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200
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Anatomy

Upper Limb

Question 197 of 239

An 85 year old man presents to the ED following a fall at home. On examination you note he is tender over the distal attachment of the latissimus dorsi and you suspect an underlying bony injury. The latissimus dorsi muscle inserts onto which of the following structures:

Answer:

The latissimus dorsi muscle inserts onto the floor of the intertubercular sulcus of the humerus.

Latissimus Dorsi Muscle

Anatomy / Upper Limb / Pectoral Region

Last Updated: 8th April 2019

The latissimus dorsi muscle forms much of the muscle mass underlying the posterior axillary skin fold extending obliquely upwards from the trunk to the arm.

Table: Function and Innervation of the Latissimus Dorsi Muscle

Muscle Latissimus Dorsi
Origin Spinous processes of lower 6 thoracic vertebrae and related interspinous ligaments; via the thoracolumbar fascia to the spinous processes of the lumbar vertebrae, related interspinous ligaments and iliac crest; lower 3 – 4 ribs
Insertion Floor of intertubercular sulcus
Function Adduction, medial rotation and extension of arm at glenohumeral joint
Innervation Thoracodorsal nerve

Origin

The latissimus dorsi originates from the spinous processes of the lower six thoracic vertebrae and related interspinous ligaments, via the thoracolumbar fascia to the spinous processes of the lumbar vertebrae, related interspinous ligaments and iliac crest and from the inferior 3 or 4 ribs.

Insertion

The muscle inserts onto the floor of the intertubercular sulcus of the humerus.

Function

The latissimus dorsi produces adduction, medial rotation and extension of the humerus at the glenohumeral joint.

Innervation

The latissimus dorsi is innervated by the thoracodorsal nerve.

By Mikael Häggström (Image:Gray409.png) [Public domain or Public domain], via Wikimedia Commons

Latissimus Dorsi Muscle. (Image by Mikael Häggström (Image:Gray409.png) [Public domain or Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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