Fascia of the chest. Muscles and fascia of the chest. A set of exercises to strengthen the muscles of the back

On the surface of the chest walls, the jugular notch of the sternum is determined in the form of bony landmarks, the clavicle to the right and left of it, below is the xiphoid process of the sternum, as well as the ribs and costal arches. The jugular notch of the sternum corresponds to the lower edge of the II thoracic vertebra. The lower border of the sternum body is at the level of the IX thoracic vertebra. The angle of the sternum is projected onto the intervertebral disc between the IV and V thoracic vertebrae. On the surface of the chest walls, the contours of the pectoralis major muscle and the deltoid-pectoral groove (in men) are determined. In women, at the level of the III-VI ribs, the mammary glands are located, separated by a gap. On the lateral surface of the chest, a dentate line is visible, formed by the initial teeth of the serratus anterior muscle and the external oblique muscle of the abdomen. The skin of the chest is thin; in men, there is hair in the area of ​​the sternum and shoulder blades. Sweat and sebaceous glands are most numerous in the area of ​​the sternum, shoulder blades, on the lateral surfaces of the chest. Subcutaneous tissue is moderately expressed, more in women. Superficial veins, terminal branches of arteries (internal thoracic, intercostal, lateral thoracic), anterior and lateral branches of intercostal nerves pass through the tissue.

The superficial fascia, which is part of the superficial fascia of the body, is poorly developed. She participates in the formation of the mammary gland capsule, extending deep into its connective tissue septa, dividing the gland into lobes. The fascia bundles extending from the connective tissue capsule of the mammary gland to the clavicle are called the ligament that supports the mammary gland (lig. Suspensorium mammae).

The pectoral fascia (fascia pectoralis), lying under the surface, has two sheets (plates) - superficial and deep, which form the sheath of the pectoralis major muscle.

Superficial lamina of the thoracic fascia at the top it is attached to the clavicle, medially - fuses with the periosteum of the anterior surface of the sternum. This plate extends laterally into the deltoid fascia, which passes downward into the axillary fascia.

Deep plate of pectoral fascia located on the back surface of the pectoralis major muscle, between it and the pectoralis minor. It forms the sheath of the pectoralis minor. Above, within the clavicothoracic triangle (between the upper edge of the pectoralis minor and the clavicle), the deep plate is compacted and takes on the name of the clavicular-pectoral fascia (fascia clavipectoralis). Laterally and downward from the pectoralis minor muscle, the deep plate of the pectoral fascia grows together with the superficial plate of this fascia. Three triangles are distinguished behind the small and large pectoral muscles. Clavicothoracic triangle located between the clavicle at the top and the upper edge of the pectoralis minor at the bottom. This triangle corresponds to the location of the clavo-thoracic fascia. The pectoral triangle corresponds to the outlines of the pectoralis minor. The pectoralis triangle is located between the lower edges of the pectoralis minor and pectoralis major muscles. In the area of ​​the sternum, the pectoral fascia grows together with the periosteum of the sternum and forms a dense connective tissue plate - the anterior membrane of the sternum.

Between both pectoral muscles lying in the fascial sheaths is located inframammary cellular space. Under the pectoralis minor muscle - deep chest space. Both are filled with a thin layer of fatty tissue.

In addition to these fascia, the thoracic and intrathoracic fascia are also distinguished. The pectoral fascia itself (fascia thoracica) covers the outside of the external intercostal muscles, as well as the ribs, growing together with their periosteum. The intrathoracic fascia (fascia endothoracica) lines the chest cavity from the inside, i.e. adjoins from the inside to the internal intercostal muscles, the transverse muscle of the chest and the inner surfaces of the ribs.

21 22 23 24 25 26 27 28 29 ..

Muscles and fascia of the chest (human anatomy)

The muscles of the chest are divided into the muscles of the chest, related to the shoulder girdle and upper limb (pectoralis major and minor, subclavian and serratus anterior muscles), and the own muscles of the chest (external and internal intercostal muscles) (see Fig. 40).

