Module 22: The Axial Skeleton

Lesson 7: The Vertebral Column: Overview

Cột Sống: Tổng Quan

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Dưới đây là danh sách những thuật ngữ Y khoa của module The Axial Skeleton.
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Medical Terminology: The Axial Skeleton

articular cartilage
thin layer of cartilage covering an epiphysis; reduces friction and acts as a shock absorber
articulation
where two bone surfaces meet
bone
hard, dense connective tissue that forms the structural elements of the skeleton
canaliculi
(singular = canaliculus) channels within the bone matrix that house one of an osteocyte’s many cytoplasmic extensions that it uses to communicate and receive nutrients
cartilage
semi-rigid connective tissue found on the skeleton in areas where flexibility and smooth surfaces support movement
central canal
longitudinal channel in the center of each osteon; contains blood vessels, nerves, and lymphatic vessels; also known as the Haversian canal
closed reduction
manual manipulation of a broken bone to set it into its natural position without surgery
compact bone
dense osseous tissue that can withstand compressive forces
diaphysis
tubular shaft that runs between the proximal and distal ends of a long bone
diploë
layer of spongy bone, that is sandwiched between two the layers of compact bone found in flat bones
endochondral ossification
process in which bone forms by replacing hyaline cartilage
endosteum
delicate membranous lining of a bone’s medullary cavity
epiphyseal line
completely ossified remnant of the epiphyseal plate
epiphyseal plate
(also, growth plate) sheet of hyaline cartilage in the metaphysis of an immature bone; replaced by bone tissue as the organ grows in length
epiphysis
wide section at each end of a long bone; filled with spongy bone and red marrow
external callus
collar of hyaline cartilage and bone that forms around the outside of a fracture
flat bone
thin and curved bone; serves as a point of attachment for muscles and protects internal organs
fracture
broken bone
fracture hematoma
blood clot that forms at the site of a broken bone
hematopoiesis
production of blood cells, which occurs in the red marrow of the bones
hole
opening or depression in a bone
hypercalcemia
condition characterized by abnormally high levels of calcium
hypocalcemia
condition characterized by abnormally low levels of calcium
internal callus
fibrocartilaginous matrix, in the endosteal region, between the two ends of a broken bone
intramembranous ossification
process by which bone forms directly from mesenchymal tissue
irregular bone
bone of complex shape; protects internal organs from compressive forces
lacunae
(singular = lacuna) spaces in a bone that house an osteocyte
long bone
cylinder-shaped bone that is longer than it is wide; functions as a lever
medullary cavity
hollow region of the diaphysis; filled with yellow marrow
modeling
process, during bone growth, by which bone is resorbed on one surface of a bone and deposited on another
nutrient foramen
small opening in the middle of the external surface of the diaphysis, through which an artery enters the bone to provide nourishment
open reduction
surgical exposure of a bone to reset a fracture
orthopedist
doctor who specializes in diagnosing and treating musculoskeletal disorders and injuries
osseous tissue
bone tissue; a hard, dense connective tissue that forms the structural elements of the skeleton
ossification
(also, osteogenesis) bone formation
ossification center
cluster of osteoblasts found in the early stages of intramembranous ossification
osteoblast
cell responsible for forming new bone
osteoclast
cell responsible for resorbing bone
osteocyte
primary cell in mature bone; responsible for maintaining the matrix
osteogenic cell
undifferentiated cell with high mitotic activity; the only bone cells that divide; they differentiate and develop into osteoblasts
osteoid
uncalcified bone matrix secreted by osteoblasts
