Musculoskeletal Anatomy

ILIOCOSTALIS LUMBORUM

- Most lateral muscle group of erector spinae muscles - Extend from pelvis to neck - ORIGIN Sacrum/iliac crest/Spinious Processes (SP) of lower lumbar thoracic vertebrae - INSERTION Ribs (lower 6) - ACTIONS- Laterally flex head & neck to same side Bilaterally extend vertebral column - ANTAGONIST Rectus abdominis muscle ILIOCOSTALIS THORACIS

- Origin: Superior borders of the angles of the lower six ribs, medial to the proximal tendon of the iliocostalis lumborum - Insertion: Superior borders of the angles of the upper six ribs and the posterior aspect of the transverse process of C7 Innervation: Dorsal primary rami of T1 to T12 Primary Actions: 1. Extension of the thoracic spine when acting bilaterally - Agonists: Iliocostalis Cervicis, Iliocostalis Thoracis, Iliocostalis Lumborum, Longissimus Cervicis, Spinalis Thoracis, Semispinalis Cervicis, Semispinalis Thoracis - Antagonists: Rectus abdominis 2. Lateral flexion of the thoracic spine when acting unilaterally - Agonists: Iliocostalis Cervicis, Iliocostalis Thoracis, Iliocostalis Lumborum, Longissimus Cervicis, External Oblique, Internal Oblique - Antagonists: Iliocostalis Cervicis, Iliocostalis Thoracis, Iliocostalis Lumborum, Longissimus Cervicis, External Oblique, Internal Obliqueon the opposite side

ILIOCOSTALIS CERVICIS

ACTION - Extension, lateral flexion of vertebral column ORIGIN angles of 3rd through 6th ribs INSERTION Tran process of 4th ,5th & 6th cervical Agonist iliocostalis thoracic

LONGISSIMUS THORACIS

Origin: Blended with Iliocostalis lumborum, from the posterior surfaces of the transverse processes of all the lumbar vertebrae and the thoracolumbar fascia Insertion: Tips of the transverse processes of all thoracic vertebrae and lower nine or ten ribs, between the tubercle and angle. Action: Extension of the thoracic spine, lateral flexion of the thoracic spine, extension of the lumbar spine, lateral flexion of the lumbar spine Innervation: Dorsal primary rami of T1 to L5 Primary Actions: 1. Extension of the thoracic spine when acting bilaterally - Agonists: Iliocostalis Cervicis, Iliocostalis Thoracis, Iliocostalis Lumborum, Longissimus Cervicis, Spinalis Thoracis, Semispinalis Cervicis, Semispinalis Thoracis - Antagonists: Rectus abdominis 2. Lateral flexion of the thoracic spine when acting unilaterally - Agonists: Iliocostalis Cervicis, Iliocostalis Thoracis, Iliocostalis Lumborum, Longissimus Cervicis, External Oblique, Internal Oblique Antagonists: Iliocostalis Cervicis, Iliocostalis Thoracis, Iliocostalis Lumborum, Longissimus Cervicis, External Oblique, Internal Obliqueon the opposite side 3. Extension of the lumbar spine when acting bilaterally Agonists: Iliocostalis Lumborum, Spinalis Thoracis Antagonists: Rectus Abdominis 4. Lateral flexion of the lumbar spine when acting unilaterally (singly) Agonists: Iliocostalis Lumborum, Psoas Major, Quadratus Lumborum, External Oblique, Internal Oblique Antagonists: Iliocostalis Lumborum, Psoas Major, Quadratus Lumborum, External Oblique, Internal Oblique on opposite side

LONGISSIMUS CERVICIS - Origin: Attaches to the transverse processes of T1 through T5 vertebrae. - Insertion: Attaches to the transverse process of the 2nd to 6th cervical vertebrae. - Action: Acting with the Longissimus Thoracis extends the vertebral column, flexes it to one side, and pulls the ribs inferiorly. - Synergist: Semispinalis capitis and cervicis, Splenius capitis and cervicis, Spinalis cervicis, Interspinales, Iliocostalis cervicis, Multifidus. - Antagonist: Sternocleidomastoid, Longus colli and capitis, Scalenus anterior, medius, and posterior.

LONGISSIMUS CAPITUS

Origin: By tendons from the posterior surfaces of the transverse processes of T1 to T5 Insertion: Posterior margin of the mastoid process of the occipital bone Action: Extension of the head and cervical spine, lateral flexion of the head and cervical spine Innervation: Dorsal primary rami of C4 to T5 1. Extension of the head and cervical spine when acting bilaterally - Agonists: Spinalis Capitis, Splenius Capitis, Semispinalis Capitis, Sternocleidomastoid (posterior fibers) Secondary Actions: 1. Lateral flexion of the head and cervical spine Agonists: Sternocleidomastoid, Splenius Capitis Antagonists: Sternocleidomastiod, Splenius Capitis on the opposite side Antagonists: Longus Capitis, Sternocleidomastoid (posterior fibers)

SPINALIS THORACIS

- Origin: Attaches to the spinous processes of T11, T12, L1, and L2 vertebrae. - Insertion: Attaches to the spinous processes of T10, T9, T8, T7, T6, T5, T4, or T3 vertebrae. - Action: Extends, rotates and laterally flexes the vertebral column

SPINALIS CERVICIS

- Origin: Attaches to ligamentum nuchae of the spinous process of C7, T1, and T2 vertebrae. - Insertion: Attaches to the spinous process of the C2 and sometimes the spinous process of C3 or C4 vertebrae. - Action: Extends, rotates and laterally flexes the vertebral column.

