Proximal (origin) attachment for Trapezius

1. Superior nuchal line • External occipital protuberance • Ligamentumnuchae • Spinous process of C7-T12 vertebrae Proximal (origin) attachment for Trapezius • Motor – spinal accessory (CNXI) • C3 and C4 – pain and proprioceptive fibers Innervation of Trapezius • Depresses scapula Contraction of ascending part of trapezius (action) • Retracts scapula Contraction of entire Trapezius (action)

2. Distal (insertion) attachment for Trapezius • Lateral 3rd of clavicle • Acromion • Spine of scapula • Elevates scapula Contraction of descending part of trapezius (action) • Retracts scapula Contraction of middle part of trapezius (action) • Rotates glenoid cavity superiorly Contraction of descending and ascending part of Trapezius (action)

3. Proximal attachment (origin) for Latissimusdorsi • Spinous process of T6-T12 • Thoracolumbar fascia • Iliac crest • Inferior 3 or 4 ribs Distal attachment (insertion) for Latissimusdorsi • Floor of intertubercular sulcus of humerus. Innervation of Latissimusdorsi • Thoracodorsal nerve (C6, C7, C8) • Extends, adducts and medially rotates humerus • Raises body towards arms when climbing Action of LatissimusDorsi

4. Proximal attachment (origin) for Rhomboid minor • Ligamentumnuchae • Spinous processes of C7 and T1 Distal attachment (insertion) for Rhomboid minor • Vertebral border of scapula from root of spine Innervation of Rhomboid major and rhomboid minor • Dorsal scapular n. (C4-C5) • Retraction and downward rotation of scapula • Secure scapula to thoracic wall (in conjunction with serratus anterior) Action of rhomboid major and minor

5. 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

6. Proximal attachment (origin) for Levator scapulae • Transverse processes of upper C1-C4 Distal attachment (insertion) for Levator scapulae • Vertebral border of scapula from superior angle to root of spine Innervation of levator scapulae • Dorsal scapular n. (C4-C5) • Assist rhomboids • Elevation of scapula Action of levator scapulae

7. Proximal attachment (origin) for Serratus posterior superior • Spinous processes (of C7-T3) Distal attachment (insertion) for Serratus posterior superior • To ribs (superior border of ribs 2-4) Innervation of serratus posterior superior and inferior • Inter costal nerves • Assists in inspiration Action of serratus posterior superior

8. Proximal attachment (origin) for Serratus posterior inferior • Spinous processes of lower vertebrae (T11-L2) Distal attachment (insertion) for Serratus posterior inferior • Loswer ribs (Inferior border of ribs 8-11) Innervation of serratus posterior superior and inferior • Inter costal nerves • Assists in expiration Action of serratus posterior inferior

9. Capitis: Proximal attachment (origin) for Splenius Capitis and Cervicis • Nuchal ligament • Spinous processes of C7-T3 vertebrae Cervicis: • Nuchal ligament • Spinous processes of T3-T6 vertebrae Capitis: • Mastoid process • Lateral third of superior nuchal line of occipital bone. Distal attachment (insertion) for Splenius Capitis and Cervicis Cervicis: • Tubercles of transverse processes of C1-C3 or C4 vertebrae Innervation of Splenius Capitis and Cervicis • Posterior rami of spinal nerves • extension of head (both sides); ipsilateral rotation of head and neck Action of Splenius Capitis

10. What are the erector spinae muscles (lateral to medial) • Iliocostalis, longissimus, spinalis Proximal attachment (origin) for erector spinae • Arise from common inferior tendon that extends from the iliac crest to median sacral crest • Iliocostalis – ribs • Longissimus – transverse process and eventually mastoid process • Spinalis – spanning spinous processes of vertebrae on each side Distal attachment (insertion) for erector spinae • Both sides - Extension of vertebral column • One side – ipsilateral rotation Contraction of erector spinae (both sides or one side)

11. Innervation of erector spinae • Posterior primary rami of spinal nerves What are the transversospinalis muscles • Semispinaliscapitis, cervcis and thoracis • Multifidis • Rotatores What are the proximal and distal attachments of transversospinalis • Proximal – lower transverse process • Distal – higher transverse process. • Semispinalis – important in holding up head • Multifidis – stabilize vertebrae • Rotatores - stabilize vertebrae Contraction of transversospinalis

12. Proximal attachment (origin) for rectus capitis posterior minor • Below medial end of inferior nuchal line. Distal attachment (insertion) for rectus capitis posterior minor • Posterior tubercle of atlas Innervation of rectus capitis posterior minor • Suboccipitaln. • Stabilizes atlanto-occipital joint Action of rectus capitis posterior minor

13. Proximal attachment (origin) for rectus capitis posterior major • Below inferior nuchal line, lateral to rectus capitis posterior minor Distal attachment (insertion) for rectus capitis posterior major • Spine of axis Innervation of rectus capitis posterior major • Suboccipitaln. • Extend head • Rotate atlas and head to same side Action of rectus capitis posterior major

