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Dezvoltarea
coloanei
vertebrale
Introduction
Introduction
Dimensiuni
Lungimea - n medie de 73
cm la brbat i 63 cm la
femeie, reprezentnd 40% din
lungimea total a corpului.
Limea maxim - la baza
Corpul vertebral
Pe parcursul migrrii sclerotoamelor spre notocord i tubul neural,
acestea se divid ntr-o jumtate cranial i una caudal.
Jumtatea caudal a fiecrui sclerotom fuzioneaz cu jumtatea
cranial a sclerotomului succesiv.
Vertebra rezultat se dispune intersegmentar (ntre nivelurile de
emergen ale nervilor spinali, ce prezint dezvoltare segmentar).
Ca
rezultat
al
resegmentrii
sclerotomale,
nervii
spinali
segmentari prsesc mduva spinrii
ntre vertebre.
stadiul precartilaginos, n
sptmna
a
7-a
ncepe
condrificarea prin doi centri care
apar n corpul vertebrei i prin cte
unul n fiecare jumtate a arcului
vertebral,
care
se
formeaz
nconjurnd tubul neural.
Discul intervertebral
Discurile intervetebrale se formeaz ntre corpii
vertebrali, la nivelurile segmentare dintre celulele
mezenchimale localizate ntre prile cefalic i
caudal ale segmentelor sclerotomale originale.
Dei notocordul regreseaz n regiunea corpilor
vertebrali, persist i se lrgete n regiunea
discurilor
intervetebrale,
formnd
nucleul
pulpos.
Fibrele circulare cu originea n celulele sclerotoale
formeaz inelul fibros.
Nucleul pulpos este (probabil) nlocuit de celulele
de origine sclerotomal.
n plan sagital
n plan frontal
un
Lordoza cervical apare n lunile 3-5 i este rezultatul ridicrii capului de ctre sugar.
Lordoza lombar apare n jurul vrstei de 2 ani i se datoreaz staiunii verticale i locomoiei.
unghi
lombosacral
ce
separ
cifoza
Curbura
toracal
este
primar,
fiind
determinat de traciunea muchilor mai
dezvoltai la membrul superior drept;
celelalte dou curburi sunt compensatorii,
avnd scopul de a
restabili echilibrul
corporal.
The series of vertebral bodies, intervertebral discs, and vertebral arches form a
mobile rod that also protects the spinal cord.
Yet two other requirements for a useful vertebral column must be met:
(1) One should be able voluntarily to produce motion of the column,
(2) there must be mechanisms to restrict excessive movements of any one
vertebra upon another.
Voluntary motion is achieved by having muscles attach to the vertebral arch and
to lever-like processes that extend from it.
and (2) the development of ligaments between adjacent vertebral bodies, vertebral
arches, and lever-like processes.
In the thoracic region of the vertebral column, these mechanisms are further aided
by overlapping of the obliquely disposed spinous processes, which limits extension,
and by the pronounced development of the costal processes (i.e., ribs), which have
a very restrictive effect on all movements. In the sacral region, the two general
mechanisms of movement restriction are superseded by fusion of the vertebrae.
If it is necessary to identify the spine of a specific thoracic vertebra on a patient, the patient should be asked to
bend the neck forward so that the examiner may count downward from the easily recognizable spine of C7.
Counting upward to identify higher cervical spines is difficult, since the 6th cervical spine may or may not be
faa anterioar
faa posterioar
1. Faa anterioar este format de o coloan cilindric, rezultat din suprapunerea corpurilor
vertebrelor.
2. Faa posterioar prezint pe linia median procesele spinoase, care formeaz mpreun
creasta spinal. Procesele spinoase se pot explora cu mult uurin, mai ales n timpul
flectrii trunchiului. La limita dintre coloana cervical i toracal se vizualizeaz foarte net
procesul spinos al vertebrei C7 (vertebra proeminens); pornind de la acest proces spinos, se
poate numerota fiecare vertebr.
se
gsesc
anuri
profunde,
numite
anuri
Vrful procesului transversar al atlasului poate fi palpat imediat sub procesul mastoidian.
Supraspinous ligaments
Interspinous ligaments
The ligaments that limit excessive flexion of the vertebral column play a
significant role when a person bends the trunk forward while keeping the
knees straight, as if to touch the toes. Interestingly, at the end of such a
movement the muscles that extend the vertebral column cease firing.
