9. Vertebral column and bony thorax Flashcards
What are the functions of the vertebral column?
five
- Forms the trunk of the skeleton with ribs and sternum
- Provides flexible movement
- Encloses and protects the spinal cord
- Supports the head
- Provides attachment for ribs, pelvis and back muscles
How many vertebrae are there in total in a fetus? How many vertebrae in each section?
33 vertebrae
7 Cervical
12 Thoracic
5 lumbar
5 saccral
4 cocygeal
How many vertebrae are there in total in an adult? How many vertebrae in each section?
26 vertebrae
7 cervical
12 thoracic
5 lumbar
1 sacrum
1 coccyx
What is having 6 lumbar vertebrae called?
Lumbarization
How should the spine look in an AP and PA
Straight
How many curves does a fetus have?
1 curve
At how many months does an infant start to hold their head and the cervical spine changes?
3 months
When an infant starts to sit up and walk, what part of the spine changes?
Lumbar curve changes
What is the cervical curve called?
Lordotic curve
What is the thoracic curve called?
Kyphotic curve
What is the lumbar curve called?
Lordotic curve
What is the pelvic curve called?
Kyphotic curve
What are the primary curves? What type of curve are primary curves?
Throcic and sacrum, coccyx
-They are kyphotic curves
What ussually happens to the spine during pregnancy?
Increased lordotic curve and kyphotic curve
What are the secondary curves? What classification of curves are secondary curves?
Cervical and lumbar
-Lordotic curves
When do secondary curves develop?
When you gain weight and the body changes
Why do we image using the left lateral?
Easier to position the right lateral due to the position of the table
What are the 3 abnormal curves?
- Kyphosis
- Lordosis
- Scoliosis
What is kyphosis and where does it occur?
-It is an exaggeration of the abnormal kyphotic curve only in the thoracic regoin (adults)
-Common in elderly women
What is lordosis and where does it occur?
-An exaggeration of the normal lordotic curve
-Occurs in the cervical and lumbar spines
What is scolliosis and where does it occur?
-An abnormal lateral curve of the spine
-Rotation of the vertebrae to the convex side of the curve
What is the weight-bearing part of the vertebrae?
The vertebral body
What is the vertebral body seperated by?
IV discs
What is the vertebral body bounded by?
Anterior and posterior longitudinal ligaments
What is the vertebral body made of and surrounded by?
-Majority is made of spongy bone that contains red bone marrow
-Surrounded by a thin layer of compact bone
Where does the vertebral arch project?
Projects posteriorly from the body
Where are the 2 pedicals located on the vertebrae?
The vertebral arch
Where are the vertebral notches located?
On the inferior and superior surfaces of the the vertebral arch
What forms the intervertebral foramina?
The vertebral notches
Superior and inferior
Where does the spinal nerves enter and exist?
From the intervertebral foramina
Where are the 2 laminae located?
Where do they unite?
Continue from the pedicles on the vertebral arch and unite posteriorly
Where does the spinal cord pass through?
vertebral foramen
What are the processes that come off the vertebral arch?
4
- Two superior articular processes
- Two inferior articular processes
- Two transverse processes
- One spinous process
Where are the
Where is the two transverse processes located?
Roughly where the pedicle and laminae meet
Where is the spinous process located?
Posteriorly at the union of the laminae
What are the two parts of the IV discs?
- Annulus fibrosus
- Nucleus pulposus
Where are herniated discs located?
any part of the spine but primarily the lumbar
What is the nucleus pulposus?
A soft, highly elastic structure located in the IV discs that allows compression
Where do the IV discs start and end in relation to the vertebrae?
Start at C2/3 to L5/S1
How much of the IV discs contribute to the height of the vertebral column
25%
What are the types of vertebral joints?
- IV discs
- Zygapophyseal joints
What is the zygapophyseal joints function?
To permit movement
What does the zygapophyseal joints arise from?
The articulations between the superior and inferior articular process of adjacent vertebrae
What is a herniated disc?
-A pinched nerve and a slipped disk
What is the name of C1
Atlas
What is the name of C2
Axis
What is the name C7?
Vertebral prominence
What are the atypical vertebrae?
C1, 2, 7
What are the typical vertbrae of the cervical spine?
C3-C6
What cervical spine has no body or spinous process?
The atlas
What part of the spine has the largest vertebral foramina of all vertebrae? What is that called?
-The cervical spine
-Called the cervical enlargment of the spinal cord
What cervical spine are bifid and short?
The spinous process of C2 to C6
Where does the transverse process arise from on the cervical spine?
