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The human back, also called the dorsum, is the large posterior area of the
human body The human body is the structure of a Human, human being. It is composed of many different types of Cell (biology), cells that together create Tissue (biology), tissues and subsequently organ systems. They ensure homeostasis and the life, viabi ...
, rising from the top of the buttocks to the back of the
neck The neck is the part of the body on many vertebrates that connects the head with the torso. The neck supports the weight of the head and protects the nerves that carry sensory and motor information from the brain down to the rest of the body. In ...
. It is the surface of the body opposite from the chest and the abdomen. The vertebral column runs the length of the back and creates a central area of recession. The breadth of the back is created by the shoulders at the top and the
pelvis The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The ...
at the bottom. Back pain is a common medical condition, generally benign in origin.


Structure

The central feature of the human back is the vertebral column, specifically the length from the top of the thoracic vertebrae to the bottom of the lumbar vertebrae, which houses the spinal cord in its spinal canal, and which generally has some curvature that gives shape to the back. The ribcage extends from the spine at the top of the back (with the top of the ribcage corresponding to the T1 vertebra), more than halfway down the length of the back, leaving an area with less protection between the bottom of the ribcage and the hips. The width of the back at the top is defined by the scapula, the broad, flat bones of the shoulders. Gray204.png, View of the bones of the thorax and shoulders from behind. Back Muscles.jpg, Posterior view of muscles connecting the upper extremity to the vertebral column.
A Trapezius
B Teres Major
C Teres Minor
D Latissimus Dorsi
E Levator Scapulae
F Rhomboid Major Gray798-back crop.png, Distribution of cutaneous nerves, dorsal aspect. Dorsal and lateral cutaneous branches labeled at center right.


Muscles

The muscles of the back can be divided into three distinct groups; a superficial group, an intermediate group and a deep group.


Superficial group

The superficial group, also known as the appendicular group, is primarily associated with movement of the appendicular skeleton. It is composed of trapezius,
latissimus dorsi The latissimus dorsi () is a large, flat muscle on the back that stretches to the sides, behind the arm, and is partly covered by the trapezius on the back near the midline. The word latissimus dorsi (plural: ''latissimi dorsorum'') comes from L ...
,
rhomboid major The rhomboid major is a skeletal muscle on the back that connects the scapula with the vertebrae of the spinal column. In human anatomy, it acts together with the rhomboid minor to keep the scapula pressed against thoracic wall and to retract the ...
, rhomboid minor and levator scapulae. It is innervated by anterior rami of spinal nerves, reflecting its embryological origin outside the back.


Intermediate group

The intermediate group is also known as respiratory group as it may serve a respiratory function. It is composed of
serratus posterior superior The serratus posterior superior muscle is a thin, quadrilateral muscle. It is situated at the upper back part of the thorax, deep to the rhomboid muscles. Structure The serratus posterior superior muscle arises by an aponeurosis from the l ...
and serratus posterior inferior. Like the superficial group, it is innervated by anterior rami of spinal nerves.


Deep group

The deep group, also known as the intrinsic group due to its embryological origin in the back, can be further subdivided into four groups: * Spinotransversales - composed of splenius capitis and splenius cervicis. *
Erector spinae The erector spinae ( ) or spinal erectors is a set of muscles that straighten and rotate the back. The spinal erectors work together with the glutes (gluteus maximus, gluteus medius and gluteus minimus) to maintain stable posture standing or sittin ...
- composed of iliocostalis, longissismus and spinalis * Transversospinales - composed of semispinalis, multifidus and
rotatores The rotatores muscles (rotatores spinae muscles) lie beneath the multifidus and are present in all spinal regions but are most prominent in the thoracic region; they are eleven in number on either side. Each muscle is small and somewhat quadrila ...
* Segmental muscles - composed of levatores costarum,
interspinales The interspinales are short muscle fascicles, found in pairs between the spinous processes of the contiguous vertebrae, one on either side of the interspinal ligament. * In the cervical region the ''cervical interspinales'' are most distinct, ...
and intertransversarii The deep group is innervated by the posterior rami of spinal nerves.


Organs near the back

The
lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of t ...
s are within the ribcage, and extend to the back of the ribcage making it possible for them to be listened into through the back. The kidneys are situated beneath the muscles in the area below the end of the ribcage, loosely connected to the peritoneum. A strike to the lower back can damage the kidneys of the person being hit.


