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ANATOMY MUSKULOSKELETAL
AXIAL SKELETONTHORACIC, LUMBAR, SACRUM AND
COCCYX
BY : HERMIZAN BIN HALIHANAFIAH
HERMIZAN BIN HALIHANAFIAH 2
Thoracic Vertebrae• T1-T12
• Larger and stronger than cervical vertebrae.
• Spinous process of T1 and T2 are long, laterally
flattened, and directed inferiorly.
• In contrast, the spinous process of T11 and T12 are
shorter, broader and directed more posteriorly.
• Compare to cervical vertebrae, thoracic vertebrae also
have longer and larger transverse process.
HERMIZAN BIN HALIHANAFIAH 3
Thoracic Vertebrae
HERMIZAN BIN HALIHANAFIAH 4
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Cont…• Articulate with the ribs.
• Articulating surface of the vertebrae are called facets
and demifacets.
• Except for T11 and T12, the transverse process have
facets for articulating with the tubercles of the ribs.
• The bodies of the thoracic vertebrae also have facets
and demifacets for articulation with the head of the
ribs.
• The articulation between the thoracic vertebra and the
ribs called vertebrocostal joint.
HERMIZAN BIN HALIHANAFIAH 6
Cont…
• T1 has a superior facet and inferior demifacets for
head of ribs.
• T2-T8 have superior and inferior demifacets for head
of ribs.
• T9 has a superior demifacets
• T10-T12 have superior facet.
• Movements of the thoracic vertebrae are limited by
thin intervetebral disc and by attachment of the ribs
to the sternum.
HERMIZAN BIN HALIHANAFIAH 7
Vertebrocostal Joint
HERMIZAN BIN HALIHANAFIAH 8
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Vertebrocostal Joint
HERMIZAN BIN HALIHANAFIAH 10
Typical Thoracic Vertebrae
• Larger body than cervical but smaller than lumbar.
• Spinous processes pointed and angled downward.
• Superior articular facets face posteriorly permitting
some relation between adjacent vertebrae.
• Rib attachment – costal facets on vertebral body and
at ends of transverse processes for articulation ribs.
HERMIZAN BIN HALIHANAFIAH 11
Lumbar Vertebrae• Largest and strongest in the vertebral column because the
amount of body weight supported by the vertebrae increase
towards the inferior end of the backbone.
• Their processes are short and thick.
• The superior articular process directed medially instead of
superiorly and the inferior articular facets directed laterally
instead of inferiorly.
• Spinous process are thick and broad and project posteriorly –
attachment of the large back muscles.
HERMIZAN BIN HALIHANAFIAH 12
Lumbar Vertebrae
HERMIZAN BIN HALIHANAFIAH 13
Lumbar Vertebrae
HERMIZAN BIN HALIHANAFIAH 14
Large BodySuperior articular facets facing medially
Inferior articular facets facing
laterally
Spinous process thick, broad, project posteriorly
HERMIZAN BIN HALIHANAFIAH 15
Copyright 2009, John Wiley & Sons, Inc.
Vertebral Column
HERMIZAN BIN HALIHANAFIAH 16
Sacrum• Triangular bone
• Formed by the union of 5 sacral vertebrae
• Indicated as a S1-S5.
• The fusion of the sacral vertebrae begins ages 16-18
and its usually completed by age 30.
• The sacrum serves as a strong foundation for the
pelvic girdle.
• It is positioned at the posterior portion of the pelvic
cavity medial to the hip bone.
HERMIZAN BIN HALIHANAFIAH 17
Cont….
• Female sacrum are shorter, wider and more curved
between S2 and S3 than a male sacrum.
• The concave anterior side of the sacrum faces the
pelvic cavity.
• Its smooth and contains four transverse lines
(ridges) that mark the joining of the sacral vertebral
bodies.
• At the end of these lines are four pairs of anterior
sacral foramina.
