2VERTEBRAL COLUMN Vertebrae + intervertebtal (IV) discs Spine Omurga OnurğaWirbelsäuleالعمود الفقريLaf dhabarMain part of the axial skeletonVERTEBRAL COLUMNMgongo
3VERTEBRAL COLUMN from the cranium (skull) to the apex of the coccyx ¼ formed by the intervertebral (IV) discs.IV discs separate and bind the vertebrae together.
4VERTEBRAL COLUMN Protects the spinal cord and spinal nerves. Supports the weight of the body superior to the level of the pelvis.Provides a partly rigid and flexible axis for the body and an extended base on which the head is placed and pivots.Plays an important role in posture and locomotion(the movement from one place to another).
6VERTEBRAE 33 vertebrae arranged in 5 regions 7 cervical 12 thoracic 5 lumbar5 sacral4 coccygeal
7VERTEBRAE Significant motion occurs between 24 superior vertebrae. Of the 9 inferior vertebrae, 5 sacral vertebrae fused in adults to form the sacrumAfter ~ 30, the 4 coccygeal vertebrae fuse to form the coccyx
8VERTEBRAE become larger as the vertebral column descends to the sacrum then become progressively smaller toward apex of the coccyx
9Structures of the vertebrae A typical vertebra consists ofA Vertebral bodyA Vertebral arch7 processes3-4215-67
10VERTEBRAL BODY Massive, cylndircal Anterior part of the bone Gives strength to the vertebral column.Supports body weight.The size of the vertebral bodies column descendsmost markedly from T4 inferiorlyAs each bears progressively greater body weight.
11VERTEBRAL ARCH Posterior to the vertebral body Consists of two (right and left) pedicles & laminae.VERTEBRAL ARCH
12walls of vertebral foramen vertebral arch + posterior surface of the vertebral bodywalls of vertebral foramen
13Succession of vertebral foramina in the articulated vertebral column formsvertebral canal (spinal canal)
14Vertebral notches (Incisura vertebralis) Indentations observed in lateral views of the vertebraeSuperior and inferior to each pedicleBetween the superior and inferior articular processes posteriorlyBetween the corresponding projections of the body anteriorly.
15The superior and inferior vertebral notches of adjacent vertebrae and the IV discs form intervertebral foraminaIntervertebral foraminaSpinal (posterior root) ganglia are locatedSpinal nerves emerge from the vertebral column with their accompanying vessels through these foramina.
16Regional Characteristics of Vertebrae vertebrae having foramina in their transverse processes are cervical vertebrae
17articular facets orientation in each region different Movement neededarticular facets of thoracic vertebrae nearly vertical,define an arc centered in the IV discthis arrangement permits rotation and lateral flexion of the vertebral column in this region.
18Regional variations in size and shape of the vertebral canal accommodate the varying thickness of the spinal cord.
19between the cranium & thoracic vertebrae CERVICAL VERTEBRAEskeleton of the neckbetween the cranium & thoracic vertebrae
20Smallest of the 24 movable vertebrae FEATURES TYPICAL FORCERVICAL VERTEBRAESmallest of the 24 movable vertebraeRelatively larger intervertebral discsdiscs are thin, but relative to their small size; thick.3) Greatest range & variety of movement of all the vertebral regions4) foramen transversarium in the transverse process
215) anterior tubercles of vertebra C6 carotid tubercles FEATURES TYPICAL FORCERVICAL VERTEBRAE5) anterior tubercles of vertebra C6 carotid tuberclesChassaignac tubercles
226) Spinous processes of C3-C6 short and usually bifid in white people FEATURES TYPICAL FORCERVICAL VERTEBRAE6) Spinous processes of C3-C6short and usually bifid in white people
23typical cervical vertebrae Vertebrae C3-C7typical cervical vertebraeLarge vertebral foraminarestricted rotationsuperolateral marginuncus of the body uncinate process
24Most prominent spinous process in 70% of people C7- vertebra prominensA long spinous processMost prominent spinous process in 70% of people
25Atlas (C1) No body No spinous process Widest of the cervical vertebrae The kidney-shaped, concave superior articular surfaces of the lateral masses articulate with occipital condyles.
