VERTEBRAL COLUMN, RIBS & STERNUM
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VERTEBRAL COLUMN, RIBS & STERNUM . by Isabella Kung. 6. December.2013 Friday. Kaan Yücel M.D., Ph.D. Vertebrae + intervertebtal (IV) discs Spine Omurga Onurğa Wirbelsäule العمود الفقري Laf dhabar Main part of the axial skeleton. VERTEBRAL COLUMN.

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Vertebral column ribs sternum

VERTEBRAL COLUMN, RIBS & STERNUM

byIsabella Kung

6. December.2013 Friday

Kaan Yücel M.D., Ph.D.


Vertebral column ribs sternum

Vertebrae+ intervertebtal (IV) discs

Spine

Omurga

Onurğa

Wirbelsäule

العمود الفقري

Laf dhabar

Main part of theaxialskeleton

VERTEBRAL COLUMN

Mgongo


Vertebral column ribs sternum

VERTEBRAL COLUMN

fromthecranium (skull) totheapex of thecoccyx

¼ formed by the intervertebral (IV) discs.

IV discsseparateandbindthevertebraetogether.


Vertebral column ribs sternum

VERTEBRAL COLUMN

  • Protectsthespinalcordandspinalnerves.

  • Supportstheweight of the body superiortothelevel of thepelvis.

  • Providesa partlyrigidandflexibleaxisforthe body and an extendedbase on whichthehead is placedandpivots.

  • Plays an important rolein postureandlocomotion

  • (themovementfromoneplacetoanother).


Vertebral column ribs sternum

VERTEBRAE

  • vertebrae(singular = vertebra)

  • separatedbyresilientintervertebral (IV) discs.

  • Vertebralcolumnflexible


Vertebral column ribs sternum

VERTEBRAE

33 vertebraearranged in 5 regions

  • 7 cervical

  • 12 thoracic

  • 5 lumbar

  • 5 sacral

  • 4 coccygeal


Vertebral column ribs sternum

VERTEBRAE

  • Significantmotionoccursbetween24 superiorvertebrae.

  • Of the 9 inferiorvertebrae, 5 sacralvertebraefusedin adultsto form thesacrum

  • After~ 30, the4 coccygealvertebraefuseto form thecoccyx


Vertebral column ribs sternum

VERTEBRAE

becomelargeras thevertebralcolumndescendstothesacrum

thenbecomeprogressivelysmallertowardapexof thecoccyx


Vertebral column ribs sternum

Structures of thevertebrae

  • A typicalvertebraconsistsof

  • A Vertebralbody

  • AVertebralarch

  • 7 processes

3-4

2

1

5-6

7


Vertebral column ribs sternum

  • VERTEBRAL BODY

  • Massive, cylndircal

  • Anteriorpart of the bone

  • Givesstrength to the vertebralcolumn.

  • Supportsbody weight.

  • The size of the vertebral bodiescolumn descends

  • most markedly from T4 inferiorly

  • As each bears progressively greater body weight.


Vertebral column ribs sternum

  • Posteriorto the vertebral body

  • Consists of two (right and left)pedicles& laminae.

  • VERTEBRAL ARCH


Vertebral column ribs sternum

  • vertebralarch + posterior surface of the vertebral body

  • walls of vertebral foramen


Vertebral column ribs sternum

  • Successionof vertebral foramina

  • in the articulated vertebral column

  • forms

  • vertebralcanal (spinal canal)


Vertebral column ribs sternum

  • Vertebral notches(Incisura vertebralis)

  • Indentations observed in lateral views of the vertebrae

  • Superior and inferior to each pedicle

  • Between the superiorand inferior articular processes posteriorly

  • Between the corresponding projections of the body anteriorly.


Vertebral column ribs sternum

  • The superior and inferior vertebral notchesof adjacent vertebrae and the IV discs form intervertebral foramina

  • Intervertebral foramina

  • Spinal (posterior root) ganglia are located

  • Spinal nerves emerge from the vertebral column with their accompanying vessels through these foramina.


Vertebral column ribs sternum

Regional Characteristics of Vertebrae

  • vertebraehaving foramina in their transverse processes are cervicalvertebrae


Vertebral column ribs sternum

  • articularfacetsorientation in eachregiondifferent

  • Movementneeded

  • articularfacets of thoracicvertebraenearlyvertical,

  • define an arc centered in the IV disc

  • this arrangement permits rotation and lateral flexion of the vertebral column in this region.


Vertebral column ribs sternum

  • Regional variations in size and shape of the vertebral canal accommodate the varying thickness of the spinal cord.


Vertebral column ribs sternum

  • CERVICAL VERTEBRAE

skeleton of the neck

between the cranium & thoracic vertebrae


Vertebral column ribs sternum

FEATURES TYPICAL FOR

CERVICAL VERTEBRAE

Smallest of the 24 movablevertebrae

Relatively larger intervertebral discs

discs are thin, but relative to their small size; thick.

