Final Exam Notes for Deep Tissue

The three muscles that will be on the front will be gluteus minimus, anterior serratus, and pectoralis minor.

Gluteus minimus

proximal: outer surface of ilium between the anterior (middle) and inferior gluteal lines

distal: anterosuperior aspect of greater trochanter (anterior to piriformis and deep to the gluteus medius

action:

1. Abducts femur
2. Prevents contralateral hip drop
3. Medial rotation of femur and a small amount of lateral rotation
4. Assists gluteus medius medius in all functions

Gluteus Minimus

Anterior Serratus

axial: serrated muscle from the first to the ninth ribs along mid-axillary line (mid-coronal plane)

pectoral:  along the anterior (costal side of the vertebral border of the scapula from the superior to the inferior angle

action:

1. Protracts scapula
2. Elevates scapula
3. Supports flexion and abduction of arm
4. Fixes medial border of scapula against thorax
5. carries thorax during a pushup

Anterior Serratus

Pectoralis Minor

axial

third, forth, and fifth ribs near costal cartilages, occasionally 6^th, or as high as first

pectoral

medial aspect of the tip of the coracoid process (shared with coracobrachialis & short head of biceps)

action

1. Depresses scapula
2. Protracts scapula
3. Assists in forced inspiration
4. Stabilizes scapula for downward thrust of arm
5. wings scapula when clavicle acts as a lever

Pectoralis Minor

for the back of the test there are 5 axial attachments for sternocleidomastoid, pectoral major, serratus anterior, traps. Then 5 pectoral attachments for the trapezius, levator scapula, pec minor, rhomboids and latissimus dorsi

axial attachments:

sternocleidomastoid

axial(cranial)

sternal & clavicular- combined attachment on lateral surface of mastoid process and lateral half of superior nuchal line of occipital bone.

Axial and pectoral(caudal)

sternal(axial)- anterior surface of manubrium

clavicular(pectoral)- medial one third of superior border of clavicle.

Sternocleidomastoid

pectoralis major

proximal (axial)

clavicular- inferior side of medial two thirds of clavicle.

Sternal- along the lateral edge of the sternum.

Costal- cartilages of 2^nd- 6^th or 7^th ribs.

Pectoralis major

pectoralis minor

axial

3^rd, 4^th, and 5^th ribs near costal cartilages, occasionally 6^th, or as high as 1^st.

Pectoralis minor

serratus anterior

axial

serrated muscles from the frist to the ninth ribs along mid axillary line (mid coronal plane)

serratus anterior

trapezius overview

axial

superior nuchal line

occipital protuberance,

ligamentum nuchae over spinous processes of C1-C7,

spinous processes of T1-T12

trapezius

rhomboids minor

axial- ligamentum nuchae over C7, spinous of C7, T1

rhomboids minor

rhomboids major

axial- spinous process of T2-T5

rhomboids major

pectoral attachments

trapezius

pectoral-superior side of lateral one third of clavicle,

supero-medial side of acromion,

superior border of scapular spine, &

medial one-third of scapular spine

trapezius

levator scapulae

pectoral-vertebral (medial) border of scapula between superior angle and root of its spine

levator scapulae

pectoralis minor

pectoral-medial aspect of the tip of the coracoid process (shared with coracobrachialis & short head of biceps)

pectoralis minor

rhomboids minor

pectoral- medial (vertebral) border of scapula at spinal root

rhomboids minor

rhomboids major

pectoral- medial (vertebral) border of scapula from root of spine to inferior angle

rhomboids major

latissimus dorsi

pectoral- medial edge of intertubercular groove of humerus(fused w/ teres maj)

latissimus dorsi

Active myofascial TrP is a hyperirritable spot within a taut band of skeletal muscle or in the muscles fascial that causes pain currently.

1. It is always tender upon palpation
2. Prevents full lengthening of the muscle
3. Weakens the muscle
4. Usually refers pain on direct compression
5. Often produces specific autonomic phenomena in its pain reference zone.

Latent myofascial TrP is a hyperirritable spot within a taut band of skeletal muscle or in the muscle’s fascia that is not causing pain currently.

1. It is tender only upon palpation and may refer pain into its pain reference zone at this time.
2. It may also cause autonomic phenomena
3. Weakness and/or restricted ROM.

A latent TrP may persist for years after apparent recovery from injury; it predisposes to acute attack of pain since minor overstretching, overuse, or chilling of the muscle may suffice to reactivate it.

