Arteries of the Back

Artery anterior radicular Source they arise as multiple branches of several vessels (vertebral, posterior intercostal, lumbar, and lateral sacral aa.) Branches they accompany the ventral rootlets to reach the spinal cord Supply to meninges; spinal cord; spinal nerve; ventral rootlets Notes anterior radicular aa. anastomose with the anterior spinal a.

anterior spinal contributions received from several arteries (vertebral, posterior intercostal, subcostal, lumbar, lateral sacral aa.)

pial arterial plexus

meninges; spinal cord; medulla (dorsal motor nucleus of cranial nerve X, nucleus ambiguus, spinal accessory nucleus and hypoglossal nucleus)

anterior spinal a. anastomoses with the anterior radicular brs. of the spinal rami of the vertebral, posterior intercostal, subcostal, lumbar and lateral sacral aa.

axillary

subclavian a. (axillary a. is the continuation of the subclavian lateral to the 1st rib)

1st part: superior pectoral region, pectoralis minor thoracic a.; nd shoulder region m. crosses part: and upper limb anterior to the thoracoacromial a., axillary artery lateral thoracic a.; and is used to !rd part: anterior delineate the ! humeral circumflex parts mentioned a., posterior at left humeral circumflex a., subscapular a.

cervical, ascending

inferior thyroid unnamed muscular deep muscles of ascending a. branches the nec" cervical a. ascends on the anterior surface of the anterior scalene m. beside the phrenic n.

cervical, deep costocervical trun"

unnamed muscular deep muscles of deep cervical a. branches the posterior anastomoses with nec" the occipital a. near the occipital bone unnamed muscular trape#ius muscle branches, possibly and surrounding the dorsal scapular tissues a. deep cervical a., highest intercostal a. deep muscles of the posterior nec"; posterior ends of the first intercostal spaces transverse cervical a. gives rise to the dorsal scapular a. $!%& of the time costocervical trun" is located between the anterior scalene m. and the middle scalene m.; it arches posteriorly over the cervical parietal pleura

cervical, transverse

thyrocervical trun"

costocervical trun"

subclavian a., nd part

deep cervical

costocervical trun"

unnamed muscular deep muscles of deep cervical a. branches the posterior anastomoses with nec" the occipital a. near the occipital bone unnamed muscular levator scapulae branches m., rhomboideus ma'or m., rhomboideus minor m. dorsal scapular a. anastomoses with the suprascapular a. and the subscapular a. to form the scapular anastomosis; dorsal scapular a is a branch of the transverse cervical a. in $!%& of cases great anterior radicular a. anastomoses with the anterior spinal a. at lower thoracic or upper

dorsal scapular

subclavian a., !rd part

great anterior the spinal br. of no named branches lower spinal radicular the lower cord posterior intercostal a., subcostal a., or upper lumbar a.,

usually on left intercostal, posterior highest intercostal (upper intercostal spaces), descending thoracic aorta (!rd(11th intercostal spaces) posterior br., spinal br., anterior br., collateral br., lateral cutaneous br. intercostal muscles, spinal cord and vertebral column, deep bac" muscles, s"in and superficial fascia overlying the intercostal spaces sacrum, sacral nerve rootlets, meninges, ad'acent muscles

lumbar spinal cord levels posterior intercostal aa. supply the lateral and posterior portions of the intercostal space; anterior intercostal aa. supply the anterior portions of the intercostal spaces there are usually lateral sacral aa. on each side, a superior one and an inferior one the * lumbar arteries on each side arise from the posterior surface of the aorta at the level of vertebrae +1( +*; they course posterior to the psoas ma'or m. median sacral a. appears to be the continuation of the abdominal aorta in the median plane, although it is much smaller in si#e posterior radicular aa. accompany the dorsal rootlets;

lateral sacral

internal iliac a., spinal brs. posterior division

lumbar

abdominal aorta anterior br., psoas ma'or m., posterior br., spinal psoas minor m., br. )uadratus lumborum m., spinal cord and vertebral column, deep bac" muscles

median sacral abdominal aorta ,th lumbar aa.

sacrum

posterior radicular

they arise as multiple branches of several vessels

no named branches meninges; spinal cord; spinal nerve; dorsal rootlets

(vertebral, posterior intercostal, lumbar, and lateral sacral aa.) posterior spinal contributions received from several arteries (posterior inferior cerebellar, vertebral, posterior intercostal, subcostal, lumbar, lateral sacral aa.) they arise as multiple branches of several vessels (vertebral, posterior intercostal, lumbar, and lateral sacral aa.) pial arterial plexus spinal cord, especially the dorsal columns; medulla (nucleus cuneatus and nucleus gracilis)

they anastomose with the posterior spinal aa.

