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Lippincott Williams & Wilkins
atlas of
ANATOMY
THE BACK
CHAPTER 1
Plate 1-01
Palpable Structures of the Back . . . . . . . . . . . . . . . . 5
Plate 1-02
Vertebral Column, Lateral View . . . . . . . . . . . . . . . 6
Plate 1-03
Cervical Vertebrae . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Plate 1-04
Articulated Cervical Vertebrae . . . . . . . . . . . . . . . . 8
Plate 1-05
Thoracic and Lumbar Vertebrae . . . . . . . . . . . . . . . 9
Plate 1-06
Articulated Thoracic Vertebrae . . . . . . . . . . . . . . . 10
Plate 1-07
Articulated Lumbar Vertebrae . . . . . . . . . . . . . . . 11
Plate 1-08
Sacrum and Coccyx . . . . . . . . . . . . . . . . . . . . . . . . 12
Plate 1-09
Ligaments of the Cervical Vertebrae . . . . . . . . . . . 13
Plate 1-10
Ligaments of the Thoracic Vertebrae . . . . . . . . . . 14
Plate 1-11
Ligaments of the Lumbar Vertebrae
and Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Plate 1-12
Cutaneous Innervation of the Back . . . . . . . . . . . . 16
Plate 1-13
Superficial Muscles of the Back . . . . . . . . . . . . . . . 17
Plate 1-14
Deep Back Muscles, Superficial Dissection . . . . . . 18
Plate 1-15
Deep Back Muscles, Deeper Dissection . . . . . . . . 19
Plate 1-16
Suboccipital Region. . . . . . . . . . . . . . . . . . . . . . . . . 20
Plate 1-17
Pattern of a Typical Spinal Nerve . . . . . . . . . . . . . 21
Plate 1-18
Spinal Cord, Posterior View . . . . . . . . . . . . . . . . . 22
Plate 1-19
Superior Portion of the Spinal Cord . . . . . . . . . . . 23
Plate 1-20
Inferior Portion of the Spinal Cord . . . . . . . . . . . . 24
Plate 1-21
Blood Supply of the Spinal Cord,
Anterior View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Plate 1-22
Venous Drainage of the Vertebral Column
and Spinal Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Plate 1-23
Dermatomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
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PLATE 1-01
Palpable Structures of the Back
Palpable bony structures
Superior nuchal line
External occipital protuberance
Superior border
of trapezius muscle
Vertebra prominens (C7)
Clavicle
Acromioclavicular
joint
Acromion of scapula
Spine of scapula
Greater tubercle
of humerus
Posterior axillary
fold
Inferior angle of
scapula
Spinous processes
of vertebrae in
vertebral furrow
Rib
Bulge of erector spinae muscles
Iliac crest
Posterior superior iliac spine
Hip bone
Sacrum
Coccyx
Greater trochanter
of femur
Ischial tuberosity
Chapter 1
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Vertebral Column, Lateral View
Cervical Vertebrae
PLATE 1-03
Vertebral Column, Lateral View
B. Atlas (C1), inferior view
A. Atlas (C1), superior view
Posterior
tubercle
Anterior tubercle
Anterior arch
Vertebral
foramen
rch
Anteriorarch
a
Posterior
Articular facet
for dens
Transverse
process
Transverse
process
Atlas (C1)
Axis (C2)
Cervical curvature
Transverse
foramen
Inferior articular
facet for axis
Posterior arch
Superior articular
facet for occipital
condyle
C7
Transverse
foramen
Vertebral
foramen
Posterior
tubercle
T1
Articular facet
for dens
Anterior arch
Groove for vertebral artery
and C1 ventral ramus
Anterior
tubercle
C. Axis (C2), superior view
Anterior arch
Dens
Anterior articular facet
for arch of atlas
Thoracic curvature
Superior articular
facet
Transverse
process
Inferior articular
process
T12