The pectoralis major muscle lies superficially, it is triangular. It starts from the outer part of the clavicle, sternum and from the cartilage of the II-VII ribs. Attaches to the crest of the large tubercle of the humerus. The muscle brings the arm to the torso, rotating it inward. The clavicular muscle raises the arm forward. With a fixed upper limb, it raises the ribs, participating in the act of inhalation.

The pectoralis minor muscle is located deeper than the large one, begins with teeth from the II-V ribs and attaches to the coracoid process of the scapula. Pulls the scapula forward and somewhat downward. When the shoulder blade is fixed, it raises the ribs, making it easier to inhale.

The subclavian muscle is very small in size, located between the I rib and the clavicle. Pulls the collarbone down and medially.

The serratus anterior muscle occupies the lateral surface of the chest. It begins with teeth from the top nine ribs and attaches to the inferior angle and medial edge of the scapula. Pulls the scapula anteriorly, while simultaneously turning its lower corner outward. This ensures that the arm is abducted above the horizontal level. Together with the rhomboid muscle, it presses the scapula to the body.

All of these muscles, when fixing the shoulder girdle and upper limb, can participate in the act of inhalation. This explains the forced posture of patients who have difficulty exhaling (for example, patients with bronchial asthma). They usually sit tightly holding onto the headboard of a bed or chair. In this position, the contraction of the chest muscles increases exhalation and makes breathing easier.

The external and internal intercostal muscles fill the intercostal spaces. The first raise the ribs (inhale), the second lower them (exhale).

Fascia of the chest. Allocate the thoracic and intrathoracic fascia. The pectoral fascia has two layers - superficial and deep. The superficial leaf covers the outside of the pectoralis major and serratus anterior muscles. The deep leaf is called the clavicular-pectoral fascia, it forms the fascial sheaths for the pectoralis minor and subclavian muscles. From the inside, the chest is lined with the intrathoracic fascia, passing to the diaphragm.

The diaphragm (Fig. 43) - the abdominal obstruction, is a thin flat muscle curved in the form of a dome with a bulge upward. The muscle bundles of the diaphragm start from the sternum, ribs and lumbar vertebrae (along the entire circumference of the lower opening of the chest). According to their beginning in the diaphragm, the sternum, costal and lumbar parts are distinguished. Muscle bundles, heading towards the middle of the diaphragm, pass into a tendon extension and form a tendon center. The lumbar part is the strongest and consists of two legs - right and left. The medial portions of the pedicles delimit two large openings through which the esophagus and aorta pass. In the tendon center there is an opening of the inferior vena cava.

Rice. 43. Aperture (bottom view). 1 - tendon center; 2, 5, 6 - legs of the lumbar part of the diaphragm; 3 - esophageal opening; 4 - aortic opening; 7 - rib part; 8 - sternum; 9 - opening of the inferior vena cava

The diaphragm is the main respiratory muscle. With contraction, it flattens and falls, while the volume of the chest increases, inhalation occurs. When the diaphragm relaxes, it rises again in the form of a dome, the lungs collapse and exhalation occurs.

Back pain can be associated with many health problems, such as a spinal disc injury. Recently, another disease has become widespread, which has attracted great attention of doctors - pain in the area where the lumbar-thoracic fascia is located.

It is important to pay attention to this problem in time in order to be able to prevent many diseases that can definitely ruin a full-fledged human life. Basically, special attention should be paid to strengthening the back muscles.

What is fascia?

Fascia is a connective thick tissue that covers muscles and bones, but the most important task is to support all organs. Sometimes pain may occur in this place. As soon as back pain appears, it can be understood that problems in the fascia region have begun. In this case, it is important to establish the cause, and there can be many of them.