paired; posterior spinal aa. anastomose with the posterior radicular brs. of the spinal rami of the vertebral, posterior intercostal, subcostal, lumbar and lateral sacral aa. anterior radicular aa. anastomose with the anterior spinal a.

radicular, anterior

they accompany the ventral rootlets to reach the spinal cord

meninges; spinal cord; spinal nerve; ventral rootlets

radicular, the spinal br. of no named branches lower spinal great anterior the lower cord posterior intercostal a., subcostal a., or upper lumbar a., usually on left radicular, posterior they arise as multiple branches of several vessels (vertebral, posterior intercostal, no named branches meninges; spinal cord; spinal nerve; dorsal rootlets

great anterior radicular a. anastomoses with the anterior spinal a. at lower thoracic or upper lumbar spinal cord levels posterior radicular aa. accompany the dorsal rootlets; they anastomose with the posterior spinal aa.

lumbar, and lateral sacral aa.) sacral, lateral internal iliac a., spinal brs. posterior division sacrum, sacral nerve rootlets, meninges, ad'acent muscles sacrum there are usually lateral sacral aa. on each side, a superior one and an inferior one median sacral a. appears to be the continuation of the abdominal aorta in the median plane, although it is much smaller in si#e

sacral, median abdominal aorta ,th lumbar aa.

scapular, circumflex

subscapular a.

unnamed muscular teres ma'or m., circumflex branches teres minor m., scapular a. infraspinatus m. anastomoses with the suprascapular a. and the dorsal scapular a. to form the scapular anastomosis unnamed muscular levator scapulae branches m., rhomboideus ma'or m., rhomboideus minor m. dorsal scapular a. anastomoses with the suprascapular a. and the subscapular a. to form the scapular anastomosis; dorsal scapular a is a branch of the transverse cervical a. in $!%& of cases the anterior spinal a. anastomoses with the anterior radicular brs. of the spinal rami of

scapular, dorsal

subclavian a., !rd part

spinal, anterior

contributions received from several arteries (vertebral, posterior

pial arterial plexus

meninges; spinal cord; medulla (dorsal motor nucleus of cranial nerve

intercostal, subcostal, lumbar, lateral sacral aa.)

X, nucleus ambiguus, spinal accessory nucleus and hypoglossal nucleus) pial arterial plexus spinal cord, especially the dorsal columns; medulla (nucleus cuneatus and nucleus gracilis)

the vertebral, posterior intercostal, subcostal, lumbar and lateral sacral aa. paired; posterior spinal aa. anastomose with the posterior radicular brs. of the spinal rami of the vertebral, posterior intercostal, subcostal, lumbar and lateral sacral aa.

spinal, posterior

contributions received from several arteries (posterior inferior cerebellar, vertebral, posterior intercostal, subcostal, lumbar, lateral sacral aa.)

thoracodorsal subscapular a.

unnamed muscular latissimus dorsi thoracodorsal a. branches m. accompanies the thoracodorsal n. unnamed muscular trape#ius muscle branches, possibly and surrounding the dorsal scapular tissues a. deep cervical a., highest intercostal a. deep muscles of the posterior nec"; posterior ends of the first intercostal spaces transverse cervical a. gives rise to the dorsal scapular a. $!%& of the time costocervical trun" is located between the anterior scalene m. and the middle scalene m.; it arches posteriorly over the cervical parietal pleura thyrocervical trun" does not give rise to the ascending cervical a.( it is a branch of the inferior thyroid a.

transverse cervical

thyrocervical trun"

trun", costocervical

subclavian a., nd part

trun", thyrocervical

subclavian a., 1st part

inferior thyroid a., lower nec", transverse cervical posterior a., suprascapular a. shoulder, thyroid gland

vertebral

subclavian a. (1st part)

spinal brs., muscular brs., anterior spinal a., posterior inferior cerebellar a., medullary brs., meningeal brs., basilar a.

deep nec", cervical spinal cord, spinal cord; medulla (dorsal motor nucleus of cranial nerve X, nucleus ambiguus, spinal accessory nucleus and hypoglossal nucleus)

vertebral a. anastomoses with the internal carotid a. in the cerebral arterial circle (of -illis); it courses through the transverse foramina of vertebrae .1(./

