Henry Gray (18251861). Anatomy of the Human Body. 1918.
muscular fibers from the external lip of the crest of the ilium lateral to the margin of the Sacrospinalis, and from the three or four lower ribs by fleshy digitations, which are interposed between similar processes of the Obliquus abdominis externus (Fig. 392, page 409). From this extensive origin the fibers pass in different directions, the upper ones horizontally, the middle obliquely upward, and the lower vertically upward, so as to converge and form a thick fasciculus, which crosses the inferior angle of the scapula, and usually receives a few fibers from it. The muscle curves around the lower border of the Teres major, and is twisted upon itself, so that the superior fibers become at first posterior and then inferior, and the vertical fibers at first anterior and then superior. It ends in a quadrilateral tendon, about 7 cm. long, which passes in front of the tendon of the Teres major, and is inserted into the bottom of the intertubercular groove of the humerus; its insertion extends higher on the humerus than that of the tendon of the Pectoralis major. The lower border of its tendon is united with that of the Teres major, the surfaces of the two being separated near their insertions by a bursa; another bursa is sometimes interposed between the muscle and the inferior angle of the scapula. The tendon of the muscle gives off an expansion to the deep fascia of the arm.
Variations.The number of dorsal vertebræ to which it is attached vary from four to seven or eight; the number of costal attachments varies; muscle fibers may or may not reach the crest of the ilium.
A muscular slip, the axillary arch, varying from 7 to 10 cm. in length, and from 5 to 15 mm. in breadth, occasionally springs from the upper edge of the Latissimus dorsi about the middle of the posterior fold of the axilla, and crosses the axilla in front of the axillary vessels and nerves, to join the under surface of the tendon of the Pectoralis major, the Coracobrachialis, or the fascia over the Biceps brachii. This axillary arch crosses the axillary artery, just above the spot usually selected for the application of a ligature, and may mislead the surgeon during the operation. It is present in about 7 per cent. of subjects and may be easily recognized by the transverse direction of its fibers.
A fibrous slip usually passes from the lower border of the tendon of the Latissimus dorsi, near its insertion, to the long head of the Triceps brachii. This is occasionally muscular, and is the representative of the Dorsoepitrochlearis brachii of apes.
The lateral margin of the Latissimus dorsi is separated below from the Obliquus externus abdominis by a small triangular interval, the lumbar triangle of Petit, the base of which is formed by the iliac crest, and its floor by the Obliquus internus abdominis. Another triangle is situated behind the scapula. It is bounded above by the Trapezius, below by the Latissimus dorsi, and laterally by the vertebral border of the scapula; the floor is partly formed by the Rhomboideus major. If the scapula be drawn forward by folding the arms across the chest, and the trunk bent forward, parts of the sixth and seventh ribs and the interspace between them become subcutaneous and available for ausculation. The space is therefore known as the triangle of ausculation.
Nerves.The Trapezius is supplied by the accessory nerve, and by branches from the third and fourth cervical nerves; the Latissimus dorsi by the sixth, seventh, and eighth cervical nerves through the thoracodorsal (long subscapular) nerve.
The Rhomboideus major(Fig. 409)arises by tendinous fibers from the spinous processes of the second, third, fourth, and fifth thoracic vertebræ and the supraspinal ligament, and is inserted into a narrow tendinous arch, attached above to the lower part of the triangular surface at the root of the spine of the scapula; below to the inferior angle, the arch being connected to the vertebral border by a thin membrane. When the arch extends, as it occasionally does, only a short distance, the muscular fibers are inserted directly into the scapula.
The Rhomboideus minor(Fig. 409) arises from the lower part of the ligamentum nuchæ and from the spinous processes of the seventh cervical and first thoracic vertebræ. It is inserted into the base of the triangular smooth surface at the root of the spine of the scapula, and is usually separated from the Rhomboideus major