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Chapter 7 The Skeleton Part B Shilla Chakrabarty, Ph.D. Copyright © 2010 Pearson Education, Inc. Vertebral Column • Transmits weight of trunk to lower limbs • Surrounds and protects spinal cord • Flexible curved structure containing 26 irregular bones (vertebrae) Cervical vertebrae (7)—vertebrae of the neck Thoracic vertebrae (12)—vertebrae of the thoracic cage Lumbar vertebrae (5)—vertebra of the lower back Sacrum—bone inferior to the lumbar vertebrae Coccyx—terminus of vertebral column Copyright © 2010 Pearson Education, Inc. Vertebral Column: Curvatures C1 Cervical curvature (concave) 7 vertebrae, C1–C7 Spinous process Transverse processes Thoracic curvature (convex) 12 vertebrae, T1–T12 Intervertebral discs Intervertebral foramen Lumbar curvature (concave) 5 vertebrae, L1–L5 Sacral curvature (convex) 5 fused vertebrae sacrum Anterior view Copyright © 2010 Pearson Education, Inc. Coccyx 4 fused vertebrae Right lateral view Increase the resilience and flexibility of the spine Two posteriorly concave curvatures: Cervical and lumbar Two posteriorly convex curvatures: Thoracic and sacral Abnormal spine curvatures Scoliosis (abnormal lateral curve) Kyphosis (hunchback) Lordosis (swayback) NOTE: The vertebrae become progressively larger from cervical to lumbar region as they have to support more weight Ligaments • Strap-like ligaments and trunk muscles hold the vertebral column in place and keep it upright • Anterior and posterior longitudinal ligaments: Major supporting ligaments Run as continuous bands down the front and back surfaces of vertebrae from neck to sacrum Anterior ligament • Broad, strongly attached to bony vertebrae and discs • Besides support, prevents hyperextension (bending too far backward) of spine Posterior ligament • Narrow and relatively weak • Resists hyperflexion (bending too sharply forward) of spine • Ligamentum flavum • Connects adjacent vertebrae • Contains elastic connective tissue, especially strong • Stretches upon bending forward, recoils on resumption of erect posture • Short ligaments • Connect each vertebra to those above and below Copyright © 2010 Pearson Education, Inc. Major Ligaments Of The Vertebral Column Copyright © 2010 Pearson Education, Inc. Intervertebral Discs Cushion-like pad composed of two parts 1. Nucleus pulposus • 2. Inner gelatinous nucleus that gives the disc its elasticity and compressibility Anulus fibrosus • Strong outer collar surrounding nucleus pulposus • Composed of collagen fibers superficially and fibrocartilage internally • Limits the expansion of the nucleus pulposus when spine is compressed • Binds successive vertebrae together, withstands twisting forces, resists tension in spine Act as shock absorbers during running, walking and jumping Allow spine to flex, extend, and bend laterally (to some extent). Thickest in cervical and lumbar regions Flatten and bulge out between vertebrae at points of compression Copyright © 2010 Pearson Education, Inc. Median Section Of Three Vertebrae, Illustrating The Composition Of Discs and Ligaments Supraspinous ligament Transverse process Sectioned spinous process Ligamentum flavum Interspinous ligament Inferior articular process Copyright © 2010 Pearson Education, Inc. Intervertebral disc Anterior longitudinal ligament Intervertebral foramen Posterior longitudinal ligament Anulus fibrosus Nucleus pulposus Sectioned body of vertebra Figure 7.17a Herniated (Prolapsed) Disc • Common name: slipped disc • Anulus fibrosus ruptures • Nucleus pulposus protrudes through anulus Vertebral spinous process (posterior aspect of vertebra) Spinal cord • If protrusion presses on spinal cord or spinal nerves exiting the cord, numbness or excruciating pain result Spinal nerve root • Generally treated with moderate exercise, massage, heat therapy, painkillers Herniated portion of disc • Protruding disc may sometimes have to be removed surgically and a bone graft done to fuse the adjoining vertebrae Copyright © 2010 Pearson Education, Inc. Transverse process Anulus fibrosus of disc Nucleus pulposus of disc (c) Superior view of a herniated intervertebral disc General Structure of Vertebrae • Body or centrum Seven processes per vertebra: Anterior weight-bearing region • Vertebral arch Composed of pedicles (short bony pillars) and laminae (flat plates) that, along with centrum, enclose vertebral foramen • Vertebral foramina Together make up vertebral canal for spinal cord • Spinous process—median