What are the pains

Not so long ago, laboratory studies were carried out by scientists who came to the conclusion that pain can occur of three types:

1. Sometimes the deep plate of the lumbar-thoracic fascia undergoes minor trauma or inflammation, in which case the nerve endings are actively stimulated. The fascia in the lumbar-thoracic region is very close to the skin. In the inflammatory process, all nerve impulses are sent to the brain, and pain occurs.
2. If a person is injured, the tissues can become immobile and congested. These changes negatively affect the posture and mobility of the body, over time it causes not only inconvenience, but also pain.
3. Any injury irritates the nerve endings. The nerves branch out and the root itself resides in the spinal cord. The injury causes pain in a specific area of ​​the back.

Fascia layers

The lumbar-thoracic fascia is divided into 3 main layers. Virtually all muscles in the back are attached to the fascia. The entire muscle group runs from the first longitudinal vertebra to the very bottom:

1. The layer behind starts from the twelfth vertebra and extends to the very bottom. On the way, this layer has the internal oblique muscle and the abdominal muscle. In this case, the fascia connects the muscles of the back and the peritoneum.

2. The middle layer is the broad muscle of the back, it is he who plays the role of support for the body and helps to freely move the weight of the body. This layer begins directly from the lumbar-thoracic fascia.

3. The front layer helps to bend the body and calmly hold any upright posture.

Oddly enough, back pain can occur not only in adults, but even in the smallest. Intense pain can lead to disability.

The main functions of the fascia

It is worth noting that the fascia is primarily an inelastic support that allows you to hold the pelvis, trunk and all limbs correctly, and also allows you to freely distribute all the load throughout the body. Let us consider in detail what functions the lumbar-thoracic fascia performs:

1. While the muscles on the abdomen begin to activate, the fascia begins to restrict the movement of the pelvic bones, and the work of the iliac joints is improving.
2. When horizontal muscle tension occurs, the transverse abdominal muscles begin to contract in the peritoneal region and thereby stabilize the pelvis.
3. The muscles that connect to the fascia balance the tension and force the muscle group that is responsible for it to straighten the spine.

Most often, pain occurs in the lower back.

Fascia and its structure

Latin is often used in medicine. The lumbar-thoracic fascia is called fascia thoracolumbalis. In fact, the fascia itself is like a special depression where the spinal muscles are located. If we consider it in more detail, then it resembles two leaves, they can be divided into back and front. The anterior leaflet is located in the lumbar region and stretches between the processes at the vertebra. The superficial plate of the lumbar-thoracic fascia begins on the processes of the vertebrae and is attached to the ribs at the corners.

Should you pump your back muscles? How to do it correctly?

It is important to remember about all the rules that are for these exercises:

1. First of all, it should be borne in mind that classes should be held regularly. You can conduct such classes twice a week, you should not be too zealous either. If you do these exercises too often, then the muscles will not have time to recover.

2. It is not worth doing all the exercises at one time, it is advisable to do several approaches. Each exercise is done 15 times.

3. In no case should you start exercises without warming up the muscles.

4. The complexes must change, otherwise the muscles will get used to such constant loads.

Many are wondering what to do if the lumbar-thoracic fascia is weak. How to pump it up to forget about back pain? All the recommendations that have been given above will help to cope with this problem.

A set of exercises to strengthen the muscles of the back

Here are some exercises to help strengthen your back muscles:

1. After the body is slightly warmed up, you can start the first exercise. The body drops to a position parallel to the floor, the legs are slightly bent at the knees, and the person has dumbbells in his hands. The dumbbells in the hands should be lifted so that the shoulder blades are connected on the back. These exercises are done slowly, as the main effect is to stretch the lats.
2. If it is necessary to strengthen the area where the lumbar-thoracic fascia is located, the exercise should be selected for pulling up. It is performed on a horizontal bar. Hands are placed shoulder-width apart, you should stretch up to the crossbar, trying to reach it with your chin, after which the body slowly lowers down.
3. In the next exercise, you can use a bench. It is necessary to stand with your back to it and gradually bend to the right, leaning on the bench with the help of your right hand. In this case, it is important to bend the lower back well. The left leg is bent at the knee, and the right leg acts as a support. This exercise can be made more difficult to properly strengthen the lumbar-thoracic fascia. For example, take dumbbells in your left hand and reach up with your right. Next, change your hands and do the same with your left hand, dumbbells in your right hand.
4. To complete this exercise, you will need to use a hard mat on which you place your pelvis and legs. A person should lie down with his pelvis and legs, while the legs must be fixed in any way, only so that they do not move. Hands are placed on the back of the head. The main task is to raise your body as much as possible in this position, and then slowly lower it down. It is important to bend your back, jerking is prohibited, everything is done smoothly.

