GTS 107

THE BACK

Dr. Idris Bin Long

Physiology (Ph.D.)
 OUTLINE
Vertebral column –bones
Vertebral curvature
Muscles of the back
 The Vertebral Column
 Also called spine, backbone or spinal
column
 Functions to:
 Protect the spinal cord
 Support the head
 Serve as a point of attachment for the
ribs, pelvic girdle & muscles
 The vertebral column is curved when
viewed from the side:
 Curves increase column strength
 Help maintain balance in upright position
 Absorb shocks during walking & help
protect vertebrae from fracture
 The Vertebral Column
Flexible curved structure containing 26
irregular bones (vertebrae):
• Cervical vertebrae (7) - vertebrae of the
neck
• Thoracic vertebrae (12) - vertebrae of the
thoracic cage
• Lumbar vertebrae (5) - vertebra of the
lower back
• Sacrum (1) - bone inferior to the lumbar
vertebrae
• Coccyx (1) - terminal of vertebral column
The Vertebral column
 The Vertebral column
Newborn Spinal Curvature

 spine exhibits one continuous

C-shaped curve at birth
 known as primary curvature
 Ligaments of vertebral column
Anterior & posterior longitudinal
ligaments • from neck to
sacrum
Ligamentum flavum • connects
adjacent vertebrae
Supraspinous ligament •
located on posterior side of
vertebral column • expands to
become nuchal ligament
Interspinous ligament • join
spinous processes along their
adjacent borders
Intervertebral discs of vertebral column
• A tough fibrocartilage intervertebral disc is found
between the bodies of adjacent vertebrae.
It functions to absorb vertical shock and form joints
which are strong
yet still permit
movement
of the spine.
Intervertebral discs of vertebral column
Fibrocartilaginous or cushion-
like pad composed of TWO
parts:
1. Nucleus pulposus
 internal part
 soft, pulpy gelatinous nucleus
that gives the disc its elasticity
& compressibility
2. Annulus fibrosus (annulus =
ring-like)
 tough external part
 fibrous ring composed of
collagen & fibrocartilage
 The Vertebral Column
• Together, the vertebrae & intervertebral discs form the
vertebral column.
• Vertebrae typically consist of:
A body (weight bearing)
A pedicle and lamina
forming the vertebral arch
(surrounds the spinal cord)
Several processes (points
of attachment for muscles)
 The Vertebral Column
From the cervical region to the
sacrum, each vertebra has a
large central hole, or vertebral
foramen in which the spinal cord
can travel.
At each segmental level, on both
the right and left sides, an
intervertebral foremen is
formed for the exiting spinal
nerves.
 The Vertebral Column
• Various conditions may exaggerate the normal spinal
curves, sometimes causing severe disability.
 Cervical vertebrae
• The cervical vertebrae
comprise the bony spine in the
neck:
C1 is called the Atlas
because it holds up the
head the way the Titan of
Greek mythology supported
the world.
C2 is called the Axis
because it provides a pivot,
allowing the head to turn on
the neck.
 Cervical vertebrae
• Without these first two
specialized cervical
vertebra, the head-on-
neck range of motion
would be very limited.
 Thoracic vertebrae
• Below the neck, each of the 12 pairs of thoracic
vertebrae articulate with a rib to form the posterior
part of the thoracic cage.
 Lumbar vertebrae
• Because the lumbar vertebrae (5) bear greater
loads, they are much stouter than their more
superior cousins (the cervical and thoracic
Vertebrae).
 Sacrum
• The sacrum is a single triangular body formed from
a fusion of 5 separate vertebrae in-utero (during fetal
development).
 Coccyx
• The coccyx, commonly referred to as the tailbone,
is the final segment of the bony spine.
It is also an in-utero fusion of 3–5 separate
vertebrae.
The Vertebral Column
Recap
Muscles of the back
Muscles connecting upper limb to vertebral column

List of muscles
 Trapezius
 Latissimus dorsi
 Levator scapulae
 Rhomboid major
 Rhomboid minor
Muscles connecting upper limb to vertebral column
Name of Origin Insertion Nerve supply Action
Muscle
Trapezius* Occipital bone, Upper fibers into Spinal part of Upper fibers elevate
ligamentum nuchae, lateral 3rd of clavicle, accessory motor nerve scapula; middle fibers
spine of seventh middle and lower (motor) and C3 and 4 pull scapula medially;
cervical vertebrae, fibers into acromion (sensory) lower fibers pull
spines of all thoracic and spine of scapula medial border of
vertebrae scapula downward
Muscles connecting upper limb to vertebral column
Name of Origin Insertion Nerve supply Muscle Action

Latissimus dorsi* Spinous process of Floor of bicipital Thoracodorsal Extends, adducts

lower thoracic & groove of humerus nerve and medially
lumbar vertebrae, rotates the arm
crests of sacrum &
ilium and inferior
four ribs (via
thoracolumbar
fascia)
Muscles connecting upper limb to vertebral column
Name of Muscle Origin Insertion Nerve supply Muscle Action

Levator scapulae Transverse Medial border of C3 and 4 and Raises medial

processes of first scapula dorsal scapular border of scapula
four cervical nerve
vertebrae
Muscles connecting upper limb to vertebral column
Name of Origin Insertion Nerve supply Muscle Action

Rhomboid major 2nd to 5th thoracic

vertebrae
Medial border of Dorsal scapular Raises medial
Rhomboid minor Ligamentum scapula nerve border of scapula
nuchae & spines Medial border of Dorsal scapular upward & medially
of 7th cervical 1st scapula nerve
thoracic vertebrae
 References
1. Principle of Anatomy and Physiology. 2010. John Wiley &
Sons, Inc.
2. Clinical anatomy by region. 2008. Lippincott. William &
Wilkins.
3. Dr A. Chandra Sekhar. Handbook of Anatomy and
Physiology for Para-Medics.
THANK YOU