles are

a group of four muscles that
are located inferiorly to the
hyoid bone in the neck
Depress the hyoid bone.

Innervation: ventral rami of spinal nerves (ansa cervicalis)

Lateral view of supra- and infrahyoid muscles
 Superficial neck muscles

Sternocleidomastoid m.
Originates from the manubrium sterni and clavicle, inserts to the mastoid process of the skull
ipsilateral contraction causes ipsilateral lateral flexion and rotation of the head („ear comes
near to the shoulder”
bilateral contraction causes protraction of the head
Innervation: IX cranial nerve (with the trapezius m.)
 Cervical fascia
Fascia is a layer of fibrous tissue that surrounds muscles, vessels and nerves. In the neck, there
are several layers of fascia, which act to support and compartmentalise the structures present

Superficial layer

Pretracheal layer

Prevertebral layer
Transverse section of the neck.
The investing layer of fascia in
highlighted in blue. The fascia
completely envelopes the
sternocleidomastoid and
trapezius.

Fascia cervicalis
- Spf. Layer or investing layer
- pretracheal layer
(visceral part)
(carotid sheath)
- prevertebral layer
The trachea, esophagus, and infrahyoid
muscles are enclosed by the pretracheal
layer .
It can be anatomically divided into two
parts:
Muscular – encloses the infrahyoid
muscles(purple)
Visceral  – encloses the trachea and
oesophagus and forms
the carotid sheath

Fascia cervicalis
- Spf. Layer or investing layer
-pretracheal layer
(muscular)
(visceral)
(carotid sheath)
- prevertebral layer
The prevertebral layer surrounds
the vertebral column and its
associated muscles (scalene,
prevertebral, and deep muscles of
the back)

Fascia cervicalis
- Spf. Layer or investing layer
- pretracheal layer
(visceral part)
(carotid sheath)
- prevertebral layer
The superficial layer and muscular part of pretracheal layer end at the
sternum, but the visceral layer and the prevertebral layer continous
downward to the thorax!! - inflammation
 Auxiliary respiratory muscles
Nasal muscles (nostrils
widen)

Scalenus
anterior,
medius et
posterior
(elevates upper
ribs)

Sternocleidomastoideus
(elevates clavicle)
 Serratus post. sup.
Auxiliary respiratory muscles (elevates the upper
ribs)
Levator costarum
(elevates the ribs)

Serratus post. inf.

Quadratus lumborum (depresses the lower
(depresses the XIIth rib) ribs)
 Movements of the cervical part

Articulatio atlantooccipitalis
articulatio ellipsoidea
movements:
flexio lateralis
flexio ventralis és dorsalis

Articulatio atlantoaxialis
articulatio trochoidea
movements:
¾ of rotation of the neck!!!

Cervical spine
direction of the articular surfaces:
horizontal
movements:
flexio lateralis + small rotation
flexio ventralis and dorsalis
 Movements of thoracic and lumbal part

Thoracic part
direction of the articular surfaces:
oblique
movements:
small torsion
flexio lateralis

Lumbal part
direction of the articular surfaces:
sagittal
movements:
flexio ventralis and dorsalis
flexio lateralis
 Movements of the spine

Rotation:
-C. no
-Lower Th.
-L. hardly
C
lordosis
Lateralflexion T
kyphosis
C.-L. L lor-
Th. hardly dosis

Anteflexion Dorsalflexion

C.-L. lordosis decreased C.-L. lordosis increased

Th. kyphosis increased Th. kyphosis decreased

very: between the C.-Th.

and
L.-S. borderlands
vulnerable !
Irodalom:
images.MD, 2006 Current Medicine LLC
Kahle W, Leonhardt H, Platzer W: Color Atlas/Text of Human Anatomy, 1992,
Thieme, Stuttgart
Putz R, Pabst R (editors): Sobotta Atlas of Human Anatomy, 1993, Urban &
Schwarzenberg, München
Romanes GJ (editor): Cunningham’s Textbook of Anatomy, 1991, Oxford University
Press, Oxford
Szentágothai J, Réthelyi M: Funkcionális anatómia, 2002, Medicina, Budapest
Vízkelety T: Az ortopédia tankönyve, 1995, Semmelweis Kiadó, Budapest

http://teachmeanatomy.info/the-basics/

https://www.youtube.com/watch?v=F2sSVWEdjWQ

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