Such seemingly simple exercises will help relieve back pain and significantly strengthen the muscles, which is important for a normal, mobile lifestyle.

What should you consider when exercising at home?

In order for the lumbar-thoracic fascia to strengthen, it is always worth remembering the main rules when performing exercises:

If you follow all the recommendations that were given in the article, then you can once and for all get rid of such a problem as back pain. Additionally, you can consult with a specialist doctor who can not only help you compose a diet for the day, but also select the right exercises.

The pectoral fascia (fascia pectoralis) (Fig. 106) consists of two sheets. The superficial leaflet covers the outer surface of the pectoralis major muscle (in women, the superficial leaflet of the pectoral fascia separates the pectoralis major muscle from the mammary gland). A deep leaf is located between the pectoral muscles. In the upper part, it grows together with the clavicle and the coracoid process, in the subclavian region on both sides it surrounds the pectoralis minor muscle and the subclavian muscle, forming a dense area called the claviothoracic fascia (fascia clavipectoralis), in the central part it grows together with the sternum, on the sides it passes to the anterior dentate muscle, and from top to bottom - into the fascia of the abdominal wall. Throwing from the lower edge of the pectoralis major muscle to the lower edge of the broad dorsi muscle, a deep leaf of the pectoral fascia lines the area of ​​the axillary fossa, forming the axillary fascia (fascia axillaris).

Rice. 106. Superficial muscles and fascia of the chest and abdomen: 1 - digastric muscle: anterior abdomen;2 - maxillary-hyoid muscle;3 - sternocleidomastoid muscle;4 - scapular-hyoid muscle;5 - subcutaneous muscle of the neck;6 - sternohyoid muscle;7 - trapezius muscle;8 - deltoid muscle;9 - pectoralis major muscle;10 - pectoral fascia;11 - biceps brachii;12 - the broadest muscle of the back;13 - shoulder fascia;14 - serratus anterior muscle;15 - aponeurosis of the external oblique muscle of the abdomen;16 - external oblique muscle of the abdomen

The intrathoracic fascia (fascia endothoracica) lines the inner surface of the chest walls.

Diaphragm

The diaphragm (diaphragma) (Fig. 107, 108), which is also called the abdominal obstruction, is a muscular septum between the chest cavity and the abdominal cavity. This is a thin, wide, unpaired plate curved with the convex side up, closing the lower opening of the chest.

Rice. 107. Aperture (top view):

1 - the lumbar part of the diaphragm; 2 - aortic opening; 4 - esophageal opening; 5 - opening of the vena cava; 6 - tendon center; 7 - sternal part of the diaphragm

The diaphragm serves as the main respiratory muscle. By flattening as it contracts, it increases the volume of the chest, facilitating inhalation. When relaxed, the diaphragm takes on a spherical convex shape, reduces the chest, which allows exhalation. When contracted together with the abdominal muscles, the diaphragm helps the abdominal muscles work.

All muscle bundles of the diaphragm, which go from the bone and cartilaginous parts of the lower aperture of the chest and lumbar vertebrae, go to the center, where they pass into tendon bundles and form a tendon center (centrum tendineum) (Fig. 107, 108), which looks like a trefoil. In the tendon center there is a four-sided opening of the vena cava (foramen venae cavae) (Fig. 107, 108), which passes the inferior vena cava.

