DOCSLIB.ORG

The Development of the Vertebra and the Intervertebral Disc 1

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Development of the Vertebra and the Intervertebral Disc 1 1 THE DEVELOPMENT OF Disc Disease and Dynamic Stabilization Lumbar Degenerative THE VERTEBRA AND THE INTERVERTEBRAL DISC 1 Safiye CAVDAR M.D. fibrosus’. The nucleus pulposus’ plus the anulus fib- 1. Precartilage Stage (mesenchimal stage) rosus form the intervertebral disc. Some remnents of the notochord may remain within the interverteb- The vertebral column develops from the mesenchi- ral disc which can result as ‘chordoma’. This neop- mal cells that accumulated around the notochord lasm frequently occurs at the base of the skull and during the 4th week of the embryonic period. At the at lumbosacral region (1-3). end of the 4th week the mesenchimal cells that de- rive from the scleratom of the somits accumulates in 3 major regions (1-3). 1.b. Region surounding the neurol tube The mesenchimal cells at this region gives rise to 1.a. Region surounding the Notchord the vertebral archs. In the 4th week of the embryonic period the sclera- toms elgine around the notochord as paired mesenc- 1.c. Region surouunding the corpus hial cells. Each of the scleratoms cells are grouped lo- The mesenchimal cells at this region gives rise to the osely at cranial and compact at caudal levels. Some costal processes. The costal porocesses will give rise of the dense cells groups migrate cranially and form to the ribs at thoracic region (1-3). the intervertebral disc. The rest of the dens cell group together with the caudal loose scleratom group uni- 2. Cartilage Stage tes and forms the mesenchimal vertebral centrum. Each centrum is formed by two adjacent scleratom At the 6th week of the embryonal stage the mesenchi- and forms an intergemental structure. mal cells forms the central cartilage of the vertebrae. The nerves are closely related to the interverteb- At the end of this embryonic period the two centers ral disc and the segmental arteies which are closely of the centrum unites to form the cartilage centrum. localized to the side of the body (corpus) of the ver- At the same time the centrum of the arch of the ver- tebrae. At the thoracic levels the dorsal intersegmen- tebra unite with each other. The elongation of the car- tal arteries are converted to intercostal arteries. tilage centers of the arches forms the ‘spinous pro- The notochord around the developing verteb- cesses’ and ‘transvers processes’ (Figure 1). ral body degenerates and vanishes. The notochord in between the vertebrae expands and forms jelati- 3. Ossification Stage nous part of the intervertebral disc. This is called the ‘nucleus pulposus’. The nucleus pulposus is surro- The typical vertebra ossification begins at this embryo- unded by regular circular fibers called the ‘anulus nic period and continuous until 25 years of age (1-3). Safiye CAVDAR M.D. 2 two at the tip of the transverse process and two at 4. Prenatal Stage the epiphysis (anular epiphysis). The two epiphysis one is located on the superior and the other is lo- The centrum consists of two primary ossification cen- cated at the inferior surface of the body of the ver- ters (ventral and dorsal). The two ossification cen- tebrae (Figure 2). The superior and inferior surface of ters unite to form a single center. At the end of this embryonic period 3 basic ossification centers deve- the body of vertebrae is formed by anular epyp- lops. One of these is located at centrum and the ot- hysis and in between there is bony structure. The her two at the vertebral arch of each vertebra half. centrum present in the body of the vertebrae, part The ossification of the arch becomes more promi- of the vertebral arch and costal heads contains arti- nent at the 8th week. At birth each vertebra is com- cular facets. The secondary ossification centers ossi- posed of 3 parts and each portion is connected to fies by the end