Neuralgia

How the vertebrae in the spine are connected. Connections of the bones of the body - vertebrae, ribs and sternum. The arches of the vertebrae are connected using

It is considered impossible to imagine the structure of the human body without its individual formations that perform certain functions.

When considering the structure of the human body, the first attention is paid to the skeleton. There are 2 fundamental functions of the skeleton - mechanical and biological. In order not to go into specific anatomical details, we can simply note that the skeleton is the foundation for the entire human body, it is a support for internal organs and a lever that activates the human muscles, allowing independent motor functions, namely walking, running, jumping, swimming, etc.

The next important component of human anatomy is muscles. Muscles are the active part of the human locomotor system. It is the muscles that allow a full variety of movements between different parts of the skeleton, movement of a person, and fixation of individual parts of the body in various positions. The muscles also activate human speech, respiratory function, swallowing and chewing. In addition, muscles influence the location of internal organs, promote normal blood flow in the body, and take an active part in metabolism. The human body has about 600 different muscles.

Full functioning of the human body is impossible without internal organs. These organs are located inside the human body, mainly in the key cavities (thoracic and abdominal). At the same time, there are also organs that are located in the neck, head and pelvic cavity. The most direct function of the internal organs is to actively participate in the metabolic process. Internal organs usually include: digestive organs, respiratory organs, urinary organs and genital organs. Due to the fact that these organs pass food, air, urine and reproductive cells through themselves, they are basically tube-shaped. The remaining internal organs that do not have internal cavities are called parenchymal internal organs.

The material presented in the atlas of human anatomy is not limited to the idea of just the structure of the body, but shows the human body as a single whole.

a., aa. - arteria, arteriae (artery, arteries)

lig., ligg. - ligamentum, ligamenta (ligament, ligaments)

Vertebral connections

The vertebral bodies are connected to each other by intervertebral discs, discus intervertebrales. The intervertebral disc is a fibrocartilaginous formation. Externally, it is in the form of a fibrous ring, anulus fibrosus, the fibers of which run obliquely to adjacent vertebrae. In the center of the disc is the nucleus pulposus, which is a remnant of the dorsal chord. Thanks to the elasticity of the disc, the spinal column absorbs and absorbs shock energy that is transferred to it during walking, running and jumping.

The height of all intervertebral cartilages is 1/4 of the entire length of the spinal column. Their thickness is not the same everywhere: the greatest in the lumbar region, the smallest in the thoracic region. In the cervical and lumbar regions it is greater in front than behind, and in the thoracic region - vice versa.

Two longitudinal ligaments pass along the vertebral bodies: anterior and posterior. Front, lig. longitudinale anterius, located on the anterior surface of the vertebral bodies. It originates from the anterior tubercle of the arch of the atlas and stretches to the first sacral vertebra. Posterior longitudinal ligament, lig. longitudinable posterius, runs in the middle of the spinal canal from the body of the second cervical vertebra to the first sacral vertebra and limits the flexion of the spine. Both ligaments are firmly connected to the intervertebral disc using fibrous bundles.

Connection of vertebral arches. The gaps between the vertebral arches are tightened with yellow ligaments, ligg. flavae. Between the spinous processes of the vertebrae there are interspinous ligaments, ligg. interspinals, which at the tips of the processes pass into the supraspinous ligament, lig. supraspinal, which runs in the form of a round longitudinal cord along the entire length of the spinal column. In the cervical region above the seventh vertebra, the ligaments thicken in the sagittal plane, are located outside the spinous processes and are attached to the external occipital protrusion and crest, forming the nuchal ligament, lig. nuchae. The space between the transverse processes of the vertebrae is covered with intertransverse ligaments, ligg. intertransversaria. They reach their greatest development in the thoracic and lumbar regions of the spinal column.