Posterior articular facet for
transverse ligament of atlas
Lamina
L1
Spinous
process
D. Cervical vertebra (C4), superior view
Lumbar curvature
E. Cervical vertebra (C4), lateral view
Body
Transverse process:
L5
Anterior
tubercle
Uncinate
process
Sacrum
Uncinate
process
Pedicle
Transverse
foramen
Sacral curvature
Superior articular
facet and process
Transverse process:
Anterior
tubercle
Posterior
tubercle
Transverse
foramen
Posterior
tubercle
Superior
articular
facet
Vertebral
foramen
Spinous
process
Inferior
Body
articular process
Lamina
Spinous
process
Coccyx
Chapter 1
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Chapter 1
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Articulated Cervical Vertebrae
A. Lateral view
PLATE 1-05
Thoracic and Lumbar Vertebrae
B. Radiograph of cervical vertebrae, lateral view
B. Thoracic vertebra (T6), lateral view
A. Thoracic vertebra (T6), superior view
Body
Occipital bone
C1
Superior articular
facet and process
Vertebral
foramen
Anterior arch
of atlas (C1)
C1
C2
Superior
costal facet
Superior
vertebral
notch
Transverse
costal facet
Pedicle
C2
Transverse
process
Transverse
costal facet
Intervertebral disc
C3
C3
C4
C4
Zygapophyseal joint
C6
Transverse
process
C6
Lamina
Inferior
articular
process
Spinous
process
Spinous
process
Inferior
vertebral
notch
Anulus
fibrosus
C7
T1
Nucleus pulposus
D. Radiograph of cervical vertebrae, posterior view
C. Posterior view
C1
D. Lumbar vertebra (L3), superior view
Mandible
E. Lumbar vertebra (L3), lateral view
Body
Superior
articular Superior
process vertebral
notch
C2
C3
C3
C4
Transverse
process of C4
C4
Spinous processes
C5
C5
C6
Lamina of C6
C6
C7
C7
T1
Chapter 1
Lippincott Williams & Wilkins Atlas of Anatomy
Spinous process
of C7
Pedicle
Transverse
process
Pedicle
PAGE 8
Inferior
costal facet
C. Intervertebral disc, superior view
Transverse process
C7
Superior
articular
facet
C5
Intervertebral foramen
Spinous process of C6
Body
Pedicle
Posterior arch
of atlas (C1)
C5
Superior
vertebral
notch Superior
costal facet
Vertebral
foramen
Transverse
process
Superior
articular
process
and facet
Lamina
Mammillary
process
Spinous
process
Spinous
process
Inferior
articular
process
Inferior
vertebral
notch
Body
Inferior
articular
facet
Chapter 1
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Articulated Thoracic Vertebrae
Articulated Lumbar Vertebrae
B. Posterior view
A. Lateral view
B. Radiograph of lumbar vertebrae, lateral view
A. Lateral view
Inferior articular
process
T12
T12
Superior articular
process
Pedicle
C7
L1
T1
PLATE 1-07
L1
Intervertebral disc
Spinous processes
L2
L2
Spinous process
Inferior vertebral
notch
Intervertebral foramina
Transverse
costal facets
L3
L3
Intervertebral
foramen
L4
Superior vertebral
notch
L4
Transverse
process of L4
Inferior costal facets
L5
Laminae
Body
L5
Sacrum
Superior costal facets
Transverse processes
C. Posterior view
D. Radiograph of lumbar vertebrae, posterior view
T12
T12
Pedicles
Transverse process
L1
L1
Zygapophyseal
joint
Intervertebral discs
L2
L2
Inferior articular process
Superior articular process
Pedicle
L3
L3
Spinous process
L4
Lamina
L4
T12
L5
L5
L1
Sacrum
Chapter 1
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Chapter 1
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Sacrum and Coccyx
Ligaments of the Cervical Vertebrae
Base of sacrum
PLATE 1-09
A. Lateral view
A. Anterior view
Anterior atlanto-occipital membrane
