Topic

Definition
Sceletal
Joint
Muscle
Vascularisation and Nerves
Movements
 Back
The back comprises the posterior aspect of the trunk,
inferior to the neck and superior to the buttocks

It Includes:
Skin and subcutaneous tissue.
Muscles
Vertebral column: the vertebrae, intervertebral (IV) discs,
and associated ligaments
Ribs
Spinal cord and meninges
Various segmental nerves and vessels.
 Vertebrae Column
The vertebral column in an adult typically consists
of 33 vertebrae arranged in five regions:

7 cervical
12 thoracic
5 lumbar
5 sacral
and 4 coccygeal
 Typical Vertebra
Tampak Superior

pedicles are bony pillars that attach the vertebral arch to the vertebral body;
laminae are flat sheets of bone that extend from each pedicle to meet in the midline and
form the roof of the vertebral arch
Typical Vertebra
REGIONAL CHARACTERISTIC OF
VERTEBRAE
Typical cervical vertebrae
 CERVICAL VERTEBRAE
Part Characteristics

Body Small and wider from side to side than anteroposteriorly; superior surface concave
with uncus of body (uncinate process); inferior surface convex

Vertebral foramen Large and triangular

Transverse processes Foramina transversarii and anterior and posterior tubercles; vertebral arteries and
accompanying venous and sympathetic plexuses pass through foramina
transversarii of all cervical vertebrae except C7, which transmits only small
accessory vertebral veins.

Articular processes Superior facets directed superioposteriorly; inferior facets directed

inferioanteriorly; obliquely placed facets are most nearly horizontal in this region

Spinous processes Short (C3-C5) and bifid (C3-C6); process of C6 long, that of C7 is longer (thus C7 is
called vertebra prominens)
ATYPICAL CERVICAL VERTEBRAE
Vertebrae Cervicalis I
Tuberculum anterior dan posterior
Facet for occipital condyles
Facets for dens
Impression ofalar ligaments
Vertebra cervicalis 2
Dens epistropheus
THORACIC
VERTEBRAE
 Thoracic Vertebrae
Part Characteristics

Body Heart shaped; one or two costal facets for articulation with head of rib

Vertebral foramen Circular and smaller than those of cervical and lumbar vertebrae (admits the distal part
of a medium-size index finger)

Transverse processes Long and strong and extend posterolaterally; length diminishes from T1 to T12 (T1-T10
have facets for articulation with tubercle of rib)

Articular processes Superior facets directed posteriorly and slightly laterally; inferior facets directed
anteriorly and slightly medially; plane of facets lies on arc centered about vertebral body

Spinous processes Long; slope posteroinferiorly; tips extend to level of vertebral body below
VERTEBRAE LUMBALIS
Parts Characteristics

Body Massive; kidney shaped when viewed superiorly

Vertebral foramen Triangular; larger than in thoracic vertebrae and

smaller than in cervical vertebrae

Transverse processes Long and slender; accessory process on posterior

surface of base of each process

Articular processes Superior facets directed posteromedially (or

medially); inferior facets directed anterolaterally (or
laterally); mammillary process on posterior surface of
each superior articular process

Spinous processes Short and sturdy; thick, broad, and hatchet shaped
Perbandingan antar vertebrae pada
CV
 OS SACRUM & COCCYGEUM
terdiri dari 5 vertebrae sacrales dan discus intervertebraelis
di antaranya. Vertebraee sacrales ini terpisah jelas pada
usia muda, pada orang dewasa setelah usia 25 tahun
tulang-tulang ini bersatu (berfusi) menjadi os sacrum.
Os sacrum berbentuk baji, dengan basis yang lebar di atas
dan apex di bawah. Basis sacrum bersendi dengan
vertebrae lumbalis terakhir dan apex sacrum bersendi
dengan os coccygis. Os sacrum mempunyai dua permukaan
yaitu: facies pelvina, facies dorsalis
Facies pelvina mempunyai empat pasang foramina sacralia
anterior
Facies dorsalis ossis sacri
OS SACRUM & COCCYGEUM
JOINTS OF VERTEBRAL COLUMN
The joints of the vertebral column include the:
Joints of the vertebral bodies.
Joints of the vertebral arches.
Craniovertebral (atlanto-axial and atlanto-
occipital) joints.
Costovertebral joints
Lumbosacral joint
Sacroiliaca joint
Joints Of Vertebral Bodies