  • 3) Greatest range & variety of movement of all the vertebral regions

  • 4) foramen transversariumin the transverse process


Vertebral column ribs sternum

FEATURES TYPICAL FOR

CERVICAL VERTEBRAE

5) anterior tubercles of vertebra C6 carotid tubercles

Chassaignactubercles


Vertebral column ribs sternum

FEATURES TYPICAL FOR

CERVICAL VERTEBRAE

6) Spinousprocesses of C3-C6

short and usually bifid in white people


Vertebral column ribs sternum

Vertebrae C3-C7

typicalcervicalvertebrae

Largevertebralforamina

restrictedrotation

superolateralmargin

uncusof the body uncinateprocess


Vertebral column ribs sternum

  • C7- vertebraprominens

  • A longspinousprocess

  • Mostprominent spinous process in 70% of people


Vertebral column ribs sternum

  • Atlas (C1)

No body

No spinousprocess

Widestof the cervical vertebrae

Thekidney-shaped, concavesuperiorarticularsurfaces of thelateralmassesarticulatewithoccipitalcondyles.


Vertebral column ribs sternum

Anterior and posteriorarches

a tubercle in the center of its externalaspect

extendbetweenthelateralmassesforming a complete ring.

Posteriorarch

A wide groove for the vertebral artery on its superior surface.

C1 nerve also runs in this groove.


Vertebral column ribs sternum

strongest of the cervicalvertebrae

C1, carrying the cranium, rotates on C2 (e.g., when a person turns the head to indicate “no”).

Axis (C2)


Vertebral column ribs sternum

  • Axis (C2)

The distinguishing featureblunt tooth-like dens

Lies anterior to the spinalcord.

Serves as the pivot about which the rotation of the head occurs.


Vertebral column ribs sternum

  • Axis (C2)

  • largebifid spinousprocess


Vertebral column ribs sternum

  • THORACIC VERTEBRAE

  • The thoracic skeleton includes:

  • 12 pairs of ribs and associated costal cartilages

  • 12 thoracic vertebrae and the intervertebral discs between them

  • Sternum


Vertebral column ribs sternum

FEATURES TYPICAL FOR

THORACIC VERTEBRAE

articulation with ribs.

1) Bilateral costal demifacetson the vertebral bodies

for articulation with heads of ribs

2)Costal facets on the transverse processes

for articulation with tubercles of ribs


Vertebral column ribs sternum

FEATURES TYPICAL FOR

THORACIC VERTEBRAE

articulation with ribs.

3) Articular processes of thoracic vertebrae extend vertically

with paired, nearly coronally oriented articular facets define an arc.

greatest degree of rotation is permitted here!


Vertebral column ribs sternum

FEATURES TYPICAL FOR

THORACIC VERTEBRAE

4)Heart-shaped bodies

5) Long, inferiorly slanting spinous processes


Vertebral column ribs sternum

T1-T4 vertebrae share some features of cervical vertebrae.

The middle four thoracic vertebrae (T5-T8) demonstrate all the features typical of thoracic vertebrae.


Vertebral column ribs sternum

T1atypical

1. long, horizontalspinousprocess

Vertebraprominens? No.

2. complete costal facetfor the 1st rib

3. demifacetfor the 2nd rib.

Typicalpattern

1+0.5

1+1 costalfacet

@ transverseprocesses

0.5+0.5demifacet

0.5+0.5demifacet


Vertebral column ribs sternum

[T9]-T10vertebrae

No inferiordemifacet

1+1 costalfacet

@ transverseprocesses

0.5+0.5demifacet

T11-T12vertebrae

No transverse costal facets

1 completefacet on eachside

1+1 demifacet


Vertebral column ribs sternum

mostcommonlyfracturedvertebra

T12

superiorhalfthoracic in character

costalfacets& articular processes

inferiorhalflumbar in character

nocostalfacets

articular processes that permit only flexion and extension.


Vertebral column ribs sternum

  • LUMBAR VERTEBRAE

in the lower back between the thorax and sacrum


Vertebral column ribs sternum

FEATURES TYPICAL FOR

LUMBAR VERTEBRAE

  • massivebodies

  • transverseprocessesprojectposterosuperiorlyas well as laterally.

  • mammillaryprocesses & accessoryprocesses


Vertebral column ribs sternum

  • SACRUM

L. sacred

Wedged-shaped

Usually composed of 5 fused sacral vertebrae in adults.

Located between the hipbones

Sacralcanal

continuation of thevertebralcanal in thesacrum.


