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Anatomy_Gray_100 | Anatomy_Gray | Fig. 1.36 Dermatomes. C6 segment of spinal cordSpinal ganglionDermatomyotomeAutonomous region(where overlap ofdermatomes isleast likely)of C6 dermatome(pad of thumb)Skin on the lateral side of the forearm and on thethumb is innervated by C6 spinal level (spinal nerve).The dermis of the skin in this region develops from... | Anatomy_Gray. Fig. 1.36 Dermatomes. C6 segment of spinal cordSpinal ganglionDermatomyotomeAutonomous region(where overlap ofdermatomes isleast likely)of C6 dermatome(pad of thumb)Skin on the lateral side of the forearm and on thethumb is innervated by C6 spinal level (spinal nerve).The dermis of the skin in this region... | [
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Anatomy_Gray_101 | Anatomy_Gray | Fig. 1.38 Dermatomes. A. Anterior view. B. Posterior view. Fig. 1.39 Development of the visceral part of the nervous system. Motor nerve endingassociated withblood vessels,sweat glands,arrector pili musclesat peripheryPart of neural crest developinginto spinal gangliaVisceral motor ganglionMotor nerve ending associated... | Anatomy_Gray. Fig. 1.38 Dermatomes. A. Anterior view. B. Posterior view. Fig. 1.39 Development of the visceral part of the nervous system. Motor nerve endingassociated withblood vessels,sweat glands,arrector pili musclesat peripheryPart of neural crest developinginto spinal gangliaVisceral motor ganglionMotor nerve end... | [
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Anatomy_Gray_102 | Anatomy_Gray | Fig. 1.41 Parts of the CNS associated with visceral motor components. SympatheticT1 to L2spinal segmentsBrainstemcranial nervesIII, VII, IX, XS2 to S4spinal segmentsParasympathetic Fig. 1.42 Sympathetic part of the autonomic division of the PNS. Abdominal visceraHeartOrgansPeripheralSympathetic nerves followsomatic ner... | Anatomy_Gray. Fig. 1.41 Parts of the CNS associated with visceral motor components. SympatheticT1 to L2spinal segmentsBrainstemcranial nervesIII, VII, IX, XS2 to S4spinal segmentsParasympathetic Fig. 1.42 Sympathetic part of the autonomic division of the PNS. Abdominal visceraHeartOrgansPeripheralSympathetic nerves fol... | [
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Anatomy_Gray_103 | Anatomy_Gray | Fig. 1.44 Course of sympathetic nerves that travel to the periphery in spinal nerves that are not the ones through which they left the spinal cord. Sympathetic paravertebral trunksPeripheral distribution ofascending sympatheticsPeripheral distribution ofdescending sympathetics(C1) C2 to C8T1 to L2L3 to CoWhite ramus co... | Anatomy_Gray. Fig. 1.44 Course of sympathetic nerves that travel to the periphery in spinal nerves that are not the ones through which they left the spinal cord. Sympathetic paravertebral trunksPeripheral distribution ofascending sympatheticsPeripheral distribution ofdescending sympathetics(C1) C2 to C8T1 to L2L3 to Co... | [
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Anatomy_Gray_104 | Anatomy_Gray | Fig. 1.46 Course of sympathetic nerves traveling to abdominal and pelvic viscera. White ramus communicansGray ramus communicansSacral splanchnic nervesLumbar splanchnic nervesLeast splanchnic nervesLesser splanchnic nervesGreater splanchnic nervesPrevertebral plexusand gangliaParavertebralsympathetic trunkAbdominalandp... | Anatomy_Gray. Fig. 1.46 Course of sympathetic nerves traveling to abdominal and pelvic viscera. White ramus communicansGray ramus communicansSacral splanchnic nervesLumbar splanchnic nervesLeast splanchnic nervesLesser splanchnic nervesGreater splanchnic nervesPrevertebral plexusand gangliaParavertebralsympathetic trun... | [
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Anatomy_Gray_105 | Anatomy_Gray | Fig. 1.48 Enteric part of the nervous system. Fig. 1.49 Nerve plexuses. C7C6C5C4C3C2C1T1T2T3T4T5T6T7T8T9T10T11T12L1S1S2S3S4S5L2L3L4L5C8GreaterLeastLesserSOMATIC PLEXUSESVISCERAL PLEXUSESCervical plexusanterior rami C1 to C4Brachial plexusanterior rami C5 to T1Lumbar plexusanterior rami L1 to L4Sacral plexusanterior ram... | Anatomy_Gray. Fig. 1.48 Enteric part of the nervous system. Fig. 1.49 Nerve plexuses. C7C6C5C4C3C2C1T1T2T3T4T5T6T7T8T9T10T11T12L1S1S2S3S4S5L2L3L4L5C8GreaterLeastLesserSOMATIC PLEXUSESVISCERAL PLEXUSESCervical plexusanterior rami C1 to C4Brachial plexusanterior rami C5 to T1Lumbar plexusanterior rami L1 to L4Sacral plex... | [
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Anatomy_Gray_106 | Anatomy_Gray | Fig. 1.50 Mechanism for referred pain from an inflamed appendix to the T10 dermatome. Table 1.1 The approximate dosage of radiation exposure as an order of magnitude In the clinic These are extra bones that are not usually found as part of the normal skeleton, but can exist as a normal variant in many people. They are ... | Anatomy_Gray. Fig. 1.50 Mechanism for referred pain from an inflamed appendix to the T10 dermatome. Table 1.1 The approximate dosage of radiation exposure as an order of magnitude In the clinic These are extra bones that are not usually found as part of the normal skeleton, but can exist as a normal variant in many peo... | [
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Anatomy_Gray_107 | Anatomy_Gray | In the clinic Determination of skeletal age Throughout life the bones develop in a predictable way to form the skeletally mature adult at the end of puberty. In western countries skeletal maturity tends to occur between the ages of 20 and 25 years. However, this may well vary according to geography and socioeconomic co... | Anatomy_Gray. In the clinic Determination of skeletal age Throughout life the bones develop in a predictable way to form the skeletally mature adult at the end of puberty. In western countries skeletal maturity tends to occur between the ages of 20 and 25 years. However, this may well vary according to geography and so... | [
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Anatomy_Gray_108 | Anatomy_Gray | In certain disease states, such as malnutrition and hypothyroidism, bony maturity may be slow. If the skeletal bone age is significantly reduced from the patient’s true age, treatment may be required. In the healthy individual the bone age accurately represents the true age of the patient. This is important in determin... | Anatomy_Gray. In certain disease states, such as malnutrition and hypothyroidism, bony maturity may be slow. If the skeletal bone age is significantly reduced from the patient’s true age, treatment may be required. In the healthy individual the bone age accurately represents the true age of the patient. This is importa... | [
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Anatomy_Gray_109 | Anatomy_Gray | From birth most of the body’s marrow is red; however, as the subject ages, more red marrow is converted into yellow marrow within the medulla of the long and flat bones. Bone marrow contains two types of stem cells. Hemopoietic stem cells give rise to the white blood cells, red blood cells, and platelets. Mesenchymal s... | Anatomy_Gray. From birth most of the body’s marrow is red; however, as the subject ages, more red marrow is converted into yellow marrow within the medulla of the long and flat bones. Bone marrow contains two types of stem cells. Hemopoietic stem cells give rise to the white blood cells, red blood cells, and platelets.... | [
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Anatomy_Gray_110 | Anatomy_Gray | In the clinic Fractures occur in normal bone because of abnormal load or stress, in which the bone gives way (Fig. 1.16A). Fractures may also occur in bone that is of poor quality (osteoporosis); in such cases a normal stress is placed upon a bone that is not of sufficient quality to withstand this force and subsequent... | Anatomy_Gray. In the clinic Fractures occur in normal bone because of abnormal load or stress, in which the bone gives way (Fig. 1.16A). Fractures may also occur in bone that is of poor quality (osteoporosis); in such cases a normal stress is placed upon a bone that is not of sufficient quality to withstand this force ... | [
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Anatomy_Gray_111 | Anatomy_Gray | After a fracture has occurred, the natural response is to heal the fracture. Between the fracture margins a blood clot is formed into which new vessels grow. A jelly-like matrix is formed, and further migration of collagen-producing cells occurs. On this soft tissue framework, calcium hydroxyapatite is produced by oste... | Anatomy_Gray. After a fracture has occurred, the natural response is to heal the fracture. Between the fracture margins a blood clot is formed into which new vessels grow. A jelly-like matrix is formed, and further migration of collagen-producing cells occurs. On this soft tissue framework, calcium hydroxyapatite is pr... | [
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Anatomy_Gray_112 | Anatomy_Gray | In the clinic Avascular necrosis is cellular death of bone resulting from a temporary or permanent loss of blood supply to that bone. Avascular necrosis may occur in a variety of medical conditions, some of which have an etiology that is less than clear. A typical site for avascular necrosis is a fracture across the fe... | Anatomy_Gray. In the clinic Avascular necrosis is cellular death of bone resulting from a temporary or permanent loss of blood supply to that bone. Avascular necrosis may occur in a variety of medical conditions, some of which have an etiology that is less than clear. A typical site for avascular necrosis is a fracture... | [
