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Bone, Muscles of vertebral column By Prof. Pasuk Mahakkanukrauh, MD.

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Presentation on theme: "Bone, Muscles of vertebral column By Prof. Pasuk Mahakkanukrauh, MD."— Presentation transcript:

1 Bone, Muscles of vertebral column By Prof. Pasuk Mahakkanukrauh, MD

2 Vertebral Column Vertebrae : cervical (C) : thoracic (T) : thoracic (T) : lumbar (L) : lumbar (L) : sacrum (S) : sacrum (S) : coccyx (Co) : coccyx (Co) Function : Protection : Weight bearing : Weight bearing : Movement : Movement

3 Normal Curvature of Vertebral Column Primary Curvature Secondary Curvature Clinical correlation : kyphosis : thoracic kyphosis : lordosis : lumbar lordosis : lordosis : lumbar lordosis : scoliosis : myopathic, idiopathic : scoliosis : myopathic, idiopathic

4 Vertebrae Vertebral Body : weight bearing Vertebral Arch : Protection : pedicle : pedicle : lamina : lamina : spinous process : spinous process : articular process : articular process : transverse process : transverse process * Vertebral foramen * Vertebral (spinal) canal * Vertebral (spinal) canal Component

5 Cervical vertebrae Foramen transversarium : vertebral a. C3-C6 : short spinous process+bifid : Uncinate process (Uncus) : Uncinate process (Uncus) : Luschka Joint : Luschka Joint C1 : Atlas C2 : Axis C7 : prominens spinous process Facet joint : horizontal

6 Atlas Articular facet : kidney No spinous process No body Anterior-posterior tubercle Lateral mass Anterior-posterior arch

7 Axis Dens or Odontoid process Bifid big spinous process

8 Thoracic vertebrae Costal facet Long spinous process Body : Heart shape : T5-8 T1-4 : cervical like T9-12 : lumbar like Facet joint : oblique

9 Lumbar vertebrae Big body : L5 No costal facet Body : kidney shape Big transverse process Lumbosacral angle Facet joint : vertical

10 Sacrum : anterior Fusion 5 sacrum Triangular shape Lateral mass Sacral foramina Sacral promontary

11 Sacrum : posterior Median crest Intermediate sacral crest Lateral sacral crest Sacral hiatus Sacral cornua

12 Clinical Application Epidural (caudal) anesthesia or block LumbarizationSacralization

13 Coccyx 4 Remnant…..1 Coccygeal cornua No weight bearing ** Coccygonia

14 Movement Joint of the vertebral column Joint of the vertebral column Back muscle and ligament Back muscle and ligament

15 Craniovertebral joint atlanto-occipital joint - synovial type (condyloid) - synovial type (condyloid) - Atlanto-occipital membrane - transverse ligament, cruciform ligament - transverse ligament, cruciform ligament - alar ligament, apical ligament - alar ligament, apical ligament - tectorial membrane - tectorial membrane atlanto-axial joint - synovial type (pivot type) - synovial type (pivot type) - transverse ligament - transverse ligament Uncovertebral (Luschka) joint

16 Joint of the vertebral column Joint of vertebral body Joint of vertebral arch - zygapophyseal (facet) joint

17 Joint of vertebral body Main ligament - ALL - ALL - PLL - PLL Intervertebral disc - Connect vertebrae - Connect vertebrae - Shock absorber - Shock absorber - Weight bearing - Weight bearing - Component : nucleus pulposus (H2O) - Component : nucleus pulposus (H2O) : anulus fibrosus (Collagen) : anulus fibrosus (Collagen) Accessory ligament -Ligament flavum -Ligament flavum -Interspinous ligament -Interspinous ligament -Intertransverse ligament -Intertransverse ligament -Supraspinous ligament -Supraspinous ligament

18 Zygapophyseal Joint Articular process Accessory ligament -Ligament flavum -Ligament flavum -Interspinous ligament -Interspinous ligament -Intertransverse ligament -Intertransverse ligament -Supraspinous ligament -Supraspinous ligament

19 Biomechanic : C-spine Most Movement Occipitoatlantoaxial complex - O-C1 : main F/E, no rotation - C1-C2 : main rotation, no lateral rotation Lower cervical spine - C3-C7 : F/E, lateral flexion, rotation

20 Biomechanic : T-spine main rotation, lateral flexion main rotation, lateral flexion mild F/E : facet joint, costal cartilage, spinous process

21 Biomechanic : L-spine Weight bearing main F/E, lateral flexion, no rotation

22 Clinical correlation SpondylolysisSpondylolisthesisSpondylosisSpondylitis Whiplash injury Counting vertebrae

23 Back Muscles Extrinsic back muscles - superficial layer : trapezius,latissimus dorsi - superficial layer : trapezius,latissimus dorsi - middle layer : serratus posterior, levator costarum - middle layer : serratus posterior, levator costarum Intrinsic back muscles : deep layer - superficial back muscles - superficial back muscles - middle back muscles - middle back muscles - deep back muscles - deep back muscles

24 Superficial back muscles Splenius muscle - splenius capitis - splenius capitis - splenius cervicis - splenius cervicis ** Cervical flexion: levator scapulae, sternocleidomastoid,scalenus ant.-medius Cervical extension

25 Middle back muscles Ertector spinae (sacrospinalis) m. - Iliocostalis - Iliocostalis - Longissimus - Longissimus - spinalis - spinalis *** Function: back extension *** Function: back extension *** Back strain *** Back strain

26 Deep back muscles (transversospinalis) SemispinalisMultifidusRotatorInterspinalisIntertransversarius levator costarum

27 Middle-deep layer : back extension **** back flexion : abdominal m.

28 Abdominal Muscles External Oblique Internal Oblique Transversus Abdominis Rectus abdominis

29 Stability of spine Ligaments : ALL, PLL, LF, Interspinous lig. Back muscles

30 Reference ผาสุก มหรรฆานุเคราะห์. มหกาย วิภาคศาสตร์การเคลื่อนไหว. กรุงเทพฯ : พีบีฟอเรนบุคส์ เซน เตอร์ ; 2547. 294 หน้า

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32 Neck Flexion Neck Flexion - Sternocleidomastoid - Scalenus muscle - Levator scapulae Neck Extension - Splenius muscle

33 Trunk Flexion Trunk Flexion - Abdominal muscle EO,IO,TA,RA Trunk Extension - Erector spinae - Deep layer of back muscle (multifidus, rotator, interspinalis, intertransversalis)

34 Trunk lateral bending Trunk lateral bending Anterior-posterior Abdominal muscle Ipsilateral contraction Trunk rotation - Ipsilateral contraction IO - Contralateral EO - Multifidus


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