THE BACK

Surface Anatomy
External occipital protuberance Superior border of trapezius muscle

Spinous process
Spine of scapula Acromion of scapula

Spinous processes of thoracic vertebrae

Medial border of scapula Inferior angle of scapula

Lateral border of latissimus dorsi muscle

Median furrow Erector spinae muscle Iliac crest Posterior iliac spine

Skin dimple

SKELETON OF THE BACK

SCAPULA

Acromion (Acromion Process)

Forms the lateral extremity of the spine of scapula Forms the highest point of the shoulder Connects with the clavicle at a small oval surface in the middle of the spine Gives attachment to deltoid and trapezius muscles

Spine
Prominent plate of bone Begins at the vertical border by a smooth, triangular area Ends in the acromion

Superior Angle
Formed by the junction of the superior and vertebral borders Thin, smooth, rounded, inclined somewhat lateralward Gives attachment to a few fibers of the Levator scapulae

Medial (Vertebral) Border

Longest of the three borders Forms a prominent ridge Ends at the superior angle (above) and at the inferior angle (below)

Inferior Angle
Thick and rough Formed by the union of the vertebral and axillary borders Its dorsal surface affords attachment to the Teres major and frequently to a few fibers of the Latissimus dorsi

Inferior angle of the scapula

ILIUM

Iliac Crest
Thick curved upper border of the ilium Most prominent bone on the pelvis Stretches posteriorly from anterior superior iliac spine (ASIS) to posterior superior iliac spine (PSIS)

Divides into an outer and inner lip separated by the intermediate zone (behind ASIS) Outer lip bulges laterally into the iliac tubercle

Posterior Superior Iliac Spine

Serves as attachment of the oblique portion of the posterior sacroiliac ligaments and the Multifidus

OCCIPITAL BONE

External Occipital Protuberance

Lies at the junction of the head and neck

Superior Nuchal Line

Attachment of Occipitalis muscle, and Splenius capitis muscle, and trapezius muscle

TEMPORAL BONE

Mastoid Process
Conical prominence projecting from the undersurface of the mastoid portion of the temporal bone Located just behind the external acoustic meatus, and lateral to the styloid process

Larger in the male than in the female Point of attachment for several muscles (splenius capitis, longissimus capitis, digastric posterior belly, and sternocleidomastoid)

VERTEBRAL COLUMN
Central bony pillar of the body Supports the skull, pectoral girdle, upper limbs, and thoracic cage Protects spinal cord and roots of spinal nerves

Consists of:
7 Cervical (C) 12 Thoracic (T) allow flexibility and movement of vertebral column 5 Lumar (L) 5 Sacral (S) provide rigid support of pelvic girdle 4 Coccygeal (Co)

THORACIC VERTEBRAE

Intervertebral disk and articular processes unite two adjacent vertebrae Intevertebral foramen combination of vertebral notches of two adjacent vertebra

Characteristics
Body is medium sized and heartshaped Vertebral foramen is small and circular Spines are long and inclined downward Costal facets are present on the transverse process

Superior articular processes bear facets that face backward and laterally Inferior articular processes face forward and medially

A - transverse process B - spinous process C - demifacet for articulation with head of own rib D - demifacet for articulation with head of rib below E - facet for articulation with tubercle of own rib

CERVICAL VERTEBRAE

Characteristics (Typical)
Possesses a foramen transvesarium Spines are small and bifid Body is small from side to side Vertebral foramen is large and triangular

Superior articular processes have facets facing backward and upward Inferior articular processes have facets facing downward and forward

A - foramen transversarium B - vertebral body C - vertebral canal D - spinous process (bifid) E - transverse process F - ulcinate process

Characteristics (Atypical 1st,2nd, 7th)

1st or Atlas
Does not possess a body Doesnt have a spinous process Has anterior and posterior arch Has lateral mass on each side

A - facet for dens B - anterior tubercle C - anterior arch D - lateral mass E - impressions for alar ligaments F - posterior arch G - posterior tubercle H - facet for occipital condyle I - formaen transversarium J - transverse process

2nd or Axis
Has peglike odontoid process

A - dens B - facet for attachment of alar ligaments

7th or vertebra prominens

Longest spinous process and not bifid Transverse process is large Foramen transversium is small

LUMBAR VERTEBRAE

Characteristics
Body is large and kidney-shaped Pedicles are strong and directed backward Laminae are thick Vertebral foramina are triangular

Transverse processes are long and slender Spinous processes are short, flat, and quadrangular and project backward Superior articular processes face medially Inferior articular processes face laterally

LUMBAR VERTEBRA A - vertebral body B - transverse process C - spinous process D - mammilary process

SACRUM
Consists of five rudimentary vertebrae Forms a wedge-shaped bone Laterally articulates with two iliac bones Sacral promontory

superiormost portion of sacrum Marks part of the border of the pelvic inlet

Sacral canal
Runs throughout the greater part of the sacral bone Opening in the center of the sacrum Lodges the sacral nerves

Sacral hiatus
an opening in the posterior surface of the sacrum in the midline

5 sacral vertebra fused together A - anterior sacral foramina B - facet for articulation with pelvic bone C - posterior sacral foramina

COCCYX

Small triangular bone formed by four rudimentary coccygeal vertebra

A - Coccygeal cornu

SURFACE ANATOMY OF THE BACK

INFRASPINATUS FASCIA
Location: deep fascia covering the superficial surface of the infraspinatus muscle Attaches to the spine of the scapula and the posterior surface of the scapula at the margins of the infraspinatus fossa Strong origin for the infraspinatus muscle

NUCHAL FASCIA

Location: deep fascia covering the muscles of the posterior neck Part of the prevertebral layer of deep cervical fascia

THORACOLUMBAR FASCIA
Location:deep fascia surrounding the erector spinae muscle mass Serves as an origin for the latissimus dorsi muscle