Anatomy of the Back, Spinal Cord

and Spinal Nerves

Djoko Prakosa, M.Mansyur Romi

Department of Anatomy, Embryology &
Anthropology
 CLINICAL
ANATOMY: THE
BACK

• REASONS FOR
STUDYING THE BACK
-LOW BACK PAIN
 CLINICAL
ANATOMY:
THE BACK
• REASONS FOR
STUDYING THE
BACK
• BACK PAIN
 CLINICAL
ANATOMY: THE
BACK
 Functions of the Back

- carry load

- allow movement of the different body parts

- provide protection to the spinal cord and

nerve roots
Compositionsof the Back

Bones
Joints & Ligament
Muscles
Nerves
etc
 Joints of the Spine
1. Joints of vertebral bodies
- Intervertebral discs composed:
- nucleus pulposus
- annulus fibrosus
function:
- provide movement
- transmit body forces through hydrostatic pressure

Anterior Longitudinal Ligament

Posterior Longitudinal Ligament
PLL narrow caudally  only cover 50% central
portion of lower lumbar discs  herniation
Intervertebral discs
 Intervertebral discs
• In the adult predominant source of nutrition
from blood vessels in the vertebrale bodies
through endplates.
• It receive innervation  pain
• Aging :
* endplates undergo calcification 
progressive degeneration of the discs.
* nucleus pulposus water content 90%  74%
 :
-
 Joints of the Spine (cont.)
2. Joints of vertebral arches
- zygapophyseal joints
* capsule innervated by noci- and mechanoceptors
 able to react to tension and compression moments
imposed by different postures and physical activity
* involved in weight bearing
 in degenerative disc  more weight imposed
on facet joints
* restrict rotation of the spine

* ligamenta flava * supraspinous ligament

* ligamentum nuchae * interspinous ligaments
* intertransverse ligaments

Provide tension
 Joints of the Spine (cont.)
• 3. Atlanto-occipito-axialis joint
• 4. Sacroiliac joint
• 5. Costovertebral joints
 Movements of the spine

Motion segments:
Each motion segment = Functional Spinal
Unit (FSU) consists of 2 adjacent vertebrae
- Represents the smallest segments of the
spine exhibiting biomechanical characteristics
similar to those of the entire spine
- translation and rotation can occur at each
motion segment
 Spine motion

Cervical spine most mobile --> greatest

range of flex-ext, axial rotation, lateral bending
Lumbar spine: signific flex-ext, moderate
lateral bending, little axial rotation
Thorax + sacral: relatively inflexible
Motion coupling
 Motion Segment
(Functional Spinal Unit)
• Composed of two portions:

* Anterior portion: mainly bear compressive loads

and restrain excessive motion
vertebral bodies, intervertebral
discs, ALL and PLL
* Posterior portion: guides movement
vertebral arches, facets joints, transverse and spinous
processes and ligaments
 Muscles of the Back
1. Muscles of the back
Extrinsic: - superficial: e.g. trapezius, latissim. dorsi
- intermediate: serratus posterior, rhomboid
Intrinsic: - deep muscle
* superficial: splenius muscles
* intermediate: erector spinae muscles:
iliocostalis, longissimus, spinalis.
* deep: semispinalis, multifidus, rotatores
2. Muscles of the neck
3. Muscles of the abdomen
CLINICAL ANATOMY: THE BACK
THE INTRINSIC BACK MUSCLES
CLINICAL ANATOMY: THE BACK
THE INTRINSIC BACK MUSCLES
Horizontal section of the spinal cord showing the meninges. The dura is
in yellow, the arachnoid in red, and the pia in blue. The anterior and
posterior spinal arteries are shown. C.S.F., cerebrospinal fluid in the
subarachnoid space.
CLINICAL ANATOMY: THE BACK
THE SPINAL CORD
 Median section of the vertebral
column, showing of vertebral
bodies, myelomeres, and spinous
processes.
The spinal cord ends at Ll/2 level,
subarachnoid space at S1/2 level.
Cisternal, lumbar, and epidural
punctures are shown.

E.g. of a spinal nerve: S1 nerve

arising from myelomere S1 opposite
the T12 vertebra, descending (as
part of the cauda equina), and
emerging from the first sacral
foramen.