imaging vertebrae

8/11/2019 Imaging Vertebrae

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IMAGING OF VERTEBRAE

IMAGES FROM CROSS-SECTIONAL ANATOMY TUTOR PROGRAM

1) REVIEW VERTEBRAL COLUMN AND BACK2) VERTEBRAE ARE USEFUL LANDMARKS FOR

ORIENTATION IN CT, MRI IMAGES

3) LOOK AT VIEWS OF VERTEBRAE ON X-RAYS IN LAB


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1) SAGITTAL PLANE -

divides body in RIGHT

and LEFT parts (Median

Sagittal Plane-divides

body into right and left

halves)

2) CORONAL PLANE -

divides body into FRONTand BACK parts

3) HORIZONTAL PLANE

Plane = transverse plane -cross section-divides

body into TOP and

BOTTOM parts

perpendicular to long axisof body

ANATOMICAL PLANESSagittal

Coronal

Horizontal


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AXIAL CT SERIES

- generates sections in

HORIZONTAL PLANE

- VIEW FROMFEET

- viewing patient inhospital bed from his/her

feet

FEET


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PATIENT'S

RIGHT

PATIENT'S

LEFT

POSTERIOR

ANTERIOR

ORIENTATION IN IMAGES - seemingly right/left reversed

Series In Horizontal

Plane = Axial Series


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INTENSITIES STORED AS PIXEL VALUES

CAN'RESECTION'

SERIES

OF DIGITAL

IMAGES INANY PLANE

PATIENT'S

RIGHT

PATIENT'S

LEFT


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1. BODY anterior, solid transmits weight

2. VERTEBRAL ARCH posterior, surrounds vertebral canal, spinalcord; consists of a) PEDICLES project from body

b) LAMINAE unite to form arch posteriorly

BODY

VERTEBRAL

ARCH

PEDICLE

TRANSVERSE

PROCESS-

LATERAL

LAMINA

3. TRANSVERSE AND SPINOUS PROCESSES - projections

from arch for muscle, ligament attach

TYPICAL VERTEBRA by convention thoracic

SPINOUS PROCESS -

POSTERIOR{

ant.


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RIBS- have bumps for articulation with vertebra

Head

Articulateswith facet on Body

Tubercle

Articulateswith facet on

Transverse process

Vertebrae

Ribs

Dorsal viewof skeleton


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CT OF THORACIC VERTEBRA


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USE FOR ORIENTATION

T5

SUBS

IS

TRAP RHOMB.MAJ.


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body is small

Foramen Transversarium - in

transverse process (C1-C7) for

vertebral artery & veins

ARTICULAR FACETS

- angled superiorly &

medially

SPINOUS PROCESS bifid (divided) for Ligamentum nuchae

TRANSVERSE

PROCESS

BODY

CERVICAL VERTEBRA

ant.

post.

lat.

view


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CERVICAL VERTEBRA - CT

Foramen Transversarium

Body - small


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Bodies - hefty

Pedicles - stout

Lamina - thickSpinous Processes- broad

Articular processes

in sagittal plane

spinousprocess lamina

pedicle

body

LUMBAR VERTEBRA


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LUMBAR VERTEBRA AXIAL CT

Articular process

Articular process

L3 L5


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LATERAL VIEW OF VERTEBRA

4. Spinal nerves leavevertebral canal via

INTERVERTEBRAL

FORAMINA - between

vertebrae;bordered by Superior and

Inferior Vertebral Notches

Sup. Vertebral Notch

Inf. Vertebral Notch

5. SUPERIOR AND INFERIOR

ARTICULAR PROCESSES -

(zygapophyses) - Articular

facets form joints betweenadjacent vertebrae (Orientation

of facets determines

movement)

6. Bodies -

joined by

intervertebral

discs


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MOVEMENTS OF VERTEBRAE IN DIFFERENT REGIONS-Determined by orientations of articular facets

permit considerable flexion-

extension, lateral flexion,rotation - useful-move head

permit some rotation little orno flex-extend (also limited by

ribs); useful- no flex down on

heart, lungs

Lumbar- facets in sagittal plane

Thoracic - facets in coronal plane

permit flex-extend, little or no

rotation; useful- help increase

abdominal pressure;

dangerous- increase load

pressure on vertebral discs

Cervical (C3-C7)-facets angled

superiorly and mediallya. CERVICAL (C3-C7)-

b. THORACIC

c. LUMBAR


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1. ANTERIOR

LONGITUDINAL

LIGAMENT -

Strong band onanterior side

VERTEBRAL LIGAMENTS

2. POSTERIOR

LONGITUDINAL

LIGAMENT-

weaker, narrowerband

3. LIGAMENTA

FLAVA - yellow

elastic bands

connectinglaminae

View inside vertebral canal


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SAGITTAL SECTION

4. INTERSPINOUS AND SUPRASPINOUS LIGAMENTS -connect spines

Greatly thickened in cervical region to form LIGAMENTUM

NUCHAE- from Ext. Occip. Protuberance of skull to C7;Support Head, Provide muscle attachments