Surface of the back

The skin of the human back is thicker and has fewer nerve endings than the skin on any other part of the torso. With some notable exceptions (see, e.g.
George "The Animal" Steele William James Myers (April 16, 1937 – February 16, 2017), better known by his ring name George "The Animal" Steele, was an American professional wrestler, school teacher, author, and actor. His career lasted from 1967 until 1988, though he mad ...
), it tends to have less hair than the chest on men. The upper-middle back is also the one area of the body which a typical human under normal conditions might be unable to physically touch. The skin of the back is innervated by the ''dorsal cutaneous branches'', as well as the ''lateral abdominal cutaneous branches of intercostal nerves''.


Movement

The intricate anatomy of the back provides support for the head and trunk of the body, strength in the trunk of the body, as well as a great deal of flexibility and movement. The upper back has the most structural support, with the ribs attached firmly to each level of the thoracic spine and very limited movement. The lower back (lumbar vertebrae) allows for flexibility and movement in back bending (extension) and forward bending (flexion). It does not permit twisting.


Clinical significance


Back pain

The back comprises interconnecting nerves, bones, muscles, ligaments, and tendons, all of which can be a source of pain. Back pain is the second most common type of pain in adults (the most common being headaches). By far the most common cause of back pain is muscle strain. The back muscles can usually heal themselves within a couple of weeks, but the pain can be intense and debilitating. Other common sources of back pain include disc problems, such as degenerative disc disease or a
lumbar In tetrapod anatomy, lumbar is an adjective that means ''of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum.'' The lumbar region is sometimes referred to as the lower spine, or as an area of the back i ...
disc herniation, many types of fractures, such as spondylolisthesis or an osteoporotic fracture, or osteoarthritis.


Society and culture

The curvature of the female back is a frequent theme in paintings, because the sensibilities of many cultures permit the back to be shown nude - implying full nudity without actually displaying it. Indeed, the practice of showing explicitness on the lower back has been performed for centuries. Certain articles of clothing, such as the haltertop and the backless dress, are designed to expose the back in this manner. The lower back is typically exposed frequently by many types of shirts in woman's fashion, and even the more conservative shirts and blouses will reveal the lower back. This happens for a variety of reasons- the lower waist area is a pivot point for the body and lengthens and arches as a person sits or bends. Secondly, woman's fashion typically favors tops that are waist length, allowing the back to be left bare during slight movement, bending or sitting. The back also serves as the largest
canvas Canvas is an extremely durable plain-woven fabric used for making sails, tents, marquees, backpacks, shelters, as a support for oil painting and for other items for which sturdiness is required, as well as in such fashion objects as handbags ...
for body art on the human body. Because of its size and the relative lack of hair, the back presents an ideal canvas on the human body for lower back tattoos, mostly among young women. Indeed, some individuals have tattoos that cover the entirety of the back. Others have smaller tattoos at significant locations, such as the shoulder blade or the bottom of the back. Many English
idiom An idiom is a phrase or expression that typically presents a figurative, non-literal meaning attached to the phrase; but some phrases become figurative idioms while retaining the literal meaning of the phrase. Categorized as formulaic language, ...
s mention the back, usually highlighting it as an area of vulnerability; one must "watch one's back", or one may end up "with one's back up against the wall"; worse yet, someone may "stab one in the back", but hopefully a friend "has got one's back". The back is also a symbol of strength and hard work, with those seeking physical labor looking for "strong backs", and workers being implored to "put their back into it". Historically, flagellation of a person across the back with a whip was both a common form of
punishment Punishment, commonly, is the imposition of an undesirable or unpleasant outcome upon a group or individual, meted out by an authority—in contexts ranging from child discipline to criminal law—as a response and deterrent to a particular acti ...
of criminals, and a common means of forcing slaves to work. As well, self-flagellation, as in self punishment, may include the use of whipping oneself. This is one method of mortification, the practice of inflicting physical suffering on oneself with the religious belief that it will serve as penance for one's own sins or those of others. While more moderate forms of mortification are widely practiced—particularly in the Catholic Church—self flagellation is not encouraged by mainstream religions or religious leaders. A well-known instrument used for flagellations is the infamous Cat 'o Nine Tails, a nine-corded whip with one handle enabling a much more effective whipping than would be possible with only one lashing at a time.


References

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