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Anatomy_Gray_113 | Anatomy_Gray | In the clinic As the skeleton develops, there are stages of intense growth typically around the ages of 7 to 10 years and later in puberty. These growth spurts are associated with increased cellular activity around the growth plate between the head and shaft of a bone. This increase in activity renders the growth plate... | Anatomy_Gray. In the clinic As the skeleton develops, there are stages of intense growth typically around the ages of 7 to 10 years and later in puberty. These growth spurts are associated with increased cellular activity around the growth plate between the head and shaft of a bone. This increase in activity renders th... | [
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Anatomy_Gray_114 | Anatomy_Gray | In the clinic Degenerative joint disease is commonly known as osteoarthritis or osteoarthrosis. The disorder is related to aging but not caused by aging. Typically there are decreases in water and proteoglycan content within the cartilage. The cartilage becomes more fragile and more susceptible to mechanical disruption... | Anatomy_Gray. In the clinic Degenerative joint disease is commonly known as osteoarthritis or osteoarthrosis. The disorder is related to aging but not caused by aging. Typically there are decreases in water and proteoglycan content within the cartilage. The cartilage becomes more fragile and more susceptible to mechani... | [
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Anatomy_Gray_115 | Anatomy_Gray | In the United States, osteoarthritis accounts for up to one-quarter of primary health care visits and is regarded as a significant problem. The etiology of osteoarthritis is not clear; however, osteoarthritis can occur secondary to other joint diseases, such as rheumatoid arthritis and infection. Overuse of joints and ... | Anatomy_Gray. In the United States, osteoarthritis accounts for up to one-quarter of primary health care visits and is regarded as a significant problem. The etiology of osteoarthritis is not clear; however, osteoarthritis can occur secondary to other joint diseases, such as rheumatoid arthritis and infection. Overuse ... | [
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Anatomy_Gray_116 | Anatomy_Gray | Arthroscopy allows the surgeon to view the inside of the joint and its contents. Notably, in the knee, the menisci and the ligaments are easily seen, and it is possible using separate puncture sites and specific instruments to remove the menisci and replace the cruciate ligaments. The advantages of arthroscopy are that... | Anatomy_Gray. Arthroscopy allows the surgeon to view the inside of the joint and its contents. Notably, in the knee, the menisci and the ligaments are easily seen, and it is possible using separate puncture sites and specific instruments to remove the menisci and replace the cruciate ligaments. The advantages of arthro... | [
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Anatomy_Gray_117 | Anatomy_Gray | Large joints are commonly affected, including the hip, knee, and shoulder. However, with ongoing developments in joint replacement materials and surgical techniques, even small joints of the fingers can be replaced. Typically, both sides of the joint are replaced; in the hip joint the acetabulum will be reamed, and a p... | Anatomy_Gray. Large joints are commonly affected, including the hip, knee, and shoulder. However, with ongoing developments in joint replacement materials and surgical techniques, even small joints of the fingers can be replaced. Typically, both sides of the joint are replaced; in the hip joint the acetabulum will be r... | [
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Anatomy_Gray_118 | Anatomy_Gray | In the clinic The importance of fascias A fascia is a thin band of tissue that surrounds muscles, bones, organs, nerves, and blood vessels and often remains uninterrupted as a 3D structure between tissues. It provides important support for tissues and can provide a boundary between structures. Clinically, fascias are e... | Anatomy_Gray. In the clinic The importance of fascias A fascia is a thin band of tissue that surrounds muscles, bones, organs, nerves, and blood vessels and often remains uninterrupted as a 3D structure between tissues. It provides important support for tissues and can provide a boundary between structures. Clinically,... | [
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Anatomy_Gray_119 | Anatomy_Gray | In the clinic Placement of skin incisions and scarring Surgical skin incisions are ideally placed along or parallel to Langer’s lines, which are lines of skin tension that correspond to the orientation of the dermal collagen fibers. They tend to run in the same direction as the underlying muscle fibers and incisions th... | Anatomy_Gray. In the clinic Placement of skin incisions and scarring Surgical skin incisions are ideally placed along or parallel to Langer’s lines, which are lines of skin tension that correspond to the orientation of the dermal collagen fibers. They tend to run in the same direction as the underlying muscle fibers an... | [
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Anatomy_Gray_120 | Anatomy_Gray | In the long term, muscle paralysis will produce secondary muscle wasting and overall atrophy of the region due to disuse. In the clinic Muscle atrophy is a wasting disorder of muscle. It can be produced by a variety of causes, which include nerve damage to the muscle and disuse. Muscle atrophy is an important problem i... | Anatomy_Gray. In the long term, muscle paralysis will produce secondary muscle wasting and overall atrophy of the region due to disuse. In the clinic Muscle atrophy is a wasting disorder of muscle. It can be produced by a variety of causes, which include nerve damage to the muscle and disuse. Muscle atrophy is an impor... | [
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Anatomy_Gray_121 | Anatomy_Gray | In the clinic Muscle injuries and strains tend to occur in specific muscle groups and usually are related to a sudden exertion and muscle disruption. They typically occur in athletes. Muscle tears may involve a small interstitial injury up to a complete muscle disruption (Fig. 1.26). It is important to identify which m... | Anatomy_Gray. In the clinic Muscle injuries and strains tend to occur in specific muscle groups and usually are related to a sudden exertion and muscle disruption. They typically occur in athletes. Muscle tears may involve a small interstitial injury up to a complete muscle disruption (Fig. 1.26). It is important to id... | [
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Anatomy_Gray_122 | Anatomy_Gray | In the clinic Atherosclerosis is a disease that affects arteries. There is a chronic inflammatory reaction in the walls of the arteries, with deposition of cholesterol and fatty proteins. This may in turn lead to secondary calcification, with reduction in the diameter of the vessels impeding distal flow. The plaque its... | Anatomy_Gray. In the clinic Atherosclerosis is a disease that affects arteries. There is a chronic inflammatory reaction in the walls of the arteries, with deposition of cholesterol and fatty proteins. This may in turn lead to secondary calcification, with reduction in the diameter of the vessels impeding distal flow. ... | [
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Anatomy_Gray_123 | Anatomy_Gray | In the clinic Varicose veins are tortuous dilated veins that typically occur in the legs, although they may occur in the superficial veins of the arm and in other organs. In normal individuals the movement of adjacent leg muscles pumps the blood in the veins to the heart. Blood is also pumped from the superficial veins... | Anatomy_Gray. In the clinic Varicose veins are tortuous dilated veins that typically occur in the legs, although they may occur in the superficial veins of the arm and in other organs. In normal individuals the movement of adjacent leg muscles pumps the blood in the veins to the heart. Blood is also pumped from the sup... | [
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Anatomy_Gray_124 | Anatomy_Gray | Treatment of varicose veins depends on their location, size, and severity. Typically the superficial varicose veins can be excised and stripped, allowing blood only to drain into the deep system. In the clinic All organs require a blood supply from the arteries and drainage by veins. Within most organs there are multip... | Anatomy_Gray. Treatment of varicose veins depends on their location, size, and severity. Typically the superficial varicose veins can be excised and stripped, allowing blood only to drain into the deep system. In the clinic All organs require a blood supply from the arteries and drainage by veins. Within most organs th... | [
