Basic and Clinical Anatomy of the Spine, Spinal Cord, and Ans

450 Pages·1995·66.23 MB·English

by  Gregory D. Cramer

BASIANDC CLINICANAALT OMY OFT HE
SPINES,P INALC ORD,
ANDANS
BASIC CLINICAL ANATOMY OF
AND THE
SPINES,P INALC ORD,
ANDANS
GREGORYD .C RAMER ,D .C.Ph,.D .
ProfessDoerp,a rtmeonftAn atomy
Deano fR esearch,
TheN ationCaolU egeo fC hiropractic
SUSAN A. DARBY ,P h.D.
AssociaPtreo fessor
DepartmeonftA natomy
AssistAacnatd emiDce an
TheN ationCaoll legoefC hiropractic
Illustrator'
ALLY A.C UMMINGS Mol\., M. .
PhotograjJher
RON MENSCHIN G
wit2h9 3i llustrations
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CramerG,r egorDy.
Basiacn dc linicaanla tomoyf t hes pines,p inaclo rda,n dAN S /
GregorDy. C ramerS,u saAn. D arbyi;U ustraStaoUryA, . C ummings;
photographReorn,M ensching.
p. cm.
Includbeisb liograprehfiecraeln caensd i ndex
ISBN0 -8016-6467-5
1. Spinaclo rd-Anatomy. 2. Spine-Anatomy.3 . Autonomince rvous
system-AnalOmy.I . DarbyS,u saAn. 11. Title.
[DNlM: I. SpinaClo rd-anatom&y h istology2.. AutonomiNce rvous
System-anatom&y h istology.WL 400 C889b 1995)
QM465.C73 1995
611' .82-dc20
DNlM!DlC
forL ibraorfyC ongress 94-30169
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98 99 00 01 02 / 9 8 7 6 5 4 3 2
Contriblltors
WIL.LL\;\( E.B ACIIOP,P h.D.
Professor
DepartmeonftA natomy
TheN ationCaolU egeo fC hiropractic
8\ {L\\ .B \A"KKUM,D . ., ph.. D
.
AssistParnotf essor
DepartmeonftA natomy
TheN ationCaoll legoefC hiropractic
DARRYL L D\LEY,P h.D.
AssistParnto fessor
DivisioofnN aturaSlc iencaen dM athematics
SnowC ollege
CJl-\E-SO, R'OG. M.D.,P h.D.
AssociaPtreo fessor
DepartmeonftA natomy
TheN ationCaoll legoefC hiropractic
PETERC. SlATHOPOlL OS,M .Ed �.l..S D.C.
..
Professor
Departmeonft Anatomy
TheN ationCaoll legoefC hiropractic
v
To
Chris andD avid
Dave,K atherinaen,d J ason
Thanky ouf ory ouri nvaluasbulpep orpta,t iencaen,de ncouragement
throughotuhtew ritionfgt hitse xt.
Forewords
DrsC.r amera ndD arbyw,i tht hea blaes sistaonfcc eo l­ Thisi nevitalbelayd tso c omprehensioofnt heu nderly­
leagueisn Anatomya nd Physioloagty t heN ational ingp rinciples inavnodlf vaecdi litaantaetso mirce ason­
Collegoef C hiroprachtaivc,ec reatead r emarkabrlee­ inga nd easiearc quisitoifo and ditionmaolr phologic
sourcfeo rb othc liniciaanndss tudents. factasn dc oncepts.
Basiacn d ClinicAanla tomyo ft heS pineS,p inal Fort hec liniCitahni,bs o okp rovides essential back­
Corda,n dA NS isd esignetdo f acilitaa lteea rneru'ns­ groundk nowledgfeo rt hes afaen da ppropricaatree o f
derstandionfig m portant anactoonmciecp tasn dt heir patienwtist hn euromusculoskedliestoarld eorfs the
relationsthoci lpi nipcraalc ticTeh.em osti mportaanst­ spineV.a luabclhea ptehrasv eb eeni ncludoend t hes ur­
pectosf t hibso oki ncludceo mprehensicvoev eragoef facea natomyo ft heb ack,m uscletsh ati nfluentchee
spinaaln atomayn dr elatneedu roanatowmiyt hc leaerx ­ spinep,a ino f spinaolr igina,n d the microscopic
planatioonfss t ructurrealla tionshtihpees x;t ensiuvsee anatomoyf t hezy gapophysejaoli natnsd i ntervertebral
ofi Uustratiaonndsp hotograpthos e nhancea natomic discSsp.e cieamlp hasiissp laceodn stnlCtutrheasmt a y
detaialn;d n umerouwse ll-referecnlciendi pceaalr ltsh at bea ffectbeydm anual spinal tecEhancihcq huaepst.e irs
relaaten aotmy toc liniccaarle . extensivreelfye rencIeh di.g hly recommtehnidis n valu­
Anatomyf aculatnyd s tudenwtisl filn dt hatth ibso ok abler esourcteoa lslt udenatnsd p ractitiownheor rse g­
goesb eyonda mered escriptoifot nh es tructuorfet he ularclayr ef orp atienwtist hs pinadli sorders.
