1. The Vertebral Column

2. 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

3. 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)

5. Cervical Vertebrae Transverse process Body
Foramen transversarium / transverse foramin (C1 – C6 = vertebral artery)
Anterior and posterior tubercle
Body
Uncus (uncinate process)
Spinous processes – bifid (C3-C6)
C7 – vertebra prominens

6. 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

7. 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

9. 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 )

10. 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

11. 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

12. 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)

13. Superficial Back Muscles

14. Erector spinae

15. Deep intrinsic back muscles
These interconnect and stabilise – found deep to spinalis
Semispinalis
Multifidus
Rotatores (brevis and longus)
Interspinales
Intertransversarii

18. Anatomy of the Pelvis

19. 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

20. Ischium Pubis 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

24. 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

26. 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).

28. Peritoneum of Pelvis

29. Learn for Surg Rotation

30. Arteries of the pelvis