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Anatomy_Gray_125 | Anatomy_Gray | There are circumstances in which loss of a vein produces significant venous collateralization. Some of these venous collaterals become susceptible to bleeding. This is a considerable problem in patients who have undergone portal vein thrombosis or occlusion, where venous drainage from the gut bypasses the liver through... | Anatomy_Gray. There are circumstances in which loss of a vein produces significant venous collateralization. Some of these venous collaterals become susceptible to bleeding. This is a considerable problem in patients who have undergone portal vein thrombosis or occlusion, where venous drainage from the gut bypasses the... | [
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Anatomy_Gray_126 | Anatomy_Gray | In the clinic Lymph nodes are efficient filters and have an internal honeycomb of reticular connective tissue filled with lymphocytes. These lymphocytes act on bacteria, viruses, and other bodily cells to destroy them. Lymph nodes tend to drain specific areas, and if infection occurs within a drainage area, the lymph n... | Anatomy_Gray. In the clinic Lymph nodes are efficient filters and have an internal honeycomb of reticular connective tissue filled with lymphocytes. These lymphocytes act on bacteria, viruses, and other bodily cells to destroy them. Lymph nodes tend to drain specific areas, and if infection occurs within a drainage are... | [
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Anatomy_Gray_127 | Anatomy_Gray | In the clinic A knowledge of dermatomes and myotomes is absolutely fundamental to carrying out a neurological examination. A typical dermatome map is shown in Fig. 1.38. Clinically, a dermatome is that area of skin supplied by a single spinal nerve or spinal cord level. A myotome is that region of skeletal muscle inner... | Anatomy_Gray. In the clinic A knowledge of dermatomes and myotomes is absolutely fundamental to carrying out a neurological examination. A typical dermatome map is shown in Fig. 1.38. Clinically, a dermatome is that area of skin supplied by a single spinal nerve or spinal cord level. A myotome is that region of skeleta... | [
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Anatomy_Gray_128 | Anatomy_Gray | In the clinic Referred pain occurs when sensory information comes to the spinal cord from one location but is interpreted by the CNS as coming from another location innervated by the same spinal cord level. Usually, this happens when the pain information comes from a region, such as the gut, which has a low amount of s... | Anatomy_Gray. In the clinic Referred pain occurs when sensory information comes to the spinal cord from one location but is interpreted by the CNS as coming from another location innervated by the same spinal cord level. Usually, this happens when the pain information comes from a region, such as the gut, which has a l... | [
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Anatomy_Gray_129 | Anatomy_Gray | Pain is most often referred from a region innervated by the visceral part of the nervous system to a region innervated, at the same spinal cord level, by the somatic side of the nervous system. to another. For example, irritation of the peritoneum on the inferior surface of the diaphragm, which is innervated by the phr... | Anatomy_Gray. Pain is most often referred from a region innervated by the visceral part of the nervous system to a region innervated, at the same spinal cord level, by the somatic side of the nervous system. to another. For example, irritation of the peritoneum on the inferior surface of the diaphragm, which is innerva... | [
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Anatomy_Gray_130 | Anatomy_Gray | When the appendix becomes inflamed, the visceral sensory fibers are stimulated. These fibers enter the spinal cord with the sympathetic fibers at spinal cord level T10. The pain is referred to the dermatome of T10, which is in the umbilical region (Fig. 1.50). The pain is diffuse, not focal; every time a peristaltic wa... | Anatomy_Gray. When the appendix becomes inflamed, the visceral sensory fibers are stimulated. These fibers enter the spinal cord with the sympathetic fibers at spinal cord level T10. The pain is referred to the dermatome of T10, which is in the umbilical region (Fig. 1.50). The pain is diffuse, not focal; every time a ... | [
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Anatomy_Gray_131 | Anatomy_Gray | Although this is a typical history for appendicitis, it should always be borne in mind that the patient’s symptoms and signs may vary. The appendix is situated in a retrocecal position in approximately 70% of patients; therefore it may never contact the parietal peritoneum anteriorly in the right iliac fossa. It is als... | Anatomy_Gray. Although this is a typical history for appendicitis, it should always be borne in mind that the patient’s symptoms and signs may vary. The appendix is situated in a retrocecal position in approximately 70% of patients; therefore it may never contact the parietal peritoneum anteriorly in the right iliac fo... | [
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Anatomy_Gray_132 | Anatomy_Gray | Although appendicitis is common, other disorders, for example of the bowel and pelvis, may produce similar symptoms. The Body In the clinic—cont’d The back consists of the posterior aspect of the body and provides the musculoskeletal axis of support for the trunk. Bony elements consist mainly of the vertebrae, although... | Anatomy_Gray. Although appendicitis is common, other disorders, for example of the bowel and pelvis, may produce similar symptoms. The Body In the clinic—cont’d The back consists of the posterior aspect of the body and provides the musculoskeletal axis of support for the trunk. Bony elements consist mainly of the verte... | [
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Anatomy_Gray_133 | Anatomy_Gray | The skeletal and muscular elements of the back support the body’s weight, transmit forces through the pelvis to the lower limbs, carry and position the head, and brace and help maneuver the upper limbs. The vertebral column is positioned posteriorly in the body at the midline. When viewed laterally, it has a number of ... | Anatomy_Gray. The skeletal and muscular elements of the back support the body’s weight, transmit forces through the pelvis to the lower limbs, carry and position the head, and brace and help maneuver the upper limbs. The vertebral column is positioned posteriorly in the body at the midline. When viewed laterally, it ha... | [
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Anatomy_Gray_134 | Anatomy_Gray | As stresses on the back increase from the cervical to lumbar regions, lower back problems are common. Muscles of the back consist of extrinsic and intrinsic groups: The extrinsic muscles of the back move the upper limbs and the ribs. The intrinsic muscles of the back maintain posture and move the vertebral column; thes... | Anatomy_Gray. As stresses on the back increase from the cervical to lumbar regions, lower back problems are common. Muscles of the back consist of extrinsic and intrinsic groups: The extrinsic muscles of the back move the upper limbs and the ribs. The intrinsic muscles of the back maintain posture and move the vertebra... | [
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Anatomy_Gray_135 | Anatomy_Gray | In the cervical region, the first two vertebrae and associated muscles are specifically modified to support and position the head. The head flexes and extends, in the nodding motion, on vertebra CI, and rotation of the head occurs as vertebra CI moves on vertebra CII (Fig. 2.3). Protection of the nervous system The ver... | Anatomy_Gray. In the cervical region, the first two vertebrae and associated muscles are specifically modified to support and position the head. The head flexes and extends, in the nodding motion, on vertebra CI, and rotation of the head occurs as vertebra CI moves on vertebra CII (Fig. 2.3). Protection of the nervous ... | [
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Anatomy_Gray_136 | Anatomy_Gray | The major bones of the back are the 33 vertebrae (Fig. 2.5). The number and specific characteristics of the vertebrae vary depending on the body region with which they are associated. There are seven cervical, twelve thoracic, five lumbar, five sacral, and three to four coccygeal vertebrae. The sacral vertebrae fuse in... | Anatomy_Gray. The major bones of the back are the 33 vertebrae (Fig. 2.5). The number and specific characteristics of the vertebrae vary depending on the body region with which they are associated. There are seven cervical, twelve thoracic, five lumbar, five sacral, and three to four coccygeal vertebrae. The sacral ver... | [
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Anatomy_Gray_137 | Anatomy_Gray | The vertebral arch is firmly anchored to the posterior surface of the vertebral body by two pedicles, which form the lateral pillars of the vertebral arch. The roof of the vertebral arch is formed by right and left laminae, which fuse at the midline. The vertebral arches of the vertebrae are aligned to form the lateral... | Anatomy_Gray. The vertebral arch is firmly anchored to the posterior surface of the vertebral body by two pedicles, which form the lateral pillars of the vertebral arch. The roof of the vertebral arch is formed by right and left laminae, which fuse at the midline. The vertebral arches of the vertebrae are aligned to fo... | [
