Você está na página 1de 56

Department of Anatomy LEI Yueshan

Wuhan University School of Medicine 雷岳山

The bones of trunk


The bones of trunk sternum Cervical
vertebrae
Vertebrae (24)
Including
Sacrum (1)
Coccyx (1)
adult)

Sternum (1) Ribs


(In

Thoracic
vertebrae
Ribs (24)
Vertebral Column
Thoracic Cage
Pelvis
Lumbar
Ⅰ.Vertebral Column vertebrae
Cervical vertebrae(C1-C7)
Thoracic vertebrae(T1-T12 )
Lumbar vertebrae( L1-L5) Sacrum
Sacrum (1) Coccyx
Coccyx (1)
-1-
1.General features of vertebrae
vertebral
① vertebral body foramen
anterior, more massive part
A typical spherical to oval
vertebra supports body weight
② vertebral arch
posterior to the vertebral body
pedicles and laminae A viewed Superiorly
seven processes

body vertebral body


vertebral vertebral
arch foramen canal

spinal cord housing

B viewed Laterally
-2- C viewed Laterally
vertebral
notch
spinous
Transverse process
process articular
processes

vertebral body
Pedicle Viewed Laterally
vertebral
body

Viewed superiorly
intervertebral
foramen
vertebral arch Intervertebral
① pedicles arch ---- body foramen

the superior vertebral pedicle superior vertebral


notches intervertebral inferior notch
foramina
the inferior vertebral superior
notches articular
process
② laminae
spinous
③ Seven processes process
Inferior vertebral
articular
ⅰ. spinous process process
body
projects dorsally from the fusion of
the laminae on either side
ⅱ. transverse processes
project laterally from the junctions of
the pedicles and laminae
ⅲ. superior and inferior articular processes
project cranially or caudally from the
junctions of the pedicles and laminae
-3-
transverse
2.Main characterstics of costal fovea
transverse Spinous
costal process
vertebrae in each regions facets

(1)Thoracic vertebrae
1.Body Heart-shaped; medium; facets
for rib articulations ( the Superior
costal
articular
costal fovea) facet
fovea
2.Vertebral Small and round
Vertebral
foramen body

3.Spinous Long ; slender; not split; tip


process points posterocaudally
superior
4.Transverse All but two(T11, T12 ) have transverse
costal
demifacet for

processes facets for rib articulation (the facets


head of rib

transverse costal fovea )


5.Articular facets Posteriorly or anteriorly;
of articular Relatively coronary inferior
processes demifacet for
spinous
head of rib
process

-4-
Vertebral Bifid tip of
(2)Cervical vertebrae foramen spinous process
1.Body Oval; small; curved spinous
Superior
process
faces articular
process lamin
2.Vertebral Triangular ; large Superior a
foramen articular
facet
3.Spinous Short; split (bifid ) transverse
pedicle
process other than C1,7; tip vertebral body foramen
points posteriorly
4.Transverse Have transverse
processes foramima
5.Articular facets Superoposteriorly or
of articular
processes inferoanteriorly,
Relatively horizontal

-5-
(3)Lumbar vertebrae
1.Body Kindey-shaped; thicker
and massive;

2.Vertebral Triangular and medium


foramen
A Lateral view
3.Spinous Blunt; broad; tip points
process posteriorly

4.Transverse long; no articular facets


processes or transverse foramina

5.Articular facets of Posteromedially or


articular processes anterolaterally Relatively
sagittal plane

-6- B Superior view


Table compares of each regions of vertebrae
vertebrae cervical thoracic lumbar
Body Oval; small Heart-shaped; medium; Kindey-shaped;
facets for rib articulations thicker and massive
(costal fovea )

Vertebral Triangular ; Small; round Triangular; medium


foramen large
Spinous Short; bifid Long and slender; projects Blunt; broad; projects
process posterocaudally posteriorly
Transverse transverse All but two(T11, T12 ) have long; no articular
processes foramina facets for rib articulation facets or transverse
(transverse costal fovea) foramina
Articular Relatively Relatively coronary Relatively sagittal
processes horizontal

