Lesson+3_Skeleton+of+the+trunk.pptx

Lesson 3 Skeleton of the trunk Human Anatomy and Embryology Prof. Mar Ubero Dentistry Index CONTENT -Vertebral column: bones and joints. -Biomechanics. -Muscles of the posterior region of the trunk. 1. Vertebral column • 7 cervical vertebrae. • 12 thoracic vertebrae. • 5 lumbar vertebrae. • 5...

Lesson 3 Skeleton of the trunk Human Anatomy and Embryology Prof. Mar Ubero Dentistry Index CONTENT -Vertebral column: bones and joints. -Biomechanics. -Muscles of the posterior region of the trunk. 1. Vertebral column • 7 cervical vertebrae. • 12 thoracic vertebrae. • 5 lumbar vertebrae. • 5 sacral vertebrae (fused into sacrum). • 3-4 coccygeal vertebrae (fused into coccyx). 1. Vertebral column • Linked to adjacent vertebral bodies by intervertebral discs and ligaments. • Size increases caudally as the amount of weight supported increases. • Effects of movement between vertebrae are additive along the length of the vertebral column. • First two cervical vertebrae and associated muscles: Support, move, and position head. • Protection of the nervous system: 1. Vertebral column • Primary curvature: Concave ventrally, reflecting original shape of the embryo, maintained in thoracic and sacral regions. • Secondary curvatures: Concave dorsally, in the cervical and lumbar region. General features of a vertebra 1. Vertebral column • 2 pedicles (attach arch to body) and 2 laminae (from pedicle to midline). • Spinous process projects dorsally and inferiorly from laminae (muscle and ligament attachment. • Transverse process extends laterally (articulation with ribs in thoracic region). • Superior and inferior articular processes project cranially and caudally respectively. Cervical vertebrae 1. Vertebral column 7 cervical vertebrae (C1-C7): •Along the neck, between thorax and skull. •Small size, triangular vertebral canal. •Squared shape body when seen from above. •Spinous process —> bifid. •Foramen transversarium (transverse foramen) in the transverse process. Cervical vertebrae 1. Vertebral column Atlanto-axial joint ATLA S C1 Atlanto-occipital joint AXI S C2 Cervical vertebrae 1. Vertebral column Cervical vertebrae 1. Vertebral column Biomechanics of the cervical vertebrae In Vivo September 2020, 34 (5) 2401-2406; DOI: https://doi.org/10.21873/invivo.12053 Thoracic vertebrae 1. Vertebral column 12 thoracic vertebrae (T1-T12): •All characterised by their articulation with ribs. •Superior and inferior costal facets on each side of the body (to articulate with the head of the rib). •Transverse costal facet on transverse process (to articulate with the tubercle of the rib). •Vertebral body: heart-shaped. •Circular vertebral canal. Thoracic vertebrae 1. Vertebral column Lumbar vertebrae 1. Vertebral column 5 lumbar vertebrae (L1-L5): •Large size, and cylindrical shaped body. •Lack of costal facets. •Transverse process generally thin and long. •Vertebral foramen is triangular in shape and larger than in the thoracic vertebrae. Sacral vertebrae 1. Vertebral column 5 fused sacral vertebrae (S1-S5): Sacrum •Triangular shape and curved (concave anterior surface and convex posterior surface). •Articulates with L5 cranially, Coccyx caudally and laterally with pelvic bone (L- shaped articular facets). •2 large facets on lateral surfaces for articulation with the pelvic bones. •4 anterior and posterior foramina for the passage of S1-S4 spinal nerves Coccigeal vertebrae 1. Vertebral column 3-4 fused coccygeal vertebrae (Co1-Co3-4): Coccyx •Small size. •Absence of vertebral arches and therefore vertebral canal. 1. Vertebral column Joints INTERVERTEBRAL FORAMEN • Area where the spinal nerve and blood vessels pass in and out the vertebral canal. • Formed between adjacent vertebral arches. 1. Vertebral column Joints JOINTS BETWEEN VERTEBRAE: - Zygapophysial joints: Synovial joints between superior and inferior articular processes on - adjacent vertebrae. Symphysis: The symphysis between adjacent vertebral bodies. This joint is formed by a layer of hyaline cartilage on each vertebral body intervertebral disc. and an 1. Vertebral column JOINTS BETWEEN VERTEBRAE: - Uncovertebral joints (cervical vertebrae): The lateral margins of the upper surfaces are elevated into crests named uncinate processes that articulate with the above (synovial joint). vertebra 1. Vertebral column INTERVERTEBRAL DISCS Nucleus pulposus (gelatinous). Absorbs compression forces between vertebrae. Anulus fribrosus (collagen). Arranged in a lamellar configuration. Limits rotation between vertebrae. Image from Jain SK and Jain G, 2015. Spine and spinal orthoses. Jaypee Brothers Medical Publishers (P) Ltd.; 1st Ed. 2015 1. Vertebral column INTERVERTEBRAL DISCS: Disc protrusion Ligaments 1. Vertebral column Ligamentum flavum Posterior longitudinal ligament Interespinous ligament Supraspinous ligament C7-L3 Anterior longitudinal ligament Martini FH, Tallitsch RB, Nath JL. Human Anatomy. 