HUMAN

ANATOMY AND
PHYSIOLOGY
LABORATORY

SKELETAL SYSTEM
(BACK REGION)

REVIEWER BY G4
 SCAPULA
(POSTERIOR PERSPECTIVE)
Also called as 'shoulder blade'.
A posterior bone.
A flat and triangular bone that can easily be felt and seen.
ACROMION PROCESS
referring to the tip of the shoulder blade.
FUNCTIONS OF ACROMION PROCESS (SCAPULA)
F orms a protective cover for the shoulder joint.
F orms the attachment site for the clavicle.
P rovides attachment points for shoulder muscles.
SCAPULAR SPINE
It extends from the acromion process across the posterior surface of the scapula.
It divides the surface into a small 'supraspinous fossa' and a larger 'infraspinous fossa'.
SUPRASPINOUS FOSSA INFRASPINOUS FOSSA SUBSCAPULAR FOSSA
Superior to the spine. Inferior to the spine. The deep, anterior surface of the scapula.
GLENOID CAVITY
Located in the superior lateral portion of the bone.
Articulates with the head of the humerus.

VERTEBRAL COLUMN
(GENERAL PERSPECTIVE)
Usually consists of 26 bones, called 'vertebrae'.
Vertebrae is divided into 5 regions (e.g. cervical, thoracic, lumbar, sacral, and coccygeal).
A developing embryo has about 33 or 34 vertebrae.
GENERAL FEATURES OF THE VERTEBRAE NUMBER OF VERTEBRAE IN EACH REGION
BODY (MEALTIMES-IN-A-DAY)
The weight-bearing portion of the vertebra. Breakfast
VERTEBRAL ARCH C1-C7 7 A.M.
Forms the lateral and posterior walls of the
vertebral foramen.
Lunch
PEDICLE T1-T12
12 P.M.
Foot of the arch with one on each side
Forms the lateral walls of the vertebral foramen
LAMINA Dinner
The posterior part of the arch; forms the L1-L5
posterior wall of the vertebral foramen. 5 P.M.
VERTEBRAL FORAMEN Midnight snacks
A large opening in each vertebra through 1 A.M.
which the spinal cord passes. 1 A.M.
VERTEBRAL CANAL
It contains the spinal cord and 'cauda equina'. FUNCTIONS OF VERTEBRAL COLUMN
TRANSVERSE PROCESS P rotects the spinal cord.
Process projecting laterally from the junction S upports the weight of the head and trunk.
of the lamina and pedicle. A llows spinal nerves to exit the spinal cord.
SPINOUS PROCESS P rovides a site for muscle attachment.
Projects posteriorly at the point where two P ermits movement of the head and trunk.
laminae join (felt as lumps at the back).
 INTERVERTEBRAL FORAMINA
It is formed in the location where two vertebrae meet.
INTERVERTEBRAL NOTCHES
It forms intervertebral foramen in the pedicles of adjacent vertebrae.
SUPERIOR ARTICULAR PROCESSES
Two of which articulate (form joints) with the two inferior articular processes of the vertebra above them.
INFERIOR ARTICULAR PROCESSES
Articulate with the two superior articular processes of the vertebra below them.
ARTICULAR FACET
Formed by the region of overlap and articulation between the superior and inferior articular processes.
INTERVERTEBRAL JOINTS
The articulations formed between the vertebral bodies and articular facets of successive vertebrae.

INTERVERTEBRAL DISKS
(GENERAL PERSPECTIVE)
Found between the bodies of adjacent vertebrae from
the C2 to the sacrum (acts as shock absorber).
Accounts for about 25% of the height of the vertebral
column.

ANNULUS FIBROSUS
Annulus means 'ring-like'.
An outer fibrous ring consisting of fibrocartilage.

NUCLEUS PULPOSUS
Pulposus means 'pulp-like'.
An inner soft, pulpy, highly elastic substance.