of the 25 years of age together with each other via cartilage (1-3) (Figure 1). the vertebrae. The ossification age can show varia- tions according to individuals. The secondary ossi- fication centers should not be mixed with persistent 5. Postnatal Stage epiphysis fractures (1-3) (Figure 1). The arch of each half of the vertebral fusses between 3-5 weeks. The fusion of the lumbar arches continu- 6. The variations in the number of Vertebrae ous until 6 years of age. First fusion takes place at the the arches of the lumbar levels and then the lamina Approximately 90% of the people contain 12 thora- Lumbar Degenerative Disc Disease and Dynamic Stabilization Lumbar Degenerative of the upper level vertebrae fuss. The union of the cic, 5 lumbar, 5 sacral and 3-4 coccygeal vertebrae. arches of the vertebrae with the centrum forms the In approximately 3% there may be 1 or 2 extra or neurocentral joint. These joints allows the enlarge- less number of vertebrae (Figure 2). The vertebral co- ment of the vertebral arches during development of lumn must evaluated as whole because less verteb- the spinal cord (medulla spinalis). Between 3-6 years rae at one segment level can be compensated with an of age the union of centrum and the vertebral arch extra vertebrae at other segment level. For example disappears. After puberty 5 ossification centers are the number of thoracic vertebrae can be 11, however defined; one at the tip of the spinous process and the number of lumbar vertebrae can be 6 (4,5) (Figure 2). Intervertebral Notochord Nucleus pulposus and disc intervertebral disc Precartilage vertebral corpus Arter Vein Anulus fibrosus Segment of scleratom a b c Figure 1: Development of vertebras and embryonel disc; a) Notochord, b) Nucleus pulposus and intervertebral disc, c) Mature intervertebral disc The Development of the Vertebra and the Intervertebral Disc 3 is located the spinal cord, meninx and the roots of Disc Disease and Dynamic Stabilization Lumbar Degenerative Wedge vertebrae Hemivertebrae the spinal nerves. Where the pedicle meets the la- mina there are 3 pairs of processes these are called ‘superior articular processes,’ inferior articular pro- cesses and ‘transverse process’. Where the two la- mina meets there is a single process which extends posteriorly called the ‘spinous processes. The supe- rior articular process extends superiorly and has an articular surface on its posterior surface. This articu- lar surface articulates with the articular surface on the inferior articular process of the vertebrae above. The inferior articular process extends inferiorly and has an articular surface on its anterior surface (5,6) (Figure 3a,b). It articulates with the articular surface on the superior articular process of the vertebrae below. The movement (facet joint or zygapohysial joint) ca- pacity of this joint is highly restricted and variati- ons according to the vertebral level. The transvers process extends horizontally and it receives the at- tachments of the muscles which produce the rota- Unilateral segmentation Bilateral segmentation tion and lateral flexion of the trunk. The transverse defect defect processes of the thoracic vertebra has and articular surface which articulates with the ribs. The trans- Figure 2: Vertebral Column Development Anomalies. verse processes are formed by the union of real transverse processes and costal elements (5,6). When we view the vertebrae from the side between the body, pedicle and the superior articular process is 7. Abnormal development of the vertebral a notch called ‘superior vertebral notch’. Similarly column (Spina Bifida Occulta) between the body, pedicle and the inferior articular process is another notch called ‘inferior vertebral In the case of spina bifida the vertebral arches do notch’ (Figure 3a,b). The inferior vertebral notch is dee- not develop and does not unite in the mid-line. This per than the superior (5,6). In an articulated vertebral congenital