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THE VERTEBRAL COLUMN

AND THE VERTEBRAL CANAL


THE VERTEBRAL COLUMN
• The central bony pillar of the body

• Functions:
1. To support the skull, pectoral girdle, upper limbs,
thoracic cage and the pelvic girdle
2. To protect the spinal cord, roots of the spinal
nerves, ad the meninges (coverings) located in the
vertebral cavity
3. For posture and locomotion
4. To support the body
The Vertebral Column
• COMPOSITION: 33 vertebrae
• The regions in the vertebral column are as follows:

Cervical (7)

Thoracic (12)

Lumbar (5)

Sacral (5) Fused to form the sacrum

Coccygeal (4) Last 3 fused to form the coccyx


The Vertebral Column
• Flexible structure due to
– Segmented
– Made up of vertebrae, joints, intervertebral
disk

• Stabilized by ligaments, muscles and the


intervertebral discs
CURVES
• SAGITTAL PLANE • CORONAL PLANE
– Due to upright posture – Due to the use of the
and weight-bearing upper limbs
musculature
Curves in the Sagittal Plane

In the fetus,
the curve is one continuous
anterior cavity.

At birth,
the lumbosacral angle appears.
Curves in the Sagittal Plane

At 3-4 months,
when the infant starts to raise his head,
the cervical part becomes concave.
Curves in the Sagittal Plane

At around 1 year old,


the child begins to stand upright.

The lumbar part becomes


concave posteriorly.

The secondary curves


are due to the shape
of the intervertebral disks.
Curves in the Sagittal Plane

In an adult,
the regional curves are identifiable:
cervical (posterior concavity)
thoracic (posterior convexity)
lumbar (posterior concavity)
sacral (posterior convexity –
to preserve the center of gravity)
Curves in the Sagittal Plane

Primary Curves

Secondary Curves
Curves in the Coronal Plane

Late Childhood:

Minor lateral curves (thoracic area) – NORMAL

Compensatory curves above and below the


lateral curve.
PARTS OF A VERTEBRA
• GENERAL DESIGN
Posterior

Vertebral Arch

Vertebral Body

Anterior
PARTS OF A VERTEBRA
• GENERAL DESIGN
Posterior

Laminae – flattened

Vertebral foramen – enclosed by the arch and the body


- where the spinal cord
and its coverings are
Pedicle
VERTEBRAL CANAL
– formed by the succession of foramina
Anterior
PARTS OF A VERTEBRA
• GENERAL DESIGN
Processes (7)
Posterior
Spinous Process

Transverse processes (2)

Articular process (Inferior - 2)

Articular process (Superior - 2)


Anterior

Superior vertebral notch


Posterior Anterior
Inferior vertebral notch
Intervertebral
Foramen

Transmits the
spinal nerves and
blood vessels
THE CERVICAL VERTEBRAE
Parts Cervical
A. BODY •Small,
•broad from side to
side
B. VERTEBRAL ARCH Large, triangular
with Vertebral Canal/
Foramen
D. PROCESSES
1. spinous Small and bifid
2. transverse Has a transverse
foramen (vertebral
artery and vein)
3. Superior Articular Facets face upward
and backward
4. Inferior Articular Facets face downward
and forward
THE CERVICAL VERTEBRAE
Parts Typical Cervical C1-Atlas C2- Axis C7
Vertebrae (Atypical) (Atypical) (Atypical ?)
(C2-C7)
A. BODY •Small, •Absent Body of C1 fused
•broad from side to side with body of C2 to
form the odontoid
process
B. VERTEBRAL Large, triangular Has an anterior
ARCH with and posterior arch
Vertebral Canal/ Each with a
Foramen tubercle and a
lateral mass
D. PROCESSES

1. spinous Small and bifid Absent Not bifid, Long


(vertebral prominens)

2. transverse Has a transverse foramen


(vertebral art. & vein)