Vertebral column ribs sternum

On the pelvic and posterior surfaces of the sacrum

four pairs of sacralforamina


Vertebral column ribs sternum

Anterior projecting edge of the body of the S1 vertebra

Sacral promontory (L. mountain ridge)

importantobstetricallandmark


Vertebral column ribs sternum

The sacrum supports the vertebral column and forms the posterior part of the bony pelvis.

The sacrum is tilted so that it articulates with the L5 vertebra at the lumbosacral angle.

Eur Spine J. 2009 Feb;18(2):212-7. Epub 2008 Nov 18.

Assessment of lumbosacral kyphosis in spondylolisthesis: a computer-assisted reliability study of six measurement techniques.

Glavas P, Mac-Thiong JM, Parent S, de Guise JA, Labelle H.


Vertebral column ribs sternum

  • The pelvic surface of the sacrum is smooth and concave.

  • 4 transverselines

  • Fusion of the sacral vertebrae starts after age20.


Vertebral column ribs sternum

The dorsal surface of the sacrum

marked by five prominent longitudinal ridges.

mediansacralcrest

fused rudimentary spinous processes of the superior three or four sacralvertebra


Vertebral column ribs sternum

Intermediate sacral crestsfusedarticularprocesses

Lateral sacral creststips of the transverse processes of fusedsacralvertebrae


Vertebral column ribs sternum

Inverted U-shaped sacral hiatus

Sacral cornua (L. Horns)

The sacral hiatus leads into the sacral canal.

Thesacralcornua, representingtheinferiorarticularprocesses of S5 vertebra, projectinferiorly on eachside of thesacralhiatusandare a helpfulguidetoitslocation.


Vertebral column ribs sternum

The superior part of the lateral surface of the sacrum

auricularsurface


Vertebral column ribs sternum

  • COCCYX

  • tailbone;kuyruksokumu

  • A small triangular bone

  • Formedby fusion of 4 rudimentary coccygeal vertebrae.

  • Co1 may remain separate from the fused group.

  • Rudimentaryarticularprocesses @ post. surface


Vertebral column ribs sternum

  • Last 3 coccygeal vertebrae often fuse during middlelife

  • forminga beak-likecoccyx

  • Aging- A single bone!

  • Muscularattachment!

  • No contributiontosupport of the body weight in standing!

Coccydynia


Vertebral column ribs sternum

VARIATIONS IN VERTEBRAE

33

32 or 34

race, gender, and developmental factors (genetic and environmental)

34

32

Lumbarsacralization


Vertebral column ribs sternum

VARIATIONS IN VERTEBRAE

  • A CRANIAL SHIFT

  • Acervical rib articulates with C7

  • Rib12 is small.

  • L5partially "sacralized" .

  • S5partially freed

  • B Commonarrangement

  • C CAUDAL SHIFT

  • Rib12 is large.

  • Asmall lumbar rib is present.

  • S1 partially "lumbarized" .

  • Co1 is incorporated into the sacrum


Vertebral column ribs sternum

Curvatures in the Vertebral Column

1. The neck or cervical spine, curves gently inward (lordosis)

2. The mid back, or thoracic spine, curved outward (kyphosis)

3. The low back, or lumbar spine, also curves inward (lordosis)

4. Pelvic (Sacral) curvature


Vertebral column ribs sternum

  • RIBS, COSTAL CARTILAGES, AND INTERCOSTAL SPACES

  • Ribs(L. costae) are curved, flat bones that form most of

  • the thoracic cage.

  • Remarkably light in weight yet highly resilient.

  • Each rib has a spongy interior containing bone marrow

  • (hematopoietic tissue), which forms blood cells.


Vertebral column ribs sternum

  • There are three types of ribs that can be classified as

  • typical or atypical

  • True (vertebrocostal) ribs (1st-7th ribs):

  • They attach directly to the sternum through their own costal cartilages.

  • False (vertebrochondral) ribs (8th, 9th, and usually 10th ribs):Their cartilages are connected to the cartilage of the rib above them; thus their connection with the sternum is indirect.

  • Floating (vertebral, free) ribs (11th, 12th, and sometimes 10th ribs):

  • The rudimentary cartilages of these ribs do not connect even indirectly with the sternum; instead they end in the posterior abdominal musculature.


Vertebral column ribs sternum

  • Typical ribs (3rd-9th) have the following components:

  • Head: wedge-shaped and has two facets, separated by the crest of the head; one facet for articulation with the numerically corresponding vertebra and one facet for the vertebra superior to it.

  • Neck: connects the head of the rib with the body at the level of the tubercle.


Vertebral column ribs sternum

  • Tubercle: located at the junction of the neck and body

  • articulates with the corresponding transverse process of the vertebra


Vertebral column ribs sternum

  • Body (shaft): thin, flat, and curved, most markedly at the costal angle where the rib turns anterolaterally.

