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ANATOMY AND DISSECTION OF SPINE

Spinal column Total number of vertebrae: 33 Cervical: 7, small, light, and mobile Thoracic: 12, large, relatively immobile Lumbar: 5, large, mobile Sacral- 5 Coccyx- 4 Sacral and coccyx fused

Surface Anatomy: Spinous processes are easily palpable C2- first palpable spinous process C7- largest T3- spinous process of scapula T7- Angle of scapula L4-5 intervertebral space- Highest point of Iliac crest S2- line joining 2 posterior superior iliac spines

Layers on approach Skin: Thick and firmly attached to underlying fascia Subcutaneous tissue: Thoracolumbar fascia: Broad, thick, white sheet of tissue. Forms sheath for the sacrospinalis muscles.

Attachments: Medial- spinous processes and Supraspinous ligament, medial crest of sacrum Lateral- continues with origin of the aponeurosis of transverses abdominus and latissimus dorsi

Superior-become continuous with nuchal fascia. Inferior- Iliac crest

Parts of the spinal column and vertebrae Spinous processes: Paravertebral group of muscles: o o Superficial layer-Latissimus dorsi Deep layer Superficial group- Sacrospinalis (erector spinae) Deep group (rotators)- Multifidus, Longissimus, Iliocostalis, Intertransversaii Supraspinous ligament: o o o Extends from vertebra to vertebra Connects spinous processes Blends thoracolumbar fascia intimately with spinous process

Interspinous ligament: Lamina: Facet joints: Pedicle: Transverse process: Body: Ligamentum flavum: o o o o also called yellow ligament Elastic tissue Origin- leading edge of the lower lamina Insertion- anterior surface of upper lamina

Steps To take in Anatomy dissection Lab

1. Make a midline skin incision from T7 to L4 level

2. Cut the skin down to the subcutaneous layer

3. Identify the supraspinous ligament and the tips of the spinous processes

4. Dissected the paravertebral muscles subperiosteally to expose the spinous process, the lamina, the facet joints and the transverse process

5. You should also identify the interlaminal space, and the ligamentum flavum.

6. Use a Rongeur to remove the spinous process and the lamina. You can also use the chisel, mallet and the Kerrison Punches to aid you in remove the bone.

7. This would expose the dura sac, the exit foramina and the nerve roots. Trace the nerve roots laterally and you will see a bulbous portion which represents the dorsal root ganglion. 8. Retract the dura sac medially and you should identify the intervertebral disc and the posterior surface of the vertebral body.

Characteristics of a Typical Thoracic Vertebra

A typical thoracic vertebra has the following characteristics: The body is medium size and heart shaped. The vertebral foramen is small and circular. The spines are long and inclined downward. Costal facets are present on the sides of the bodies for articulation with the heads of the ribs. Costal facets are present on the transverse processes for articulation with the tubercles of the ribs (T11 and 12 have no facets on the transverse processes). The superior articular processes bear facets that face backward and laterally, whereas the facets on the inferior articular processes face forward and medially. The inferior articular processes of the 12th vertebra face laterally, as do those of the lumbar vertebrae.

Characteristics of a Typical Lumbar Vertebra

A typical lumbar vertebra has the following characteristics: The body is large and kidney shaped. The pedicles are strong and directed backward. The laminae are thick. The vertebral foramina are triangular. The transverse processes are long and slender. The spinous processes are short, flat, and quadrangular and project backward. The articular surfaces of the superior articular processes face medially, and those of the inferior articular processes face laterally. Ligaments Supraspinous ligament: This runs between the tips of adjacent spines. Interspinous ligament: This connects adjacent spines. Intertransverse ligaments: These run between adjacent transverse processes. Ligamentum flavum: This connects the laminae of adjacent vertebrae. The anterior and posterior longitudinal ligaments: run as continuous bands down the anterior and posterior surfaces of the vertebral column from the skull to the sacrum. The anterior ligament is wide and is strong. The posterior ligament is weak and narrow 4

These ligaments hold the vertebrae firmly together but at the same time permit a small amount of movement to take place between them.

Intervertebral Discs
Responsible for one fourth of the length of the vertebral column Thickest in the cervical and lumbar regions, where the movements of the vertebral column are greatest. Their physical characteristics permit them to serve as shock absorbers Their elasticity allows the rigid vertebrae to move one on the other Each disc consists of a peripheral part, the annulus fibrosus, and a central part, the nucleus pulposus o The annulus fibrosus is composed of fibrocartilage, in which the collagen fibres are arranged in concentric layers or sheets. The nucleus pulposus is an ovoid mass of gelatinous material containing a large amount of water, a small number of collagen fibres, and a few cartilage cells.

Function of the Intervertebral Discs o o Allows movement at vertebrae Act as shock absorber

Relationships of Spinal Cord Segments to Vertebral Numbers Vertebrae Cervical Upper thoracic Lower thoracic (T7 to 9) Tenth thoracic Eleventh thoracic Twelfth thoracic First lumbar Spinal Segment Add 1 Add 2 Add 3 L1 and 2 cord segments L3 and 4 cord segments L5 cord segment Sacral and coccygeal cord segments