REGIONS OF THE VERTEBRAL COLUMN

(GENERAL PERSPECTIVE)

C ervical vertebrae Confused,

T horacic vertebrae Toddlers, Lost,
L umbar vertebrae
Spinal nerves,
S acral
C occygeal
Childishly

CERVICAL VERTEBRAE
The topmost part of the vertebral column.
A vertebral column region that is close to the hyoid attachment
(neck).
Have very small bodies except for the “atlas” which has no body.
Most have bifid spinous processes (clearly distinct cleft resulting
into two elongated projections) and transverse foramen (an
opening that is occupied by the vertebral artery and vein within
the first six vertebral regions).
Dislocations and fractures are more common in this area than in
other regions of the vertebral column (due to its relatively
delicate structure and small bodies).
 FUNCTIONS OF CERVICAL VERTEBRAE
(A-GERMAN-TERM-FOR-DOG)

H ead movement
U pper limb movement
N eck and shoulder movement
D iaphragdm movement

CERVICAL VERTEBRAE
(THE 7 BONES)

ATLAS (C1)
The 'first cervical vertebrae'.
It does not contain a vertebral body or a spinous process
(atypical vertebrae).
Holds up the head, as “Atlas” in classical mythology.
Movement between the atlas and the occipital bone is
responsible for a “yes” motion of the head.
Allows slight tilting of the head from side to side.

AXIS (C2)
The 'second cervical vertebrae'.
Also known as 'epistropheus'.
An “atypical cervical vertebrae”.
A considerable amount of rotation happens, as in
shaking the head “no”.
Dens (odontoid process) - a peg-like process that
projects superiorly through the anterior vertebral
foramen of C1; the process by which rotations
occur.

SUBAXIAL (C3)
The 'third cervical vertebrae'.
An uncommon site for isolated injury, accounting for less
than 1% of all cervical spine injuries.
It controls head and neck movements, and gives
sensations to the side of the face and back of the head.
It is a 'typical cervical vertebrae'.

FOURTH CERVICAL VERTEBRAE (C4)

The 'fourth cervical vertebrae'.
Gives sensation for parts of the neck, shoulder, and
upper arms.
It belongs to the “typical cervical vertebral”
classification.

FIFTH CERVICAL VERTEBRAE (C5)

The 'fifth cervical vertebrae'.
Located in the lower portion of the cervical vertebrae.
Provides sensation to the upper arm down to the
elbow.
A typical cervical vertebrae.
 SIXTH CERVICAL VERTEBRAE (C6)
The 'sixth cervical vertebrae'.
Provides blood flow to the brain and some head,
facial, and neck movements.
It is where the esophagus originates.
It belongs to “typical cervical vertebrae”
classification.

VERTEBRA PROMINENS (C7)

The 'seventh cervical vertebrae'.
The end point or region (lower part) of the cervical
vertebrae.
The spinous process is not bifid and is quite
pronounced and can be seen and felt as a lump
between the shoulders.
The most prominent spinous process in this area is
“vertebral prominens”.
It controls the triceps and the wrist extensor muscles.
It belongs to “atypical cervical vertebrae” classification.

THORACIC VERTEBRAE
Considerably larger and stronger than cervical vertebrae.
Have longer and larger transverse processes.
Spinous process on T1 to T10 (long, flattened, and
inferior).
Spinous process on T11 to T12 (shorter, broader,
posterior).
They articulate with the ribs (costal facets).

FACET VS. DEMIFACET

FACET
Formed when the head of a rib articulates with the body
of one vertebra.
DEMIFACET VERTEBROCOSTAL JOINTS
Formed when the head of a rib articulates with two
adjacent vertebral bodies. Articulations between the thoracic vertebrae
and the ribs.
 FUNCTIONS OF THORACIC VERTEBRAE
(PASS O' PASS)

P rotects spinal cord, spinal nerves, heart, and lungs.

A llows greatest range of rotation.
S tabilize ribcage and thoracic spine.
S et attachments for the ribs.

THORACIC VERTEBRAE
(THE 12 BONES)

T1
The first of the twelve thoracic vertebrae.
The smallest vertebra of the thoracic region.
A part of the 'brachial plexus' which is a network of
nerves in shoulders carrying signals from the spinal
cord to the appendicular region.

T2
The second thoracic vertebra.
Has faceted sides that allow the vertebra to press
up against the ribs.
Larger than T1 but smaller than T3.
Helps control ribcage, lungs, and diaphragm.

