BACK

REVIEW
Parts of avertebra
Corpus (1) Arcus vertebralis
Pedicle (4)
Lamina (6)
Foramen vertebralis (5)
Facies articularis (7)
Processus transversus (3)
Processus spinosus (2)

The lesser load the smaller in

size

Department of Anatomy, Medical Faculty

2
Udayana University
Intervertebral Foramen

8
 Lumbar Spine Anatomy
• Ligaments
1 – Anterior longitudinal
ligament
6 – Posterior longitudinal
ligament
– Ligamentum flavum
2 – Interspinous ligaments
– Supraspinous ligament
5 – Intertransverse ligaments
4

3
Vertebral Column: Intervertebral Discs

Figure10
7.14b
Cervical Vertebrae: The Atlas (C2)

Figure11
7.17a
Axis

12
Department of Anatomy, Medical Faculty
14
Udayana University
Department of Anatomy, Medical Faculty
15
Udayana University
Postural Malalignments
 Muscles of the Back
• Extrinsic back muscles (produce & control limb
& respiratory movements)
• Intrinsic back muscles (act on vertebral
column, maintaining posture)
• Suboccipital and deep neck muscles
 Extrinsic back muscles

• Superficial (trapezius, latisimus dorsi, levator

scapulae, rhomboids)  menghub. Upper
limb dng truncus. Act on upper limb.
• Intermediate (serratus posterior).
– Tipis, lbh berfungsi sbg proprioceptive.
– Letak: di bwh rhomboids (serratus posterior
superior), di bwh latissimus dorsi (Serratus
posterior inferior).
– Innervasi: nn. Intercostalis,
 Intrinsic back muscles

• = muscles of back proper, deep back muscles.

• Innervasi: posterior rami of spinal nerves.
• Act: maintain posture, control movement of
vertebral column.
• Extend from pelvis to cranium.
• Ditutupi oleh deep fascia yg melekat di medial
nuchal ligament, tips of spinous process of
vertebrae, supraspinous ligament, median
crest of the sacrum.
 Intrinsic back muscle

• Fascia melekat di lateral pd cervical dan

lumbar transverse processes and angle of the
ribs.
• Thoracolumbar fascia: deep fascia di bgn
thoracic dan lumbar
• Dikelompokan mjd: superficial, intermediate
dan deep layer.
 Superficial layer of intrinsic back
muscles
• Splenius muscles: tebal, flat, pd aspek lateral
dan posterior leher, berjalan superolateral dari
tengah ke cervical vertebrae (splenius cervicis)
dan cranium (splenius capitis)  menutup dan
menjaga deep neck muscles pd posisinya.
 Intermediate layer of intrinsic back
muscles
• Erector spinae muscles:
– Letak: pd “groove” di setiap sisi vertebral column
antara spinous process di sentral dan angles of the
rib di lateral.
– Chief extensor vertebral column (masive erector
spinae), dibagi mjd 3 column:
1. Lateral column (dibtk o/ iliocostalis).
2. Intermediate column (longissimus).
3. Media column (spinalis).
• Tiap column dibagi lg mjd 3 bgn tergantung pd
perlekatannya di superior (iliocostalis
lumborum, iliocostalis thoracis, iliocostalis
cervicis).
• Erector spinae = long muscles of the back,
dynamic (motion-producing), act bilateral u/
extensi tbh.
 Deep layer of intrinsic back muscles

• Transversospinal muscle group: di bwh erector

spinae, tdd: semispinalis, multifidus dan
rotatores.
• Semispinalis:
– Semispinalis capitis longitudinal bulge in the
back of the neck near the median plane.
– Semispinalis thoracis
– Semispinalis cervicis
 Minor deep back muscles

• Interspinal, intertransverse dan elevator of

ribs.
– Kurang berkembang
– Interspinal dan intertransverse 
menghubungkan spinous dan transverse process.
 Lumbar Spine Anatomy:
Vascular Structures
• The aorta and vena cava
bifurcate around the level
of the L3/L4 disc space
– Aorta
– Vena cava
– Iliac arteries
– Iliac veins
– Midsacral vessels
Principal muscles producing movement of
the cervical, thoracic and lumbar IV joint
• Back muscle
– relatif inaktif pd stand-easy posisition
– Act as static postural muscles (terutama shorter
deep layer of intrinsic back muscles), maintaining
tension and stability.
– all movement of vertebral column kecuali extensi
murni mrpk concentric contraction dari abdominal
muscles.
 Back Sprain
• Injury of the ligament or attachment of
ligament to bone.
• No dislocation or fracture.
• Result from excessively strong contraction
related to movement of the vertebral column
(excessive extension or rotation).
 Back strain
• Commonly cause of LBP
• It is due to overly strong muscular contraction.
• Commonly happen in sports, pd erector
spinae column
• Involves some degree of stretching or
microscopic tearing of muscle fibers that
producing movements of the IV joint
(especially the erector spinae column).
• If the weight is not properly balanced on the
vertebral column, strain is exerted on the
muscle.
 Spasm

• Is a protective mechanism after injury or in

respons to inflammation of structures in the
back (ligaments)
• Sudden involuntary contraction
• Attended by cramps, pain, interference with
function, producing involuntary movement
and distortion.
 Suboccipital and deep neck muscles
• Suboccipital region: superior part of the
posterior cervical region.
– Is the triangular area, inferior to the occipital
region of the head (including posterior aspects of
vertebra C1 and C2).
– Muscles lies deep to the trapezius and
semispinalis capitis muscles, consist of: rectus
capitis posterior (major and minor) & two obliquus
muscles which are innervated by posterior ramus
of C1 (suboccipital nerve)
• Inferior oblique of the head is the only capitis
muscle that has no attachment to the
cranium.
• Function: maintain posture and producing
movement of the head.
Suboccipital and deep neck muscles
 Movement of vertebral column

• Flexi, extensi, lateral flexion and extension,

rotation.
• Range of movement of the vertebral column
dibatasi o/:
– Ketebalan, elastisitas dan compressibility IV discs.
– Bentuk dan orientasi zygapophysial joints.
– Tension of the joint capsule of the zygapophysial
joints.
– Resistance of back muscles and ligaments
– Melekat pd thoracic (rib) cage
– Bulk of surrounding tissue
• Flexi, extensi, lateral flexi dan rotasi leher
umumnya bebas, karena:
1. IV discs, relatif tebal dibandingkan corpus
vertebra pada leher.
2. Articular surface of zygapophysial joint relatif
besar dan hampir horizontal.
3. Joint capsules of zygapophysial joints are loose.
4. Neck is relatively slender
• Cervical flexi dan lateral flexi terbesar.
• Lumbar  IV disc relatif besar, gerakan extensi
dan lateral flexi terbesar drpd vertebra lain.