spinethorax - Spine and vertebra RIBS STERNUM Danil...

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Unformatted text preview: Spine and vertebra RIBS STERNUM Danil Hammoudi.MD http://www.getbodysmart.com/ap/skeletalsystem/skeleton/axial/ver tebrae/atlas/animation.html 1 Axial v. Appendicular Skeleton Green ­ axial § Axial Skeleton § § § Skull Vertebral column Thoracic cage § Ribs and sternum Gold – App. § Appendicular Skeleton § Bones of the upper and lower limbs Plus, pectoral and pelvic girdles § 2 The spine, or ver tebra l colu mn, is composed of 5 main segments: •the cervical, •thoracic, •and lumbar curvatures, • the sacrum, •and the coccyx. Each of these cur vatur es is composed of individual vertebrae, which provide structural su pport and pr otection for the spina l cord. ­There are 24 movable vertebrae e in the spine; •7 in the cervical curvature, •12 in the thoracic curvature, •5 in the lumbar curvature. •Additionally, the sacrum consists of 5 fused vertebrae •the coccyx is composed of three to five fused vertebrae. Regions of Vertebral Co lumn Cervical 7 Thoracic 12 Lumbar 5 Sacral 5 fused Coccygeal 4 fused Lordosis Kyphosis Lordosis lordosis 3 The spine provides attachment for our ribs, muscles and ligaments which make up the trunk. It is divided into 3 regions: Neck (cervical) 7 vertebrae Thoracic 12 vertebrae Lumbar 5 vertebrae The f our curves f unction to: a.increase the strength of the spine b.help maintain balance in the upright position c.absorb shocks from walking and jumping d.help protect the spine from fracture. 4 The vertebral column (also called the backbone, spine, or spinal column) consists of a series of 33 irregularly shaped bones, called vertebrae. These 33 bones are divided into five categories depending on where they are located in the backbone. The first seven vertebrae are called the cervical vertebrae. Located at the top of the spinal colum n, these bones form a flexible framework for the neck and support the head. The first cervical vertebrae is called the atlas and the second is called the axis. The atlas' shape allows the head to nod "yes" and the axis' shape allows the head to shake "no". The next twelve vertebrae are called the thoracic vertebrae. These bones move with the ribs to form the rear anchor of the rib cage. Thoracic vertebrae are larger than cervical vertebrae and increase in size from top to bottom. After the thoracic vertebrae, come the lumbar vertebrae. These five bones are the largest vertebrae in the spinal column. These vertebrae support most of the body's weight and are attached to many of the back muscles. The sacrum is a triangular bone located just below the lumbar vertebrae. It consists of four or five sacral vertebrae in a child, which become fused into a single bone after age 26. The sacrum forms the back wall of the pelvic girdle and moves with it. The bottom of the spinal column is called the coccyx or tailbone. It consists of 3­5 bones that are fused together in an adult. Many muscles connect to the coccyx. 5 These bones compose the vertebral column, resulting in a total of 26 movable parts in an adult. In between the vertebrae are intervertebral discs made of fibrous cartilage that act as shock absorbers and allow the back to move. As a person ages, these discs compress and shrink, resulting in a distinct loss of height (generally between 0.5 and 2.0cm) between the ages of 50 and 55. When looked at from the side, the spine forms four curves. • These curves are called the cervical, thoracic, lumbar, and pelvic curves. • The cervical curve is located at the top of the spine and is composed of cervical vertebrae. Next come the thoracic and lumbar curves composed of thoracic and lumbar vertebrae respectively. •The final curve called the pelvic or sacral curve is formed by the sacrum and coccyx. These curves allow human beings to stand upright and help to maintain the balance of the upper body. The cervical and lumbar curves are not present in an infant. The cervical curves forms around the age of 3 months when an infant begins to hold its head up and the lumbar curve develops when a child begins to walk. In addition to allowing humans to stand upright and maintain their balance, the vertebral column serves several other important functions. It helps to support the head and