HERMIZAN BIN HALIHANAFIAH 18
Cont…
• The lateral portion of the superior surface
contains a smooth surface called the sacral ala,
which is formed by the fused transverse
processes of the 1st sacral vertebrae.
• The convex, posterior surface of the sacrum
contains a median sacral crest and lateral sacral
crest.
HERMIZAN BIN HALIHANAFIAH 19
Cont…
• Median sacral crest is the fused of the spinous
processes of the upper sacral vertebrae.
• Lateral sacral crest is the fused transverse processes
of the sacral vertebrae.
• 4 pairs of posterior sacral foramina communicate with
the anterior sacral foramina through which nerves and
blood vessels pass.
• The sacral canal is a continuation of the vertebral
canal.
HERMIZAN BIN HALIHANAFIAH 20
Cont…
• The laminae of the 5th sacral vertebrae, and sometimes the
4th sacral vertebrae fails to meet.
• This leaves an inferior entrance to the vertebral canal called
the sacral hiatus.
• On the either side of the sacral hiatus are the sacral cornua,
the inferior articular processes of the fifth sacral vertebrae.
• The narrow inferior portion of the sacrum is called apex.
• The broad superior portion of the sacrum is called base.
HERMIZAN BIN HALIHANAFIAH 21
Cont…
• The anteriorly projecting border of the base called sacral
promontory.
• On both of the lateral surface, the sacrum has a large
auricular surface that articulates with the illium of each of
hipbone to form sacroilliac joint.
• Posterior to the auricular surface is a roughened surface
called sacral tuberosity, contain depression for the
attachment of the ligamants.
• The sacral tuberosity is the another surface of the sacrum
that formed sacroilliac joint with the hipbones.
HERMIZAN BIN HALIHANAFIAH 22
Sacroilliac Joint
HERMIZAN BIN HALIHANAFIAH 23
Cont…
• The superior articular surface of the sacrum
articulate with the 5th lumbar vertebrae .
• The base of the sacrum articulates with the
body of the 5th lumbar vertebrae, to form the
lumbosacral joint.
HERMIZAN BIN HALIHANAFIAH 24
HERMIZAN BIN HALIHANAFIAH 25
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HERMIZAN BIN HALIHANAFIAH 27
Coccyx• Triangular
• Formed by the fusion of usually four coccygeal
vertebrae.
• Indicated as a Co1-Co4
• The coccygeal vertebrae fused when a person is
between 20-30 years of age.
• The dorsal surface of the body of coccyx contain 2
long coccygeal cornua that are connected by
ligaments to the sacral cornua.
HERMIZAN BIN HALIHANAFIAH 28
• Coccygeal cornua are the pedicles and superior
articular process of the 1st coccygeal vertebrae.
• On the lateral surface of the coccyx are a series of
transverse processes, the first pair being the largest.
• The coccyx articulates with the apex of the sacrum.
• In females, the coccyx points inferiorly and males
points anteriorly.
Coccyx
HERMIZAN BIN HALIHANAFIAH 29
Normal Curves of the Vertebrae
• Normal curves – 4 slight bends of vertebral column.
• Cervical and lumbar curves are convex (bulging out)
• Thoracic and sacral curves and concave (cupping in).
• The curves of the vertebral column increase its strength, help
in maintain balance in the upright position, absorb shocks
during walking, and help protect vertebrae from fracture.
HERMIZAN BIN HALIHANAFIAH 30
HERMIZAN BIN HALIHANAFIAH 31
• Fetus only has a single anteriorly concave curve.
• The thoracic and sacral curves are called primary curvature because they form earlier during fatal development.
• The cervical and lumbar curves are known as secondary curves because they begin to form later, several month after birth.
• All curves are fully developed by age 10.
Normal Curves of the Vertebrae
HERMIZAN BIN HALIHANAFIAH 32
Primary Curvature of Newborn
HERMIZAN BIN HALIHANAFIAH 33
Cont…
• Various condition may exaggerate the
normal curves, resulting abnormal curves.