D ezvoltarea
sternului
coastelor
Coastele
se
dezvolt
din
procesele costale ae vertebrelor
toracice,
din
poriunea
sclerotomial a mezodermului
paraaxial.
n
mezodermul
somatic
peretelui ventral al corpului.
al
Canalul vertebral
Diametrele
canalului
vertebral
variaz: sunt mai mari n regiunea
cervical i lombar, n raport cu
mobilitatea mai mare a coloanei
vertebrale n aceste regiuni. n
regiunea toracal, unde mobilitatea
coloanei vertebrale este mai redus,
diametrele canalului vertebral sunt
mai mici.
CORELAII CLINICE
Coloana vertebrala poate prezenta i curburi
patologice, ca urmare a exagerrii curburilor
normale:
Cifoza patolologic se caracterizeaz prin
accentuarea convexitii posterioare.
Lordoza patologic se caracterizeaz prin
accentuarea convexitii anterioare.
Scolioza const in exagerarea curburilor n
plan frontal.
Curburile patologice ale coloanei vertebrale pot
fi:
ereditare sau dobndite.
Dezvoltarea i funcionarea unor viscere pot fi
influenate n sens negativ de ctre curburile
patologice ale coloanei vertebrale.
Coloana vertebrala poate prezenta i curburi
patologice, ca urmare a exagerrii curburilor
normale:
Defectele
vertebrale
apar
datorit
induciei anormale a sclerotoamelor:
scolioza
spina bifida
anencefalia
Scoliosis
Scoliosis
is
an
abnormal
curvature of the spine. If your
child has scoliosis, the view from
behind may reveal one or more
abnormal curves.Scoliosis runs in
families, but doctors often don't
know the cause. More girls than
boys have severe scoliosis. Adult
scoliosis may be a worsening of a
condition that began in childhood,
but wasn't diagnosed or treated.
In other cases, scoliosis may
result from a degenerative joint
condition in the spine.
Kyphosis
Lordosis
A normal spine,
when viewed from
behind
appears
straight. However,
a spine affected by
lordosis
shows
evidence
of
a
curvature of the
back
bones
(vertebrae) in the
lower back area,
giving the child a
"swayback"
appearance.
As a form of extrapulmonary
tuberculosis that impacts the spine,
Potts disease has an effect that is
sometimes described as being a sort
of arthritis for the vertebrae that
make up the spinal column. More
properly known as tuberculosis
spondylitis, Potts disease is named
after Dr. Percivall Pott, an eighteenth
century surgeon who was considered
an authority in issues related to the
back and spine.
TO R A C ELE
SkeletalSystem
The bones of the skeleton form an internal framework to support soft
tissues, protect vital organs, bear the bodys weight, and help us move.
Typically, there are 206 bones in an adult skeleton, although this
the body,
the skull
the vertebral column
the thoracic cage
The appendicular skeleton consists of the bones of the appendages
upper and lower limbs
the bones that hold the limbs to the trunk of the body.
Thoracic Cage
Borders:
Thoracic vertebrae
posteriorly
Ribs laterally
Sternum and costal
cartilages anteriorly
anterior midline
of the thorax
Consists of 3
fused sternebrae
(sections):
The manubrium
The body
The xiphoid
process
Sternum -M anubrium
Handle
Connected to the
Costal Cartilage
first 2 ribs
Clavicular notches
articulate with
clavicles (collarbone)
Clavicular Articular
facets
Sternum -Body
Blade or
gladiolus
Connects with ribs 27
Sides are notched
where it articulates
with the costal
cartilages
4 separate parts until
after puberty
Tip
Cartilaginous
(hyaline) that
becomes bony over
the years (@40)
Partial attachment of
many muscles
Sternum
3 major anatomical
landmarks:
1. Jugular notch
Central indentation in
manubrium
2. Sternal angle
Cartilaginous union
between xiphoid
process and body
12 pairs
True ribs
Superior 7 pairs that
attach directly to
sternum by CC
False ribs (8-12)
Ribs
Typical ribs
# 2-9
Atypical ribs
# 1, 10-12
1-7
Decrease in length from
8-12
Costal margin
Tubercle of Rib
Articulates with Transverse Costal
Facet (Thoracic vertebra)
Ventral attachment
Costal cartilage
vessels
#1, and 10-12 articulate with only 1 vertebral
body
#11 and 12 do not articulate with a vertebral
transverse process
The scalenes help increase thoracic cavity dimensions by elevating the first and second
ribs during forced inhalation.
The ribs elevate upon contraction of the external intercostals, thereby increasing the
transverse dimensions of the thoracic cavity during inhalation.