Notes on Trigger Point: TrP

 

Myofascial Trigger Point (TrP):  A hyperirritable spot within a band of skeletal muscle [or the muscle’s fascia] that is not causing pain currently. It is tender only upon palpation and may refer pain into its pain reference zone at this time. It may also cause autonomic phenomena, weakness and/or restricted ROM. A latent TrP may persist for years after apparent recovery from injury; it predisposes to acute attack of pain since minor over stretching, overuse, or chilling of the muscle may suffice to reactivate it.

multifidus

semispinalis

multifidus

ilicostalis

rectus capitis posterior minor

rectus capitis posterior major

obliquus capitis superior

obliquus capitis inferior

semispinalis cervicus

semispinalis capitis

longissimus cervicus

longissimus capitis

splenius cervicus

splenius capitis

levator scapulae (axial)

posterior serratus superior

rhomboideus minor (axial)

rhomboideus major (axial)

quadratus lumborum (axial)

ilicostalis lumborum (axial)

iliocosalis lumborum (axial)

posterior serratus inferior

upper trapezius (axial)

middle trapezius (axial)

lower trapezius (axial)

 levator scapulae

axial posterior tubercles on transverse process of C1- C4

pectoral vertebral (medial) border of scapula between superior angle and root of its spine.

Action 1.elevates whole scapula

2.Rotates scapula facing glenoid fossa downwards

3.Lateral flexion of neck to same side

levator scapulae

 

rhomboideus minor

axial ligamentum nuchae over C7, spinous processes of C7, T1

pectoral medial (vertebral) border of scapula at spinal root.

Action 1.retracts scapula

2.Elevates scapula

3.Stabilizes scapula

4.Assists bilateral extension of thoracic spine

reverse action

Rotates the spine to opposite side when scapula is fixed

rhomboideus minor

 

rhomboideus major

axial spinous processes of T2-T5

pectoral media (vertebral) border of scapula from root of spine to inferior angle

Action 1.retracts scapula

2.Elevates scapula

3.Stabilizes scapula

4.Rotates glenoid fossa downwards

5.Assists bilateral extension of thoracic spine

reverse action

Rotates the spine to opposite side when scapula is fixed

rhomboideus major

 

quadratus lumborum

axial ends of lumbar transverse processes and medial half of 12^th rib

pectoral uppermost posterior crest of ilium and iliolumbar ligament

action 1.laterally flexes spine to same side with the pelvis fixed- concave

2.Opposite side brakes motion with lengthening contraction

3.Elevates the ipsilateral hip with spine fixed

4.Assists bilateral extension of lumbar spine

5.Stabilizes 12^th rib for breathing

quadratus lumborum

 

iliocostalis lumborum

axial angles of ribs 7-12

pelvic medial iliac crest, lumbordorsal fascia

action 1.bilaterally extends lumbar vertebrae

2.Laterally flexes lumbar vertebrae

3.function similarily to the quadratus lumborum

iliocostalis lumborum

 

upper trapezius

axial superior nuchal line, occipital protuberance and ligamentum nuchae over spinous processes of C1-C7

pectoral superior (cranial) side of lateral one third of clavicle and supero-medial side of acromion

action 1.elevates scapula and clavicle

2.Rotates glenoid fossa upwards

3.Aids flexion and abduction of humerus

4.Bilateral assists extension of cervical spine
reverse action

Sidebending of neck and head while rotation chin to contralateral side

upper trapezius

 

middle trapezius

axial spinous processes of T1-T5

pectoral superior (cranial) border of scapular spine

action 1.retracts (adducts) scapula

2.Rotates glenoid fossa upward

3.Aids flexion and abduction of humerus

4.Bilateral assists extension of cervical and thoracic spin

middle trapezius

 

lower trapezius

action spinous processes of T6-T12

pectoral medial one-third of scapular spine action

            1. Retracts (adducts) scapula
            2.Depresses scapula
            3.Rotates glenoid fossa upward
            4.Aids flexion and abduction of humerus
            5.Bilateral assists extension of thoracic spine

l              lower trapezius

 trapezius overview

axial superior nuchal line, occpital protuberance, ligamentum nuchae over spinous processes of C1-C7, and spinous processes of T1-T12

pectoral superior side of lateral one-third of clavicle, supero-medial side of acromion, superior border of scapular spine, medial one-third of scapular spine

action 1.elevates scapula and clavicle

2.Retracts scapula

3.Depresses scapula

4.Rotates glenoid fossa upwards

5.Bilateral assists extension of cervical and thoracic spine

reverse action

Sidebending of neck and head while rotation chin to

contralateral side

trapezius overview

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