Upload
jardee-datsima
View
214
Download
0
Embed Size (px)
Citation preview
8/14/2019 AnatomyThe Vertebral Column.pptx
1/70
The Vertebral Column
Rene C. Catan, MD
Associate ProfessorMHAMCM
8/14/2019 AnatomyThe Vertebral Column.pptx
2/70
Outline
I. General structure
II. Structure of Typical Vertebra
III. Regional Modifications of VertebralCharacteristics
IV. Intervertebral Disks
V. Ligaments
8/14/2019 AnatomyThe Vertebral Column.pptx
3/70
8/14/2019 AnatomyThe Vertebral Column.pptx
4/70
8/14/2019 AnatomyThe Vertebral Column.pptx
5/70
I. General StructureA. Composition- 33 vertebrae
connected by 23-24
intervertebral discs
1. Vertebrae- cervical, thoracic,
lumbar, sacral, coccygeal
2. Intervertebral Discs (IVD)
a. Location. Amphiarthoses(symphyses)
1) None between occiput &
atlas, atlas & axis
2) Fibrocartilage- littlemovement
b. Intervertebral ligaments.
Stabilizes
8/14/2019 AnatomyThe Vertebral Column.pptx
6/70
I. General structure B. Spinal curvature- terrestrialadaptation & erect stance
1. Normal curvatures- takeshape of IVDa. Sacral curve (S1-coccyx)-
concave anteriorly
1) Characteristic of fetusesand lower animal forms
2) Primary curve
b. Lumbar curve (T12-L5)-concaveposteriorly
1) Appears between 12 to 18months
2) Pronounced in females,potential for instability
3) Adaptational curvesecondary to uprightposture
8/14/2019 AnatomyThe Vertebral Column.pptx
7/70
I. General structureB. Spinal curvature- terrestrialadaptation & erect stance
1. Normal curvatures- takeshape of IVD
c. Thoracic Curve (T2T12)
1) Characteristic of fetus &lower animal forms
2) Primary curved. Cervical curvature (C2-T2)
1) Appears late intrauterine,established 3-4 monthsafter birth
2) Secondary adaptational/adaptation to quadrupedalposture
8/14/2019 AnatomyThe Vertebral Column.pptx
8/70
B. Spinal curvatures
1. Abnormal curvatures
a. Kyphosis (hunchback)-exaggerated thoracic curve
(congenital, pathologic ,
traumatic collapse of
vertebrae)
b. Lordosis (swayback)-
exaggerated lumbar curve(posterior compression of
IVD, late pregnancy)
8/14/2019 AnatomyThe Vertebral Column.pptx
9/70
Abnormal curvec. Scoliosis- lateral curvature
1) Congenital, pathologic,
unilateral paralysis ofvertebral mm.
a) Idiopathic (mostcommon)
b) Compensatory curveopposite direction inanother region
2) Rotation of vertebratoward convex with
progression.3) Amenable to surgery in
late teens or beforechilbearing
8/14/2019 AnatomyThe Vertebral Column.pptx
10/70
8/14/2019 AnatomyThe Vertebral Column.pptx
11/70
8/14/2019 AnatomyThe Vertebral Column.pptx
12/70
Scoliosis- Lateral curvature
of the spine
8/14/2019 AnatomyThe Vertebral Column.pptx
13/70
II. Structure of Typical
Vertebra
A. Body- major support
B. Structure- cylindric, functionfor support, increase in bulk
toward sacrum1. Articulations
a. Amphiarthoses. IVD thatform symphyses
b. Diarthroses. Superior &inferior articular processesby synovial joints
C. Vertebral (neural) arch-
pedicles & laminae, formsposterior portion of vertebra
1. Pedicles- posterolaterallyfrom vertebral body
2. Laminae- fuse in midline
8/14/2019 AnatomyThe Vertebral Column.pptx
14/70
II. Structure of Typical
Vertebra
C. Vertebral processes
1. Spinous processes- from
vertebral arch laminaefuse, attachments of
vertebral muscles
2. Transverse processes- from
side of v. arch pedicle
laminae fuse;
a. Attachments of muscles,
ligaments
b. Articulate with ribs 1-10
c. Form sacral ala, articualtes
with ilium
8/14/2019 AnatomyThe Vertebral Column.pptx
15/70
II. Structure of Typical
Vertebra
3. Costal process- side of v. bodyant. to pedicle; articulate ribs ofthoracic region, contribute tocervical transverse processes
and alae of sacrum4. Superior articular processes-
a. Form diarthrodialarticulations with articularprocesses below
b. Face posteriorly in cervicalregion, posteromedially inthoracic, medically in lumbar,posteriorly in sacrum
5. Inferior articular processes-a. Diarthrodial joints
b. Face anteriorly in cervical,anterolaterally in thoracic,laterally in lumber, but ant in5thlumbar.