3. Superior Facets face upward and Kidney-shaped


Articular backward facet is large to
articulate with the
occipital condyle

4. Inferior Facets face downward ?


Articular and forward
?
THE THORACIC VERTEBRAE
Parts Thoracic
A. BODY •Medium – sized,
•heart-shaped
•Has costal facets on
sides to articulate with
the head of the ribs
B. VERTEBRAL ARCH Small, circular
with Vertebral Canal/
Foramen
D. PROCESSES
1. spinous Long, inclined forward
2. transverse Has costal facets to
articulate with the
tubercle of the ribs
3. Superior Articular Facets that face
backward and laterally
4. Inferior Articular Facets that face
forward and medially
THE THORACIC VERTEBRAE
Parts Thoracic
A. BODY •Medium – sized,
•heart-shaped
•Has costal facets on
sides to articulate with
the head of the ribs
B. VERTEBRAL ARCH Small, circular
with Vertebral Canal/
Foramen
D. PROCESSES
1. spinous Long, inclined forward
2. transverse Has costal facets to
articulate with the
tubercle of the ribs
3. Superior Articular Facets that face
backward and laterally
4. Inferior Articular Facets that face
forward and medially
THE THORACIC VERTEBRAE
Parts Typical Thoracic Atypical Thoracic Atypical Thoracic
Vertebrae Vertebrae Vertebrae
(T5-T8) (T1 to T4) (T9 to T12)
With features of With tubercles similar
cervical vertebrae to lumbar vertebrae
A. BODY •Medium – sized, •T1 – has a complete
•heart-shaped ocstal facet on its body
•Has costal facets on sides and a demifacet on its
inferior edge
to articulate with the head of
the ribs
B. VERTEBRAL ARCH Small, circular
with
Vertebral Canal/ Foramen

D. PROCESSES

1. spinous Long, inclined forward T1 – long, horizontal spine


2. transverse Has costal facets to T11 – T12
articulate with the tubercle No costal facets to articulate
of the ribs with ribs

3. Superior
Articular

4. Inferior T12 – facets face laterally


Articular
THE LUMBAR VERTEBRAE
Parts Lumbar
A. BODY Large,
Kidney-shaped
B. VERTEBRAL ARCH •triangular
with Vertebral Canal/ •Pedicles are strong and
Foramen directed backwards.
•Laminae are thick.
D. PROCESSES
1. spinous Short, flat quadrangular,
projects backward
2. transverse Long, slender,
no costal facets

3. Superior Articular Faces medially


No facets for ribs
4. Inferior Articular Faces laterally
PECULIAR FEATURES OF THE VERTEBRAE
IN EACH REGION
Parts Cervical Thoracic Lumbar
A. BODY •Small, •Medium – sized, Large,
•broad from side to •heart-shaped Kidney-shaped
side •Has costal facets on
sides to articulate with
the head of the ribs
B. VERTEBRAL ARCH Large, triangular Small, circular •triangular
with Vertebral Canal/ •Pedicles are strong and
Foramen directed backwards.
•Laminae are thick.
D. PROCESSES
1. spinous Small and bifid Long, inclined forward Short, flat quadrangular
projects backward
2. transverse Has a transverse Has costal facets to Long, slender, no costal
foramen (vertebral articulate with the facets
artery and vein) tubercle of the ribs
3. Superior Articular Facets face upward Facets that face Faces medially
and backward backward and laterally No facets for ribs
4. Inferior Articular Facets face downward Facets that face Faces laterally
and forward forward and medially
SACRAL BONE
• 5 rudimentary vertebrae fused to form a
wedge-shaped bone concaved anteriorly
• Articulations* Where sacral nerves pass through
Sacral canal
•Sacral n.
•Coccygeal n.
•Filum terminale
•Fibrofatty material

Promontory

Laminae fail to
meet at the midline
(sacral hiatus)

Vertebral foramina forms the sacral canal, contains the subarachnoid space
THE COCCYX

The first coccygeal bone is usually


Fused or incompletely fused with the
Second coccygeal bone.
LIGAMENTS
• Anterior Longitudinal Ligament • Posterior Longitudinal Ligament

 Strong, broad fibrous band  Weaker, narrower band

 Covers and connects the  Runs along the posterior bodies


anterior aspects fo the of the vertebral bodies within the
verterbral bodies and vertebral canal
intervertebral discs
 From C2 to the sacrum
 From the anterior tubercle of
C1 and the occipital bone of
the skull anterior to the
foramen magnum to the
sacrum
 Prevents hyperextension of the
 pelvic surface of the sacrum to vertebral colmn
the Prevents hyperextension
of the vertebral column
LIGAMENTS
• Anterior Longitudinal Ligament

