Transcript Bone, Muscles of vertebral column

Bone, Muscles of vertebral column
By
Prof. Pasuk Mahakkanukrauh, MD
Vertebral Column
Vertebrae : cervical (C)
: thoracic (T)
: lumbar (L)
: sacrum (S)
: coccyx (Co)
Function : Protection
: Weight bearing
: Movement
Normal Curvature of Vertebral Column
Primary Curvature
Secondary Curvature
Clinical correlation
: kyphosis : thoracic kyphosis
: lordosis : lumbar lordosis
: scoliosis : myopathic, idiopathic
Vertebrae
Vertebral Body : weight bearing
Vertebral Arch : Protection
: pedicle
: lamina
: spinous process
Component
: articular process
: transverse process
* Vertebral foramen
* Vertebral (spinal) canal
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
Atlas
Articular facet : kidney
No spinous process
No body
Anterior-posterior tubercle
Lateral mass
Anterior-posterior arch
Axis
Dens or Odontoid process
Bifid big spinous process
Thoracic vertebrae
Costal facet
Long spinous process
Body : Heart shape : T5-8
T1-4 : cervical like
T9-12 : lumbar like
Facet joint : oblique
Lumbar vertebrae
Big body : L5
No costal facet
Body : kidney shape
Big transverse process
Lumbosacral angle
Facet joint : vertical
Sacrum : anterior
Fusion 5 sacrum
Triangular shape
Lateral mass
Sacral foramina
Sacral promontary
Sacrum : posterior
Median crest
Intermediate sacral crest
Lateral sacral crest
Sacral hiatus
Sacral cornua
Clinical Application
Epidural (caudal) anesthesia or block
Lumbarization
Sacralization
Coccyx
4 Remnant…..1
Coccygeal cornua
No weight bearing
** Coccygonia
Movement
Joint of the vertebral column
Back muscle and ligament
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
Joint of the vertebral column
Joint of vertebral body
Joint of vertebral arch
- zygapophyseal (facet) joint
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
Zygapophyseal Joint
Articular process
Accessory ligament
-Ligament flavum
-Interspinous ligament
-Intertransverse ligament
-Supraspinous ligament
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
Biomechanic : T-spine
main rotation, lateral flexion
mild F/E : facet joint, costal cartilage,
spinous process
Biomechanic : L-spine
Weight bearing
main F/E, lateral flexion, no rotation
Clinical correlation
Spondylolysis
Spondylolisthesis
Spondylosis
Spondylitis
Whiplash injury
Counting vertebrae
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
Superficial back muscles
Splenius muscle
- splenius capitis
Cervical extension
- splenius cervicis
** Cervical flexion: levator scapulae,
sternocleidomastoid,scalenus ant.-medius
Middle back muscles
Ertector spinae (sacrospinalis) m.
- Iliocostalis
- Longissimus
- spinalis
*** Function: back extension
*** Back strain
Deep back muscles
(transversospinalis)
Semispinalis
Multifidus
Rotator
Interspinalis
Intertransversarius
levator costarum
Middle-deep layer : back extension
**** back flexion : abdominal m.
Abdominal Muscles
External Oblique
Internal Oblique
Transversus Abdominis
Rectus abdominis
Stability of spine
Ligaments : ALL, PLL, LF, Interspinous lig.
Back muscles
Reference
ผาสุ ก มหรรฆานุเคราะห์ . มหกายวิภาคศาสตร์ การ
เคลือ่ นไหว. กรุงเทพฯ : พีบีฟอเรนบุคส์ เซนเตอร์ ; 2547.
294 หน้ า
Neck Flexion
Neck Extension
- Sternocleidomastoid - Splenius muscle
- Scalenus muscle
- Levator scapulae
Trunk Flexion
Trunk Extension
- Abdominal muscle - Erector spinae
EO,IO,TA,RA
- Deep layer of back muscle
(multifidus, rotator,
interspinalis,
intertransversalis)
Trunk lateral
bending
Trunk rotation
Anterior-posterior
- Ipsilateral contraction IO
Abdominal muscle
- Contralateral EO
Ipsilateral contraction - Multifidus