Anatomija Kralješnice

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11071-01_CH01.

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Lippincott Wil liams & Wilkins


atlas of

ANATOMY
Latin Edition
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Lippincott Williams & Wilkins


atlas of

ANATOMY
THE BACK CHAPTER 1

Plate 1-01 Palpable Features of the Back . . . . . . . . . . . . . . . . . 5


Plate 1-02 Vertebral Column, Lateral View . . . . . . . . . . . . . . . 6
Plate 1-03 Cervical Vertebrae . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Plate 1-04 Articulated Cervical Vertebrae . . . . . . . . . . . . . . . . 8
Plate 1-05 Thoracic and Lumbar Vertebrae . . . . . . . . . . . . . . . 9
Plate 1-06 Articulated Thoracic Vertebrae . . . . . . . . . . . . . . . 10
Plate 1-07 Articulated Lumbar Vertebrae . . . . . . . . . . . . . . . 11
Plate 1-08 Sacrum and Coccyx . . . . . . . . . . . . . . . . . . . . . . . . 12
Plate 1-09 Ligaments of the Cervical Vertebrae . . . . . . . . . . . 13
Plate 1-10 Ligaments of the Thoracic Vertebrae . . . . . . . . . . 14
Plate 1-11 Ligaments of the Lumbar Vertebrae
and Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Plate 1-12 Cutaneous Innervation of the Back . . . . . . . . . . . . 16
Plate 1-13 Superficial Muscles of the Back . . . . . . . . . . . . . . . 17
Plate 1-14 Deep Back Muscles, Superficial Dissection . . . . . . 18
Plate 1-15 Deep Back Muscles, Deeper Dissection . . . . . . . . 19
Plate 1-16 Suboccipital Region. . . . . . . . . . . . . . . . . . . . . . . . . 20
Plate 1-17 Pattern of a Typical Spinal Nerve . . . . . . . . . . . . . 21
Plate 1-18 Spinal Cord, Posterior View . . . . . . . . . . . . . . . . . 22
Plate 1-19 Superior Portion of the Spinal Cord . . . . . . . . . . . 23
Plate 1-20 Inferior Portion of the Spinal Cord . . . . . . . . . . . . 24
Plate 1-21 Blood Supply of the Spinal Cord,
Anterior View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Plate 1-22 Venous Drainage of the Vertebral Column
and Spinal Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Plate 1-23 Dermatomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
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Palpable Features of the Back PLATE 1-01

Palpable bony structures

Linea nuchalis superior

Protuberantia occipitalis externa

Margo superior
musculi trapezius

Vertebra prominens (C7) Clavicula

Articulatio Acromion
acromioclaviculare
Spina scapulae

Tuberculum majus Plica axillaris


posterior

Angulus inferior
Processus spinosus

Costa

Musculus erector spinae


Crista iliaca

Os coxae
Spina iliaca posterior superior

Os sacrum

Trochanter major
Os coccygis

Tuber ischiadicum

Chapter 1
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PLATE 1-02 Vertebral Column, Lateral View Cervical Vertebrae PLATE 1-03

A. Atlas (C1), superior view B. Atlas (C1), inferior view


Tuberculum
Arcus anterior atlantis Tuberculum anterius posterius
Arcus posterior Foramen
atlantis vertebrale
Processus Fovea dentis
transversus
Processus
transversus

Atlas (C1)

Axis (C2) Foramen


transversarium Foramen Foramen
Curvatura cervicalis vertebrale transversarium

Facies articularis Arcus posterior Facies articularis


superior atlantis inferior
C7 Fovea dentis
T1 Tuberculum posterius Arcus anterior
Sulcus arteriae vertebralis atlantis Tuberculum
anterius

C. Axis (C2), superior view


Facies articularis
Dens axis anterior

Curvatura thoracica
Facies articularis
superior
Processus
transversus
Processus
articularis
inferior
T12
Facies articularis posterior
L1 Lamina arcus
vertebrae
Processus
spinosus