abnormality can occur in the form of total column the inferior vertebral notch of the vertebra absence to partial absence of the vertebral arch (2,3). above and the superior notch of the vertebrae be- The stability of the vertebral column is achieved by low forms a complete foramen called the ‘interver- the intervertebral disc, ligaments and the muscles. tebral foramen’. The roots of the spinal nerves exits During the movements of the vertebral column the from these foramens (Figure 3a,b). discs has a function of absorbing the shocks. For this reason the shape and volume of the vertebrae chan- 8. The anatomy of the lumbar vertebrae ges according to the segmental level. A typical ver- tebra anteriorly is composed of a body and posteri- The number of lumbar vertebra varies from 5 to 6. orly an arch. The projections extending posteriorly The characteristic features of the lumbar vertebra is from the body is called the ‘pedicles’. The pedicles that they are very large compared to the rest of the extending further posteriorly become flat and they vertebrae. They do not have an articular surfaces on are called ‘lamina’. The body, pedicle and the lamina their transverse processes for the articulation with encircle a foramen called the ‘vertebral foramen’. In the ribs and do not have a foramen in their trans- an articulated vertebral column the vertebral fora- vers processes. The transverse diameter of the cor- men pile one on top of the other and form a canal pus of the lumbar vertebra are larger compared to called the ‘vertebral canal’ (Figure 3a,b). Within this canal the other vertebrae. The vertebral foremen of the Safiye CAVDAR M.D. 4 Spinose process (Prosesus Spinosus) Superior Superior Articular Process Articular Vertebral (Prosesus Articularis Superior) Process Lamina Transverse Corpus (Prosesus Foramen process Articularis (Prosesus Superioris) Transverse process Transversus) (Prosesus Transversus) Pedicule Spinose process (Prosesus Spinosus) Inferior Articular Process Corpus a b (Prosesus Articularis Inferior) Figure 3: Anatomia of lumbar vertebrae.
Load more

Recommended publications
  • An Anatomical Exploration Into the Variable Patterns of the Venous Vasculature of the Human Kidney
    AN ANATOMICAL EXPLORATION INTO THE VARIABLE PATTERNS OF THE VENOUS VASCULATURE OF THE HUMAN KIDNEY. by KAPIL SEWSARAN SATYAPAL Submitted in partial fulfilment of the requirements for the degree of DOCTOR OF MEDICINE in the Department of Surgery University of Natal Durban 1993 To my wife Pratima, daughter Vedika, son Pravir, and my family. m ABSTRACT In clinical anatomy, the renal venous system is relatively understudied compared to the arterial system. This investigation aims to clarify and update the variable patterns of the renal venous vasculature using cadaveric human (adult and foetal) and Chacma baboon (Papio ursinus) kidneys and to reflect on its clinical application, particularly in surgery and radiology. The study employed gross anatomical dissection and detailed morphometric and statistical analyses on resin cast and plastinated kidneys harvested from 211 adult, 20 foetal and 10 baboon cadavers. Radiological techniques were used to study intrarenal flow, renal veins and collateral pathways and renal vein valves. The gross anatomical description of the renal veins and its relations were confirmed and updated. Additional renal veins were observed much more frequently on the right side (31 %) than previously documented (15.4%). A practical classification system for the renal veins based on the number of primary tributaries, additional renal veins and anomalies is proposed. Detailed morphometric analyses of the various parameters of the renal veins corroborated and augmented previous anatomical studies. Contrary to standard anatomical textbooks, it was noted that the left renal vein is 2.5 times the length of its counterpart and that there are variable levels of entry of the renal veins into the IVe.