Capsule of atlanto-occipital joint
Posterior atlanto-occipital membrane
Ala (lateral part)
Anterior arch of atlas (C1)
Superior articular process
Body of axis (C2)
Lumbosacral
articular surface
Vertebral artery
Promontory
Anterior (pelvic)
sacral foramina
Capsules of zygapophyseal joints
(C3–C4 and C4–C5)
Ligamenta flava
Transverse
ridges
Anterior longitudinal ligament
Ligamentum nuchae
Apex of sacrum
Interspinous ligament
Intervertebral discs
(C4–C5 and C6–C7)
Coccyx
Spinous process of C7 vertebra
(vertebra prominens)
T1
B. Posterior view
B. Posterior view
Occipital bone
Superior
articular facet
Auricular surface
Capsule of
atlanto-occipital joint
Posterior atlanto-occipital membrane
Capsule of lateral
atlantoaxial joint
Transverse process of atlas (C1)
Atlas (C1)
Axis (C2)
Median sacral crest
Posterior sacral
foramina
Lateral sacral crest
Ligamenta flava
Ligamentum nuchae
Vertebral artery
Capsules of zygapophyseal joints
Sacral hiatus
Coccyx
T1
Supraspinous ligament
Chapter 1
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Chapter 1
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Ligaments of the Thoracic Vertebrae
Ligaments of the Lumbar Vertebrae and Sacrum
A. Lateral view
Body of T12
Ligamenta
flava
Body of L1
Posterior longitudinal ligament
Anulus fibrosus
Nucleus pulposus
Tip of conus medullaris (cut)
surrounded by nerve roots
A. Lateral view
Intervertebral
foramen
Supraspinous
ligament
C7
Interspinous
ligament
T1
PLATE 1-11
L2 spinal nerve
Zygapophyseal
joint capsules
Anterior longitudinal ligament
Intervertebral foramen
Posterior longitudinal
ligament
Intertransverse
ligaments
Anterior longitudinal
ligament
Superior
costotransverse
ligaments
Supraspinous
ligament
B. Posterior view
Intervertebral disc
C7
Interspinous
ligament
T1
Spinous
process
Transverse
process
Pedicle
Dorsal rami:
L4
L5
Radiate
ligaments
Ventral rami:
L4
L5
Ribs
B. Posterior view
Superior
costotransverse
ligament
Ribs
Lamina
Supraspinous
ligament
Sacrum
Lateral
costotransverse
ligament
Intervertebral
discs
Posterior
longitudinal
ligament
Intertransverse
ligament
Pedicle
(cut)
Spinous process
Lamina
Anterior
longitudinal
ligament
Transverse process
T12
L1
Lamina
Intertransverse ligament
Ligamenta flava
Zygopophyseal joint capsule
Iliolumbar ligament
Supraspinous ligament
T12
L1
Chapter 1
PAGE 14
Lippincott Williams & Wilkins Atlas of Anatomy
Posterior sacroiliac
ligament
Chapter 1
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Cutaneous Innervation of the Back
PLATE 1-13
Superficial Muscles of the Back
Superior nuchal line
Greater occipital nerve
(dorsal ramus of C2)
Sternocleidomastoid muscle
Splenius capitis muscle
Accessory nerve (CN XI)
Spinous process of C7
Third occipital nerve
(dorsal ramus of C3)
Splenius cervicis muscle
Transverse cervical artery
Trapezius muscle
Skin
Trapezius muscle
Levator scapulae muscle
Rhomboid minor muscle
Spine of scapula
Rhomboid major muscle
Posterior cutaneous branches
(dorsal rami of C4–T6)
Trapezius muscle
Deltoid muscle
Deltoid muscle
Infraspinatus fascia
Teres major muscle
Infraspinatus
fascia
Thoracodorsal
artery and nerve
Teres major
muscle
Latissimus dorsi muscle
Posterior cutaneous branches
(dorsal rami of T7–T12)
Superficial
fascia
External abdominal oblique muscle
Triangle of
auscultation
Erector spinae muscles
(deep to thoracolumbar fascia)
Latissimus dorsi
muscle (cut)
Latissimus dorsi muscle
