1. Bone, Muscles of vertebral columnBy
Prof. Pasuk Mahakkanukrauh, MD

2. Vertebral Column Vertebrae : cervical (C) : thoracic (T) : lumbar (L)
: sacrum (S)
: coccyx (Co)
Function : Protection
: Weight bearing
: Movement

3. Normal Curvature of Vertebral Column
Primary Curvature
Secondary Curvature
Clinical correlation
: kyphosis : thoracic kyphosis
: lordosis : lumbar lordosis
: scoliosis : myopathic, idiopathic

4. Vertebrae Vertebral Body : weight bearing Vertebral Arch : Protection
: pedicle
: lamina
: spinous process
: articular process
: transverse process
* Vertebral foramen
* Vertebral (spinal) canal
Component

5. Cervical vertebrae Foramen transversarium : vertebral a.
C3-C6 : short spinous process+bifid
: Uncinate process (Uncus)
: Luschka Joint
C1 : Atlas
C2 : Axis
C7 : prominens spinous process
Facet joint : horizontal

6. Atlas Articular facet : kidney No spinous process No body
Anterior-posterior tubercle
Lateral mass
Anterior-posterior arch

7. Axis
Dens or Odontoid process
Bifid big spinous process

8. Thoracic vertebrae Costal facet Long spinous process
Body : Heart shape : T5-8
T1-4 : cervical like
T9-12 : lumbar like
Facet joint : oblique

9. Lumbar vertebrae Big body : L5 No costal facet Body : kidney shape
Big transverse process
Lumbosacral angle
Facet joint : vertical

10. Sacrum : anterior Fusion 5 sacrum Triangular shape Lateral mass
Sacral foramina
Sacral promontary

11. Sacrum : posterior Median crest Intermediate sacral crest
Lateral sacral crest
Sacral hiatus
Sacral cornua

12. Clinical Application Epidural (caudal) anesthesia or block
Lumbarization
Sacralization

13. Coccyx
4 Remnant…..1
Coccygeal cornua
No weight bearing
** Coccygonia

14. Movement
Joint of the vertebral column
Back muscle and ligament

15. Craniovertebral joint
atlanto-occipital joint
- synovial type (condyloid)
- Atlanto-occipital membrane
- transverse ligament, cruciform ligament
- alar ligament, apical ligament
- tectorial membrane
atlanto-axial joint
- synovial type (pivot type)
- transverse ligament
Uncovertebral (Luschka) joint

16. Joint of the vertebral column
Joint of vertebral body
Joint of vertebral arch
- zygapophyseal (facet) joint

17. Joint of vertebral body
Main ligament
- ALL
- PLL
Intervertebral disc
- Connect vertebrae
- Shock absorber
- Weight bearing
- Component : nucleus pulposus (H2O)
: anulus fibrosus (Collagen)
Accessory ligament
-Ligament flavum
-Interspinous ligament
-Intertransverse ligament
-Supraspinous ligament

18. Zygapophyseal Joint Articular process Accessory ligament
-Ligament flavum
-Interspinous ligament
-Intertransverse ligament
-Supraspinous ligament

19. Biomechanic : C-spine Most Movement Occipitoatlantoaxial complex
- O-C1 : main F/E, no rotation
- C1-C2 : main rotation, no lateral rotation
Lower cervical spine
- C3-C7 : F/E, lateral flexion, rotation

20. Biomechanic : T-spine main rotation, lateral flexion
mild F/E : facet joint, costal cartilage, spinous process

21. Biomechanic : L-spine Weight bearing
main F/E, lateral flexion, no rotation

22. Clinical correlation Spondylolysis Spondylolisthesis Spondylosis
Spondylitis
Whiplash injury
Counting vertebrae

23. Back Muscles Extrinsic back muscles
- superficial layer : trapezius,latissimus dorsi
- middle layer : serratus posterior, levator costarum
Intrinsic back muscles : deep layer
- superficial back muscles
- middle back muscles
- deep back muscles

24. Superficial back muscles
Splenius muscle
- splenius capitis
- splenius cervicis
** Cervical flexion: levator scapulae, sternocleidomastoid,scalenus ant.-medius
Cervical extension

25. Middle back muscles Ertector spinae (sacrospinalis) m. - Iliocostalis
- Longissimus
- spinalis
*** Function: back extension
*** Back strain

26. Deep back muscles (transversospinalis)
Semispinalis
Multifidus
Rotator
Interspinalis
Intertransversarius
levator costarum

27. Middle-deep layer : back extension
**** back flexion : abdominal m.

28. Abdominal Muscles External Oblique Internal Oblique
Transversus Abdominis
Rectus abdominis

29. Stability of spine Ligaments : ALL, PLL, LF, Interspinous lig.
Back muscles

30. Reference
ผาสุก มหรรฆานุเคราะห์. มหกายวิภาคศาสตร์การเคลื่อนไหว. กรุงเทพฯ : พีบีฟอเรนบุคส์ เซนเตอร์; หน้า

31. Good Luck

32. Neck Extension Neck Flexion Sternocleidomastoid Scalenus muscle
Levator scapulae
Neck Extension
Splenius muscle

33. Trunk Extension Trunk Flexion Abdominal muscle EO,IO,TA,RA
Erector spinae
Deep layer of back muscle
(multifidus, rotator, interspinalis,
intertransversalis)

34. Trunk rotation Trunk lateral bending
Anterior-posterior Abdominal muscle
Ipsilateral contraction
Trunk rotation
Ipsilateral contraction IO
Contralateral EO
Multifidus