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The Vertebral Column. 33 vertebra in total 7C 12T 5L 5S (fuse by age 30) 4 coccygeal (form coccyx) ¼ of length = IV disc Synovial zygapophysial joints = flexibility. Features of All Vertebrae. Vertebral body Supports weight

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slide2

33 vertebra in total

    • 7C
    • 12T
    • 5L
    • 5S (fuse by age 30)
    • 4 coccygeal (form coccyx)
  • ¼ of length = IV disc
  • Synovial zygapophysial joints = flexibility
features of all vertebrae
Features of All Vertebrae
  • Vertebral body
    • Supports weight
    • Superior and inferior end plates (discs of hyaline cartilage) = epiphyseal rim
    • Centrum (POC)
  • Vertebral arch
    • Pedicles
    • Laminae
    • Vertebral foramen  vertebral canal
    • Vertebral notches  IV foramina
  • Seven processes
    • Spinous
    • Transverse (x2)
    • Articular (x4)
cervical vertebrae
Cervical Vertebrae
  • Transverse process
    • Foramen transversarium / transverse foramin (C1 – C6 = vertebral artery)
    • Anterior and posterior tubercle
  • Body
    • Uncus (uncinate process)
  • Spinous processes – bifid (C3-C6)
  • C7 – vertebra prominens
slide6

Atlas – no body, no spinous process, pedicles = lateral masses (bear weight).

    • Ant / post arch
    • Ant / post tubercles
    • Fovea for the dens
  • Axis
    • Dens (odontoid process)
    • Superior articular facets
    • Transverse ligament of atlas
thoracic vertebrae
Thoracic Vertebrae
  • T1: costal facet for 1st rib, demifacet for 2nd rib
  • T2 – T8 = demifacets, vertical articular processes
    • Permit rotation, some lateral flexion
    • Spinous processes angle inferiorly and overlap
  • T9 – T11: Single costal facet
  • T12: One demifacet, most commonly fractured vertebra
lumbar vertebrae
Lumbar vertebrae
  • Supracristal line crosses L4/L5 IV disc
  • Facets in sagittal plane – permit flexion and extension
  • Also accessory and mammillary processes
  • Lumbosacral angle (normally 130-160)
sacrum
Sacrum
  • Superior half transmits force L5 to ilia
  • Sacral canal (for caudaequina)
  • Sacral foramina (ventral and dorsal)
  • Base = superior surface of S1
    • Sacral promonory
  • Apex = S5
    • Articular facet for coccyx)
  • Pelvic surface = smooth
  • Lateral surface
    • Median / intermediate / lateral sacral crests
    • Sacral hiatus
    • Sacral cornua
coccyx
Coccyx
  • Fuses with sacrum, though Co1 can remain separate (has coccygeal cornua, remnants of articular processes)
  • Provides attachment for glut max, coccygeus, anococcygeal ligaments
  • Apex is palpable 2.5cm posterosuperior to the anus
ligaments of the spine
Ligaments of the Spine
  • Ligamentumflavum (connects laminae)
  • Supraspinous ligament
  • Interspinous ligament
  • Nuchal ligament (occiput-C1-C7)
  • Posterior longitudinal ligament (prevents herniation)
  • Anterior longitudinal ligament (limits extension)
deep intrinsic back muscles
Deep intrinsic back muscles
  • These interconnect and stabilise– found deep to spinalis
  • Semispinalis
  • Multifidus
  • Rotatores (brevis and longus)
  • Interspinales
  • Intertransversarii
bony pelvis
Bony Pelvis
  • 3 bones each side, forms pelvic girdles
  • Oscoxae = ilium, ischium, pubis
  • Ilium
    • Arcuate line
    • Iliac crest
    • Iliac fossa
    • Auricular surface
    • Iliac tuberosity
    • Ala
    • Gluteal lines
    • ASIS, AIIS, PSIS, PIIS
slide20

Ischium

    • Body
    • Ramus (obturator foramen)
    • Greater sciatic notch
    • Ischial spine
    • Lesser sciatic notch
    • Ischial tuberosity
  • Pubis
    • Superior ramus (acetabulum)
    • Inferior ramus
    • Body of pubis
    • Pubic crest
    • Pubic tubercle
    • Pubic symphysis
    • Pecten pubis
muscles of the pelvis
Muscles of the pelvis
  • Lateral wall = obturator internus (traverses lesser sciatic foramen to attach on greater trochanter), obturator fascia
  • Posterior wall = SI joint and piriformis (arises from sacrum, passes through greater sciatic f. to attach to greater trochanter)
  • Pelvic floor = pelvic diaphragm = coccygeus + levator ani
levator ani
Levator ani
  • Broad sheet between pubic bodies and ischial spines. Supports abdominopelvic viscera and is tonically contracted to maintain continence
  • Puborectalis = puborectal sling
  • Pubococcygeous
    • Muscle slips names after structures: pubo-analis, puboperinealis, pubovaginalis, puboprostaticus
  • Iliococcygeus (most posterolateral part).