arms, while permitting freedom of movement. It also provides attachment for many muscles, the ribs, and some of the organs and protects the spinal cord, which controls most bodily functions. The cervical spine is further divided into two parts; •the upper cervical region (C1 and C2), • the lower cervical region (C3 through C7). •C1 is termed the Atlas and C2 the Axis. •The Occiput (CO), also known as the Occipital Bone, is a flat bone that forms the back of the head. 6 Functions of the Vertebral or Spinal Column Include: Protection •Spinal Cord and Nerve Roots •Many internal organs •Ligaments •Tendons •Muscles •Head, shoulders, chest •Connects upper and lower body •Balance and weight distribution Base for Attachment Structural Support Flexibility and Mobility Flexion (forward bending) •Extension (backward bending) •Side bending (left and right) •Rotation (left and right) •Combination of above •Bones produce red blood cells •Mineral storage Other A typical vertebra has the following structural features: i . ii. a. b. iii. a. b. c. d. body vertebral arch, which consists of: two pedicles two laminae 7 processes: two transverse processes one spinous process (spine) two superior articular processes with facets two inferior articular processes with facets 7 Cervical Vertebrae § Seven vertebrae (C ­C ) are the smallest, lightest 1 7 vertebrae C ­C are distinguished with an oval body, short 3 7 spinous processes, and large, triangular vertebral foramina Each transverse process contains a transverse foramen § § Cervical Vertebrae Table 7.2.2 8 Cervical Vertebrae: The Atlas (C1) § § The atlas has no body and no spinous process It consists of anterior and posterior arches, and two lateral masses The superior surfaces of lateral masses articulate with the occipital condyles § Cervical Vertebrae: The Atlas (C1) Figure 7.16a, b 9 Cervical Vertebrae: The Axis (C2) § The axis has a body, spine, and vertebral arches as do other cervical vertebrae Unique to the axis is the dens, or odontoid process, which projects superiorly from the body and is cradled in the anterior arch of the atlas The dens is a pivot for the rotation of the atlas § § Cervical Vertebrae: The Axis (C2) Figure 7.16c 10 11 Cervical Vertebrae: The Atlas (C2) Figure 7.17a ATLAS VERTEBRA 12 ATLAS (1ST CERVICAL VERTEBRA) AXIS (2ND CERVICAL VERTEBRA) TYPICAL 3RD ­ 7TH CERVICAL VERTEBRA THORACIC VERTEBRA LUMBAR VERTEBRA SACRUM & COCCYX 13 14 Atlas (C1) The Atlas is the first cervical vertebra and therefore abbreviated C1. This vertebra supports the skull. Its appearance is different from the other spinal vertebrae. The atlas is a ring of bone made up of two lateral masses joined at the front and back by the anterior arch and the posterior arch. Axis (C2) The Axis is the second cervical vertebra or C2. It is a blunt tooth–like process that projects upward. It is also referred to as the ‘dens’ (Latin for ‘tooth’) or odontoid process. The dens provides a type of pivot and collar allowing the head and atlas to rotate around the dens. 15 16 AXIS atlas: no centrum, articular surface for odontoid process, no spinous process axis: odontoid process (dens) dens) 17 CERVICAL 18 THORACIC Unique thoracic fe at ures:de mifacets for artic ulation with rib head, seen from side (exce pt for 11th and 12th.), art icular f acets on transverse processes (for rib tubercle) and long delicate spino us processes Thoracic Vertebrae § There are twelve vertebrae (T1 ­T12 ) all of which articulate with ribs Major markings include two facets and two demifacets on the heart­shaped body, the circular vertebral foramen, transverse processes, and a long spinous process The location of the articulate facets prevents flexion and extension, but allows rotation of this area of the spine § § 19 Thoracic Vertebrae Figure 7.17b Lumbar Vertebrae § The five lumbar vertebrae (L1 ­L5 ) are located in the small of the back and have an enhanced weight­bearing function They have short, thick pedicles and laminae, flat hatchet­shaped spinous processes, and a triangular­ shaped vertebral foramen Orientation of articular facets locks the lumbar vertebrae together to provide stability § § 20 Lumbar Vertebrae Figure 7.17c 1.1st Lumbar vertebra 2.2nd Lumbar vertebra 3.3rd Lumbar vertebra 4.4th Lumbar vertebra 5.5th Lumbar vertebra 6.T12 7.Twelfth rib 8.Sacroiliac jo int 9.Sacrum 10.Sacral foramen 11.Ilium 12.Pelvic brim 13.Superior ramus of pubic bone 14.Pubic symphysis 21 22 centrum, neural arch, vertebral foramen, pedicle, spinous process, lamina, superior articular processes, transverse process 23 5th thoracic vertebra with rib. Anterior aspect. Lum bar vertebra. Anterior aspect (above). Left lateral aspect (below). 