General Bones and Spine

Axial skeleton includes

Skull, vertebral column, rib cage

Appendicular Skeleton

the upper and lower

extremities and hip bone

Red marrow skeleton

(hematopoietic); Humerus, Scapula, neck, metaphysis of femur, ilium

(mainly in the axial skeleton)

Yellow marrow skeleton

(mainly fat)

Skeletal Features

1. Articulations

2. Extensions and projections

3.Depressions

4. Passages

Articulations

1. Condyle

2.Facet

3.Head

Extensions and projections:

1.Crest

2.Epicondyle

3.Line

4.Process:

5. Protuberance

6.Spine:

7. Trochanter

8. Tubercle

9. Tuberosity

Depressions

Alveolus

Fossa

Fovea

Foveola

Sulcus/Groove

Passages

Canal: tubular passage or tunnel in a bone

Fissure: a slit through a bone

Foramen: a rounded hole of short length in a bone

Meatus: an opening or passage, usually air-filled

General Features of Long Bones

•Epiphyses

•Metaphysis

•Marrow (medullary) cavity

•Articular cartilage

•Diaphysis

Compact bone and spongy bone

Epiphyses

1.The end of a long bone.

2.Articulates with another bone.

3.Capped by articular cartilage.

4.During growth, it has a physis (growth cartilage/growth plate).

Metaphysis

growth zone between the epiphysis and the diaphysis during development of a long bone

2. The cone-shaped region connecting the diaphysis to the epiphysis.

Diaphysis

shaft of a long bone

Each limb is supported by a

cingulum (girdle)

Pectoral girdle

scapula + clavicle → supports the free upper limb

Hip bone supports

the free lower limb

Most joints of the appendicular skeleton are

synovial joints.

Epiphysis vs. Apophysis

Epiphysis = articulation/joint

It is involved in a joint and therefore is covered with articular cartilage.

Apophysis = attachment

Apophysis

Bones also have projections for the attachments of muscles and ligaments, but these projections do not get involved in joints and do not have articular cartilage.

During growth, an apophysis has a

has a physis or growth cartilage. Eventually over time, the physes of both epiphyses and apophyses finish growing and completely ossify (synostosis).

Both an epiphysis and an apophysis have a physis during growth. Eventually, that growth cartilage ossifies:

Epiphysis → epiphyseal line

Apophysis → apophyseal line

If the physis is interrupted by disease or malnutrition, the cells lay down bone without a filigree of new cells, producing a dense line called

lines of interrupted growth or Harris lines.

. Note the appearance of these lines extending into the metaphyses of the long bones

]fractures (fxs) occur at the ends of growing long bones through portions of the Physis called

Salter-Harris

Fractures that go through the Epiphysis are

serious/ BAD

different types of Salter-Harris fxs are based on the

The important proliferative cells are on the epiphysis side of the physis. Fxs that Epiphysis Physis Metaphysis involve the epiphysis side of the physis are more serious . fx destroys portions of the epiphysis-side of the physis are more serous

Salter-Harris Fracture Classification: Type 1

-straight across the physis, but not injuring the proliferative cell layers

Salter-Harris Fracture Classification: Type 2

the fx goes across the growth plate and away into the metaphysis

Salter-Harris Fracture Classification: Type 3

he fx goes through part of the physis and through part of the epiphysis, thus, destroying part of the proliferative cell layer

Salter-Harris Fracture Classification: Type IV (4)

the fx goes through the epiphysis, physis and metaphysis

Salter-Harris Fracture Classification; Type V (5)

proliferative cell layer is crushed. This type of fx is uncommon

the most common Salter-Harris fx in the upper limb.

Type II

the worst form of Salter-Harris fx, with the worst prognosis because of complete interruption of growth.

Type V

Structure of a typical vertebra

7 cervical

12 thoracic

5 lumbar

fused 5 sacral vertebrae into forming the sacrum

3-4 fused coccygeal vertebrae forming the coccyx

The center of gravity for the body resides slightly in front of the body of

S1

Lumbarization

Occurs when the first sacral vertebra fails to unite with the remainder of the sacrum

sacralization

L5 vertebra may fuse with the rest of the sacrum

Intervertebral disks and numbering

numbered according the the superjacent vertebra.

Ex disk connecting vertebra C5 and C6 is IVD C5

The cervical vertebrae exhibit a curve called

cervical lordotic curve

Degree of curve for cervical vertebrae

Normal 20-40 degree

The thoracic vertebrae show an anterior concave face called what curve

Thoracic kyphotic curve

Thoracic kyphotic curve degree of the curve

Normal 20-40

The lumbar vertebrae curve is called and what is the degree

lumbar lordotic curve (facing posterior)

Normal is 30-50

Fused Sacrum has a curve called

Sacral kyphotic curve

kyphosis

hunchback/ abnormal anterior bending curve

Lordosis

abnormal posterior bending

Herniated disks occur most frequently at these inflection points

IVDs C5 or C6 and IVDs L4 and L5

Noteworthy landmark on the back

The spinous process of C7

The first palpable (and longest) spinous process of the cervical vertebrae so C7 is called

vertebra prominens

Most common spinous process involved in a clay shoveler's fracture.

C7

Intervertebral foramen

each side for the emergence of a spinal nerve.

thoracic vertebrae bear facets have the same number as

respective rib of the same number.

One of the most common causes of kyphosis is

age-related degeneration of the spine

Scoliosis is classified as a Cobb angle of curvature of greater than

10°

The Cobb angle is the angle measured by

intersecting lines of the upper end-vertebra and lower end-vertebra of the structural curve.

vertebral column motion depends on

the architecture of the zygapophyseal joints which changes from one region to another.

Cervical and thoracic vertebrae motion

best at permitting rotational movements.

Lumbar vertebrae motion

do not permit much rotational movements and such movements put stress on their zygapophyseal joints.

The entire column permits lateral bending. The cervical and lumbar vertebrae are

good for flexion and extension of the body

A Risser grade of 5 means

there is not growth plate of the apophysis evident and thus, it is safe to assumes that growth has stopped and that it is unlikely for the scoliosis to progress.

Primary Curve (Scoliosis)

The largest, most rigid, and original structural curve in scoliosis that dictates the main treatment plan.

Secondary Curve (Scoliosis)

smaller, more flexible compensatory curve created naturally by the body to keep the head and torso balanced over the pelvis.

Anterior boundary of intervertebral foramen

Portions of two vertebral bodies and the intervertebral disk.

Posterior boundary of intervertebral foramen

The zygapophyseal joint and portions of the articular processes.

Superior/inferior boundaries of intervertebral foramen

Inferior vertebral notch above and superior vertebral notch below.

Location of intervertebral disk in intervertebral foramen

Located at the lower 1/3rd of the foramen.

Interlaminar space

The space between the laminae of successive vertebrae.

Interlaminar space in lower lumbar spine

Wider and less blocked compared to higher regions of the vertebral column.

Effect of flexion on interlaminar spaces

Body flexion widens the interlaminar spaces, facilitating clinical access to the vertebral canal.

Pars interarticularis (isthmus)

The portion of the lumbar vertebra lamina that anchors the superior articular process.

An important region of the lumbar vertebra

Pars interarticularis (isthmus)