The muscles of the back can be divided into three groups – superficial, intermediate and deep: Superficial – associated with movements of the shoulder. Intermediate – associated with movements of the thoracic cage. Deep – associated with movements of the vertebral column. The deep muscles develop embryologically in the back, and are thus described as intrinsic muscles. The superficial and intermediate muscles do not develop in the back, and are classified as extrinsic muscles. This article is about the anatomy of the superficial back muscles – their attachments, innervations and functions. The superficial back muscles are situated underneath the skin and superficial fascia. They originate from the vertebral column and attach to the bones of the shoulder – the clavicle, scapula and humerus. All these muscles are therefore associated with movements of the upper limb. The muscles in this group are the trapezius, latissimus dorsi, levator scapulae and the rhomboids. The trapezius
Patients present with a variety of conditions, and assessments need to be adapted to suit their needs. This section provides a basic framework for the subjective and physical musculoskeletal assessment of a patient. Subjective examination Body chart Location of current symptoms Type of pain Depth, quality, intensity of symptoms Intermittent or constant Abnormal sensation (e.g. pins and needles, numbness) Relationship of symptoms Check other relevant regions Behaviour of symptoms Aggravating factors Easing factors Severity Irritability Daily activities/functional limitations 24-hour behaviour (night pain) Stage of the condition Special questions Red flags Spinal cord or cauda equina symptoms Bilateral extremity numbness/pins and needles Dizziness or other symptoms of vertebrobasilar insufficiency (diplopia, drop attacks, dysarthria, dysphagia, nausea) History of present condition Mechanism of inj