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Download Anatomy of the Spine and Repro - Part 1 - UQMBBS-2013
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The Vertebral Column • 33 vertebra in total • 7C • 12T • 5L • 5S (fuse by age 30) • 4 coccygeal (form coccyx) • ¼ of length = IV disc • Synovial zygapophysial joints = flexibility Features of All Vertebrae • Vertebral body • Supports weight • Superior and inferior end plates (discs of hyaline cartilage) = epiphyseal rim • Centrum (POC) • Vertebral arch • Pedicles • Laminae • Vertebral foramen vertebral canal • Vertebral notches IV foramina • Seven processes • Spinous • Transverse (x2) • Articular (x4) Cervical Vertebrae • Transverse process • Foramen transversarium / transverse foramin (C1 – C6 = vertebral artery) • Anterior and posterior tubercle • Body • Uncus (uncinate process) • Spinous processes – bifid (C3-C6) • C7 – vertebra prominens • Atlas – no body, no spinous process, pedicles = lateral masses (bear weight). • Ant / post arch • Ant / post tubercles • Fovea for the dens • Axis • Dens (odontoid process) • Superior articular facets • Transverse ligament of atlas Thoracic Vertebrae • T1: costal facet for 1st rib, demifacet for 2nd rib • T2 – T8 = demifacets, vertical articular processes • Permit rotation, some lateral flexion • Spinous processes angle inferiorly and overlap • T9 – T11: Single costal facet • T12: One demifacet, most commonly fractured vertebra Lumbar vertebrae • Supracristal line crosses L4/L5 IV disc • Facets in sagittal plane – permit flexion and extension • Also accessory and mammillary processes • Lumbosacral angle (normally 130-160) Sacrum • Superior half transmits force L5 to ilia • Sacral canal (for cauda equina) • Sacral foramina (ventral and dorsal) • Base = superior surface of S1 • Sacral promonory • Apex = S5 • Articular facet for coccyx) • Pelvic surface = smooth • Lateral surface • Median / intermediate / lateral sacral crests • Sacral hiatus • Sacral cornua Coccyx • Fuses with sacrum, though Co1 can remain separate (has coccygeal cornua, remnants of articular processes) • Provides attachment for glut max, coccygeus, anococcygeal ligaments • Apex is palpable 2.5cm posterosuperior to the anus Ligaments of the Spine • Ligamentum flavum (connects laminae) • Supraspinous ligament • Interspinous ligament • Nuchal ligament (occiput-C1C7) • Posterior longitudinal ligament (prevents herniation) • Anterior longitudinal ligament (limits extension) Superficial Back Muscles Erector spinae Deep intrinsic back muscles • These interconnect and stabilise – found deep to spinalis • Semispinalis • Multifidus • Rotatores (brevis and longus) • Interspinales • Intertransversarii Anatomy of the Pelvis Bony Pelvis • 3 bones each side, forms pelvic girdles • Os coxae = ilium, ischium, pubis • Ilium • • • • • • • • Arcuate line Iliac crest Iliac fossa Auricular surface Iliac tuberosity Ala Gluteal lines ASIS, AIIS, PSIS, PIIS • Ischium • • • • • • Body Ramus (obturator foramen) Greater sciatic notch Ischial spine Lesser sciatic notch Ischial tuberosity • Pubis • • • • • • • Superior ramus (acetabulum) Inferior ramus Body of pubis Pubic crest Pubic tubercle Pubic symphysis Pecten pubis Muscles of the pelvis • Lateral wall = obturator internus (traverses lesser sciatic foramen to attach on greater trochanter), obturator fascia • Posterior wall = SI joint and piriformis (arises from sacrum, passes through greater sciatic f. to attach to greater trochanter) • Pelvic floor = pelvic diaphragm = coccygeus + levator ani Levator ani • Broad sheet between pubic bodies and ischial spines. Supports abdominopelvic viscera and is tonically contracted to maintain continence • Puborectalis = puborectal sling • Pubococcygeous • Muscle slips names after structures: pubo-analis, puboperinealis, pubovaginalis, puboprostaticus • Iliococcygeus (most posterolateral part). Peritoneum of Pelvis Learn for Surg Rotation Arteries of the pelvis