Bones of the Back Region - Listed in Superior to Inferior Order

Bone occipital Structure Description the bone forming the posterior surface of the s"ull Notes it articulates superolaterally with the parietal bones through the lambdoid suture, anteroinferiorly with the temporal bone and anteriorly with the body of the sphenoid bone

external occipital protuberance

a low process on the it is an attachment site for the external surface of the ligamentum nuchae; the superior occipital bone in the nuchal lines of the two sides meet

midline

in the midline at the external occipital protuberance; also "nown as: inion

inferior nuchal line

a low ridge that runs it is an attachment site for deep transversely on the nec" muscles external surface of the s)uamous part of the occipital bone inferior to the superior nuchal line

superior nuchal a low ridge that runs it is an attachment site the for the line transversely on the trape#ius and splenius mm. external surface of the s)uamous part of the occipital bone occipital condyle a low, wide pro'ection paired; it articulates with the atlas from the inferior surface of the lateral part of the occipital bone one of a series of irregular bones that form the spine a vertebra has two parts: the vertebral body and the vertebral arch; there are !! vertebrae total: 0 cervical, 1 thoracic, , lumbar, , fused to form the sacrum, * coccygeal; features of a typical vertebra include: body, pedicles, transverse processes, laminae, articular processes, spinous process it is shaped li"e a short cylinder; ad'acent vertebral bodies articulate through a symphysis the transverse processes and spinous process are attached to the neural arch; the neural arch protects the spinal cord paired; it connects the body with the transverse process; it is mar"ed by superior 1 inferior vertebral notches;

vertebra

vertebral body

the largest part of the vertebra the ring of bone formed by the paired pedicles and paired laminae of the vertebra short strong process that extends posteriorly from the posterolateral surface

vertebral arch

pedicle

of the vertebral body transverse process a lateral process the a site for muscle attachment and rib extends from the articulation 'unction of the pedicle and the lamina of the vertebra a broad flat plats of bone located between the transverse process and the spinous process of the vertebra processed that pro'ect inferiorly and superiorly from the 'unction of the lamina and pedicle of the vertebra a notch on the superior and inferior surface of the vertebral pedicle an opening between the pedicles of ad'acent vertebrae paired; it is flattened mar"edly in the anteroposterior direction; ligamenta flava span the interval between the laminae of ad'acent vertebrae two pair on each vertebra (superior and inferior); the superior articular processes of one vertebra articulate with the inferior processes of the ad'acent vertebra through synovial 'oints the superior intervertebral notch of one vertebra combined with the inferior intervertebral notch of the ad'acent vertebra forms the intervertebral foramen ad'acent intervertebral notches form the intervertebral foramen; an opening for passage of the spinal nerve

lamina

articular processes

intervertebral notch

intervertebral foramen

vertebral canal

the opening formed by it contains the spinal cord, the combination of the meninges, epidural fat and the body and the vertebral internal vertebral plexus of veins arch it pro'ects downward and inferiorly; it is an important site of muscle attachment; spinous processes of cervical vertebra (/ are bifid

spinous process a posterior midline process arising from the 'unction of the two laminae of the vertebra cervical vertebrae

the seven vertebrae of cervical vertebrae have the features the nec" of the typical vertebra plus all have transverse foramina (for passage of the vertebral artery); . (./ have bifid spinous processes; cervical

vertebrae have relatively small bodies; several cervical vertebra are named: atlas, axis, vertebra prominens atlas (.1) the first cervical vertebra it is called atlas in comparison the mythological 2ree" 3itan 4tlas, who bore the weight of the world on his shoulders; it has no vertebral body, only anterior 1 posterior arches; it articulates with the odontoid process of the axis the odontoid process (dens) pro'ects superiorly from its body; it articulates with the anterior arch of the atlas

axis (. )

the second cervical vertebra

vertebra prominens thoracic vertebrae

the seventh cervical vertebra the 1 vertebrae associated with the thoracic region

it has a long, non(bifid spinous process which is prominent at the nape of the nec", hence its name thoracic vertebrae have the features of a typical vertebra plus they are characteri#ed by long slender spines that pro'ect inferiorly; they have facets for articulation with ribs; thoracic vertebrae have bodies of intermediate si#e most thoracic vertebrae have costal facets on each side (one superior and one inferior); the superior costal facet of one vertebra and the inferior costal facet of the ad'acent vertebra both articulate with the head of the same rib; also "nown as demifacets