T3
The third segment of 12 thoracic bones.
Larger than T1 and T2.
It controls the lungs and respiratory muscles that
help a person to breath.
T4 - T8
Make up the rest of the thoracic vertebrae before
T9 to T12.
Primarily control abdominal and back muscles.
Helps with balance and posture.
T4 and T5 vertebrae are the most commonly
injured thoracic vertebrae.

T9-T12
Also known as the 'transition vertebrae'.
T9 directly communicates to the adrenal glands
through nerves.
T10 controls the muscles of the lower abdomen.
T11 is the first of the transitional vertebra that is
not attached to a true rib.
T12 is the largest thoracic bone and the last
vertebra before transitioning into the lumbar
section of the spinal column.
 LUMBAR VERTEBRAE
Consists of 5 lumbar vertebrae.
The largest and strongest of the unfused bones in the vertebral
column.
The amount of body weight supported by the vertebrae
increases toward the inferior end of the backbone.
Various projections are short and thick.
The spinous processes are quadrilateral in shape, are thick and
broad, and project nearly straight posteriorly- well adapted for
large back muscles attachment.
Found in the lower back.

FUNCTIONS OF LUMBAR VERTEBRAE

(BANGKO SENTRAL NG PILIPINAS)

B ody's balance and supports most of the body's weight.

S tability for the back and spinal column.
P oint of attachment for muscles and ligaments.

LUMBAR VERTEBRAE
(THE 5 BONES)

L1
The topmost section of the lumbar spinal column.
It contains a portion of spinal cord.
Provides sensation for groin and genital area.
Hip movement.

L2 - L4
Located at the mid-region of the lumbar spinal
column.
Relatively have larger structures than the previous.
Provide sensation to the front part of the thigh and
inner side of the lower leg.
Hip and knee muscle movements.

L5
The fifth and the last section of the lumbar spinal
column.
Is a part of the greater lumbar spinal region.
Is closest to the sacral attachment
May become fused into the sacrum.
The curve above the buttocks.
Provides sensation to the outer side of your lower
leg, the upper part of your foot and the space
between your first and second toe.
Hip, knee, foot and toe movements.
 SACRAL VERTEBRAE
Fused into a single bone called 'sacrum'.
Positioned at the posterior portion of the pelvic cavity, medial to
the two hip bones.
Fuses in individuals between 16 and 18 years of age and gets
completed by age 30.
It serves as a strong foundation for the pelvic girdle.
Sacrum is shorter, wider, and more curved between S2 and S3
in females than males.
Not movable compared to cervical, thoracic, and lumbar.
SACRUM
A triangular bone formed by the union of five sacral
vertebrae.
came from the words 'sa-krum' which means
'sacred bone'.
TRANSVERSE LINES
are where the individual sacral vertebrae fuse.
SACRAL FORAMINA
occur on the anterior and posterior surfaces of the
sacrum.
SACRAL ALA
Wing-shaped areas which are formed by the
fused transverse processes of S1.
MEDIAN SACRAL CREST
Fused spinous processes of the upper sacral
vertebrae.
LATERAL SACRAL CREST
Fused transverse processes of the sacral
vertebrae
SACRAL CANAL
A continuation of the vertebral cavity.
SACRAL HIATUS
An inferior entrance to the vertebral canal.
SACRAL CORNU
An inferior articular process of the S5. SACRAL VERTEBRAE
APEX (ARTICULATIONS)
Narrow inferior portion of the sacrum.
BASE SACROILIAC JOINTS
Broad superior portion of the sacrum. Formed when the sacral tuberosity unites with the
hip bones.
SACRAL PROMONTORY
The anteriorly projecting border of the base. LUMBOSACRAL JOINTS
A landmark that separates the abdominal cavity Formed when the superior articular processes of the
from the pelvic cavity. sacrum articulate with the inferior articular
SACRAL TUBEROSITY processes of the L5 and the base of the sacrum
A roughened surface which contains depressions articulates with the body of the L5.
for the ligament attachment.
SACROCOCCYGEAL JOINTS
AURICULAR SURFACE The apex of the bone articulates with the base of the
A large ear-shaped in the upper part of the coccyx, to form another 'amphiarthrodial joint'.
surface that articulates with the ilium of each hip
bone to form the sacroiliac joint. (MNEMONICS)
CONVEX
The posterior surface of the sacrum containing a
median sacral crest, lateral sacral crest and four
pairs of posterior sacral foramina.
S-L-S
 FUNCTIONS OF SACRAL VERTEBRAE
(A COMMERCIAL DEVELOPMENT PROJECT IN INDIA)

