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Vertebral Column

Vertebral Column. Osteology. 7 C, 12 T, 5 L, 5 S (Fused as Sacrum), 4 coccygeal Primary Curves Secondary Curves Anterior/Posterior alignment. Primary Curve. Vertebral Segments. A-P View. Secondary Curves Lateral. Vertebral Column. Osteology. Typical Vertebrae Body

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Vertebral Column

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  1. Vertebral Column

  2. Osteology • 7 C, 12 T, 5 L, 5 S (Fused as Sacrum), 4 coccygeal • Primary Curves • Secondary Curves • Anterior/Posterior alignment

  3. Primary Curve

  4. Vertebral Segments

  5. A-P View

  6. Secondary Curves Lateral

  7. Vertebral Column

  8. Osteology • 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

  9. Typical Vertebrae

  10. Typical Vertebrae

  11. Typical Lumbar

  12. Typical Thoracic

  13. Typical C

  14. Sacrum and Coccyx

  15. Vertebral Relationships

  16. Arthrology • 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

  17. Intervertebal Discs

  18. Discs

  19. Discs

  20. Arthrology • 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)

  21. Arthrology • 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

  22. Arthrology • 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

  23. Arthrology • 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

  24. Vertebral Relationships

  25. Arthrology • 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

  26. Facet Joints (C and T)

  27. Facets L

  28. Arthrology • Typical movements in sections of the spine • Lumbar • Thoracic • Cervical

  29. Major Ligaments of the Spine • Anterior Longitudinal Ligament • Dense band along anterior and lateral surface of the vertebral bodies from C2 to sacrum • 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

  30. ALL

  31. Atlanto-Occipital Membrane

  32. A and P Longitudinal Ligament

  33. Major Ligaments • 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 • Superiorly, continues to occiput, called Tectorial Membrane • Limits flexion

  34. PLL

  35. Tectorial Membrane

  36. Ligaments • Supraspinous • Spinous process to spinous process – tip to tip • C7 to sacrum • Limits flexion • In cervical region, becomes much thicker with a greater elastic content • Called Ligamentum Nuchae

  37. Supraspinous

  38. Ligamentum Nuchae

  39. Ligaments • Interspinous • Found between spinous processes • Most well developed in lumbar region • support

  40. Interspinous

  41. Interspinous

  42. Ligaments • 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

  43. Ligamentum Flavum

  44. Atlanto-Occipital Membrane-Posterior

  45. Ligaments • Intertransverse • Only well-developed in Lumbar Region • Between transverse processes • Limit lateral flexion

  46. Special Joints of Spine • 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 lumbo-sacral 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

  47. L5/S1

  48. Lumbo-Sacral Jt.

  49. L5/S1 • 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

  50. S and S

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