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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-C1-
C7)• 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• Arcuate line• Iliac crest• Iliac fossa• Auricular surface• Iliac tuberosity• Ala• Gluteal lines• ASIS, AIIS, PSIS, PIIS
• Ischium• Body• Ramus (obturator foramen)• Greater sciatic notch• Ischial spine• Lesser sciatic notch• Ischial tuberosity
• Pubis • 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