THE BACK -posterior aspect of the trunk; inferior portion of neck down to the coccyx -region of the body

to which the head, neck, and limbs are attached BONY FRAMEWORK Vertebral column/spine/backbone -forms skeleton of neck and back -extends from the skull to the coccyx -main part of axial skeleton *cranium *vertebral column *ribs *sternum Fxns: 1. protection of spinal cord and spinal column 2.support of the weight of the body 3.provides a partly rigid and flexible axis for the body and a pivot for the head 4.posture and locomotion Regions of vertebrae: Cervical- 7 Thoracic- 12 Lumbar- 5 Sacrum- 5 Coccyx- 4 Total: 33 (only 24 for motion- cervical, thoracic, lumbar) Variations in vertebrae 1. 2. The number of cervical vertebrae is constant In 5% of cases, numbers vary in the thoracic, lumbar, and sacral vertebrae *sacralization of L5: L5 fuses with the sacrum *lumbarizaation of S1: S1 becomes a part of the lumbar vertebrae Features of a typical vertebra 1. 2. 3. 4. Becomes larger as the column descends Rigid yet flexible 3 joints are present b/n 2 adjacent vertebrae Stability of the column is dependent on the ff: *shape and strength of vertebrae *intervertebral disc *ligaments *muscles Vertebral joints *anterior joints lie in b/n 2 vertebral bodies *b/n the 2 bodies is an intervening structure- disc *1 anterior and 2 posterior joints Vertebral curves 1. 1. Primary curves

*thoracic and sacral *concavity is anterior

- evident in fetal stage (C-shaped vertebra)

Curvature is associated with the size of the vertebra (e.g.,thoracic vertebra: anterior part consists of the body is relatively shorter than the vertebral arches located posteriorly) 2. Secondary curves

1.

*cervical (when child starts to lift his head) and lumbar(when child starts to walk or stand up) *concavity is posterior

Curvature is associated with the vertebral disc which is relatively thicker anteriorly than posteriorly Abnormal curves Kyphosis- hunchback; c shape/abnormal increase in thoracic curvature; noted in sagittal view Cause: muscleweakness, collapse of vertebral body due to trauma or any pathological process Gibbus- mini kyphosis; acute angulation Lordosis-hollow back;abnormal increase in lumbar kyphosis; due to adaptive changes- pregnancy, hip problem, obesity; noted in sagittal view Scoliosis- S/C curve; 80%idiopathic; noted in AP view Parts of the vertebra 1.anterior element Body and IV disc 2.posterior element a. Vertebral arches -pedicles- attach vertebral arches to the body -lamina -processes (7) Processes of the lamina

1. 2. 3.

a. b. c. d.

Spinous process- at the junction of 2 lamina Transverse process- at the junction b/n lamina and pedicle Superior articular processes

Inferior articular processes *both superior and inferior articular processes also arise from the junction of pedicle and lamina Vertebral foramen-b/n vertebral arches and body -series of it forms the vertebral canal(spinal nerve, Spinal cord and its meninges, BV) Vertebral notches -bet. Sup/inf articular processes and the body(superior and inferior v.notch) -converted to foramen-intervertebral foramen for entry/exit of spinal nerves and BV, meninges Spinal bifida Spina bifida occulta- failure of lamina of L5 or S1 to unite Spinal bifida cystica- spinal arches fail to develop completely TYPICAL CHARS. OF VERTEBRA Body: small and wider from side to side than anteroposteriorly; superior surface is concave, inferior surface convex Vertebral foramen: large and triangular Transverse processes: transverse foramina(vertebral arteries , vertebral veins, sympathetic plexuses; small or absent in C7); C7 transmits only small accessory vertebral veins; anterior and posterior tubercles Articular processes: superior facets directed superoposteriorly, inferior facets directed inferoanteriorly Spinous processes: C3-C5 short and bifid (split in two parts); process of C6 is long but that of C7 is longer (C7 is called the vertebra prominens)

CERVICAL VERTEBRAE C1 and C2: atypical vertebrae C1- ATLAS, kidney-shaped, no body, lateral masses are connected by anterior and posterior arches, concave superior articular facets C2- AXIS, with dens(odontoid process); strongest cervical vertebra FEATURES OF THORACIC VERTEBRA Body: heart -shaped, has one or 2 facets for articulation with head at a rib Vertebral foramen: circular and smaller than in cervical and lumbar regions Transverse process: long and strong and extends posterolaterally; length diminishes from T1-t12 (T1-T10 have facets for articulation with tubercle of a rib) Articular processes: superior facets directed posteriorly and slightly laterally; inferior facets directed anteriorly and slightly medially Spinous process:long and slopes posteroinferiorly; lip extends to level of vertebral body below FEATURES OF LUMBAR VERTEBRA Body:massive, kidney-shaped when viewed from above or below Vertebral foramen: triangular; larger than in thoracic region and smaller than in the cervical region Transverse processes: long and slender, accessory process on posterior surface of base of each process Articular process: superior facets directed posteromedially (or medially), inferior facets directed anterolaterally (or laterally), mammillary process on posterior surface of each superior articular process Spinous process: short and sturdy VERTEBRAL BLOOD SUPPLY ARTERIAL -vertebral and ascending cervical (neck) Vertebral artery- branch of subclavian artery Ascending cervical- branch of external carotid -posterior intercostals (thorax)- branches of thoracic aorta -subcostal and lumbar arteries (lumbar)- branches of abdominal aorta -iliolumbral lateral and medial sacral (sacrum)- branches of the posterior division of internal iliac artery VENOUS -external venous plexus form the spinal veins -internal venous plexus -basivertebral veins- located within the vertebral body; drain the internal and external venous plexuses -intervertebral veins- where basivertebral veins drain