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Lumbar Spine
Anatomy
Orthopedic Assessment III
Head, Spine, and Trunk
with Lab
PET 5609C
Clinical Anatomy
Vertebral Column:
Cervical Spine:
Thoracic Spine:
Lordotic curvature
Greatest ROM
Most vulnerable to
injury
Greatest protection
Least ROM
Lumbar Spine:
Balance between
protection/ROM
Clinical Anatomy
Vertebral Column:
Superiorly: 24
individual vertebrae
(separated by
intervertebral discs)
Inferiorly: 9 fuse to
form 2 composite
bones
Sacrum (5)
Coccyx (4)
Clinical Anatomy
Vertebral
Column:
Functions:
Transmits weight
of the trunk to
the lower limbs
Surrounds/protec
ts spinal cord
Attachment point
for the ribs and
muscles of neck
and back
Clinical Anatomy
Vertebral Column:
Major Supporting
Ligaments
Anterior Longitudinal
Ligament runs
vertically along anterior
surface of vertebral
bodies
Neck - Sacrum
Attaches strongly to both
vertebrae and
intervertebral discs (very
wide)
Prevents back
hyperextension
Clinical Anatomy
Vertebral Column:
Major Supporting
Ligaments
Posterior
Longitudinal
Ligament - runs
vertically along
posterior surfaces of
vertebral bodies
Narrower, weaker
Attaches to
intervertebral discs
Prevents hyperflexion
Clinical Anatomy
Clinical Anatomy
Vertebral Column:
Supporting
Ligaments
Intertransverse
Ligament - located
between the
transverse processes
Clinical Anatomy
Vertebral Column:
Supporting
Ligaments
Interspinal
Ligament - connect
spinous processes
(spans the entire
process)
Meets the
ligamentum flavum
in front and the
supraspinal ligament
behind
Clinical Anatomy
Vertebral Column:
Supporting Ligaments
Supraspinal Ligament
-connects together the
apexes of the spinous
processes
Supraspinal
Ligament
Clinical Anatomy
Bony Anatomy:
Body : Centrum
Anterior part
Weight-bearing
segment
Vertebral Arch:
Neural Arch
Posterior part
Formed by pedicle
and lamina on each
side
Clinical Anatomy
Bony Anatomy:
Vertebral Foramen:
Pedicles: (2)
Opening
Sides of vertebral
arch
Little feet project
posteriorly from
body
Laminae: (2)
Clinical Anatomy
Bony Anatomy:
Transverse Processes:
Spinous Processes:
Prominent posterior
projections
Attachment site for
intrinsic ligaments and
muscles
Cervical
Cervical
Thoracic
Thoracic
Lumbar
Vertebrae
Lumbar
Vertebrae
Clinical Anatomy
Facet Joints:
Articulations between
superior articular
facet (bottom
vertebrae) and inferior
articular facet (above
vertebrae)
Contribute to ROM
Weight-bearing
stress through
vertebral body and
disc
Synovial joints
Clinical Anatomy
Pars Interarticularis:
Clinical Anatomy
Intervertebral
Foramen:
Can be occluded by
arthritic degenerative
changes and spaceoccupying lesions
(tumors, spinal disc
herniations)
Vertebral Anatomy
Level
Vertebral
Body
Transverse
Process
Spinous Process
Cervical
Small;
Vertebral
body
absent in
C1;
remaining
bodies
progressive
ly in size
Short;
Processes
contain the
transverse
foramen for
passage of
vertebral
artery
Thoracic
Diameter
and
thickness
as spine
continues
inferiorly
Attachment of
muscles and
costovertebral
ligaments;
Processes of
T1-T12 have
articular
surfaces for
the ribs
Clinical Anatomy
Thoracic Segment:
Wider/thicker help
support torso weight
Spinous Processes:
Downward projection
Limit extension
Attachment for thoracic
muscles/ligaments
Transverse Processes:
Costotransverse Joints:
Ribs 1 10
Ribs 11 and 12
No articulation with