Between vertebral bodies

Symphysis
Articular surface: connected by IV
and ligament
IV disc consists of :anulus fibrosus,
an outer fibrous part, composed of
concentric lamellae of
fibrocartilage, and a gelatinous
central mass, called the nucleus
pulposus.
Structure & Function IV disc
Relationship of ligaments to vertebrae
and IV discs
ACCESSORY LIGAMENTS OF
INTERVERTEBRAL JOINTS
pale yellow bands of elastic tissue called
the ligamenta flava
extend almost vertically from the lamina
above to the lamina below, those of
opposite sides meeting and blending in
the midline
help preserve the normal curvatures of
the vertebral column and assist with
straightening of the column after flexing.
JOINTS OF VERTEBRAL ARCHE
 zygapophysial joints (often
called facet joints).
plane synovial joints between
the superior and inferior
articular processes
permit gliding movements
between the articular processes
are innervated by articular
branches of the posterior rami
of spinal nerves
CRANIOVERTEBRAL JOINT
1. ATLANTOOCCIPITAL JOINT
2. ATLANTOAXIAL JOINT
 CRANIOVERTEBRAL JOINT
Atlantooccipital Joint
between the superior articular
surfaces of the lateral masses of
the atlas and the occipital
condyles
permit nodding of the head
synovial joints of the condyloid
type and have thin, loose joint
capsules.
also connected by anterior and
posterior atlanto-occipital
membranes
Atlanto-axial Joints.
two (right and left) lateral
atlantoaxial joints (between the
inferior facets of the lateral masses of
C1 and the superior facets of C2), and
one median atlantoaxial joint
(between the dens of C2 and the
anterior arch of the atlas). Gliding
type synovial joint
The lateral atlanto-axial joints are
gliding-type synovial joints, whereas
the median atlanto-axial joint is a
pivot joint.
MOVEMENTS
 Movements of Vertebral Column
primarily from the compressibility and
elasticity of the IV discs.
is capable of flexion, extension, lateral flexion
and extension, and rotation (torsion)
Bending of the vertebral column to the right
or left from the neutral (erect) position is
lateral flexion; returning to the erect posture
from a position of lateral flexion is lateral
extension.
 Curvatures of Vertebral Column
primary curvatures are in the
same direction as the main
curvatures of the fetal
vertebral column.
secondary curvatures result
from extension from the
flexed fetal position. They
begin to appear during the
late fetal period but do not
become obvious until infancy.
It is maintained primarily by
differences in thickness
between the anterior and the
posterior parts of the IV discs.
Vasculature of Vertebral Column
Vertebral and
ascending cervical
arteries in the neck
(Chapter 8).
The major segmental
arteries of the trunk:
Posterior intercostal
arteries in the thoracic
region (
Subcostal and lumbar
arteries in the abdomen
Iliolumbar and lateral
and medial sacral
arteries in the pelvis
 Nerves of Vertebral Column
Zygapophysial joints are innervated by medial
branches of adjacent posterior rami;
(recurrent) meningeal branches of spinal
nerves supply most bone (periosteum), IV
discs, and ligaments as well as the meninges
(coverings) of the spinal cord. These two
(groups of) nerves convey all localized pain
from the vertebral column.
 MUSCLES OF BACK
Extrinsic Back Muscles
The superficial extrinsic back muscles (trapezius, latissimus dorsi, levator scapulae,
and rhomboids) are posterior axioappendicular muscles that connect the axial
skeleton (vertebral column) with the superior appendicular skeleton
The intermediate extrinsic back muscles (serratus posterior)

Intrinsic Back Muscles

connect elements of the axial skeleton, are mostly innervated by posterior rami of spinal
nerves, and are arranged in three layers: superficial (splenius muscles), intermediate
(erector spinae), and deep (transversospinalis muscles).
The spinal cord, spinal nerve roots, CSF, and meninges that
surround them are the main contents of the vertebral canal.

CONTENTS OF VERTEBRAL CANAL

Sistem Urinarius,
Pelvis & Perineum
Dr.Tri Suciati, M.Kes
 Topic
Pelvis and Pelvic girdle, and Joints of Pelvis
Pelvic cavity, pelvic peritoneum, and pelvic
fascia
Neurovascular structures of the pelvis
Pelvis and Pelvic girdle, and Joints of
Pelvis
 Pelvic Girdle
an articulated bony ring
composed of the sacrum and two
hip bones
Innominate bone (Ilium, ischium
and pubis)
Sacrum
Coccyx
Joined anteriorly by pubic
symphysis
Posteriorly by sacro-iliac joint
Pelvic Bone
Apertura Pelvis Superior/PelvicInlet
The bony edge (rim) surrounding and defining
the pelvic inlet is the pelvic brim, formed by the:
Promontory and ala of the sacrum (superior
surface of its lateral part, adjacent to the body
of the sacrum).
A right and left linea terminalis (terminal line)
together form a continuous oblique ridge
consisting of the:
Arcuate line on the inner surface of the
ilium.
Pecten pubis (pectineal line) and pubic
crest, forming the superior border of the
superior ramus and body of the pubis.
Apertura Pelvis Inferior
The pelvic outlet (inferior pelvic
aperture) is bounded by the
Pubic arch anteriorly.
Ischial tuberosities laterally.
Inferior margin of the
sacrotuberous ligament (running
between the coccyx and the ischial
tuberosity) posterolaterally.
Tip of the coccyx posteriorly.
Sacrum and Coccygeus
 Joints
Articulatio:
Amphiarthrosis sacroiliaca
Synarthrosis:
1. Syndesmosis elastica
sacrococcygeus
2. Syndesmosis fibrosa: lig
sacrospinosum et tuberosum
3. Synchondrosis: symphysis
ossium pubis
Sacroilliaca Joints
anterior synovial joint
(between the earshaped
auricular surfaces of the
sacrum and ilium, covered
with articular cartilage) and a
posterior syndesmosis
(between the tuberosities of
the same bones)
Anterior and posterior
sacroiliaca ligament
Sacrotuberosa dan
sacrospinosa ligament
Symphysis Pubis

secondary cartilaginous joint

fibrocartilaginous interpubic disc
interpubic disc
superior pubic ligament
inferior (arcuate) pubic ligament
Pelvis
the space enclosed by
the pelvic girdle, which
is subdivided into the
greater pelvis and the
lesser pelvis
 Lesser and Greater Pelvis

the inferior part of the

abdominal cavity, which
receives the protection of
the alae of the ilia)
Bounded by abdominal wall
anteriorly, the iliac fossa
posteriolaterally and L5 S1
vertebrae posteriorly