Curvatura lumbalis D. Cervical vertebra (C4), superior view E. Cervical vertebra (C4), lateral view
Corpus vertebrae
Processus transversus: Processus
Processus Processus et facies
L5 Tuberculum uncinatus uncinatus
anterius articularis superior
Foramen Pediculus
transversarium arcus
vertebrae
Processus transversus:
Curvatura sacralis Tuberculum Tuberculum
Os sacrum posterius anterius
Foramen
transversarium
Facies Tuberculum
articularis posterius
superior
Foramen Processus Processus Corpus
vertebrale spinosus articularis inferior vertebrae
Lamina arcus
vertebrae Processus
spinosus
Os coccygis

Chapter 1 Chapter 1
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PLATE 1-04 Articulated Cervical Vertebrae Thoracic and Lumbar Vertebrae PLATE 1-05

A. Lateral view B. Radiograph of cervical vertebrae, lateral view A. Thoracic vertebra (T6), superior view B. Thoracic vertebra (T6), lateral view
Corpus vertebrae

Incisura
Facies et processus vertebralis superior
Os occipitale Foramen articularis superior
Fovea costalis Fovea Corpus
vertebrale Pediculus arcus costalis vertebrae
Arcus anterior superior
vertebrae superior
atlantis
C1 C1 Incisura Pediculus arcus Fovea costalis
vertebralis vertebrae processus
Arcus posterior transversus
atlantis (C1) superior
Fovea costalis
C2 C2 processus transversus Processus
Discus transversus
C3 intervertebralis
C3 Processus
articularis
C4 Facies Lamina arcus inferior Incisura Fovea costalis
Articulatio C4 articularis vertebrae vertebralis
Processus inferior
zygapophysialis transversus superior inferior
Processus Processus
C5 C5 spinosus spinosus
Foramen intervertebrale

Processus spinosus (C6) C6


C6 C. Intervertebral disc, superior view
Processus transversus Anulus
C7 C7 fibrosus

T1 Nucleus pulposus

C. Posterior view D. Radiograph of cervical vertebrae, posterior view

D. Lumbar vertebra (L3), superior view E. Lumbar vertebra (L3), lateral view
Mandibula
C1 Corpus vertebrae
Processus
articularis
C2 superior Incisura vertebralis
superior
Pediculus arcus
C3 vertebrae
C3 Processus
transversus
Processus C4 Pediculus arcus
C4 transversus (C4) vertebrae
Processus spinosus Foramen Processus
C5 Processus spinosus
C5 vertebrale
transversus

Lamina arcus C6
C6
vertebrae (C6) Incisura
Processus vertebralis
C7 et facies inferior Corpus
C7 articularis Processus
Lamina arcus vertebrae
Processus superior articularis
spinosus (C7) Processus vertebrae inferior Facies
T1 mammillaris articularis
Processus inferior
spinosus

Chapter 1 Chapter 1
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PLATE 1-06 Articulated Thoracic Vertebrae Articulated Lumbar Vertebrae PLATE 1-07

A. Lateral view B. Posterior view A. Lateral view B. Radiograph of lumbar vertebrae, lateral view

Processus articularis
T12 inferior T12
Processus articularis
C7 superior
Pediculus arcus L1
T1 L1 vertebrae
Discus intervertebralis
Processes spinoses
L2 L2
Processus spinosus

Incisura vertebralis
Foramina intervertebrales inferior
Fovea costalis L3 L3
processus Foramen
transversus intervertebrale

L4 Incisura vertebralis
superior L4
Foveae costales inferior Processus
transversus (L4)
Laminae arcus
vertebrae L5
Corpus vertebrae L5

Os sacrum

Foveae costales superior


Processus transversus

C. Posterior view D. Radiograph of lumbar vertebrae, posterior view

T12
T12
Pediculi arci vertebrae
Processus transversus L1
L1
Articulationes
zygapophysiales
L2
Discus intervertebralis Processus articularis
L2 inferior
Processus articularis
superior
L3
Pediculus arcus
L3 vertebrae
Processus spinosus
L4
L4 Lamina arcus vertebrae
T12

L1 L5 L5

Os sacrum

Chapter 1 Chapter 1
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PLATE 1-08 Sacrum and Coccyx Ligaments of the Cervical Vertebrae PLATE 1-09

Basis ossis sacri


A. Anterior view A. Lateral view

Membrana atlantooccipitalis anterior


Capsula articulatio atlantooccipitalis
Ala ossis sacri Membrana atlantooccipitalis posterior
(pars lateralis) Processus articularis superior Arcus anterior atlantis (C1)