8/14/2019 AnatomyThe Vertebral Column.pptx
16/70
II. Structure of Typical
VertebraD. Foramina
1. Vertebral foramen- formed
by posterior surface ofbody and vertebral arch
a. Vertebral neural arch
b. Contain spinal cord & nerve
roots
2. Intervertebral foraminaa. Formed by deep notch in inferior
surface of pedicle above withsuperior surface of notch of
vertebra below
b. Transmit spinal nerves,
intervertebral arteries
8/14/2019 AnatomyThe Vertebral Column.pptx
17/70
Intervertebral foramen & notch
8/14/2019 AnatomyThe Vertebral Column.pptx
18/70
III. Regional modifications
of vertebralA. Cervical vertebra C1 to C7
1. Atlas C1. No body & spinous
processes; consists ofanterior arch, neural arch,paired transverse processes
Articulations. Atlantooccipital
jointa. Nearly horizontal facets,
concave receive condyles
b. Flexion/extension
(15 degrees)
c. No IV disc
d. Articulates inferiorly withaxis flat, broad facets
8/14/2019 AnatomyThe Vertebral Column.pptx
19/70
8/14/2019 AnatomyThe Vertebral Column.pptx
20/70
III. Regional modifications A.2. Axis C2
a. Structure. Dens (odontoid
process), large flat superiorarticular facets
b. Articulations. Atlantoaxialjoint: dens with anterior
arch of C11) Dens stabilized by ligaments ,
serves as pivot
a) Cruciform ligament
b) Fracture2) Rotation (25 degrees)
3) No disc
8/14/2019 AnatomyThe Vertebral Column.pptx
21/70
8/14/2019 AnatomyThe Vertebral Column.pptx
22/70
8/14/2019 AnatomyThe Vertebral Column.pptx
23/70
III. Regional modifications
A.3. Typical cervical vertebra
a. Structure. Transverse
foramen in each transverseprocess
1) Hiatus represents
incomplete fusion of costal
and transverse processes2) Vertebral artery except C7
3) Bifid spinous processes,
angle downward except C7
which almost horizontal(vertebra prominens)
8/14/2019 AnatomyThe Vertebral Column.pptx
24/70
III. Regional modifications
b. Articulations.1) Superior facets are convex
2) Rotation, flexion/extension, lateral flexion
3) Superior facets face posteriorly, inferior facets face
anteriorly4) Predisposition to dislocations
4. Movements.
a. Flexion: 40 deg./ extn:90 deg. Atlantooccipital jt.
b. Lateral flexion (abduction):40 deg C2-C7c. Rotation: 45 deg at atlantooccipital joint
d. Circumduction
8/14/2019 AnatomyThe Vertebral Column.pptx
25/70
III. Regional modifications B. Thoracic vertebrae T1-T12
1. Structurea. Spinous processes long
oriented caudallyb. Costal processes developed
into ribs
c. Articular facets (diarthrodialjoints)
2. Intervertebral articulationsa. Paired superior facets face
posterolaterally, paired inferior
facets face anteromediallyb. Rotation at T12 facilitated by
facet position
c. Movement limited by ribs
8/14/2019 AnatomyThe Vertebral Column.pptx
26/70
III. Regional modifications C. Lumbar vertebrae L5-S1
1. Structure. Spinous process
stubby, horizontal.
2. Articulations.
a. Lie on parasagittal planes.
b. Superior facets face medially,
inferior face laterally1) Flexion (60 deg), extn (35
deg)
2) Lateral flexion (20 deg)
3) Rotation (5 deg)
4) Circumduction
c. L5 facets directed anteriorly
8/14/2019 AnatomyThe Vertebral Column.pptx
27/70
Posterior approach to the lumbar
spine
8/14/2019 AnatomyThe Vertebral Column.pptx
28/70
III. Regional modifications
D. Sacral vertebrae
1. Structure. 4 horizontal fusion lines, rudimentary disc at
S1-S2 around spinal nerves form sacral foramina
Sacralization of L5a. Median sacral crest- fused spinous processes
b. Alae- fused transverse processes
c. Sacral hiatus, sacral cornua.