26Anterior and posterior arches a tubercle in the center of its external aspectextend between the lateral masses forming a complete ring.Posterior archA wide groove for the vertebral artery on its superior surface.C1 nerve also runs in this groove.
27strongest of the cervical vertebrae C1, carrying the cranium,» rotates on C2 (e.g., when a person turns the head to indicate “no”).Axis (C2)
28Axis (C2) The distinguishing feature blunt tooth-like dens Lies anterior to the spinal cord.Serves as the pivot about which the rotation of the head occurs.Axis (C2)
31THORACIC VERTEBRAE The thoracic skeleton includes: 12 pairs of ribs and associated costal cartilages12 thoracic vertebrae and the intervertebral discs between themSternum
32articulation with ribs. FEATURES TYPICAL FORTHORACIC VERTEBRAEarticulation with ribs.1) Bilateral costal demifacets on the vertebral bodiesfor articulation with heads of ribs2) Costal facets on the transverse processesfor articulation with tubercles of ribs
33greatest degree of rotation is permitted here! FEATURES TYPICAL FORTHORACIC VERTEBRAEarticulation with ribs.3) Articular processes of thoracic vertebrae extend verticallywith paired, nearly coronally oriented articular facets define an arc.greatest degree of rotation is permitted here!
35T1-T4 vertebrae share some features of cervical vertebrae. The middle four thoracic vertebrae (T5-T8) demonstrate all the features typical of thoracic vertebrae.
360.5+0.5 demifacet T1 atypical 1+0.5 1+1 costal facet 1. long, horizontal spinous processVertebra prominens? No.2. complete costal facet for the 1st rib3. demifacet for the 2nd rib.Typical pattern1+0.51+1 costal facet@ transverse processesdemifacet
370.5+0.5 demifacet 1+1 demifacet [T9]-T10 vertebrae 1+1 costal facet No inferior demifacet1+1 costal facet@ transverse processesdemifacetT11-T12 vertebraeNo transverse costal facets1 complete facet on each side1+1 demifacet
38T1 T10 (T9) T12 1 COMPLETE SUP. COSTAL FACET NO INF. COSTAL DEMIFACETT121 COMPLETE COSTAL FACETNO INF. COSTAL DEMIFACETNO COSTAL FACET ON TRANSVERSE PROCESS
39T12 most commonly fractured vertebra superior half thoracic in charactercostal facets & articular processesinferior half lumbar in characterno costal facetsarticular processes that permit only flexion and extension.
40in the lower back between the thorax and sacrum LUMBAR VERTEBRAEin the lower back between the thorax and sacrum
41transverse processes project posterosuperiorly as well as laterally. FEATURES TYPICAL FORLUMBAR VERTEBRAEmassive bodiestransverse processes project posterosuperiorly as well as laterally.mammillary processes & accessory processes
42SACRUM L. sacred Wedged-shaped Usually composed of 5 fused sacral vertebrae in adults.Located between the hip bonesSacral canalcontinuation of the vertebral canal in the sacrum.
43On the pelvic and posterior surfaces of the sacrum four pairs of sacral foramina
44Anterior projecting edge of the body of the S1 vertebra Sacral promontory (L. mountain ridge)important obstetrical landmark
45The 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 Feb;18(2): 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.
46The pelvic surface of the sacrum is smooth and concave. 4 transverse linesFusion of the sacral vertebrae starts after age 20.
47The dorsal surface of the sacrum marked by five prominent longitudinal ridges.median sacral crestfused rudimentary spinous processes of the superior three or four sacral vertebra
48Intermediate sacral crests fused articular processes Lateral sacral crests tips of the transverse processes of fused sacral vertebrae
49Inverted U-shaped sacral hiatus Sacral cornua (L. Horns)The sacral hiatus leads into the sacral canal.The sacral cornua, representing the inferior articular processes of S5 vertebra, project inferiorly on each side of the sacral hiatus and are a helpful guide to its location.
