脊柱解剖醫(yī)學(xué)知識(shí)培訓(xùn)

脊柱Vertebralcolumn基礎(chǔ)醫(yī)學(xué)院人體解剖教研室第1頁(yè)Thevertebralcolumn脊柱consistsof24vertebrae,thesacrum,andthecoccyx.

第2頁(yè)一、Vertebrae椎骨Thereare33vertebraeinchildren,arrangedasfollows:Cervicalvertebrae頸椎C.7Thoracicvertebrae

胸椎T.12Lumbarvertebrae

腰椎L.5Sacralvertebrae

骶椎S.5sacrum骶骨Coccygealvertebrae

尾椎Co.3~4coccyx尾骨第3頁(yè)GeneralfeaturesofvertebraeVertebralbody椎體Vertebralarch椎弓pedicleofvertebralarch椎弓根:sup.andinf.Vertebralnotch

椎上、下切跡

laminaofvertebralarch椎弓板process(7):spinousprocess棘突transverseprocess橫突sup.andinf.articularprocesses上、下關(guān)節(jié)突Vertebralforamen椎孔

Vertebralcanal椎管Intervertebralforamen椎間孔第4頁(yè)RegionalvariationsofvertebraeCervicalvertebraeVertebraeBody:smallVertebralforamen:largerandtriangularSpinousprocesses:shortandbifidinC3toC5,longinC6,andlongerinC7Transverseprocesses:shortandbifid,transverseforamen橫突孔Articularprocesses:horizontal第5頁(yè)AtypicalvertebeaeAtlas寰椎(C1)Bodyandspinousprocessabsent,consistsofanteriorandposteriorarches,andtwolateralmassesGrooveforvertebralartery椎動(dòng)脈溝第6頁(yè)Axis樞椎(C2):distinguishedbydens齒突whicharticulateswithdentalfoveaofanteriorarchofatlas第7頁(yè)Carotidtubercle:頸動(dòng)脈結(jié)節(jié):anteriortubercleoftransverseprocessofC6Vertebraprominens

隆椎(C7):containslongandnon-bifidspinousprocess,itisvisiblewithneckflexed,usedasclinicallandmarkincountingcervicalandthoracicspinousprocesses第8頁(yè)Thoracicvertebrae

VertebraeBody：

heart-shape,superiorandinferiorcostalfovea上、下肋凹Vertebralforamen：

smaller,rounder

Spinousprocesses：

long,pointobliquelydownward

Transverseprocesses：transversecostalfovea橫突肋凹

Articularprocesses:coronal

第9頁(yè)Lumbarvertebrae

VertebraeBody：larger,kidney-shapeVertebralforamen:largerandtriangularSpinousprocesses:projectshorizontallyTransverseprocesses:longArticularprocesses:sagittal第10頁(yè)Sacrum

Anteriorsurface:

promontory岬,anteriorsacralforamina

骶前孔(fourpairs)

Posteriorsurface:

mediansacralcrest骶正中嵴,posteriorsacralforamina(fourpairs),sacralhiatus骶管裂孔，sacral

cornu骶角Lateralpart:

auricularsurface耳狀面,sacraltuberosity骶粗隆第11頁(yè)二、ArticulationsofVertebrae

椎骨旳連結(jié)JointsofthevertebralbodiesJointsofthevertebralarches第12頁(yè)1.Jointsofthevertebralbodies椎體間旳連結(jié)Intervertebraldiscs

椎間盤(pán)betweenbodiesofadjacentvertebrae,composedof:Nucleuspulpous髓核,aninnersoft,pulpy,highlyelasticstructure(gelatinouscore)Annulusfibrosus纖維環(huán)

anouterfibrousringconsistingoffibrocartilage第13頁(yè)Anteriorlongitudinalligament

前縱韌帶StrongbandcoveringtheanteriorpartofthevertebralbodiesandintervertebraldiscsrunningfromtheanteriormarginofforamenmagnumtotheS1~S2MaintainsstabilityoftheintervertebraldiscandpreventshyperextensionofthevertebralcolumnPosteriorlongitudinalligament后縱韌帶AttachedtotheposterioraspectoftheintervertebraldiscsandposterioredgesofthevertebralbodiesfromC2vertebratosacrumPreventshyperflexionofthevertebralcolumnandposteriorprotrusionofthediscs第14頁(yè)Herniaofnucleuspulpous

髓核脫出第15頁(yè)2.Jointsofthevertebralarches椎弓間旳連結(jié)Ligamentaflava

黃韌帶―elasticligament,unitelaminaeofadjacentvertebrae,andcompletetheposteriorwallofvertebralcanal;tendtopreventhyperflexionofthevertebralcolumnInterspinalligament棘間韌帶Supraspinalligament棘上韌帶Ligamentumnuchae項(xiàng)韌帶

Intertansverseligament橫突間韌帶Zygapophysialjoint關(guān)節(jié)突關(guān)節(jié)第16頁(yè)三、Atlantooccipitaljoint

寰枕關(guān)節(jié)BetweensuperiorarticulatingsurfacesofatlasandoccipitalcondylesSupportedbymembrancesandligamentsthatjoinoccipitalboneandatlasAction―noddingofhead,lateraltiltingofhead第17頁(yè)四、Atlantoaxialjoint

寰樞關(guān)節(jié)ThreesynovialjointsbetweenatlasandaxisLaterally,pairedjointsbetweenarticulatingfacesMedianjointbetweendensofaxisandanteriorarchofatlas第18頁(yè)Supportedbyligamentsapicalligamentofdens齒突尖韌帶alarligament翼狀韌帶transverseligamentofatlas寰椎橫韌帶tectorialmembrane覆膜Action―allowatlas(andhead)topivotontheaxisandvertebralcolumn第19頁(yè)五、NormalCurvesofvertebralcolumnCervicalcurvature頸曲

convexforwardThoraciccurvature胸曲

convexbackward

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