    [Show full text]
  • GROSS ANATOMY and CLINICAL PROBLEMS of CNS BLOOD SUPPLY and GLOSSOPHARYNGEAL NERVE © 2019Zillmusom
    GROSS ANATOMY AND CLINICAL PROBLEMS OF CNS BLOOD SUPPLY AND GLOSSOPHARYNGEAL NERVE © 2019zillmusom I. OVERVIEW - Branches to CNS are described as arising from two sources: Vertebral and Internal Carotid arteries. A. Spinal Cord - Anterior Arteries and Posterior Spinal Arteries form as branches of Vertebral Arteries; however, most blood supply to the spinal cord is derived from Radicular arteries (branches of segmental arteries that enter via Intervertebral Foramina) B. Brain - Common Carotid arteries bifurcate to Internal and External Carotid arteries; Internal Carotid arteries supply 80% of brain; 15% of strokes are associated with stenosis (narrowing) of Internal Carotid artery at or near bifurcation. II. GROSS ANATOMY OF BLOOD SUPPLY OF SPINAL CORD A. Arterial supply 1. Anterior Spinal artery - single artery formed from branches of both Vertebral arteries; courses on anterior surface of cord. 2. Posterior Spinal arteries - paired arteries dorsolateral to spinal cord; arise (75%) from Posterior Inferior Cerebellar arteries (branch of Vertebral Artery) or directly from Vertebral arteries (25%). 3. Radicular (root) arteries - Most of blood supply to spinal cord is provided by Radicular (root) arteries; most these arteries arise from the Aorta and enter the spinal canal through Intervertebral foramina; one particularly large artery (Great Radicular Artery of Adamkiewicz, usually unpaired) arises from T9-T12 and provides major blood supply to lumbar and sacral spinal cord. Clinical Note: Obstruction of Radicular Artery (of Adamkiewicz) - Can occur during clamping for heart surgery or by a dissecting Aortic aneurysm; causes infarction (tissue death in spinal cord) similar to an Anterior Spinal Artery syndrome (symptoms include paraplegia (Corticospinal tracts, bilateral voluntary paralysis of legs and lower body), loss of pain and temperature sense (Spinothalamc tract, loss of sphincter control) with sparing of vibration and position sense (Dorsal Columns, sensory).
    [Show full text]
  • Basic Biomechanics
    Posture analysis • A quick evaluation of structure and function • Doctor views patient from behind (P-A) and from the side (lateral) • References points of patient’s anatomy relative to plumb (a position of balance) 9/3/2013 1 Posture analysis • Lateral View – Knees (anterior, posterior, plumb, genu recurvatum) – Trochanter (anterior, posterior, plumb) – Pelvis (anterior, posterior, neutral pelvic tilt) – Lumbar lordosis (hypo-, hyper-, normal) – Mid-axillary line (anterior, posterior, plumb) – Thoracic kyphosis (hyp-, hyper- normal) – Acromion (anterior, posterior, plumb) – Scapulae (protracted, retracted, normal) – Cervical lordosis (hypo-, hyper-, normal) – External auditory meatus (anterior, posterior, plumb) – Occiput (extended, neutral, flexed) 9/3/2013 2 Posture analysis • Posterior – Anterior View – Feet (pronation, supination, normal) – Achilles tendon (bowed in/out, normal) – Knees (genu valga/vera, normal - internal/external rotation) – Popliteal crease heights (low, high, level) – Trochanter heights (low, high, level) – Iliac crest heights (low on the right/left, normal) – Lumbar scoliosis (right/left, or no signs of) – Thoracic scoliosis (right/left, or no signs of) – Shoulder level (low on the right/left, or normal) – Cervical scoliosis (right/left, or no signs of) – Cervical position (rotation, tilt, neutral) – Mastoid (low on the right/left, or normal) 9/3/2013 3 …..poor postures 9/3/2013 4 Functional Anatomy of the Spine • The vertebral curvatures – Cervical Curve • Anterior convex curve (lordosis) develop in infancy
    [Show full text]
  • Diaphragm and Intercostal Muscles
    Diaphragm and intercostal muscles Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Skeletal System Adult Human contains 206 Bones 2 parts: Axial skeleton (axis): Skull, Vertebral column, Thoracic cage Appendicular skeleton: Bones of upper limb Bones of lower limb Dr. Heba Kalbouneh Structure of Typical Vertebra Body Vertebral foramen Pedicle Transverse process Spinous process Lamina Dr. Heba Kalbouneh Superior articular process Intervertebral disc Dr. Heba Inferior articular process Dr. Heba Facet joints are between the superior articular process of one vertebra and the inferior articular process of the vertebra directly above it Inferior articular process Superior articular process Dr. Heba Kalbouneh Atypical Vertebrae Atlas (1st cervical vertebra) Axis (2nd cervical vertebra) Dr. Heba Atlas (1st cervical vertebra) Communicates: sup: skull (atlanto-occipital joint) inf: axis (atlanto-axial joint) Atlas (1st cervical vertebra) Characteristics: 1. no body 2. no spinous process 3. ant. & post. arches 4. 2 lateral masses 5. 2 transverse foramina Typical cervical vertebra Specific to the cervical vertebra is the transverse foramen (foramen transversarium). is an opening on each of the transverse processes which gives passage to the vertebral artery Thoracic Cage - Sternum (G, sternon= chest bone) -12 pairs of ribs & costal cartilages -12 thoracic vertebrae Manubrium Body Sternum: Flat bone 3 parts: Xiphoid process Dr. Heba Kalbouneh Dr. Heba Kalbouneh The external intercostal muscle forms the most superficial layer. Its fibers are directed downward and forward from the inferior border of the rib above to the superior border of the rib below The muscle extends forward to the costal cartilage where it is replaced by an aponeurosis, the anterior (external) intercostal membrane Dr.