AALPS
EUPHORIA

A ids in supporting and transmitting the body weight while standing or sitting.
A long with the hip bone, it protects the delicate organs of excretory and reproductive systems.
L ocks the hip bones together on the posterior side, thus supporting the base of the spine.
P rovides stability of the hip.
S urrounds and protects the spinal nerves of the lower back.
TRACING SACRAL VERTEBRAE
(MARKING MECHANISMS AND FUNCTIONS)

COCCYGEAL VERTEBRAE
Formed by the fusion of 4 coccygeal vertebrae (Co1-Co4).
Coccygeal vertebrae fuse between ages of 20 and 30.
Also called as 'tailbone'.
Is the most inferior portion of the vertebral column and usually consists of 3 to 5 semi-fused vertebrae
forming a triangle structure.
In females, the coccyx points inferiorly allowing the baby delivery during birth. In males, it points anteriorly .
COCCYX
Formed by the union of usually four coccygeal
vertebrae.
COCCYGEAL CORNUA
The pedicles and superior articular processes of
the first coccygeal vertebra.
SACROCOCCYGEAL JOINTS
Formed when the coccyx articulates superiorly
with the apex of the sacrum.
 RIBCAGE
(POSTERIOR PERSPECTIVE)
Also known as 'thoracic cage'.
Consists of several pairs of narrow and curved strips of bone
called 'ribs' (sometimes thought of as cartilage)
It is composed of 12 pairs of ribs.
Lends support to the trunk musculature.
Protects the heart and lungs within the thorax; forms a semirigid
chamber.
It has the ability to increase and decrease in volume during
respiration.

RIB
(POSTERIOR PERSPECTIVE)
Cost means 'rib'
The ribs increase in length from the first through 7th, and
decrease in length to the 12th rib.
Each rib articulates posteriorly with its corresponding thoracic
vertebra.
The first through 7th pairs of ribs have a direct anterior
attachment to the sternum by a strip of hyaline cartilage called
'costal cartilage'.
Tend to break at the point where the greatest force is applied,
but they may also break at their weakest point-the site of
greatest curvature, just anterior to the costal angle.
The ribs are attached to the breastbone (a long bone that runs
down the center of the chest).
Attached in front by cartilage (a firm yet flexible tissue).
Attached to the spine at the back

TWO DISTINCT TYPES OF RIBS

(ACCORDING TO THEIR ATTACHMENT TO THE STERNUM)

TRUE RIBS
Also called as 'vertebrosternal ribs'.
The ribs that have costal cartilages and attach directly to the
sternum.
The articulations formed between the true ribs and the sternum
are called 'sternocostal joints'.

FALSE RIBS
The inferior 5 pairs (8th to 12th rib) articulate with the thoracic
vertebrae but do not attach directly to the sternum.
Classified into two rib groups such as vertebrochondral ribs and
floating ribs.

VERTEBROCHONDRAL RIBS
Includes 8th to 10th ribs.
FLOATING RIBS Joined by a common cartilage to the costal cartilage of the 7th
Also known as 'vetebral ribs' rib, which is attached to the sternum.
Do not attach to the sternum.
Attach only posteriorly to the thoracic vertebrae.
 TWO POINTS IN WHICH THE RIB ARTICULATE WITH THE THORACIC VERTEBRAE
(GENERALIZATION)

Head
Tubercle

HEAD
(RIB PROJECTION)
A projection at the posterior end of the rib that contains
a pair of articular facets (superior and inferior).
Articulates with the bodies of two adjacent vertebrae and
the intervertebral disk between them.
Each rib’s head articulates with the inferior articular facet
of the superior vertebra and the superior articular facet
of the inferior vertebra.