Facies articularis Corpus vertebrae axis (C2)


superior
Promontorium Arteria vertebralis

Foramina sacralia Capsulae articulationibus


anteriora Ligamenta flava zygapophysiales
Lineae
transversae
Ligamentum longitudinale anterius
Ligamentum nuchae

Apex ossis sacralis


Ligamenta interspinalia Disci intervertebrales
(C4–C5, C6–C7)
Os coccygis

Vertebra prominens (C7)

T1

B. Posterior view
B. Posterior view

Os occipitale

Processus articularis Capsula articulationis Membrana atlantooccipitalis posterior


superior atlantooccipitalis lateralis
Processus transversus
Capsula articulationis
Facies auricularis atlantoaxialis lateralis Atlas (C1)
Axis (C2)
Crista sacralis mediana
Foramina sacralis Ligamenta flava
Crista sacralis lateralis posteriora Ligamentum nuchae

Arteria vertebralis
Capsula articulationis
Hiatus sacralis zygapophysialis

Os coccygis

T1
Ligamentum supraspinale

Chapter 1 Chapter 1
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PLATE 1-10 Ligaments of the Thoracic Vertebrae Ligaments of the Lumbar Vertebrae and Sacrum PLATE 1-11

A. Lateral view Corpus vertebrae (T12)

Ligamenta Corpus vertebrae (L1)


flava
Ligamentum longitudinale posterius
A. Lateral view Anulus fibrosus
Nucleus pulposus
Foramen Tip of conus medullaris
Ligamentum intervertebrale
supraspinale surrounded by radiculi nervi
C7
Ligamenta Nervus spinalis (L2)
interspinalia T1 Articulationes
zygapophysiales
Foramen Ligamentum longitudinale
intervertebrale Ligamentum anterius
Ligamentum longitudinale B. Posterior view supraspinale
posterius
Ligamenta Discus intervertebralis
intertransversaria Ligamentum Ligamentum
longitudinale C7
interspinalis Pediculus arcus vertebrae
anterius
Ligamentum
costotransversarium T1 Processus
superius Processus spinosus
transversus
Rami dorsales: Rami ventrales:
Ligamenta L4
capitis costae L4
L5 L5
radiatum
Costae B. Posterior view
Ligamentum
costotransversarium
superius Lamina
Costae arcus
Ligamentum
supraspinale vertebrae
Sacrum
Ligamentum
Disci costotransversarium
intervertebrales laterale Pediculus
Ligamenta Ligamentum arcus
intertransversaria longitudinale vertebrae
posterius

Processus spinosus

Lamina arcus vertebrae

T12 Processus transversus


Lamina arcus
vertebrae Ligamenta intertransversaria Ligamenta flava
L1
Capsula articulationis
zygapophysiales
Ligamentum iliolumbale

Ligamentum
supraspinale

T12
Ligamentum
sacroiliacum posterius
L1

Chapter 1 Chapter 1
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PLATE 1-12 Cutaneous Innervation of the Back Superficial Muscles of the Back PLATE 1-13

Linea nuchalis superior

Nervus occipitalis major


Musculus sternocleiodomastoideus Musculus splenius capitis
Nervus accessorius (XI)
Nervus occipitalis tertius Processus spinosus vertebra (C7)
Musculus splenius cervicis

Arteria transversa cervicis


Musculus trapezius Musculus levator scapulae
Cutis Musculus trapezius
Musculus rhombiodeus minor

Spina scapulae Musculus rhomboideus major


Rami cutanei posteriores
(rami dorsales C4–T6)

Musculus Musculus trapezius


deltoideus
Musculus deltoideus
Fascia infraspinata
Musculus teres major Fascia
infraspinata

Arteria et nervus
Musculus thoracodorsalis
teres major
Musculus latissimus dorsi

Rami cutanei posteriores Trigonum


(rami dorsales T7–T12) auscultationis

Musculus obliquus externus abdominis


Tela subcutanea Musculi erector spinae

Musculus
Musculus latissimus dorsi latissimus dorsi
Rami cutanei laterales, rami ventrales
(nervi intercostales) Musculus obliquus
externus abdominis
Musculus serratus anterior