-7-
(4) Particular vertebrae supererior anterior arch
articular
1) The atlas(C1) facet
transverse
two lateral masses process
anterior arch vertebral
posterior arch Fovea dentis (for foramem
dens of axis) on posterior
anterior arch arch
The following features:
Atlas, superior view
(1) No body or a spinous process
(2) semicircular anterior arch transverse anterior
foramem tubercle
----fovea dentis anterior
transverse arch
semicircular posterior arch process
(3) oval superior articular facet vertebral
------ articulating with the foramem
inferior
occipital condyle articular
posterior
round inferior articular facet facet Posterior
arch
------articulating with the axis tubercle
-8- Atlas, inferior view
dens
2) The axis(C2)
Distinguishing feature:
The dens
---projects superiorly C2 C2
Anterior articular surface Right lateral view posterior view
------Articulation with
the fovea dentis

3) Vertebra prominens(C7) Spinous


process
Spinous process:
C6 posterior view C7
long and nonbifid
a prominence C7
under the skin

-9-
(5) The sacrum The projecting anterior
edge of the body of the
A. In adults consists of 1st sacral vertebra
the five fused sacral vertebrae
B. Anterior surface
The sacral promontory
smooth and concave ;
four transverse lines ;
anterior sacral foramina(4 pairs)

anterior
sacral
foramina
transverse
Sacral Sacral apex
Sacral lines
hiatus apex
Viewed posteriorly Viewed laterally Viewed anteriorly
- 10 -
rough and convex
C.Dorsal surface
the median sacral crest
the lateral sacral crest
the intermediate sacral crest
posterior sacral foramina (4 pairs)
sacral hiatus sacral hiatus sacral cornua
In the inferior end of the sacral canal,
Sacral
resulted from the absence of the laminae tuberosity
and spinous processes of S4 and S5
Lateral
vertebrae. leads into the sacral canal sacral
posterior sacral crest
foramina
sacral cornua Median
sacral
Intermediate
Project inferiorly on each side sacral crest crest
of the sacral hiatus, representing Sacral Sacral
hiatus cornua
the inferior articular processes of
S5 vertebra Coccyx

Viewed posteriorly
- 11 -
D.Lateral surfaces

The auricular surface


----articulating with ilium
Auricular surface
The sacral tuberosity
Sacral
---- for the ligament tuberosity

attachment lateral
sacral
crest
(6)The coccyx median
sacral
crest
no pedicles, laminae, sacral sacral
or spinous processes Sacral cornua curve
hiatus
in adulthood
coccyx

Viewed posteriorly Viewed laterally

- 12 -
Ⅱ. Sternum
Broad and triangular
The jugular notch
Manubrium
The clavicular notch
The 1st costal notch

An obtuse angle of the


The sternal junction of manubrium with
angle body, slightly convex forward.
Forms a useful landmark
A series of articular facets (costal
Body notches ) on the lateral margins
articulating with costal cartilages
from rib pairs 2-7
Xiphoid

- 13 -
superior demifacet
transverse
for head of rib
Ⅲ Rib costal facets

Scalene
The costal bone tubercle
The costal cartilage tubercle
Head
neck
True ribs Attaching directly The first rib
to the sternum head
(1-7) inferior demifacet
for head of rib

False ribs Costal arch (8-10) spinous


process
Floating ribs (11,12) The 12th rib
(8-12)
a head
a neck
Structure projecting
Tubercle:
dorsally

a costal groove,
a body
costal angle
- 14 -
Highlights of this chapter

Important Concepts
sacral promontory
sternal angle

intervertebral foramen
Important Contents
Main characterstics of vertebrae in each regions
The features of the sternum and the ribs