8th Edition. Pearson Education SA, 2018 Ligaments 1. Vertebral column ANTERIOR LIGAMENT: LONGITUDINAL - Attached cranially to the anterior base of the cranium and extends caudally to attached to the ventral surface of the sacrum. - Along its length it is attached to both the vertebral bodies and intervertebral discs. - Reinforcement maintenance of the joints. and Ligaments 1. Vertebral column POSTERIOR LIGAMENT: LONGITUDINAL - Lines the ventral surface of the vertebral canal. - Attached to the posterior part of both vertebral bodies and intervertebral discs. - Reinforcement maintenance of the joints. and Ligaments 1. Vertebral column SUPRASPINOUS LIGAMENT: - Connects and passes along the spinous processes from C7 to sacrum. - Reinforcement maintenance of the joints. and Ligaments 1. Vertebral column LIGAMENTUM NUCHAE: - Triangular, sheet-like structure in the median sagittal plane. - From external occipital protuberance to foramen magnum, and caudally until spinous process of C7. - It supports the head, resists flexion and facilitates return to anatomical position. - Reinforcement maintenance of the joints. and Ligaments 1. Vertebral column LIGAMENTUM FLAVUM: - On each side, attached to the laminae of adjacent vertebrae. - Reinforcement maintenance of the joints. and Ligaments 1. Vertebral column INTERSPINOUS LIGAMENT: - Pass between adjacent spinous processes. - Attached from the base to the apex of each spinous process and blend with supraspinous ligament dorsally and ligamenta flava ventrally on each side. - Reinforcement and maintenance of the joints. 1. Vertebral column Biomechanics of the trunk Image from Jain SK and Jain G, 2015. Spine and spinal orthoses. Jaypee Brothers Medical Publishers (P) Ltd.; 1st Ed. 2015 2. Muscles of the back MUSCLES OF SUPERFICIA INTERMEDIATE THE BACK L ORIGIN Extrinsic INNERVATIO Anterior rami of spinal nerves N GENERAL FUNCTION Upper limb movement DEEP Extrinsic Intrinsic Anterior rami of spinal nerves Posterior rami of spinal nerves Respiratory function (attached to ribs) Vertebral column and head movement 2. Muscles of the back: EXTRINSIC MUSCLES SUPERFICIAL GROUP 1. Trapezius. 2. Latissimus dorsi. 3. Romboid major. 4. Romboid minor. 5. Levator scapulae. General characteristics: - Immediately deep to the skin and superficial fascia. - They attach the scapular girdle and upper limb to the axial skeleton. 2. Muscles of the back: EXTRINSIC MUSCLES SUPERFICIAL GROUP 2. Muscles of the back: EXTRINSIC MUSCLES INTERMEDIATE GROUP 1. Serratus posterior superior (deep to Rhomboid) 2. Serratus posterior inferior (deep to Latissimus dorsi) - Two thin muscular sheets in the superior and inferior regions of the back. 2. Muscles of the back: EXTRINSIC MUSCLES INTERMEDIATE GROUP 2. Muscles of the back: INTRINSIC MUSCLES DEEP GROUP Erector spinae muscle group: 1.Spinalis * Common origin in 2.Longissimus the thoracolumbar fascia 3.Iliocostalis - These are primary extensors of the vertebral column and head. - Acting bilaterally, they straighten the back, returning it to the upright position from a fixed position, and pull the head posteriorly. - They also participate in controlling vertebral column flexion by contracting and relaxing in a coordinated fashion. - Acting unilaterally, they bend the vertebral column laterally. - In addition, unilateral contractions of muscles attached to the head turn the head to the actively contracting side * BIBLIOGRAP HY Drake RL, Vogl AW, Mitchell AWM. Gray's Basic Anatomy, 4th Edition. Philadelphia, PA: Elsevier, 2019. Drake RL, Vogl AW, Mitchell AWM, Tibbitts R, Richardson P. Gray ́s Atlas of Anatomy, 3rd Edition. Philadelphia, PA: Elsevier, 2020. Martini FH, Tallitsch RB, Nath JL. Human Anatomy. 8th Edition. Pearson Education SA, 2018. Moore K; Dalley A, Agur A. Clinical oriented anatomy. 7th Edition. Lippincott Williams & Wilkins, 2013. Nielsen M, Miller S. Atlas of Human Anatomy. Chichester, UK: John Wiley & Sons Ltd, 2011. Tortorra, G.J. & Derrickson, B. “Principles of Anatomy and Physiology”. Ed. Panamericana 2018 (15th Ed). In Vivo September 2020, 34 (5) 2401-2406; DOI: https://doi.org/10.21873/invivo.12053 Jain SK and Jain G, 2015. Spine and spinal orthoses. Jaypee Brothers Medical Publishers (P) Ltd.; Maria del Mar Ubero Martinez [email protected] UCAM Universidad Católica de Murcia © UCAM