costal articular facet on the body

small smooth areas at the 'unction of the body and the vertebral arch

costal articular facet on the transverse process lu bar

a small smooth area it articulates with the articular facet on the transverse on the tubercle of the rib process of the thoracic vertebra the , vertebrae located lumbar vertebrae have the features

vertebrae

in the lumbar region

of a typical vertebra plus they are characteri#ed by short, blunt spines that pro'ect posteriorly; lumbar spines do not overlap ma"ing the lumbar level a good one for spinal tap; lumbar vertebrae are built strong and have the largest bodies of all vertebrae it is formed by , fused vertebrae; the sacrum and two os coxae bones form the pelvis

sacru

a triangular bone that is the posterior s"eletal element forming the pelvis anterior sacral foramina

an opening in the there are four pairs; each transmits anterior surface of the the ventral primary ramus of the sacrum respective sacral spinal nerve; branches of the lateral sacral aa. enter the sacral canal through these openings there are four pairs; each transmits the dorsal primary ramus of the respective sacral spinal nerve the body of the fifth lumbar vertebra sits on the sacral promontory and articulates with it through a symphysis it is the continuation of the vertebral canal at sacral vertebral levels this surface articulates with the ilium in the sacroiliac articulation the body is e)uivalent to the bodies of the other vertebra

posterior sacral an opening in the foramina posterior surface of the sacrum promontory a pro'ection of the superior part of the sacrum in an anterior direction the opening in the center of the sacrum

sacral canal

articular surface the roughened area located on the lateral surface of the sacrum body base the central portion of the sacrum

the superior surface of the base of the sacrum articulates the sacrum with the fifth lumbar vertebra through an intervertebral dis" an opening in the posterior surface of the sacrum in the midline it is a normal feature that results from the failure of fusion of the laminae of the fifth sacral segment (and sometimes the fourth) during

sacral hiatus

development ala the lateral portion of the sacrum paired; it pro'ects laterally from the body of the sacrum; it represents the fused costal and transverse processes of the first sacral vertebra the coccyx results from the fusion of the four coccygeal vertebrae; it may be a single bone or the first coccygeal vertebra may be separated from the other three; it articulates with the fifth sacral segment; coccygeal vertebrae are reduced in complexity, having no pedicles, laminae or spines

coccy!

the most inferior portion of the vertebral column

"asciae of the Back Region - Arranged Alphabetically

Structure fascia, infraspinatus Location#Description deep fascia covering the superficial surface of the infraspinatus m. Notes infraspinatus fascia attaches to the spine of the scapula and the posterior surface of the scapula at the margins of the infraspinatus fossa; it is a strong origin for the infraspinatus m.

fascia, nuchal fascia, thoracolumbar

deep fascia covering the nuchal fascia is part of the prevertebral muscles of the posterior nec" layer of deep cervical fascia deep fascia surrounding the erector spinae muscle mass thoracolumbar fascia in lumbar regions serves as an origin for the latissimus dorsi m.

$oints and Liga ents of the Back Region - Listed Alphabetically

$oint or liga ent anterior longitudinal ligament interspinous ligament intervertebral Description a ligament that courses from superior to inferior along the anterior surfaces of all vertebral bodies a ligament that connects the spinous processes of two ad'acent vertebra a fibrocartilaginous dis" Notes it lies directly posterior to the thoracic and abdominal viscera

a syndesmosis

a symphysis; it is composed of two

disc

between ad'acent vertebral bodies

parts: an outer anulus fibrosus and an inner nucleus pulposus; the nucleus pulposus is the remnant of the notochord; the intervertebral dis"s are important shoc" absorbers between vertebrae a syndesmosis; paired; the ligamentum flavum is penetrated by the needle during spinal tap; the word flavum is derived from the +atin word flavus, which means 5yellow5 ( a reference to the predominance of yellow elastic fibers which gives this ligament its grossly visible color a syndesmosis; it provides muscle attachments to the cervical spinous processes without the necessity of long spinous processes that would hinder extension of the nec" it is broader at the intervertebral dis"s and narrow at the vertebral bodies which gives it a scalloped edge; it is located in the vertebral canal; it is 673 penetrated by the needle during spinal tap

ligamenta flava

a ligament formed predominantly by elastic fibers which 'oins the laminae of ad'acent vertebrae

nuchal ligament a midline ligament that extends posteriorly from the spinous processes of cervical vertebrae and extends from the base of the s"ull to the 0th cervical vertebra posterior longitudinal ligament a ligament that courses from superior to inferior along the posterior surfaces of all vertebral bodies

supraspinous ligament

a ligament that connects the a syndesmosis; the supraspinous tips of the spinous processes of ligament begins at the .0 vertebra and thoracic and lumbar vertebrae ends at the mid(sacral segmental level; it serves as a muscle attachment site a small 'oint between the articular processes of ad'acent vertebrae a synovial plane 'oint

#ygapophyseal 'oint

Note: Although the back and extremities contain numerous lymphatic capillaries, within these regions there are very few lymph nodes that are large enough to be named.

