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Page 1: The Spine & Thorax Bones

  • Cervical Vertebrae: C1 is rostral to C7

  • Costal Relation: C7 is costal to C1

  • Vertebral Column: Structure comprising multiple vertebrae.

Page 2: Overview of the Vertebral Column

  • Often referred to as the spinal column or spine.

  • Composition: Consists of 33 vertebrae.

  • Functions:

    • Supports the trunk.

    • Protects the spinal cord.

  • Movements: Includes flexion, extension, lateral flexion, and rotation.

  • Intervertebral Discs: Found between adjacent vertebrae; primarily composed of water.

Page 3: Spinal Development

  • Fetal Stage: Vertebral column is C-shaped (convex).

  • Newborn Stage: Slight flexure occurs between lumbar and sacral areas.

  • Adult Stage:

    • Thoracic & sacral curvatures persist from original curve.

    • Cervical & lumbar concavities are posteriorly directed (lordotic).

    • These adaptations enhance weight balance on the vertebral column.

    • Cervical Lordosis: Develops when a child attempts head control.

    • Lumbar Lordosis: Develops during stages of standing and walking.

Page 4: Structure of a Typical Vertebra

  • Body: Cylindrical, heavy; made of spongy bone and covered with a thin cortical bone layer.

  • Pedicles: Two on the posterior side; extend back and connect to laminae, forming the vertebral arch.

  • Vertebral Foramen: Space between arch and the body that houses the spinal cord.

  • Vertebral Canal: Formed by successive vertebral foramina.

  • Transverse Process: Projects laterally where the pedicle and lamina meet; offers attachment for muscles and articulation with ribs.

Page 5: Key Features of Vertebrae

  • Notches: Inferior and superior vertebral notches of lower pedicle form the intervertebral foramen, through which spinal nerves exit from the vertebral canal.

  • Zygapophyses (Z joints): Connect pedicle and lamina to form facets for articulation with adjacent vertebrae.

  • Spinous Process: Midline posterior projection providing muscle attachment.

Page 6: Cervical Vertebrae

  • Transverse Foramen: Present in each transverse process.

  • Delicate Bodies: Larger diameter laterally.

  • Articular Processes:

    • Superior face upward and backward.

    • Inferior face forward and downward.

  • Size increases caudally, with C7 marking the transition to thoracic vertebrae.

Page 7: Atlas (C1)

  • Articular Facets: Superior facets are concave, articulating with the occipital condyles of the skull; inferior facets flatter and articulate with the axis.

Page 8: Axis (C2)

  • Dens: Projects upward and articulates with the anterior arch of the atlas, allowing rotation.

Page 9: Thoracic Vertebrae

  • Articular Facets: Superior and inferior facets are aligned almost in a frontal plane.

  • Costal Facets: Points of articulation with ribs; spinous processes are long and directed downward.

Page 10: Lumbar Vertebrae

  • Structure: Massive bodies; heavy and broad spinous processes; shorter laminae than body; long and slender transverse processes.

Page 11: Sacrum & Coccyx

  • Pelvic Sacral Foramina: Ventral rami of S1-S4 exit through these openings.

  • Median Crest: Comprises rudimentary spinous processes.

Page 12: Dorsal Sacral Foramina

  • Function: Dorsal rami of S1-S4 exit here.

  • Coccyx: Usually composed of 3 or 4 vertebrae, with the first typically separate.

  • Terminology:

    • Vertebral foramen = sacral foramen

    • Canal of sacrum = sacral canal

    • Sacral hiatus = deficient caudal portion of the canal.

Page 13: Functions of Vertebral Column

  • Composed of 33 bones:

    • 7 cervical

    • 12 thoracic

    • 5 lumbar

    • 5 sacral

    • 3-4 coccygeal.

  • Key function: Support for the trunk and spinal cord protection.

  • Movements: flexion, extension, lateral flexion, and rotation.

Page 14: Intervertebral Discs

  • Role in weight bearing; not primarily for movement.

  • Size & thickness vary across different spinal regions.

  • Structure is related to the spine's curvature.

  • Most prominent discs between C2-C3 and L5-S1.

  • Comprised of annulus fibrosus surrounding nucleus pulposus.

Page 15: Annulus Fibrosus & Nucleus Pulposus

  • Annulus Fibrosus: Inserts into smooth rims on the vertebral bodies’ articular surface.

  • Nucleus Pulposus: High water content, more posterior than central, acts as a shock absorber and is avascular.

