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Title: Anatomy of the back
Description: Understanding the anatomy of the back and its clinical significance.

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THE BACK

ANATOMY
Lecture Notes By: John Lorenz Beleno, RM, RN, MD

THE BACK
- Posterior Aspect of the trunk
- Region of the body to which the head, neck and
limbs are attached
- Shape, size and contour varies



Bony Framework
- Part of Axial skeleton
• Vertebral column/Spine/Backbone
o Forms the skeleton of neck and back
o Extends from the skull to the coccyx
o Main part of axial skeleton
▪ Cranium
▪ Vertebral Column
▪ Ribs
▪ Sternum
Functions
1
...
Supports the weight of the body
3
...
Plays an important role in posture and locomotion
5
...
Anterior element
▪ Body and intervertebral disc
2
...
b/n bodies
2
...
superior process of inferior
vertebra



Processes
o Spinous process (1) – found at the junction
between two laminae

Dr
...

• Intervertebral Foramen / Neural Foramen
– formed by the superior notch of one
vertebra and inferior notch of adjacent
vertebra
- allow passage of spinal nerves and
blood vessels


Vertebral/Neural Arches
▪ Spina Bifida – the lamina of L5 failed to
unite

General Characteristics of Typical Vertebra
-

Consists of rounded body and vertebral arch posteriorly
Encloses a space – vertebral foramen – spinal
canal
Vertebral arch consists of pair of pedicles and a
pair of lamina
Vertebral arch gives rise to 7 processes

Features of Typical Cervical Vertebra

Part
Body

Vertebral
foramen
Transverse
processes

Articular
Processes
Spinous
Process

Distinctive Characteristics
Small and wider from side to side
than anteroposteriorly; superior surface is concave and inferior surface is
convex
Large and triangular
Transverse foramina (L
...
They are typical vertebrae
except for C1, C2, and C7
...
John Lorenz Beleno





ANATOMY

o Transverse Processes (2)– located laterally
on the junction at each side between the
pedicle anteriorly and the lamina posteriorly
o Articular Processes(4) - projected at the
junction of the lamina and pedicles, articular
surfaces covered with hyaline cartilage
▪ Superior Articular Processes (2)
▪ Inferior Articular Processes (2)

2
Jlb_MD

THE BACK

Articular processes

Features of Thoracic Vertebra

Body

Vertebral foramen

Transverse processes
(TP)

Articular processes

Spinous process (SP)

Distinctive characteristic
Heart shaped; has one or
two facets for articulation
with head of a rib (H)
Circular and smaller than
in cervical and lumbar
regions
Long and strong and extends postrolaterally;
length diminishes from
T1-T12 (T1-T10 have facets for articulation with
tubercle of a rib)
Superior facets directed
posteriorly and slightly
laterally; inferior facets
directed anteriorly and
slightly medially
Long and slopes postero
inferiorly; tip extends onlevel of vertebral body
below

Costal facet – can be found on each side of the vertebral body or on the transverse processes and will
articulate with the tubercle of the rib
Features of Lumbar Vertebrae
Part
Body

Vertebral foramen

Transverse processes
(TP)

Distinctive Characteristics
Massive; kidney shaped
when viewed from above
or below
Triangular; larger than in
thoracic region and smaller than in cervical region
Long and slender; accessory process on posterior
surface of the base of each
process

Spinous process (SP)

Thoracic – natural bending
Lumbar – flexion and extension
VERTEBRAE
• Curves
In the fetus, the vertebral column has one continuous anterior concavity
...
After birth
when the child becomes able to raise his or her head,
the cervical vertebra becomes concave posteriorly
...

The primary curve is due to anatomic structure
of the vertebra, neural arch is thicker than the anterior element (body)
...



Abnormal Curves
o Kyphosis – hunch back, caused by muscle
weakness, collapse (osteoporosis, infectious
process), trauma
▪ Exaggeration in the sagittal curvature in
the thoracic vertebrae
o Lordosis- exaggeration in the sagittal curvature in the lumbar region
Jlb_MD

DR
...

Thoracic – called intercostal veins
*They are valveless…caliber remains the
same
...
Intervertebral Disc
 PARTS
 ANNULUS FIBROSUS- outer fibrous
layer
 NUCLEUS PULPOSUS- gelatinous
central mass
 FEATURES
 No disc between C1 and C2
 Disc thickness vary in different regions
 Thickest in the lumbar region
 Disc is thicker anteriorly in the cervical and lumbar
 Uniform thickness in the thoracic region
 Contributes 25% to vertebral height
 Nucleus Pulposus – maximum water
content at birth and decreases with
age
 Shock absorber for axial forces

DR
...
Posterior Longitudinal Ligament
 MUCH WEAKER AND NARROWER
 RUNS W/IN THE CANAL ALONG THE POSTERIOR ASPECT OF THE BODY
 ATTACHES TO POSTERIOR EDGE OF THE
BODIES AND DISC FROM C2-SACRUM
 PREVENTS HYPEREXTENSION AND DISC
PROTRUSION
 W/ PAIN NERVE ENDINGS
4
...
Interspinous Ligament
 UNITE ADJACENT SPINOUS PROCESSES
 WEAK
6
...
Intertransverse Ligament
 CONNECTS ADJACENT TRANSVERSE PROCESSES

*In Lumbar Puncture
Structures to be hit ( posterior going anterior)
1
...
Interspinous ligament
3
...
Subdural space/Subarachnoid Space
 JOINTS OF VERTEBRAL BODY
 SECONDARY CARTILAGENOUS
JOINT(SYMPHYSIS)
 DESIGNED FOR WEIGHT BEARING
AND STRENGTH
 ARTICULATING SURFACES OF ADJACENT VERTEBRAE ARE CONNECTED BY DISC AND LIGAMENTS
 ZYGOAPOPHYSIAL JOINT(FACET JOINT)
 PLANE SYNOVIAL TYPE OF JOINT
BETWEEN SUPERIOR AND INFERIOR ARTICULAR PROCESSES
 GLIDING MOVEMENT
 INNERVATED BY ARTICULAR
BRANCHES OF POSTERIOR RAMI OF
SPINAL NERVES
 UNCOVERTEBRAL JOINT OF LUSCHKA
 BETWEEN THE UNCINATE(HOOK
LIKE) PROCESSES OF VERTEBRA
AND BEVELLED SURFACES OF VERTEBRA ABOVE THEM
 LOCATED AT LATERAL/POSTEROLATERAL MARGINS
OF IV DISC
 THESE JOINT LIKE STRUCTURE ARE
COVERD WITH CARTILAGE AND
CONTAIN ACAPSULE FILLED WITH
FLUID

DR
...
Anterior Longitudinal Ligament
 FIBROUS BAND THAT COVERS AND CONNECT THE ANTEROLATERAL ASPECT OF
VERTEBRAL BODIES ABD DISC
 EXTENDFROM SACRUM-ANTERIOR TUBERCLE OF C1 – ANTERIOR RIM OF FORAMEN MAGNUM
 HELPS PREVENT HYPEREXTENSION

8
...


5
Jlb_MD


Title: Anatomy of the back
Description: Understanding the anatomy of the back and its clinical significance.