The back refers to the region on the posterior surface of the trunk which extends from the inferior border of the neck to the gluteal region. The layers of the back comprise the skin, subcutaneous tissue, superficial (extrinsic) and deep (intrinsic) back muscles, the posterior portion of the ribs, and the vertebral column housing the spinal cord and surrounding meninges.
The back performs several important functions including housing and protecting the spinal cord, holding the body and head upright, bearing the weight of the upper body, transmitting this weight to the pelvic girdle and lower limbs when standing or walking, and facilitating the movements of the upper and lower limbs.
Regions of the back
The back and the buttocks comprise the posterior aspect of the trunk. Like the rest of the body, the back and the buttocks are divided into several regions, which help clinicians localize, describe and communicate various diseases and injuries clearly and accurately.
The regions of the back are the suprascapular, scapular, interscapular, infrascapular, vertebral, lateral pectoral, lumbar and sacral regions.
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The vertebral column (spine) is composed of 33-35 vertebrae, of which 24 are separated by intervertebral discs. The remaining vertebrae are usually fused to form two distinct bones: the sacrum and the coccyx. The vertebral column is divided into five regions, from superior to inferior: cervical, thoracic, lumbar, sacral, and coccygeal.
The vertebrae articulate with each other by connecting their bodies and arches via intervertebral joints. These joints are present throughout the entire spine, while some regions have specific types of joints, such as the thoracic spine with the ribs.
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Superficial muscles of the back
The superficial muscles of the back are located beneath the skin and superficial fascia of the back and extend between the vertebral column and bones of the pectoral girdle and arm.
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Deep (intrinsic) muscles of the back
Their main functions include maintaining the body posture as well as facilitating the movements of the vertebral column.
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Neurovasculature of the back
The structures of the back are supplied by several important arteries, veins, and nerves. The arterial supply arises from several main sources: directly from the aorta for much of the posterior thorax and abdomen, or via the subclavian arteries in the neck and scapular regions.
The veins of the back and neck mainly drain into the brachiocephalic veins, azygos venous system, and inferior vena cava. The nervous supply mainly arises from the cervical, thoracic and lumbar spinal nerves.
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