24 heavy centra, a broad heavy spinous process, transverse process lacks facets Regional Characteristics of Vertebrae Table 7.2.1 25 Regional Characteristics of Vertebrae Table 7.2.2 Sacrum § Sacrum § Consists of five fused vertebrae (S ­S ), which 1 5 shape the posterior wall of the pelvis It articulates with L superiorly, and with the 5 auricular surfaces of the hip bones Major markings include the sacral pro montory, transverse lines, alae, dorsal sacral foramina, sacral canal, and sacral hiatus § § 26 Coccyx § Coccyx (Tailbone) § The coccyx is made up of four (in so me cases three to five) fused vertebrae that articulate superiorly wit h the sacrum 1. Sacral crest 2. Coccyx 3. Posterior sacral foramen 4. Iliac crest 5. Sacral hiatus 6. Vertebral foramen 27 Sacrum and Coccyx: Anterior View Figure 7.18a Sacrum and Coccyx: Posterior View Figure 7.18b 28 Sacrum § 5 vertebrae fuse together to for m a single bone Articulates with: § § § L5 (through SAP) Coccyx § Functions in weight transfer Anterior surface § § § § Sacral promontory Transverse ridges Anterior sacral foramina § Posterior surface § Median and lateral sacral crest Posterior sacral foramen § SACRUM COCCYX 29 SACRUM (posterior view): • dorsal sacral foramina, superior articular facet, •auricular surface (on sides, for os coxa), •(ala), •median sacral crest, •sacral canal, • sacral hiatus. 30 1.Promont ory 2. T ransve rse Ridges 3. Coccyx 4. Body of Sacrum 5. Sacral Canal 6. Supe ri or Arti cul ar Surface 7. Medi an Sacral Cre st 8. Sacrum to Ilium Arti cul ar Surface 9. D orsal Sacral Forami na 10. Sacral Hi at us 31 The sa cru m ar ticulat es with four bones: the la st lu mbar vertebra above, the coccyx below, a nd the hip bone on either side. Althou gh in most people the sacro­iliac joints are tightly bou nd and immobile, some ar e a ble to rotat e the sa crum for war d a few degr ees vis­à ­vis the ilia. This motion is sometimes called "nu tation", and the rever se motion "counter ­ nutation •The pelvic surface of sacrum is concave from above downward, and slight ly so from side to side. •The dorsal surface of sacrum is convex and narrower than the pelvic. •The lateral surface o f sacrum is broad above, but narrowed into a thin edge below. •The base of the sacrum, which is broad and expanded, is directed upward and forward. 32 The apex (apex oss. sacri) is directed downward, and presents an oval facet for articulation wit h the coccyx. The vertebral canal (canalis sacralis; sacral canal) runs throughout the greater part of the bone; above, it is triangular in form; below, its posterior wall is inco mplete, from the non­development of the laminae and spinous processes. It lodges the sacral nerves, and its walls are perforated by the anterior and posterior sacral foramina through which these nerves pass out. For Hindus and Sahaja Yogis the kundalini resides in the sacrum bone in a dormant state. 33 Coccyx (3­5 fused) § § “Tailbone” Useless bone…….. § But painful! § Slight support to pelvic organs and ligament attachment Articulates superiorly with sacrum Anterior concave Posterior convex § § § Bony Thorax (Thoracic Cage) Figure 7.19a 34 The Bony Thorax § § § § § Sternum (3 parts) Ribs Clavicle Scapula Vertebrae (5 parts) Bony Thorax (Thoracic Cage) § The thoracic cage is composed of the § § § thoracic vertebrae dorsally, the ribs laterally, and the sternum and costal cartilages anteriorly 35 Bony Thorax (Thoracic Cage) § Functions § Forms a protective cage around the heart, lungs, and great blood vessels Supports the shoulder girdles and upper limbs Provides attachment for many neck, back, chest, and shoulder muscles Uses intercostal muscles to lift and depress the thorax during breathing § § § 2. Thoracic Cage § Bor ders: § § § Thoracic vertebrae posteriorly Ribs laterally Sternum and costal cartilages anteriorly § Forms protective cage @ heart, lungs, and other or gans Composed of: § § § Sternum Ribs 36 RIBS