This ppt will give you the basic knowledge about thoracic, lumbar, sacrum and coccyx vertebrae.

1. ANATOMY
MUSKULOSKELETAL
AXIAL SKELETON
THORACIC, LUMBAR, SACRUM AND
COCCYX
BY : HERMIZAN BIN HALIHANAFIAH

2. HERMIZAN BIN HALIHANAFIAH 2
Thoracic Vertebrae
• T1-T12
• Larger and stronger than cervical vertebrae.
• Spinous process of T1 and T2 are long, laterally
flattened, and directed inferiorly.
• In contrast, the spinous process of T11 and T12 are
shorter, broader and directed more posteriorly.
• Compare to cervical vertebrae, thoracic vertebrae
also have longer and larger transverse process.

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Thoracic Vertebrae

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Cont…
• Articulate with the ribs.
• Articulating surface of the vertebrae are called facets
and demifacets.
• Except for T11 and T12, the transverse process have
facets for articulating with the tubercles of the ribs.
• The bodies of the thoracic vertebrae also have facets
and demifacets for articulation with the head of the
ribs.
• The articulation between the thoracic vertebra and the
ribs called vertebrocostal joint.

6. HERMIZAN BIN HALIHANAFIAH 6
Cont…
• T1 has a superior facet and inferior demifacets for
head of ribs.
• T2-T8 have superior and inferior demifacets for head
of ribs.
• T9 has a superior demifacets
• T10-T12 have superior facet.
• Movements of the thoracic vertebrae are limited by
thin intervetebral disc and by attachment of the ribs
to the sternum.

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Vertebrocostal Joint

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Vertebrocostal Joint

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Typical Thoracic Vertebrae
• Larger body than cervical but smaller than lumbar.
• Spinous processes pointed and angled downward.
• Superior articular facets face posteriorly permitting
some relation between adjacent vertebrae.
• Rib attachment – costal facets on vertebral body and
at ends of transverse processes for articulation ribs.

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Lumbar Vertebrae
• Largest and strongest in the vertebral column because the
amount of body weight supported by the vertebrae increase
towards the inferior end of the backbone.
• Their processes are short and thick.
• The superior articular process directed medially instead of
superiorly and the inferior articular facets directed laterally
instead of inferiorly.
• Spinous process are thick and broad and project posteriorly –
attachment of the large back muscles.

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Lumbar Vertebrae

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Lumbar Vertebrae

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Large BodySuperior
articular facets
facing medially
Inferior articular
facets facing
laterally
Spinous process
thick, broad,
project posteriorly

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Copyright 2009, John Wiley & Sons,
Inc.
Vertebral Column

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Sacrum
• Triangular bone
• Formed by the union of 5 sacral vertebrae
• Indicated as a S1-S5.
• The fusion of the sacral vertebrae begins ages 16-18
and its usually completed by age 30.
• The sacrum serves as a strong foundation for the
pelvic girdle.
• It is positioned at the posterior portion of the pelvic
cavity medial to the hip bone.

17. HERMIZAN BIN HALIHANAFIAH 17
Cont….
• Female sacrum are shorter, wider and more curved
between S2 and S3 than a male sacrum.
• The concave anterior side of the sacrum faces the
pelvic cavity.
• Its smooth and contains four transverse lines
(ridges) that mark the joining of the sacral vertebral
bodies.
• At the end of these lines are four pairs of anterior
sacral foramina.

18. HERMIZAN BIN HALIHANAFIAH 18
Cont…
• The lateral portion of the superior surface
contains a smooth surface called the sacral
ala, which is formed by the fused transverse
processes of the 1st
sacral vertebrae.
• The convex, posterior surface of the sacrum
contains a median sacral crest and lateral
sacral crest.

19. HERMIZAN BIN HALIHANAFIAH 19
Cont…
• Median sacral crest is the fused of the spinous
processes of the upper sacral vertebrae.
• Lateral sacral crest is the fused transverse processes
of the sacral vertebrae.
• 4 pairs of posterior sacral foramina communicate with
the anterior sacral foramina through which nerves and
blood vessels pass.
• The sacral canal is a continuation of the vertebral
canal.

20. HERMIZAN BIN HALIHANAFIAH 20
Cont…
• The laminae of the 5th
sacral vertebrae, and sometimes the
4th
sacral vertebrae fails to meet.
• This leaves an inferior entrance to the vertebral canal called
the sacral hiatus.
• On the either side of the sacral hiatus are the sacral cornua,
the inferior articular processes of the fifth sacral vertebrae.
• The narrow inferior portion of the sacrum is called apex.
• The broad superior portion of the sacrum is called base.