14. Proximal attachment (origin) for obliquuscapitis superior • Transverse process of atlas Distal attachment (insertion) for obliquuscapitis superior • Inferior nuchal line (lateral to rectus capitis major) Innervation of obliquuscapitis superior • Suboccipitaln. • Extends head Action of obliquuscapitis superior

15. Proximal attachment (origin) for obliquuscapitis inferior • Spinous process of axis Distal attachment (insertion) for obliquuscapitis inferior • Transverse process of atlas Innervation of obliquuscapitis inferior • Suboccipitaln. • Rotates atlas and head to same side Action of obliquuscapitis inferior

16. Proximal attachment (origin) for Deltoid • Clavicle, • Scapular spine • Acromion Distal attachment (insertion) for Deltoid • Deltoid tuberosity Innervation of Deltoid • Axillaryn. • Abduction of arm (middle part; w/ supraspinatus) • Flexion and medial rotation of humerus (anterior part) • Extension and lateral rotation of humerus (posterior part) Action of Deltoid

17. Proximal attachment (origin) for Supraspinatus • Supraspinousfossa Distal attachment (insertion) for Supraspinatus • Greater tubercle of humerus Innervation of Supraspinatus • Suprascapularn. • Abducts humerus Action of Supraspinatus

18. Proximal attachment (origin) for Infraspinatus • Infraspinousfossa Distal attachment (insertion) for Infraspinatus • Greater tubercle of humerus Innervation of Infraspinatus • Suprascapularn. • Laterally rotates humerus Action of Infraspinatus

19. Proximal attachment (origin) for Teres minor • Axillary border of scapula Distal attachment (insertion) for Teres minor • Greater tubercle of humerus Innervation of Teres minor • Axillaryn. • Laterally rotates humerus Action of Teres minor

20. Proximal attachment (origin) for Subscapularis • Subscapularfossa Distal attachment (insertion) for Subscapularis • Lesser tubercle of humerus Innervation of Subscapularis • Upper subscapularn. • Lower subscapularn. • Adducts and medially rotates humerus Action of Subscapularis

21. Proximal attachment (origin) for Teres major • Axillary border of scapula Distal attachment (insertion) for Teres major • Medial edge of intertubercularsulcus Innervation of Teres major • Lower subscapularn. • Secures humerus at shoulder • Adducts and medially rotates humerus Action of Teres major

22. Location of Platysma • Superficial fascia of anterior and posterior cervical triangle Innervation of Platsyma • Facial n.

23. Proximal attachment (origin) for Sternocleidomastoid • Sternum • Medial end of clavicle Distal attachment (insertion) for Sternocleidomastoid • Mastoid process of temporal bone Innervation of Sternocleidomastoid • Spinal accessory n. • Flexion of head • Ipsilateral flexion, • Contralateral rotation Action of Sternocleidomastoid

24. Proximal attachment (origin) for Omohyoid • Superior border of scapula • Intermediate tendon • Clavicle Distal attachment (insertion) for Omohyoid • Hyoid Innervation of Omohyoid • Ansacervicalis • Depression of hyoid bone • Aid in swallowing Action of Omohyoid

25. Proximal attachment (origin) for Scalenus anterior, medius, and posterior • Transverse process of cervical vertebrae Distal attachment (insertion) for Scalenus anterior, medius, and posterior • First and second rib Innervation of Scalenus anterior, medius, and posterior • Anterior primary rami of cervical nn. • Accessory respitory • Flexor of neck • Contralateral rotator of neck Action of Scalenus anterior, medius, and posterior

26. Innervations of thoracodorsal nerve • Latissimusdorsi • Rhomboid major • Rhomboid minor • Levator scapulae Innervations of dorsal scapular nerve Innervations of spinal accessory nerve • Trapezius • Sternocleidomastoid • Rectus capitis posterior major • Rectus capitis posterior minor • Obliquuscapitis superior • Obliquuscapitis inferior Innervation of suboccipital nerve

27. Innervations of greater occipital nerve • Posterior surface of scalp (cutaneous) Innervations of axillary nerve • Deltoid • Teres minor • Triceps brachi, long head • Supraspinatus • Infraspinatus Innervations of suprascapular nerve • Subscapularis Innervations of upper subscapular nerve

28. Subscapularis • Teres major Innervations of lower subscapular nerve Innervations of greater auricular nerve • Skin around ear (cutaneous) Innervations of transverse cervical nerve • Skin of anterior neck (cutaneous) Innervations of supraclavicular nerve • Skin inferior to clavicle (cutaneous)

29. Scalp behind ear (cutaneous) Innervations of lesser occipital nerve Innervations of ansacervicalis • Omohyoid • Sternohyoid • Sternothyroid Innervations of phrenic nerve • Diaphragm

30. Spinal roots of thoracodorsal nerve • C6, C7, C8 • C4-C5 Spinal roots of dorsal scapular nerve Spinal roots of suboccipitaln. • C1 (motor only) Spinal roots of greater occipital n. • C2

31. 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