- 15 -
Department of Anatomy LEI Yueshan
Wuhan University School of Medicine 雷岳山

The bones of trunk


(sample)
What to observe in the practice
1.When you pick up a typical vertebra, you first identify which region
it is according to the particular features: costal fovea, transverse
costal fovea; bifid, transverse foramen.
2.Then you must find the the following structures: vertebral body,
pedicles, laminae, vertebral foramen, spinous process, Superior,
inferior articular processes, transverse processes, superior vertebral
notches, the inferior vertebral notches, intervertebral foramina
1) The atlas(C1): anterior arch, posterior arch, superior
facet, inferior articular facet
2) The axis(C2): dens
3) Vertebra prominens(C7): Spinous process
4) The sacrum: transverse lines, anterior or posterior sacral
foramina, sacral promontory, the median or lateral sacral crest,
sacral cornua, sacral hiatus, auricular surface, sacral tuberosity
3.Sternum: manubrium, body, Xiphoid, jugular notch,
clavicular notch, sternal angle, costal notch
4.Rib: head, neck, body, tubercle, costal groove
1.General features of vertebrae
① vertebral body pedicle superior
vertebral vertebral
superior articular inferior notch
② vertebral arch foramen processes
① pedicles
the superior
vertebral notches vertebral body
intervertebral spinous process
the inferior foramina
vertebral notches inferior articular processes

② laminae
function parts
Seven processes Muscle attachment spinous process

articular
spinous process processes
superior articular processes Restriction of
movement
inferior articular processes transverse
Protection of spinal cord process
transverse processes
vertebral
Support of body weight
body

- 16 - A
2.Main characteristics of vertebrae in each regions
transverse
costal facets

Bifid tip of spinous process


Superior
articular
facet Spinous
Vertebral process
foramen Lamina
superior
demifacet for Superior
head of rib articular
facet

Pedicle Transverse
inferior foramen
demifacet for Vertebral body
spinous head of rib
process
(1)Thoracic vertebrae (2)Cervical vertebrae
- 17 -
(3) The atlas(C1) anterior
transverse
vertebral anterior tubercle
supererior foramem
foramem arch
articular facet

transverse
process

articular facet (for dens of axis) inferior articular posterior


on anterior arch facet arch
Posterior tubercle

Atlas, superior view Atlas, inferior view

(4)The axis(C2)
(5) Vertebra prominens(C7)
dens Spinous
process

- 18 - C2 C7
(6)Lumbar vertebrae

Viewed laterally

- 19 - Viewed superiorly
(7) The sacrum and coccyx
The sacral promontory

Sacral
tuberosity

Transverse lines lateral


sacral
crest

Anterior Posterior median


sacral sacral
sacral crest
foramena foramena
Sacral
Sacral cornua
hiatus

coccyx

- 20 - Viewed anteriorly Viewed posteriorly


(7) The sacrum

auricular
surface

Viewed laterally The Sternum


- 21 -
The sternum

The rib

Viewed anteriorly
- 22 -
Department of Anatomy LEI Yueshan
Wuhan University School of Medicine 雷岳山

Joints of bones
of trunk
Ⅰ.Joints of vertebral column
Joints of vertebral bodies and the arches
Intervertebral disc
1.Joints of vertebral bodies Anterior longitudinal lig.
① Intervertebral disc Posterior longitudinal lig.
anulus fibrosus ---Outer fibrous part
a shock absorber
nucleus pulposus ---Gelatinous central mass

Intervertebral
disc

nucleus
pulposus
anulus Viewed anteriorly
fibrosus
Viewed superiorly
-1-
Prolapsed disc

Rupture

anulus
fibrosus

Area of nucleus
protrusion pulposus

Because of trauma or degenerative changes , the relatively thin


posterior part of the anulus fibrosus may rupture, allowing the
nucleus pulposus to protrude posterolaterally into the vertebral
canal. The escaped disc can compress the adjacent spinal nerve
roots and cause pain of leg and/or lower part of back.

-2-
② Anterior longitudinal lig.
The sacrum The foramen magnum

Anterior Vertebral bodies


surfaces Intervertebral discs
Prevent hyperextension
Maintain stability

③ Posterior longitudinal lig.