21. HERMIZAN BIN HALIHANAFIAH 21
Cont…
• The anteriorly projecting border of the base called sacral
promontory.
• On both of the lateral surface, the sacrum has a large
auricular surface that articulates with the illium of each of
hipbone to form sacroilliac joint.
• Posterior to the auricular surface is a roughened surface
called sacral tuberosity, contain depression for the
attachment of the ligamants.
• The sacral tuberosity is the another surface of the sacrum
that formed sacroilliac joint with the hipbones.

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Sacroilliac Joint

23. HERMIZAN BIN HALIHANAFIAH 23
Cont…
• The superior articular surface of the sacrum
articulate with the 5th
lumbar vertebrae .
• The base of the sacrum articulates with the
body of the 5th
lumbar vertebrae, to form the
lumbosacral joint.

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Coccyx
• Triangular
• Formed by the fusion of usually four coccygeal
vertebrae.
• Indicated as a Co1-Co4
• The coccygeal vertebrae fused when a person is
between 20-30 years of age.
• The dorsal surface of the body of coccyx contain 2
long coccygeal cornua that are connected by
ligaments to the sacral cornua.

28. HERMIZAN BIN HALIHANAFIAH 28
• Coccygeal cornua are the pedicles and superior
articular process of the 1st
coccygeal vertebrae.
• On the lateral surface of the coccyx are a series of
transverse processes, the first pair being the largest.
• The coccyx articulates with the apex of the sacrum.
• In females, the coccyx points inferiorly and males
points anteriorly.
Coccyx

29. HERMIZAN BIN HALIHANAFIAH 29
Normal Curves of the Vertebrae
• Normal curves – 4 slight bends of vertebral column.
• Cervical and lumbar curves are convex (bulging out)
• Thoracic and sacral curves and concave (cupping in).
• The curves of the vertebral column increase its strength, help
in maintain balance in the upright position, absorb shocks
during walking, and help protect vertebrae from fracture.

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• Fetus only has a single anteriorly concave
curve.
• The thoracic and sacral curves are called
primary curvature because they form earlier
during fatal development.
• The cervical and lumbar curves are known
as secondary curves because they begin to
form later, several month after birth.
• All curves are fully developed by age 10.
Normal Curves of the Vertebrae

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Primary Curvature of Newborn

33. HERMIZAN BIN HALIHANAFIAH 33
Cont…
• Various condition may exaggerate the
normal curves, resulting abnormal curves.
• 3 such abnormal curves called:
1. Kyphosis
2. Lordosis
3. Scoliosis

34. HERMIZAN BIN HALIHANAFIAH 34
KYPHOSIS
• Kyphosis is a curving
of the spine that
causes a bowing of the
back, such that the
apex of the angle
points backwards
leading to a
hunchback or
slouching posture.

35. HERMIZAN BIN HALIHANAFIAH 35
• Caused by muscular
imbalance, vertebral
fractures, congenital,
nutritional.
KYPHOSIS

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KYPHOSIS

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LORDOSIS
• Inward curvature of a
portion of the vertebral
column
• Two segments of the
vertebral column, namely
cervical and lumbar, are
normally lordotic, that is,
they are set in a curve that
has its convexity anteriorly
(the front) and concavity
posteriorly (behind), in the
context of human anatomy

38. HERMIZAN BIN HALIHANAFIAH 38
• Mainly because of the
difference of thickness
between the anterior and
posterior part of the
intervertebral disc
• Common causes of
excessive lordosis including
tight low back muscles,
excessive visceral fat, and
pregnancy.
LORDOSIS (cont..)

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LORDOSIS

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SCOLIOSIS
• Scoliosis is a
medical condition in
which a person's
spine is curved
from side to side,
and may also be
rotated.
• Congenital or
idiopathic

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SCOLIOSIS

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Scoliosis

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46. HERMIZAN BIN HALIHANAFIAH 46
Superficial Muscles of Back
• Trapezius
• Latisimus dorsi
• Levator scapulae
• Rhomboid major
• Rhomboid minor

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Intermediate Muscles of Back
• Serratus posterior
superior
• Serratus posterior
inferior

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• Serratus posterior
superior
– O – ligamentum nuchae,
spinous process of C7-T3
– I – upper borders of 2nd
–
5th
ribs
– A – Elevate the ribs,
assist in inspiration
Intermediate Muscles of Back

49. HERMIZAN BIN HALIHANAFIAH 49
• Serratus posterior
inferior
– O – Vertebra T11- L3
– I – Inferior border of 9th
- 12th
ribs
– A – depress the lower ribs,
aids in expiration
Intermediate Muscles of Back

50. HERMIZAN BIN HALIHANAFIAH 50
• Can divide into 4 groups:
1. Splenius
2. Erector spinae
3. Transversospinalis
4. Segmental
Deep Muscles of Back