Ly phatics of the Back - Listed Alphabetically

Structure occipital nodes Location superior nuchal line, along the course of Afferents fro %fferents to Regions drained Notes occipital nodes are or ! nodes located between the attachments of the sternocleidomastoid m.

lymphatic accessory occipital vessels from nodes part of the the posterior scalp and head and the

the occipital nec" a. and v.

superior nec"

and the trape#ius m.

&uscles of the 'pper Li b that are dissected in the Back Region

&uscle latissimus dorsi Origin Insertion Action extends the arm and rotates the arm medially Innervation Artery Notes vertebral floor of the spines from intertubercul 30 to the ar groove sacrum, posterior third of the iliac crest, thoracodorsa thoracodors the l nerve al a. inserting (.0,8) from tendon the posterior twists so cord of the that fibers brachial originating plexus highest

lower ! or * ribs, sometimes from the inferior angle of the scapula levator scapulae transverse processes of .1(.* vertebrae medial elevates border of the the scapula scapula from the superior angle to the spine dorsal scapular nerve (.,); the upper part of the muscle receives branches of .! 1 .* dorsal scapular a.

insert lowest

levator scapulae is named for its action

rhomboide spines of us ma'or vertebrae 3 (3,

medial border of the scapula inferior to the spine of the scapula medial border of the scapula at the root of the spine of the scapula medial border of the scapula on its costal (deep) surface

retracts, dorsal elevates scapular and nerve (.,) rotates the scapula inferiorly retracts, dorsal elevates scapular and nerve (.,) rotates the scapula inferiorly it draws the scapula forward; the inferior fibers rotate the scapula superiorl y

dorsal scapular a.

named for its shape

rhomboide inferior end us minor of the ligamentum nuchae, spines of vertebrae .0 and 31 serratus anterior ribs 1(8 or 9

dorsal scapular a

named for its shape

long thoracic lateral nerve (from thoracic a. ventral rami .,(.0)

a lesion of long thoracic nerve will cause winging of the scapula (i.e., the medial border of the scapula falls away from the

posterior chest wall and loo"s li"e an angel:s wing) trape#ius medial third of the superior nuchal line, external occipital protuberanc e, ligamentum nuchae, spinous processes of vertebrae .0(31 lateral third of the clavicle, medial side of the acromion and the upper crest of the scapular spine, tubercle of the scapular spine elevates and depresses the scapula (dependi ng on which part of the muscle contracts) ; rotates the scapula superiorl y; retracts scapula motor: spinal transverse accessory cervical a. (X;), propriocepti on: .!(.* named for its shape; trape#ius is an example of a muscle that migrates during developme nt from its level of origin (cervical) to its final position, pulling its nerve and artery along behind

&uscles of the Back Region - Listed Alphabetically

&uscle erector spinae Origin iliac crest, sacrum, transverse and spinous processes of vertebrae and supraspinal ligament Insertio Innervatio Action n n angles of the ribs, transvers e and spinous processe s of vertebrae , posterior extends and laterally bends the trun", nec" and head segmentall y innervated by dorsal primary rami of spinal nerves .1( <, Artery supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa. Notes the erector spinae m. is separated into ! columns of muscle: iliocostalis laterally, longissimus in an intermediate

aspect of the s"ull

position and spinalis medially; each of these columns has multiple named parts supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa. supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa. supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa. supplied segmentall y by: deep cervical a., posterior intercostal the most lateral part of the erector spinae; it may be subdivided into lumborum, thoracis and cervicis portions these are small and fairly insignificant muscles

iliocostalis

iliac crest and sacrum

angles of extends dorsal the ribs and primary laterally rami of bends spinal the nerves .*( trun" <, and nec"

interspinales

upper border lower extend of spinous border of trun" process spinous and process nec" above

dorsal primary rami of spinal nerves .1( +,

intertransversa upper border lower laterally rii of transverse border of bend process transvers trun" e process and above nec"