2. Articulations.Lumbosacral joint
8/14/2019 AnatomyThe Vertebral Column.pptx
29/70
III. Regional modifications F. Clinical considerations1. Compression fractures of the
vertebral bodies
a. Internal collapse result tokyphosis or scoliosis
b. Spinal nerve compression,spinal cord (sc) trauma
2. Pedicle fractures result to
instabilitya. Misalignment of vertebral
column result to nerve rootcompression or sc trauma
b. Cervical region and lumbar
region- wide canal,compression fracture maynot result to sc compression
c. Thoracic region fracture-common paraplegia
8/14/2019 AnatomyThe Vertebral Column.pptx
30/70
IV. Intervertebral Disc A. External structure1. 25% total length of vertebral
column
2. cervical thin, lumbar large & thick3. Secondary vetebral curvature:
differences in thickness anteriorlyvs posteriroly
B. Internal structure
1. Annulus fibrosus forms centralportion of disc
a. composed of lamelliformconnective tissue
b. attached to adjacent vetebra,forming amphiarthrosis
c. supports central nucleuspulposus
8/14/2019 AnatomyThe Vertebral Column.pptx
31/70
IV. Intervertebral Disc
2. Nucleus pulposus- forms central portion
a. remnant of the notochord
b. surrounded & supported by the annulus fibrosus
c. cartilaginous, mucinous tissue withmucopolysaccharide- high osmotic pressure
d. 70-80% water: contribute to total height
C. Functions.
1. Amphiarthrosis. Bind vertebra together, allow
limited movement between vertebrae
2. nucleus pulposus. distributes forces over entire
surface of vertebra
8/14/2019 AnatomyThe Vertebral Column.pptx
32/70
Annulus fibrosus- concentric lamella of
fibrocartilage forming the circumference
of the IV disc. Run obliquely from one
vertebra to another, thus allowing
movement and strong bond
Nucleus pulposus- central core, pulpy,
Catilaginous (dehydrates later).
Semifluid fulcrum- flexibility and resilience.
Shock absorber, avascular (diffusion)Posteriorly placed- a.f. thin post. & laterally
8/14/2019 AnatomyThe Vertebral Column.pptx
33/70
IV. Intervertebral Disc D. Clinical consideration
1. Disc degeneration. Dehydrationof nucleus pulposus
a. leads to narrowing of iv disc,reduces disc capacity to act ascushion between vetebrae
b. diminished stature, decrease
size of iv foramina, nerve rootcompression
c. osteophytes-progressivecalcification of superior and
inferior vertebral body margins.chronic low back, cervical pain
with arm pain
8/14/2019 AnatomyThe Vertebral Column.pptx
34/70
IV. Intervertebral Disc2. Disc herniation ("slipped disc")-
extrusion of nucleus pulposus through
annulus fibrosusa. Most common: L4-L5; then L5-S1,
cervical region 5-10 %
b. Schmorl's node- prolapse of nucleus
pulposus into vertebral body
c. Commonly directed posterolaterally.