Each transverse process arises from the pedicle and the body
Rather than the pedicle/lamina junction
What do the articular pillars/lateral masses of the cervical spine form?
The zygapophyseal joints
Where are the articular pillars located on the cervical spine?
Between the superior and inferior articular processes of the same vertebra
The mass of bone between the articular facets is called the articular pillar.
Where are the zygapophyseal joints located on the cerivcal spine?
Between adjacent articular pillars
Should be open on a true lateral
Where is the intervertebral formina located?
In cervical spine
Opens anteior 45 degrees to the midsaggital plane and projected 15 degrees inferiorly
How do you demonstrate the right intervertebral formaina? Of cervical vertebrae
LPO 45 degree position with a 15 degree cephalad angle
What the 2 arches of C1?
- Anterior arch
- Posterior arch
What forms the atlanto-occipiatal joint and what motion does it permit?
-The superioro articular process
-Permits the motion of “YES”
What forms the atlato-axial joint?
The infeior articular processes articulating with C2
What charectoristics does C7 have?
-Is non bifid
-Has a spinous process (single point)
-Useful external landmark
What part of the rib articulates with the transverse process?
The tubercle
What does the head of the 5th rib articulate with?
The superior demifaucet of T5 and inferior demifaucet of T4
What thoracic vertebrae resemble cervical?
Upper bodies of T 1-4 resemble cervical
What thoracic vertebrae resemble lumbar vertebrae?
Lower bodies of T 9-12 resemble lumbar
Describe the charectoristics of thoracic spinous processes:
-Long
-Project inferiorly
Describe the charectoristics of the transverse processes on thoracic verebrae and describe the location:
Transverse processes are large and are at the junction of the pedicle and the lamina
What vertebrae are the first to attach to the ribs?
The thoracic vertebrae
What are the two articulations (joints) that are formed by the thoracic vertebrae?
- Costovertebral joints
- Costotransverse joints
Where does the head of the rib articulate with on the throacic vertebrae?
ie; superior, inferior
The posterolateral part on vertebral body
Define a whole faucet:
If the head of the rib only articulates with one body
Thoracic vertebrae
Describe a demifacet:
(Half faucet)-if the head of the rib articulates with 2 vertebral bodies
On the superior aspect of T1, what type of facet is present?
Whole faucet
On the inferior aspect of T1, what type of facet is present?
Demifacet
On the superior aspect of T2-T8, what type of facet is present?
Demifacet
On the inferior aspect of T2-T8, what type of facet is present?
Demifacet
On the superior aspect of T9, what type of facet is present?
Demifacet
On the inferior aspect of T9, what type of facet is present?
None
On the superior aspect of T10-12, what type of facet is present?
Whole facet
On the inferior aspect of T10-T12, what type of facet is present?
None
What does the head of the rib articulate with on the thoracic vertebrae? What kind of joint is this?
Head of rib articulates with the posterolateral part on the vertebral body-forms the costovertebral joints
What does the tubercle of the rib articulate with on the thoracic vertebrae? What kind of joint does this form?
Tubercle of rib articulates with the transverese process of verebrae T1 to T10
Forms costovertebral joint
What structure is demonstrated clearly on a true lateral of the thoracic vertebrae?
The intervertebral formaina
What are the zygapophyseal joints made up of in the thoracic vertebrae?
Superior and inferior proccesses of adjacent vertebrae
What angle are the zygapophyseal joints at from a true lateral position?
In cervical spine
At a steep oblique (15 degrees from true lateral)
What section of vertebrae is the largest, and which vertebrae specifically is the biggest?
Lumbar, L5
What position of the body demonstrates the left and right zygapophyseal joints of thoracic vertebrae:
- LAO, 75 degree oblique demonstrates the L side
- LPO, 75 degree oblique demonstrates the right side
Describe the location of the pars interarticularis: How many do we have?
Part of the lamina that is located between the superior and inferior articular processes of the same vertebrae in lumbar spine
-2 on each vertebra
Where does the spinal cord end, and what is located after the spinal cord?
Spinal cord ends at the disc between L1 and L2 and continues as the spinal nerves
Describe the characteristics of the spinous process and the transverse processes of the Lumbar vertebrae
Spinous processes: Thick, blunt, and project horizontally
Transverse processes: Smaller compared to thoracic
Describe the characteristics of the bodies of the Lumbar vertebrae:
-Concave and project anteriorly and laterally
-Deeper (bigger) anteriorly compared to posteriorly
What is the function of the lumbar vertebrae?
Compensates for more weight
What is spondylolysis?
A fracture of the pars interarticularis
What is Spondylolisthesis?
