Transcript Anatomy of the Spine and Repro - Part 1 - UQMBBS-2013

The Vertebral
Column
• 33 vertebra in total
• 7C
• 12T
• 5L
• 5S (fuse by age 30)
• 4 coccygeal (form
coccyx)
• ¼ of length = IV disc
• Synovial zygapophysial
joints = flexibility
Features of All Vertebrae
• Vertebral body
• Supports weight
• Superior and inferior
end plates (discs of
hyaline cartilage) =
epiphyseal rim
• Centrum (POC)
• Vertebral arch
• Pedicles
• Laminae
• Vertebral foramen 
vertebral canal
• Vertebral notches  IV
foramina
• Seven processes
• Spinous
• Transverse (x2)
• Articular (x4)
Cervical
Vertebrae
• Transverse process
• Foramen
transversarium /
transverse foramin
(C1 – C6 = vertebral
artery)
• Anterior and
posterior tubercle
• Body
• Uncus (uncinate
process)
• Spinous processes –
bifid (C3-C6)
• C7 – vertebra
prominens
• Atlas – no body, no spinous
process, pedicles = lateral
masses (bear weight).
• Ant / post arch
• Ant / post tubercles
• Fovea for the dens
• Axis
• Dens (odontoid process)
• Superior articular facets
• Transverse ligament of
atlas
Thoracic Vertebrae
• T1: costal facet for 1st rib,
demifacet for 2nd rib
• T2 – T8 = demifacets,
vertical articular
processes
• Permit rotation, some
lateral flexion
• Spinous processes angle
inferiorly and overlap
• T9 – T11: Single costal
facet
• T12: One demifacet, most
commonly fractured
vertebra
Lumbar vertebrae
• Supracristal line
crosses L4/L5 IV disc
• Facets in sagittal
plane – permit
flexion and
extension
• Also accessory and
mammillary
processes
• Lumbosacral angle
(normally 130-160)
Sacrum
• Superior half transmits
force L5 to ilia
• Sacral canal (for cauda
equina)
• Sacral foramina (ventral
and dorsal)
• Base = superior surface of
S1
• Sacral promonory
• Apex = S5
• Articular facet for coccyx)
• Pelvic surface = smooth
• Lateral surface
• Median / intermediate /
lateral sacral crests
• Sacral hiatus
• Sacral cornua
Coccyx
• Fuses with sacrum, though Co1 can remain separate (has
coccygeal cornua, remnants of articular processes)
• Provides attachment for glut max, coccygeus, anococcygeal
ligaments
• Apex is palpable 2.5cm posterosuperior to the anus
Ligaments of
the Spine
• Ligamentum flavum (connects
laminae)
• Supraspinous ligament
• Interspinous ligament
• Nuchal ligament (occiput-C1C7)
• Posterior longitudinal
ligament (prevents
herniation)
• Anterior longitudinal ligament
(limits extension)
Superficial
Back
Muscles
Erector
spinae
Deep intrinsic back muscles
• These interconnect and stabilise –
found deep to spinalis
• Semispinalis
• Multifidus
• Rotatores (brevis and longus)
• Interspinales
• Intertransversarii
Anatomy of the
Pelvis
Bony Pelvis
• 3 bones each side, forms pelvic
girdles
• Os coxae = ilium, ischium, pubis
• Ilium
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Arcuate line
Iliac crest
Iliac fossa
Auricular surface
Iliac tuberosity
Ala
Gluteal lines
ASIS, AIIS, PSIS, PIIS
• Ischium
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Body
Ramus (obturator foramen)
Greater sciatic notch
Ischial spine
Lesser sciatic notch
Ischial tuberosity
• Pubis
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Superior ramus (acetabulum)
Inferior ramus
Body of pubis
Pubic crest
Pubic tubercle
Pubic symphysis
Pecten pubis
Muscles of the pelvis
• Lateral wall = obturator
internus (traverses
lesser sciatic foramen
to attach on greater
trochanter), obturator
fascia
• Posterior wall = SI joint
and piriformis (arises
from sacrum, passes
through greater sciatic
f. to attach to greater
trochanter)
• Pelvic floor = pelvic
diaphragm = coccygeus
+ levator ani
Levator ani
• Broad sheet between pubic bodies
and ischial spines. Supports
abdominopelvic viscera and is
tonically contracted to maintain
continence
• Puborectalis = puborectal sling
• Pubococcygeous
• Muscle slips names after
structures: pubo-analis,
puboperinealis, pubovaginalis,
puboprostaticus
• Iliococcygeus (most posterolateral
part).
Peritoneum of Pelvis
Learn for Surg Rotation
Arteries of the
pelvis