Henry Gray (18251861). Anatomy of the Human Body. 1918.
a. The Muscles Connecting the Upper Extremity to the Vertebral ColumnThe muscles of this group are:
Superficial Fascia.The superficial fascia of the back forms a layer of considerable thickness and strength, and contains a quantity of granular fat. It is continuous with the general superficial fascia.
Deep Fascia.The deep fascia is a dense fibrous layer, attached above to the superior nuchal line of the occipital bone; in the middle line it is attached to the ligamentum nuchæ and supraspinal ligament, and to the spinous processes of all the vertebræ below the seventh cervical; laterally, in the neck it is continuous with the deep cervical fascia; over the shoulder it is attached to the spine of the scapula and to the acromion, and is continued downward over the Deltoideus to the arm; on the thorax it is continuous with the deep fascia of the axilla and chest, and on the abdomen with that covering the abdominal muscles; below, it is attached to the crest of the ilium.
The Trapezius(Fig. 409) is a flat, triangular muscle, covering the upper and back part of the neck and shoulders. It arises from the external occipital protuberance and the medial third of the superior nuchal line of the occipital bone, from the ligamentum nuchæ, the spinous process of the seventh cervical, and the spinous processes of all the thoracic vertebræ, and from the corresponding portion of the supraspinal ligament. From this origin, the superior fibers proceed downward and lateralward, the inferior upward and lateralward, and the middle horizontally; the superior fibers are inserted into the posterior border of the lateral third of the clavicle; the middle fibers into the medial margin of the acromion, and into the superior lip of the posterior border of the spine of the scapula; the inferior fibers converge near the scapula, and end in an aponeurosis, which glides over the smooth triangular surface on the medial end of the spine, to be inserted into a tubercle at the apex of this smooth triangular surface. At its occipital origin, the Trapezius is connected to the bone by a thin fibrous lamina, firmly adherent to the skin. At the middle it is connected to the spinous processes by a broad semi-elliptical aponeurosis, which reaches from the sixth cervical to the third thoracic vertebræ, and forms, with that of the opposite muscle, a tendinous ellipse. The rest of the muscle arises by numerous short tendinous fibers. The two Trapezius muscles together resemble a trapezium, or diamond-shaped quadrangle: two angles corresponding to the shoulders; a third to the occipital protuberance; and the fourth to the spinous process of the twelfth thoracic vertebra.
Variations.The attachments to the dorsal vertebræ are often reduced and the lower ones are often wanting; the occipital attachment is often wanting; separation between cervical and dorsal portions is frequent. Extensive deficiencies and complete absence occur.
The clavicular insertion of this muscle varies in extent; it sometimes reaches as far as the middle of the clavicle, and occasionally may blend with the posterior edge of the Sternocleidomastoideus, or overlap it.
The Latissimus dorsi(Fig. 409) is a triangular, flat muscle, which covers the lumbar region and the lower half of the thoracic region, and is gradually contracted into a narrow fasciculus at its insertion into the humerus. It arises by tendinous fibers from the spinous processes of the lower six thoracic vertebræ and from the posterior layer of the lumbodorsal fascia (see page 397), by which it is attached to the spines of the lumbar and sacral vertebræ, to the supraspinal ligament, and to the posterior part of the crest of the ilium. It also arises by