    [Show full text]
  • Diagnosis of Atlantoaxial Instability Requires Clinical Suspicion To
    al of S rn pi ou n Henderson Sr and Henderson Jr, J Spine 2017, 6:2 J e Journal of Spine DOI: 10.4172/2165-7939.1000364 ISSN: 2165-7939 Mini Review OMICS International Diagnosis of Atlantoaxial Instability Requires Clinical Suspicion to Drive the Radiological Investigation Fraser C Henderson Sr.1,2* and Fraser C Henderson Jr.3 1Doctors Community Hospital, Lanham, MD, USA 2The Metropolitan Neurosurgery Group, LLC, Chevy Chase, MD, USA 3Medical University of South Carolina, Charleston, SC, USA Introduction bending to the contralateral side, are often injured in motor vehicle collisions, and could be implicated in whiplash-associated disorders Atlantoaxial instability (AAI) occurs as a result of trauma, [15]. Failure of the alar ligament allows a 30% increased rotation to congenital conditions such as os odontoideum, neoplasm, infection the opposite side [16]. The atlantoaxial joint is ill-equipped to handle and degenerative connective tissue disorders such as rheumatoid the required multi-axial movements in the presence of ligamentous arthritis, genetic conditions such as HOX-D3 and Down syndrome, laxity or disruption [17]. Weakness of the muscles and ligaments, and heritable connective tissue disorders, emblematic of which are hormonal changes, infection, immunological problems, and congenital the Ehlers Danlos syndromes (EDS). Prototypical of disorders in dysmorphism may contribute to the overall mechanical dysfunction at which AAI is diagnosed, is rheumatoid arthritis (RA). Prior to the the C1-C2 motion segment. development of effective disease-modifying pharmacotherapies, 88% of RA patients exhibited radiographic evidence of C1-C2 involvement, Hypermobility of the AAJ is common in children, and up to 45° of in whom 49% were symptomatic and 20% myelopathic; ultimately, rotation may be observed in each direction.
    [Show full text]
  • Applied Anatomy of the Hip RICARDO A
    Applied Anatomy of the Hip RICARDO A. FERNANDEZ, MHS, PT, OCS, CSCS • Northwestern University The hip joint is more than just a ball-and- bones fuse in adults to form the easily recog- socket joint. It supports the weight of the nized “hip” bone. The pelvis, meaning bowl head, arms, and trunk, and it is the primary in Latin, is composed of three structures: the joint that distributes the forces between the innominates, the sacrum, and the coccyx pelvis and lower extremities.1 This joint is (Figure 1). formed from the articu- The ilium has a large flare, or iliac crest, Key PointsPoints lation of the proximal superiorly, with the easily palpable anterior femur with the innomi- superior iliac spine (ASIS) anterior with the The hip joint is structurally composed of nate at the acetabulum. anterior inferior iliac spine (AIIS) just inferior strong ligamentous and capsular compo- The joint is considered to it. Posteriorly, the crest of the ilium ends nents. important because it to form the posterior superior iliac spine can affect the spine and (PSIS). With respect to surface anatomy, Postural alignment of the bones and joints pelvis proximally and the PSIS is often marked as a dimple in the of the hip plays a role in determining the femur and patella skin. Clinicians attempting to identify pelvic functional gait patterns and forces associ- distally. The biomechan- or hip subluxations, leg-length discrepancies, ated with various supporting structures. ics of this joint are often or postural faults during examinations use There is a relationship between the hip misunderstood, and the these landmarks.