SPINALIS CAPITUS - Origin: Attaches to the transverse processes of C7 and T1 through T6 vertebrae, as well as the articular processes of the 4th to 6th cervical vertebrae. - Insertion: Attaches between the superior and inferior nuchal line of the occipital bone. - Action: Extends, rotates and laterally flexes the vertebral column.

QUADRATUS LUMBORUM Origin Posterior iliac crest. Iliolumbar ligament. Insertion Twelfth rib. Transerve processes of L1-L4. Actions Lateral flexion (side-bends) of the trunk. Daily uses Bending sideways to pick something up. Related muscles - Internal obliques. - External obliques.

LEVATORES COSTARUM

Origin Transverse processes of C7 to T12 vertebrae Insertion Superior surfaces of the ribs immediately inferior to the preceding vertebrae Actions Assists in elevation of the thoracic rib cage

SERRATUS POSTERIOR SUPERIOR Origin: Lower part of the nuchal ligament and the spinous processes of the vertebrae C7 through T3 and their corresponding supraspinous ligaments Insertion: Superior borders and external surfaces of the second to fifth ribs, lateral to their angles Action: Elevate the ribs which aids in inspiration Innervation: Ventral rami of T1, 2, 3, 4, 5 Primary Actions: 1. Forced inspiration - Agonists: , Levatores costarum brevis and longi - Antagonists: Serratus posterior superior, Transversus abdominis SERRATUS POSTERIOR INFERIOR

Origin: The spinous processes of the T11 to L2/L3 and their corresponding supraspinous ligaments, blending with the lumbar part of the thoracolumbar fascia. Insertion: Inferior borders and outer surfaces of the lower four ribs (9th 12th), lateral to their angles Action: Depresses the lower ribs aiding in expiration, Assists in rotation and extension of the trunk Innervation: Ventral primary rami of T9 T12 (intercostal and subcostal nerves). Primary Actions:

1. Forced expiration - Agonists: Transversus abdominis - Antagonists: Serratus posterior superior, Levatores costarum brevis & longi

MULTIFIDUS
Origin Sacrum, Erector spinae Aponeurosis, PSIS, and Iliac crest Insertion spinous process Actions Stabilizes vertebrae in local movements of vertebral column

ROTATORES Origin: Transverse processes Insertion: Spinous processes one above Action: Rotation of the trunk; Extension of the trunk Agonist Muscles: Erector Spinae- Multifidi, Erector Spinae- Interspinalis, Erector Spinae- Intertransversarii, Longissimus Thoracis, Quadratus Lumborum Antogonist Muscles: Rectus Abdominis, Internal Oblique, External

SPLENIUS CERVICIS

Origin spinous processes of T3-T6 Insertion transverse processes of C1-C3 Actions Bilaterally: Extend the head & neck, Unilaterally: Lateral flexion to the same side, Rotation to the same side

SEMISPINALIS CAPITIS Origin: Tips of the transverse processes of C7 to T7, the articular processes of C4 to C6 and occasionally from the spinous process of C7 or T1 Insertion: Medial part of the area between the superior and inferior nuchal lines of the occipital bone, blending with the spinalis thoracis Action: Extension of the head and cervical spine, rotation of the head and cervical spine 1. Extension of the head and cervical spine when acting bilaterally - Agonists: Longissimus Cervicis, Spinalis Capitis, Splenius Capitis, Sternocleidomastoid (posterior fibers) - Antagonists: Longus Capitis, Sternocleidomastoid (posterior fibers) 2. Contralateral rotation of the head and cervical spine when acting unilaterally - Agonists: Sternocleidomastoid - Antagonists: Sternocleidomastiod on the opposite side 3. Assists with lateral flexion of the head and cervical spine when acting unilaterally

Agonists: Splenius Capitis and Sternocleidomastoid Antagonists: Splenius Capitis and Sternocleidomastoid on the opposite side.

SPLENIUS CAPITIS

Origin Ligamentum nuchae, spinous process of C7-T3 Insertion Mastoid process of temporal and occipital bone Actions Extend, rotate, and laterally flex the head

ANTERIOR SCALENE

Origin C3-C6 Insertion First rib Actions Elevates first rib, rotate the neck to the opposite side

MEDIAL SCALENE Origin Transverse processes of C4 - C6 Insertion Second rib Actions Elevate second rib, tilt the neck to the same side, acting together flex neck POSTERIOR SCALENE

Origin C2-C6 Insertion First rib Actions Elevate 1st rib, rotate the neck to the opposite side, acting together flex neck

STERNOCLEIDOMASTOID

Origin Insertion Upper part of the anterior surface of Lateral surface of mastoid process manubrium Superior border/anterior surface of medial Nuchal line of occipital bone third of clavicle The SCM's main responsibility is moving the vertebral column and head Unilateral bends neck laterally rotates head to opposite side Bilateral flexes neck, draws head ventrally & elevates chin, draws sternum superiorly in deep inspiration

LONGUS COLLI

Origin Transverse processes of C-5 to T-3 Insertion Anterior arch of the atlas Actions Flexes the neck and head

LONGUS CAPITIS

Longus capitis is an anterior muscle of the neck.

- Origin: Attaches to the anterior tubercles of the transverse process of C3 through C6 vertebra. - Insertion: Attaches to the basilar part of the occipital bone. - Action: Flexes the head.