Topic

Definition
Sceletal
Joint
Muscle
Vascularisation and Nerves
Movements

Back

The back comprises the posterior aspect of the

trunk, inferior to the neck and superior to the
buttocks

It Includes:
Skin and subcutaneous tissue.
Muscles
Vertebral column: the vertebrae, intervertebral (IV)
discs, and associated ligaments
Ribs
Spinal cord and meninges
Various segmental nerves and vessels.

Vertebrae Column
The vertebral column in an adult typically
consists of 33 vertebrae arranged in five
regions:

7 cervical
12 thoracic
5 lumbar
5 sacral
and 4 coccygeal

Typical Vertebra
Tampak Superior

pedicles are bony pillars that attach the vertebral arch to the vertebral body;
laminae are flat sheets of bone that extend from each pedicle to meet in the
midline and form the roof of the vertebral arch

Typical Vertebra

Typical
cervical
vertebrae

CERVICAL VERTEBRAE
Part

Characteristics

Body

Small and wider from side to side than anteroposteriorly; superior surface
concave with uncus of body (uncinate process); inferior surface convex

Vertebral foramen

Large and triangular

Transverse processes

Foramina transversarii and anterior and posterior tubercles; vertebral

arteries and accompanying venous and sympathetic plexuses pass through
foramina transversarii of all cervical vertebrae except C7, which transmits
only small accessory vertebral veins.

Articular processes

Superior facets directed superioposteriorly; inferior facets directed

inferioanteriorly; obliquely placed facets are most nearly horizontal in this
region

Spinous processes

Short (C3-C5) and bifid (C3-C6); process of C6 long, that of C7 is longer

(thus C7 is called vertebra prominens)

Vertebrae
Cervicalis I
Tuberculum anterior dan
posterior
Facet for occipital condyles
Facets for dens
Impression ofalar ligaments

Vertebra cervicalis
2
Dens epistropheus

THORACIC
VERTEBRAE

Thoracic Vertebrae
Part

Characteristics

Body

Heart shaped; one or two costal facets for articulation with head of rib

Vertebral foramen

Circular and smaller than those of cervical and lumbar vertebrae (admits the
distal part of a medium-size index finger)

Transverse processes

Long and strong and extend posterolaterally; length diminishes from T1 to T12
(T1-T10 have facets for articulation with tubercle of rib)

Articular processes

Superior facets directed posteriorly and slightly laterally; inferior facets directed
anteriorly and slightly medially; plane of facets lies on arc centered about
vertebral body

Spinous processes

Long; slope posteroinferiorly; tips extend to level of vertebral body below

Parts

Characteristics

Body

Massive; kidney shaped when viewed

superiorly

Vertebral foramen

Triangular; larger than in thoracic vertebrae

and smaller than in cervical vertebrae

Transverse processes

Long and slender; accessory process on

posterior surface of base of each process

Articular processes

Superior facets directed posteromedially (or

medially); inferior facets directed
anterolaterally (or laterally); mammillary
process on posterior surface of each
superior articular process

Spinous processes

Short and sturdy; thick, broad, and hatchet

shaped

Perbandingan antar vertebrae

pada CV

OS SACRUM &
COCCYGEUM

terdiri dari 5 vertebrae sacrales dan discus

intervertebraelis di antaranya. Vertebraee sacrales ini
terpisah jelas pada usia muda, pada orang dewasa
setelah usia 25 tahun tulang-tulang ini bersatu (berfusi)
menjadi os sacrum.
Os sacrum berbentuk baji, dengan basis yang lebar di atas
dan apex di bawah. Basis sacrum bersendi dengan
vertebrae lumbalis terakhir dan apex sacrum bersendi
dengan os coccygis. Os sacrum mempunyai dua
permukaan yaitu: facies pelvina, facies dorsalis
Facies pelvina mempunyai empat pasang foramina
sacralia anterior
Facies dorsalis ossis sacri

OS SACRUM &
COCCYGEUM

The joints of the vertebral column include

the:
Joints of the vertebral bodies.
Joints of the vertebral arches.
Craniovertebral (atlanto-axial and
atlanto-occipital) joints.
Costovertebral joints
Lumbosacral joint
Sacroiliaca joint

Joints Of Vertebral
Bodies

Between vertebral bodies

Symphysis
Articular surface: connected by
IV and ligament
IV disc consists of :anulus
fibrosus, an outer fibrous part,
composed of concentric
lamellae of fibrocartilage, and a
gelatinous central mass, called
the nucleus pulposus.

Structure & Function IV

disc

Relationship of ligaments to
vertebrae and IV discs

ACCESSORY LIGAMENTS OF
INTERVERTEBRAL JOINTS

pale yellow bands of elastic tissue

called the ligamenta flava
extend almost vertically from the
lamina above to the lamina below,
those of opposite sides meeting and
blending in the midline
help preserve the normal curvatures
of the vertebral column and assist
with straightening of the column after
flexing.

zygapophysial joints (often called

facet joints).
plane synovial joints between the
superior and inferior articular
processes
permit gliding movements between
the articular processes
are innervated by articular
branches of the posterior rami of
spinal nerves

CRANIOVERTEBRAL JOINT

between the superior articular

surfaces of the lateral masses
of the atlas and the occipital
condyles
permit nodding of the head
synovial joints of the condyloid
type and have thin, loose joint
capsules.
also connected by anterior
and posterior atlanto-occipital
membranes

Atlantooccipital Joint

two (right and left) lateral

atlantoaxial joints (between the
inferior facets of the lateral
masses of C1 and the superior
facets of C2), and one median
atlantoaxial joint (between the
dens of C2 and the anterior arch
of the atlas).
The lateral atlanto-axial joints are
gliding-type synovial joints,
whereas the median atlanto-axial
joint is a pivot joint.