• 3 such abnormal curves called:
1. Kyphosis
2. Lordosis
3. Scoliosis
HERMIZAN BIN HALIHANAFIAH 34
KYPHOSIS
• Kyphosis is a curving of the spine that causes a bowing of the back, such that the apex of the angle points backwards leading to a hunchback or slouching posture.
HERMIZAN BIN HALIHANAFIAH 35
• Caused by muscular
imbalance, vertebral
fractures, congenital,
nutritional.
KYPHOSIS
HERMIZAN BIN HALIHANAFIAH 36
KYPHOSIS
HERMIZAN BIN HALIHANAFIAH 37
LORDOSIS• Inward curvature of a portion
of the vertebral column
• Two segments of the vertebral column, namely cervical and lumbar, are normally lordotic, that is, they are set in a curve that has its convexity anteriorly (the front) and concavity posteriorly (behind), in the context of human anatomy
HERMIZAN BIN HALIHANAFIAH 38
• Mainly because of the difference of thickness between the anterior and posterior part of the intervertebral disc
• Common causes of excessive lordosis including tight low back muscles, excessive visceral fat, and pregnancy.
LORDOSIS (cont..)
HERMIZAN BIN HALIHANAFIAH 39
LORDOSIS
HERMIZAN BIN HALIHANAFIAH 40
SCOLIOSIS
• Scoliosis is a medical condition in which a person's spine is curved from side to side, and may also be rotated.
• Congenital or idiopathic
HERMIZAN BIN HALIHANAFIAH 41
SCOLIOSIS
HERMIZAN BIN HALIHANAFIAH 42
Scoliosis
HERMIZAN BIN HALIHANAFIAH 43
HERMIZAN BIN HALIHANAFIAH 44
HERMIZAN BIN HALIHANAFIAH 45
HERMIZAN BIN HALIHANAFIAH 46
Superficial Muscles of Back
• Trapezius
• Latisimus dorsi
• Levator scapulae
• Rhomboid major
• Rhomboid minor
HERMIZAN BIN HALIHANAFIAH 47
Intermediate Muscles of Back
• Serratus posterior
superior
• Serratus posterior
inferior
HERMIZAN BIN HALIHANAFIAH 48
• Serratus posterior superior
– O – ligamentum nuchae,
spinous process of C7-T3
– I – upper borders of 2nd –
5th ribs
– A – Elevate the ribs,
assist in inspiration
Intermediate Muscles of Back
HERMIZAN BIN HALIHANAFIAH 49
• Serratus posterior
inferior
– O – Vertebra T11- L3
– I – Inferior border of 9th- 12th
ribs
– A – depress the lower ribs,
aids in expiration
Intermediate Muscles of Back
HERMIZAN BIN HALIHANAFIAH 50
• Can divide into 4 groups:
1. Splenius
2. Erector spinae
3. Transversospinalis
4. Segmental
Deep Muscles of Back
HERMIZAN BIN HALIHANAFIAH 51
Splenius Group (referred to previous lesson slide)
• Bandages like
• Important to move the head and neck region.
• Superiorly (head) – splenius capitis
• Inferiorly (neck) – splenius cervicis– Origin – spine of T3-T6– Insertion – transverse process C1-C4– Action – same with splenius capitis– Nerve cervical spinal nerve
HERMIZAN BIN HALIHANAFIAH 52
• Erector spinae group.
– 3 columns muscles
– From sacrum to the ribs
– Extends vertebral column
– Consists
- illiocostalis (lateral)
- Longissimus( intermediate)
- spinalis (medial)
Deep Muscles of Back
HERMIZAN BIN HALIHANAFIAH 53
Iliocostalis (lateral fiber)• Consists 3 fibers:
1. Iliocostalis cervicis
2. Iliocostalis thoracis
3. Illiocostalis lumborum
• Origin – Ribs 1-6, ribs 7-12
and Iliac crest of pelvic
• Insertion – transverse process
of C4-C6, Ribs 1-6, ribs 7-12
HERMIZAN BIN HALIHANAFIAH 54
Iliocostalis
• Action
• Acting together, muscles of each
region extend and maintaining
erect posture of vertebral
column.
