VERTEBRAL COLUMN VERTEBRAL COLUMN
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1 VERTEBRAL COLUMN FUNCTIONS: 1) Support weight - transmits weight to pelvis and lower limbs 2) Houses and protects spinal cord - spinal nerves leave cord between vertebrae 3) Permits movements - *clinical problems 4) Provides for muscle attachments - muscles of back; also muscles of head, neck, upper extremity, thorax VERTEBRAL COLUMN
2 A. TYPICAL VERTEBRA by convention thoracic 1. BODY anterior, solid transmits weight 2. VERTEBRAL ARCH posterior, surrounds vertebral canal, spinal cord; consists of a) PEDICLES project from body b) LAMINAE unite to form arch posteriorly ant. NOSE BODY VERTEBRAL { ARCH PEDICLE TRANSVERSE PROCESS- LATERAL LAMINA SPINOUS PROCESS - POSTERIOR 3. TRANSVERSE AND SPINOUS PROCESSES - projections from arch for muscle, ligament attach
3 LATERAL VIEW OF VERTEBRA NOSE 4. Spinal nerves leave vertebral canal via INTERVERTEBRAL FORAMINA -between vertebrae; bordered by Superior and Inferior Vertebral Notches Sup. Vertebral Notch Inf. Vertebral Notch 5. SUPERIOR AND INFERIOR ARTICULAR PROCESSES - (zygapophyses) - Articular facets form joints between adjacent vertebrae (Orientation of facets determines movement) 6. Bodies - joined by intervertebral discs
4 B. REGIONS OF VERTEBRAL COLUMN Cervical (neck) - 7 vertebrae (C1-C7) Thoracic (chest) - 12 vertebrae (T1-T12) Lumbar (lower back) - 5 vertebrae (L1-L5) Sacral (pelvis) - 5 fused vertebrae (S1-S5) Coccygeal (tail) vertebrae (Co1-Co3) - Structure of vertebrae differ in different regions - Some cervical vertebrae are uniquely identifiable (ex. C1, C2 and C7)
5 CERVICAL VERTEBRA BODY ant. body is small Foramen Transversarium - in transverse process (C1-C7) for Vertebral artery & veins TRANSVERSE PROCESS post. SPINOUS PROCESS bifid (divided) for Ligamentum nuchae lat. view ARTICULAR FACETS - angled superiorly & medially
6 FIRST CERVICAL VERTEBRA = C1 (ATLAS) LATERAL MASS ANTERIOR ARCH POSTERIOR ARCH Ant. tubercle Post. tubercle 1) has no body only ring of bone 2) anterior & posterior arches and lateral mass 3) bumps on arches- ant. & post. tubercles 4) has foramina transversaria 5) superior articular facets to occipital bone of skull; permits Flex-Ext yes move head SECOND CERVICAL VERTEBRA = C2 (AXIS) DENS 1) has peg-like odontoid process = Dens (may be fused body of C1) 2) joint between C1-C2 is pivot joint allowing rotation; Rotation = no move head important in hanging
7 SEVENTH CERVICAL VERTEBRA = C7 (VERTEBRA PROMINENS) Small foramina transversaria- transmit only Vertebral Veins (Vert. Artery through C1-C6) Spinous process- long and not bifid; can be palpated externally to tell vertebral level
8 THORACIC VERTEBRA (12) BODY heart-shaped; larger than cervical vertebrae (bodies of vertebrae increase in size in rostral-caudal sequence) COSTAL FACETS for ribs on - body - transverse process COSTAL FACET ON BODY COSTAL FACET ON TRANSVERSE PROCESS
9 RIBS- have bumps for articulation with vertebra Vertebrae Dorsal view of skeleton Ribs Head Articulates with facet on Body Tubercle Articulates with facet on Transverse process
10 CT OF THORACIC VERTEBRA
11 LATERAL VIEW OF THORACIC VERTEBRA Spines inclined Inf. post ant 3. Costal Facets for Ribs - Body - Facets for Heads of rib Transverse Process - Facets for Tubercles of ribs 4. Spines of thoracic vertebraelong and inclined posteriorly & inferiorly Articular process 5. Articular Processes in coronal plane Note: Bodies increase in size from rostral to caudal
12 LUMBAR VERTEBRA spinous process lamina pedicle Bodies - hefty Pedicles - stout Lamina - thick Spinous Processes- broad body Articular processes in sagittal plane
13 Ant. View SACRUM = 5 FUSED VERTEBRAE Lateral Mass = fused transverse processes Post. View Sacro- Iliac Joint Anterior & posterior sacral foramina = Intervertebral Foramina for sacral spinal nerves Medial Crest = fused spinous processes Sacro-Iliac Joint- transmits weight from vertebrae to pelvis (Innominate Bone)
14 COCCYX = 3-5 FUSED VERTEBRAE RUDIMENTARY TAIL BONES