Processus spinosus vertebra (T12)


Musculus serratus
Trigonum lumbale posterior inferior

Costa 12
Nervi clunium superiores Crista iliaca
(rami dorsales L1–L3)
Fascia thoracolumbalis
Crista iliaca

Nervi clunium medii


(rami dorsales S1–S3)

Chapter 1 Chapter 1
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PLATE 1-14 Deep Back Muscles, Superficial Dissection Deep Back Muscles, Deeper Dissection PLATE 1-15

Linea nuchalis superior


Protuberantia occipitalis externa Musculi rectus capitis posterior:
Protuberantia occipitalis externa Minus
Majus

Linea nuchalis superior Musculus obliquus capitis superior


Processus transversus (C1)
Tuberculum posterius atlantis (C1)
Tuberculum posterius atlantis Musculus obliquus capitis inferior
Processus spinosus (C2)
Musculi splenius Musculi interspinales cervicis
Musculus semispinalis capitis capitis et cervicis Musculi semispinales:
Capitis Musculi rotatores cervicis:
Musculus longissimus cervicis Thoracis Longus
Brevis
Processus spinosus
vertebra (C7) Musculus iliocostalis cervicis

Musculus iliocostalis Processus spinosus (C7)


thoracis

Musculus serratus
posterior superior

Musculi rotatores
thoracis:
Longus
Brevis

Musculi intercostales
externi

Musculus interspinalis thoracis


Musculus erector spinae: Musculus spinalis thoracis
Musculus iliocostalis
Musculus longissimus Musculi levatores costarum:
Musculus spinalis Musculus longissimus thoracis Longus
Musculi multifidi Brevis

Musculus iliocostalis lumborum

Musculus serratus
posterior inferior
Musculus interspinalis lumborum

Musculus obliquus Musculus obliquus Musculus intertransversarius


externus abdominis internus abdominis lateralis lumborum

Crista iliaca
Crista iliaca

Chapter 1 Chapter 1
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PLATE 1-16 Suboccipital Region Pattern of a Typical Spinal Nerve PLATE 1-17

A. Orientation

B. Oblique section

Nervus intercostalis (6), ramus cutaneus anterior:


Ramus medialis
Ramus lateralis

Pleura parietalis
Musculus trapezius Arteria occipitalis Nervus occipitalis major
Tela subcutanea

Musculus rectus capitis Cutis


posterior minor

Musculus rectus capitis


posterior major
Sternum

Arteria vertebralis Membrana intercostalis externa


Musculus intercostalis externus
Musculus obliquus Musculus transversus thoracis
Musculus intercostalis internus
capitis superior
Musculus intercostalis intimus
Musculus
sternocleiodomastoideus

Nervus suboccipitalis
Nervus intercostalis (6),
Musculus ramus cutaneus lateralis:
sternocleiodomastoideus Ramus anterior
Ramus posterior
Musculus obliquus
capitis inferior Corpus vertebrae (T6)

Nervus occipitalis minor Musculus splenius


capitis Ganglion sympathicum
Rami communicantes
Musculus semispinalis capitis Nervus occipitalis major albus et griseus
(ramus posterior, nervus
spinalis C2) Radix anterior
Musculus splenius capitis

Musculus trapezius Nervus occipitalis tertius Medulla spinalis


(ramus posterior, nervus
spinalis C3) Radix posterior
Ganglion sensorium
nervi spinalis
Musculus longissimus capitis Nervus spinalis (T6)
Scapula Ramus anterior
(nervus intercostalis)
Ramus posterior
Nervus spinalis (T6),
ramus posterior, ramus cutaneus
posterior
Ramus lateralis
Ramus medialis

Musculi dorsi proprii

Chapter 1 Chapter 1
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PLATE 1-18 Spinal Cord, Posterior View Superior Portion of the Spinal Cord PLATE 1-19

Os occipitale A. Orientation

Vertebra (C1)
Nervus spinalis (C1)
B. Dissection
Vertebra (C2)
Musculi splenius capitis et cervicis
Ligamentum denticulatum
Vertebra (C7)
Ganglion sensorium nervi spinalis
Vertebra (T1)

Pediculus arcus vertebrae (C5)