spinea ndn ervolslyss temI.ts etosu tt oe xplaihno w a
Alan H.A damsD,. C.
structudreev elopetdo,u ncovepra tteronfsd istribution,
Vice PrefsoPirrd oefnets Asfifoaniarls
andt of ostaenra ppreciatoifto hne m orphologbiacs iosf
Los AngeCloeUse geo fCh iropractic
variatiAonna.t omifca ctasr ep resentweidt hitnh ec on­ WhittieCra,l ifornia
texotf t heimru tuarle lationsahnidpc sl inircealle vance.
viii
Medicatle xtbooakrseu suaLtlayr getaetdt hei nterests clearalnyd c onciseTlhye.s electioofmn a teriiasal p pro­
anenle edso fu ndergradumaetdei caslt udentWsh.i leo n priatfeo rb otht heu ndergradusattued enatn df ora ny­
oneh andt hihse lppsr ovidae c ommon languagameo ng onei nt hefi eld wishtions go liditfhye ifro undatioonrs
healtcha rep rovideirtsf ,r equendtoleys n otd oj ustitcoe "brusuhp "f ore xaminations.
seversaple ciaarle aosf c oncertno t hosset udenatnsd Inr ecognitoifot nh eh ighlvyi sunaalt uroef a natomy,
practitioinnetresr esitnen de uromusculoskefluentca­l thet exti ss upplementweidt hd etailieldl ustrations,
tionN.o wherei st hadte ficienmcoyr ea pparentth ani n many inf ulclo lorI.n a dditiomna,n y high-quaplhiot­y
thea natomoyf t hes pinaen do ft hea utonomince rvous tographtsa keno fc arefcuald avedri ssectiroenisn force
systemt,w oa reatsh aatr eo fp articurlealre vantcoec lin­ further impocrotnacnetp tisnt hea natomoyf s pinarle ­
icaplr actiTchei.sh asp lacead b urdeonn t hosien volved gionsI.b elietvhea tth iiss p articulhaerllpyf tuolt hes tu­
int het eachionfga natomya,sw ella so n thosdee siring dento fa natomwy ho isa skedt od issetchte s pinarle ­
toe xtentdh eikrn owledgbee yondt her athetre rsdee ­ giona ideodn lyb ya tlases, dwohn iocthd o justitcoet he
scriptioonf st heset opicasv ailabilne m osta natomy regioFni.n allIya ,m veryp leasebdy thea dditioofnr a­
texts. diographcso,m putedt omogramsa,n d magnetirce so­
TherefoIr ree ceivweidt he nthusiatshme n ewst hat nancei magesW.i tht hep roliferatoifdo ina gnostic imag­
DrsC.r amera ndD arbyw eree mbarkingo n a projectto ingt echnoloignyc linicparla cticcoem esa speciiaml­
creatae t extth awto uldr emediamtaen yo ft hed eficien­ portancien presentirnagd iographainCa tomyi n a
cieisn e xistiannga tomitce xtbookSso.m eo fm y excite­ mannert hats upportfsu rthesrt udyo f radiographic
mentc amef romt hef actth atI havek nownt hesaeu ­ pathologIyn.s hortI, b elievteh att hitse xtfi llasn im­
thorfso rm anyy earasn dh aver ecogniztehde icro mmit­ portandte ficienciyn modern medical anatomy text­
ment to undergraduaatned graduateed ucatioMny. booksa ndw ilble a valuabalded ititoona nyl ibrary.
optimiswma sb asedo n thek nowledgteh atth eitre ach­
Rand S. SwensMo.nD..P ,IlD. .DC.. .
ing methoadnsd styloef expositihoand been" field
DepartmenotfA natomya ndS ectioonfN eurology
testedo"n literatlhloyu sandosf studentosv erm ore
DartmoutMhe dicaSlc hooaln dD artmoutll-HircMhecdoicckaC le nter
thana d ecadeI.a m pleasetdos ayt hatth ep roduct does EditoJro, urnoaftl b Nee llromllscu!»lsotsekme letal
notd isappoiTnhte. a uthors predsifefinctu lcto ncepts
ix
Preface
Currenatn atomtye xttsh adte scritbhee s pines,p inal book throughm any illustratainodn psh otograpthos
corda,n da utonomince rvoussy stefmr equendtilsyc uss helpt her eadeers tablias thh ree-dimensiimoangaelo f
thimsa teriianla rathegre nerawla y.O ftent hep agedse ­ thes pines,p inaclo rda,n da utonomince rvoussy stem.
