Superficial Back M.Pizzimenti, Ph.D.

Reading: MA 275-90; 303-310; 307; 423-427 Objectives: • Identify the lamina, pedicle, transverse, and spinous process of a typical vertebra. • Describe the differences between cervical and thoracic vertebrae. • Define spina bifida • Outline the primary and secondary curvatures of the vertebral column. Describe how you might identify a patient with scoliosis, extreme lordosis, or kyphosis • Construct a model of the intervertebral disc and adjoining vertebrae. Explain how this disc might be damaged. • Sketch the superficial muscles of the back. Indicate their attachment points, nerve supply, arterial supply, and primary actions. • List the deep muscles of the back. How do they differ from the superficial group? • Predict what motor deficit would occur if the following nn. were injured: spinal accessory (CN XI), dorsal scapular, suprascapular, axillary, thoracodorsal • List the mm. of the rotator cuff. Describe the actions and nerve supply of the rotator cuff musculature. Typical Vertebra • 33 total vertebrae ! 7 cervical ! 12 thoracic ! 5 lumbar ! 5 sacral ! 4 coccyx Basic Components ! pedicle ! lamina ! spinous process ! transverse process • Spina bifida ! common congenital anomaly Fig 143 ! vertebral arch fails to close ! lamina fail to fuse properly ! skin covers the defect but is often indicated by a tuft of hair ! meninges herniate (meningiocele) and spinal cord may prolapse (meningiomyelocele)

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2000.Secondary = convex • Abnormal Curvatures .Lordosis .implications? 2 .approx.23 .Primary = concave .Kyphosis .capable of movement under loads . 90 concentric lamellae of fibrocartilage N • Nucleus pulposus .Vertebral Column • Normal Curvatures .Scoliosis Intervertebral Discs • shock absorbers . Fig 4.avascular .derivative of notochord Fig 144 .continued flexed posture > migrates more posteriorly .glycoproteins/proteoglycans • Annulus . Grant’s Atlas.fibrogelatinous © LifeArt.fibrocartilagenous • mobility • water imbibing A .

15.spines of T6-T12.18 Spinal Cord (Very Basic) • Structure ! cervical enlargement (C) ! lumbar enlargement (L) ! conus medullaris (M) " adults L1-L2 " at birth L3 ! cauda equina (CE) ! filum terminale (F) • Spinal Nerves . clavicle.* in cervical region. spinous processes of cervical and thoracic vertebrae > spine and acromion. .© LifeArt. iliac crest. • © LifeArt.thoracodorsal n. rotates and adducts scapula . Grant’s Dissector. 12 thoracic. 5 lumbar. 1 coccygeal .8 cervical.thoracodorsal a.superior nuchal line. Fig 4. Fig. • Latissimus dorsi m.CN XI (spinal accessory) .31 pairs . 2000. extends. lateral 1/3 of clavicle . 5 sacral. 4. . medially rotates humerus . numbered nerves pass superior to corresponding vertebrae Back Musculature Superficial • Trapezius (also considered a muscle of the pectoral girdle) .adducts.elevates scapula. lumbodorsal fascia >floor of intertubercular sulcus .transverse cervical a.bilateral:extends head .ipsilateral: tilts chin contralaterally . Grant’s Atlas. 4. inion.29 3 . 2000.

retract & rotate glenoid cavity inferiorly .elevates & rotates scapula . Serratus posterior superior and inferior are controlled by ventral rami 4 . .Longissimus .dorsal scapular n.spinous processes of C7-T5 >medial border of scapula . • Rhomboid major & minor .Spinalis All of these are controlled by dorsal rami of spinal nn.dorsal scapular a.dorsal scapular n.Levator scapulae . Intermediate and Deep Group • • • Splenius (capitus and cervicis) Semispinalis capitus Erector spinae . .transverse processes C1-4 > superior angle of scapula .Iliocostalis .dorsal scapular a.

2007. PW.. n. A. Clinically Oriented Anatomy (4th Ed).Scapular Musculature and the Rotator Cuff ! Suprspinatus ! Infraspinatus ! Teres Minor ! Subscapularis Identify the attachments for these mm. 1999. Lippincott Williams & Wilkins GA = Agur AMR and Dalley.. A 2005. Essential Clinical Anatomy (3rd Ed). Grant’s Dissector (13th Ed). 2005. and ligament Vascular anastomosis around the scapula MA = Moore. Lippincott Williams & Wilkins MD = Moore. AMR. Lippincott Williams & Wilkins Unlabelled images © LifeArt 5 . Grant’s Atlas of Anatomy (11th Ed). KL and Agur. Lippincott Williams & Wilkins GD = Tank. KL and Dalley. Note the relationship between the suprascapular a.

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