Thoracic Cage ­ Ribs § 12 pairs § True ribs § Superior 7 pairs that attach directly to sternum by CC § False ribs (8­12) § Inf erior 4 pairs (8­10) and attach indirectly to sternum Floating ribs § § Ribs 11 and 12 and hav e no anterior attachments (muscles) 37 Ribs § Typical ribs § # 2­9 § Atypical ribs § # 1, 10­12 § Increase in length from 1­7 Decrease in length from 8­12 Costal margin § § Rib Anatomy – Typical Ribs § Shaft § costal groove at inferior border § Head § Articulates with 2 demifacets § § § § Neck Tubercle Angle Subcostal groove 38 Ribs § There are twelve pair of ribs forming the flaring sides of the thoracic cage All ribs attach posteriorly to the thoracic vertebrae The superior 7 pair (true, or vertebrosternal ribs) attach directly to the sternum via costal cartilages Ribs 8­10 (false, or vertebrocondral ribs) attach indirectly to the sternum via costal cartilage Ribs 11­12 (floating, or vertebral ribs) have no anterior attachment § § § § Ribs Figure 7.19a 39 Structure of a Typical True Rib § Bowed, flat bone consisting of a head, neck, tubercle, and shaft Figure 7.20a Structure of a Typical True Rib § Bowed, flat bone consisting of a head, neck, tubercle, and shaft Figure 7.20b 40 § Rib Anatomy – Typical Ribs Dorsal attachment § Head of Rib à 2 Demifacets § § Superior demifacet Inferior demifacet of vertebra above it Intervertebral disc Articulates with Transverse Costal Facet (Thoracic vertebra) § § Tubercle of Rib § § Ex. Rib #4 articulates with Superior Demifacet and Transverse Costal Facet of T4 & Inferior demifacet of T3 § Ventral attachment § Costal cartilage Rib Anatomy – Atypical Ribs § § § #1 – flat and broad, supports subclavian vessels #1, and 10­12 – articulate with only 1 vertebral body #11 and 12 – do not articulate with a vertebral transverse process 41 The rib cage is jo ined to the thoracic vertebrae. At T11 and T12, the ribs do not attach and are so are called "float ing ribs." The thoracic spine's range of motion is limited due to the many rib/vertebrae connections and the long spinous processes. RIBS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Articular Facet of Ri b Interarticular Crest Neck Articular Portion of Tubercle Nonarticular Portion o f Tubercle Angle of Ri b Costal Groov e Body of Ri b Articular Facet of Transv erse Process Transv erse Process Spinous Process Lami na Vertebral Foramen 42 Peculiar Ribs.—The first, s ec ond, tenth, eleventh, and twelfth ribs pr es ent c ertain var iations The first rib is the most curved and usually the shortest of all the ribs The ribs are thin, flat, curved bones that form a protective cage around the organs in the upper body. They are comprised 24 bones arranged in 12 pairs. These bones are divided into three categories: •The first seven bones are called the true ribs. These bones are connected to the spine (the backbone) in back. In the front, the true ribs are connected directly to the breastbone or sternum by a strips of cartilage called the costal cartilage. •The next three pairs of bones are called false ribs. These bones are slightly shorter than the true ribs and are connected to the spine in back. However, instead of being attached directly to the sternum in front, the false ribs are attached to the lowest true rib. •The last two sets of rib bones are called floating ribs. Floating ribs are smaller than s both the true ribs and the false ribs. They are attached to the spine at the back, but are not connected to anything in the front. •The ribs form a kind of cage the encloses the upper body. They give the chest its familiar shape. •The ribs serve several im portant purposes. They protect the heart and lungs from injuries and shocks that might damage them . Ribs also protect parts of the stomach, spleen, and kidneys. The ribs help you to breathe. As you inhale, the muscles in between the ribs lift the rib cage up, allowing the lungs to expand. When you exhale, the rib cage m oves down again, squeezing the air out of your lungs. 