votedt ot hesteo picasr es cattertehdr oughotuhte t ext, The secondp urposoef t het extw as accomplished
deemphasizeodr, r elegatteod l atecrh apterAst. t he witha thorougshe arcohf t hec urrenlti teratiunsr pei nal
othere nd of thes pectrums,e verahli ghlsyp ecializeda natomyw,i tht her esulotfs m any otfh esec linically
textosn spinaaln atomdye scriab e singrleeg ioonf t he relevasnttu diiensc ludeidnt het extE.v ent hought he
spineI.n s omei nstanceevse ns ubregioonfst hev erte­ sciencoefa natomiys v eryo lda, s urprisilnagrlgyne u m­
braclo lumns,u cha st hei ntervertdeibsrcaoslr i nterver­bero f studierse latetdo spinaaln atomyc ontinuteo
tebrfaolr aminbae,c omet hes olteo piocf t het extT.h ese appeari nt hes cielltific liTtheer aptausrt1e .5y ears
generaaln ds pecialitzeexdt bso ths erviem portapnutr ­ havea lsos eena n explOSioonf new neuroanatomic
posesH.o weverw,e feltth aat neede xistefdo ra cohe­ information.
sivew,e ll-illustterxactto evde risnpgi naaln atomyw,h ich Including retshuel otfs r ecenitn vestigasttiuvdei es
includetdh en euroanatoomfyt hes pinaclo rda ndt he alsop rovidead m eansb y whicht het hirodb jectiovfe
autonomic nersvyosutse ams w ell. thibso okw asa ttainTehdi.s o bjectiwvaes tos ervaes a
Thep urposoef t hibso oki st hreefold: bridgbee tweetnh eb asiscc iencoefa natomayn dt hea p­
• To providaen accuraatned c omplettee xft ors tu­ plieadn atomoyf c linicparla cticTeh.r oughoutth et ext
dentss tudyintgh es pines,p inaclo rd,a nd auto­ ther esulotfsc linicarlellye varnets earhcahv eb eenp re­
nomicn ervoussy stem. sentewdi tha redn ilreu nninbge sidteh,u sp rovidian g
• To servaes a reliabrleef erentcoes pinaaln atomy rapirde ferentcoet hicsl inically applicable information.
and relatende uroanatofmoyr c liniciaannds r e­ IIIa dditioan c,h apteorn paing eneratoarnsdp ainp ath­
searchers. wayso ft heb ackh asb eeni nclude(dC hapte1r)1 .Th is
• To helpb ridgteh eg apb etweetnh eb asiscc ience chaptefro cuseosn thosset nICtutrheasct a nb e a source
of anatomya nd thea pplieadn atomyo f clinical of backp aina ndd etails the mbayn wnheirc ht her e­
practice. sultinnogc iceptsitvien1 ualriet ransmitatneddp erceived
To accomplitshhe f irsptu rposteh ea natomyo ft he byt hep atient.
spines,p inaclo rda,n da utonomince rvoussy steims o r­ Numerousm agnetirce sonanciem aginsgc ansh ave
ganizewdi thb otht hes tudenatn dt hec liniciinam ni nd. beeni ncludetdh roughoutth ist extT.h e purposeo f
Thefi rscth apteorn surfacaen atompyr ovidbeost ht he thessec aniss n oto nlyt od emonstractlei nicarlellye vant
neophytaen dt hes easonecdl inicwiiatnh a valuabrlee­ anatomyb,u ta lstoo a idt het mfamiliraera debre ginning
source-ac omprehensive ovfi eswu rfaclea ndmarks thee xcitipnrgo cess loefa rnicnrgo ss-sectsipoinnaall
andt hev ertebrlaelv elofsc linicarlellye vasnttr uctures.a natomyw,h ichi so ftecnl eralyd emonstratoend t hese
Generaclo ncepts aalrseeo m phasizetdh roughotuhte scans.
xi
xii PREFACE
Thisb ooki sd esignetdos ervteh en eedsa ndi nterestsi ndexeFdi.n altlhye,i nclusiooftn h er esulotfsr ecenrte ­
ofm anyg roupsT.h eb asiacn atomayn dc onceptssh ould searcsht udieassw, e lla sd iscussioonn sc linically related
be an aidt ot heb eginninsgt udenotf s pinaaln atomy topicwsi,l hlo pefulslpya rikn tereasntdh ighlitghheti m­
whethetrh eyb ea llopatohsitce,o pathcihci,r opracotri c, portanocfet hes pinfeo rt hen ew studentas sw,e lals t he
physictahle rapsyt udentTsh.e texsth ouladl spor ovide experienciendd ividual.
a readys ourcfeo rt hosei nc linicparla ctidcees irian g
GregoDry. C ramer
rapirde ferenocne a specifict opirce latteodt hes pine,
SusaAn.D arby
sincet heb ooki sa rrangetdo picalalnyd exhaustively