Back & Vertebral Column (Spine)

Muscles connected to the shoulder girdle

What are superficial muscles of the back?

Muscles involved with movement of the thoracic wall

What are intermediate muscles of the back?

Muscles associated with the vertebral column

What are deep (post vertebral) muscles of the back?

Trapezius

Identify structure #1

Latissimus dorsi

Identify structure #2

Thoracolumbar fascia

Identify structure #3

Deltoid

Identify structure #4

Teres minor

Identify structure #5

Teres major

Identify structure #6

Infraspinatus

Identify structure #7

Supraspinatus

Identify structure #8

Rhomboid major

Identify structure #9

Rhomboid minor

Identify structure #10

Levator scapulae

Identify structure #11

Splenius capitis

Identify structure #12

Semispinalis capitis

Identify structure #13

Sternocleidomastoid

Identify structure #14

cervical, thoracic, lumbar, sacral, coccygeal

What is the composition of the vertebral column?

7

How many cervical vertebrae are there?

12

How many thoracic vertebrae are there?

5

How many lumbar vertebrae are there?

1 sacrum (5 fused bones)

How many sacral vertebrae are there?

1 coccyx (4 fused vertebrae)

How many coccygeal vertebrae are there?

Cervical: posterior concavity

Thoracic: posterior convexity

Lumbar: posterior concavity

Sacral: posterior convexity

Describe these curvatures per region of the back

primary curavture is 'c' shaped with a posterior convexity

How does primary curvature differ from secondary curvature

5. Structural Curves, Thoracic and Sacral

6. Functional Curves, Cervical

7. Functional Curves, Lumbar

Describe the curves of 5,6,7

These are all abnormal curvatures

8. Kyphosis (increased posterior convexity of mainly the thoracic region)

9. Lordosis (increased anterior convexity of lumbar curve)

10. Scoliosis (lateral deviation)

Describe the curves of 8,9,10

Vertebral Body & Vertebral Discs

What is the vertebral column comprised of?

Vertebral Discs & zygaopophyseal (facet) joints

What are the two joints of the vertebral column

annulus fibrosus and nucleus pulposus

What is the vertebral disc comprised of?

These are synovial joints between superior and inferior articular processes, gliding motion

What is the zygaopophyseal joint comprised of?

Abnormal curvatures

Herniated disc

Fractures

Spina bifida

What are the 4 anomalies of the back?

nucleus pulposus is squeezing out of annulus fibrosus, causing a herniated disc

What is going on here and what structures are involved?

Spina Bifida - Occulta

Open channel due to incomplete vertebral arch

What is going on here?

meningocele spina bifida

Open channel due to incomplete vertebral arch with a subarachnoid space containing CSF

What is going on here?

Meningomyelocele (spina bifida)

Open channel due to incomplete vertebral arch with a subarachnoid space containing CSF and spinal cord is also in the sac

What is going on here?

The spinal cord is located in the vertebral column which is formed by the vertebral foramina

Where is the spinal cord located?

40-45cm

How long is the spinal cord?

foramen magnum

Where does the spinal cord leave the brain from?

L2

Where does the spinal cord technically end?

Conus Medullaris

then it is tapered into the Filum terminale

What is the end of the spinal cord called?

Orange arrow: Conus medullaris

Yellow arrow: Filum terminale

Identify these structures

Outer: Spinal Dura Mater

Middle: Spinal Arachnoid mater

Inner: Spinal pia mater

What are the meninges of the spinal cord?

Pia mater extends laterally as denticulate ligament that runs on each side of the spinal cord. They insert into dura matter and they separate the anterior (ventral) and posterior (dorsal) roots of spinal nerves.

What is this Pia mater doing?

Epidural space, subdual space, and subarachnoid space

What are the spaces associated with the meninges?

space between arachnoid and pia mater

What space contains CSF?

7 cervical, 12 thoracic, 5 lumbar, 1 sacral, 1 coccygeal

What are the spinal segments?

Gray matter and white matter

What is the matter of the spinal cord?

Dorsal and Ventral roots

Dorsal is sensory

Ventral is motor

The spinal cord is composed of two kinds of roots, name them and explain what they do

White matter (myelinated fibers)

Identify structure #1

Gray matter (cells)

Identify structure #2

Anterior horn

Identify structure #3

Posterior horn

Identify structure #4

Lateral (intermediate) horn

Identify structure #5

Posteror root (Afferent, sensory)

Identify structure #6

Posterior root ganglion (Dorsal, spinal)

Identify structure #7

Anterior root (Efferent, motor)

Identify structure #8

Spinal nerve

Identify structure #9

Posterior (dorsal) ramus

Identify structure #10

Anterior (ventral) ramus

Identify structure #11

skin and intrinsic muscles of the back

What do posterior rami innervate?

the skin and muscles of the neck, trunk, and extremities.

What do anterior rami innervate?

an area of skin that is mainly supplied by a single spinal nerve.

What is a dermatome?

Review