43 44 Thoracic Cage ­ Sternum § Lies in the anterior midline of the thorax Consists of 3 fused ster nebrae (sections): § § The manubrium The body The xiphoid process § § Sternum ­ Manubrium § § “Handle” Connected to the first 2 ribs Clavicular notches articulate with clavicles (collarbone) Clavicular Articular facets § § Costal Cartilage 45 Sternum ­ Body § § § “Blade” or “gladiolus” Connects with ribs 2­7 Sides are notched where it articulates with the costal cartilages 4 separate parts until after puberty § Sternum – Xiphoid Process § § “Tip” Cartilaginous (hyaline) that becomes bony over the years (@40) Partial attachment of many muscles § 46 Sternum § 3 major anatomical landmarks: § 1. Jugular notch § Central indentation in manubrium § 2. Sternal angle § Manubrium jo ins the body § 3. Xiphisternal jo int § Cartilaginous union between xipho id process and body STERNUM 1. 2. 3. 4. 5. Jugular Notch Manubrium Sternal Angle Body (Gladiolus) Xiphoid Process •The ste rnum or b re astb one i s a long, fl at bone locate d in the cente r of the thorax (chest). • It conne ct s t o the rib bone s vi a cartilage, forming the rib cage with them, and thus hel ps t o prote ct the lungs , he art and maj or bl ood vessels from physical trauma. •The ste rnum is some time s cut ope n ( a medi an sternotomy) to gai n access t o the thoraci c content s when pe rformi ng cardi ot horaci c surge ry. The sternum is composed of three parts: •The manubrim, also called t he "handle", is located at the top of the sternum and mo ves slightly. It is connected to the first two ribs. •The body, also called the "blade" or the "gladiolus ", is located in the middle of the sternum and connects the third to seventh ri bs directly and the eig hth through tenth ribs indi rectly. •The xiphoid process, also called the "tip ", is located on the bottom of the sternum. It is often cartil agino us (cartilage), but does become bony in later years. These three segments of bone are us ually fused in adults. The sternum serves an i mporta nt function i n the body. The ri bs are connected to it by the costal cartilage. Without the sternum, the re would be a hole in the bo ne structure i n the middle of your chest, rig ht above your heart and lungs. The sternum protects this vital area and completes the circle of the rib cage. 47 Sternum (Breastbone) § A dagger­shaped, flat bone that lies in the anterior midline of the thorax Results from the fusion of three bones – the superior manubrium, the body, and the inferior xiphoid process Anatomical landmarks include the jugular (suprasternal) notch, the sternal angle, and the xiphisternal joint § § 48 49 1.Rib 2.Sternum 3.Breast 4.Position of oblique fissure 5.Position of horizontal fissure 50 Pectoral Girdles (Shoulder Girdles) Appendicular Skeleton § The appendicular skeleton is made up of the bones of the limbs and their girdles Pectoral girdles attach the upper limbs to the body trunk Pelvic girdle secures the lower limbs § § 51 Pectoral Girdles (Shoulder Girdles) § The pectoral girdles consist of the anterior clavicles and the posterior scapulae They attach the upper limbs to the axial skeleton in a manner that allows for maximum movement They provide attachment points for muscles that move the upper limbs § § Pectoral Girdles (Shoulder Girdles) Figure 7.22a 52 Clavicles (Collarbones) § Slender, doubly curved long bones lying across the superior thorax The acromial (lateral) end articulates with the scapula, and the sternal (medial) end articulates with the sternum Provide attachment points for numerous muscles, and act as braces to hold the scapulae and arms out laterally away from the body § § 53 Clavicles (Collarbones) Figure 7.22b, c Scapulae (Shoulder Blades) § Triangular, flat bones lying on the dorsal surface of the rib cage, between the second and seventh ribs Scapulae have three borders and three angles Major markings include the suprascapular notch, the supraspinous and infraspinous fossae, the spine, the acromion, and the coracoid process § § 54 Scapulae (Shoulder Blades) Figure 7.22d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Coracoid Process Scapular Notch Superior Margin Supraspinatus Fossa Superior Angle Scapular Spine Vertebral Margin Infraspinatus Fossa Inferior Angle Axillary Margin Gleno id Cavit y Margin Acro mio n Process 55 Left Scapula (Lateral Aspect) 1. 2. 3. 4. 5. 6. 7. Coracoid Process Gleno id Cavit y Scapular Spine Acro mio n Process Infraspinatus Fossa Inferior Angle Axillary Margin Scapulae (Shoulder Blades) Figure 7.22e 56 Scapulae (Shoulder Blades) Figure 7.22f 57 ...
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