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Anatomy_Gray_138 | Anatomy_Gray | A spinous process projects posteriorly and generally inferiorly from the roof of the vertebral arch. On each side of the vertebral arch, a transverse process extends laterally from the region where a lamina meets a pedicle. From the same region, a superior articular process and an inferior articular process articulate ... | Anatomy_Gray. A spinous process projects posteriorly and generally inferiorly from the roof of the vertebral arch. On each side of the vertebral arch, a transverse process extends laterally from the region where a lamina meets a pedicle. From the same region, a superior articular process and an inferior articular proce... | [
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Anatomy_Gray_139 | Anatomy_Gray | Muscles in the back can be classified as extrinsic or intrinsic based on their embryological origin and type of innervation (Fig. 2.7). The extrinsic muscles are involved with movements of the upper limbs and thoracic wall and, in general, are innervated by anterior rami of spinal nerves. The superficial group of these... | Anatomy_Gray. Muscles in the back can be classified as extrinsic or intrinsic based on their embryological origin and type of innervation (Fig. 2.7). The extrinsic muscles are involved with movements of the upper limbs and thoracic wall and, in general, are innervated by anterior rami of spinal nerves. The superficial ... | [
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Anatomy_Gray_140 | Anatomy_Gray | The anterior wall is formed by the vertebral bodies of the vertebrae, intervertebral discs, and associated ligaments. The lateral walls and roof are formed by the vertebral arches and ligaments. Within the vertebral canal, the spinal cord is surrounded by a series of three connective tissue membranes (the meninges): Th... | Anatomy_Gray. The anterior wall is formed by the vertebral bodies of the vertebrae, intervertebral discs, and associated ligaments. The lateral walls and roof are formed by the vertebral arches and ligaments. Within the vertebral canal, the spinal cord is surrounded by a series of three connective tissue membranes (the... | [
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Anatomy_Gray_141 | Anatomy_Gray | In the vertebral canal, the dura mater is separated from surrounding bone by an extradural (epidural) space containing loose connective tissue, fat, and a venous plexus. The 31 pairs of spinal nerves are segmental in distribution and emerge from the vertebral canal between the pedicles of adjacent vertebrae. There are ... | Anatomy_Gray. In the vertebral canal, the dura mater is separated from surrounding bone by an extradural (epidural) space containing loose connective tissue, fat, and a venous plexus. The 31 pairs of spinal nerves are segmental in distribution and emerge from the vertebral canal between the pedicles of adjacent vertebr... | [
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Anatomy_Gray_142 | Anatomy_Gray | The anterior rami form the major somatic plexuses (cervical, brachial, lumbar, and sacral) of the body. Major visceral components of the PNS (sympathetic trunk and prevertebral plexus) of the body are also associated mainly with the anterior rami of spinal nerves. Cervical regions of the back constitute the skeletal an... | Anatomy_Gray. The anterior rami form the major somatic plexuses (cervical, brachial, lumbar, and sacral) of the body. Major visceral components of the PNS (sympathetic trunk and prevertebral plexus) of the body are also associated mainly with the anterior rami of spinal nerves. Cervical regions of the back constitute t... | [
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Anatomy_Gray_143 | Anatomy_Gray | Thorax, abdomen, and pelvis The different regions of the vertebral column contribute to the skeletal framework of the thorax, abdomen, and pelvis (Fig. 2.10). In addition to providing support for each of these parts of the body, the vertebrae provide attachments for muscles and fascia, and articulation sites for other ... | Anatomy_Gray. Thorax, abdomen, and pelvis The different regions of the vertebral column contribute to the skeletal framework of the thorax, abdomen, and pelvis (Fig. 2.10). In addition to providing support for each of these parts of the body, the vertebrae provide attachments for muscles and fascia, and articulation si... | [
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Anatomy_Gray_144 | Anatomy_Gray | During development, the vertebral column grows much faster than the spinal cord. As a result, the spinal cord does not extend the entire length of the vertebral canal (Fig. 2.11). In the adult, the spinal cord typically ends between vertebrae LI and LII, although it can end as high as vertebra TXII and as low as the di... | Anatomy_Gray. During development, the vertebral column grows much faster than the spinal cord. As a result, the spinal cord does not extend the entire length of the vertebral canal (Fig. 2.11). In the adult, the spinal cord typically ends between vertebrae LI and LII, although it can end as high as vertebra TXII and as... | [
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Anatomy_Gray_145 | Anatomy_Gray | The superior and inferior margins are formed by notches in adjacent pedicles. The posterior margin is formed by the articular processes of the vertebral arches and the associated joint. The anterior border is formed by the intervertebral disc between the vertebral bodies of the adjacent vertebrae. Any pathology that oc... | Anatomy_Gray. The superior and inferior margins are formed by notches in adjacent pedicles. The posterior margin is formed by the articular processes of the vertebral arches and the associated joint. The anterior border is formed by the intervertebral disc between the vertebral bodies of the adjacent vertebrae. Any pat... | [
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Anatomy_Gray_146 | Anatomy_Gray | Skeletal components of the back consist mainly of the vertebrae and associated intervertebral discs. The skull, scapulae, pelvic bones, and ribs also contribute to the bony framework of the back and provide sites for muscle attachment. There are approximately 33 vertebrae, which are subdivided into five groups based on... | Anatomy_Gray. Skeletal components of the back consist mainly of the vertebrae and associated intervertebral discs. The skull, scapulae, pelvic bones, and ribs also contribute to the bony framework of the back and provide sites for muscle attachment. There are approximately 33 vertebrae, which are subdivided into five g... | [
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Anatomy_Gray_147 | Anatomy_Gray | Inferior to the thoracic vertebrae are five lumbar vertebrae, which form the skeletal support for the posterior abdominal wall and are characterized by their large size (Figs. 2.14 and 2.17). Next are five sacral vertebrae fused into one single bone called the sacrum, which articulates on each side with a pelvic bone a... | Anatomy_Gray. Inferior to the thoracic vertebrae are five lumbar vertebrae, which form the skeletal support for the posterior abdominal wall and are characterized by their large size (Figs. 2.14 and 2.17). Next are five sacral vertebrae fused into one single bone called the sacrum, which articulates on each side with a... | [
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Anatomy_Gray_148 | Anatomy_Gray | A typical vertebra consists of a vertebral body and a posterior vertebral arch (Fig. 2.19). Extending from the vertebral arch are a number of processes for muscle attachment and articulation with adjacent bone. The vertebral body is the weight-bearing part of the vertebra and is linked to adjacent vertebral bodies by i... | Anatomy_Gray. A typical vertebra consists of a vertebral body and a posterior vertebral arch (Fig. 2.19). Extending from the vertebral arch are a number of processes for muscle attachment and articulation with adjacent bone. The vertebral body is the weight-bearing part of the vertebra and is linked to adjacent vertebr... | [
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Anatomy_Gray_149 | Anatomy_Gray | The vertebral arch of each vertebra consists of pedicles and laminae (Fig. 2.19): The two pedicles are bony pillars that attach the vertebral arch to the vertebral body. The two laminae are flat sheets of bone that extend from each pedicle to meet in the midline and form the roof of the vertebral arch. A spinous proces... | Anatomy_Gray. The vertebral arch of each vertebra consists of pedicles and laminae (Fig. 2.19): The two pedicles are bony pillars that attach the vertebral arch to the vertebral body. The two laminae are flat sheets of bone that extend from each pedicle to meet in the midline and form the roof of the vertebral arch. A ... | [