Lateral cutaneous branches
of ventral rami (intercostal nerves)
External abdominal oblique muscle
Serratus anterior
muscle
Spinous process of T12
Lumbar triangle
Superior cluneal nerves
(dorsal rami of L1–L3)
Iliac crest
Serratus posterior
inferior muscle
12th rib
Thoracolumbar fascia
Iliac crest
Middle cluneal nerves
(dorsal rami of S1–S3)
Chapter 1
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Deep Back Muscles, Superficial Dissection
Deep Back Muscles, Deeper Dissection
PLATE 1-15
Superior nuchal line
External occipital protuberance
External occipital protuberance
Obliquus capitis superior muscle
Superior nuchal line
Posterior tubercle of atlas (C1)
Posterior tubercle of atlas
Spinous process of axis (C2)
Semispinalis capitis muscle
Splenius capitis and
cervicis muscles
Longissimus cervicis muscle
Spinous process of C7
Rectus capitis posterior muscles:
Minor
Major
Semispinalis muscles:
Capitis
Thoracis
Transverse process of altas (C1)
Obliquus capitis inferior muscle
Interspinalis cervicis muscle
Rotatores cervicis muscles:
Longus
Brevis
Iliocostalis cervicis muscle
Spinous process of C7
Iliocostalis thoracis muscle
(retracted)
Serratus posterior
superior muscle
Rotatores thoracis
muscles:
Longus
Brevis
External intercostal
muscles
Erector spinae muscle:
Iliocostalis muscle
Longissimus muscle
Spinalis muscle
Interspinalis thoracis muscle
Spinalis thoracis muscle
Longissimus thoracis muscle
Multifidus muscles
Levatores costarum muscles:
Longus
Brevis
Iliocostalis lumborum muscle
Serratus posterior
inferior muscle
Interspinalis lumborum muscle
External abdominal
oblique muscle
Internal abdominal
oblique muscle
Iliac crest
Chapter 1
PAGE 18
Lippincott Williams & Wilkins Atlas of Anatomy
Lateral
intertransversarius muscle
Iliac crest
Chapter 1
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Suboccipital Region
PLATE 1-17
Pattern of a Typical Spinal Nerve
A. Orientation
B. Oblique section
Anterior cutaneous branch of 6th intercostal nerve:
Medial branch
Lateral branch
Trapezius muscles (cut)
Occipital artery
Parietal pleura
Greater occipital nerve
Superficial fascia
Rectus capitis posterior
minor muscle
Skin
Rectus capitis posterior
major muscle
Sternum
Vertebral artery
Obliquus capitis
superior muscle
Sternocleidomastoid
muscle (cut)
Sternocleidomastoid
muscle (cut)
Suboccipital nerve
(dorsal ramus of C1
spinal nerve)
External intercostal membrane
External intercostal muscle
Transversus thoracis muscle
Internal intercostal muscle
Innermost intercostal muscle
Lateral cutaneous branch
of 6th intercostal nerve:
Anterior branch
Posterior branch
Obliquus capitis
inferior muscle
Lesser occipital nerve
Semispinalis capitis muscle
Body of 6th thoracic vertebra
Splenius capitis muscle
(cut and reflected)
Sympathetic ganglion
White and gray rami
communicantes
Greater occipital nerve
(dorsal ramus of C2
spinal nerve)
Ventral root
Splenius capitis muscle
Trapezius muscle (cut)
3rd occipital nerve
(dorsal ramus of C3
spinal nerve)
Spinal cord
Dorsal root
Dorsal root ganglion
Longissimus capitis muscle
6th thoracic spinal nerve
Scapula
Ventral ramus (intercostal nerve)
Dorsal ramus
Posterior cutaneous branch
of dorsal ramus of 6th thoracic
spinal nerve:
Lateral branch
Medial branch
Deep back muscles
Chapter 1
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Spinal Cord, Posterior View
PLATE 1-19
Superior Portion of the Spinal Cord
