Download TransCom Page 1 of 6 extends from the skull to the top of the coccyx

The Back
▪ extends from the skull to the top of the coccyx
▪ posterior surface of the trunk
▪ the scapulae and the muscles that connect the scapulae to the
trunk are superimposed on the upper part of the posterior surface of
the thorax
The Vertebral Column
▪ central bony pillar of the body (72-75 cm long)
▪ supports the skull, pectoral girdle, upper limb and thoracic cage
▪ through the pectoral girdle, transmits weight of the body to the
lower limbs
▪ its cavity protects and encases the spinal cord, roots of spinal
nerves and covering meninges
Composition of the Vertebral Column
▪ 33 vertebrae: cervical (7)
thoracic (12)
Lumbar (5)
sacral (5)
Coccygeal (4)
▪ 26 in an adult d/t fusion of sacral and coccygeal bones
(sacral bones form the sacrum; coccygeal bones forms
the coccyx)
▪ flexible structure d/t segmentation, joints and pads of
fibrocartilage (intervertebral discs)
 Nucleus polpusos
 Annulus fibrosus
General Characteristics of a Vertebra
-all vertebra show a common pattern
A. Body- located anteriorly
- encloses a space called the vertebral foramen
* vertebral foramen- space where the spinal cord and its coverings
are located
B. Vertebral Arch- located posteriorly
i. Pedicle- pair of cylinders which form the sides of the arch
ii. Laminae- pair of flattened structures which complete the arch
posteriorly
Vertebral Arch gives rise to seven processes
a. Spinous process/spine (1)- directed posteriorly from the junction of
two laminae
b. Transverse processes (2)-directed laterally from the junction of
laminae and the pedicles (paired)
**Spinous and transverse processes serve as levers and receive
attachments of muscles and ligaments
c. Articular processes (4)-vertically arranged
- consists of 2 superior and 2 inferior processes
- arise from the junction of laminae and pedicles
- covered with hyaline cartilage
**Articular surfaces of 2 superior and 2 inferior articular processes
articulate with each other forming synovial joints
Ia. Characteristics of an Atypical Cervical Vertebrae (C1,C2,C7)
- has anterior and posterior arches
- no body
▪ Superior and Inferior Vertebral Notches- formed by the notches on
the upper and lower borders of the pedicles
▪ Intervertebral foramen- formed by the superior and inferior notch of
the adjacent vertebrae on each side
-transmits spinal nerves and BV’s
▪ Segmental Spinal nerves- formed by the anterior and posterior
spinal roots together with their dura coverings and the
intervertebral foramen
*Lateral masses with articular surfaces articulates with condyles of
the skull
1. Atlas (C1)
- does not possess a body and a spinous process
- anterior and posterior arches & anterior and posterior
tubercles are present
- presence of lateral mass on each side with articular
surfaces on its upper surface for articulation with the occipital
condyles (atlanto-occipital jt) and articular surfaces on its
lower surface for articulation with the axis (atlanto-axial jt)
*Articular surfaces forms joint with another bone
TransCom
Page 1 of 6
2. Axis (C2)
- has a peg-like odontoid process (believed to be the body
of C1) called dens which projects from the superior surface of
the body: lateral mass that articulates with atlas
-has superior and inferior surfaces and spinous process
3. Vertebral Prominens (C7)
-1st palpable spinous process, landmark to count level of
vertebrae
-has the longest spinous process which is not bifid
-transverse processes are large but foramen
transversarium is small and transmits the vertebral veins
(only)
Ib. Characteristics of a Typical Cervical Vertebra (C3, C4, C5, C6)
- transverse processes have foramen transversarium
- has a small body that is broad (circular) from side to side
- has large triangular vertebral foramen (passage of vertebral tracts)
- superior articular processes facets:face upward and backward
- inferior articular processes facets: face downward and forward
*Foramen transversarium- within the transverse process, allows for
passage of vertebral aer and veins (from C1-C6, not C7. C7 also has
small foramen transversarium but transmits veins only)
*Figure: Typical Thoracic Vertebra
III. Characteristics of a Typical Lumbar Vertebra
-large, kidney shaped body
-has pedicles that are strong and directed backward
- small, triangular vertebral foramina
- long and slender lateral transverse processes
- spinous processes are short, flat, quadrangular and project
backward
-superior articular processes: face medially
-inferior articular processes: face laterally
- large and bulky since it is where center of gravity is located
*has no facets for articulation with ribs and no foramina in the
transverse processes.