15 1) SAGITTAL PLANE - divides body in RIGHT and LEFT parts (Median Sagittal Plane-divides body into right and left halves) 2) CORONAL PLANE - divides body into FRONT and BACK parts 3) HORIZONTAL PLANE Plane = transverse plane - cross section-divides body into TOP and BOTTOM parts perpendicular to long axis of body ANATOMICAL PLANES Coronal Sagittal Horizontal
16 C. LIGAMENTS Adjacent vertebrae held tightly together (protect spinal cord) 1. ANTERIOR LONGITUDINAL LIGAMENT - Strong band joins bodies on anterior side Anterior view
17 View down column CORONAL SECTION - through Vertebral Canal (view ligaments as if standing in vertebral canal) anterior posterior SAGITTAL SECTION actually in median sagittal plane
18 On post. Side of bodies VIEW FROM INSIDE VERTEBRAL COLUMN LOOK ANTERIOR LOOK POSTERIOR 2. POSTERIOR LONGITUDINAL LIGAMENT- weaker, narrower band 3. LIGAMENTA FLAVA - yellow elastic bands connecting laminae
19 SAGITTAL SECTION 4. INTERSPINOUS AND SUPRASPINOUS LIGAMENTS - connect spines INTERSPINOUS ANT SUPRASPINOUS Greatly thickened in cervical region to form LIGAMENTUM NUCHAE- from Ext. Occip. Protuberance of skull to C7; Support Head, Provide muscle attachments
20 SUMMARY: LOCATION OF LIGAMENTS BODY 1. ANTERIOR LONGITUDINAL LIGAMENT LAMINA 2. POSTERIOR LONGITUDINAL LIGAMENT 3. LIGAMENTA FLAVA SPINOUS PROCESS 4. INTERSPINOUS AND SUPRASPINOUS LIGAMENTS
21 D. JOINTS BETWEEN VERTEBRAE 1. Joints between articular processes - anatomically classed as plane joints (synovial joint permits gliding or sliding movements) 2. Joints between bodies - formed by intervertebral discs Articular Process Space for intervertebral disc
22 JOINTS BETWEEN VERTEBRAE 1. Joints between articular processes - synovial plane joints permit Sliding Movements 2. Intervertebral Discinterposed between bodies
23 STRUCTURE/ FUNCTION OF INTERVERTEBRAL DISC Shock absorbers in young quite strong trauma to vertebra produces fractures a) Nucleus pulposusinner gelatinous core b) Anulus fibrosus - collagen fibers & fibrocartilage
24 DAMAGE TO INTERVERTEBRAL DISC Postero-lateral lateral post SPINAL NERVE In older people. 1) degenerative changes in anulus fibrosus (start in teens) 2) strain back can cause herniation of nucleus pulposus = Slipped Disc Typically in Postero-Lateral Direction, lateral to Posterior Longitudinal Ligament; often L4-L5 or L5-S1; can lead to nerve compression at intervertebral foramen
25 E. MOVEMENTS OF VERTEBRAL COLUMN a. Extension b. Flexion d. Rotation = rotation about long axis of spinal column -Bend anterior -Bend posterior c. Lateral flexion - Bend lateral
26 MOVEMENTS OF VERTEBRAE IN DIFFERENT REGIONS- Determined by orientations of articular facets a. CERVICAL (C3-C7)- permit considerable flexionextension, lateral flexion, rotation - useful-move head b. THORACIC permit some rotation - little or no flex-extend (also limited by ribs); useful- no flex down on heart, lungs c. LUMBAR permit flex-extend, little or no rotation; useful- help increase abdominal pressure; dangerous- increase load, pressure on vertebral discs Cervical (C3-C7) - facets angled superiorly and medially Thoracic - facets in coronal plane Lumbar- facets in sagittal plane
27 F. SPINAL CURVATURES - some normal, some abnormal 1. Normal Primary curvature - fetal position - curved concave anteriorly NOSE IS ANTERIOR Primary Remains in adult Thorax Secondary concave Sacrum Secondary
28 2. Normal Secondary Curvatures Develop in early childhood NOSE IS ANTERIOR Ant Post Cervical curvature Lumbar curvature a. Cervical curvature - concave posteriorly - help support head b. Lumbar curvature - concave posteriorly - develops with walking - helps support trunk, upper body c. Lateral curvature - Right handed concave to side opposite handedness - helps to carry bags of money R L
29 3. ABNORMAL CURVATURES a. KYPHOSIS - hump back, exaggerated curvature concave anteriorly Concave anteriorly Usually in thorax of elderly
30 b. SCOLIOSIS - abnormal lateral curvature ( kink in spine)
31 SCOLIOSIS- can be due to 'presence of hemivertebra' - ½ of vertebra fails to develop HEMI- VERTEBRA
32 ABNORMAL CURVATURE - LORDOSIS c. LORDOSIS = exaggerated lumbar curvature Concave posteriorly
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