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Anatomy_Gray_150 | Anatomy_Gray | Between the vertebral body and the origin of the articular processes, each pedicle is notched on its superior and inferior surfaces. These superior and inferior vertebral notches participate in forming intervertebral foramina. The seven cervical vertebrae are characterized by their small size and by the presence of a f... | Anatomy_Gray. Between the vertebral body and the origin of the articular processes, each pedicle is notched on its superior and inferior surfaces. These superior and inferior vertebral notches participate in forming intervertebral foramina. The seven cervical vertebrae are characterized by their small size and by the p... | [
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Anatomy_Gray_151 | Anatomy_Gray | The spinous process is short and bifid. The vertebral foramen is triangular. The first and second cervical vertebrae—the atlas and axis—are specialized to accommodate movement of the head. Vertebra CI (the atlas) articulates with the head (Fig. 2.21). Its major distinguishing feature is that it lacks a vertebral body (... | Anatomy_Gray. The spinous process is short and bifid. The vertebral foramen is triangular. The first and second cervical vertebrae—the atlas and axis—are specialized to accommodate movement of the head. Vertebra CI (the atlas) articulates with the head (Fig. 2.21). Its major distinguishing feature is that it lacks a ve... | [
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Anatomy_Gray_152 | Anatomy_Gray | The atlanto-occipital joint allows the head to nod up and down on the vertebral column. The posterior surface of the anterior arch has an articular facet for the dens, which projects superiorly from the vertebral body of the axis. The dens is held in position by a strong transverse ligament of atlas posterior to it and... | Anatomy_Gray. The atlanto-occipital joint allows the head to nod up and down on the vertebral column. The posterior surface of the anterior arch has an articular facet for the dens, which projects superiorly from the vertebral body of the axis. The dens is held in position by a strong transverse ligament of atlas poste... | [
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Anatomy_Gray_153 | Anatomy_Gray | The axis is characterized by the large tooth-like dens, which extends superiorly from the vertebral body (Figs. 2.20B and 2.21). The anterior surface of the dens has an oval facet for articulation with the anterior arch of the atlas. The two superolateral surfaces of the dens possess circular impressions that serve as ... | Anatomy_Gray. The axis is characterized by the large tooth-like dens, which extends superiorly from the vertebral body (Figs. 2.20B and 2.21). The anterior surface of the dens has an oval facet for articulation with the anterior arch of the atlas. The two superolateral surfaces of the dens possess circular impressions ... | [
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Anatomy_Gray_154 | Anatomy_Gray | Each transverse process also has a facet (transverse costal facet) for articulation with the tubercle of its own rib. The vertebral body of the vertebra is somewhat heart shaped when viewed from above, and the vertebral foramen is circular. The five lumbar vertebrae are distinguished from vertebrae in other regions by ... | Anatomy_Gray. Each transverse process also has a facet (transverse costal facet) for articulation with the tubercle of its own rib. The vertebral body of the vertebra is somewhat heart shaped when viewed from above, and the vertebral foramen is circular. The five lumbar vertebrae are distinguished from vertebrae in oth... | [
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Anatomy_Gray_155 | Anatomy_Gray | The vertebral body of a typical lumbar vertebra is cylindrical and the vertebral foramen is triangular in shape and larger than in the thoracic vertebrae. The sacrum is a single bone that represents the five fused sacral vertebrae (Fig. 2.20E). It is triangular in shape with the apex pointed inferiorly, and is curved s... | Anatomy_Gray. The vertebral body of a typical lumbar vertebra is cylindrical and the vertebral foramen is triangular in shape and larger than in the thoracic vertebrae. The sacrum is a single bone that represents the five fused sacral vertebrae (Fig. 2.20E). It is triangular in shape with the apex pointed inferiorly, a... | [
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Anatomy_Gray_156 | Anatomy_Gray | The posterior wall of the vertebral canal may be incomplete near the inferior end of the sacrum. The coccyx is a small triangular bone that articulates with the inferior end of the sacrum and represents three to four fused coccygeal vertebrae (Fig. 2.20F). It is characterized by its small size and by the absence of ver... | Anatomy_Gray. The posterior wall of the vertebral canal may be incomplete near the inferior end of the sacrum. The coccyx is a small triangular bone that articulates with the inferior end of the sacrum and represents three to four fused coccygeal vertebrae (Fig. 2.20F). It is characterized by its small size and by the ... | [
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Anatomy_Gray_157 | Anatomy_Gray | Each intervertebral foramen is a confined space surrounded by bone and ligament, and by joints. Pathology in any of these structures, and in the surrounding muscles, can affect structures within the foramen. In most regions of the vertebral column, the laminae and spinous processes of adjacent vertebrae overlap to form... | Anatomy_Gray. Each intervertebral foramen is a confined space surrounded by bone and ligament, and by joints. Pathology in any of these structures, and in the surrounding muscles, can affect structures within the foramen. In most regions of the vertebral column, the laminae and spinous processes of adjacent vertebrae o... | [
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Anatomy_Gray_158 | Anatomy_Gray | The two major types of joints between vertebrae are: symphyses between vertebral bodies (Fig. 2.31), and synovial joints between articular processes (Fig. 2.32). A typical vertebra has a total of six joints with adjacent vertebrae: four synovial joints (two above and two below) and two symphyses (one above and one belo... | Anatomy_Gray. The two major types of joints between vertebrae are: symphyses between vertebral bodies (Fig. 2.31), and synovial joints between articular processes (Fig. 2.32). A typical vertebra has a total of six joints with adjacent vertebrae: four synovial joints (two above and two below) and two symphyses (one abov... | [
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Anatomy_Gray_159 | Anatomy_Gray | Movements by vertebrae in a specific region (cervical, thoracic, and lumbar) are determined by the shape and orientation of joint surfaces on the articular processes and on the vertebral bodies. The symphysis between adjacent vertebral bodies is formed by a layer of hyaline cartilage on each vertebral body and an inter... | Anatomy_Gray. Movements by vertebrae in a specific region (cervical, thoracic, and lumbar) are determined by the shape and orientation of joint surfaces on the articular processes and on the vertebral bodies. The symphysis between adjacent vertebral bodies is formed by a layer of hyaline cartilage on each vertebral bod... | [
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Anatomy_Gray_160 | Anatomy_Gray | The nucleus pulposus fills the center of the intervertebral disc, is gelatinous, and absorbs compression forces between vertebrae. Degenerative changes in the anulus fibrosus can lead to herniation of the nucleus pulposus. Posterolateral herniation can impinge on the roots of a spinal nerve in the intervertebral forame... | Anatomy_Gray. The nucleus pulposus fills the center of the intervertebral disc, is gelatinous, and absorbs compression forces between vertebrae. Degenerative changes in the anulus fibrosus can lead to herniation of the nucleus pulposus. Posterolateral herniation can impinge on the roots of a spinal nerve in the interve... | [
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Anatomy_Gray_161 | Anatomy_Gray | In cervical regions, the zygapophysial joints slope inferiorly from anterior to posterior and their shape facilitates flexion and extension. In thoracic regions, the joints are oriented vertically and their shape limits flexion and extension, but facilitates rotation. In lumbar regions, the joint surfaces are curved an... | Anatomy_Gray. In cervical regions, the zygapophysial joints slope inferiorly from anterior to posterior and their shape facilitates flexion and extension. In thoracic regions, the joints are oriented vertically and their shape limits flexion and extension, but facilitates rotation. In lumbar regions, the joint surfaces... | [
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Anatomy_Gray_162 | Anatomy_Gray | Joints between vertebrae are reinforced and supported by numerous ligaments, which pass between vertebral bodies and interconnect components of the vertebral arches. The anterior and posterior longitudinal ligaments are on the anterior and posterior surfaces of the vertebral bodies and extend along most of the vertebra... | Anatomy_Gray. Joints between vertebrae are reinforced and supported by numerous ligaments, which pass between vertebral bodies and interconnect components of the vertebral arches. The anterior and posterior longitudinal ligaments are on the anterior and posterior surfaces of the vertebral bodies and extend along most o... | [