Rice. 108. Diaphragm and muscles of the back wall of the abdomen:

1 - sternal part of the diaphragm; 2 - tendon center; 3 - costal part of the diaphragm; 4 - opening of the vena cava; 5 - esophageal opening; 6 - the lumbar part of the diaphragm; 7 - medial arc ligament; 8 - aortic opening; 9 - median arcuate ligament; 10 - lateral arch ligament; 11 - left leg of the diaphragm; 12 - right leg of the diaphragm

At the site of the beginning of the muscle bundles in the diaphragm, three parts are distinguished. The sternum (pars sternalis diaphragmatis) (Fig. 107, 108) starts from the posterior surface of the xiphoid process. The costal part (pars costalis diaphragmatis) (Fig. 107, 108) is the most extensive. It begins on the inner surface of the bony and cartilaginous parts of the six lower ribs. Its beams are directed upward and inward. The lumbar part (pars lumbalis diaphragmatis) (Fig. 107, 108) is divided into the right leg (crus dextrum) (Fig. 108) and the left leg (crus sinistrum) (Fig. 108), each of which starts from the anterolateral surface I – III lumbar vertebrae and tendon lumbar ligaments. The medial arc ligament (lig. Arcuatum mediale) (Fig. 108) goes from the body to the transverse process of the I lumbar vertebra, the lateral arc ligament (lig. Arcuatum laterale) (Fig. 108) - from the transverse process of the I lumbar vertebra to the XII rib; median arc ligament (lig. arcuatum medianum) (Fig. 108) closes the aortic opening. The central muscle bundles of the lumbar part limit the aortic opening (hiatus aorticus) (Fig. 107, 108), which passes the aorta. Slightly lower is the esophageal opening (hiatus esophageus) (Fig. 107, 108), which passes the esophagus.

The thoracic and abdominal surfaces of the diaphragm are covered with fascia.

In the muscle group of the chest, superficial muscles that attach to the bones of the shoulder girdle - pectoralis major and minor, serratus anterior and subclavian muscles, and deep, or intrinsic, chest muscles - external and internal intercostal muscles. The muscles of the chest also include diaphragm.

Pectoralis major muscle triangular in shape, begins on the outer surface of the clavicle, sternum and cartilage II-VII ribs. The muscle is attached to the crest of the greater tubercle of the humerus. The muscle brings the arm to the torso and rotates it inward. With a fixed hand, it raises the ribs, expands the chest.

Pectoralis minor lies under the pectoralis major muscle. It begins on the II-V ribs, goes up and laterally and is attached to the coracoid process of the scapula. The muscle pulls the scapula forward and downward, with a fixed scapula lifts the ribs, participating in the act of inhalation.

Subclavian muscle located between the clavicle and the first rib, pulls the clavicle down and medially.

Serratus anterior muscle begins with teeth from the nine upper ribs, goes posteriorly and medially and attaches to the medial edge of the scapula, down to its lower angle. The muscle pulls the scapula anteriorly, turning its lower angle outward. With a fixed scapula, the muscle raises the ribs, participating in the act of inhalation.

Outdoor and internal intercostal muscles are located in the intercostal spaces in two layers. The external muscles raise the ribs (the act of inhalation), the internal muscles lower the ribs (the act of exhalation).

Diaphragm, or midriff, separating the chest cavity from the abdominal cavity, has the form of a dome, convex facing upwards. Her muscle bundles begin at the sternum (sternum), ribs (rib part), lumbar vertebrae ( lumbar) - along the lower border of the chest. Then the muscle bundles pass into a flat tendon extension that occupies the middle part of the diaphragm - this is its tendon center... The lumbar part of the diaphragm forms two legs - right and left. The medial parts of the legs limit two openings: the posterior one for the aorta, the anterior one for the esophagus. The tendon center has an opening for the inferior vena cava. The diaphragm is the main respiratory muscle; when contracted, it flattens, descends, increasing the volume of the chest cavity (the act of inhalation). When the diaphragm relaxes, it rises, while the volume of the chest cavity decreases (the act of exhalation).

Breast fascia.

Superficial fascia of the chest lies on the pectoralis major and dentate anterior muscles. Deep fascia forms a vagina for the pectoralis minor and subclavian muscles, it is also adjacent to the external intercostal muscles. The inner surface of the chest walls covers intrathoracic fascia which also extends to the diaphragm.