  • The angle also demarcates the lateral limit of attachment of the deep back muscles to the ribs.

  • The concave internal surface of the body has a costal groove paralleling the inferior border of the rib, which provides some protection for the intercostal nerve and vessels.


Vertebral column ribs sternum

  • Atypical ribs (1st, 2nd, and 10th-12th) are dissimilar:

  • The 1st rib is the broadest (i.e., its body is widest and nearly horizontal), shortest, and most sharply curved of the 7 true ribs.

  • A single facet on its head for articulation with the T1 vertebra only 2 transversely directed grooves crossing its superior surface for the subclavian vessels; the grooves are separated by a scalene tubercle and ridge, to which the anterior scalene muscle is attached.

  • .


Vertebral column ribs sternum

The 2nd ribis has a thinner, less curved body and is substantially longer than the 1st rib.

Its head has two facets for articulation with the bodies of the T1 and T2 vertebrae.

Main atypical feature is, the tuberosity for serratus anterior

a rough area on its upper surfacefrom which part of that muscle originates


Vertebral column ribs sternum

  • 10th-12th ribs, like the 1st rib, have only one facet on their heads and articulate with a single vertebra.

  • 11th and 12th ribs are short and have no neck or tubercle.


Vertebral column ribs sternum

  • Costal cartilages

  • Prolong the ribs anteriorly

  • Contribute to the elasticity of the thoracic wall

  • Provide a flexible attachment for their anterior ends (tips).

  • The cartilages increase in length through the first 7 and then gradually decrease.

  • .


Vertebral column ribs sternum

Intercostal spaces

Separate the ribs and their costal cartilages from one another.

Named according to the rib forming the superior border of the space.

4th intercostal space lies between ribs 4 and 5.

11 intercostal spaces and 11 intercostalnerves

intercostalmuscles and membranes, and two sets (main and collateral) of intercostal blood vessels andnerves

identified by the same number assigned to the space.


Vertebral column ribs sternum

  • The space below the 12th ribsubcostalspace

  • Anteriorramus (branch) of spinal nerve T12 subcostalnerve.


Vertebral column ribs sternum

  • The intercostal spaces

  • widestanterolaterally

  • widenfurther withinspiration

  • furtherwidened by extension and/or lateral flexion of the thoracic vertebral column to the contralateralside.


Vertebral column ribs sternum

STERNUM

G. sternon, chest

Flat, elongated bone

Forms the middle of the anterior part of the thoracic cage.

Affords protection for mediastinal viscera in general and much of the heart in particular.


Vertebral column ribs sternum

STERNUM

G. sternon, chest

Manubrium

Body

Xiphoidprocess


Vertebral column ribs sternum

A roughly trapezoidal bone.

Widest and thickest of the three parts of thesternum

Manubrium

L.. handle, as in the handle of a sword, with the sternal body forming theblade


Vertebral column ribs sternum

  • jugular notch (suprasternal notch)

The easily palpated concave center of superior border of manubrium.

Deepened by the medial (sternal) ends of the clavicles, which are much larger than the relatively small clavicular notches in the manubrium that receive them, forming the sternoclavicular (SC) joints.


Vertebral column ribs sternum

Inferolateral to the clavicular notch, the costal cartilage of the 1st rib is

tightly attached to the lateral border of themanubrium.

synchondrosis of the firstrib


Vertebral column ribs sternum

  • sternal angle

The manubrium and body of the sternum in slightly different planesmanubriosternaljointsternalangle (of Louis)


Vertebral column ribs sternum

Body of the sternum (Corpus sterni)

Longer, narrower, and thinner than the manubrium.

Located at the level of the T5-T9 vertebrae.

Its width varies because of the scalloping of its lateral borders by the costal notches.

.

Gladiolus


Vertebral column ribs sternum

Smallest and most variable part of the sternum

Thin and elongated

Inferior end lies at the level of T10 vertebra.

  • Xiphoid process


Vertebral column ribs sternum

Surface Anatomy: Key Landmarks

  • Jugular (suprasternal)notch:T2 vertebra in male, T4 in female

  • Sternalangle (of Louis) Th 4 vertebra

  • Theborderbetweensuperiorandinferiormediastinum

  • Overliesthetrachealbifurcationandaorticarch

  • Usefulforcountingintercostalspaces(2nd ribsarticulate here).


Vertebral column ribs sternum

  • Xiphoidprocessan important landmark in the medianplane

  • Itsjunction with the sternal body at the xiphisternal joint

  • inferior limit of the central part of the thoracic cavity

  • Xiphisternaljointsite of the infrasternal angle (subcostal angle) formed by the right and left costal margins

  • Midlinemarker forsuperiorlimit of the liver, centraltendon of the diaphragm, inferiorborder of the heart.


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