Page 16: Anterior Longitudinal Ligament

  • Broad fibrous band connecting anterior vertebral bodies and intervertebral discs from sacrum to C1.

  • Stabilizes joints, prevents hyperextension of the spine, and is involved in whiplash injuries.

Page 17: Posterior Longitudinal Ligament

  • Narrower and weaker than the anterior ligament, runs posteriorly along the vertebral bodies.

  • Prevents hyperflexion and posterior protrusion of nucleus pulposus.

Page 18: Zygapophyseal (Z) Joints

  • Synovial joints between superior and inferior articular processes allow gliding movements.

  • Orientation in cervical region permits increased flexibility for movement.

Page 19: Ligaments of Intervertebral Joints

  • Ligamenta Flava: Joins laminae of adjacent vertebral arches and helps maintain spinal curvature.

  • Interspinous Ligaments: Connect adjacent spinous processes (weak).

  • Supraspinous Ligament: Strong, supports attached spinous processes.

Page 20: Atlantooccipital Joint

  • Joint between the skull and C1 allows nodding of the head.

  • Atlantoaxial Joint: Joint between C1 and C2 facilitates head rotation.

Page 21: Transverse Ligaments of Axis

  • Hold the dens in position against the anterior arch of the atlas with additional support from the cruciform ligament and alar ligaments.

Page 22: Tectorial Membrane

  • Extends from the body of the atlas to the occipital bone, covering alar and transverse ligaments.

Page 23: Extrinsic Back Muscles

  • Divided into superficial (e.g., trapezius, latissimus dorsi, levator scapulae) which help with limb movements and intermediate muscles (serratus posterior) which are primarily proprioceptive.

Page 24: Serratus Posterior Muscles

  • Superior:

    • Origin: Ligamentum nuchae, spinous processes of C7-T2/3

    • Insertion: 2nd-5th ribs

    • Action: Assists in elevating ribs.

Page 25: Serratus Posterior Inferior

  • Origin: Spinous processes of T11-L2.

  • Insertion: 9th-12th ribs.

  • Action: Draw lower ribs downward and stabilize them.

Page 26: Intrinsic (Deep) Back Muscles

  • Maintain posture and control spine movements, extending from pelvis to cranium, composed of multiple layers distinguished by fiber direction and length.

Page 27: Splenius Muscles

  • Splenius Capitis & Cervicis:

    • Origins: Ligamentum nuchae and spinous processes from C7 & T1-T3/4.

    • Insertions: Occipital bone and transverse processes of cervical vertebrae.

    • Actions: Rotate head and assist in extension of neck.

Page 28: Erector Spinae Group

  • Origin: Posterior sacrum, iliac crest, spinous processes of T11-L5.

  • Actions: Extends the thoracic vertebral column.

Page 29: Erector Spinae Subgroups

  • Consists of three groups moving from largest to smallest.

Page 30: Iliocostalis System

  • Origins: From iliac crest to lower ribs.

  • Insertions: Lower ribs to transverse processes.

Page 31: Longissimus System

  • Origins: Common tendon of erector spinae to cervical and thoracic vertebrae.

  • Insertions: Transverse processes and mastoid process.

Page 32: Spinalis System

  • Origins: Spinous processes of lumbar and thoracic vertebrae.

  • Insertions: Upper thoracic and axis spinous processes.

Page 33: Deep Layer: Transversospinalis Muscles

  • Includes Semispinalis (deep to erector spinae), Multifidus, and Rotators.

  • Function: Extend and rotate the spine.

Page 34: Semispinalis Muscles

  • Origins: Transverse processes of thoracic and cervical vertebrae.

  • Insertions: Occipital bone and spinous processes of cervical vertebrae.

Page 35: Multifidus

  • This muscle assists in extending the spine bilaterally and rotates the spine unilaterally.

Page 36: Rotatores

  • Short muscles that help in rotation and extension of the spine.

Page 37: Quadratus Lumborum

  • Origin: Posterior iliac crest, Insertion: Last rib and lumbar vertebrae transverse processes; acts to stabilize lumbar region and supports lateral flexion.

Page 38: Lecture Notes Summary

  • Discussed common muscle groups in various spinal regions:

    • Cervical Region: Notable flexibility due to disc structure.

    • Thoracic Region: More restricted movements; rib attachment influences motion.

    • Lumbar Region: Facilitates flexion and extension, limited by structure.

Page 39: General Anatomy Notes of Muscles

  • Muscle Fibers: Arrangement and layers contribute to strength and movement.

    • Longer muscles are superficial; short muscles lie directly against vertebrae.