Contraction of the internal intercostals depresses the ribs, but this only occurs during
forced exhalation.
A small transversus thoracis extends across the inner surface of the thoracic cage and
attaches to ribs 26. It helps depress the ribs.
Two posterior thorax muscles also assist with respiration. These muscles are located
deep to the trapezius and latissimus dorsi, but superficial to the erector spinae muscles.
The serratus posterior superior elevates ribs 25 during inhalation, and the serratus
posterior inferior depresses ribs 812 during exhalation.
The pectoralis minor, serratus anterior, and sternocleidomastoid help with forced
inhalation, while the abdominal muscles (external and internal obliques, transversus
abdominis, and rectus abdominis) assist in active exhalation.
Landm arks
Xiphoid process
spaces
Costal arch
Infrasternal angle
Xiphocostal angle
Papillae
Thoracic w all
Skin
Superficial fascia
Thoracoepigastric v.
Supraclavicular n.
Anterior and lateral
cutaneous
branches of
intercostal n.
Deep fascia
Intercostal space
Posterior intercostal v.
Posterior intercostal a.
Intercostal n.
Internal thoracic
vessels
Internal thoracic a.&v.
Parasternal ln.
Endothoracic fascia
Boyles Law
Landm arks
Xiphoid process
spaces
Costal arch
Infrasternal angle
Xiphocostal angle
Papillae
Thoracic w all
Skin
Superficial fascia
Thoracoepigastric v.
Supraclavicular n.
Anterior and lateral
cutaneous
branches of
intercostal n.
Deep fascia
Intercostal space
Posterior intercostal v.
Posterior intercostal a.
Intercostal n.
M ED IA S TIN
M ediastinum
Superior
mediastinum
Area above T4/T5
(above
angle of sternum)
Inferior mediastinum
Area below T4/T5
(below
angle of sternum)
Superior
M ediastinum
Superior border
Inferior border
Manubrium of sternum
Posterior border
Anterior border
Lateral borders
T1-T4
Contents
Thymus, brachiocephalic
veins, SVC, arch of aorta,
trachea, esophagus, nerves
Superior m ediastinum
Locating from inlet of thorax to plane extending
from level of sternal angle anteriorly to lower
border of T4 vertebra posterioly
Contents
Superficial layer
Thymus
Three veins
Left brachiocephelic v.
Right brachiocephelic v.
Superior vena cava
Middle layer
Aotic arch and its three branches
Phrenic n.
Vagus n.
Posterior layer
Trachea
Esophagus
Thoracic duct
Inferior m ediastinum
Anterior
mediastinum
Location posterior to
body of sternum and
attached costal
cartilages, anterior to
heart and pericardium
Anterior (Inferior)
M ediastinum
Superior border
Inferior border
Body of sternum
Posterior border
Anterior border
Diaphragm
Lateral borders
Pericardial sac
Contents
Middle
mediastinum
Location between
anterior mediastinum
and posterior
mediastinum
Contents: hart and
pericardium,
beginning or
termination of great
vessels, phrenic
nerves,
pericardiacophrenic
vessels , lymph
nodes,
Posterior mediastinum
Location posterior to
heart
and
pericardium,
anterior to vertebrae T5
T12
Contents:
esophagus,
vagus n., thoracic aorta,
azygos system of veins,
thoracic
duct,
thoracic
sympathetic trunk, posterior
mediastinal lymph nodes
M iddle
M ediastinum
Posterior
Mediastinum
Aortic arch
Thoracic aorta
Sympathetic trunk
Pericardium
Esophagus
Greater splanchnic n
Relations ofesophagus
M ediastinalspaces
Retrosternal space
Underlying muscle
Pectoralis major and minor
Part of serratus anterior, external
Innervations
Intercostal nerves
M am m ary G lands
Modified sweat glands
Function only in lactating
females
Role to provide
cells
Secrete milk
the nipple
M am m ary G lands
Suspensory ligament
Lobes surrounded by
adipose and
connective tissue
Areola
Pigmented skin that
M am m ary G lands
S U R FA C E A N ATO M Y
Midclavicular Line
Midaxillary Line
Locating InternalStructures
Heart deep to
xiphosternal angle
Pleural Cavities
Inferior margin = adjacent
to T12 in Posterior Midline
To Rib 10 at Midaxillary line
To Rib 8 at Midclavicular
line
To Xiphosternal joint
medially
Lungs posterior border is 2