ANT

SUPRASPINOUS

INTERSPINOUS


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JOINTS BETWEEN VERTEBRAE

1. Joints between

articular processes -

synovial plane joints

permit Sliding

Movements

2. Intervertebral Disc-

interposed between

bodies


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ORIENT TO MEDIAN MRI

BODY

SPINE

ant

post

ant

SPINEBODY

post

SAGITTAL

PLANE


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LUMBAR MRI


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Shock

absorbers inyoung quite

strong

trauma to

vertebrafractures

STRUCTURE/

FUNCTION OF

INTERVERTEBRAL

DISC

a) Nucleus

pulposus-inner

gelatinous

core

b) Anulus fibrosus -

collagen fibers &fibrocartilage


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MRI OF 'SLIPPED DISK' FROM SNELL'S TEXTBOOK

ANTERIOR POSTERIOR

HERNIATION

OF

NUCLEUSPULPOSUS


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Typically in Postero-Lateral Direction, lateral to Posterior Longitudinal

Ligament; often L4-L5 or L5-S1; can lead to nerve compression atintervertebral foramen

Postero-

lateral

lateral

post

DAMAGE TO INTERVERTEBRAL DISC

ANTERIORLONGITUDINAL LIGAMENT

POSTERIOR

LONGITUDINAL

LIGAMENT


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Cervicalcurvature

Lumbarcurvature

NORMAL CURVATURES OF VERTEBRAL COLUMN

Secondary - concave posterior

a. Cervical curvature - concaveposteriorly - help support head

b. Lumbar curvature

- concave posteriorly- develops with walking

- helps support trunk, upper body

c. Lateral curvature -concave to side opposite

handedness - helps to carry

bags of money

Ant Post

Right handed

R L

Thoracic

curvature

Sacralcurvature

Primary - concave anterior - remainsIn thorax and sacrum


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LATERAL X-RAY -

TRANSVERSE

PROCESSESLOOK LIKE

RINGS

Transverse

process

LUMBAR CURVATURE ON LATERAL X-RAY


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INTERNAL STRUCTURE OF BONE

OUTER COMPACT (CORTICAL) BONE

INNER SPONGY BONE

COMPACT

SPONGY

Long bone in cross-section


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IN LATERAL

VIEW SEETRANSVERSE

PROCESSES

ON ENDLATERAL

VIEW

ATTENUATION HIGHEST

(X-RAY IS MOST WHITE)

WHEN PASS THROUGHMOST COMPACT BONE

Transverseprocess


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ANTERIOR-POSTERIOR

(AP)X-RAY OF LUMBAR

VERTEBRAE

Pedicles look like

eyes

SPINE

PEDICLE


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AP VIEW

SEE

PEDICLES AND

SPINES ALONG

THEIR LENGTH

SPINE

PEDICLE


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ABNORMAL CURVATURES

KYPHOSIS humpback, exaggerated

curvature; often in

thorax of elderly;concave anteriorly

SCOLIOSISabnormal lateral

curvature (kink in

spine); can be dueto hemivertebra

LORDOSISexaggerated

lumbar curvature

concaveposteriorly


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LATERAL X-RAY THORACIC SPINE

NORMAL ADULT ELDERLY PATIENT

T11


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ERECTOR SPINAE

SPINALIS- most medial spinous

process to spinous process

LONGISSIMUS- intermediate-transverse process to transverse

process

ILIOCOSTALIS- lateral ilium and

ribs to ribs and transverseprocesses

1. Act to extend trunk

2. Located dorsal to vertebral column

3. Innervated by dorsal primary rami of

spinal nerves

Deep: Transversospinalis transverseprocess to spinous process


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IMAGING OF VERTEBRAE

IMAGES FROM CROSS-SECTIONAL ANATOMY

TUTOR PROGRAM

ERECTOR SPINAETRANSVERSOSPINALIS

imaging vertebrae

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