*Figure: Typical Lumbar Vertebra
*Figure: Typical Cervical Vertebra
II. Characteristics of a Typical Thoracic Vertebra
-medium sized, heart shaped body
-small and circular vertebral foramen
-spines are long and are inclined downward
-presence of costal facets on sides of the bodies for articulation with
the heads of the ribs
-costal facets on transverse processes for articulation with the
tubercles of ribs except T11 and T12 (floating ribs)
-superior articular processes facets: face backward & laterally
-inferior articular processes facets: face forward & medially
- T12: inferior facets: face laterally
TransCom
IV. Sacrum
-consists of 5 rudimentary vertebrae fused together to form a wedgeshaped bone
-concave anteriorly
-base or upper border articulates with L5
-inferior border articulates with coccyx
-lateral articulates with 2 iliac bones forming sacroiliac joints
-anterior and posterior surfaces of sacrum have 4 foramina on each
side for the passage of anterior and posterior rami of the upper 4
sacral nerves
Page 2 of 6
▪Sacral Promontory-posterior
margin of the pelvic inlet formed by
the forward bulging of the anterior and upper margin of S1
*important in giving birth in order to measure the size of the
pelvis
▪Sacral Canal-fusion of vertebral foramina of the sacral vertebrae
and contains the anterior and posterior roots of the sacral and
coccygeal spinal nerves, filum terminale, and fibrofatty material
▪Sacral Hiatus- formed from the failure of S5 and sometimes S4 to
fuse at the midline
*superior: lumbar
Inferior: coccyx
Lateral: pelvis
V. Coccyx
- single, small triangular bone that articulates at its base with the
lower end of the sacrum
-4 vertebrae fused together (no contents)
-1st coccygeal vertebra is not fused or incompletely fused with 2nd
coccygeal vertebra
Joints of the Vertebral Column
▪Ligaments:
1. Anterior atlanto-occipital
-stabilized the atlanto-occipital jt
-continuation f anterior longitudinal ligament (tectorial
membrane)
-connects the anterior arch of atlas to anterior margin of
foramen magnum
2. Posterior atlanto-occipital
-stabilizes atlanto-occipital jt
-similar to ligamentum flavum
-connects posterior arch of atlas to posterior margin of
foramen of magnum
Axn: flexion, extension, Lateral flexion but does not rotate
II. Atlanto-axial jts.
-“NO” joint
-Movement: rotation
-composed of 3 synovial jts
i. 1 between odontoid process and anterior arch of atlas
ii. 2 are between lateral masses of atlas and axial bones
▪Ligaments:
1. Membrane tectoria
- upward continuation of posterior longitudinal ligament
- attached to occipital bone (beneath foramen magnum)
- covers posterior surface of odontoid process and the
apical, alar and crucial ligaments
2. Cruciate ligament
-consists of transverse part and a vertical part:
a. Transverse part-attached on each side to the inner
aspect of the lateral mass of atlas and binds the
odontoid process to the anterior arch of atlas
b. Vertical part- runs from the axis to the interior margin of
the foramen magnum
-covers alar and apical ligament
c. Alar ligament- paired (lie on each side of apical ligament)
- connect lateral part of odontoid process to the
medial sides of occipital condyles
d. Apical ligament- connects the apex of odontoid process
to anterior margin of foramen magnum
I. Atlanto-occipital jts.
-synovial jts. formed between the occipital condyles and the facets on
superior surfaces of lateral mass of atlas
-“YES” joint
Figure of altanto-axial jtn (posterior view)
III. Joints between 2 vertebral bodies
-covered by thin plate of hyaline cartilage
-between plates of hyaline cartilage are IV discs of fibrocartilage
-collagen unites bodies of 2 adjacent vertebrae
▪Ligaments:
1. Anterior longitudinal ligament
-wide and strongly attached to front and sides of vertebral
bodies and to IV discs
2. Posterior longitudinal ligament
-weak and narrow
-attached to posterior borders of the discs
TransCom
Page 3 of 6
▪Ligaments for lumbar tap
-needle is inserted between L3-L4 or L2-L3
- supraspinous
Interspinous (ligamentum flavum)
Dura mater
Arachnoid membrane
Subarachnoid space (CSF)
*Nuchal Ligament (LIgamentum nuchae)- extends from the external
occipital protuberance and median nuchal line to the spinous
process of the seventh cervical vertebra.