Connection of vertebral processes. The lower articular processes of the vertebra above are connected to the upper articular processes of the vertebra below with the help of arcapophyseal combinations, articulationes zygapophysiales. According to the shape of the articular surfaces, they are flat, except for the lumbar spine, where they are cylindrical. The joint capsule is attached along the edge of the articular surfaces, limiting their movement, but their possible movements are of greater amplitude when minor displacements are added in one direction (for example, during flexion or extension of the spine as a whole).

Relevant sections:

All material is presented for informational purposes only.

Types of joints of the spinal column

In humans, due to upright posture and the need for good stability, the articulations between the vertebral bodies began to gradually transform into continuous articulations.

Since individual vertebrae were united into a single spinal column, longitudinal ligaments were formed that stretch along the entire spine and strengthen it as a single whole.

As a result of development, the structure of the human spinal column contains all possible types of compounds that can only be found.

Intermittent and continuous connections

Methods and types of connection of vertebrae in the spine:

syndesmosis - ligamentous apparatus between the transverse and spinous processes;
synelastosis – ligamentous apparatus between the arches;
synchondrosis - a connection between the bodies of several vertebrae;
synostosis - connection between the vertebrae of the sacrum;
symphysis - a connection between the bodies of several vertebrae;
diarthrosis - a connection between articular processes.

As a result, all articulations can be divided into two main groups: between the vertebral bodies and between their arches.

Connection of vertebrae to each other

Connections of vertebral bodies and arches

The vertebral bodies, which directly form the support of the entire body, are connected thanks to the intervertebral symphysis, which is represented by intervertebral discs.

They lie between two adjacent vertebrae, which are located along the length from the cervical spine to the connection with the sacrum. This cartilage occupies a quarter of the length of the entire spine.

A disc is a type of fibrocartilage.

In its structure, there is a peripheral (marginal) part - the fibrous ring, and a centrally located - nucleus pulposus.

There are three types of fibers in the structure of the annulus fibrosus:

The ends of all types of fibers are connected to the periosteum of the vertebrae.

The central part of the disk is the main spring layer, which has an amazing ability to shift when bent in the opposite direction.

In structure, it can be solid or with a small gap in the center.

In the very center of the disc, the main intercellular substance significantly exceeds the content of elastic fibers.

At a young age, the median structure is very well expressed, but with age it is gradually replaced by elastic fibers that grow from the fibrous ring.

The shape of the intervertebral disc completely coincides with the surfaces of the vertebrae facing each other.

There is no disc between the 1st and 2nd cervical vertebrae (atlas and axial).

The discs have unequal thickness throughout the spinal column and gradually increase towards its lower parts.

An anatomical feature is that in the cervical and lumbar regions the front part of the discs is slightly thicker than the back. In the thoracic region, the discs in the middle part are thinner, and in the upper and lower parts they are thicker.

Facet joints - connection of arches

Low-moving joints are formed between the upper and lower articular processes of the underlying and overlying vertebrae, respectively.

The joint capsule is attached to the edge of the cartilage of the joint.

The planes of the joints in each section of the spinal column are different: in the cervical - sagittal, in the lumbar - sagittal (antero-posterior), etc.

The shape of the joints in the cervical and thoracic regions is flat, in the lumbar region it is cylindrical.

Since the articular processes are paired and are located on both sides of the vertebra, they participate in the formation of combined joints.

Movement in one of them entails movement in the other.

Where is the dura mater of the spinal cord located? Read here.

Spinal ligaments

The structure of the spine has long and short ligaments.

anterior longitudinal - runs along the front and lateral surfaces of the vertebrae from the atlas to the sacrum, in the lower parts it is much wider and stronger, tightly connected to the discs, but loosely with the vertebrae, the main function is to limit excessive extension.

Fig.: anterior longitudinal ligament

posterior longitudinal - runs from the posterior surface of the axial vertebra to the beginning of the sacrum, stronger and wider in the upper sections; the venous plexus is located in the loose layer between the ligament and the vertebral bodies.

