Muscles of the Back

Authors

Affiliations

Nate Yomogida, PT, DPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, PT, DPT

Doctor of Physical Therapy

B.A. in Neuroscience

OIAN

Suboccipitals

Warning: No 'path' link found for variable 'nan' in YAML data.

Table 1: Suboccipital Muscles

Muscle	Origin	Insertion	Innervation	Action
Obliquus capitis inferior
Obliquus capitis superior
Rectus capitis posterior major				UNIL: I/L head rotation
Rectus Capitis Posterior Minor	C1 (posterior tubercle)	Occipital bone (inferior nuchal line, inner 1/3)	Suboccipital N.	BIL: Extend head UNIL: I/L head rotation

Prevertebral Muscles

• Longus capitis
• Longus Colli Cervicis
• Rectus Capitis anterior
• Rectus Capitis Lateralis

Table 2: Prevertebral Muscles

Muscle	Origin	Insertion	Innervation	Action
Anterior Intertransversarii cervicis	C2-C7 Anterior tubercle of superior segment	C2-C7 Anterior tubercle of inferior segment	Spinal nn. (anterior rami)	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend
Anterior scalene	Anterior tubercle of TP of C3-C6	Scalene tubercle of 1st Rib	Anterior Rami C4 - C6	Mobile ribs: Elevates ribs during forced inspiration Fixed ribs (unilateral): I/L C/s sidebend (unilateral) Fixed ribs (bil): C/s flexion, Cervical lateral stabilization
Longus capitis	C3-C6 Anterior tubercle of TP	Occipital bone (basilar part)	Anterior rami C1 - C3	OA Joint: Head flexion
Longus colli cervicis	C5-T3 Anterior surface of vertebral body	C2-C4 Anterior surface	Anterior rami C2 - C6	Unilateral: C/L sidebend, C/L rotation Bilateral: Forward flexion
Middle scalene	C1-C2 TP Posterior tubercle of TP of C3-C7	1st Rib (posterior to groove for subclavian a.)	Anterior Rami C3 - C8	Mobile ribs: Elevates ribs during forced inspiration Fixed ribs (unilateral): I/L C/s sidebend (unilateral) Fixed ribs (bil): C/s flexion, Cervical lateral stabilization
Posterior intertransversarii cervicis	C2-C7 Posterior tubercle of superior segment	C2-C7 Posterior tubercle of superior segment	Spinal nn. (posterior rami)	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend
Posterior scalene	Posterior tubercle of TP of C5-C7	2nd Rib (outer surface)	Anterior Rami C6 - C8	Mobile ribs: Elevates ribs during forced inspiration Fixed ribs (unilateral): I/L C/s sidebend (unilateral) Fixed ribs (bil): C/s flexion, Cervical lateral stabilization
Rectus capitis anterior	C1 Lateral mass	Occipital bone (basilar part)	Anterior rami C1	Unilateral: OAJ ipsilateral sidebend
Rectus capitis lateralis	C1 TP	Occipital bone (basilar part and lateral to occipital condyles)	Anterior rami C1	Unilateral: OAJ ipsilateral sidebend

Superficial intrinsic back Muscles

• Serratus posterior superior
• Serratus posterior inferior
• Splenius capitis
• Splenius cervicis

Table 3: Superficial Intrinsic Back Muscles

Muscle	Origin	Insertion	Innervation	Action
Serratus posterior inferior
Serratus posterior superior
Splenius capitis	Nuchal lig. C7-T4 SP	Lateral third of nuchal line Mastoid process	Spinal nn. Posterior rami (lateral br.) C1 - C6	Bilateral: Head and neck extension Unilateral: I/L sidebend, I/L rotation
Splenius cervicis	T3-T7 SP	C1-C4 SP	Spinal nn. Posterior rami (lateral br.) C1 - C6	Bilateral: Head and neck extension Unilateral: I/L sidebend, I/L rotation

Intermediate intrinsic back muscles (Erector Spinae)