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Anatomy_Gray_163 | Anatomy_Gray | The posterior longitudinal ligament is on the posterior surfaces of the vertebral bodies and lines the anterior surface of the vertebral canal. Like the anterior longitudinal ligament, it is attached along its length to the vertebral bodies and intervertebral discs. The upper part of the posterior longitudinal ligament... | Anatomy_Gray. The posterior longitudinal ligament is on the posterior surfaces of the vertebral bodies and lines the anterior surface of the vertebral canal. Like the anterior longitudinal ligament, it is attached along its length to the vertebral bodies and intervertebral discs. The upper part of the posterior longitu... | [
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Anatomy_Gray_164 | Anatomy_Gray | The supraspinous ligament connects and passes along the tips of the vertebral spinous processes from vertebra CVII to the sacrum (Fig. 2.37). From vertebra CVII to the skull, the ligament becomes structurally distinct from more caudal parts of the ligament and is called the ligamentum nuchae. The ligamentum nuchae is a... | Anatomy_Gray. The supraspinous ligament connects and passes along the tips of the vertebral spinous processes from vertebra CVII to the sacrum (Fig. 2.37). From vertebra CVII to the skull, the ligament becomes structurally distinct from more caudal parts of the ligament and is called the ligamentum nuchae. The ligament... | [
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Anatomy_Gray_165 | Anatomy_Gray | Interspinous ligaments pass between adjacent vertebral spinous processes (Fig. 2.38). They attach from the base to the apex of each spinous process and blend with the supraspinous ligament posteriorly and the ligamenta flava anteriorly on each side. Muscles of the back are organized into superficial, intermediate, and ... | Anatomy_Gray. Interspinous ligaments pass between adjacent vertebral spinous processes (Fig. 2.38). They attach from the base to the apex of each spinous process and blend with the supraspinous ligament posteriorly and the ligamenta flava anteriorly on each side. Muscles of the back are organized into superficial, inte... | [
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Anatomy_Gray_166 | Anatomy_Gray | Superficial group of back muscles The muscles in the superficial group are immediately deep to the skin and superficial fascia (Figs. 2.42 to 2.45). They attach the superior part of the appendicular skeleton (clavicle, scapula, and humerus) to the axial skeleton (skull, ribs, and vertebral column). Because these muscle... | Anatomy_Gray. Superficial group of back muscles The muscles in the superficial group are immediately deep to the skin and superficial fascia (Figs. 2.42 to 2.45). They attach the superior part of the appendicular skeleton (clavicle, scapula, and humerus) to the axial skeleton (skull, ribs, and vertebral column). Becaus... | [
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Anatomy_Gray_167 | Anatomy_Gray | Each trapezius muscle is flat and triangular, with the base of the triangle situated along the vertebral column (the muscle’s origin) and the apex pointing toward the tip of the shoulder (the muscle’s insertion) (Fig. 2.43 and Table 2.1). The muscles on both sides together form a trapezoid. The superior fibers of the t... | Anatomy_Gray. Each trapezius muscle is flat and triangular, with the base of the triangle situated along the vertebral column (the muscle’s origin) and the apex pointing toward the tip of the shoulder (the muscle’s insertion) (Fig. 2.43 and Table 2.1). The muscles on both sides together form a trapezoid. The superior f... | [
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Anatomy_Gray_168 | Anatomy_Gray | The blood supply to the trapezius is from the superficial branch of the transverse cervical artery, the acromial branch of the suprascapular artery, and the dorsal branches of posterior intercostal arteries. Latissimus dorsi is a large, flat triangular muscle that begins in the lower portion of the back and tapers as i... | Anatomy_Gray. The blood supply to the trapezius is from the superficial branch of the transverse cervical artery, the acromial branch of the suprascapular artery, and the dorsal branches of posterior intercostal arteries. Latissimus dorsi is a large, flat triangular muscle that begins in the lower portion of the back a... | [
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Anatomy_Gray_169 | Anatomy_Gray | Levator scapulae is a slender muscle that descends from the transverse processes of the upper cervical vertebrae to the upper portion of the scapula on its medial border at the superior angle (Figs. 2.43 and 2.45 and Table 2.1). It elevates the scapula and may assist other muscles in rotating the lateral aspect of the ... | Anatomy_Gray. Levator scapulae is a slender muscle that descends from the transverse processes of the upper cervical vertebrae to the upper portion of the scapula on its medial border at the superior angle (Figs. 2.43 and 2.45 and Table 2.1). It elevates the scapula and may assist other muscles in rotating the lateral ... | [
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Anatomy_Gray_170 | Anatomy_Gray | The larger rhomboid major originates from the spinous processes of the upper thoracic vertebrae and attaches to the medial scapular border inferior to rhomboid minor. The two rhomboid muscles work together to retract or pull the scapula toward the vertebral column. With other muscles they may also rotate the lateral as... | Anatomy_Gray. The larger rhomboid major originates from the spinous processes of the upper thoracic vertebrae and attaches to the medial scapular border inferior to rhomboid minor. The two rhomboid muscles work together to retract or pull the scapula toward the vertebral column. With other muscles they may also rotate ... | [
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Anatomy_Gray_171 | Anatomy_Gray | The dorsal scapular nerve, a branch of the brachial plexus, innervates both rhomboid muscles (Fig. 2.46). Intermediate group of back muscles The muscles in the intermediate group of back muscles consist of two thin muscular sheets in the superior and inferior regions of the back, immediately deep to the muscles in the ... | Anatomy_Gray. The dorsal scapular nerve, a branch of the brachial plexus, innervates both rhomboid muscles (Fig. 2.46). Intermediate group of back muscles The muscles in the intermediate group of back muscles consist of two thin muscular sheets in the superior and inferior regions of the back, immediately deep to the m... | [
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Anatomy_Gray_172 | Anatomy_Gray | Serratus posterior superior is deep to the rhomboid muscles, whereas serratus posterior inferior is deep to the latissimus dorsi. Both serratus posterior muscles are attached to the vertebral column and associated structures medially, and either descend (the fibers of the serratus posterior superior) or ascend (the fib... | Anatomy_Gray. Serratus posterior superior is deep to the rhomboid muscles, whereas serratus posterior inferior is deep to the latissimus dorsi. Both serratus posterior muscles are attached to the vertebral column and associated structures medially, and either descend (the fibers of the serratus posterior superior) or a... | [
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Anatomy_Gray_173 | Anatomy_Gray | Deep group of back muscles The deep or intrinsic muscles of the back extend from the pelvis to the skull and are innervated by segmental branches of the posterior rami of spinal nerves. They include: the extensors and rotators of the head and neck— the splenius capitis and cervicis (spinotransversales muscles), the ext... | Anatomy_Gray. Deep group of back muscles The deep or intrinsic muscles of the back extend from the pelvis to the skull and are innervated by segmental branches of the posterior rami of spinal nerves. They include: the extensors and rotators of the head and neck— the splenius capitis and cervicis (spinotransversales mus... | [
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Anatomy_Gray_174 | Anatomy_Gray | Superiorly, it passes anteriorly to the serratus posterior muscle and is continuous with deep fascia in the neck. In the thoracic region, it covers the deep muscles and separates them from the muscles in the superficial and intermediate groups. Medially, it attaches to the spinous processes of the thoracic vertebrae an... | Anatomy_Gray. Superiorly, it passes anteriorly to the serratus posterior muscle and is continuous with deep fascia in the neck. In the thoracic region, it covers the deep muscles and separates them from the muscles in the superficial and intermediate groups. Medially, it attaches to the spinous processes of the thoraci... | [