C2 (axis) the sacrum
Posterior Vertebral bodies
surfaces Intervertebral discs

Hyperflexion Posterior Anterior


Prevent longitudinal lig. longitudinal lig.
Posterior protrusion of
the intervertebral discs Viewed lateriorly
-3-
2 . Joints of vertebral arches
The zygapophysial joints
Accessory ligaments

(1) The zygapophysial joints

The superior articular process


The inferior articular process

Plane synovial joints

Only slightly gliding


Zygapophysial joints
Viewed anteriorly

-4-
(2) Accessory ligaments
1) Ligamenta flava
Ligamentum
Laminae ------ laminae Intervertebral
nuchae
disc
Prevent hyperflexion Anterior
and injury of discs longitudinal
Ligamenta
ligament
2) Interspinous ligaments: flava
Spinous process -------spinous process
3) Supraspinous ligament :
------A strong fibrous cord
Interconnects the tips of the spinous processes
C7 ----- the sacrum Interspinous
lig.
4) Ligamentum nuchae:
Supraspinous
-------A large elastic lig.
lig.
C7 ---- the external occipital crest
Maintain the head in an upright position

-5-
3. Joints of the atlas with the axis
1) Median atlantoaxial joint Anterior arch
----a pivot joint dens
Transverse lig.
The fovea dentis of atlas
atlas
The dens axis
Transverse ligament of atlas Median atlantoaxial joint
Occipital Apical lig.
2) Lateral atlantoaxial joints(2) of dens
bone
The inferior articular facets of Cl Alar lig.

The superior articular facets of C2


Movement: the head to turn from
side to side (as when shaking the C1
head to indicate “no”) Lateral
atlantoaxial C2
The skull and atlas rotate joint
as a unit on the axis. Lateral atlantoaxial joints
-6-
4.Joints of the vertebral
column with the cranium
Atlantooccipital joints
The atlantooccipital joints Occipital Apical lig. of dens
bone Alar lig.
Condyloid, cooperated
joints
Occipital condyles
Superior articular C1
surfaces of the atlas

Movement: nodding C2

Viewed posteriorly

-7-
5.Vertebral column as a whole and its Movements
(1) Vertebral column as a whole

① Viewed anteriorly:
The width of the vertebral bodies

C2 S2 small large
S2 Co large small
progressively larger to bear the
progressively greater body weight

-8-
② Viewed posteriorly:
The spinous processes
C2
The cervical region: cervical
long, horizontal and bifid region bifid
The thoracic region: C7
In the upper part:
slant downward and overlapping
In the middle part:
long and almost vertical
In the lower part stumpy , nearly
Lumbar region horizontal

a groove of vertebral column

-9-
③ Viewed laterally Cervical
curve
Four physiological curves
(In the sagittal plane)
To provide a flexible support (shock- Thoracic
curve
absorbing resilience) for the body
Cervical curve
Convex forward, Secondary curves Lumbar
Hold up its head(3-4 months) curve
Thoracic curve Sacral
Concave forward, Primary curves curve
Lumbar curve
Convex forward, Secondary curves Lumbar curve
Begins to walk and assumes the Cervical curve

upright posture (12 months) Primary curve

Sacral curve
Concave forward, Primary curves
newborn 3~4months 12 months
- 10- The forming of curves in the infant
(2) Movements of the vertebral column
The following movements of the vertebral column are possible:
①Anterior flexion (bending forward) The extent and variety of the movements
②Extension (bending backward) influenced by
The elasticity, thickness of the
③Lateral flexion (bending to the side ) intervertebral discs

④Rotation or twisting Surfaces muscles and ligaments


The shape and direction of articulation

Extension
② flexion

③ Lateral bending ④ Rotation


- 11 - Movements of the vertebral column
(3) Functions of the vertebral column
(1)Protects the spinal cord and spinal nerves.
(2)Supports the weight of the body.
(3)Provides a partly rigid and flexible axis for
the body and a pivot for the head.
(4)Help maintain an upright body position, as
in sitting or standing.

