A - Back and Spine

Cauda Equina

"horse tail" bundle of spinal nerves (L2-L5; S1-S5; and coccygeal nerves) Originates at Conus Medularis

Cervical Vertebrae (Distinguishing Characteristics)

Transverse Processes (Foramen Transversarium) Small bodies Spinous Processes: short and Bifid Verterbral bodies have a superior-projecting lip at the border

Superficial Back Muscles

Trapezius Latissimus dorsi Rhomboid INNERVATION: Trap: Accessory n. Lats: Thoracodorsal n. Rhomboid: Doroscapular n.

Back Muscles to Know

Trapezius Latissimus dorsi Rhomboid Serratus posterior superior Serratus posterior inferior Erector spinae group Multifidi Rotatores Interspinalis Intertransversali

Intervertebral Discs

cartilagenous (symphysis), not synovial parts of the intervertebral disk: i annulus fibrosis ii. Nucleus Pulposus (Center)

Directional Terms

right, left medial, lateral intermediate, superior, inferior anterior, posterior proximal, distal superficial, deep

Spinal Nerve Information

1) ANS 2) Motor 3) Sensory

Longitudinal Spinal Ligaments

Anterior Posterior Supraspinous

Filum Terminale

20cm strand of fibrous tissue that emerges from the end of the Cauda Equina and is fused to the dura matter and the coccyx to anchor the bottom of the spinal cord. Top part is continuous with Pia matter, bottom with dura matter.

Sacrum

5-6 sacral vertebrae are fused in adults articulates with hip bones and coccyx

Intervertebral Foramina

Foramen between 2 vertebrae (formed by pedicles)

Atlas

C1

Spinal Cord Proper Level

C1-L2

Axis

C2

Spinal Column Curves/Regions

Cervical Thoracic Lumbar Sacral and Coccygeal

Thoracic Vertabrae Costal Facets

Costal Facets (Superior, Inferior, Transverse)

Thoracic Vertebrae (Distinguishing Characteristics)

Costal Facets Kidney shaped body Spinous Processes: long, slender, sloping and Overlapping

Sensory Nerves stem from...

Dorsal Horn

Spinal Meninges (Superficial to Deep)

Epidural Adipose Tissue (NOT part of meninges) Epidural Space (under adipose, before dura matter - black smudge in pic) Dura Arachnoid Subarachnoid Space (location of spinal fluid) Pia Matter

Identify what layers would be passed through at the site of a lumbar puncture

Epidural Fat Epidural Space Dura Matter Arachnoid Matter Enter Subarachnoid Space to get fluid This is best done BELOW L2

Deep Back Muscles

Erector spinae group Multifidi Rotatores Interspinalis Intertransversalis INNERVATION: Dorsal Spinal Rami Nerves

Joint Type between Articular Surfaces

Facet Joint Encaspulated Movement: flexion and extension of the spine

Autonomic Motor Nerves stem from...

Intermedial Lateral Horn (Lateral) Only in T1-L2

Segmental Spinal Ligaments

Interspinous Intertransverse Ligamentumflavum

Skin

It is a tough, pliable covering for the body surface many functions epidermis dermis hypodermis

Dorsal, Lateral, and Ventral Columns of Gray Matter

Lateral horn only found in T1-L2

Sensory Ganglion

Location of cell bodies of CNS and PNS nerves clump of cell bodies

Spinal Ligamants

Longitudinal (anterior, posterior, supraspinous) Segmental (interspinous, intertransverse, ligamentumflavum)

Spinal "C" Curve

Newborn: flexed the whole extent: primary curve (this curve is called a kyphosis) Normal curves develop as infant learns to lift head (neck) and walk (thoracic and lumbar)

Surface Anatomy of the Back (Labeled Image)

See Image

Intermediate Back Muscles

Serratus posterior superior Serratus posterior inferior INNERVATION: intercostal nerves

Parts of Vertabrae

Spinous Process Transverse Process Lamina Pedicle Veterbral Body Vertebral Foramina

Vertebral Articular Surfaces

Superior and Inferior

Functions of Verterbal Column

Support and transmit weight - Head and trunk - Lower limbs below Houses and protects spinal cord Permits movements Important bony articulations - Skull - Ribs - Pelvic girdle

Conus Medularis

Tapered end of spinal cord at L1-L2 before transition to Cauda Equina Below this is where you do spinal taps and epidural blocks

Motor Nerves stem from...

Ventral Horn (Motor is in the front of the car)

Ventral vs Dorsal ROOT Nerves

Ventral: Motor and Autonomic Dorsal: Sensory Root nerves come off of spinal column and enter spinal nerve

Ventral vs Dorsal RAMI Nerves

Ventral: rest of body Dorsal: deep spinal muscles Rami nerves branch off of the spinal nerve

Lumbar Vertebrae (Distinguishing Characteristics)

Very large, kidney shaped body Pedicles and lamina short and thick Transverese Processes: long and thin Spinous Processes: short, quadrilateral shaped, horizontal

Spinal Column Cross Section

White Matter, Gray Matter with Horns Spinal Roots, Rami, Ganglion, and Chain Ganglions Meninges

Coccxy

approx 4 vertebrae, fused in adults, resembles a mini-sacrum

Muscles Groups of the Back

superficial group intermediate group deep group