脊柱,解剖部分.ppt

单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,脊柱,解剖复习,脊 柱,Vertebral column,脊柱的作用：维持稳定、保护神经、具有活动范围,一、,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.34 coccyx,尾骨,脊柱,（一）、椎骨的基本形态与结构,椎体,椎孔,椎弓根,椎,弓板,棘突,横突,图,1-3,纤维环摸式图,1.,软骨终板,2,髓核,3,纤维环,1,2,3,1,、,椎,间盘：占脊柱全长约,1/4,，颈、腰段最厚。,髓核,纤维环,软骨终板,髓核,纤维环,椎间盘结构,棘突,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,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,以腰椎为例,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,Anterior longitudinal ligament,前纵韧带,位于脊柱前面，起自枕骨大孔前缘，止于骶骨前面。随着位置下降，前纵韧带逐渐增宽。功能：防止过伸，为纤维环提供前方支持。,Posterior,longitudinal ligament,后纵韧带,2.Joints of the vertebral arches,椎弓间的连结,黄韧带：阶段性韧带，分布于椎板及相邻椎体。功用是维持直立姿势，有助于保持正常的脊柱曲度。,棘间韧带：,棘上韧带：是中线结构，走行于棘突后面，颈椎的棘上韧带扩展为项韧带,项韧带,横突间韧带,关节突关节,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,脊柱神经解剖,共有,31,对脊神经，,C8,对，,T12,对，,L5,对，骶,5,对，尾,1,对。,脊髓通常止于,L1,或,L2,水平，短于脊柱，脊髓支配上下枝的神经分别构成颈膨大和腰膨大，脊髓的末端为脊髓圆锥，神经根继续向远端走行，构成马尾。,脊柱常见的检查,感觉,肌力,反射,病理征,三柱理论,三柱结构分别如下：前柱：前纵韧带、椎体前三分之二和椎间盘及纤维环的前二分之一；中柱：椎体后三分之一及椎间盘、纤维环后二分之一，后纵韧带及椎管；后柱：椎板、黄韧带、棘上和棘间韧带，棘突等脊柱附件。,当脊柱受到屈曲压缩外力，主要是前柱承受压力，中后柱承受张力。前柱压缩超过,1/2,时，中柱受损，后柱分离，椎体不稳。牵张伸展外力时，后柱承受压力，出现椎板及棘突骨折，而椎体前部间隙增宽，则表示有前纵韧带损伤，椎体不稳。爆裂骨折多为垂直性外力，如骨折仅累及中柱，则较稳定；同时累及后柱，系不稳定骨折。骨折脱位是三柱同时受损的一种类型，无论何种外力所致，均属于不稳定性骨折。,