Vertebral Column Osteology z z z Osteology and Arthrology Primary Curve A P View z 7 C 12 T 5 L 5 S Fused as Sacrum 4 coccygeal Primary Curves Secondary Curves Anterior Posterior alignment Vertebral Segments Secondary Curves Lateral 1 Vertebral Column Osteology z z z z z Typical Vertebrae Typical Lumbar Typical Vertebrae Body Superior and inferior surfaces of body plateaus Thickened around the rim location of epiphyseal plates Cartilaginous end plates Vertebral Arch Pedicles Laminae Transverse Processes Spinous Process Facets superior articular and inferior articular Spinal Foramen Intervertebral Foramen Typical Vertebrae Typical Thoracic 2 Typical C Vertebral Relationships Sacrum and Coccyx Arthrology z z z z z Intervertebal Discs Intervertebral Discs Fibrocartilaginous joints Increase in size from C to L 3mm to 9 mm Ratio remains the same Make up 20 30 of length of column Discs 3 Discs Arthrology z z z Arthrology z z z z z Anulus encloses a central mass called the nucleus pulposus About 80 90 water less with increased age Contains a mucopolysaccharide matrix Changes shape releases and absorbs water Thicker in AM than PM Neither blood vessels or nerves penetrate nucleus Arthrology z z z z Two Components Outer rim of fibrocartilage called the anulus fibrosus attaches to cartilaginous end plate Connects vertebral bodies in a fibrocartilaginous joint no capsule little motion Arthrology z z z z Structure deforms when pressure is put on vertebral column as in weight bearing Acts as a shock absorber Annulus totally encloses the nucleus and keeps it under constant pressure As you get older the H2O content decreases and the nucleus becomes more fibrocartilaginous therefore less easily deformable and more easily damaged Vertebral Relationships Nucleus when under extreme pressure can herniate or extrude from the disc in a posterior or posterior lateral direction Usually occurs in cervical or lumbar region Nucleus can put pressure on spinal nerve causing refereed symptoms motor and sensory Can cause pressure on cord itself if true posterior 4 Facet Joints C and T Arthrology z z z z z Facets L Arthrology z z z z Major Ligaments of the Spine z z Typical movements in sections of the spine Lumbar Thoracic Cervical ALL Anterior Longitudinal Ligament ALL Dense band along anterior and lateral surface of the vertebral bodies from C2 to sacrum z Facet Joints Typical Superior articular facets of one vertebrae with inferior facets of vertebrae above Synovial gliding joints Surrounded by joint capsule and small capsular ligaments The type and amount of motion in any given part of the spine is dictated by the orientation of the articular facets as well as the fluidity elasticity and thickness of the intervertebral discs Superficial bridge several vertebrae Deep short run from V to V blends with fibers of anulus fibrosus Limits extension of V column From C1 to skull called Atlanto Occipital Membrane 5 A and P Longitudinal Ligament Atlanto Occipital Membrane Major Ligaments z PLL Posterior Longitudinal Ligament Runs along posterior surface of vertebral bodies anterior to spinal canal C2 to Sacrum Short fibers attach ligament to posterior disc reinforce disc posteriorly z z Superiorly continues to occiput called Tectorial Membrane Limits flexion Tectorial Membrane Ligaments z Supraspinous Spinous process to spinous process tip to tip C7 to sacrum z z z Limits flexion In cervical region becomes much thicker with a greater elastic content Called Ligamentum Nuchae 6 Supraspinous Ligamentum Nuchae Ligaments z z z z Interspinous Interspinous Found between spinous processes Most well developed in lumbar region support Interspinous Ligaments z z z z z Ligamentum Flavum Connects lamina of one to lamina of the other Found from axis to sacrum Limit flexion Continuation to the skull is called Posterior Atlanto Occipital membrane 7 Ligamentum Flavum Atlanto Occipital MembranePosterior Ligaments Special Joints of Spine z z z z Intertransverse Only well developed in Lumbar Region Between transverse processes Limit lateral flexion z z z Lumbo Sacral Jt Lumbo Sacral L5 and S1 or sacrum Drastic change from lordotic to kyphotic curve Strong shearing forces The sacral segment is inclined anteriorly and inferiorly forms an angel with the horizontal called the lumbosacral angle Angle can be increased significantly with an increase in lumbar curve During flexion extension the greatest mobility of the spine occurs between L5 and S1 L5 S1 8 L5 S1 z z Spondylolysis a developmental anomaly of the lamina wherin a bony defect separates the sup and inf Articular processes thus separating the post Part of the neural arch from the ant Arch and the vertebral body Usually asymptomatic very common in males L5 S1 z Spondylolistheses an anterior movement of the L5 vertebral body and can cause compression of the cauda equina which rests posteriorly Lumbarization z S and S Superior aspect of the sacrum assumes characteristics of the 5th lumbar vertebrae Sacralization z Where 5th lumbar vertebrae takes on characteristics of the sacrum and may be partially or completely fused with sacrum S I Joint z z z z z Review Hip Bone AKA Innominate AKA Os Coxae Ilium Ischium and Pubis Fuse at Puberty Acetabulum Pelvis 2 coxal bones the sacrum and coccyx 9 Innominate Bone AKA Hip Sacrum Pelvis Female Pelvis S I S I Joint z z z Auricular surface of ilium with auricular surface of sacrum Little movement Joint under relatively constant pressure to rotate anteriorly based on anatomical design Upper part of joint is not synovial is fibrous held in place by tough Interrosseous S I ligaments helps limit anterior motion 10 S I Joint S I Joint S I Synovial Aspect of Joint S I Joint z z z z z z Major Ligaments mostly designed to prevent ant motion Posterior S I runs down and medially from ilium to sacrum Iliolumbar L4 and 5 transverse processes to posterior iliac crest Anterior S I ilium to sacrum Sacrotuberous iliac tuberosity and post Surface of lower sacrum to ischial tuberosity Sacrospinous lateral borders of lower sacrum and coccyx to attach to the spine of ischium S I Joint Pubic Symphysis z z z z z z Anterior connection of pelvis Fibrocartilaginous joint Limited motion Motion increase dramatically during pregnancy especially at the time of birth Similar increase in SI joint mobility at this time Superior and Inferior Pubic Ligaments 11 Pubic Symphysis Atlanto Axial Joint z z z z z Atlas and Axis Pivot Two convex superior facets of axis with two concave