Iliocostalis

• Iliocostalis Cervicis
• Iliocostalis Thoracis
• Iliocostalis lumborum

Longissimus

• Longissimus Capitis
• Longissimus Cervicis
• Longissimus Thoracis

Spinalis

• Spinalis Cervicis
• Spinalis Thoracis

Table 4: Intermediate intrinsic back muscles

Muscle	Origin	Insertion	Innervation	Action
Iliocostalis cervicis	Ribs 3-7	C4-C6 TP	Spinal nn. Posterior rami (lateral br.) C8 - L1	Bilateral: Extends spine Unilateral: Spine ipsilateral sidebend
Iliocostalis lumborum	Sacrum Iliac crest Thoracolumbar fascia (posterior layer)	Ribs 6-12 Upper lumbar TP Thoracolumbar fascia (posterior layer)	Spinal nn. Posterior rami (lateral br.) C8 - L1	Bilateral: Extends spine Unilateral: Spine ipsilateral sidebend
Iliocostalis thoracis	Ribs 7-12	Ribs 1-6	Spinal nn. Posterior rami (lateral br.) C8 - L1	Bilateral: Extends spine Unilateral: Spine ipsilateral sidebend
Longissimus capitis	T1-T3 TP C4-C7 TP & articular process	Mastoid process	Spinal nn. Posterior rami (lateral br.) C1 - C5	Bilateral: Head extension Unilateral: Ipsilateral head sidebend, Ipsilateral rotation
Longissimus cervicis	T1-T6 TP	C2-C5 TP	Spinal nn. Posterior rami (lateral br.) C1 - C5	Bilateral: Extends spine Unilateral: Ipsilateral spine sidebend
Longissimus thoracis	Sacrum Iliac crest Lumbar vertebrae SP Lower thoracic TP	2-12 Ribs Thoracic TP Lumbar TP	Spinal nn. Posterior rami (lateral br.) C1 - C5	Bilateral: Extends spine Unilateral: Ipsilateral spine sidebend
Spinalis cervicis	C5-T2 SP	C5-T2 SP	Spinal nn. Posterior rami (lateral br.)	Bilateral: Cervical extension, Thoracic extension Unilateral: Cervical ipsilateral sidebend, Thoracic ipsilateral sidebend
Spinalis thoracis	T10-L3 SP and Lateral surfaces	T2-8 SP & Lateral surfaces	Spinal nn. Posterior rami (lateral br.)	Bilateral: Cervical extension, Thoracic extension Unilateral: Cervical ipsilateral sidebend, Thoracic ipsilateral sidebend

Transversospinalis Muscles

• Rotatores Breves
• Rotatores Longi
• Multifidi
• Semispinalis Capitis
• Semispinalis Cervicis
• Semispinalis Thoracis

Table 5: Transversospinalis muscles

Muscle	Origin	Insertion	Innervation	Action

Deep Segmental Back Muscles

• Interspinales Cervicis
• Interspinales Lumbora

Warning: No 'path' link found for variable 'ref-medial-intertransversarii-cervices' in YAML data.

Table 6: Transversospinalis muscles

Muscle	Origin	Insertion	Innervation	Action
Anterior Intertransversarii cervicis	C2-C7 Anterior tubercle of superior segment	C2-C7 Anterior tubercle of inferior segment	Spinal nn. (anterior rami)	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend
Interspinales cervicis	C1-C7 SP of superior segment	C1-C7 SP of inferior segment	Spinal nn. Posterior rami	Cervical: Extension Lumbar: Extension
Interspinales lumbora	L1-L5 SP of superior segment	L1-L5 SP of inferior segment	Spinal nn. Posterior rami	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend
Lateral intertransversarii lumbora	L1-L5 TP of superior segment	L1-L5 TP of inferior segment	Spinal nn. (anterior rami)	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend
Levatores cosatrum breves	C7-T11 TP	Costal angle of next inferior rib	Spinal nn. (posterior rami)	Bilateral: Thoracic extension Unilateral: Thoracic ipsilateral sidebend, contralateral rotation
Levatores costarum longi	C7-T11 TP	Costal angle of rib 2 segments inferior	Spinal nn. (posterior rami)	Bilateral: Thoracic extension Unilateral: Thoracic ipsilateral sidebend, contralateral rotation
Medial intertransversarii cervicis
Medial intertransversarii lumbora	L1-L5 Mammillary process of superior segment	L1-L5 Mammillary process of inferior segment	Spinal nn. (posterior rami)	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend
Posterior intertransversarii cervicis	C2-C7 Posterior tubercle of superior segment	C2-C7 Posterior tubercle of superior segment	Spinal nn. (posterior rami)	Bilateral: Cervical extension and stabilization, lumbar extension and stabilization Unilateral: Cervical extension and ipsilateral sidebend, Lumbar extension and ipsilateral sidebend

Lumbar spine muscles

For the lumbar spine, we will organize the muscles based on depth (superficial → deep) as well as location from midline (medial → lateral).

Palpation

Prone

• vertebra
  • SPs
  • spacing
  • rotation
  • Depth