Musculus serratus
posterior superior Nervus spinalis (T1)

Dura mater
Dura mater spinalis et Arachnoidea mater
arachnoidea mater

Spatium subarachnoideum
Musculus erector spinae:
Musculus iliocostalis Fila radicularia, nervi spinales
Musculus longissimus (T2–T11)
(musculus spinalis removed)
Ramus anterior Pia mater on surface of
Ramus posterior medulla spinalis
Musculus serratus
posterior inferior Sulcus medianus posterior
Fila radicularia posterior
Conus medullaris

Nervus spinalis (L1)


Vertebra (T12) Arteria radicularis posterior
Nervus spinalis,
Termination of medulla spinalis radix posterior
Vertebra (L1) at discus intervertebralis L1/L2
Ligamentum denticulatum
Cauda equina

Arteriae spinales posteriores


Filum terminale internum Nervus spinalis,
radix anterior
Vertebra (L5)
Nervus spinalis (L5)
Os sacrum Ganglion sensorium nervi
Nervus spinalis (S1) spinalis
Os coxae Termination of dural sac Arteria intercostales
at S2 vertebral level posteriores, rami spinales

Pediculus arcus
Nervus spinalis (S5) vertebrae T3
Filum terminale externum
Nervus coccygeus
Os coccygis

Chapter 1 Chapter 1
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PLATE 1-20 Inferior Portion of the Spinal Cord Blood Supply of the Spinal Cord, Anterior View PLATE 1-21

A. Orientation B. Dissection

Arteriae spinales posterior


Vertebrae Arteria spinalis anterior Medulla spinalis
thoracicae
Dura mater
Arachnoidea mater
Dura mater et arachnoidea Ligamentum denticulatum Arachnoidea mater
mater Arteria radicularis posterior
Arteria intercostalis posterior, Arteria
Conus medullaris ramus corpus vertebrae intercostalis
Arteria intercostalis Arteria radicularis anterior posterior
et dura mater
posterior, ramus
spinalis
Arteriae radicularis Vertebrae lumbales

Cauda equina

Pediculus arcus
vertebrae

Filum terminale internum

Ganglia sensoria
nervi spinales
Os sacrum

Filum terminale externum

C. MRI (T2 weighted), sagittal view


Nervi
intercostales
Arteria intercostalis
Venae posterior, ramus Vena hemiazygos
basivertebrales dorsalis accessoria
Conus medullaris
Pars descendens
Corpora vertebrae Truncus sympathicus thoracica aortae
(L2, L3) et ganglion
Processus spinosus Ductus thoracicus
Liquor cerebrospinalis,
cisterna lumbalis Arteriae intercostales posterior
Discus
intervertebralis
Cauda equina Vena hemiazygos accessoria

Vena azygos

Os sacrum

Chapter 1 Chapter 1
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PLATE 1-22 Venous Drainage of the Vertebral Column and Spinal Cord Dermatomes PLATE 1-23

A. Sagittal view A. Anterior view B. Posterior view


CN V
C2
Plexus venosus C3
vertebralis externus C2
anterior C4
C5
C3 C6
Vena basivertebralis C7
Plexus venosus C4 C8
vertebralis internus T1
T1 T2
C6 T3
T2
T4
C5 T3 T5
T4 T6
Cutaway sections of: T7
Textus adiposus T5 T8
Corpus vertebrae (L1)
epidurale T6 T9
Dura mater T10
Arachnoidea mater T1 T7 T11
Medulla spinalis T12
T8 L1
L2 C6
T9
L3
T10 L4 C8
L1 T11 L5
Plexus venosus S1
vertebralis externus posterior T12
L2 S2
S3
S4
C6
S2–S3 S5 C7
C7 C8

L3

L4
B. Superior view Plexus venosus
vertebralis externus
S1

Vena spinalis mediana


Vena anterior
basivertebralis
Vena spinalis lateralis
Plexus venosus anterior
vertebralis internus
Vena radicularis anterior
Vena L5
intervertebralis Vena radicularis posterior
S2

Textus adiposus
epidurale Vena spinalis lateralis
posterior
Plexus venosus
vertebralis externus Vena spinalis mediana posterior S1
L5

Chapter 1 Chapter 1
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