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Dr. Laygo | Back and Upper Extremities (10/05-06/15)
B. CURVATURE SCOLIOSIS:
PRIMARY VS. SECONDARY Curvature of spine in AP view (10 degrees
• Primary: present at birth curvature deviation is accepted)
Thoracic and sacral concavity is ANTERIOR Arm dominancy factor
Anterior vertebral height is shorter
C. GENERAL STRUCTURE
Posterior vertebral height is longer producing a C
1. Number:
like curve
a. 33 in child
• Secondary b. 26 in adult
Cervical and lumbar concavity is POSTERIOR 2. Motion: 24 vertebrae
Develops when a child starts to lift his head and No motion: Sacrum and coccyx
walk 3. Configuration : “double isosceles”
Difference in height in vertebral disc 4. Parts
o Thick: anterior a. Anterior (Body): cylindrical, flat surfaced,
a. (+) Intervertebral disk
o Thin: posterior
b. Intervertebral foramen
Development of curvature starts at 2/12 months up to b. Posterior:
10/12 years of age Lamina
Pedicle: arises from body as it meets the lamina
on each side
• Cervical: convex
1 spinous process: 2 lamina meet
• Thoracic: concave
2 transverse: junction of pedicles and
• Lumbar: convex
lamina
• Sacral: concave
2 superior articular
2 inferior articular
Superior/inferior articular facet and joint
A.ka. superior/inferior zygapophyseal
process
Junction of pedicle and lamina
c. Joints
True: intervertebral (single)
Joint: amphiarthrodial type
Facet joint (paired): arthrodial
False: uncovertebral joint of Lushka (only in
cervical
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ANATOMY
Dr. Laygo | VERTEBRAL COLUMN
I.CERVICAL VERTEBRA
A. TYPICAL (C3 to C6)
Small body with uncinated process (Luschka
joint), downward pointing transverse process
bifid spinous process
Transverse process with vertebral arterial
foramen
Anteriior tubercle of transverse process/
Chaissagnac’s tubercle: landmark for control of
carotid artery bleeding; and local anesthesia of
brachial plexus and cervical plexus via
supraclavicular approach
Part Characteristics
B. ATYPICAL Vertebral Small and wider from side to side than anteroposteriorly,
1. C1: ATLAS; body superior surface concave with uncus of body (uncinated
process); inferior surface convex
Body joins C2; articulates with occiput Vertebral Large and triangular
Kidney shape foramen
With depression: NUCHAL GROOVE Transverse Transverse foramina small or absent in C7; vertebral
Superior articular facet are concave Process arteries and accompanying venous and sympathetic
plexuses pass through foramina except C7, which
2. C2: AXIS transmits only small accessory vertebral veins; anterior
With dens/ odontoid process projects from and posterior tubercles
the body superiorly Articular Superior facets directed superioposteriorly, inferior
Thick spinous process o no C1-C2 process facets directed inferioanteriorly; obliquely placed facets
are most nearly horizontal in this region
intervertebral disk
Spinous Short (C3-C5) and bifid (C3-C6) process of C6 long that of
Strongest cervical vertebra process C7 is longer (thus C7 called “vertebra prominens”)
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ANATOMY
Dr. Laygo | VERTEBRAL COLUMN
Part Characteristics
C. CERVICAL MOTION Vertebral Heart shaped; 1 or 2 costal facets for articulation
MOTION 0-C1 C1-C2 TOTAL RANGE body with head of rib
Flexion 10 degrees 5 degrees 60 degrees Vertebral Circular and smaller than those of cervical and
Extension 25 10 80 foramen lumbar vertebrae
Rotation 0 45 75 Transverse Long and strong and extend posterolaterally; length
Lateral Bend 5 10 45 process diminishes from T1–T12 (T1-T10 have facets for
articulation with tubercle of rib)
Articular Nearly vertical articular facets; superior facets
D. CLINICAL CORRELATION process directed posteriorly and slightly laterally; inf facets
“pinched nerve” directed anteriorly and slightly medially
(+) collapsed or fractured vertebral foramen Spinous Long; slope postero-inferiorly ; tips extend to level of
transverse process of the 2 adjoining cervical process vertebral body below
vertebra compresses with each other (pinched
nerve)
III. LUMBARVERTEBRA
1. Bodies are thick and wide; broad thick posteriorly
oriented spinous process; facet oriented along
sagittal plane
2. Motion:
a) Lateral bending = 20 degrees
b) Rotation = 30 degrees
c) flex-extension= 80 degrees: in which occurs at:
75% at L5 S1; 20% at L4-L5; 5% at L1-L4
Part Characteristics
Vertebral Massive, kidney shaped when viewd superiorly
body
Vertebral Triangular, larger than in thoracic vertebrae and
foramen smaller than in cervical vert.
Transverse Long and slender; accessory process on posterior
Process surface of base of each process
Articular Nearly vertical facets; sup facets directed
process posteromedially; inf facets directed anteromedially;
mammillary process on posterior surface of each sup
articular processs
Spinous Short and sturdy; thick, broad, and hatchet shaped
process
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ANATOMY
Dr. Laygo | VERTEBRAL COLUMN
V. COCCYX
1. One or two bones from 4 vertebrae
2. Rudimentary tail
3. Anatomically insignificant BUT clinically problematic
(as in childbearing and fracture/dislocation)
*Coccygo-dynia – pain in coccyx region, common in elderly.
b. Lordosis/Kyphosis
Refers to the normal inward lordotic curvature of the
lumbar and cervical regions of the spine. Excessive
curvature on the back is known as lumbar
hyperlordosis, commonly called sway back, hollow
back, or saddle back (after a similar condition that
affects some horses)
b. Spondylosis
Degenerative disease of intervertebral discs
c. Spondylolysis
Defect allowing part of a vertebral arch to be
separated from its body.
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ANATOMY
Dr. Laygo | VERTEBRAL COLUMN
* Vertebral arch - the posterior projection from the vertebral Inter-Vertebral Disk
body that surrounds the spinal canal and bears the articular, Functions:
transverse, and spinal processes. 1. Add 25% to total length of spine
2. Binds vertebra yet allow motion
III. Abnormalities in Parts 3. Contribute to formation of curvature
a. Number 4. Shock absorber during vertical loading stress
1. cervical rib
rib arising from the anterior tubercle of the
transverse process of the 7th cervical
vertebra
2. sacralization
The distal lumbar spine, usually the 5th
lumbar spine is attached to the superior
part of the sacrum
3. Lumbarisation
Instead of fusing with sacral segments, the
1st part of the sacrum becomes the 6th
lumbar vertebrae.
b. Anterior Segmentation
1. Hemi vertebra
Congenital defect where the vertebral body
seems to appear like equally divided parts.
2. Wedge vertebra
Abnormality wherein there are several
fragments or divisions of the vertebra.
c. Posterior Segmentation
1. spina bifida manifesta (“meningocoele”,
“myelo/meningo-coele”)
2. spina bifida occulta
Not very apparent but there is a defect
within the spine. There is no structure that
is protruding up the spinal column.
IV. Laminectomy
Removal of lamina, to decompress spinal cord
Most common surgical orthopedic procedures in the
spinal column
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