Fig.: posterior longitudinal ligament

yellow ligaments - are located in the space between the arches from the axial vertebra to the sacrum, are located obliquely (from top to bottom and from the inside to the outside) and limit the intervertebral foramina, are most developed in the lumbar region and are absent between the atlas and the axial vertebra, the main function is to hold the body during extension and reduction of muscle tension during flexion.

Fig.: yellow ligaments of the spine

interspinous - located in the space between the two spinous processes of adjacent vertebrae, most developed in the lumbar region, least in the cervical region;

supraspinous - a continuous strip running along the spinous vertebrae in the thoracic and lumbar regions, at the top it turns into a rudiment - the nuchal ligament;

nuchal - stretches from the 7th cervical vertebra upward to the outer crest of the occipital bone;

intertransverse - located between adjacent transverse processes, most pronounced in the lumbar region, least in the cervical region, the main function is to limit lateral movements, sometimes bifurcated in the cervical region or completely absent.

With a skull

The connection of the spine with the skull is represented by the atlanto-occipital joint, which is formed by the occipital condyles and the atlas:

The axes of the joints are directed longitudinally and somewhat closer anteriorly;
The articular surfaces of the condyles are shorter than those of the atlas;
The joint capsule is attached along the edge of the cartilage;
The shape of the joints is elliptical.

Fig.: atlanto-occipital joint

Movements in both joints are carried out simultaneously, since they belong to the type of combined joints.

Possible movements: nodding and slight lateral movements.

The ligamentous apparatus is represented by:

anterior atlanto-occipital membrane - stretched between the edge of the large foramen of the occipital bone and the anterior arch of the atlas, fused with the anterior longitudinal ligament, behind it the anterior atlanto-occipital ligament is stretched;
posterior atlanto-occipital membrane - stretches from the edge of the foramen magnum to the posterior arch of the atlas, has openings for blood vessels and nerves, is a modified ligamentum flavum, the lateral sections of the membrane form the lateral atlanto-occipital ligaments.

The connection of the atlas and axial joints is represented by 2 paired and 1 unpaired joint:

paired, lateral atlantoaxial - a low-moving joint, flat in shape, possible movements - sliding in all directions;
unpaired, median atlantoaxial - between the tooth of the axial vertebra and the anterior arch of the atlas, cylindrical in shape, possible movements - rotation around a vertical axis.

Median joint ligaments:

cover membrane;
cruciate ligament;
ligament of the apex of the tooth;
pterygoid ligaments.

Ribs with vertebrae

The ribs are connected at their posterior ends to the transverse processes and vertebral bodies through a series of costovertebral joints.

Fig.: joints between ribs and vertebrae

The rib head joint is formed directly by the rib head and the costal fossa of the vertebral body.

Basically (2-10 ribs) on the vertebrae, the articular surface is formed by two fossae, upper and lower, located respectively in the lower part of the overlying and upper part of the underlying vertebrae. Ribs 1, 11 and 12 connect to only one vertebra.

In the joint cavity there is a ligament of the rib head, which is directed towards the intervertebral disc from the crest of the rib head. It divides the articular cavity into 2 chambers.

The joint capsule is very thin and is additionally fixed by the radiate ligament of the rib head. This ligament stretches from the anterior surface of the costal head to the disc and the above and underlying vertebrae, where it ends in a fan shape.

The costotransverse joint is formed by the tubercle of the rib and the costal fossa of the transverse process of the vertebra.

Fig.: connections of the ribs to the spine

Only 1-10 ribs have these joints. The joint capsule is very thin.

Ligaments of the costotransverse joint:

superior costotransverse ligament - stretches from the lower surface of the transverse process of the vertebra to the crest of the neck of the rib lying below;
lateral costotransverse ligament - stretches from the spinous and transverse processes to the posterior surface of the rib lying below;
costotransverse ligament - stretched between the neck of the rib (its posterior part) and the anterior surface of the transverse process of the vertebra, located at the same level as the rib;
lumbocostal ligament - is a thick fibrous plate, stretches by the costal processes of the two upper lumbar vertebrae and the lower thoracic vertebrae, the main function is to fix the rib and strengthen the aponeurosis of the transverse abdominal muscle.