Anterior and posterior longitudinal
ligaments reinforce the disc.d. Nerve compression
8/14/2019 AnatomyThe Vertebral Column.pptx
35/70
Intervertebral disc herniation
8/14/2019 AnatomyThe Vertebral Column.pptx
36/70
IV. Intervertebral Disc
d. Nerve compression
(1) Posterolateral discprolapse impinges onspinal nerve of the nextlower vertebra causingsymptoms on dermatomicand myotomic distribution
8/14/2019 AnatomyThe Vertebral Column.pptx
37/70
V. LigamentsA. Supraspinous ligaments
connects tip of spinous
processes. Ligamentumnuchae in cervical region
B. Interspinous ligamentsrun between spinousprocesses
1. Limit motion on vertebrae
2. Hyper flexion trauma mayresult to small tears
(whiplash injury)
8/14/2019 AnatomyThe Vertebral Column.pptx
38/70
V. LigamentsC. Ligamentum flavum- paired,stretches between adjacentlaminae; + vetebral arch = postreriorvertebral canal
1. Elastic tissue
2. Hyperflexion - buckling resultto spinal cord injury
D. Anterior longitudinal
ligament- vertebral bodies & IVDanteriorly
1. Sacrum to occipital bone
2. Resist increased lordosis
3. Reinforces annulus fibrosus,herniation posteriorly
4. Splint fractured vertebrae,trunk cast in extension
8/14/2019 AnatomyThe Vertebral Column.pptx
39/70
Accessory Ligaments
Anterior Longitudinal LigamentVery dense, powerful ligament
Attachments: from axis down to sacrumattaching along anterior disc and vertebral
bodies of the motion segment
Function: limits hyperextension of the spine
restrains forward movement of one vertebrae
over another
8/14/2019 AnatomyThe Vertebral Column.pptx
40/70
V. Ligaments E. Posterior longitudinal ligament-
connects vertebral bodies
posteriorly
1. Denticulate ligament- wide
post to vertebral body,
narrow post to iV dsc2. Resist kyphosis
3. Supports annulus fibrosus
posteriroly, herniationdirected posterolaterally
8/14/2019 AnatomyThe Vertebral Column.pptx
41/70
V. Ligaments F. Cruciform ligament-of atlassupports dens
1. Extends to base occiput to
body of axis
2. Principal: prevent atlanto-
axial subluxation
8/14/2019 AnatomyThe Vertebral Column.pptx
42/70
I. Posterior vertebral muscles
A. Overview. Move and stabilize the vertebralcolumn
B. Organization. (Most superficial: upward & obliquely
outward; Middle: parallel to vertebral column; Innermost:upward & obliquely inward)
1. Spinotransverse group
2. Sacrospinalis group
3. Transversospinalis group
4. Suboccipital muscles
8/14/2019 AnatomyThe Vertebral Column.pptx
43/70
I. Posterior vertebral
muscles
B.1. Spinotransverse group-from spinous processes & nuchal
lig., insert into upper cervical
transverse processes & base of skull
a. Divisions.
1) Splenius capitis . C7-T4,
nuchal lig to sup nuchal
line & mastoid process
2) Splenius cervicis. T3-T6 to
transverse process C2-C7
b. Group actions.Unilaterally rotate head,
bilaterally elevate & extend
neck
8/14/2019 AnatomyThe Vertebral Column.pptx
44/70
The splenius capitisis a broad, straplike
muscle in the back of the neck. It pulls on
the base of the skull from vertebrae in theneck and upper thorax.
Origin Ligamentum nuchae, spinous
processof C7-T3
Insertion Mastoid processof temporaland
occipital bone
Artery muscular branches of the aortaNerve dorsal rami of C3, C4
Actions Extend, rotate, and laterally flex the
head
Splenius capitis
http://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/Mastoid_processhttp://en.wikipedia.org/wiki/Mastoid_processhttp://en.wikipedia.org/wiki/Occipital_bonehttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/Occipital_bonehttp://en.wikipedia.org/wiki/Occipital_bonehttp://en.wikipedia.org/wiki/Temporal_bonehttp://en.wikipedia.org/wiki/Mastoid_processhttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeletonhttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/Ligamentum_nuchaehttp://en.wikipedia.org/wiki/Ligamentum_nuchaehttp://en.wikipedia.org/wiki/Ligamentum_nuchaehttp://en.wikipedia.org/wiki/Ligamentum_nuchaehttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton8/14/2019 AnatomyThe Vertebral Column.pptx
45/70
Origin spinous processesof T3-T4
Insertion transverse processesof C1-C3
Artery transverse cervical arteryand occipital
artery
Nerve Posterior ramiof the lower Cervical spinal
nerves
Actions Bilaterally: Extend the head & neck,
Unilaterally: Lateral flexion to the same
side, Rotation to the same side.
