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Osteology
7 C, 12 T, 5 L, 5 S (Fused as Sacrum), 4 coccygeal
Primary Curves Secondary Curves Anterior/Posterior alignment
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
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
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)
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
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
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
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
Major Ligaments of the Spine
Anterior Longitudinal Ligament - ALL 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
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
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
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
Ligaments
Intertransverse Only well-developed in Lumbar Region Between transverse processes Limit lateral flexion
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
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
L5/S1
Spondylolistheses – an anterior movement of the L5 vertebral body and can cause compression of the cauda equina which rests posteriorly
Sacralization
Where 5th lumbar vertebrae takes on characteristics of the sacrum and may be partially or completely fused with sacrum
S-I Joint
Review Hip Bone AKA Innominate AKA Os Coxae
Ilium, Ischium and Pubis Fuse at Puberty Acetabulum Pelvis = 2 coxal bones the sacrum and
coccyx
S-I
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
S-I – Synovial Aspect of Joint 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
Pubic Symphysis
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
Atlanto-Axial Joint
Atlas and Axis Pivot Two convex superior facets of axis with two
concave inferior facets of the atlas Atlas also posses a facet on the internal
surface of the anterior arch which articulates with the dens of the axis
Major ligaments from spine support – Ant. Atlanto-Occipital, Tectorial Membrane, Post. A-O
A-A Joint
Alar – from dens to occiput Transverse - around dens Cruciate
• Sup. Longitudinal Band
• Inferior Longitudinal Band
• Transverse
Atlanto-Occipital Joint
Two concave superior facets of atlas articulate with two convex surfaces of occipital condyles of the skull
Supported by major ligaments Small saddle joint Very limited motion – nodding type
motions in all directions.