anatomythe vertebral column.pptx

8/14/2019 AnatomyThe Vertebral Column.pptx

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The Vertebral Column

Rene C. Catan, MD

Associate ProfessorMHAMCM


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Outline

I. General structure

II. Structure of Typical Vertebra

III. Regional Modifications of VertebralCharacteristics

IV. Intervertebral Disks

V. Ligaments


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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


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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


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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


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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)


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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


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Scoliosis- Lateral curvature

of the spine


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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


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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


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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.


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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


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Intervertebral foramen & notch


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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


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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


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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)


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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


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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


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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


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Posterior approach to the lumbar

spine


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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


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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


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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


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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


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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


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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


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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


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Intervertebral disc herniation


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IV. Intervertebral Disc

d. Nerve compression

(1) Posterolateral discprolapse impinges onspinal nerve of the nextlower vertebra causingsymptoms on dermatomicand myotomic distribution


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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)


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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


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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


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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


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V. Ligaments F. Cruciform ligament-of atlassupports dens

1. Extends to base occiput to

body of axis

2. Principal: prevent atlanto-

axial subluxation


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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


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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


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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_skeleton


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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_skeleton


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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


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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/Iliocostalis


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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/Longissimus


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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/Spinalis


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Transversopinales group

1. Semispinalis (superficial)

a. Capitis

b. Cervicis

c. Dorsi

2. Multifidus (middle)

3. Rotatores (deepest)

I P t i t b l


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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


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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_skeleton


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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_skeleton


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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_skeleton


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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


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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_skeleton


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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


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b. Group actions.

Unilaterally rotate the

neck & trunk toopposite side, bilaterally

extend vertebral

column

II. Anterior vertebralA O i I l t


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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


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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


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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


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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


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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 (


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L B k St i


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Low Back Strain

Low Back Pain Syndrome


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Thank you!

anatomythe vertebral column.pptx

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