Nerve Supply of Vertebral Joints
▪ joints between vertebral bodies are innervated by small meningeal
branches of the spinal nerve
▪ joints between articular processes are innervated by branches from
the posterior rami of spinal nerves
▪Intervertebral Discs
-between 2 vertebral bodies
-responsible for ¼ of length of vertebral column
-thickest in cervical and lumbar regions where movements are
greatest
-serve as shock absorbers
-elasticity allows the rigid vertebrae to move to one another
-resilience is gradually lost with age
*Parts:
1. Annulus fobrosus (peripheral part)
-composed of fibrocartilage in which collagen fibers are
arranged in concentric layers
-pass obliquely between adjacent vertebral bodies and
attach to posterior and anterior longitudinal ligament
2. Nucleus pulposus (central)
-in children, seen as ovoid mass of gelatinous material
- contains large amounts of water, small number of
collagen and a few cartilage cells
-semi fluid nature allows it to change in shape and permits
the vertebra to rock back and forth on another
Curves of Vertebral Column
A. Fetus- possesses anterior concavity
B. Proceeding months- appearance of lumbosacral angle
C. After birth- cervical part starts to concave posteriorly because of
child’s ability to raise his head
* No discs are found between the 1st 2 cervical vertebrae or in
sacrum and coccyx
*Movement of Vertebral Column
Flexion
Lateral bending
Extension
Rotation
IV. Joints between 2 Vertebral Arches
-consist of synovial joints between superior and inferior articular
processes of adjacent vertebrae
-articular facets covered with hyaline cartilage
-surrounded by capsular ligament
▪Ligaments:
1. Supraspinous ligament-runs bet. tips of adjacent spines
2. Interspinous ligament-connect adjacent spines
3. Intertransverse ligament-bet. adjacent transverse processes
4. Ligamentum flavum- joins one vertebral arch to the next
- from anterior aspect of one laminae to posterior aspect of
lamina below
D. One year old- lumbar part of vertebral column concave posteriorly
E. Adult (standing posn)
i. cervical-posterior concavity
ii. thoracic-posterior convexity
iii. lumbar-posterior concavity
iv. sacral-posteriorconvexity
*Primary Curvature-thoracic and sacral (concave anteriorly)
Secondary Curvature-cervical and lumbar (convex anteriorly)
Muscles of the Deep Back
-form broad, thick column of muscle tissue, which occupies the
hollow on each side of spinous process
-extends from sacrum to skull
A. Erector Spinae- adjacent to spiral column
- superficially vertical running muscles which include:
iliocostalis, longissimus, spinalis
-used for bending ipsilaterally
B. Transversospinalis- intermediate oblique running muscles which
include: semispinalis, multifidus, rotators
-main stabilizer of vertebral column
C. Deepest Muscles (minor muscles)
-include: interspinales, intertransversarii and levatores
Costarum
TransCom
Page 4 of 6
Table1. Erector spinae
Muscle & Origin
Action
Insertion
Splenius
draws head back,
Cervicis
bends
head
Capitis
laterally, rotates
face on the same
side
Erector spinae (sacrospinalis)
Iliocostalis
Lumborum
Bends vertebral -Angles of ribs
-Crest of Ilium
column to the
Thoracis
side
-Transverse
-Transverse
processes at higher
process at lower
levels;posterior
levels
margin of mastoid
Cervicis
process (capitis)
-Spinous process
-Spinous process
Longissimus
Cervicis
Bend column on to
-Transverse
one side and depress
processes of C7the ribs
T6/T7
Thoracis
Extends head, bends
Capitis
head to side, rotates
face to same side
Spinalis
Thoracis
Cervicis
Capitis
*Nerve Supply: Branches of Dorsal/Posterior Primary Rami of Spinal
Nerves
Table3. Deepest Muscle of the Back (Minor)
Muscle
Origin
Action
Interspinales
Spinous process of C & L
Intertransversii
Transverse process of C
&L
Levatores
Lateral
Costarum
bending
Brevis
Longus
*Nerve Supply: Branches of Dorsal/posterior Primary Rami of Spinal
Nerves
* Intertransverse (intertransversarii)
Interspinous (interspinales)
TransCom
Table2.Transversopinalis (obliquely running)
Muscle & Origin
Action
Insertion
Semispinalis
-Extends column and
Transverse
- Posterior
rotate primarily
process of
surface of sacrum, unilaterally; stabilize
tendon of erector
column
spinae and C4
Cervicis
-Rotates column to
opposite side
Thoracis
-Extends upper column
and rotate centralaterally
Capitis
-Powerful extensor of
head (extends head,
rotates head to opposite
side)
Multifidus
-Rotates column to
opposite side
Rotatores
-Rotates column to
Longus
opposite side
Brevis
*Nerve Supply: Branches of Dorsal/posterior Primary Rami of Spinal
Nerves
Table4. Suboccipital Muscles
Muscle
Action
Rectus capitis
Extends head
posterior major and rotates it
to same side
Innervation
Suboccipital
nerve (C1
dorsal ramus
of 1st cervical
nerve)
Middle of
inferior
nuchal line
and occipital
bone
beneath
Rectus capitis
posterior minor
Extends the
head (C1
ipsilaterally)
Obliquus
Turns head to
capitis inferior
the same side
Obliquus
Extends head
capitis
and bends it to
superior
the same side
▪Suboccipital triangle: obliquus capitis minor & major + rectus capitis
posterior major.