    [Show full text]
  • How to Perform a Transrectal Ultrasound Examination of the Lumbosacral and Sacroiliac Joints
    DIAGNOSTIC IMAGING How to Perform a Transrectal Ultrasound Examination of the Lumbosacral and Sacroiliac Joints Erik H.J. Bergman, DVM, Diplomate ECAR, Associate Member LA-ECVDI*; Sarah M. Puchalski, DVM, Diplomate ACVR; and Jean-Marie Denoix, DVM, PhD, Agre´ge´, Associate Member LA-ECVDI Authors’ addresses: Lingehoeve Veldstraat 3 Lienden 4033 AK, The Netherlands (Bergman); Uni- versity of California, Davis, One Shields Avenue, School of Veterinary Medicine, Davis, CA 95616 (Puchalski); E´ cole Nationale Ve´te´rinaire d’Alfort, 7 Avenue du Ge´ne´ral de Gaulle, 94700 Maisons- Alfort, France (Denoix); e-mail: [email protected]. *Corresponding and presenting author. © 2013 AAEP. 1. Introduction have allowed for identification of these structures 5 There is increasing interest in pathology of the and the inter-transverse joints. These authors urge lumbosacral and sacroiliac joints giving rise to stiff- caution in the interpretation of lesions identified on ness and/or lameness and decreased performance radiography in the absence of other diagnostic im- in equine sports medicine.1–3 Pain arising from aging and clinical examination. Nuclear scintigra- these regions can be problematic alone or in con- phy is an important component of work-up for junction with lameness arising from other sites sacroiliac region pain, but limitations exist. Sev- 9,10 (thoracolumbar spine, hind limbs, or forelimbs).4 eral reports exist detailing the anatomy and tech- Localization of pain to this region is critically impor- nique findings in normal horses11,12 and findings in tant through clinical assessment, diagnostic anes- lame horses.13 Patient motion, camera positioning, thesia, and imaging. and muscle asymmetry can cause errors in interpre- In general, diagnostic imaging of the axial skele- tation.
    [Show full text]
  • The Effect of Training on Lumbar Spine Posture and Intervertebral Disc Degeneration in Active-Duty Marines
    The Effect of Training on Lumbar Spine Posture and Intervertebral Disc Degeneration in Active-Duty Marines Ana E. Rodriguez-Soto, PhDc, David B. Berry, MScc, Rebecca Jaworski, PhDd,1, Andrew Jensen, MScd,g,2, Christine B. Chung, MDe,f, Brenda Niederberger, MAd,g, Aziza Qadirh, Karen R. Kelly, PT, PhDd,g , Samuel R. Ward, PT, PhDa,b,c aDepartments of Radiology, bOrthopaedic Surgery, and cBioengineering University of California, San Diego 9500 Gilman Drive (0610), La Jolla, CA 92093 dDepartment of Warfighter Performance, Naval Health Research Center 140 Sylvester Road, San Diego, CA 92106-3521 eDepartment of Radiology, Veteran Administration San Diego Healthcare System 3350 La Jolla Village Dr., San Diego, CA 92161 fDepartment of Radiology, University of California, San Diego Medical Center 408 Dickinson Street, San Diego, CA 92103-8226 gSchool of Exercise and Nutritional Sciences, San Diego State University ENS Building room 351, 5500 Campanile, San Diego, CA 92182-7251 hVital Imaging Center 5395 Ruffin Rd Suite 100, San Diego CA 92123 Ana Elvira Rodriguez-Soto, PhD E-mail: [email protected] David Barnes Berry, MS E-mail: [email protected] Rebecca Jaworski, PhD E-mail: [email protected] Present Address: 1Office of the Naval Inspector General 1254 9th St. SE, Washington Navy Yard, DC 90374-5006 Andrew Jensen, MS E-mail: [email protected] Present address: 2Department of Biological Sciences, University of Southern California PED 107 3560 Watt Way, Los Angeles, CA 90089-0652 Christine B. Chung, MD E-mail: [email protected] Brenda Niederberger, MA E-mail: [email protected] Aziza Qadir E-mail: [email protected] Karen R.