A. Orientation
Occipital bone
C1 vertebra
(atlas, cut)
C1 spinal nerve
C2 vertebra
(axis, cut)
B. Dissection
Splenius capitis and splenius cervicis muscles
(cut and reflected)
Denticulate ligament
C7 vertebra
(cut)
Dorsal root ganglion
T1 vertebra
(cut)
C5 pedicle (cut)
Serratus posterior
superior muscle
(cut and reflected)
T1 spinal nerve
Dura mater
Dura and arachnoid mater
(cut and reflected)
Arachnoid mater
Pia mater on surface
of spinal cord
Erector spinae muscle:
Iliocostalis muscle
Longissimus muscle
(spinalis muscle removed)
Roots of spinal nerves T2–T11
Dorsal median sulcus
Ventral ramus
Dorsal ramus
Serratus posterior
inferior muscle
(cut and reflected)
Conus medullaris
Dorsal rootlets
L1 spinal nerve
T12 vertebra
(cut)
Dorsal root of spinal nerve
Posterior radicular artery
Termination of spinal cord
at intervertebral disc L1/L2
L1 vertebra
(cut)
Cauda equina
Denticulate ligament
Posterior spinal arteries
Filum terminale internum
L5 vertebra
(cut)
L5 spinal nerve
Sacrum
(cut)
S1 spinal nerve
Hip bone
Termination of dural sac
at S2 vertebral level
S5 spinal nerve
Filum terminale externum
Ventral root of spinal nerve
Dorsal root ganglion
Spinal branches
of posterior intercostal artery
T3 pedicle (cut)
Coccygeal nerve
Coccyx
Chapter 1
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Inferior Portion of the Spinal Cord
PLATE 1-21
Blood Supply of the Spinal Cord, Anterior View
B. Dissection
A. Orientation
Posterior spinal arteries
Thoracic vertebrae
Anterior spinal
artery
Dura mater
Arachnoid mater
Dura and arachnoid mater
(cut and reflected)
Denticulate ligament (cut)
Arachnoid mater
Posterior radicular artery
Conus medullaris
Radicular arteries
Spinal cord
Branch to vertebral body
and dura mater
Lumbar vertebrae
Posterior
intercostal
artery
Anterior radicular artery
Spinal branch
Cauda equina
Pedicles (cut)
Filum terminale internum
Dorsal root ganglia
Sacrum
Filum terminale externum
C. MRI (T2 weighted), sagittal view
Basivertebral
veins
Conus medullaris
Vertebral bodies
(L2 and L3)
Spinous process
Cerebrospinal fluid
in lumbar cistern
Intercostal
nerves
Dorsal branch
of posterior
intercostal artery
Accessory
hemiazygos vein
Descending
thoracic aorta
Sympathetic trunk
and ganglion
Thoracic duct
Posterior intercostal arteries
Intervertebral disc
Cauda equina
Accessory hemiazygos vein
Azygos vein
Sacrum
Chapter 1
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Venous Drainage of the Vertebral Column and Spinal Cord
PLATE 1-23
Dermatomes
A. Sagittal view
A. Anterior view
B. Posterior view
CN V
C2
Anterior external
vertebral venous plexus
C3
C2
C4
Basivertebral vein
Internal vertebral
venous plexus
C3
C4
T1
C6
T2
T3
C5
Cutaway sections of:
Epidural fat
Dura mater
Arachnoid mater
Spinal cord
T4
L1 vertebral body
T5
T6
T1
T7
T8
T9
T10
Posterior external
vertebral venous plexus
L1
T11
T12
L2
C5
C6
C7
C8
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10
T11
T12
L1
L2
L3
L4
L5
C6
C8
S1
S2
S3
S4
C6
S2–S3
S5
C7 C8
C7
L3
B. Superior view
External vertebral
venous plexus
L4
S1
Basivertebral vein
Internal vertebral
venous plexus
Intervertebral vein
Anterior median spinal vein
Anterior lateral spinal vein
Anterior radicular vein
Posterior radicular vein
L5
S2
Epidural fat
External vertebral venous plexus
Posterior lateral
spinal vein
Posterior median
spinal vein
S1
L5
Chapter 1
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