50The superior part of the lateral surface of the sacrum auricular surface
52tailbone;kuyruksokumu COCCYXtailbone;kuyruksokumuA small triangular boneFormed by fusion of 4 rudimentary coccygeal vertebrae.Co1 may remain separate from the fused group.Rudimentary articular post. surface
53Last 3 coccygeal vertebrae often fuse during middle life forming a beak-like coccyxAging- A single bone!Muscular attachment!No contribution to support of the body weight in standing!Coccydynia
54VARIATIONS IN VERTEBRAE 3332 or 34race, gender, and developmental factors (genetic and environmental)3234Lumbar sacralization
55VARIATIONS IN VERTEBRAE A CRANIAL SHIFTA cervical rib articulates with C7Rib 12 is small.L5 partially "sacralized" .S5 partially freedB Common arrangementC CAUDAL SHIFTRib 12 is large.A small lumbar rib is present.S1 partially "lumbarized" .Co1 is incorporated into the sacrum
56Curvatures 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
57RIBS, COSTAL CARTILAGES, AND INTERCOSTAL SPACES Ribs (L. costae) are curved, flat bones that form most ofthe thoracic cage.Remarkably light in weight yet highly resilient.Each rib has a spongy interior containing bone marrow(hematopoietic tissue), which forms blood cells.
58There are three types of ribs that can be classified as typical or atypicalTrue (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.
60Typical 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.
61Tubercle: located at the junction of the neck and body articulates with the corresponding transverse process of the vertebra
62Body (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.
64Atypical 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..
65Main atypical feature is, the tuberosity for serratus anterior The 2nd rib is 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 anteriora rough area on its upper surfacefrom which part of that muscle originates
6610th-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.
67Costal cartilagesProlong the ribs anteriorlyContribute to the elasticity of the thoracic wallProvide a flexible attachment for their anterior ends (tips).The cartilages increase in length through the first 7 and then gradually decrease..
6811 intercostal spaces and 11 intercostal nerves 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 intercostal nervesintercostal muscles and membranes, and two sets (main and collateral) of intercostal blood vessels and nervesidentified by the same number assigned to the space.
69The space below the 12th rib subcostal space Anterior ramus (branch) of spinal nerve T12 subcostal nerve .
70widest anterolaterally widen further with inspiration The intercostal spaceswidest anterolaterallywiden further with inspirationfurther widened by extension and/or lateral flexion of the thoracic vertebral column to the contralateral side.
71STERNUM 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.
72STERNUMG. sternon, chestManubriumBodyXiphoid process
73Manubrium A roughly trapezoidal bone. Widest and thickest of the three parts of the sternumManubriumL.. handle, as in the handle of a sword, with the sternal body forming the blade
74jugular 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.
75synchondrosis of the first rib Inferolateral to the clavicular notch, the costal cartilage of the 1st rib istightly attached to the lateral border of the manubrium.synchondrosis of the first rib
76sternal angleThe manubrium and body of the sternum in slightly different planes manubriosternal joint sternal angle (of Louis)
77Body 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
78Xiphoid process Smallest and most variable part of the sternum Thin and elongatedInferior end lies at the level of T10 vertebra.Xiphoid process
80Surface Anatomy: Key Landmarks Jugular (suprasternal)notch:T2 vertebra in male, T4 in femaleSternal angle (of Louis) Th 4 vertebraThe border between superior and inferior mediastinumOverlies the tracheal bifurcation and aortic archUseful for counting intercostal spaces (2nd ribs articulate here).
82inferior limit of the central part of the thoracic cavity Xiphoid process an important landmark in the median planeIts junction with the sternal body at the xiphisternal jointinferior limit of the central part of the thoracic cavityXiphisternal joint site of the infrasternal angle (subcostal angle) formed by the right and left costal marginsMidline marker for superior limit of the liver, central tendon of the diaphragm, inferior border of the heart.