Splenius cervicis
I Posterior vertebral B 2 S i l
http://en.wikipedia.org/wiki/Occipital_arteryhttp://en.wikipedia.org/wiki/Cervical_spinal_nerveshttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Cervical_spinal_nerveshttp://en.wikipedia.org/wiki/Cervical_spinal_nerveshttp://en.wikipedia.org/wiki/Posterior_ramihttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Occipital_arteryhttp://en.wikipedia.org/wiki/Occipital_arteryhttp://en.wikipedia.org/wiki/Transverse_cervical_arteryhttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/Transverse_processeshttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeletonhttp://en.wikipedia.org/wiki/Spinous_processeshttp://en.wikipedia.org/wiki/Spinous_processeshttp://en.wikipedia.org/wiki/Spinous_processeshttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton8/14/2019 AnatomyThe Vertebral Column.pptx
46/70
I. Posterior vertebral
musclesB.2.Sacrospinales group(erector spinae)- middle layer;from sacrum, iliac crest lumbar &lower thoracic spinous processses toribs & transverse processes
a. Divisions1) Iliocostalis- Lateral segment:
lumbar , thoracic, cervical
2) Longissimus- Middlesegment: thoracic, cervical,capitis
3) Spinalis segment- Medialsegment: poorly developed
b. Group actions- Unilaterally:flex the column on same side;bilaterally extend thevertebral column
8/14/2019 AnatomyThe Vertebral Column.pptx
47/70
Erector spinae
Iliocostalis:The iliocostalis originates from the sacrum, erector
spinae aponeurosisand iliac crest. The iliocostalis
has three different insertions according to the parts:
iliocostalis lumborumhas the lumbar part(where its
insertion is in the 12th to 7th ribs)
iliocostalis thoraciswhere its insertion runs from the
last 6 ribs to the first 6 ribs.
iliocostalis cerviciswhich runs from the first 6 ribs to
the posterior tubercle of the transverse process of
C6-C4
http://en.wikipedia.org/wiki/Iliocostalishttp://en.wikipedia.org/wiki/Sacrumhttp://en.wikipedia.org/w/index.php?title=Erector_spinae_aponeurosis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Erector_spinae_aponeurosis&action=edit&redlink=1http://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/wiki/Iliocostalis_lumborumhttp://en.wikipedia.org/wiki/Iliocostalis_thoracishttp://en.wikipedia.org/wiki/Iliocostalis_cervicishttp://en.wikipedia.org/wiki/Iliocostalis_cervicishttp://en.wikipedia.org/wiki/Iliocostalis_cervicishttp://en.wikipedia.org/wiki/Iliocostalis_cervicishttp://en.wikipedia.org/wiki/Iliocostalis_cervicishttp://en.wikipedia.org/wiki/Iliocostalis_thoracishttp://en.wikipedia.org/wiki/Iliocostalis_thoracishttp://en.wikipedia.org/wiki/Iliocostalis_thoracishttp://en.wikipedia.org/wiki/Iliocostalis_thoracishttp://en.wikipedia.org/wiki/Iliocostalis_lumborumhttp://en.wikipedia.org/wiki/Iliocostalis_lumborumhttp://en.wikipedia.org/wiki/Iliocostalis_lumborumhttp://en.wikipedia.org/wiki/Iliocostalis_lumborumhttp://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/w/index.php?title=Erector_spinae_aponeurosis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Erector_spinae_aponeurosis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Erector_spinae_aponeurosis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Erector_spinae_aponeurosis&action=edit&redlink=1http://en.wikipedia.org/wiki/Sacrumhttp://en.wikipedia.org/wiki/Iliocostalis8/14/2019 AnatomyThe Vertebral Column.pptx
48/70
Erector spinae
Longissimus:The longissimus muscle has three parts with different
origin and insertion:
longissimus thoracisoriginates from the sacrum,the
spinous process of lumbar vertebrate and transverse
process of the last thoracic vertebrate and inserts in the
transverse process of the lumbar vertebrate,erector
spinae aponeurosis,ribs and coastal process of thoracic
vertebrate.
longissimus cervicisoriginates from the transverse
proces of T6-T1 and inserts in the transverse process ofC7-C2.
longissimus capitisoriginates from the transverse
process of T3-T1 runs through C7-C3 and inserts in the
mastoid process of temporal bone.