51. HERMIZAN BIN HALIHANAFIAH 51
Splenius Group (referred to previous
lesson slide)
• Bandages like
• Important to move the head and neck
region.
• Superiorly (head) – splenius capitis
• Inferiorly (neck) – splenius cervicis
– Origin – spine of T3-T6
– Insertion – transverse process C1-C4
– Action – same with splenius capitis
– Nerve cervical spinal nerve

52. HERMIZAN BIN HALIHANAFIAH 52
• Erector spinae group.
– 3 columns muscles
– From sacrum to the ribs
– Extends vertebral column
– Consists
- illiocostalis (lateral)
- Longissimus( intermediate)
- spinalis (medial)
Deep Muscles of Back

53. HERMIZAN BIN HALIHANAFIAH 53
Iliocostalis (lateral fiber)
• Consists 3 fibers:
1. Iliocostalis cervicis
2. Iliocostalis thoracis
3. Illiocostalis lumborum
• Origin – Ribs 1-6, ribs 7-12
and Iliac crest of pelvic
• Insertion – transverse
process of C4-C6, Ribs 1-6,
ribs 7-12

54. HERMIZAN BIN HALIHANAFIAH 54
Iliocostalis
• Action
• Acting together, muscles of each
region extend and maintaining
erect posture of vertebral
column.
• Acting singly, laterally flex and
rotation vertebral column of their
respective region at the same
side of contracting muscles.

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• Consists 3 fibers:
1. Longissimus capitis
2. Longissimus cervicis
3. Longissimus thoracis
• Origin – Articular process of
C4-C7 and transverse process
of T1-T4, transverse process of
T4-T5, Transverse process of
lumbar vertebra.
Longissimus (Intermediate Fiber)

56. HERMIZAN BIN HALIHANAFIAH 56
• Insertion – mastoid process
of temporal, transverse
process of C2-C6,
transverse process of all
thoracic and upper lumbar
vertebra and 9th
and 10th
ribs.
• Action – Longissimus capitis
(together extend head, singly
rotate head), Longissimus
cervicis and thoracis
(extends vertebral column)
Longissimus

57. HERMIZAN BIN HALIHANAFIAH 57
• Consists 3 fibers:
1. Spinalis capitis
2. Spinalis cervicis
3. Spinalis thoracis
• Origin – arises with
semispinalis capitis,
ligamentum nuchae
and spinous process of
C7 , spinous processes
of T10-L2
Spinalis (medial)

58. HERMIZAN BIN HALIHANAFIAH 58
• Insertion – between superior
and inferior nuchal line of
occipital bone, spinous process
of axis , spinous process of
superior thoracic vertebra (T3-
T4).
• Action – acting together
extends vertebral column
Spinalis (medial)

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Transversospinales Muscles
• Semispinalis
• Multifidus
• Rotatores

60. HERMIZAN BIN HALIHANAFIAH 60
• Semispinalis group
– Vertebra to vertebra
– Important for extends neck
• Consists:
– Semispinalis capitis
– Semipinalis cervicis
– Semispinalis thoracis
Semispinalis Group

61. HERMIZAN BIN HALIHANAFIAH 61
• Origin – Articular process C4-C6
and transverse process C7-T7,
transverse process of T1-T5,
Transverse process of T6-T10.
• Insertion – occipital bone.
Spinous process of C1-C5 and
spinous process of C6-T4
• Action – extends neck, extends
vertebral column
Semispinalis Group

62. HERMIZAN BIN HALIHANAFIAH 62
• Origin – sacrum, ilium,
transverse process of
lumbar, thoracis and C4-C7
• Insertion – spinous process
of a more superior vertebra.
• Action – extends vertebral
column (both), lateral flex
vertebral column (singly)
Multifidus

63. HERMIZAN BIN HALIHANAFIAH 63
Rotatores
• Origin – transverse process
of all vertebra
• Insertion – spinous process
of vertebra superior to the
one of origin.
• Action – together weakly
extends vertebral column

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Segmental
• Consists 2 fibers:
1. Interspinales
2. Intertransversarii

65. HERMIZAN BIN HALIHANAFIAH 65
• Consists 2 fibers:
1.Interspinales
2.Intertransversarii
Segmental

66. HERMIZAN BIN HALIHANAFIAH 66
Interspinales
• Origin – superior
surface of all spinous
process
• Insertion – inferior
surface of spinous
process of vertebra
superior to the one of
origin
• Action – weakly
extends vertebral
column (together)

67. HERMIZAN BIN HALIHANAFIAH 67
• Origin – transverse
process of all vertebra
• Insertion – transverse
process of vertebra
superior to the one origin
• Action – extends vertebral
column (together)
Intertransverseraii

68. HERMIZAN BIN HALIHANAFIAH 68
• Quadratus lomborum
– O - iliac crest and
iliolumbar ligament
– I - Last rib and transverse
processes of lumbar
vertebrae
– A - Alone, lateral flexion
of vertebral column;
Together, depression of
thoracic rib cage
Deep Muscles of Back