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