THE BACK Intervertebral disc

Bones of the back/vertebrae → Composed of fibrocartilage

→ Secondary cartilaginous joint
→ Straight pillar (anteroposteriorly)
→ Flexion, extension, and lateral flexion
→ Curvature (laterally)
Spondylolisthesis – causes one of the lower vertebrae to
Vertebral Column – composed of 33 vertebrae
slip forward onto the bone directly beneath it
Composition and Description:
Slip disc – herniation of nucleus pulposus
→ 7 cervical vertebrae [posterior concavity]
CHARACTERISTICS OF A TYPICAL CERVICAL VERTEBRA
→ 12 thoracic vertebrae [posterior convexity]
→ 5 lumbar vertebrae [posterior concavity] → Foramen transversarium – passage of vertebral
→ 5 sacral vertebrae [posterior convexity] artery and veins
→ 4 coccygeal vertebrae [follows the sacrum] → Spine: short and bifid
→ Body: small and cuboid
*Rectum starts at S3.
→ Vertebral foramen: large and triangular
*The weight of the head and the upper extremities falls
on the vertebral column.
*Weight forms the curvature.

a. Newborn Infant – thoracic convexity

b. Baby holds head up steadily – cervical concavity
c. Sit up straight – lumbar concavity

Kyphosis

→ Exaggeration in the sagittal curvature in the

thoracic part
→ Most common in elderly female
Osteoporosis – abnormal refraction of bone
Lordosis
→ Lumbar vertebrae becomes more concave
→ Common to women during pregnancy
Obesity – enlargement of abdomen
CHARACTERISTICS OF THE ATYPICAL VERTEBRAE
→ C1, C2, and C7
C1/Atlas
→ No body or spinous process
→ Has 2 lateral masses that articulates with the
occipital condyles of the skull
→ Movement: flexion and extension of head

Scoliosis – lateral deviation of vertebral column

GENERAL CHARACTERISTICS OF A VERTEBRA

Typical vertebra:

→ Body – anteriorly
→ Vertebral arch – posteriorly
→ Vertebral foramen – where the spinal cord runs
→ 7 processes: 1 spinous process, 2 transverse
C2/Axis
processes, and 4 articular processes
→ Intervertebral foramen – serve to transmit the → Body: Odontoid Process
spinal nerves and blood vessels → Spinous process: short and bifid
→ Vertebral foramen: large and triangular
C7/Vertebra prominens
SACRUM
→ Longest spinous process
→ Posterior pelvic wall
→ Transverse process is large
→ 5 sacral vertebrae
→ Foramen transversarium is small
→ Sacral promontory: anterior margin of superior
→ Ligamentum nuchae – serves as attachment to
aspect of S1
muscles
→ Sacral hiatus: triangular gap and is formed by the
nonfusion of lamina
→ Sacral canal: contains the anterior and posterior
roots of the sacral and coccygeal spinal nerves

CHARACTERISTICS OF A TYPICAL THORACIC VERTEBRA

→ Body: heart-shaped
→ Vertebral foramen: small and circular
→ Spinous process: long and inclined downward COCCYX – first coccygeal vertebra is usually not fused

Spinal Nerves – 31 pairs

→ Cervical nerves – 8
→ Thoracic nerves – 12
→ Lumbar nerves – 5
→ Sacral nerves – 5
→ Coccygeal nerves -1

Spinal cord – ends between L1 and L2

Cauda Equina – bundle of spinal nerves

CHARACTERISTICS OF A TYPICAL LUMBAR VERTEBRA
→ Body: kidney-shaped
→ Vertebral foramen: large and triangular
→ Spinous process: quadrangular and project
posteriorly
→ No facets and foramina
Intercostal Nerves – anterior rami of the first thoracic
spinal nerves
2 enlargements of spinal cords:
a. Cervical area – supply nerves that innervate
upper extremities and upper back
➢ Cervical plexus
➢ Brachial plexus
 b. Lumbar area → Superficial muscles: move upper extremities
➢ Lumbar plexus – innervates lower → Intermediate muscles: moves the thorax
extremities → Deep muscles: maintain the curvature of the
vertebral column

SUPERFICIAL VERTICALLY RUNNING MUSCLES

JOINTS OF THE VERTEBRAL COLUMN
Erector Spinae
1. Atlanto-occipital joints [flexion, extension, lateral
flexion] → Longissimus
a. Anterior atlanto-occipital membrane – → Iliocostalis
connects the anterior margin of the foramen → Spinalis
magnum
b. Posterior atlanto-occipital membrane – INTERMEDIATE OBLIQUE RUNNING MUSCLES
connects the posterior arch of the atlas to Transversospinalis
the posterior margin of the foramen
magnum → Multifidus
2. Atlantoaxial joints [rotation] → Rotatores
a. Apical ligament – connects the apex of the → Semispinalis
odontoid process to the anterior margin of
DEEPEST MUSCLES
the foramen magnum
b. Alar ligaments – connect the odontoid → Interspinales
process to the medial sides of the occipital → Intertransversarii
condyles [sideways]
c. Cruciate ligament – only connection Latissimus dorsi – moves arm posteriorly
between C1 and C2. Trapezius – moves scapula
i. Transverse cruciate ligament – binds
the odontoid process to the anterior
arch of the atlas
ii. Vertical cruciate ligament – runs
from posterior surface of the body
of the axis to the anterior margin of
the foramen magnum
d. Membrana tectoria – upward continuation
of the posterior longitudinal ligament

JOINTS BETWEEN TWO VERTEBRAL ARCHES

1. Supraspinous ligament – between tips of

adjacent spines
2. Interspinous ligament – connects adjacent
spines
3. Intertransverse ligament – between adjacent
transverse process
4. Ligamentum flavum – connects laminae of
adjacent vertebrae

MUSCLES OF THE BACK