TUBERCLE
(RIB PROJECTION)
Articulates with the transverse process of the inferior
vertebra.
A 'knob-like' structure on the posterior surface where the
neck joins the body.
The non-articular part of the tubercule attaches to the
transverse process of a vertebra by a ligament called
'lateral costotransverse ligament'.
The articular part of the tubercle articulates with the
facet of a transverse process of a vertebra to form
'vertebrocostal joints'.
STRUCTURES OF RIBS
(GENERALIZATION)
NECK COSTAL ANGLE
Constricted portion of a rib just lateral to the head. A short distance beyond the tubercule, an abrupt
It can be found between the head and the tubercle. change in the curvature of the shaft occurs.
BODY OR SHAFT COSTAL GROOVE
Main part of the rib. Found in the inner surface of the rib and protects
the intercostal blood vessels and small nerves.
ANGLE
Located just lateral to the tubercule and is the INTERCOSTAL SPACE
point of greatest curvature. Spaces between ribs.
Weakest part of the rib. Occupied by intercostal muscles, blood vessels,
Can be fractured in a crushing injury (automobile and nerves.
accident). The point at which the lungs or other thoracic
structures are surgically accessed.
COSTAL CARTILAGE
It contributes to the elasticity of the thoracic cage.
It permits the rib cage to expand during
respiration.
It prevents blows to the chest from fracturing the
sternum and ribs.
It is sufficiently flexible in younger individuals to
permit considerable bending without breaking.

TWO DISTINCT TYPES OF RIBS

(TYPICAL AND ATYPICAL CLASSIFICATION)

TYPICAL RIBS
Have a generalized structure.
head, neck and body
Head is wedge shaped, and has two articular facets connected
to the vertebrae that is separated by a wedge of bone.
Neck contains no bony prominences, but simply connects the
head with the body.
Body, or shaft of the rib is flat and curved. The internal surface of
the shaft has a groove for the protection of vessels and nerves.

ATYPICAL RIBS
Have variations on structure.
Ribs 1, 2, 10 11 and 12 are ‘atypical’ because they have features
that are not common to all the ribs.
Rib 1 is shorter, wider than the other ribs and has one facet on
its head for articulation with its corresponding vertebra. The
superior surface is marked by two grooves, which make way for
the subclavian vessels.
Rib 2 is thinner and longer than rib 1, and has two articular
facets on the head as normal. It’s a roughened area on its upper
surface, from which the serratus anterior muscle originates.
Rib 10 only has one facet for articulation with its numerically
corresponding vertebra.
Ribs 11 and 12 have no neck, and only contain one facet, which
is for articulation with their corresponding vertebra.

COSTOTRANSVERSE JOINT LUMBAR RIBS

Between the tubercle of the rib and the transverse May be developed in lumbar vertebra.
costal facet of the corresponding vertebra.
COSTOVERTEBRAL JOINT
Between the head of the rib, superior costal facet
of the corresponding vertebra, and the inferior
costal facet of the vertebra above.
CERVICAL RIBS
A separate bone sometimes formed by the
transverse processes of the 7th cervical
vertebra.
May be tiny pieces of bone or may be long
enough to reach the sternum.
 ABDONINAL SPINAL CURVATURES
Three most common Spinal Curvatures

LORDOSIS
lōr-dō′sis; hollow back
Is an exaggeration of the convex curve of the
lumbar region.
Sometimes called hollow back, is an increase in the
lumbar curve of the vertebral column.
May result from increased weight of the abdomen as
in pregnancy or extreme obesity, poor posture,
rickets, osteoporosis, or tuberculosis of the spine.

KYPHOSIS
kī-fō′sis; hump back
Is an exaggeration of the concave curve of the thoracic
region.
It is most common in postmenopausal women but can
also occur in men and becomes more prevalent as
people age.
Is an increase in the thoracic curve of the vertebral
column that produces a “hunchback” look.
Kyphosis may also be caused by rickets and poor
posture. It is also common in females with advanced
osteoporosis.

