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VERTEBRAL COLUMN, RIBS & STERNUM . by Isabella Kung. 10. February.2014 Monday. Kaan Yücel M.D., Ph.D. VERTEBRAL COLUMN. Vertebrae + intervertebtal (IV) discs Spine Omurga Main part of the axial skeleton. VERTEBRAL COLUMN.

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slide1

VERTEBRAL COLUMN, RIBS & STERNUM

byIsabella Kung

10. February.2014 Monday

Kaan Yücel M.D., Ph.D.

slide2

VERTEBRAL COLUMN

Vertebrae+ intervertebtal (IV) discs

Spine

Omurga

Main part of theaxialskeleton

slide3

VERTEBRAL COLUMN

fromthecranium (skull) totheapex of thecoccyx

¼ formed by the intervertebral (IV) discs.

IV discsseparateandbindthevertebraetogether.

slide4

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).
slide5

VERTEBRAE

33 vertebraearranged in 5 regions

  • 7 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 4 coccygeal
slide6

Structures of thevertebrae

  • A typicalvertebraconsistsof
  • A Vertebralbody
  • AVertebralarch
  • 7 processes

3-4

2

1

5-6

7

slide7

Posteriorto the vertebral body

  • Consists of two (right and left)pedicles& laminae.
  • VERTEBRAL ARCH
slide9

Successionof vertebral foramina

  • in the articulated vertebral column
  • forms
  • vertebralcanal (spinal canal)
slide10

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.
slide11

Regional Characteristics of Vertebrae

  • vertebraehaving foramina in their transverse processes are cervicalvertebrae
slide12

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.
slide13

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

slide14

CERVICAL VERTEBRAE

skeleton of the neck

between the cranium & thoracic vertebrae

slide15

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
slide16

Vertebrae C3-C7

typicalcervicalvertebrae

Largevertebralforamina

restrictedrotation

superolateralmargin

uncusof the body uncinateprocess

slide17

C7- vertebraprominens

  • A longspinousprocess
  • Mostprominent spinous process in 70% of people
slide18

Atlas (C1)

No body

No spinousprocess

Widestof the cervical vertebrae

Thekidney-shaped, concavesuperiorarticularsurfaces of thelateralmassesarticulatewithoccipitalcondyles.

slide19

strongest of the cervicalvertebrae

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

Axis (C2)

slide20

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.

slide21

THORACIC VERTEBRAE

  • The thoracic skeleton includes:
  • 12 pairs of ribs and associated costal cartilages
  • 12 thoracic vertebrae and the intervertebral discs between them
  • Sternum
slide22

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

slide23

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!

slide24

FEATURES TYPICAL FOR

THORACIC VERTEBRAE

4)Heart-shaped bodies

5) Long, inferiorly slanting spinous processes

slide25

T1

1 COMPLETE SUP. COSTAL FACET

T10 (T9)

1 COMPLETE SUP. COSTAL FACET

NO INF. COSTAL DEMIFACET

T11-12

  • 1 COMPLETE COSTAL FACET
  • NO INF. COSTAL DEMIFACET
  • NO COSTAL FACET ON TRANSVERSE PROCESS
slide26

LUMBAR VERTEBRAE

in the lower back between the thorax and sacrum

slide27

FEATURES TYPICAL FOR

LUMBAR VERTEBRAE

  • massivebodies
  • transverseprocessesprojectposterosuperiorlyas well as laterally.
  • mammillaryprocesses & accessoryprocesses
slide28

SACRUM

L. sacred

Wedged-shaped

Usually composed of 5 fused sacral vertebrae in adults.

Located between the hipbones

Sacralcanal

continuation of thevertebralcanal in thesacrum.

slide30

Anterior projecting edge of the body of the S1 vertebra

Sacral promontory (L. mountain ridge)

importantobstetricallandmark

slide33

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
slide34

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

slide35

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

slide36

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.
slide37

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.
slide39

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.
slide40

Tubercle: located at the junction of the neck and body

  • articulates with the corresponding transverse process of the vertebra
slide41

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.
slide44

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.
  • .
slide45

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.

slide46

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.

slide47

STERNUM

G. sternon, chest

Manubrium

Body

Xiphoidprocess

slide48

sternal angle

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

slide50

Surface Anatomy: Key Landmarks

  • Jugular (suprasternal)notch:T2 vertebra in male, T4 in female
  • Sternalangle (of Louis) T4-T5 vertebra
  • Theborderbetweensuperiorandinferiormediastinum
  • Overliesthetrachealbifurcationandaorticarch
  • Usefulforcountingintercostalspaces(2nd ribsarticulate here).
slide51

Surface Anatomy: Key Landmarks

  • Sternalangle (of Louis) Th 4 –Th5 vertebra
  • Theborderbetweensuperiorandinferiormediastinum
  • Overliesthetrachealbifurcationandaorticarch
  • Usefulforcountingintercostalspaces(2nd ribsarticulate here).
slide53

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.