http://en.wikipedia.org/wiki/Longissimushttp://en.wikipedia.org/wiki/Longissimus_thoracishttp://en.wikipedia.org/wiki/Longissimus_cervicishttp://en.wikipedia.org/wiki/Longissimus_cervicishttp://en.wikipedia.org/wiki/Longissimus_capitishttp://en.wikipedia.org/wiki/Longissimus_capitishttp://en.wikipedia.org/wiki/Longissimus_capitishttp://en.wikipedia.org/wiki/Longissimus_capitishttp://en.wikipedia.org/wiki/Longissimus_cervicishttp://en.wikipedia.org/wiki/Longissimus_cervicishttp://en.wikipedia.org/wiki/Longissimus_cervicishttp://en.wikipedia.org/wiki/Longissimus_cervicishttp://en.wikipedia.org/wiki/Longissimus_thoracishttp://en.wikipedia.org/wiki/Longissimus_thoracishttp://en.wikipedia.org/wiki/Longissimus_thoracishttp://en.wikipedia.org/wiki/Longissimus_thoracishttp://en.wikipedia.org/wiki/Longissimus8/14/2019 AnatomyThe Vertebral Column.pptx
49/70
Erector spinae
Spinalis:The spinalis muscle, as usual, has three
parts:
spinalis thoraciswhich originates from the
spinous process of L3-T10 and inserts inthe spinous process of T8-T2.
spinalis cervicisoriginates from the
spinous process of T2-C6 and inserts in
the spinous process of C4-C2.
spinalis capitisis an inconstant muscles
fibres that runs from the cervical and upperthoracic which then inserts in the external
occipital protuberance.
http://en.wikipedia.org/wiki/Spinalishttp://en.wikipedia.org/wiki/Spinalis_thoracishttp://en.wikipedia.org/wiki/Spinalis_cervicishttp://en.wikipedia.org/wiki/Spinalis_capitishttp://en.wikipedia.org/wiki/Spinalis_capitishttp://en.wikipedia.org/wiki/Spinalis_capitishttp://en.wikipedia.org/wiki/Spinalis_capitishttp://en.wikipedia.org/wiki/Spinalis_cervicishttp://en.wikipedia.org/wiki/Spinalis_cervicishttp://en.wikipedia.org/wiki/Spinalis_cervicishttp://en.wikipedia.org/wiki/Spinalis_thoracishttp://en.wikipedia.org/wiki/Spinalis_thoracishttp://en.wikipedia.org/wiki/Spinalis_thoracishttp://en.wikipedia.org/wiki/Spinalis8/14/2019 AnatomyThe Vertebral Column.pptx
50/70
Transversopinales group
1. Semispinalis (superficial)
a. Capitis
b. Cervicis
c. Dorsi
2. Multifidus (middle)
3. Rotatores (deepest)
I P t i t b l
8/14/2019 AnatomyThe Vertebral Column.pptx
51/70
I. Posterior vertebral
musclesB.3. Transversospinalis group-Innermost; from tranverse
processes, inserts into spinous
processes
a. Divisions
1) Semispinalis- thoracic,
cervical capitis portionsbeneath erector spinae
passes over 5 > vertebrae
8/14/2019 AnatomyThe Vertebral Column.pptx
52/70
Semispinalis capitis
Origin Transversal process of lower
cervical and higher thoracal
columna
Insertion Area between superior and
inferior nuchal line
Artery
Nerve Greater occipital nerve
Actions Extend the head
http://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Greater_occipital_nervehttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeletonhttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton8/14/2019 AnatomyThe Vertebral Column.pptx
53/70
Semispinalis cervicis
Origin transverse processes of the
upper five or six thoracic
vertebr
Insertion cervical spinous processes,
from the axis to the fifth
Artery
Nerve
Actions
http://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeletonhttp://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton8/14/2019 AnatomyThe Vertebral Column.pptx
54/70
Semispinalis dorsi
Origin transverse processes of the
sixth to the tenth thoracic
vertebr
Insertion spinous processes of theupper four thoracic and lower
two cervical vertebrae
Artery
Nerve
Actions
I Posterior vertebral B 3 T i li
http://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/Cervical_vertebraehttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/Cervical_vertebraehttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeletonhttp://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/Thoracic_vertebr%C3%A6http://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton8/14/2019 AnatomyThe Vertebral Column.pptx
55/70
I. Posterior vertebral
musclesB.3. Transversospinalis group-Innermost; from tranverse
processes, inserts into spinous
processes
2) Multifidus- deep into
semispinalis, pass over 3
vertebraea) Extinguishable from E.S.