osteon
(also, Haversian system) basic structural unit of compact bone; made of concentric layers of calcified matrix
osteoporosis
disease characterized by a decrease in bone mass; occurs when the rate of bone resorption exceeds the rate of bone formation, a common occurrence as the body ages
perforating canal
(also, Volkmann’s canal) channel that branches off from the central canal and houses vessels and nerves that extend to the periosteum and endosteum
perichondrium
membrane that covers cartilage
periosteum
fibrous membrane covering the outer surface of bone and continuous with ligaments
primary ossification center
region, deep in the periosteal collar, where bone development starts during endochondral ossification
projection
bone markings where part of the surface sticks out above the rest of the surface, where tendons and ligaments attach
proliferative zone
region of the epiphyseal plate that makes new chondrocytes to replace those that die at the diaphyseal end of the plate and contributes to longitudinal growth of the epiphyseal plate
red marrow
connective tissue in the interior cavity of a bone where hematopoiesis takes place
remodeling
process by which osteoclasts resorb old or damaged bone at the same time as and on the same surface where osteoblasts form new bone to replace that which is resorbed
reserve zone
region of the epiphyseal plate that anchors the plate to the osseous tissue of the epiphysis
secondary ossification center
region of bone development in the epiphyses
sesamoid bone
small, round bone embedded in a tendon; protects the tendon from compressive forces
short bone
cube-shaped bone that is approximately equal in length, width, and thickness; provides limited motion
skeletal system
organ system composed of bones and cartilage that provides for movement, support, and protection
spongy bone
(also, cancellous bone) trabeculated osseous tissue that supports shifts in weight distribution
trabeculae
(singular = trabecula) spikes or sections of the lattice-like matrix in spongy bone
yellow marrow
connective tissue in the interior cavity of a bone where fat is stored
zone of calcified matrix
region of the epiphyseal plate closest to the diaphyseal end; functions to connect the epiphyseal plate to the diaphysis
zone of maturation and hypertrophy
region of the epiphyseal plate where chondrocytes from the proliferative zone grow and mature and contribute to the longitudinal growth of the epiphyseal plate
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The vertebral column is also known as the spinal column or spine (Figure 1). It consists of a sequence of vertebrae (singular = vertebra), each of which is separated and united by an intervertebral disc. Together, the vertebrae and intervertebral discs form the vertebral column. It is a flexible column that supports the head, neck, and body and allows for their movements. It also protects the spinal cord, which passes down the back through openings in the vertebrae.
The vertebral column originally develops as a series of 33 vertebrae, but this number is eventually reduced to 24 vertebrae, plus the sacrum and coccyx. The vertebral column is subdivided into five regions, with the vertebrae in each area named for that region and numbered in descending order. In the neck, there are seven cervical vertebrae, each designated with the letter “C” followed by its number. Superiorly, the C1 vertebra articulates (forms a joint) with the occipital condyles of the skull. Inferiorly, C1 articulates with the C2 vertebra, and so on. Below these are the 12 thoracic vertebrae, designated T1–T12. The lower back contains the L1–L5 lumbar vertebrae. The single sacrum, which is also part of the pelvis, is formed by the fusion of five sacral vertebrae. Similarly, the coccyx, or tailbone, results from the fusion of four small coccygeal vertebrae. However, the sacral and coccygeal fusions do not start until age 20 and are not completed until middle age.