dorsal primary rami of spinal nerves .1( +,

these are small and fairly insignificant muscles

longissimus

transverse process at inferior vertebral levels

transvers e process at superior vertebral levels

extends and laterally bends the trun",

dorsal primary rami of spinal nerves .1( <1

the intermediate part of the erector spinae;it may be subdivided

and mastoid process multifidus sacrum, transverse processes of .!(+, spinous processe s (* vertebral levels superior to their origin

nec" and head extend and laterally bend trun" and nec", rotate to opposit e side dorsal primary rami of spinal nerves .1( +,

aa., subcostal aa., lumbar aa. supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa.

into thoracis, cervicis and capitis portions semispinalis, multifidus and rotatores ma"e up the transversospin al muscle group

obli)uus spinous capitis inferior process of the axis

transvers rotates e process the of atlas head to the same side

suboccipita occipital a. l nerve (=>? of .1)

greater occipital nerve (=>? of . ) passes superiorly around the inferior margin of inferior obli)ue the suboccipital triangle is formed by obli)uus capitis superior and inferior and rectus capitis posterior ma'or

obli)uus transverse capitis superior process of atlas

occipital bone above inferior nuchal line

extends the head, rotates the head to the same side

suboccipita occipital a. l nerve (=>? of .1)

rectus capitis spinous posterior ma'or process of axis

inferior nuchal line

extends the head, rotate to same side

suboccipita occipital a. none l nerve (=>? of .1)

rectus capitis

posterior

inferior

extends suboccipita occipital a. rectus capitis

posterior minor

tubercle of atlas

nuchal the line head medially

l nerve (=>? of .1)

posterior minor is deeper and inserts more medial than rectus capitis posterior ma'or supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa. semispinalis, multifidus and rotatores ma"e up the transversospin al muscle group

rotatores

transverse processes

long rotates rotatores the : spines vertebra l vertebrae column above to the origin; opposit short e side rotatores : spines 1 vertebrae above origin extends the trun" and laterally bends the trun", rotates the trun" to the opposit e side pulls down lower ribs

dorsal primary rami of spinal nerves .1( +,

semispinalis

transverse capitis: processes of bac" of .0(31 s"ull between nuchal lines; cervicis 1 thoracis: spines *( / vertebrae above origin thoracolumb ar fascia, spines of vertebrae 311(31 and +1(+ ribs 9( 1 , lateral to the angles

dorsal primary rami of spinal nerves .1( 31

supplied segmentall y by: deep cervical a., posterior intercostal aa., subcostal aa., lumbar aa.

three parts are named based on their insertions: capitis, cervicis and thoracis; semispinalis, multifidus and rotatores ma"e up the transversospin al muscle group a respiratory muscle, it receives ventral ramus innervation; embryonically related to the intercostal

serratus posterior inferior

branches of the ventral primary rami of spinal nerves 39( 31

lowest posterior intercostal a., subcostal a., first two lumbar aa.

muscles, not the deep bac" mm. serratus posterior superior ligamentum nuchae, spines of vertebrae .0 and 31(3! ribs 1(*, lateral to the angles elevates the upper ribs branches posterior of the intercostal ventral aa. 1(* primary rami of spinal nerves 31( 3* a respiratory muscle, it receives ventral ramus innervation; embryonically related to the intercostal muscles, not the deep bac" mm. most medial part of the erector spinae; may be subdivided into thoracis, cervicis and capitis portions splenius means bandage; it gets its name from its broad, flat shape

spinalis

spinous processes at inferior vertebral levels

spinous processe s at superior vertebral levels and base of the s"ull capitis: mastoid process 1 superior nuchal line laterally; cervicis: posterior tubercles of .1( .! vertebrae mastoid process and lateral end of

extends and laterally bends trun" and nec"

dorsal supplied primary segmentall rami of y by: deep spinal cervical a., nerves . ( posterior +! intercostal aa., subcostal aa., lumbar aa. dorsal supplied primary segmentall rami of y by: deep spinal cervical a., nerves . ( posterior ./ intercostal aa.