posterior projection • Transverse processes (2)—project laterally • Superior articular processes (2)—protrude superiorly • Inferior articular processes (2)—protrude inferiorly Facets covered with hyaline cartilage Posterior Lamina Spinous process Transverse process Vertebral arch • Intervertebral foramina Lateral openings between adjacent vertebrae (formed by notches on the superior and inferior border of pedicles) for spinal nerves issuing from spinal cord Superior articular process and facet Vertebral foramen Pedicle Body (centrum) Anterior Copyright © 2010 Pearson Education, Inc. Cervical Vertebrae • C1 to C7: smallest, lightest vertebrae • C3 to C7 share the following features Oval body, wider from side to side Spinous processes short and bifid (except C7) Large, triangular vertebral foramen Transverse foramen in each transverse process for passage of vertebral arteries that supply blood to the brain NOTE: Spinous process of C7 is much larger than the other cervical vertebrae, and is plalpable through the skin, C7can be used as a landmark for counting the vertebrae and is called the vertebra prominens. Copyright © 2010 Pearson Education, Inc. Cervical Vertebrae • C1 (atlas) and C2 (axis) have unique features • Atlas (C1) Ring of bone, no body or spinous process Consists of anterior and posterior arches, and two lateral masses Superior surfaces of lateral masses articulate with the occipital condyles of skull, to allow the head to nod “yes”. Inferior articular facets form joints with the axis (C2 ) below. C1 Posterior Lateral masses Posterior Posterior tubercle Posterior arch Anterior tubercle (a) Superior view of atlas (C1) Anterior arch Copyright © 2010 Pearson Education, Inc. Transverse foramen Superior articular facet Posterior arch Transverse process Lateral masses Posterior tubercle Inferior articular facet Transverse Anterior foramen arch Facet for dens Anterior tubercle (b) Inferior view of atlas (C1) Dens of axis Transverse ligament of atlas C1 (atlas) C2 (axis) C3 Inferior articular process Bifid spinous process Transverse processes C7 (vertebra prominens) (a) Cervical vertebrae Copyright © 2010 Pearson Education, Inc. Figure 7.20a Cervical Vertebrae • Axis (C2) Knob-like dens projects superiorly into the anterior arch of atlas Dens is the “missing” body of the atlas which fuses with the axis during embryogenesis Dens is cradled in anterior arch of atlas by transverse ligaments and acts as a pivot for rotation of atlas. [Head can move from side to side, to indicate “no”.] Posterior C2 Spinous process Inferior articular process Lamina Pedicle Transverse process Dens Body (c) Superior view of axis (C2) Copyright © 2010 Pearson Education, Inc. Superior articular facet Thoracic Vertebrae • T1 to T12 • First T1 looks like C7; last 4 look more like lumbar vertebrae • Heart-shaped body with two demifacets (superior and inferior costal facet). • Demifacets receive head of ribs [T10 – T 12 have a single facet to receive their respective ribs] • Circular vertebral foramen • Long spinous process, pointing downwards • Transverse processes with facets (except T11 – T 12 ] • Location of articular facets in frontal plane prevents flexion and extension, but allows rotation of this area of spine Copyright © 2010 Pearson Education, Inc. Transverse process Superior articular process Transverse costal facet (for tubercle of rib) Intervertebral disc Body Spinous process Inferior costal facet (for head of rib) Inferior articular process (b) Thoracic vertebrae Copyright © 2010 Pearson Education, Inc. Figure 7.20b Lumbar Vertebrae • L1 to L5 • Weight bearing, receive most stress • Massive kidney-shaped bodies • Short, thick pedicles and laminae • Robust flat hatchet-shaped spinous processes project backwards for attachment of large back muscles • Orientation of articular facets locks lumbar vertebrae together so as to prevent rotation while allowing flexion and extension Copyright © 2010 Pearson Education, Inc. Superior articular process Transverse process Body Intervertebral disc Inferior articular process Spinous process (c) Lumbar vertebrae Copyright © 2010 Pearson Education, Inc. Figure 7.20c Sacrum and Coccyx Sacral promontory Sacrum Ala • Triangular structure representing 5 fused vertebrae (S1–S5), forms posterior wall of pelvis • Articulates with L5 superiorly (via its superior articular process) and with coccyx inferiorly • Articulates laterally with auricular surfaces of hip bones to form sacroiliac joints of pelvis • Four transverse ridges in anterior aspect mark lines of fusion of sacral vertebrae • Anterior sacral foramina at lateral ends of ridges transmit blood vessels and anterior rami of sacral spinal nerves • Posterior midline roughened by medial sacral crest (fused spinous processes of sacral vertebrae) • Sacral crest flanked laterally by posterior sacral foramina (which transmit posterior rami of sacral spinal nerves) and lateral sacral crests (remnants of transverse processes of S1–S5 • Vertebral canal continues inside as sacral canal • Sacral hiatus, an enlarged external opening at inferior end of sacral canal represents area where laminae of 5th sacral vertebrae fail to fuse medially Body of first sacral vertebra Transverse ridges (sites of vertebral fusion) Apex Coccyx (a) Anterior view Ala Sacral canal Median sacral crest Posterior sacral foramina Coccyx (b) Posterior view Copyright © 2010 Pearson Education, Inc. Anterior sacral foramina Body Facet of superior articular process Auricular surface Lateral sacral crest Sacral hiatus Coccyx • Tailbone • Small, triangular, formed by 3-5 fused vertebrae • Articulates superiorly with sacrum • Provides slight support to pelvic organs, but otherwise useless Copyright © 2010 Pearson Education, Inc. Thoracic Cage Roughly cone-shaped, with broad dimensions positioned posteriorly Composed of • Thoracic vertebrae dorsally • Sternum costal cartilages anteriorly • Ribs laterally NOTE: Costal cartilages secure ribs to sternum Functions • Protective cage around vital organs (heart, lung, great blood vessels) of thoracic cavity • Supports shoulder girdle and upper limbs • Provides attachment sites for many muscles of neck, back, chest and shoulders • Intercostal muscles in intercostal spaces between ribs used to lift and depress thorax during breathing Copyright © 2010 Pearson Education, Inc. Sternum (Breastbone) • Lies in anterior midline of thorax • Flat bone resembling a dagger • Formed by fusion of three bones Manubrium: Articulates with clavicles and ribs 1 and 2 Body: Articulates with costal cartilages of ribs 2 through 7 Xiphoid process: Site of muscle attachment, not ossified until ~ age 40 Copyright © 2010 Pearson Education, Inc. Ribs and Their Attachments • 12 pairs • All attach posteriorly to thoracic vertebrae • Pairs 1 through 7: True (vertebrosternal) ribs, attach directly to sternum by individual costal cartilages • Pairs 8 through12: False ribs • Pairs 8–10: Also called vertebrochondral ribs, attach indirectly to sternum by joining costal cartilage of rib above • Pairs 11–12 also called vertebral (floating) ribs, have no attachment to sternum Copyright © 2010 Pearson Education, Inc. Ribs and Their Attachments Jugular notch Clavicular notch Manubrium Sternal angle Body Xiphisternal Sternum joint Xiphoid process True ribs (1–7) False ribs (8–12) Intercostal spaces Costal cartilage Costal margin L1 Vertebra Floating ribs (11, 12) (a) Skeleton of the thoracic cage, anterior view Copyright © 2010 Pearson Education, Inc. Figure 7.22a Structure of a Typical Rib Main parts: • Head: Articulates posteriorly with facets (demifacets) on bodies of two adjacent vertebrae • Neck • Tubercle: Articulates posteriorly with transverse costal facet of same-numbered thoracic vertebra • Transverse costal facet (for tubercle of rib) Angle of rib Superior costal facet (for head of rib) Body of vertebra Head of rib Intervertebral disc Neck of rib Tubercle of rib Shaft Shaft Sternum Crosssection of rib Costal groove Costal cartilage (a) Vertebral and sternal articulations of a typical true rib Copyright © 2010 Pearson Education, Inc. Structure of a Typical Rib Main parts: • Head: Articulates posteriorly with facets (demifacets) on bodies of two adjacent vertebrae • Neck • Tubercle: Articulates posteriorly with transverse costal facet of same-numbered thoracic vertebra • Shaft Transverse costal facet (for tubercle of rib) Angle of rib Superior costal facet (for head of rib) Articular facet on tubercle of rib Spinous process Shaft Body of vertebra Head of rib Intervertebral disc Neck of rib Tubercle of rib Shaft Sternum Ligaments Neck of rib Head of rib Crosssection of rib Costal groove Costal cartilage (a) Vertebral and sternal articulations of a typical true rib Copyright © 2010 Pearson Education, Inc. Transverse costal facet (for tubercle of rib) Body of thoracic vertebra Superior costal facet (for head of rib) (b) Superior view of the articulation between a rib and a thoracic vertebra Figure 7.23b