-between spine of axis, transverse process of atlas and occipital
bone
-contains: vertebral arteries, suboccipital nerve and fibrofatty tissue
-others: greater occipital nerve (C2) & occipital artery
Page 5 of 6
B.Thoracolumbar Fascia- encloses erector spinae/sacrospinales
- between iliac crest and 12th rib
- cover deep muscles
Layers
Nerve Supply of the Back
-skin and muscles are supplied in a segmental manner by the
posterior rami of the 31 pairs of spinal nerves
-posterior rami of the 1st, 6th, 7th and 8th cervical nerves and 4th and
5th lumbar nerves supply the deep muscles of the back (not the skin)
-posterior ramus of the 2nd cervical nerve (greater occipital nerve)
ascends over the back of the head and supplies the skin and scalp
Blood Supply of the Back
I.Arteries
A. Cervical Region- branches arise from:
1. Occipital artery- branch of external carotid artery
2. Vertebral artery-branch of subclavian artery
3. deep cervical artery- from costocervical trunk
4. Ascending cervical artery- from inferior thyroid artery
B. Thoracic Region-branches arise from posterior intercostals
arteries
C. Lumbar Region- branches arise from subcostal and lumbar
arteries
D. Sacral Region- arise from iliolumbar and lateral sacral arteries
(branches of internal iliac artery)
*branches of spinal artery (regional)
I.Posterior- midline (spine process), laterally ends of aponeurosis of
transverse adominis muscle
II.Middle-deep to erector spinae group of muscles and end in
transverse process of lumbar vertebrae
III. Anterior-pass medially; attached to anterior surface of transverse
process of lumbar vertebrae and lies in front of quadrates
lumborum muscle.
Quiz
1.Suboccipital nerve
2. Vertebral artery
3. Pedicle
4. Laminae
5. Posterior rami/Dorsal rami
6. Axillary nodes
7. Lumbar
8. Semispinales
9. Multifidus
10. Rotatores
Greetings!!!!!!!!!!!!!
Hello sa aking group, pseudogroup at pseudoroomates!! PH
people hello sa inyo, go team!! And sa MGA crush ko jan,
HELLO (ehem joy, frances ung banner natin ha haha)!! Chen,
hello sa CHORVA mo (bilang kapalit ng pagbati mo kay boyps
haha) Mau, pinapaligaya mo ang buhay ko! And to Fafa Paul,
II.Veins
-forms plexuses extending along the vertebral column from
skull to coccyx
A.Ext. Vert. Venous Plexus-lie external to vertebral column
-*intervertebral costal lateral sacral veins
B. Int. Vert. Venous Plexus-lie within vertebral canal
- drained by intervertebral veins
-*pierce bodies and drain the column
Take care ‘cos I care haha!
“Matalino man at magaling,
ang chaka, CHAKA pa din!!”
Hi kay faye, thanks sa support! To joy and lea astig kaung ka
team sa trans. To ICS 3, d best ICS. Sa crush ko, cute mo sa
pic. Kay grethel, humahaba at kumukulot hair mo first lady.
*Intervertebral veins-pass outward with the spinal nerves through the
intervertebral foramina
-ventral arch to anterior and posterior internal
plexus on to the intervertebral veins
*Int. and ext. venous plexus interconnect without valves and extend
from pelvis to cranium; role in metastasis of Ca (ex. Pelvi-brain)
Ana, inom pa tayo. Berry, award winning ang goal natin.
Sinetch Itey!!!

kingdom sa mayamang lupain.

Fascia
Sinetch ang boylet na magmamay-ari ng isang
museum na puro cya ang model ng mga paintings at
Lymphatic Drainage of the Back
A.Deep lymph vessels follow the veins, drains into:
i. deep cervical nodes
ii. posterior mediastinal nodes
iii. lateral aortic nodes
iv. sacral nodes
B. Lymph vessels from the skin of the neck: cervical nodes
C. From the trunk above iliac crest: axillary nodes
D. Below level of Iliac crest: superficial inguinal nodes
Sinetch ang girlaloo na future princess ng isang
sculptures.

Sinetch ang girlaloo na may sariling timezone na
sinusunod and “always rrready.”

Sinetch ang boylet na papa mo, papa ko at papa ng
lahat na pampagising eh maghanap ng mga taong
natutulog sa class.
GO GO GO team!!! Edward, wag kang pumayag na
binibitinan ka lang nila, sikuhin mo… hehehe. Faye and
Mau, god bless mamaya… I love you. Hehehe Aja!
A.Nuchal Fascia- posterior portion of prevertebral layer of cervical
fascia
TransCom
Page 6 of 6