Anatomy of the Neck and Back

• Author: Michael J. Morse
• Pages: 103-124

CHAPTER 2

Anatomy of the

Neck and Back

I. Spinal Column

A. Anatomy

§ 2:10 Introduction

§ 2:20 Vertebrae

§ 2:30 Intervertebral Discs

§ 2:40 Ligaments

§ 2:50 Fascia

§ 2:60 Muscles

§ 2:61 Muscles of the Neck: Anatomic Limits, Innervation and

Function

B. Injury

§ 2:70 Overview

II. Nervous System

A. Anatomy

1. Spinal Cord

§ 2:80 Introduction

§ 2:90 Major Membranes

2. Nerve Roots

§ 2:100 Introduction

§ 2:110 Dermatomes and Myotomes

3. Relationship of Spinal Nerves and Intervertebral Discs

§ 2:120 Introduction

§ 2:121 Innervation

§ 2:130 Cervical Region

§ 2:131 Blood Supply to the Cervical Spine Column

§ 2:132 Cervical Radiculopathy

§ 2:140 Thoracic Region

§ 2:141 Brachial Plexus

§ 2:150 Lumbar Region

B. Injury

§ 2:160 Overview

III. Checklist

§ 2:170 Chapter Checklist

LITIGATING NECK AND BACK INJURIES

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§ 2:10

2-2

I. Spinal Column

A. Anatomy

§ 2:10 Introduction

A personal injury lawyer must accomplish two

goals when preparing to examine physicians

during a trial. First, the lawyer must learn

almost as much medicine as the witnesses in

order to control direct examination and con-

duct an effective cross-examination. Although

the attorney will seldom be as knowledgeable

or versatile in the medical field as a physician,

a certain level of sophistication is necessary to

ensure effectiveness.

Second, the lawyer must be able to present

sophisticated material to a group of ordinary

people: the jurors. A good attorney can reduce

even the most complicated neck or back case

to basic, simple terms. The following discussion

presents a basic understanding of the impor-

tant anatomical structures relevant to neck,

back and soft tissue injuries. Although this

text is generally sufficient for presenting most

cases to the jury, the attorney should review an

anatomy text to develop a greater insight into

this topic before examining or cross-examining

a medical witness.

A lawyer in a case that involves neck or back

injuries should have a basic familiarity with

the components of the neck and back in order

better to understand their functioning and the

diagnosis and treatment of their injury. The

most important components of the neck and

back are the:

• vertebrae (see §2:20)

• intervertebral discs (see §2:30)

• spinal cord (see §§2:80, 2:90)

• nerve roots (see §§2:100, 2:110)

• ligaments (see §2:40) and

• muscles (see §2:60).

While the anatomy of each can be extremely

technical, their basic structures and interre-

lationship may be reduced to manageable lay

terms.

The prospect of developing an in-depth under-

standing of the anatomy of the neck and back

can seem intimidating at first glance. However,

determination coupled with repeated exposure

to these issues will allow you to become well-

versed in the area. Take the following steps to

enhance your understanding the anatomy of

the neck and back:

• Do not gloss over medical reports.

Take the time to look up terms that are

unfamiliar to you and study the anatomy

described and evaluated by the physicians

involved in the case.

• Study anatomical models.

Take every opportunity to study anatomi-

cal models of the neck and back struc-

tures. For instance, ask physicians if they

could show you any models they have in

their office.

• Review popular literature.

Popular magazines often have health

related articles that are written for a lay

audience.

• Purchase medical texts.

Purchasing well-recognized medical texts

allows you to research an issue when it

arises rather than later when you find

time to visit a medical library, greatly

increasing your comprehension. Ask phy-

sicians in your area to recommend books.

The spinal column consists of the articulated

cervical, thoracic, lumbar, sacral and coccygeal

(pronounced kok sij’ e al) vertebrae. See Plate

2:1. These are the bony building blocks of the

spine and are connected by various ligaments

with intervertebral discs cushioning successive

vertebrae. Working together, the vertebrae, liga-

ments and discs protect the spinal cord, sup-

port the body, and permit movement. Of these

regions, only the cervical and lumbar have an

appreciable degree of mobility.

§ 2:20 Vertebrae

There are 33 vertebrae in the spine: 7 cervi-

cal, 12 thoracic, 5 lumbar, 5 sacral (fused into

one), and 4 coccygeal (fused into one). Since

most people regard the sacrum and coccyx as

a single unit, it is common to refer to only 26

vertebrae in humans. See Plate 2:1.