splenius

ligamentum nuchae and spines .0( 3/

extends and laterally bends nec" and head; rotates head to same side

splenius capitis ligamentum nuchae and spines of .0(3/ vertebrae

extends and laterally bends the

dorsal primary rami of spinal nerves . (

supplied segmentall y by: deep cervical a., posterior

named for its shape: splenius means bandage and

the superior nuchal line

nec" ./ and head, rotates head to the same side extends and laterally bends nec" and head, rotates head to the same side

intercostal capitis refers aa. to the insertion of this portion of the muscle

splenius cervicis

ligamentum nuchae and spines of .0(3/ vertebrae

posterior tubercles of the transvers e processe s of .1( .! vertebrae

dorsal supplied primary segmentall rami of y by: deep spinal cervical a., nerves . ( posterior ./ intercostal aa.

named for its shape: splenius means bandage and cervicis refers to the insertion of this portion of the muscle

Nerves of the Back Region - Listed Alphabetically

Nerve Source Branches &otor Sensory Notes also "nown as: .6 X;, 11th cranial nerve; spinal root enters cranial cavity by passing through the foramen magnum; exits s"ull by passing through the 'ugular foramen; accessory n. is motor only; the subtrape#ial plexus of nerves receives proprioceptive fibers: for the sternocleidomastoi d m. from the ventral primary rami of spinal nn. . and .! ( for trape#ius via ventral primary rami of .! and .* 5clunis5 is a +atin word meaning buttoc" accessory cranial no named root: branches medulla ( nucleus ambiguus ; spinal root: spinal nucleus of the upper cervical spinal cord 2<@: none sternocleidomasto id and trape#ius mm.

cluneal, inferior

posterior no named femoral branches cutaneou s n. lateral no named cutaneou branches s branches of the dorsal primary rami of spinal

none

s"in of the lower part of the buttoc"

cluneal, middle

none

s"in of the 5clunis5 is a +atin intermediate word meaning medial buttoc" portion of the buttoc"

nerves <1(! cluneal, superior lateral no named cutaneou branches s branches of the dorsal primary rami of spinal nerves +1(! none s"in of the 5clunis5 is a +atin superomedial word meaning portion of the buttoc" buttoc"

coccygeal ventral plexus primary rami of spinal nerves <*, <,, .1 dorsal primary ramus

anococcyge none al n.

s"in of the region overlying the coccyx

only part of the <* ventral primary ramus is contributed to the coccygeal plexus

first numerous branch off of the dorsal side of the spinal nerve from the none dorsal horn of the spinal cord to the spinal nerve dorsal rootlets dorsal rootlets

to the deep bac" mm.; sympathetic innervation to the s"in

general sense (touch, pressure, pain, heat, cold, etc.) to the s"in of the bac" general sense (touch, pressure, pain, heat, cold, etc.)

a mixed nerve containing both motor and sensory fibers

dorsal root

none

dorsal root is entirely sensory in function; it is located dorsal to the denticulate ligament a sensory ganglion; located in the intervertebral foramen of the vertebral column on the dorsal root ( one per spinal

dorsal root ganglion

none

one dermatome

nerve; location of the cell bodies of somatic afferent (sensory) neurons dorsal scapular n. brachial no named plexus branches (br. of ., ventral primary ramus) lateral 1 anterior cutaneous brs. rhomboideus ma'or and minor mm.; levator scapulae m. none dorsal scapular n. passes through the scalenus medius m.

intercosta ventral l n. primary rami of spinal nerves 31(311

intercostal muscles; abdominal wall muscles (via 30( 311); muscles of the forearm and hand (via 31)

s"in of the chest and abdomen anterolaterall y; s"in of the medial side of the upper limb (via 31( 3 ) s"in of the posterior surface of the scalp

intercostal n.travels below the posterior intercostal a. in the costal groove

occipital, dorsal no named greater primary branches ramus of spinal nerve . (medial br.) occipital, ventral no named lesser primary branches ramus of spinal nerve . occipitali dorsal no named s tertius primary branches ramus of spinal nerve .! (medial br.) ramus, dorsal primary first numerous branch off of the dorsal

posterior nec" muscles

muscles innervated by this nerve develop from epimeres in the embryo

none

s"in behind the ear

lesser occipital n. arises from the cervical plexus

posterior nec" muscles

s"in of the posterior surface of the nec"

muscles innervated by this nerve develop from epimeres in the embryo

to the deep bac" mm.; sympathetic innervation to the s"in

general sense (touch, pressure, pain, heat,

a mixed nerve containing both motor and sensory fibers

side of the spinal nerve ramus, ventral primary first numerous branch off of the ventral side of the spinal nerve to s"eletal mm. of the nec", trun" and extremities; sympathetic innervation to the s"in