MUSCLES AND FASCES OF THE ABDOMINAL.

The abdominal cavity is abdomen, the walls of which are formed at the top by the diaphragm, at the bottom by the bones and muscles of the pelvis and the pelvic floor. The back wall is formed by the spinal column and the paired square muscle of the lower back. The anterior and lateral walls are also formed by paired muscles and their fascia. These are paired external and internal oblique, transverse and rectus abdominis muscles.

External oblique muscle of the abdomen, wide, thin, begins with teeth on the lower eight ribs, from where it follows forward and downward. The muscle continues into a broad tendon (aponeurosis), which attaches to the iliac crest, the pubic symphysis. Along the midline of the anterior abdominal wall, the aponeurosis of the external oblique muscle of the abdomen connects with the same tendon of the other external oblique muscle, where they form the so-called white line belly. This line extends from the xiphoid process to the pubic symphysis.

In some cases (increased intra-abdominal pressure, for example, with constipation), the connective tissue fibers that form the white line of the abdomen can delaminate, form narrow gaps. As a result, these areas are weak points, and here can form hernia of the white line of the abdomen.

Approximately in the middle of the white line there is umbilical ring (navel), closed by connective tissue. In embryos, fetuses, blood vessels pass through the umbilical ring. The umbilical ring can also be the site of umbilical hernia formation.

Internal oblique muscle of the abdomen located under the outer. It starts at the iliac crest, inguinal ligament, and travels forward and upward. The posterior bundles of the oblique abdominal muscle are attached to the cartilage of the lower ribs, and its wide aponeurosis is involved in the formation of the white line of the abdomen.

Transverse abdominal muscle lies in the third layer, under the two previous oblique muscles. It begins on the inner surface of the six lower ribs, the iliac crest, and the inguinal ligament. The muscle is directed forward, continues into a wide aponeurosis, woven into the white line of the abdomen.

Rectus abdominis muscle located on the side of the white line of the abdomen, its bundles have a vertical direction. The muscle begins on the xiphoid process of the sternum, the cartilage of the V-VII ribs and attaches to the pubic ridge and pubic symphysis.

The rectus abdominis muscles pull the ribcage downward and flex the torso. The oblique muscles of the abdomen also tilt the body forward, participate in turning it to the right and left and in breathing, since they are attached to the ribs.

Square muscle of the lower back located on the side of the lumbar spine. It participates in the formation of the posterior abdominal wall. This muscle begins on the XII rib, the transverse processes of the I-IV lumbar vertebrae, and attaches to the iliac crest and the transverse processes of the lumbar vertebrae. This muscle, when contracted, tilts the spine to its side.

The muscles of the abdomen, with their contraction, increase intra-abdominal pressure, which is important for keeping the internal organs in their natural position. Intra-abdominal pressure promotes bowel movement (bowel movement), urination, and in women, the expulsion of the fetus from the uterus during childbirth. In connection with these functions, the abdominal muscles form the so-called abdominal Press.

Abdominal fascia cover not only individual muscles of the abdominal walls. Outside there is superficial fascia, which covers the outer layer of the abdominal muscles, being an extension of the superficial fascia of the chest. From the side of the abdominal cavity, the abdominal wall is lined intra-abdominal fascia.

Inguinal canal, which looks like a gap, is located above the inguinal ligament. The anterior wall of the inguinal canal is the lower aponeurosis of the external oblique muscle of the abdomen. The upper wall is formed by the lower bundles of fibers of the internal oblique and transverse abdominal muscles, and the posterior wall of the transverse fascia is part of the intra-abdominal fascia. The length of the inguinal canal is about 5 cm. From the side of the abdominal cavity there is deep (inner) groin ring, which is located 2 cm above the inguinal ligament, approximately above its middle. Superficial inguinal ring is located above the medial part of the inguinal ligament in the gap between the divergence of the fibers of the external oblique muscle of the abdomen. The spermatic cord passes through the inguinal canal in men, and the round ligament of the uterus in women.