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Bone, Muscles of vertebral column

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Presentation on theme: "Bone, Muscles of vertebral column"— Presentation transcript:

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

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

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

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

5 Cervical vertebrae Foramen transversarium : vertebral a.
C3-C6 : short spinous process+bifid : Uncinate process (Uncus) : 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
Lumbarization Sacralization

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

14 Movement Joint of the vertebral column Back muscle and ligament

15 Craniovertebral joint
atlanto-occipital joint - synovial type (condyloid) - Atlanto-occipital membrane - transverse ligament, cruciform ligament - alar ligament, apical ligament - tectorial membrane atlanto-axial joint - synovial type (pivot type) - 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 - PLL Intervertebral disc - Connect vertebrae - Shock absorber - Weight bearing - Component : nucleus pulposus (H2O) : anulus fibrosus (Collagen) Accessory ligament -Ligament flavum -Interspinous ligament -Intertransverse ligament -Supraspinous ligament

18 Zygapophyseal Joint Articular process Accessory ligament
-Ligament flavum -Interspinous ligament -Intertransverse 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
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 Spondylolysis Spondylolisthesis Spondylosis
Spondylitis Whiplash injury Counting vertebrae

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

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

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

26 Deep back muscles (transversospinalis)
Semispinalis Multifidus Rotator Interspinalis Intertransversarius 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. มหกายวิภาคศาสตร์การเคลื่อนไหว. กรุงเทพฯ : พีบีฟอเรนบุคส์ เซนเตอร์; หน้า

31 Good Luck

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

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

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

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