    [Show full text]
  • Epithelia Joitns
    NAME LOCATION STRUCTURE FUNCTION MOVEMENT Temporomandibular joint Condylar head of ramus of Synovial Diarthrosis Modified hinge joint mandible and glenoid fossa of Rotation and gliding temporal bone Biaxial Zygapophyseal joint Between articular processes of Synovial Diarthrosis Gliding 2 adjacent vertebrae Non axial Atlanto-Occipital joints Atlas and occipital condyle of Synovial Diarthrosis Ellipsoid occipital bone Biaxial Atlantoaxial joints Atlas and axis Synovial Diarthrosis Pivot Uniaxial Joints of vertebral arches Ligaments Fibrous Amphiarthrosis Syndesmoses Intervertebral symphyseal Intervertebral disk between 2 Cartilaginous Amphiarthrosis joints vertebrae Symphysis Costovertebral Head of ribs and body of Synovial Diarthrosis Gliding thoracic vertebra Non axial Costotrasnverse joints Tubercle of rib and transverse Synovial Diarthrosis Gliding process of thoracic vertebra Non axial Lumbosacral Joint Left and right zygopophyseal Laterally Synovial joint Intervertebral symphyseal joint Symphysis SternoclavicularJoint Clavicular notch articulates Synovial Diarthrosis Gliding with medial ends of clavicle Non Axial Manubriosternal Joint Hyaline cartilage junction Cartilaginous Synarthrosis Sternal Angle between manubrium and body Symphysis Xiphisternal Joint Cartilage between xiphoid Synchondrosis Synarthrosis process and body Synostoses Sternocostal Joint (1st) Costocartilage 1 with sternum Cartilaginous Synchondrosis Synarthrosis NAME Location Section Anterior longitudinal runs down anterior surface of vertebral body Vertebral column ligament Posterior longitudinal in canal, runs down posterior surface of vertebral body ligament Interspinous ligament Connects spinous processes Ligamentum flavum Connects laminae ! Intra-articular Disc Between articulating surface of sternum and clavicle Sternoclavicular Joint Costoclavicular ligament 1st rib to clavicle !.
    [Show full text]
  • Duplication of the Alar Ligaments: a Case Report
    Open Access Case Report DOI: 10.7759/cureus.2893 Duplication of the Alar Ligaments: A Case Report Asad Rizvi 1 , Joe Iwanaga 2 , Rod J. Oskouian 3 , Marios Loukas 4 , R. Shane Tubbs 5 1. St. Georges University School of Medicine, St. Georges, GRD 2. Seattle Science Foundation, Seattle, USA 3. Neurosurgery, Swedish Neuroscience Institute, Seattle, USA 4. Anatomical Sciences, St. George's University, St. George's, GRD 5. Neurosurgery, Seattle Science Foundation, Seattle, USA Corresponding author: Joe Iwanaga, [email protected] Abstract The alar ligament is one of the two strongest ligaments stabilizing the craniocervical junction. The literature describes many variations of the attachment, insertion, shape, and orientation of the alar ligament and an understanding of these variations is vital as they can lead to altered biomechanics or misinterpretation on imaging. Herein, we report, to our knowledge, the first case of duplication of the alar ligaments and discuss the anatomical variations present in the literature. Categories: Neurology, Pathology Keywords: alar ligament, duplication, craniocervical junction, variant, transverse occipital ligament, anatomy Introduction The craniocervical junction is composed of the atlantooccipital and the atlantoaxial joints. Several ligaments stabilize these joints, namely the transverse, alar, transverse occipital, accessory, lateral atlantooccipital, and apical ligaments [1]. The transverse and alar ligaments are the two strongest ligaments stabilizing the craniocervical junction with approximately 400 N and 200 N necessary until failure, respectively [1-2]. The alar ligaments are fibrous cords that attach to the dens bilaterally and insert on the base of the skull. They function to limit axial rotation and lateral bending on the contralateral side, and flexion secondarily [1- 2].