• Acting singly, laterally flex and
rotation vertebral column of their
respective region at the same
side of contracting muscles.
HERMIZAN BIN HALIHANAFIAH 55
• Consists 3 fibers:
1. Longissimus capitis
2. Longissimus cervicis
3. Longissimus thoracis
• Origin – Articular process of C4-C7 and transverse process of T1-T4, transverse process of T4-T5, Transverse process of lumbar vertebra.
Longissimus (Intermediate Fiber)
HERMIZAN BIN HALIHANAFIAH 56
• Insertion – mastoid process of temporal, transverse process of C2-C6, transverse process of all thoracic and upper lumbar vertebra and 9th and 10th ribs.
• Action – Longissimus capitis (together extend head, singly rotate head), Longissimus cervicis and thoracis (extends vertebral column)
Longissimus
HERMIZAN BIN HALIHANAFIAH 57
• Consists 3 fibers:
1. Spinalis capitis
2. Spinalis cervicis
3. Spinalis thoracis
• Origin – arises with semispinalis capitis, ligamentum nuchae and spinous process of C7 , spinous processes of T10-L2
Spinalis (medial)
HERMIZAN BIN HALIHANAFIAH 58
• Insertion – between superior
and inferior nuchal line of
occipital bone, spinous process
of axis , spinous process of
superior thoracic vertebra (T3-
T4).
• Action – acting together
extends vertebral column
Spinalis (medial)
HERMIZAN BIN HALIHANAFIAH 59
Transversospinales Muscles
• Semispinalis
• Multifidus
• Rotatores
HERMIZAN BIN HALIHANAFIAH 60
• Semispinalis group
– Vertebra to vertebra
– Important for extends neck
• Consists:
– Semispinalis capitis
– Semipinalis cervicis
– Semispinalis thoracis
Semispinalis Group
HERMIZAN BIN HALIHANAFIAH 61
• Origin – Articular process C4-C6
and transverse process C7-T7,
transverse process of T1-T5,
Transverse process of T6-T10.
• Insertion – occipital bone.
Spinous process of C1-C5 and
spinous process of C6-T4
• Action – extends neck, extends
vertebral column
Semispinalis Group
HERMIZAN BIN HALIHANAFIAH 62
• Origin – sacrum, ilium,
transverse process of
lumbar, thoracis and C4-C7
• Insertion – spinous process
of a more superior vertebra.
• Action – extends vertebral
column (both), lateral flex
vertebral column (singly)
Multifidus
HERMIZAN BIN HALIHANAFIAH 63
Rotatores
• Origin – transverse process
of all vertebra
• Insertion – spinous process
of vertebra superior to the
one of origin.
• Action – together weakly
extends vertebral column
HERMIZAN BIN HALIHANAFIAH 64
Segmental
• Consists 2 fibers:
1. Interspinales
2. Intertransversarii
HERMIZAN BIN HALIHANAFIAH 65
• Consists 2 fibers:
1.Interspinales
2.Intertransversarii
Segmental
HERMIZAN BIN HALIHANAFIAH 66
Interspinales • Origin – superior surface
of all spinous process• Insertion – inferior
surface of spinous process of vertebra superior to the one of origin
• Action – weakly extends vertebral column (together)
HERMIZAN BIN HALIHANAFIAH 67
• Origin – transverse
process of all vertebra
• Insertion – transverse
process of vertebra
superior to the one origin
• Action – extends vertebral
column (together)
Intertransverseraii
HERMIZAN BIN HALIHANAFIAH 68
• Quadratus lomborum– O - iliac crest and
iliolumbar ligament– I - Last rib and transverse
processes of lumbar vertebrae
– A - Alone, lateral flexion of vertebral column; Together, depression of thoracic rib cage
Deep Muscles of Back