Bilateral spondylolysis
and slipped vertebrae
What is the intervertebral foramen formed by in Lumbar vertebrae and what position is it best seen on?
Formed by the superior and inferior vertebral notch of adjacent vertebra, and best seen on a lateral projection
What angle is the zygapophyseal joints located at in the Lumbar vertebrae? How much should you rotate the patient?
30-50 degrees from midsagittal plane, and you should rotate the patient an average of 45 degrees
What body position best demonstrates the right zygapophyseal or facet joints of the Lumbar vertebrae?
-RPO or LAO 45 degree oblique
What age does the sacrum fuse at and how many do we have?
Fuses at 16-18 and we have 5
How do you demonstrate the right IV foramina of the C spine?
-LPO 45 degree oblique with a 15 degree cephalad angle
-RAO 45 degree oblique with a 15 degree caudad angle
Which way does the sacrum curve and how do we image it?
Curves concave and we image by using a 15 degree cephalad angle (bisecting angle)
What 6 structures are located on the anterior view of the sacrum?
- Base
- Sacral ala
- Sacral prominatory
- Two superior articular processes
- 4 pairs of anterior sacral foramina
- Apex
What part of the sacrum articulates with the coccyx?
The apex
What do the two superior articular processes articulate with in the sacrum?
The inferior articular processes of L5
What is the fused transverse process of S1 called?
The sacral ala
What forms the SI joint?
The auricular surface on the lateral edge of the sacrum and the auricular surface of the illium
What 6 structures are located on the posterior view of the sacrum?
- Convex surface
- MEdian sacral crest
- Lateral Sacral crest
- Four pairs of posterior sacral foramina
- Sacral Hiatus
- Sacral cornu
What type of spinous and transverse process does the sacrum have?
Fused spinous and transverse process
Where is the sacral cornu located?
Adjacent to the sacral hiatus at the inferior articular process of S5
What part of the coccyx articulates with the sacrum?
The base
Where is the apex of the coccyx located?
At the level of the symphysis pubis
What is the thoracic cage composed of?
- Thoracic vertebra
- Ribs
- Sternum
What 3 things make up the sternum?
- Body
- Manubrium
- Xiphoid process
At what age does the sternum fuse?
25
What is the anterior connection for the ribs?
The sternum
Does the sternum produce red bone marrow?
Yes
What two notches are located on the manubrium?
- Jugular notch
- Clavicular notch
Where is the jugular notch located?
In relation to the vertebrae
In the disc space between T2 and T3
Where does the cartilage of the first rib attach?
Just below the SC joint
What junction does the sternal angle form?
Forms the junction between the manubrium and the body of the sternum
What is the landmark for the start of the aortic arch?
What part of the sternum
The body of the sternum
Where is the sternal angle and which ribs attach to it?
Located on the body of the sternum in the disc space between T4 and T5
-Ribs 2-7 attach
What landmark (s) are located at T10?
- Xiphoid process
- Bottom of heart and anterior diaphram
How many pairs of ribs are there? Describe the position of the ribs in general:
-12 ribs
-Are in an oblique plane and slant anterior and inferior
Where does the costal groove run along, and what travels through the groove?
Costal groove runs along the inferior surface of rib, and the artery, vein, and nerve travels through it
Where is the anterior part of a rib located and what does it attach to? (In general)
Located 3-5 inches inferior to the vertebral or posterior part of the same rib and attaches to a costocartilage
What are the 3 main parts of a typical rib?
- Vertebral end
- Shaft or body
- Sternal end
What landmarks are located at the vertebral end of a rib?
-Head
-Neck
-Tubercle
What does the head of the vertebral end of a rib articulate with?
The vertebral body
What does the tubercle of the vertebral end of a rib articulate with?
The transverse process of vertebra
What does the sternal end of a rib attach to?
Costocartilage
What ribs are the true, false, and floating ribs?
True: 1-7
False: 8-12
Floating: 11-12
What are compression fractures due to?
Loss of cortical bone
What is the top of the head called?
The vertex
On a 45-degree angle, where should the ZPJ be located in the lumbar spine? WHat about the Pars?
ZPJ: Should be directly in the middle of the vert. body
PI: Located posterior to the vertebral bodies
Label radiographs
He probably will ask about these
How do you name the thoracic vertebrae articulations with the ribs?
a. Participants in joint of the head of the rib
-Body of vertebrae above rib
-IV disc
-Head of rib
-Body of the vertebrae thats same as rib
b. Costotransverse joint
-Transverse process of the vertebrae of the same # as rib
-Tubercle of rib #
