Download - Anatomy of back
ANATOMY OF ANATOMY OF SPINESPINE
OUTLINEOUTLINE
Conceptual overview Regional anatomy Surface anatomy Radiological anatomy
Conceptual Conceptual overviewoverview
Functions
Support
Movement <additive>
Protection of central & peri nervous
systems
flexion
extension
lateral flexion
rotation, and
circumduction
curvescurves
Sec curvature bring the center
of gravity to a vertical line,
which allows the body’s weight
to be balanced on the vertebral
column in a way that expends
the least amount of muscular
energy to maintain an
upright bipedal stance.
Conceptual Conceptual overviewoverview
Component parts
Bones
Muscles –Extrinsic- sup,inter; Intrinsic-
deep
Vertebral canal
Spinal nerves
Dermatomes and myotomes
Conceptual Conceptual overviewoverview
Key features
Long vertebral column, short spinal
cord
Intervertebral foramina and spinal
nerves
Innervation of back
Regional Regional
anatomyanatomy
Intervertebral DiscsIntervertebral Discs
LigamentsLigaments
Supraspinous This runs between the tips of adjacent spines.
Interspinous : This connects adjacent spines.
Intertransverse: These run between adjacent transverse processes.
Ligamentum flavum : This connects the laminae of adjacent vertebrae.
cervical region= supraspinous and interspinous ligaments greatly
thickened to form the strong ligamentum nuchae.
LigamentsLigaments
Dislocations and fractures of the vertebral column. A. Unilateral dislocation of the fifth or the sixth cervical vertebra. Note the forward displacement of the inferior articular process over the superior
articular process of the vertebra below. B. Bilateral dislocation of the fifth or the sixth cervical vertebra. Note that 50% of the vertebral body width has moved forward on
the vertebra below. C. Flexion compression–type fracture of the vertebral body in the lumbar
region. D. Jefferson's-type fracture of the atlas. E. Fractures of the odontoid process and the pedicles (hangman's fracture) of the axis.
A. Arrangement of A. Arrangement of the deep muscles of the deep muscles of the back. B. Lateral the back. B. Lateral view of the skeleton view of the skeleton showing the line of showing the line of gravity. gravity. Because the Because the greater part of the body greater part of the body weight lies anterior to the weight lies anterior to the vertebral column, the vertebral column, the deep muscles of the back deep muscles of the back are important in are important in maintaining the normal maintaining the normal postural curves of the postural curves of the vertebral column in the vertebral column in the standing position.standing position.
MusclesMusclesTrap, Lat dorsi, Lev scap, Rho maj & min
Serratus posterior sup & inf
DeepSuperficial Vertically Running Muscles
Intermediate Oblique Running Muscles
Deepest MusclesInterspinalesIntertransversarii
Muscular triangles of backMuscular triangles of backAuscultatory Triangle
The auscultatory triangle is the site on the back where
breath sounds may be most easily heard with a
stethoscope. The boundaries are the latissimus dorsi, the
trapezius, and the medial border of the scapula.
Lumbar TriangleThe lumbar triangle is the site where pus may emerge from
the abdominal wall. The boundaries are the latissimus dorsi,
the posterior border of the external oblique muscle of the
abdomen, and the iliac crest.
Deep Fascia of the Back Deep Fascia of the Back (Thoracolumbar Fascia)(Thoracolumbar Fascia)
The lumbar part of the deep fascia is situated in the interval
between the iliac crest and the 12th rib. It forms a strong
aponeurosis and laterally gives origin to the middle fibers of the
transversus and the upper fibers of the internal oblique muscles of
the abdominal wall
Medially, the lumbar part of the deep fascia splits into three
lamellae. The posterior lamella covers the deep muscles of the back
and is attached to the lumbar spines. The middle lamella passes
medially, to be attached to the tips of the transverse processes of
the lumbar vertebrae; it lies in front of the deep muscles of the back
and behind the quadratus lumborum. The anterior lamella passes
medially and is attached to the anterior surface of the transverse
processes of the lumbar vertebrae; it lies in front of the quadratus
lumborum muscle.
Blood Supply of the BackBlood Supply of the Back Arteries
◦ In the cervical region, branches arise from the occipital artery, a branch of the external carotid; from the vertebral artery, a branch of the subclavian; and from the deep cervical artery, a branch of the costocervical trunk.
◦ In the thoracic region branches arise from the posterior intercostal arteries.
◦ In the lumbar region branches arise from the subcostal and lumbar arteries.
◦ In the sacral region branches arise from the iliolumbar and lateral sacral arteries, branches of the internal iliac artery.
Veins◦ The veins draining the structures of the back form plexuses extending along
the vertebral column from the skull to the coccyx.
◦ The external vertebral venous plexus lies external and surrounds the vertebral column.
◦ The internal vertebral venous plexus lies within the vertebral canal but outside the dura mater of the spinal cord.
Lymph Drainage of the Lymph Drainage of the BackBack
The deep lymph vessels follow the veins and drain into
the deep cervical, posterior mediastinal, lateral aortic,
and sacral nodes.
The lymph vessels from the skin of the neck drain into
the cervical nodes,
from the trunk above the iliac crests drain into the
axillary nodes, and those
from below the level of the iliac crests drain into the
superficial inguinal nodes
RelationRelation
Vertebrae Spinal Segment
Cervical Add 1
Upper thoracic Add 2
Lower thoracic (T7 to 9) Add 3
Tenth thoracic L1 and 2 cord segments
Eleventh thoracic L3 and 4 cord segments
Twelfth thoracic L5 cord segment
First lumbar Sacral and coccygeal cord segment
Posterior views of vertebral bodies in the
cervical and lumbar regions showing the
relationship that might exist between the
herniated nucleus pulposus and the spinal
nerve roots. Note that there are eight
cervical spinal nerves but only seven
cervical vertebrae. In the lumbar region,
for example, the emerging L4 nerve roots
pass out laterally close to the pedicle of
the fourth lumbar vertebra and are not
related to the intervertebral disc between
the fourth and fifth lumbar vertebrae. E.
Pressure on the L5 motor nerve root
produces weakness of dorsiflexion of the
ankle; pressure on the S1 motor nerve
root produces weakness of plantar flexion
of the ankle joint.
SPINAL CORD INJURY WITHOUT RADIOLOGICAL ABNORMALITY:
‘SCIWORA’
This is particularly liable to occur if the vertebral canal is
abnormally narrowed, usually by osteoarthritic changes.
Surface Surface anatomyanatomy
Surface Surface anatomyanatomy
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