- 12 -
Ⅱ.Joints of the thoracic cage costal transverse costal fovea
fovea
The costovertebral joints
The sternocostal joints
The interchondral joints

1.The costovertebral joints


ribs vertebrae
( 1 ) Joints of costal head Joints of
The heads of ribs costal head

The costal fovea on the bodies Costotransverse


of the thoracic vertebrae joints

( 2 ) Costotransverse joints
The tubercle of the ribs
The transverse costal fovea on
the transverse processes
- 13 -
2.The sternocostal joints
costal cartilages (2—7)

costal notches of the sternum


The 1st rib
The manubrium of the sternum

synchondrosis
3. The interchondral joints

The costal arch


formed by the costal cartilages of 7th,
8th, 9th and 10th ribs to articulate one
by one with small interchondral joints. Infrasternal
angle

- 14 -
4. Thoracic cage as a whole
An osseous—cartilaginous cage; conical in shaped
12 thoracic vertebrae
12 pairs of ribs with their costal cartilages
the sternum
their connections
thoracic
vertebrae

sternum

ribs

costal
cartilages

- 15 -
The superior aperture of thorax
The inferior aperture of thorax

The 1st pair of The 1st thoracic


ribs and their vertebra
costal cartilages
The superior border
of manubrium

The sternal angle

Xiphoid process

The costal
arches The free border of 12th
and 11th ribs laterally
T12

- 16 -
5. Functions of thoracic cage
Three functions
(1) It protects structures in the thoracic cavity
the heart, lungs, thymus, and the others

(2) It protects some upper abdominal organs


such as the liver

(3) It serves as an attachment point for muscles


involved with
1) respiration
2) the position of the vertebral column
3) movements of the pectoral girdle and upper limbs

- 17 -
Highlights of this chapter

Important Concepts
Intervertebral disc

costal arch

Important Contents
1.Joints of vertebral bodies

2.Joints of vertebral arches

3.Vertebral column as a whole and its movements

- 18 -
Department of Anatomy Lei Yueshan
Wuhan University School of Medicine 雷岳山

Joins of bones of trunk


(sample)
What to observe in the practice
1.Joints of vertebral bodies: Intervertebral disc; nucleus pulposus,
anulus fibrosus; Anterior longitudinal lig. Posterior longitudinal lig.
2 . Joints of vertebral arches: The zygapophysial joints; Ligamenta
flava; Interspinous lig.; Supraspinous lig.; Ligamentum nuchae

3. Vertebral column as a whole: ① Viewed anteriorly: The vertebral


bodies ② Viewed posteriorly: The shape and direction of the
spinous processes ③ Viewed laterally Four physiological curves

1 ) Joints of cotal head


4.The costovertebral joints
2 ) Costotransverse joints
5.The sternocostal joints

6. The interchondral joints; the costal arch


7.The structure of thorax
Ⅰ.Joins of vertebral column Intervertebral disc
1.Joints of vertebral bodies Anterior longitudinal ligament
Posterior longitudinal ligament
nucleus
pulposus
anulus fibrosus

Posterior
longitudinal
ligament

Anterior
nucleus
longitudinal
pulposus anulus fibrosus
ligament

- 17 -
2 . Joints of vertebral
arches
(1) The zygapophysial joints
(2) Accessory ligaments
1) Ligamenta flava Ligamentum
2) Interspinous ligaments nuchae
3) Supraspinous ligament
4) Ligamentum nuchae

Ligamenta
flavum

Zygapophysial joint
intervertebral
disc Interspinous lig.
Anterior
longitudinal lig.

Supraspinous
Viewed anteriorly lig.
- 18-
5.Vertebral column as a whole

Bifid
Cervical
C2

Long,
S2
overlap Thoracic

small
stumpy , Lumbar
horizontal
large

Sacral curve

① Anterior view ② Posterior view ③ Lateral view


The vertebral bodies The spinous processes physiological curves
- 19 -
Ⅱ.Joints of the thoracic cage
1.The costovertebral joints
( 1 ) Joints of cotal head
( 2 ) Costotransverse joints Costotransverse joints

Joints of costal head

- 20 -
2. The sternocostal joints
3. The interchondral joints

Sternocostal costal cartilages


joints costal notches

Interchondral
joints

- 21 -
4.Thoracic cage
The superior or inferior aperture of thorax

The 1st pair of The 1st thoracic


ribs and their vertebra
costal cartilages
The superior border
of manubrium

The sternal angle

Xiphoid process

The costal
arches The free border of 12th
and 11th ribs laterally
T12

- 22 -