    [Show full text]
  • Posterior Longitudinal Ligament Status in Cervical Spine Bilateral Facet Dislocations
    Thomas Jefferson University Jefferson Digital Commons Department of Orthopaedic Surgery Faculty Papers Department of Orthopaedic Surgery November 2005 Posterior longitudinal ligament status in cervical spine bilateral facet dislocations John A. Carrino Harvard Medical School & Brigham and Women's Hospital Geoffrey L. Manton Thomas Jefferson University Hospital William B. Morrison Thomas Jefferson University Hospital Alex R. Vaccaro Thomas Jefferson University Hospital and The Rothman Institute Mark E. Schweitzer New York University & Hospital for Joint Diseases Follow this and additional works at: https://jdc.jefferson.edu/orthofp Part of the Orthopedics Commons LetSee next us page know for additional how authors access to this document benefits ouy Recommended Citation Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Vaccaro, Alex R.; Schweitzer, Mark E.; and Flanders, Adam E., "Posterior longitudinal ligament status in cervical spine bilateral facet dislocations" (2005). Department of Orthopaedic Surgery Faculty Papers. Paper 3. https://jdc.jefferson.edu/orthofp/3 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Department of Orthopaedic Surgery Faculty Papers by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected].
    [Show full text]
  • Intervertebral Veins Directly Connecting the Vertebral Venous System to the Azygos Venous System Rather Than the Proximal End Of
    Intervertebral Veins Rev Arg de Anat Clin; 2015, 7 (2): 88-92 ___________________________________________________________________________________________ Original Communication INTERVERTEBRAL VEINS DIRECTLY CONNECTING THE VERTEBRAL VENOUS SYSTEM TO THE AZYGOS VENOUS SYSTEM RATHER THAN THE PROXIMAL END OF THE POSTERIOR INTERCOSTAL VEINS Naief Dahran1,2, Roger Soames1 1Centre for Anatomy and Human Identification, College of Art, Science and Engineering, University of Dundee, Dundee, United Kingdom 2Department of Anatomy, College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia RESUMEN ABSTRACT La estructura de las venas de la cavidad torácica varía Veins in the thoracic cavity are highly variable in terms significativamente en función de sus conexiones. of their communications. Thirty Thiel-embalmed Treinta cadáveres embalsamados con la técnica de cadavers were dissected (18 females and 12 males), Thiel fueron disecados (18 mujeres, 12 hombres), con ranging in age from 48 to 98 years old (mean edades comprendidas entre 48 y 98 años (media 81.3±12.40). The lungs, heart, thoracic aorta, 81.3±12.40). Los pulmones, el corazón, la aorta oesophagus and parietal pleura were removed torácica, el esófago y la pleura parietal fueron carefully to expose the azygos, hemiazygos, accessory cuidadosamente retirados para permitir la visualización hemiazygos veins and thoracic duct. In most de las venas ácigos, hemiácigos y hemiácigos specimens (21) intervertebral veins were connected accesoria así como el conducto torácico. En la directly to the azygos venous systems rather than the mayoría de los especímenes (21) se encontró que las proximal end of the posterior intercostal veins. This venas intervertebrales estaban directamente presentation was observed to be more common on the conectadas con el sistema venoso ácigos en vez de right side, but not at all vertebral levels.
    [Show full text]