Surface anatomy of the back

Prepared by: Zariifard n

Length60-70

neck: 12cm thoracic:28cmlumbar:12cmpelvis:18cm

2cm

2/5 length of body

Size of body

L3

C2

Apex of co

• Cervical lordosis– When starts to hold up his head(3-9 months)

– Lumbar lordosis

– When starts to stand(12-18 months)

Curvatures of the vertebral column /In the sagittal plane ‘S’ shape/Muscle development lead to the early appearance of secondary cervical &lumbar spinal curvature

Curvatures of the vertebral column

R=n2 +1(R=32+1=10)/355kg weight&125kg tension

C1-T2

T2-T12

T12-(L5 S1)

C4-C5

T6-T9

L3

Lumbosacral j-co

Curvatures of the vertebral column with soft tissue

Lateral curvature(Minor degree)

Line of gravity of the vertebral column

Dense of atlas

Ant of body of T2

Centre of body of T12

Rear of body of L5

Forward bending

• Assessing lumbo-pelvic congruency– Palpation from cervical

spine to pelvis

Spinuos process

5-7cm

inion

Foramen magnum in flextion

Cerebellomedullary cysterna puncture

3-6 not palpable(nuchal lig

C7:Vertebral prominence

T1:under C7

T4-10:oblique

T11&12 similar to lumbar

C6

C7

T3

T8

T10

T10

L3 infant

L2

L3

Transverse process

5cm

Lp

2.5 cm

5cm Adult &2.5 infant

Sacrum

Median sacral crest/spinous tubercle/sacral hiatus

Spinous tubercle

PSIS/ASIS/Sacroiliac joint/End of subarachnoid space &CSF

Spinous tubercle

S3(upper part of natal cleft)

S3

Sacral hiatus

5cm

Or 6cm upper to anus

Posterior sacral foramina4 n

Posterior sacral foramina

5cm

3cm

2.5cm

Sacral promontary

Coccyx(Apex,base)

1cm upper anus6cm upper anus

Scoliosis• A medio-lateral curve of the

vertebral column Exceeding 100

– Types• Congenital abnormalities of

thevertebrae(hemivertebrae)

• Neuromuscular(muscular dystrophy,poliomyelitis)

• Idiopathic

– Treatment• Exercises

Back Inspection (Forward Flexion)

Detection of Scoliosis

12cm

Kyphosis• An exaggerated curvature in the

sagittal plane• Possible causes

– Wedge compression fracture– Senile osteoporosis– Destructive tumors of spine

Patient presenting with deformity

Back Inspection (standing)

Fractures to the column

T12-L1

Dene of axis

Forced flextion injury inviolent blow on the back(T5-T6)

Fall on to the feet or head(T9-L2)

vertebral column in elderly

– Dowager s hump in midthoracic region in female( senile osteoporosis)

– lumbar lordosis ( in body weight)

in eldery:changes in the collagen content of the disc&decline in the activity of spinal muscle dynamic decline in vertebral column mobility particularly in the lumbar spine

Inferior angle(7 R)

Scapula

Superior angle(R2)

Scapula

Spine(T4 body)Inferior angle(T7 spine)

48

49

Palpation of rib

Count of rib

5cm

4r

Splenius capitis

Splenius capitis

Superior angle:External occipital protuberanceInferior angle:T12 (spine)Lateral angle:Shoulder

59

Motion Segment

Theory of weight bearingNeck:thick disk/thoracic:thin dick/lumbosacral j thick dick

forward flexion

Lateral Flexion

Referred Pain