cold, etc.) to the s"in of the bac" general sense (touch, pressure, pain, heat, cold, etc.) to the s"in of the trun" (except the bac") and extremities; visceral pain via the white rami of the sympathetic nervous system (31( + ) general sense (touch, pressure, pain, heat, cold, etc.) a mixed nerve containing both motor and sensory fibers

root, dorsal

from the none dorsal horn of the spinal cord to the spinal nerve from the none ventral horn of the spinal cord to the spinal nerve

none

dorsal root is entirely sensory in function; it is located dorsal to the denticulate ligament entirely motor in function; located ventral to the denticulate ligament; at all spinal core levels it contains 2<@ for s"eletal mm.; at levels 31(+ it contains 2A@ (preganglionic sympathetic) for blood vessels, sweat glands, thoracic viscera, abdominal viscera, pelvic viscera

root, ventral

to s"eletal mm.; preganglionic sympathetic (31( + )

none

spinal n.

formed at the point where the dorsal and ventral rootlets meet; it ends where the dorsal and ventral primary rami diverge

dorsal primary ramus; ventral primary ramus

to s"eletal mm.; some levels carry preganglionic sympathetic axons (31(+ )

general sense (touch, pressure, pain, heat, cold, etc.) from the entire surface of the nec", trun" and extremities; visceral pain (via the white ramus communicans and the sympathetic nervous system) general sense (touch, pressure, pain, heat, cold, etc.) to the s"in of the trun" (except the bac") and extremities; visceral pain via the white rami of the sympathetic nervous system (31( + ) none

located at the intervertebral foramen; there are !1 pairs of spinal nerves ( 8 cervical, 1 thoracic, , lumbar, , sacral, 1 coccygeal

ventral primary ramus

first numerous branch off of the ventral side of the spinal nerve

to s"eletal mm. of the nec", trun" and extremities; sympathetic innervation to the s"in

a mixed nerve containing both motor and sensory fibers

ventral root

from the none ventral horn of the spinal cord to the spinal nerve

to s"eletal mm.; preganglionic sympathetic (31( + )

entirely motor in function; located ventral to the denticulate ligament; at all spinal core levels it contains 2<@ for s"eletal mm.; at levels 31(+ it

contains 2A@ (preganglionic sympathetic) for blood vessels, sweat glands, thoracic viscera, abdominal viscera, pelvic viscera

(opographical Anato y of the Back - Listed Alphabetically

Structure#Space external occipital Description#Boundaries a bump located in the midline on the Significance the medial ends of the

protuberance

posterior surface of the occipital bone

superior nuchal lines meet at the external occipital protuberance; the ligamentum nuchae attaches here lumbar triangle may be the site of an abdominal hernia; also "nown as: triangle of >etit natal cleft lies between the gluteus maximus muscles paravertebral line is used as a descriptive landmar" the axillary n. and the posterior circumflex humeral a. pass through this space triangle of auscultation is used to listen to (auscultate) the lungs because the stethoscope can be placed close to the thoracic wall at this location

lumbar triangle

a triangle defined by the border of the latissimus dorsi m. medially, the external abdominal obli)ue m. laterally and the iliac crest inferiorly; its floor is the internal abdominal obli)ue m. midline cleft between the buttoc"s an imaginary line located lateral to the midline on the posterior surface of the body, parallel to the vertebral column an area on the posterior surface of the bac" bounded by the teres minor m. superiorly, the teres ma'or m. inferiorly, the long head of the triceps brachii m. medially and the humerus laterally a triangle located below the inferior angle of the scapula bounded by the trape#ius m. medially, rhomboideus ma'or m. superiorly and the latissimus dorsi m. inferiorly; its floor is the posterior thoracic wall

natal cleft paravertebral line

)uadrangular space

triangle of auscultation

triangular interval

the interval between the teres ma'or m. the radial n. passes superiorly, long head of the triceps brachii through this interval to get m. medially and humerus laterally from the axilla to the posterior surface of the humerus the space bounded by the teres minor m. superiorly, the teres ma'or m. inferiorly and the long head of the triceps brachii m. laterally the .0 vertebra, so named because its spine is easily seen and palpated the circumflex scapular vessels are located in this space as they pass from the axilla to the dorsum of the scapula vertebra prominens is an easily palpable landmar" which indicates the level

triangular space

vertebra prominens

of transition from cervical to thoracic vertebra vertebral furrow midline furrow down the bac" surface landmar" that indicates the location of the vertebral spines; the erector spinae muscle masses lie on either side of it