Dr Jyoti Chopra Professor Department of Anatomy Vertebral
Column
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Houses and Protects spinal cord Supports weight Site for muscle
attachments
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Vertebral Column Part of the axial skeleton 33 vertebrae 7
Cervical 12 Thoracic 5 Lumbar 5 Sacral 4 Coccygeal Part of the
axial skeleton 33 vertebrae 7 Cervical 12 Thoracic 5 Lumbar 5
Sacral 4 Coccygeal
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Typical Vertebra 1. Body 2. Vertebral Arch a)Pedicles b)Laminae
c)Processes Transverse Spinous Articular Superior Inferior 3.
Spinal Foramen 1. Body 2. Vertebral Arch a)Pedicles b)Laminae
c)Processes Transverse Spinous Articular Superior Inferior 3.
Spinal Foramen
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Intervertebral Foramen Superior and Inferior vertebral notch
Superior and Inferior- pedicle Anterior- Intervertebral disc and
vertebral body Posterior- Articular processes and joints Superior
and Inferior vertebral notch Superior and Inferior- pedicle
Anterior- Intervertebral disc and vertebral body Posterior-
Articular processes and joints
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Intervertebral foramina: Contents Spinal nerves Segmental
arteries and veins embedded in areolar tissue Recurrent meningeal
Branch Pressure on/ stretching of spinal nerves: Herniation of IV
disc fracture of vertebral body Osteoarthritis of articular
processes or joint
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Intervertebral disc Fibrocartilaginous Extend from C2- sacrum
as C1 has no vertebral body Thickest in cervical & lumbar
region where movement of vertebral column are greatest Make upto
25% of length of column
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Structure of Intervertebral disc Outer rim- anulus fibrosus
fibrocartilage Concentrically arranged collagen fibers Collagen
bundle pass obliquely and connects vertebral bodies Peripheral
fibers attach to anterior and posterior longitudinal ligament
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Structure of Intervertebral disc Central- Nucleus pulposus
Contains mucopolysaccharide matrix About 80-90% water Normally
under pressure Nearer to posterior margin Neither blood vessels nor
nerves penetrate nucleus
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Functions Changes shape, permit movement between vertebrae
Structure deforms when pressure is put on vertebral column as in
weight bearing Acts as a shock absorber Annulus totally encloses
the nucleus and keeps it under constant pressure With age H2O
content decreases and nucleus becomes more fibrocartilaginous,
therefore less easily deformable and more easily damaged
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Clinical Notes Nucleus, when under extreme pressure, can
herniate or extrude in posterior or posterior-lateral direction
Usually occurs in cervical or lumbar region Nucleus can put
pressure on spinal nerve causing referred symptoms (motor and
sensory) Can cause pressure on cord itself if true posterior
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Curvature of Vertebral Column Primary curvature Secondary
curvature
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During later part of pregnancy Posterior lumbar concavity
increases (Lordosis) Attempt to preserve centre of gravity In old
age Intervertebral discs atrophy Loss of height Gradual return of
continuous anterior concavity (Senile kyphosis)
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Abnormal Curves of Vertebral Column Kyphosis Exaggeration of
thoracic curve Caused by muscular weakness or structural changes in
vertebral bodies/ intervertebral disc Lordosis Exaggeration of
lumbar curve Caused by diseases of vertebral column like
spondylolisthesis
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Abnormal Curves of Vertebral Column Scoliosis Lateral deviation
of vertebral column Common in thoracic region Caused by muscular or
vertebral defects (poliomyelitis, congenital hemivertebra, short
leg, hip disease)
Contents of Vertebral Canal Epidural space Spinal meninges
Spinal cord with its nerve roots
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Epidural Space Location: between spinal dura and periosteum of
vertebral canal Contents: roots of spinal nerve, internal vertebral
venous plexus, spinal arteries, areolar tissue Feature: minus
atmospheric pressure.
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Internal vertebral venous plexus Longitudinal, valveless
vertebral venous plexus Communicates above with intracranial venous
sinuses, segmentally with veins of thorax, abdomen and pelvis
Anteriorly receives basivertebral vein
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Internal vertebral venous plexus Pelvic venous blood enters in
vertebral venous plexus specially if intra abdominal pressure
raised Thus carcinoma of prostate metastasize to vertebral column
and cranial cavity
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Spinal pia mater Spinal dura arachnoid
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Spinal Duramater Continuous superiorly through foramen magnum
with meningeal layer of dura Inferiorly ends on filum terminale at
lower border of S2 Extends along each nerve root and continues with
epineurium Seperated from arachnoid mater by subdural space
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Arachnoid mater Delicate impermeable membrane Inferiorly ends
on filum terminale at lower border of S2 Seperated from pia mater
by subarachnoid space
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Pia mater Vascular membrane Closely covers spinal cord
Inferiorly fuses with filum terminale Extends along each nerve root
Ligamentum denticulatum- thickening on either side between the
nerve roots Laterally attached to dura Helps in suspending spinal
cord in middle of dural sheath
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Subarachnoid Space Between arachnoid and pia mater Contents:
cerebrospinal fluid (CSF) Features: pressure equal to the normal
atmospheric pressure
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Spinal Cord Terminates in adults- lower border of L1 In
children- upper border of L3 Inferiorly taper in Conus medullaris
Filum terminale- prolongation of piamater Attached to back of
coccyx
Length of the roots increases progressively from above
downwards Roots of lumbar and sacral nerves form leash of nerves-
Cauda equina
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Lumbar puncture Needle passes through- Skin Superficial fascia
Supraspinous ligament Interspinous ligament Ligamentum flavum
Areolar tissue containing IVVP in epidural space Duramater
Arachnoidmater
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Complications of Lumbar puncture Post lumbar puncture headache-
Starts after 24-48 hrs Due to leak of CSF if wide bored needle used
Due to leak, downward displacement of brain, stretching of
meninges- pain sensitive- headache Brain herniation- LP
contraindicated in raised intracranial tension If done can lead to
caudal displacement of uncus through tentorial notch or medulla
through foramen magnum
Development of Vertebral Column Paraxial mesoderm Divides in
block of tissues- somites (4 th week) Somites- Ventromedial-
sclerotome Dorsomedial- dermamyotome Mesenchymal cells of
sclerotome migrate around notocord
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Development of Vertebral Column Caudal half of each sclerotome
fuses with cephalic half of succeeding sclerotome- form vertebral
body Vertebral body- intersegmental Notocord degenerates but in
intervertebral regions form nucleus pulposus Anulus fibrosus-
scerotic mesenchyme of intervertebral region
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Development of Vertebral Column Mesenchymal vertebral body-
dorsal and lateral growth Dorsal growth- around neural tube, fuses
with fellow of opposite side- neural arch Lateral growth- costal
processes
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Development of Vertebral Column Cartilagenous vertebrae Primary
ossification centers- Centrum-2 Neural arch- 1 for each half
Secondary ossification centers- Superior and inferior end of
vertebral body Tip of each spinous process Tip of each transverse
sprocess