SCOLIOSIS
skō′lē-ō′sis
Is an abnormal lateral and rotational curvature of
the vertebral column
often accompanied by secondary abnormal
curvatures, such as kyphosis.
The most common of the abnormal curves, is a
lateral bending of the vertebral column.
It may result from congenitally malformed vertebrae,
chronic sciatica, paralysis of muscles on one side of
the vertebral column, poor posture, or one leg being
shorter than the other.
Signs of scoliosis include uneven shoulders and
waist, one shoulder blade more prominent than the
other, one hip higher than the other, and leaning to
one side.
In severe scoliosis (a curve greater than 70 degrees),
breathing is more difficult and the pumping action of
the heart is less efficient.
Treatment options include wearing a back brace,
physical therapy, chiropractic care, and surgery
(fusion of vertebrae and insertion of metal rods,
hooks, and wires to reinforce the surgery.
 PATHOPHYSIOLOGY

SPINA BIFIDA
SPIˉ-na BIF-i-da
A congenital defect of the vertebral column in which
laminae of L5 and/or S1 fail to develop normally and
unite at the midline
Caused by a failure of laminae to unite at the midline.
The least serious form is called spina bifida occulta
which occurs in L5 or S1 and produces no symptoms.
If the sac contains the meninges from the spinal cord
and cerebrospinal fluid, the condition is called spina
bifida with meningocele.
If the spinal cord and/or its nerve roots are in the sac, the
condition is called spina bifida with meningomyelocele.

HERNIATED DISK
Ruptured disk
Results when the annulus fibrosus breaks or
balloons, releasing all or part of the nucleus
pulposus.
The herniated part of the disk may push against and
compress the spinal cord, cauda equina, or spinal
nerves.
Herniated disks can be repaired in one of several
ways, one procedure is prolonged bed rest, based on
the tendency for the herniated part of the disk to
recede and the annulus fibrosus to repair itself.

RIB FRACTURES
Most common chest injuries.
They usually result from direct blows, most often from impact
with a steering wheel, falls, or crushing injuries to the chest.
The middle ribs are the most commonly fractured.
In some cases, fractured ribs may puncture the heart, great
vessels of the heart, lungs, trachea, bronchi, esophagus,
spleen, liver, and kidneys. Rib fractures are usually quite
painful.
Rib fractures are no longer bound with bandages because of
the pneumonia that would result from lack of proper lung
ventilation.
 PATHOPHYSIOLOGY

DISLOCATED RIBS

Which are common in body contact sports, involve

displacement of a costal cartilage from the sternum, with
resulting pain, especially during deep inhalations.
Sometimes goes away on its own without treatment. In
more severe cases, a single intercostal nerve block can
deliver permanent relief for some, but surgery may be
needed if the pain is debilitating or doesn't go away.

SEPARATED RIBS
Costochondral separation
Involve displacement of a rib and its costal cartilage; as a
result, a rib may move superiorly, overriding the rib
above and causing severe pain.
This type of injury is usually caused by a sudden impact
to your chest.
Symptoms include sharp pain when you breathe, cough,
or sneeze.

ABNORMAL CURVES OF THE VERTEBRAL COLUMN

Various conditions may exaggerate the normal curves of the vertebral column, or the column may
acquire a lateral bend, resulting in abnormal curves of the vertebral column.

 PATHOPHYSIOLOGY

FRACTURES OF THE VERTEBRAL COLUMN

often involve C1, C2, C4–T7, and T12–L2.
Cervical or lumbar fractures usually result from a
flexion– compression type of injury such as might be
sustained in landing on the feet or buttocks after a fall or
having a weight fall on the shoulders.
Cervical vertebrae may be fractured or dislodged by a
fall on the head with acute flexion of the neck, as might
happen on diving into shallow water or being thrown from
a horse.
Spinal cord or spinal nerve damage may occur as a
result of fractures of the vertebral column if the fractures
compromise the foramina.

THESE PROCEDURES REDUCE THE COMPRESSION OF

THE SPINAL NERVE OR SPINAL CORD:
LAMINECTOMY
is the removal of a vertebral lamina, or vertebral arch

HEMILAMINECTOMY
is the removal of a portion of a vertebral lamina

FENESTRATION
involves removal of the nucleus pulposus, leaving the
annulus fibrosus intact

CAUDAL ANESTHESIA

A procedure in which anesthetic agents that act on the sacral

and coccygeal nerves are injected through the sacral hiatus
While this approach is not as common as lumbar epidural
block, it is preferred when sacral nerve spread of the
anesthetics is preferred over lumbar nerve spread.
Anesthetic agents also may be injected through the posterior
sacral foramina.
The lumbar approach is preferred because there is
considerable variability in the anatomy of the sacral hiatus, and
with advancing age the dorsal ligaments and cornua thicken,
making it difficult to identify the hiatal margins.