Step 2 -
Dissection of the Back

  1. Reflecting the skin reveals the superficial back muscles including the trapezius and the latissiumus dorsi muscle. Delineate these muscles and find the triangle of auscultation (video).

  2. Next, reflect the trapezius muscle (video) from medial to lateral. It is particularly important to find the spinal accessory nerve (CN XI) along the superior border of the trapezius before reflecting this muscle. The superficial branch of the transverse cervical artery should also be cleaned.
    NOTE: With few exceptions, the nerve and blood supply are found on the deep surface of muscles and are typically surrounded by fat. Look where there is fat!

  3. Reflect the latissimus dorsi muscle (video) revealing the thoracodorsal nerve and artery and the underlying true back muscles. As you reflect the latissimus dorsi m., clean the serratus anterior muscle along with its nerve (long thoracic) and the lateral thoracic artery. You will study this nerve and artery again when you dissect the axilla.
    NOTE: If you do not locate the serratus anterior, you will most certainly cut it as you reflect the latissimus dorsi m. Maybe ask for help at this point.
    NOTE: The posterior inferior serratus muscle is frequently reflected along with the latissimus dorsi m. Look for it there if you don't see it.

    We will return to back muscles on the shoulder later, but you may want to clean these muscles at this time. Demonstrate the deltoid, teres major, teres minor and long head of the triceps.

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John A. McNulty, Ph.D.
Last Updated: Sep 24, 2008
Created: Mar 1, 1996