The document discusses the anatomy of the spine. It describes the key features of each region of the spine including: - The vertebrae gradually increase in size as the spine descends and the spine has four normal curvatures. - The cervical and lumbar regions have a lordotic curvature while the thoracic and sacral regions have a kyphotic curvature. - Each region has distinguishing osteological characteristics like transverse processes and vertebral bodies. - Injuries like fractures of C1 and C2 are described along with clinical conditions like scoliosis. - The document outlines the muscles, vasculature, innervation and imaging of the spine.

1. ANATOMY OF THE SPINE
Nama res
S932??
Supervisor :
dr. ?, Sp.OT (K)
ORTHOPAEDICS AND TRAUMATOLOGY DEPARTMENT
SEBELAS MARET UNIVERSITY / Dr. MOEWARDI GENERAL HOSPITAL
SURAKARTA
2022

2. • The vertebrae gradually become larger
as the column descends to the sacrum
and then become progressively smaller
toward the apex of the coccyx.
• The change in size is related to the fact
that successive vertebrae bear
increasing amounts of the body’s weight
as the column descends.
• The vertebral column in adults has four
curvatures: cervical, thoracal, lumbar,
and sacral.
• The thoracic and sacral (pelvic)
curvature concave anteriorly (kyphosis)
whereas the cervical and sacral
curvature concave posteriorly (lordosis).
OSTEOLOGY
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

3. OSTEOLOGY
Characteristics of C1 and C2
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

4. • Because the taller side of the lateral mass is directed
laterally, vertical forces (e.g., striking the bottom of a
pool in a diving accident) compressing the lateral
masses between the occipital condyles and the axis
drive them apart, fracturing one or both of the
anterior or posterior arches.
• The resulting Jefferson or burst fracture in itself does
not necessarily result in spinal cord injury, because the
dimensions of the bony ring actually increase.
• Fractures of the vertebral arch of the axis
(vertebra C2) are one of the most common
injuries of the cervical vertebrae
• Usually the fracture occurs in the pars
interarticularis. A fracture in this location,
called a traumatic spondylolysis of C2
• Usually occurs because of hyperextension
of the head on the neck
CLINICAL CORRELATION
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

5. OSTEOLOGY
Characteristics of thoracic region
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

6. Scoliosis (G., crookedness or curved back) is characterized by an abnormal lateral curvature that is
accompanied by rotation of the vertebrae. The spinous processes turn toward the cavity of the
abnormal curvature, and when the individual bends over, the ribs rotate posteriorly (protrude) on the
side of the increased convexity.
CLINICAL CORRELATION
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

7. OSTEOLOGY
Characteristics of lumbar region
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

8. CLINICAL CORRELATION
• known as humpback or
hunchback is characterized
by an abnormal increase in
the thoracic curvature; the
vertebral column curves
posteriorly.
• Dowager hump is a
colloquial name for excessive
thoracic kyphosis in older
women resulting from
osteoporosis.
• known as hollow back or
sway back is characterized
by an anterior tilting of the
pelvis (the upper sacrum is
flexed or rotated
anteroinferiorly—nutation),
with increased extension of
the lumbar vertebrae,
producing an abnormal
increase in the lumbar
kyphosis
Excessive thoracic
kyphosis
Excessive lumbar
lordosis
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.

9. • Herniation (protrusion) of the gelatinous nucleus pulposus into or through
the anulus fibrosus is a well-recognized cause of lower back pain (LBP) and
lower limb pain
• Flexion of the vertebral column produces compression anteriorly and
stretching or tension posteriorly, squeezing the nucleus pulposus further
posteriorly toward the thinnest part of the anulus fibrosus
• Sciatica, pain radiating from the lower back into the buttock and down the
posterior or lateral aspect of the thigh into the leg, is often caused by a
herniated lumbar intravertebral disc that compresses and compromises the
L5 or S1 component of the sciatic nerve
CLINICAL CORRELATION
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

10. OSTEOLOGY
Characteristics of sacral region
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

11. Posterolateral view demonstrates formation of radiographic Scottie dog. On lateral
radiograph, dog appears to be wearing a collar. Spondylosis happens due to defect or
fracture of pars interarticularis without slipping of the vertebrae
CLINICAL CORRELATION
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

12. MUSCLE
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

13. The neck has 4 major compartments.
1. Vertebral compartment which is
contains the cervical vertebrae and
associated muscles of posture,
2. Visceral compartment which contains
the thyroid, thymus and parathyroid as
well as the esophagus and larynx,
3. 2 vascular compartments on both
sides and these contain the major
blood vessels and vagus nerve.
These 4 compartments are enclosed by
musculofacial collar
COMPARTMENT
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

14. VASCULARIZATION
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.

15. VASCULARIZATION
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.

16. VASCULARIZATION
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

17. • Typical vertebrae are supplied by segmental
arteries—here lumbar arteries.
• In the thoracic and lumbar regions, each
vertebra is encircled on three sides by paired
intercostal or lumbar arteries that arise from
the aorta. The segmental arteries supply
equatorial branches to the vertebral body, and
posterior branches supply the vertebral arch
structures and the back muscles.
• Spinal branches enter the vertebral canal
through the IV foramina to supply the bones,
periosteum, ligaments, and meninges
VASCULARIZATION
Moore, K. L., Agur, A. M. R., & Dalley, A. F. (2018). Clinically oriented anatomy (Eighth edition). Wolters Kluwer.

18. INNERVATION
Thompson, J. C. (2016). Netter’s concise orthopaedic anatomy (Second edition, updated edition). Saunders Elsevier.

19. X-Ray
Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

20. X-Ray
Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

21. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

22. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

23. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

24. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

25. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

26. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

27. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

28. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

29. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

30. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

31. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

32. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

34. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

35. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

36. Greenspan, A. and Beltran, J., 2020. Orthopaedic
Imaging: A practical approach. Lippincott Williams
& Wilkins.

37. THANK YOU
ANYQUESTION?