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Anatomy_Gray_175 | Anatomy_Gray | The middle layer is attached medially to the tips of the transverse processes of the lumbar vertebrae and intertransverse ligaments—inferiorly, it is attached to the iliac crest and, superiorly, to the lower border of rib XII. The anterior layer covers the anterior surface of the quadratus lumborum muscle (a muscle of ... | Anatomy_Gray. The middle layer is attached medially to the tips of the transverse processes of the lumbar vertebrae and intertransverse ligaments—inferiorly, it is attached to the iliac crest and, superiorly, to the lower border of rib XII. The anterior layer covers the anterior surface of the quadratus lumborum muscle... | [
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Anatomy_Gray_176 | Anatomy_Gray | The two spinotransversales muscles run from the spinous processes and ligamentum nuchae upward and laterally (Fig. 2.49 and Table 2.3): The splenius capitis is a broad muscle attached to the occipital bone and mastoid process of the temporal bone. The splenius cervicis is a narrow muscle attached to the transverse proc... | Anatomy_Gray. The two spinotransversales muscles run from the spinous processes and ligamentum nuchae upward and laterally (Fig. 2.49 and Table 2.3): The splenius capitis is a broad muscle attached to the occipital bone and mastoid process of the temporal bone. The splenius cervicis is a narrow muscle attached to the t... | [
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Anatomy_Gray_177 | Anatomy_Gray | Together the spinotransversales muscles draw the head backward, extending the neck. Individually, each muscle rotates the head to one side—the same side as the contracting muscle. The erector spinae is the largest group of intrinsic back muscles. The muscles lie posterolaterally to the vertebral column between the spin... | Anatomy_Gray. Together the spinotransversales muscles draw the head backward, extending the neck. Individually, each muscle rotates the head to one side—the same side as the contracting muscle. The erector spinae is the largest group of intrinsic back muscles. The muscles lie posterolaterally to the vertebral column be... | [
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Anatomy_Gray_178 | Anatomy_Gray | The outer or most laterally placed column of the erector spinae muscles is the iliocostalis, which is associated with the costal elements and passes from the common tendon of origin to multiple insertions into the angles of the ribs and the transverse processes of the lower cervical vertebrae. The middle or intermediat... | Anatomy_Gray. The outer or most laterally placed column of the erector spinae muscles is the iliocostalis, which is associated with the costal elements and passes from the common tendon of origin to multiple insertions into the angles of the ribs and the transverse processes of the lower cervical vertebrae. The middle ... | [
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Anatomy_Gray_179 | Anatomy_Gray | The muscles in the erector spinae group are the primary extensors of the vertebral column and head. Acting bilaterally, they straighten the back, returning it to the upright position from a flexed position, and pull the head posteriorly. They also participate in controlling vertebral column flexion by contracting and r... | Anatomy_Gray. The muscles in the erector spinae group are the primary extensors of the vertebral column and head. Acting bilaterally, they straighten the back, returning it to the upright position from a flexed position, and pull the head posteriorly. They also participate in controlling vertebral column flexion by con... | [
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Anatomy_Gray_180 | Anatomy_Gray | The semispinalis muscles are the most superficial collection of muscle fibers in the transversospinales group. These muscles begin in the lower thoracic region and end by attaching to the skull, crossing between four and six vertebrae from their point of origin to point of attachment. Semispinalis muscles are found in ... | Anatomy_Gray. The semispinalis muscles are the most superficial collection of muscle fibers in the transversospinales group. These muscles begin in the lower thoracic region and end by attaching to the skull, crossing between four and six vertebrae from their point of origin to point of attachment. Semispinalis muscles... | [
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Anatomy_Gray_181 | Anatomy_Gray | The small rotatores muscles are the deepest of the transversospinales group. They are present throughout the length of the vertebral column but are best developed in the thoracic region. Their fibers pass upward and medially from transverse processes to spinous processes crossing two vertebrae (long rotators) or attach... | Anatomy_Gray. The small rotatores muscles are the deepest of the transversospinales group. They are present throughout the length of the vertebral column but are best developed in the thoracic region. Their fibers pass upward and medially from transverse processes to spinous processes crossing two vertebrae (long rotat... | [
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Anatomy_Gray_182 | Anatomy_Gray | One muscle in the transversospinales group, the semispinalis capitis, has a unique action because it attaches to the skull. Contracting bilaterally, this muscle pulls the head posteriorly, whereas unilateral contraction pulls the head posteriorly and turns it, causing the chin to move superiorly and turn toward the sid... | Anatomy_Gray. One muscle in the transversospinales group, the semispinalis capitis, has a unique action because it attaches to the skull. Contracting bilaterally, this muscle pulls the head posteriorly, whereas unilateral contraction pulls the head posteriorly and turns it, causing the chin to move superiorly and turn ... | [
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Anatomy_Gray_183 | Anatomy_Gray | The second group of segmental muscles are the true segmental muscles of the back—the interspinales, which pass between adjacent spinous processes, and the intertransversarii, which pass between adjacent transverse processes. These postural muscles stabilize adjoining vertebrae during movements of the vertebral column t... | Anatomy_Gray. The second group of segmental muscles are the true segmental muscles of the back—the interspinales, which pass between adjacent spinous processes, and the intertransversarii, which pass between adjacent transverse processes. These postural muscles stabilize adjoining vertebrae during movements of the vert... | [
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Anatomy_Gray_184 | Anatomy_Gray | Contraction of the suboccipital muscles extends and rotates the head at the atlanto-occipital and atlanto-axial joints, respectively. The suboccipital muscles are innervated by the posterior ramus of the first cervical nerve, which enters the area between the vertebral artery and the posterior arch of the atlas (Fig. 2... | Anatomy_Gray. Contraction of the suboccipital muscles extends and rotates the head at the atlanto-occipital and atlanto-axial joints, respectively. The suboccipital muscles are innervated by the posterior ramus of the first cervical nerve, which enters the area between the vertebral artery and the posterior arch of the... | [
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Anatomy_Gray_185 | Anatomy_Gray | The obliquus capitis inferior muscle forms the inferior border. The contents of the suboccipital triangle include: posterior ramus of CI, vertebral artery, and veins The spinal cord extends from the foramen magnum to approximately the level of the disc between vertebrae LI and LII in adults, although it can end as high... | Anatomy_Gray. The obliquus capitis inferior muscle forms the inferior border. The contents of the suboccipital triangle include: posterior ramus of CI, vertebral artery, and veins The spinal cord extends from the foramen magnum to approximately the level of the disc between vertebrae LI and LII in adults, although it c... | [
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Anatomy_Gray_186 | Anatomy_Gray | The spinal cord is not uniform in diameter along its length. It has two major swellings or enlargements in regions associated with the origin of spinal nerves that innervate the upper and lower limbs. A cervical enlargement occurs in the region associated with the origins of spinal nerves C5 to T1, which innervate the ... | Anatomy_Gray. The spinal cord is not uniform in diameter along its length. It has two major swellings or enlargements in regions associated with the origin of spinal nerves that innervate the upper and lower limbs. A cervical enlargement occurs in the region associated with the origins of spinal nerves C5 to T1, which ... | [
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Anatomy_Gray_187 | Anatomy_Gray | Internally, the cord has a small central canal surrounded by gray and white matter: The gray matter is rich in nerve cell bodies, which form longitudinal columns along the cord, and in cross section these columns form a characteristic H-shaped appearance in the central regions of the cord. The white matter surrounds th... | Anatomy_Gray. Internally, the cord has a small central canal surrounded by gray and white matter: The gray matter is rich in nerve cell bodies, which form longitudinal columns along the cord, and in cross section these columns form a characteristic H-shaped appearance in the central regions of the cord. The white matte... | [
