脊柱解剖

大家好！脊柱Vertebralcolumn基础医学院人体解剖教研室Thevertebralcolumn脊柱consistsof24vertebrae,thesacrum,andthecoccyx.一、Vertebrae椎骨Thereare33vertebraeinchildren,arrangedasfollows:Cervicalvertebrae颈椎C.7Thoracicvertebrae胸椎T.12Lumbarvertebrae腰椎L.5Sacralvertebrae骶椎S.5sacrum骶骨Coccygealvertebrae尾椎Co.3~4coccyx尾骨GeneralfeaturesofvertebraeVertebralbody椎体Vertebralarch椎弓pedicleofvertebralarch椎弓根:sup.andinf.Vertebralnotch椎上、下切迹laminaofvertebralarch椎弓板process(7):spinousprocess棘突transverseprocess横突sup.andinf.articularprocesses上、下关节突Vertebralforamen椎孔Vertebralcanal椎管Intervertebralforamen椎间孔RegionalvariationsofvertebraeCervicalvertebraeVertebraeBody:smallVertebralforamen:largerandtriangularSpinousprocesses:shortandbifidinC3toC5,longinC6,andlongerinC7Transverseprocesses:shortandbifid,transverseforamen横突孔Articularprocesses:horizontalAtypicalvertebeaeAtlas寰椎(C1)Bodyandspinousprocessabsent,consistsofanteriorandposteriorarches,andtwolateralmassesGrooveforvertebralartery椎动脉沟Axis枢椎(C2):distinguishedbydens齿突whicharticulateswithdentalfoveaofanteriorarchofatlasCarotidtubercle:颈动脉结节:anteriortubercleoftransverseprocessofC6Vertebraprominens隆椎(C7):containslongandnon-bifidspinousprocess,itisvisiblewithneckflexed,usedasclinicallandmarkincountingcervicalandthoracicspinousprocessesThoracicvertebraeVertebraeBody：heart-shape,superiorandinferiorcostalfovea上、下肋凹Vertebralforamen：smaller,rounderSpinousprocesses：long,pointobliquelydownwardTransverseprocesses：transversecostalfovea横突肋凹Articularprocesses:coronalLumbarvertebraeVertebraeBody：larger,kidney-shapeVertebralforamen:largerandtriangularSpinousprocesses:projectshorizontallyTransverseprocesses:longArticularprocesses:sagittalSacrumAnteriorsurface:promontory岬,anteriorsacralforamina骶前孔(fourpairs)Posteriorsurface:mediansacralcrest骶正中嵴,posteriorsacralforamina(fourpairs),sacralhiatus骶管裂孔，sacralcornu骶角Lateralpart:auricularsurface耳状面,sacraltuberosity骶粗隆二、ArticulationsofVertebrae椎骨的连结JointsofthevertebralbodiesJointsofthevertebralarches1.Jointsofthevertebralbodies椎体间的连结Intervertebraldiscs椎间盘betweenbodiesofadjacentvertebrae,composedof:Nucleuspulpous髓核,aninnersoft,pulpy,highlyelasticstructure(gelatinouscore)Annulusfibrosus纤维环anouterfibrousringconsistingoffibrocartilageAnteriorlongitudinalligament前纵韧带StrongbandcoveringtheanteriorpartofthevertebralbodiesandintervertebraldiscsrunningfromtheanteriormarginofforamenmagnumtotheS1~S2MaintainsstabilityoftheintervertebraldiscandpreventshyperextensionofthevertebralcolumnPosteriorlongitudinalligament后纵韧带AttachedtotheposterioraspectoftheintervertebraldiscsandposterioredgesofthevertebralbodiesfromC2vertebratosacrumPreventshyperflexionofthevertebralcolumnandposteriorprotrusionofthediscsHerniaofnucleuspulpous髓核脱出2.Jointsofthevertebralarches椎弓间的连结Ligamentaflava黄韧带―elasticligament,unitelaminaeofadjacentvertebrae,andcompletetheposteriorwallofvertebralcanal;tendtopreventhyperflexionofthevertebralcolumnInterspinalligament棘间韧带Supraspinalligament棘上韧带Ligamentumnuchae项韧带Intertansverseligament横突间韧带Zygapophysialjoint关节突关节三、Atlantooccipitaljoint寰枕关节BetweensuperiorarticulatingsurfacesofatlasandoccipitalcondylesSupportedbymembrancesandligamentsthatjoinoccipitalboneandatlasAction―noddingofhead,lateraltiltingofhead四、Atlantoaxialjoint寰枢关节ThreesynovialjointsbetweenatlasandaxisLaterally,pairedjointsbetweenarticulatingfacesMedianjointbetweendensofaxisandanteriorarchofatlas•Supportedbyligamentsapicalligamentofdens齿突尖韧带alarligament翼状韧带transverseligamentofatlas寰椎横韧带tectorialmembrane覆膜•Action―allowatlas(andhead)topivotontheaxisandvertebralcolumn五、NormalCurvesofvertebralcolumnCervicalcurvature颈曲convexforwardThoraciccurvature胸曲convexbackwardLumbarcurvature腰曲convexforwardSacralcurvature骶曲convexbackward六、Movementofthevertebralcolumn•flexion•extension•lateralflexion•rotation•circumductionSpinabifidacystica脊柱裂