except short bundles
b) Best developed in lumbar
& cervical regions
8/14/2019 AnatomyThe Vertebral Column.pptx
56/70
Multifidus
Origin Sacrum, Erector
spinaeAponeurosis,PSIS,
and Iliac crest
Insertion spinous process
Nerve Posterior branches
Actions Stabilizes vertebrae in local
movements of vertebral
column
http://en.wikipedia.org/wiki/Erector_spinaehttp://en.wikipedia.org/wiki/Aponeurosishttp://en.wikipedia.org/wiki/Aponeurosishttp://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Posterior_branch_of_spinal_nervehttp://en.wikipedia.org/wiki/Posterior_branch_of_spinal_nervehttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Kinesiologyhttp://en.wikipedia.org/wiki/Posterior_branch_of_spinal_nervehttp://en.wikipedia.org/wiki/List_of_human_nerveshttp://en.wikipedia.org/wiki/Spinous_processhttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeletonhttp://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/wiki/Posterior_superior_iliac_spinehttp://en.wikipedia.org/wiki/Aponeurosishttp://en.wikipedia.org/wiki/Erector_spinaehttp://en.wikipedia.org/wiki/Erector_spinaehttp://en.wikipedia.org/wiki/Sacrumhttp://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton8/14/2019 AnatomyThe Vertebral Column.pptx
57/70
I. Posterior vertebral
muscles3) Long rotators. Fromtransverse processes to spinous
processes above
4) Segmental muscles runbetween adjacent vertebra
a) Short rotators mm run betweentransverse & spinous processesof adjacent vertebra
b) Interspinales mm run betweenspinous processes, well
developed in lumbar and cervicalc) Intertransversarii mm run
between transverse processes
b G i
8/14/2019 AnatomyThe Vertebral Column.pptx
58/70
b. Group actions.
Unilaterally rotate the
neck & trunk toopposite side, bilaterally
extend vertebral
column
II. Anterior vertebralA O i I l t
8/14/2019 AnatomyThe Vertebral Column.pptx
59/70
muscles A. Overview. Incomplete,
primarily flex, rotate, &
stabilize vertebral columnB. Lateral Group
1. Scalene mm from cervical
transvers process to 2nd
ribs; elevate 1st& 2ndribs ,
lateral flexion of cervical
column
2. Levator scapulae mm fromC1-C4 transverse processes
to scapular notch
II A t i t b l C A t i
8/14/2019 AnatomyThe Vertebral Column.pptx
60/70
II. Anterior vertebral
musclesC. Anterior group
1. Longus colli m. runs fromC4-C6 to occiput. Flexes
cervical column
2. Lateral rectus capitis m.
runs between C1
transverse process tojugular notch of occiput.
Flexes and rotate the head
II. Anterior vertebral3 Anterior rectus capitis m
8/14/2019 AnatomyThe Vertebral Column.pptx
61/70
muscles 3. Anterior rectus capitis m
runs between C1
transverse process to basal
part of occipital bone.Flexes head at atlanto-
occipital joint
4. Quadratus lumborum runs
from iliac crest to inferior
borders of 12thribs.
Stabilize rib cage duringventilation
8/14/2019 AnatomyThe Vertebral Column.pptx
62/70
III. Functional considerations
A. Normal function. Major movements, keep
center of gravity over the first sacral vertebra
B. Adjustments
1. Standing erect and holding a weight. Weight is
distributed evenly over each vertebral disk
2. Lifting a weight
3. Bending forward to lift a weight
K k M W S t l S i 2009 S t 1
8/14/2019 AnatomyThe Vertebral Column.pptx
63/70
Kozanek M., Wang S. et al, Spine 2009, Sept 1:
34 (19)
Range of motion and orientation of the lumbar
facet joints in vivo.
Flexion/extension of trunk, facet joints rotated
along M-L axis (2 to 6 degrees) and translatedcephalad/caudad direction (2-4 mm)
Lateral and twisting: coupling of rotation and
translation (
8/14/2019 AnatomyThe Vertebral Column.pptx
64/70
8/14/2019 AnatomyThe Vertebral Column.pptx
65/70
L B k St i
8/14/2019 AnatomyThe Vertebral Column.pptx
66/70
Low Back Strain
Low Back Pain Syndrome
8/14/2019 AnatomyThe Vertebral Column.pptx
67/70
8/14/2019 AnatomyThe Vertebral Column.pptx
68/70
8/14/2019 AnatomyThe Vertebral Column.pptx
69/70
8/14/2019 AnatomyThe Vertebral Column.pptx
70/70
Thank you!