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Anatomy_Gray_188 | Anatomy_Gray | The arterial supply to the spinal cord comes from two sources (Fig. 2.55). It consists of: longitudinally oriented vessels, arising superior to the cervical portion of the cord, which descend on the surface of the cord; and feeder arteries that enter the vertebral canal through the intervertebral foramina at every leve... | Anatomy_Gray. The arterial supply to the spinal cord comes from two sources (Fig. 2.55). It consists of: longitudinally oriented vessels, arising superior to the cervical portion of the cord, which descend on the surface of the cord; and feeder arteries that enter the vertebral canal through the intervertebral foramina... | [
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Anatomy_Gray_189 | Anatomy_Gray | After entering an intervertebral foramen, the segmental spinal arteries give rise to anterior and posterior radicular arteries (Fig. 2.55). This occurs at every vertebral level. The radicular arteries follow, and supply, the anterior and posterior roots. At various vertebral levels, the segmental spinal arteries also g... | Anatomy_Gray. After entering an intervertebral foramen, the segmental spinal arteries give rise to anterior and posterior radicular arteries (Fig. 2.55). This occurs at every vertebral level. The radicular arteries follow, and supply, the anterior and posterior roots. At various vertebral levels, the segmental spinal a... | [
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Anatomy_Gray_190 | Anatomy_Gray | The longitudinal vessels consist of: a single anterior spinal artery, which originates within the cranial cavity as the union of two vessels that arise from the vertebral arteries—the resulting single anterior spinal artery passes inferiorly, approximately parallel to the anterior median fissure, along the surface of t... | Anatomy_Gray. The longitudinal vessels consist of: a single anterior spinal artery, which originates within the cranial cavity as the union of two vessels that arise from the vertebral arteries—the resulting single anterior spinal artery passes inferiorly, approximately parallel to the anterior median fissure, along th... | [
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Anatomy_Gray_191 | Anatomy_Gray | The anterior and posterior spinal arteries are reinforced along their length by eight to ten segmental medullary arteries (Fig. 2.55). The largest of these is the arteria radicularis magna or the artery of Adamkiewicz (Fig. 2.55). This vessel arises in the lower thoracic or upper lumbar region, usually on the left side... | Anatomy_Gray. The anterior and posterior spinal arteries are reinforced along their length by eight to ten segmental medullary arteries (Fig. 2.55). The largest of these is the arteria radicularis magna or the artery of Adamkiewicz (Fig. 2.55). This vessel arises in the lower thoracic or upper lumbar region, usually on... | [
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Anatomy_Gray_192 | Anatomy_Gray | One midline channel parallels the anterior median fissure. One midline channel passes along the posterior median sulcus. These longitudinal channels drain into an extensive internal vertebral plexus in the extradural (epidural) space of the vertebral canal, which then drains into segmentally arranged vessels that conne... | Anatomy_Gray. One midline channel parallels the anterior median fissure. One midline channel passes along the posterior median sulcus. These longitudinal channels drain into an extensive internal vertebral plexus in the extradural (epidural) space of the vertebral canal, which then drains into segmentally arranged vess... | [
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Anatomy_Gray_193 | Anatomy_Gray | The spinal dura mater is the outermost meningeal membrane and is separated from the bones forming the vertebral canal by an extradural space (Fig. 2.59). Superiorly, it is continuous with the inner meningeal layer of cranial dura mater at the foramen magnum of the skull. Inferiorly, the dural sac dramatically narrows a... | Anatomy_Gray. The spinal dura mater is the outermost meningeal membrane and is separated from the bones forming the vertebral canal by an extradural space (Fig. 2.59). Superiorly, it is continuous with the inner meningeal layer of cranial dura mater at the foramen magnum of the skull. Inferiorly, the dural sac dramatic... | [
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Anatomy_Gray_194 | Anatomy_Gray | As spinal nerves and their roots pass laterally, they are surrounded by tubular sleeves of dura mater, which merge with and become part of the outer covering (epineurium) of the nerves. The arachnoid mater is a thin delicate membrane against, but not adherent to, the deep surface of the dura mater (Fig. 2.59). It is se... | Anatomy_Gray. As spinal nerves and their roots pass laterally, they are surrounded by tubular sleeves of dura mater, which merge with and become part of the outer covering (epineurium) of the nerves. The arachnoid mater is a thin delicate membrane against, but not adherent to, the deep surface of the dura mater (Fig. 2... | [
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Anatomy_Gray_195 | Anatomy_Gray | Delicate strands of tissue (arachnoid trabeculae) are continuous with the arachnoid mater on one side and the pia mater on the other; they span the subarachnoid space and interconnect the two adjacent membranes. Large blood vessels are suspended in the subarachnoid space by similar strands of material, which expand ove... | Anatomy_Gray. Delicate strands of tissue (arachnoid trabeculae) are continuous with the arachnoid mater on one side and the pia mater on the other; they span the subarachnoid space and interconnect the two adjacent membranes. Large blood vessels are suspended in the subarachnoid space by similar strands of material, wh... | [
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Anatomy_Gray_196 | Anatomy_Gray | The spinal pia mater is a vascular membrane that firmly adheres to the surface of the spinal cord (Fig. 2.59). It extends into the anterior median fissure and reflects as sleeve-like coatings onto posterior and anterior rootlets and roots as they cross the subarachnoid space. As the roots exit the space, the sleeve-lik... | Anatomy_Gray. The spinal pia mater is a vascular membrane that firmly adheres to the surface of the spinal cord (Fig. 2.59). It extends into the anterior median fissure and reflects as sleeve-like coatings onto posterior and anterior rootlets and roots as they cross the subarachnoid space. As the roots exit the space, ... | [
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Anatomy_Gray_197 | Anatomy_Gray | Laterally, each denticulate ligament forms a series of triangular extensions along its free border, with the apex of each extension being anchored through the arachnoid mater to the dura mater. The lateral attachments of the denticulate ligaments generally occur between the exit points of adjacent posterior and anterio... | Anatomy_Gray. Laterally, each denticulate ligament forms a series of triangular extensions along its free border, with the apex of each extension being anchored through the arachnoid mater to the dura mater. The lateral attachments of the denticulate ligaments generally occur between the exit points of adjacent posteri... | [
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Anatomy_Gray_198 | Anatomy_Gray | Between the walls of the vertebral canal and the dural sac is an extradural space containing a vertebral plexus of veins embedded in fatty connective tissue. The vertebral spinous processes can be palpated through the skin in the midline in thoracic and lumbar regions of the back. Between the skin and spinous processes... | Anatomy_Gray. Between the walls of the vertebral canal and the dural sac is an extradural space containing a vertebral plexus of veins embedded in fatty connective tissue. The vertebral spinous processes can be palpated through the skin in the midline in thoracic and lumbar regions of the back. Between the skin and spi... | [
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0.0725706592202186... |
Anatomy_Gray_199 | Anatomy_Gray | Each spinal nerve is connected to the spinal cord by posterior and anterior roots (Fig. 2.61): The posterior root contains the processes of sensory neurons carrying information to the CNS—the cell bodies of the sensory neurons, which are derived embryologically from neural crest cells, are clustered in a spinal ganglio... | Anatomy_Gray. Each spinal nerve is connected to the spinal cord by posterior and anterior roots (Fig. 2.61): The posterior root contains the processes of sensory neurons carrying information to the CNS—the cell bodies of the sensory neurons, which are derived embryologically from neural crest cells, are clustered in a ... | [
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0.19279348850250244... |
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