Thoracoappendicular Muscles and Related Structures

1. Trapezius - superior attachment at superior nuchal line (insertion and functional origin)
2. Trapezius - origin from cervical spines (ligamentum nuchae) and thoracic spines
3. Trapezius - upper fibers (superior nuchal line) insert on later scapular spine
4. Trapezius - inferior fibers (lower thoracic spines) insert on medial scapular spine
5. Trapezius - understand how trapezius effects upward rotation of the scapula
6. Serratus anterior - vertebral border and inferior angle of trapezius (contributes to upward rotation
7. Latissimus dorsi - origin from thoracolumbar fascia, insertion at inferior angle scapula and at the humerus
8. Rhomboideus major - origin from spines of T2-T5, insertion on vertebral border of scapula, action is retraction
9. Rhomboideus minor - origin from spines C7-T1, insertion on verterbral scapula near superior angle, action is retraction and elevation
10. Levator scapulae - origin from transverse processes of C1-4, insertion on superior angle of scapular, action is elevation
11. Relations of levator scapulae - lateral: spinal accessory nerve and (superficial branch) transverse cervical artery
12. Relations of levator scapulae - medial: dorsal scapular nerve (nerve to the rhomboids) and dorsal scapular artery (deep branch of transverse cervical artery

Intermediate muscles of the back

1. Serratus posterior superiorus - inhalation
2. Serratus posterior inferiorus - exhalation
3. Dorsal rami of spinal nerves providing motor and sensory innervation along the posterior axial border

Deep muscles of the back

1. Splenius capitus - deep to trapezius, from nuchal ligament (spines of C7-T6) to lateral occipital bone and mastoid process, inserts immediately inferior to superior nuchal line
2. Splenius cervicis - stops short of skull to insert on transvers processes of C1-C4
3. Semispinalis capitus - from upper thoracic transverse processes to occipital of skull between superior and inferior nuchal lines
4. Greater occipital nerve - passing posterior through the semispinalis muscle at the level of the axis
5. Erector spinae - three muslces arising from common tendon on posterior sacrum
6. Spinalis lateral to vertebral spines and anterior to transvers processes
7. Longissiumus - immediately lateral to spinalis
8. Iliocostalis - origin at posterior iliac crest and insertion at the angle of the ribs
9. Appreciate that transversospinalis muscles exist (multifidus, rotatores, semispinalis) are cradles by the spines and transverse processes and must be dealt with during laminectomy