AXIAL SKELETON Vertebral column - Univerzita Karlova RIBS and STERNUM. Costa, cartilago costalis...

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Transcript of AXIAL SKELETON Vertebral column - Univerzita Karlova RIBS and STERNUM. Costa, cartilago costalis...

  • AXIAL SKELETONAXIAL SKELETON Vertebral columnVertebral column

    Rastislav DrugaRastislav Druga

  • Presacral part

    Sacrum

    C – 7

    Th – 12

    L – 5

    S – 5

    Co – 4-5

    33

    vertebrae

    C, L lordosis

    Th kyphosis

    C – when the infant begins to lift hia head

    L – when the child starts to walk

  • VERTEBRAEVERTEBRAE cervicalescervicales thoracicaethoracicae lumbaleslumbales

    os sacrumos sacrum os coccygisos coccygis

  • TH

    Corpus

    Arcus

    Processus

    Pediculus

    Vertebral notches

    (incisurae)

  • L

    Foramen vertebrae AP 13 mm

    Recessus lateralis

    AP 4 mm

    Lamina

  • Vertebrae cervicales Cervical vertebra

    C6 tuberculum anterius = tuberculum caroticum

    C7 vertebra prominens

  • Vertebrae cervicales C 1 – C7

    ATLAS

    AXIS

    Nízké intervert. Disky

  • ATLAS AXIS

  • SACRUM

    S1 – S5

  • Articulatio

    sacroiloaca

  • Homologous parts oéf vertebrae

    Black = costal element

    L – proc. costalis

    Th – costa vera

    C – proc. transversus

    S – crista sacralis lateralis

  • Articulationes intervertebralesArticulationes intervertebrales

    The joints of the vertebral columnThe joints of the vertebral column

  • Intervertebral discs

    Two cartilage endplates

    Nucleus pulposus

    Annulus fibrosus

  • DISCI

    INTERVERT.

  • DISCUS – Anulus fibrosus, nucleus pulposus

    Anulus fibrosus – vazivová chrupavka, kolagenní fibrily

    Nucleus pulposus – hydratované proteoglykany, kolagenní fibrily, vazivové buňky

    23 disků 1/5 výšky pateře,

  • L3/L4 intervertebral disc – defect in the outer annulus

  • Intervertebral disc – toluidine blue

  • DISCUS CERVICALIS DISCUS LUMBALIS

  • Nucleus pulposus -movements

  • Intervertebral discIntervertebral disc

     Annulus fibrosusAnnulus fibrosus  Laminate structure- type I, II Laminate structure- type I, II

    collagen fibers, 15 – 25 concentric collagen fibers, 15 – 25 concentric layerslayers

     Interlaminar septae - proteoglycan Interlaminar septae - proteoglycan aggregatesaggregates

     Inner AF – layers are more widely Inner AF – layers are more widely spaced, more collagen II, more spaced, more collagen II, more hydrated,chondrocyte-like cellshydrated,chondrocyte-like cells

     Outer AF - layers adhere, fibres Outer AF - layers adhere, fibres penetrqte to the bone, more penetrqte to the bone, more collagen I, fibroblast-like cells, less collagen I, fibroblast-like cells, less hydratedhydrated

     Water, collagen, proteoglycans, Water, collagen, proteoglycans, elastinelastin

     Nucleus pulposus Nucleus pulposus  Highly hydrated aggrecan-Highly hydrated aggrecan-

    containing gelcontaining gel  Chondrocyte-line cells, Chondrocyte-line cells,

    collagenous fibrescollagenous fibres

  • Degenerative lesions of discs

  • MRI of intervertebral discs – level of hydratation DW (D. Stelzeder et al. 2010)

  • Canalis vertebralis

    Prostor epidurální

    Prostor subdurální

    Prostor subarachnoideální

    (liquor)

    Foramen

    transversarium

  • Protruse intervertebrálního disku – mediální, laterální L4/L5

    Protruse laterální

    Protruse mediální

  • Sensory innervation of intervertebral disc

  • Intervertebrál discsIntervertebrál discs

     Avascular, nerve supply at the peripheryAvascular, nerve supply at the periphery  Anuli fibrosi – interconnect vertebral Anuli fibrosi – interconnect vertebral

    bodies, maintain the stability of vertebral bodies, maintain the stability of vertebral column column

     After second decade dehydratation of the After second decade dehydratation of the discdisc

     Decrease of vertical diameter of the Decrease of vertical diameter of the vertebral column, kyphotic posturevertebral column, kyphotic posture

  • Ligamenta - dlouhá, krátká

  • Lig. longitudinale posterius

    Rupture

  • Ligamenta interarcualia

    s. ligg. Flava

    Hypertrophy

  • Cervical segment and

    Vertebral artery for. transversaria (C6)

  • Atlantooccipitální articulation

  • Ligaments of atlantooccipital a atlantoaxial articulation

  • COSTAE et STERNUMCOSTAE et STERNUM

    RIBS and STERNUMRIBS and STERNUM

  • Costa, cartilago costalis

    Costae verae 1 -7 true ribs

    Costae spuriae 8 –10

    False ribs

    Costae fluctuantes

    Floatuing ribs

    11 - 12

  • Costa I Costa II

  • Juncturae thoracisJuncturae thoracis

    Joints of the thoraxJoints of the thorax

  • Articulatio capitis costae

    Articulatio costotransversaria Articulationes costovertebrales

  • Articulationes sternocostalesArticulationes sternocostales

     Articulation of cartilage of 2. – 7. rib with sternal socket Articulation of cartilage of 2. – 7. rib with sternal socket (incisura costalis). Capsules are short, ligg. (incisura costalis). Capsules are short, ligg. sternocostalia radiatasternocostalia radiata

    Articulationes interchondralesArticulationes interchondrales mutual connextion cartilagesmutual connextion cartilages of 6. – 9. ribs of 6. – 9. ribs

  • Movements of vertebral columnMovements of vertebral column

     Ventral flexion – cervical segment, lumbal segmentVentral flexion – cervical segment, lumbal segment

     Lateroflexion – cervical and lumbal cca 30Lateroflexion – cervical and lumbal cca 30ºº

     Rotations – cervical segment cca 60 - 70Rotations – cervical segment cca 60 - 70ºº (30 (30 ºº between between atlas and axis, thoracic segment 25atlas and axis, thoracic segment 25ºº - 30 - 30ºº, lumbal , lumbal segment cca 5segment cca 5ºº ) )

  • Rotační pohyby

  • Snímek 1 Snímek 2 Snímek 3 Snímek 4 Snímek 5 Snímek 6 Snímek 7 Snímek 8 Snímek 9 Snímek 10 Snímek 11 Snímek 12 Snímek 13 Snímek 14 Snímek 15 Snímek 16 Snímek 17 Snímek 18 Snímek 19 Snímek 20 Snímek 21 Snímek 22 Snímek 23 Snímek 24 Snímek 25 Snímek 26 Snímek 27 Snímek 28 Snímek 29 Snímek 30 Snímek 31 Snímek 32 Snímek 33 Snímek 34 Snímek 35 Snímek 36 Snímek 37 Snímek 38 Snímek 39 Snímek 40 Snímek 41 Snímek 42 Snímek 43 Snímek 44 Snímek 45 Snímek 46 Snímek 47 Snímek 48 Snímek 49 Snímek 50 Snímek 51 Snímek 52