Transcript cervical laminectomy

Vertebral
column
7
33 Vertebrae
Inter-vertebral
disc
Form 1/4 of its
length
12
5
5
4
Curvature of vertebral column
Thoracic and sacral (primary)
Concave anterior. Develop
during fetal period, deference
between ant and post
Thickness of the vertebra.
Cervical and lumbar :
Concave posterior, develop
during the fetal period, due to
deference in IV disc thickness
- Cervical - infant hold
head
- Lumber - infant walk
and assume upright position,
prominent in female.
Abnormal Vertebral column curvature
Kyphosis:
abnormal increase in thoracic
curv. Erosion of anterior
vertebral part.
Lordosis:
(hollow back) anterior
rotation of pelvis. Abnormal
increase in lumber curvature
(pregnancy)
Scoliosis:
(Crooked or curved back)
abnormal lateral curvature and
rotation of the back (appears
between ages of 10-15)
General Structure of Typical Vertebrae
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Body or centrum – discshaped, weight-bearing
region
Vertebral arch – composed of
pedicles and laminae that
along with the centrum,
encloses the vertebral
foramen
Vertebral foramina – make
up the vertebral canal
through which the spinal cord
passes
General Structure of typical Vertebrae cont.
 Spinous process project posterior and usually downward.
 Transverse processes project laterally
 Superior and inferior articular processes – protrude
superiorly and inferiorly from the pedicle-lamina junctions
 Inter-vertebral foramina – lateral openings formed from
notched areas on the superior and inferior borders of
adjacent pedicles
Cervical Vertebrae
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Seven vertebrae (C1-C7) are the smallest & lightest
vertebrae
C3-C7 are distinguished with an
• oval body
• long spinous processes
• Large and triangular vertebral foramina
Each transverse process contains a transverse foramen.
Superior and inferior articular facets are oriented sup. and
inf.
Atypical Cervical
Vertebrae:
The Atlas (C1)
 The atlas
 Has no body and no spinous
process
 Consists of anterior and
posterior arches, and two
lateral masses
 The superior and inferior
surface of lateral masses has
articular surfaces to
articulate with the occipital
condyles and with the axis
Atypical Cervical Vertebrae:
The Axis (C2)
 The axis has a body, spine, and
vertebral arches as do other
cervical vertebrae
 Unique to the axis is the dens,
or odontoid process, which
projects superiorly from the
body and is attached to the
anterior surface of the arch of
the atlas.
 The dens is a pivot for the
rotation of the atlas
Pivot Joint
Projection of bone 1 articulates within ring of bone 2
Movements: Rotation Around one Axes
Thoracic Vertebrae
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There are twelve vertebrae (T1-T12) all of
which articulate with ribs.
Major markings include two demi-facets on
the heart-shaped body for the head of the
rib.
Circular vertebral foramen, transverse
processes with articular costal facets for the
rib tubercles.
Long biffed spinous process that is inclined
downward.
The location of the articulate facets prevent
flexion and extension, but allow rotation of
this area of the spine.
Superior articular processes are oriented
backward and laterally.
Thoracic Vertebrae
Lumbar
Vertebrae
 The five lumbar vertebrae (L1-L5) are located in the small region of
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the back and have an enhanced weight-bearing function.
Body is large and kidney-shaped.
They have short, thick pedicles and lamina.
Flat hatchet-shaped spinous processes.
Triangular-shaped vertebral foramen.
Orientation of the sup. articular facets face medially to lock the
lumbar vertebrae together to provide stability
Vertebral characteristics
Inter-Vertebral Joints
Vertebral Column: Inter-vertebral Discs
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Cushion-like pad composed of two parts
 Nucleus pulposus – inner gelatinous nucleus
that gives the disc is elasticity and
compressibility
 Annulus fibrosus – surrounds the nucleus
pulposus with a collar composed of collagen
and Fibro cartilage.
Movements
Atlanto-occipital joints and ligaments
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Often considered to be a Hinge joint because of its primary uniaxial
range of movement (as in shaking your head “yes”).
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The atlanto-occipital joints occur between the reciprocally curved
surfaces of the two occipital condyles and the articular facets on the
lateral masses of the atlas.
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Movements:
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While the primary axis of movement is the nodding movements (flexion
and extension of the head) in the antero-posterior plane, a small amount
of side to side bending (lateral flexion), and rotation is possible at this
joint surface.
Ligaments of the joint:
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Are the fibrous membrane of the joint capsule (Ant and Post), the anterior
atlanto-occipital membrane, and the posterior atlanto-occipital membrane.
Alar ligaments:
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They connect the sides of the dens (on the axis, or the
second cervical vertebra) to the tubercles on the medial side of
the occipital condyle.
Legamentum flavum:
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They connect the laminae of adjacent vertebrae, extending from
the second thoracic vertebra, the axis, to the first segment of
the sacrum
Cruciform ligament of atlas (cruciform):
 is a cruciate ligament in the neck forming part of
the atlanto-axial joint.
Cruciate
ligament of
atlas
Ligamentum flavum
They connect the laminae of
adjacent vertebrae,
Sacrum and Coccyx
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The sacrum
 Consists of five fused
vertebrae (S1-S5), which
shape the posterior wall
of the pelvis
 It articulates with L5
superiorly, and with the
auricular surfaces of the
hip bones
 Major markings include
the sacral promontory,
transverse lines, alae,
dorsal sacral foramina,
sacral canal, and sacral
hiatus
S1
S2
S3
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Coccyx (Tailbone)
 The coccyx is made up of
four (in some cases three
to five) fused vertebrae
that articulate superiorly
with the sacrum
S4
S5
Coccyx
1
2
3
4
Disc Problems
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Slipped (degeneration) disc vs. herniated disc
Most common sites for disc problems:
 C5 - C6
 L4 - L5
 L5 - S1
Lumbago
Laminectomy ( IS a surgical removal vertebral
arch by shaving laminae to access disc)
Vertebral “Body” Fracture
Bony Thorax (Thoracic Cage)
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The thoracic cage is composed of the thoracic vertebrae
dorsally, the ribs laterally, and the sternum and costal
cartilages anteriorly
Functions
 Forms a protective cage around the heart, lungs, and
great blood vessels
 Supports the shoulder girdles and upper limbs
 Provides attachment for many neck, back, chest, and
shoulder muscles
 Uses intercostal muscles to lift and depress the
thorax during breathing
Bony Thorax (Thoracic Cage)
Sternum (Breastbone)
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A dagger-shaped, flat bone that lies in the anterior midline
of the thorax
Results from the fusion of three bones – the superior
manubrium, the body, and the inferior xiphoid process
Anatomical landmarks include the jugular (suprasternal)
notch, the sternal angle, and the xiphisternal joint
Sternum
Structure of a Typical True Rib
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Bowed, flat bone consisting of a head, neck, tubercle, and shaft
Superior facet
Inferior facet
Articular facet
of tubercle