transverse processes
Clinical Anatomy
Costoverte
bral
Joint
Costotransve
rse
Joint
Clinical Anatomy
Thoracic Segment:
Costovertebral Joint:
Superior Costal
Facet
Inferior Costal
Facet
Clinical Anatomy
Sacrum:
Curved,
triangular
shaped
5 fused vertebrae
Fixes the spinal
column to the
pelvis
Stabilizes the
pelvic girdle
Clinical Anatomy
Functions:
Motions:
Clinical Anatomy
Clinical Anatomy
SI Ligaments:
Anterior
Sacroiliac
Ligament:
Connects the
anterior surface
of the lateral part
of the sacrum to
the ilium
Note: Black
Clinical Anatomy
SI Ligaments:
Posterior Sacroiliac
Ligament:
Nearly horizontal in
direction
Ilium to upper sacrum
Oblique in direction
Lower sacrum to PSIS
Short
Long PSL
Clinical Anatomy
SI Ligaments:
Sacrotuberous
Ligament:
Sacrotuberous
Ligament
Ischial
Clinical Anatomy
SI Ligaments:
Sacrospinous
Ligament:
Originates from
the ischial spine
and attaches to
the coccyx
Sacrospinous
Ligament
Clinical Anatomy
Coccyx: Tailbone
Consists of 4 (in
some cases 3 or
5) vertebrae
fused together
Attachment site
for muscles of
pelvic floor and
sometimes
portions of
gluteus maximus
Clinical Anatomy
Intervertebral Discs:
23 intervertebral discs
No disc between skull and
C1 or between C1-C2
Discs are thickest in the
lumbar vertebrae and
cervical regions (enhances
flexibility)
Functions:
Shock absorbers
Clinical Anatomy
Annulus Fibrosus:
Outer rings
Clinical Anatomy
Decreased ROM
Narrowing intervertebral foramen
Clinical Anatomy
Lumbar:
Clinical Anatomy
Sacral:
Formed by L4, L5
and lumbosacral
trunk
Innervation:
Muscles of buttocks,
posterior femur, and
lower leg
Sciatic Nerve 3
sections
Tibial nerve
Common peroneal
nerve
Tibial nerve
Clinical Anatomy
Clinical Anatomy
Lumbarization:
Sacralization:
5th lumbar
vertebrae becomes
fused to sacrum
Clinical Anatomy
Clinical Anatomy
Middle Trapezius:
O: Lower portion of
ligamentun nuchae
and spinous
processes of C7 and
T1 T5
I: Acromion process,
scapular spine
A: Scapular
retraction and
fixation of thoracic
spine
Clinical Anatomy
Lower Trapezius:
O: Spinous
processes of T8
T12
I: Scapular spine
(medial portion)
A: Scapular
depression and
retraction;
fixation of
thoracic spine
Clinical Anatomy
Rhomboid Muscles:
Clinical Anatomy
Latissimus Dorsi:
O: Spinous processes
of T6 through T12
and the lumbar
vertebrae via the
thoracodorsal fascia,
posterior iliac crest
I: Intertubercular
groove of humerus
A: Extension of spine,
anterior rotation of
pelvis, stabilization of
lumbar spine
(depression of
shoulder girdle,
humeral extension)
Clinical Anatomy
Rectus
Abdominis:
O: Pubic crest
and symphysis
I: Xiphoid process
and costal
cartilages of 5th,
6th, and 7th ribs
A: Trunk flexion;
compression of
abdomen
Clinical Anatomy
External Oblique:
Clinical Anatomy
Internal Oblique:
O: Inguinal ligament,
iliac crest,
thoracolumbar fascia
I: Tenth, eleventh,
and twelfth ribs; linea
alba, crest of pubis
A: Bilaterally: Trunk
flexion, compression
of abdomen;
Unilaterally: lateral
bending and rotation
to same side
Clinical Anatomy
Erector Spinae: 3
muscle pairs
Iliocostalis:
Longissimus:
Iliocostalis
Lumborum
Iliocostalis Thoracis
Iliocostalis Cervicis
Longissimus Thoracis
Longissimus Cervicis
Longissimus Capitis
Spinalis:
Spinalis Thoracis
Spinalis Cervicis
Spinalis Capitis
Clinical Anatomy
Transversospinal
Muscles:
Semispinalis
Multifidus
Rotators