Atlanto-axial Joints.

Movements of Vertebral
Column

primarily from the compressibility and

elasticity of the IV discs.
is capable of flexion, extension, lateral
flexion and extension, and rotation
(torsion)
Bending of the vertebral column to the
right or left from the neutral (erect)
position is lateral flexion; returning to the
erect posture from a position of lateral
flexion is lateral extension.

Curvatures of Vertebral
Column

primary curvatures are in

the same direction as the
main curvatures of the
fetal vertebral column.
secondary curvatures
result from extension from
the flexed fetal position.
They begin to appear
during the late fetal period
but do not become obvious
until infancy. It is
maintained primarily by
differences in thickness
between the anterior and
the posterior parts of the
IV discs.

Vasculature of Vertebral
Column

Vertebral and
ascending cervical
arteries in the neck
(Chapter 8).
The major segmental
arteries of the trunk:
Posterior intercostal

arteries in the thoracic

region (
Subcostal and lumbar
arteries in the abdomen
Iliolumbar and lateral
and medial sacral
arteries in the pelvis

Nerves of Vertebral
Column

Zygapophysial joints are innervated by

medial branches of adjacent posterior
rami;
(recurrent) meningeal branches of spinal
nerves supply most bone (periosteum),
IV discs, and ligaments as well as the
meninges (coverings) of the spinal cord.
These two (groups of) nerves convey
all localized pain from the vertebral
column.

MUSCLES OF BACK
Extrinsic Back Muscles
The superficial extrinsic back muscles (trapezius, latissimus dorsi,
levator scapulae, and rhomboids) are posterior axioappendicular
muscles that connect the axial skeleton (vertebral column) with the
superior appendicular skeleton
The intermediate extrinsic back muscles (serratus posterior)

Intrinsic Back Muscles

connect elements of the axial skeleton, are mostly innervated by posterior
rami of spinal nerves, and are arranged in three layers: superficial
(splenius muscles), intermediate (erector spinae), and deep
(transversospinalis muscles).

The spinal cord, spinal nerve roots, CSF, and meninges

that surround them are the main contents of the vertebral
canal.

Dr.Tri Suciati, M.Kes

Topic

Pelvis and Pelvic girdle, and Joints of

Pelvis
Pelvic cavity, pelvic peritoneum, and
pelvic fascia
Neurovascular structures of the pelvis

Pelvic Girdle

an articulated bony ring

composed of the sacrum
and two hip bones
Innominate bone (Ilium,
ischium and pubis)
Sacrum
Coccyx
Joined anteriorly by pubic
symphysis
Posteriorly by sacro-iliac
joint

Pelvic Bone

Apertura Pelvis
Superior/PelvicInlet

The bony edge (rim) surrounding and

defining the pelvic inlet is the pelvic
brim, formed by the:
Promontory and ala of the sacrum
(superior surface of its lateral part,
adjacent to the body of the sacrum).
A right and left linea terminalis
(terminal line) together form a
continuous oblique ridge consisting of
the:
Arcuate line on the inner surface
of the ilium.
Pecten pubis (pectineal line) and
pubic crest, forming the superior
border of the superior ramus and
body of the pubis.

Apertura Pelvis Inferior

The pelvic outlet (inferior pelvic

aperture) is bounded by the
Pubic arch anteriorly.
Ischial tuberosities laterally.
Inferior margin of the
sacrotuberous ligament (running
between the coccyx and the
ischial tuberosity) posterolaterally.
Tip of the coccyx posteriorly.

Sacrum and Coccygeus

Joints
Articulatio:
Amphiarthrosis sacroiliaca
Synarthrosis:
1. Syndesmosis elastica
sacrococcygeus
2. Syndesmosis fibrosa: lig
sacrospinosum et
tuberosum
3. Synchondrosis: symphysis
ossium pubis

Sacroilliaca Joints

anterior synovial joint (between

the earshaped auricular surfaces
of the sacrum and ilium, covered
with articular cartilage) and a
posterior syndesmosis (between
the tuberosities of the same
bones)
Anterior and posterior sacroiliaca
ligament
Sacrotuberosa dan sacrospinosa
ligament

Symphysis Pubis

secondary cartilaginous joint

fibrocartilaginous interpubic disc
interpubic disc
superior pubic ligament
inferior (arcuate) pubic ligament

Pelvis

the space enclosed

by the pelvic girdle,
which is subdivided
into the greater
pelvis and the lesser
pelvis

Lesser and Greater Pelvis

the inferior part of the

abdominal cavity,
which receives the
protection of the alae
of the ilia)
Bounded by abdominal
wall anteriorly, the iliac
fossa posteriolaterally
and L5 S1 vertebrae
posteriorly