脊髓及脊柱临床应用解剖

脊髓外部结构
• 脊髓位于脊柱椎管内，约占椎管腔的2/3 。 • 上端在枕骨大孔水平与延髓相连，下端形成脊髓 圆锥。 • 圆锥尖端伸出终丝而终止与第一尾椎的骨膜，内 终丝长约15cm，外终丝长约5cm。 • 颈髓基本扁圆柱体，胸髓呈扁圆及圆柱体，腰髓 则呈圆柱体，而骶髓成菱形体。成年男性脊髓长 度约43-45cm，女性为40-42cm。 • 两处梭形膨大，颈膨大相当于颈４—胸１节段； 腰膨大相当腰１－骶１节段。


Anterior longitudinal ligament 前纵韧带


Strong band covering the anterior part of the vertebral bodies and intervertebral discs running from the anterior margin of foramen magnum to the S1~S2 Maintains stability of the intervertebral disc and prevents hyperextension of the vertebral column
1.Joints of the vertebral bodies 椎体间的连 结
Intervertebral discs 椎间盘
between bodies of adjacent vertebrae, composed of: Nucleus pulpous髓核, an inner soft, pulpy, highly elastic structure (gelatinous core ) Annulus fibrosus纤维环 an outer fibrous ring consisting of fibrocartilage
•Supported by ligaments apical ligament of dens 齿突尖韧带 alar ligament 翼状韧带 transverse ligament of atlas寰椎横韧带 tectorial membrane 覆 膜 •Action ― allow atlas (and head) to pivot on the axis and vertebral column
General features of vertebrae

Vertebral body 椎体 Vertebral arch 椎弓
pedicle of vertebral arch 椎弓根:
sup. and inf. Vertebral notch 椎上、下切迹 lamina of vertebral arch 椎弓板
韧带

Zygapophysial joint 关节突关节
三、Atlantooccipital joint 寰枕关节
Between superior articulating surfaces of atlas and occipital condyles Supported by membrances and ligaments that join occipital bone and atlas Action ― nodding of head, lateral tilting of head
六、Movement of the vertebral column
• • • • •
flexion extension lateral flexion rotation circumduction
脊
柱 裂
Spina bifida cystica
脊髓生理功能
•传导功能 •内脏和反射功能 •营养躯体功能
五、Normal Curves of vertebral column



Cervical curvature颈曲 convex forward Thoracic curvature胸曲 convex backward Lumbar curvature腰曲 convex forward Sacral curvature骶曲 convex backward
Sacrum

Anterior surface:
promontory岬, anterior sacral foramina 骶前孔(four pairs)

Posterior surface:
median sacral crest 骶正中嵴, posterior sacral foramina (four pairs), sacral hiatus骶管裂孔， sacral cornu 骶角

四、Atlantoaxial joint 寰枢关节

Three synovial joints between atlas and axis Laterally, paired joints between articulating faces Median joint between dens of axis and anterior arch of atlas
Hernia of nucleus pulpous 髓核脱出
2.Joints of the vertebral arches 椎弓间的连结


Ligamenta flava 黄韧带― elastic ligament, unite laminae of adjacent vertebrae, and complete the posterior wall of vertebral canal; tend to prevent hyperflexion of the vertebral column Interspinal ligament 棘间韧带 Supraspinal ligament 棘上韧带 Ligamentum nuchae项韧带 Intertansverse ligament横突间
Posterior longitudinal ligament后纵韧带


Attached to the posterior aspect of the intervertebral discs and posterior edges of the vertebral bodies from C2 vertebra to sacrum Prevents hyperflexion of the vertebral column and posterior protrusion of the discs
Regional variations of vertebrae
Cervical vertebrae Vertebrae Body: small Vertebral foramen: larger and triangular Spinous processes: short and bifid in C3 to C5, long in C6,and longer in C7 Transverse processes: short and bifid, transverse foramen横突孔 Articular processes: horizontal
第一节
一、脊髓的位置
脊髓的外形
上至忱骨大孔处与延髓相连，末端至L1椎体 下缘,续为脊髓圆锥（medullary cone)
二、脊髓的形态
圆柱形，前后稍扁，长45cm，重35g.
①两个膨大：颈膨大 cervical enlargement C4 ～Ｔ1节；腰骶膨大 lumberosacral enlargement L1～ S3节。 ②终丝filum terminale止于尾骨的背面，无神 经组织。
脊髓及脊柱临床应用解剖
脊
柱
Vertebral column
基础医学院人体解剖教研室
The vertebral column脊柱 consists of 24 vertebrae, the sacrum, and the coccyx.
一、Vertebrae 椎骨

There are 33 vertebrae in children, arranged as follows: Cervical vertebrae 颈椎 C.7 Thoracic vertebrae 胸椎 T.12 Lumbar vertebrae 腰椎 L.5 Sacral vertebrae 骶椎 S.5 sacrum 骶骨 Coccygeal vertebrae 尾椎 Co.3~4 coccyx尾 骨
Atypical vertebeae

Atlas寰椎 (C1) Body and spinous
process absent, consists of anterior and posterior arches, and two lateral masses
Groove for vertebral

Transverse processes：
transverse costal fovea 横突肋凹

Articular processes: coronal
Lumbar vert百度文库brae



Vertebrae Body： larger, kidney-shape Vertebral foramen: larger and triangular Spinous processes: projects horizontally Transverse processes: long Articular processes: sagittal
artery 椎动脉沟

Axis枢椎 (C2): distinguished by dens齿突 which articulates with dental fovea of anterior arch of atlas
Carotid tubercle: 颈动脉结节: anterior tubercle of transverse process of C6 Vertebra prominens 隆椎 (C7):contains long and nonbifid spinous process, it is visible with neck flexed, used as clinical landmark in counting cervical and thoracic spinous processes

Thoracic vertebrae

Vertebrae Body ：
heart-shape, superior and inferior costal fovea 上、下肋凹

Vertebral foramen：
smaller, rounder

Spinous processes：
long, point obliquely downward

Lateral part:
auricular surface耳状面, sacral tuberosity骶粗隆
二、Articulations of Vertebrae 椎骨的连结
Joints of the vertebral bodies Joints of the vertebral arches

process (7):
spinous process 棘突
transverse process 横突 sup. and inf. articular processes
上、下关节突


Vertebral foramen 椎孔 Vertebral canal 椎管 Intervertebral foramen 椎间孔
脊髓外部结构
• 脊髓三层被膜和三个腔隙，硬脊膜，脊蛛网膜，（spinal arachnoid）软脊膜。硬膜外腔，硬膜下腔，蛛网膜下腔。 • 齿状韧带 18—24个 • 6条纵行的沟裂。前正中裂 后正中沟，前后外侧沟 • 三个索。
脊 髓 被 膜
Branching And Fibers of Spinal Nerve