 Strong, broad fibrous band

 Covers and connects the


anterior aspects fo the
verterbral bodies and
intervertebral discs

 From the anterior tubercle of


C1 and the occipital bone of
the skull anterior to the
foramen magnum to the
sacrum

 pelvic surface of the sacrum to


the Prevents hyperextension
of the vertebral column
LIGAMENTS
• Posterior Longitudinal
Ligament

 Weaker, narrower band

 Runs along the posterior


bodies of the vertebral bodies
within the vertebral canal

 From C2 to the sacrum

 Prevents hyperextension of
the vertebral colmn
THE INTERVERTEBRAL DISC
• LOCATION
– ¼ the entire length of the vertebra
– Thickest at the cervical and lumbar regions
– Shock absorbers

– In between vertebrae EXCEPT


• Between C1 and C2 First disc is between C2 and C3.
Last functional disc is
• In the sacrum between L5 and S1.
• In the coccyx
Total= 18
Annulus Fibrosus
fibrocartilage and collagen fibers

Nucleus Pulposus
In children: gelatinous, with large amount of water
little amount of cells

In adults: replaced by collagen fibers


discs becomes thin and less elastic
cannot distinguish it from annulus fibrosus
HERNIATION OF THE
INTERVERTEBRAL DISC
• A sudden increase in the compression load of
the vertebra causes the semifluid nucleus
pulposus to become more flattened.

• At times the outward thrust is too great, the


annulus fibrosus ruptures and the nucleus
pulposus herniates and protrudes into the
vertebral canal (compressing the spinal cord,
roots or nerves).
HERNIATION OF THE
INTERVERTEBRAL DISC
• A sudden increase in the compression load of
the vertebra causes the semifluid nucleus
pulposus to become more flattened.

• At times the outward thrust is too great, the


annulus fibrosus ruptures and the nucleus
pulposus herniates and protrudes into the
vertebral canal (compressing the spinal cord,
roots or nerves).
ATLANTO-OCCIPITAL JOINT
Synovial Joint (condyloid)
• ARTICULATING BONES

Occipital
condyles

MOVEMENTS: flexion, extension, lateral flexion


NO ROTATION!
ATLANTO-AXIAL JOINT
• JOINT CLASSIFICATION
• Synovial Joint (Pivot Joint)

• 3 synovial joints:
– between the odontoid
process and the anterior
arch of the atlas

– 2 joints between the lateral


masses of the bones
ATLANTO-AXIAL JOINT
• JOINT CLASSIFICATION:
• Synovial Joint (Pivot Joint)

• 3 synovial joints:
– between the odontoid
process and the anterior
arch of the atlas

– 2 joints between the lateral


masses of the bones

MOVEMENTS: extensive rotation of the atlas and of the head.


LUMBAR TAP
• A procedure to
withdraw
cerebrospinal fluid
for examination

• For clinical diagnosis


• Introduce drugs
• Remove “excess
spinal fuid”
(headache)
The patient lies on his side with his
Vertebrae well flexed.

This widens the space between


the adjoining laminae.

The level of t he fourth lumbar spine


is determined by drawing
an imaginary line joining the
highest points of the iliac crest.
the vertebrae
The lumbar puncture needle
is passed into the vertebral canal
Above or below the fourth lumbar spine.

Structures:
6. Skin
7. Superficial fascia
8. Supraspinous ligament
9. Interspinous ligament
10. Ligamentum flavum
11. Areolar tissue containing the
internal vertebral venous plexus
in the epidural space
7. Dura matter
8. Arachnoid matter
9. Subarachnoid space
SPONDYLOLYSIS
• Spinous process,
laminae and inferior
articular process

separate from

the body pedicles


and the superior
articular process

• NO ANTERIOR
DISPLACEMENT
SPONDYLOLISTHESIS
• Spinous process,
laminae and inferior
articular process

separate from

the body pedicles


and the superior
articular process

• THERE IS
ANTERIOR
DISPLACEMENT
SPONDYLOLISTHESIS
• The body of a lower
lumbar vertebra
(usually of L5)
moves forward to
the body of the
vertebra below and
carries with it the
whole upper portion
of the vertebral
column

• The nerve roots


may be
compressed.
THE VERTEBRAL COLUMN
AND THE VERTEBRAL CANAL

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