An interesting anatomical fact is that almost all mammals have seven cervical vertebrae, regardless of body size. This means that there are large variations in the size of cervical vertebrae, ranging from the very small cervical vertebrae of a shrew to the greatly elongated vertebrae in the neck of a giraffe. In a full-grown giraffe, each cervical vertebra is 11 inches tall.
The adult vertebral column does not form a straight line, but instead has four curvatures along its length (see Figure 1). These curves increase the vertebral column’s strength, flexibility, and ability to absorb shock. When the load on the spine is increased, by carrying a heavy backpack for example, the curvatures increase in depth (become more curved) to accommodate the extra weight. They then spring back when the weight is removed. The four adult curvatures are classified as either primary or secondary curvatures. Primary curves are retained from the original fetal curvature, while secondary curvatures develop after birth.

During fetal development, the body is flexed anteriorly into the fetal position, giving the entire vertebral column a single curvature that is concave anteriorly. In the adult, this fetal curvature is retained in two regions of the vertebral column as the thoracic curve, which involves the thoracic vertebrae, and the sacrococcygeal curve, formed by the sacrum and coccyx. Each of these is thus called a primary curve because they are retained from the original fetal curvature of the vertebral column.

A secondary curve develops gradually after birth as the child learns to sit upright, stand, and walk. Secondary curves are concave posteriorly, opposite in direction to the original fetal curvature. The cervical curve of the neck region develops as the infant begins to hold their head upright when sitting. Later, as the child begins to stand and then to walk, the lumbar curve of the lower back develops. In adults, the lumbar curve is generally deeper in females.

Disorders associated with the curvature of the spine include kyphosis (an excessive posterior curvature of the thoracic region), lordosis (an excessive anterior curvature of the lumbar region), and scoliosis (an abnormal, lateral curvature, accompanied by twisting of the vertebral column).
Within the different regions of the vertebral column, vertebrae vary in size and shape, but they all follow a similar structural pattern. A typical vertebra will consist of a body, a vertebral arch, and seven processes (Figure 2).

The body is the anterior portion of each vertebra and is the part that supports the body weight. Because of this, the vertebral bodies progressively increase in size and thickness going down the vertebral column. The bodies of adjacent vertebrae are separated and strongly united by an intervertebral disc.

The vertebral arch forms the posterior portion of each vertebra. It consists of four parts, the right and left pedicles and the right and left laminae. Each pedicle forms one of the lateral sides of the vertebral arch. The pedicles are anchored to the posterior side of the vertebral body. Each lamina forms part of the posterior roof of the vertebral arch. The large opening between the vertebral arch and body is the vertebral foramen, which contains the spinal cord. In the intact vertebral column, the vertebral foramina of all of the vertebrae align to form the vertebral (spinal) canal, which serves as the bony protection and passageway for the spinal cord down the back. When the vertebrae are aligned together in the vertebral column, notches in the margins of the pedicles of adjacent vertebrae together form an intervertebral foramen, the opening through which a spinal nerve exits from the vertebral column (Figure 3).

Seven processes arise from the vertebral arch. Each paired transverse process projects laterally and arises from the junction point between the pedicle and lamina. The single spinous process (vertebral spine) projects posteriorly at the midline of the back. The vertebral spines can easily be felt as a series of bumps just under the skin down the middle of the back. The transverse and spinous processes serve as important muscle attachment sites. A superior articular process extends or faces upward, and an inferior articular process faces or projects downward on each side of a vertebrae. The paired superior articular processes of one vertebra join with the corresponding paired inferior articular processes from the next higher vertebra. These junctions form slightly moveable joints between the adjacent vertebrae. The shape and orientation of the articular processes vary in different regions of the vertebral column and play a major role in determining the type and range of motion available in each region.

OpenStax. (2022). Anatomy and Physiology 2e. Rice University. Retrieved June 15, 2023. ISBN-13: 978-1-711494-06-7 (Hardcover) ISBN-13: 978-1-711494-05-0 (Paperback) ISBN-13: 978-1-951693-42-8 (Digital). License: Attribution 4.0 International (CC BY 4.0). Access for free at openstax.org.

The adult vertebral column consists of 24 vertebrae, plus the sacrum and coccyx. The vertebrae are divided into three regions: cervical C1–C7 vertebrae, thoracic T1–T12 vertebrae, and lumbar L1–L5 vertebrae. The vertebral column is curved, with two primary curvatures (thoracic and sacrococcygeal curves) and two secondary curvatures (cervical and lumbar curves).

A typical vertebra consists of a body and a vertebral arch. The arch is formed by the paired pedicles and paired laminae. Arising from the vertebral arch are the transverse, spinous, superior articular, and inferior articular processes. The vertebral foramen provides for passage of the spinal cord. Each spinal nerve exits through an intervertebral foramen, located between adjacent vertebrae. Intervertebral discs unite the bodies of adjacent vertebrae.

The bodies of adjacent vertebrae are separated and united by an intervertebral disc, which provides padding and allows for movements between adjacent vertebrae. The disc consists of a fibrous outer layer called the anulus fibrosus and a gel-like center called the nucleus pulposus. The intervertebral foramen is the opening formed between adjacent vertebrae for the exit of a spinal nerve.

