vertebral column ppt PT700

vertebral column functions

1. stability

2. mobility

3. protection

vertebral column

made up of 33 vertebra

• 7 cervical

• 12 thoracic

• 5 lumbar

• 5 sacral (sacrum) → fused

• 4-5 coccygeal (coccyx) → fused

primary curve

vertebral column curve we are born with

• thoracic spine

• sacrum

“kyphotic” = curves outward

secondary curve

vertebral column curve that develops as we begin to lift head and bear weight during development

• cervical spine

• lumbar spine

• develops after birth

“lordosis” = inward curvature

lordosis

• cervical & lumbar spine

• sagittal plane

• normal & abnormal

  • abnormal increase in lumbar spine curvature

kyphyosis

• thoracic spine and sacrum

• sagittal plane

• normal & abnormal

  • abnormal increased curvature of thoracic spine

  • common in geriatric population

scoliosis

• most commonly occurs at thoraco-lumbar spine

• frontal and transverse plane of motion

• always abnormal lateral curvature

  • anything over 8 degrees = abnormal

• common in pre-adolescent females

vertebral body

• anterior cylindrical structure

• bodies will become larger going from cervical vertebrae → lumbar due to increased body weight which needs to be supported

intervertebral discs

connect adjacent vertebral bodies

• discs create height = creating openings for rami to go through

• clinical: stenosis

stenosis

• abnormal narrowing of a bodily passage or opening due to disc height in vertebral body

• This narrowing can restrict nerves

vertebral end-plate

• hyaline cartilage on superior and inferior surfaces of body

• connects to intervertebral discs

vertebral arch

• spinous process

• transverse processes

• laminate

• pedicle

• superior articular process

• inferior articular process

• zygapophpysial joint

• pars articularis

lamina

connects spinous and transverse processes on vertebral arch

pedicle

connects transverse processes of vertebral arch to vertebral body

laminectomy

clinical case → surgery to gain access to spinal, usually done in response to excessive pressure/pinching in spinal cord

facet (zygapophysial) joint

formed by an inferior articulating process from the vertebra above and a superior articulating process from the vertebra below

• connecting will keep vertebral column connected

• can become inflamed = nerve entrapment

pars articularis

on vertebral arch, b/w superior and inferior articular facets

• commonlyl fractured due to stress of gravity/weight

• “scotty dog fracture”

vertebral foramen contents

• spinal cord

• ant and post roots

• meninges

• blood vessels

• cerebrospinal fluid

intervertebral foramen

• b/w adjacent vertebrae, acts as an opening

• place where anterior and posterior roots join to form spinal nerve

• bounded by:

  • vertebral bodies

  • pedicles

  • intervertebral discs

  • facet joint

herniated disc

occurs when the soft, jelly-like center *nucleos pulposes” of a spinal disc pushes through a tear in the outer layer

• pinches roots and/or spinal nerve

• radiating pain to associated dermatome and/or muscle weakness

  • dependent upon what is being compromised

• disc “pops off”

facet joint arthritis

• swelling at facet joint

• pinches roots and/or spinal nerve

• radiating pain to associated dermatome

spina bifida

congential defect in walls of spinal canal caused by lack of union b/w the laminae

• lumbar region most common

• may cause spinal dysfunctionc

cervical spine

7 vertebrae → lordotic (secondary) curve

• C1 - “atlas”

• C2 - “axis”

• C3-C7 - typical

atlas (C1)

• ring-shaped, acts like a washer for skull to move on axis

• no body, no spinous process

• groove for vertebral artery, courses over C1 to get to brain

• has largest transverse process of all cervical vertebrae

alantoaxial joint (AAJ)

C1 (facet for dens) resting on C2 (dens process)

• superior articular process of C2 articulates with inferior articular facet of atlas (C1)

atlantoocipital joint (AOJ)

articulation spot b/w base of skull and cervical spine

• occiput of skull to superior articular facet of C1

axis (C2)

• has dens (aka odontoid process)

  • projects superior from body

  • articulates with atlas (AAJ)

• has a “bifid” spinous process

typical cervical vertebra

C3-C6

• bifid spinous process

• transverse foramen → acts as passage for vertebral A.

• uncinate processes

C7 vertebra

has a transverse foramen like C3-C6, but vertebral A. does not pass through it

• has uncinate process

uncinate processes

found on C3-C7

• superior surface of body has raised lateral lips of bone which articulate with the body above it

• forms uncovertebral joint

uncovertebral joint

found in the cervical spine (C3-C7) and are formed between the uncinate processes of the vertebrae below and the lateral edges of the vertebral bodies above

• spine stability and movement

vertebral artery

passes through all cervical transverse foramen except C7

• after passing through C1, makes 2 right angle bends to pass through foramen magnum

• supplies posterior brain

• “beauty parlor stroke syndrome”

beauty parlor stroke syndrome

hypertension of c/s, could cause comrpomised in vertebral artery

• could lead to clots → CVA

thoracic spine

• primary curve

• 12 vertebrae

• rib facets on transverse processes (unique)

transverse costal facet

small, concave surface located on the transverse process of a thoracic vertebra, specifically designed to articulate with the tubercle of a rib

superior costal facet

a site where a rib forms a joint with the top of a vertebra

inferior costal facet

bony surface on the body of a thoracic vertebra that articulates with the head of a rib.

• Specifically, it's the lower of the two facets on the vertebral body that, in combination with the superior costal facet of the vertebra below

demifacet

a half facet, specifically a smooth, concave surface on a thoracic vertebra, that forms part of the joint where the head of a rib connects

rib facets on transverse processes

articulates with tubercles on ribs

• absent on last 2-3 thoracic vertebrae

thoracic spine spinous processes

long, slender and inferiorly directed

• lower = longer

• “giraffe” shape

lumbar spine

• 5 vertebrae

• lordotic curve

  • secondary curvature

• short, blunt, rounded

  • “moose head”

lumbar spine 5th body (L5)

wedge-shaped, form fit for sacral articulation

lumbar spine: vertebral canal

spinal cord ends at L2

• cauda equina continues inferiorly

• spinal tap b/w L4-L5

cauda equina syndrome

medical emergency → “saddle region” paresthesia

• loss of bladder and/or bowel control

• can cause permanent paralysis

spondylolysis

fracture of pars articularis

• “scotty dog fracture”

spondilolisthesis

one body slips off the one below it

• anterior: top vertebrae slips forwards

• retro/posterior: top slips backwards