Notes on Back and Nervous System

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Types of vertebrae:

• Cervical vertebrae: 7

• Thoracic vertebrae: 12

• Lumbar vertebrae: 5

• Sacral vertebrae: 5

What is Nucleus Pulposus?

• Herination in posterolateral direction; may compress a nerve.

• Osteophytes: compress vertebral artery in transverse foramina and prevent blood flow to brain.

• Lumbar puncture: done through interlaminar spaces; performed at L4-L5.

Spinal Nerve Rami:

• Spinal nerve = dorsal and ventral rami.

• Ventral ramus innervates skin of back and deep muscles of back, and zygopophyseal joints.

• Anterior ramus innervates anterior and lateral portions of body wall and limbs.

Meninges (Inner to Outermost):

1. Pia mater.

2. Subarachnoid space (filled with CSF).

3. Arachnoid.

4. Dura mater.

5. Epidural space (filled with fat + plexus of veins).

Spinal tap:

• Done at level L4, which is at level of cauda equina.


• Motor innervation of smooth, cardiac, and glands of body.

• Two types: sympathetic (thoracolumbar) and parasympathetic (craniosacral).

ANS neurons:

• Preganglionic neuron has cell body in CNS.

• Postganglionic neuron has cell body in motor ganglion in PNS.

• CNS > preganglionic fiber w/ cell body > PNS ganglion > postganglionic fiber w/ cell body > target.

Lumbar puncture layers (superficial to deep):

1. Skin.

2. Superficial fascia.

3. Deep fascia.

4. Supraspinous ligament.

5. Interspinous ligament.

6. Interlaminar space.

7. Epidural space.

8. Dura.

9. Arachnoid.

10. Subarachnoid space.

Additional Notes:

• Filum terminale: composed only of pia mater; attached to tip of coccyx.

• Lumbar and sacral spine vertebrae lack costal facets.

• Hemi-vertebrae produce scoliosis.

• Knee jerk is a proprioceptive reflex of: femoral nerve.

• Hunchback: kyphosis.

• Best way to diagnose gall stones: ultrasound.

• Lower motor neurons found in: anterior horn.

• Fasciculus cuneatus begins at: T6 in spinal cord.

• Dorsal nucleus of Clarke receives group 1a and 1b fibers from lower limbs.

• Stretch reflex: type Ia and type II sensory fibers.

• Dorsal root afferents of spinal cord: medial consists of type C and lateral consists of type A.

Additional Reading:

Histology and Cytology

1. Cell Components
2. Nervous Tissue
3. Muscle Tissue
4. Lymphoid Tissue
5. Integument
6. Respiratory System
7. Gastrointestinal System
8. Renal/Urinary System
9. Male Reproductive System
10. Female Reproductive System

Gross Anatomy

1. Back and Nervous System
2. Thorax
3. Abdomen, Pelvis, and Perineum
4. Upper Limb
5. Lower Limb
6. Head and Neck
7. Chest Wall
8. Shoulder

Anatomy Videos

1. Video of Musculoskeletal Examination in a Clinical Setting
1. Video of HEENT Examination in a Clinical Setting

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1. Jugular Venous Distention Workup

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