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Script:
  1. The vertebral column forms the neck and back.
  2. The vertebral column originally develops as 33 vertebrae, but is eventually reduced to 24 vertebrae, plus the sacrum and coccyx.
  3. The vertebrae are divided into the cervical region (C1–C7 vertebrae), the thoracic region (T1–T12 vertebrae), and the lumbar region (L1–L5 vertebrae).
  4. The sacrum arises from the fusion of five sacral vertebrae and the coccyx from the fusion of four small coccygeal vertebrae.
  5. The vertebral column has four curvatures, the cervical, thoracic, lumbar, and sacrococcygeal curves.
  6. The thoracic and sacrococcygeal curves are primary curves retained from the original fetal curvature.
  7. The cervical and lumbar curves develop after birth and thus are secondary curves.
  8. The cervical curve develops as the infant begins to hold up the head, and the lumbar curve appears with standing and walking.
  9. A typical vertebra consists of an enlarged anterior portion called the body, which provides weight-bearing support.
  10. Attached posteriorly to the body is a vertebral arch, which surrounds and defines the vertebral foramen for passage of the spinal cord.
  11. The vertebral arch consists of the pedicles, which attach to the vertebral body, and the laminae, which come together to form the roof of the arch.
  12. Arising from the vertebral arch are the laterally projecting transverse processes and the posteriorly oriented spinous process.
  13. The superior articular processes project upward, where they articulate with the downward projecting inferior articular processes of the next higher vertebrae.
  14. A typical cervical vertebra has a small body, a bifid (Y-shaped) spinous process, and U-shaped transverse processes with a transverse foramen.
  15. In addition to these characteristics, the axis (C2 vertebra) also has the dens projecting upward from the vertebral body.
  16. The atlas (C1 vertebra) differs from the other cervical vertebrae in that it does not have a body, but instead consists of bony ring formed by the anterior and posterior arches.
  17. The atlas articulates with the dens from the axis.
  18. A typical thoracic vertebra is distinguished by its long, downward projecting spinous process.
  19. Thoracic vertebrae also have articulation facets on the body and transverse processes for attachment of the ribs.
  20. Lumbar vertebrae support the greatest amount of body weight and thus have a large, thick body.
  21. They also have a short, blunt spinous process.
  22. The sacrum is triangular in shape.
  23. The median sacral crest is formed by the fused vertebral spinous processes and the lateral sacral crest is derived from the fused transverse processes.
  24. Anterior (ventral) and posterior (dorsal) sacral foramina allow branches of the sacral spinal nerves to exit the sacrum.
  25. The auricular surfaces are articulation sites on the lateral sacrum that anchor the sacrum to the hipbones to form the pelvis.
  26. The coccyx is small and derived from the fusion of four small vertebrae.
  27. The intervertebral discs fill in the gaps between the bodies of adjacent vertebrae.
  28. They provide strong attachments and padding between the vertebrae.
  29. The outer, fibrous layer of a disc is called the anulus fibrosus.
  30. The gel-like interior is called the nucleus pulposus.
  31. The disc can change shape to allow for movement between vertebrae.
  32. If the anulus fibrosus is weakened or damaged, the nucleus pulposus can protrude outward, resulting in a herniated disc.
  33. The anterior longitudinal ligament runs along the full length of the anterior vertebral column, uniting the vertebral bodies.
  34. The supraspinous ligament is located posteriorly and interconnects the spinous processes of the thoracic and lumbar vertebrae.
  35. In the neck, this ligament expands to become the nuchal ligament.
  36. The nuchal ligament is attached to the cervical spinous processes and superiorly to the base of the skull, out to the external occipital protuberance.
  37. The posterior longitudinal ligament runs within the vertebral canal and unites the posterior sides of the vertebral bodies.
  38. The ligamentum flavum unites the lamina of adjacent vertebrae.
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