All joints of the head and neck of the rib are cylindrical in shape. They are functionally related.

During inhalation and exhalation, movements are carried out simultaneously in both joints.

Spine with pelvis

The connection occurs between the 5th lumbar vertebra and the sacrum through a joint - a modified intervertebral disc.

The joint is strengthened by the iliopsoas ligament, which extends from the posterior part of the iliac crest to the anterolateral surface of the 5th lumbar and 1st sacral vertebrae.

Additional fixation is provided by the anterior and posterior longitudinal ligaments.

Fig.: connection of the spine with the pelvis

Sacral vertebrae

The sacrum is represented by 5 vertebrae, normally fused into a single bone.

The shape resembles a wedge.

Located below the last lumbar vertebra and is an integral element of the posterior wall of the pelvis. The anterior surface of the sacrum is concave and faces the pelvic cavity.

<На ней сохранены следы 5 сращенных крестцовых позвонков – параллельно идущие поперечные линии.

On the sides, each of these lines ends with a hole through which the anterior branch of the sacral spinal nerves passes along with its accompanying vessels.

The posterior wall of the sacrum is convex.

It contains bone ridges that run obliquely from top to bottom - the result of the fusion of all types of processes:

The median ridge (the result of the fusion of the spinous processes) looks like four vertical tubercles, which can sometimes merge into one.
The intermediate ridge is located almost parallel (the result of the fusion of the articular processes).
Lateral (side) - the outermost of the ridges. It is the result of fusion of the transverse processes.

Between the intermediate and lateral crests there is a series of posterior sacral foramina through which the posterior rami of the spinal nerves pass.

Inside the sacrum, along its entire length, the sacral canal stretches. It has a curved shape, narrowed at the bottom. It is a direct continuation of the spinal canal.

Through the intervertebral foramina, the sacral canal communicates with the anterior and posterior sacral foramina.

Upper part of the sacrum - base:

has an oval shape in diameter;
connects to the 5th lumbar vertebra;
the anterior edge of the base forms a promontorium (protrusion).

The apex of the sacrum is represented by its lower narrow part. It has a blunt end to connect to the coccyx.

Behind it there are two small protrusions - the sacral horns. They limit the exit of their sacral canal.

The lateral surface of the sacrum has an auricular shape for connection with the iliac bones.

Why is combined injury of the spine and spinal cord dangerous? Read here.

What is fibrous bone dysplasia? See here.

Joint between the sacrum and coccyx

The joint is formed by the sacrum and coccyx, connected by a modified disk with a wide cavity.

It is reinforced with the following ligaments:

lateral sacrococcygeal - stretches between the transverse processes of the sacral and coccygeal vertebrae, in origin it is a continuation of the intertransverse ligament;
anterior sacrococcygeal – is the anterior longitudinal ligament that continues downwards;
superficial posterior sacrococcygeal – covers the entrance to the sacral canal, is an analogue of the yellow and supraspinous ligaments;
deep posterior – continuation of the posterior longitudinal ligament.

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Vertebral connections

Rice. 12. Facet joint (intervertebral joint between the II and III lumbar vertebrae):

1 - upper articular process of the third lumbar vertebra; 2 - lower articular process of the II lumbar vertebra;

3 - facet joint; 4 - yellow ligament; 5 - transverse process of the third lumbar vertebra;

6 - posterior longitudinal ligament; 7 - nucleus pulposus; 8 - fibrous ring; 9 - anterior longitudinal ligament

Rice. 13. Connections between the occipital bone and the I-II cervical vertebrae:

1 - pterygoid ligaments; 2 - occipital bone; 3 - occipital condyle; 4 - atlanto-occipital joint;

5 - transverse process of the atlas; 6 - lateral mass of the atlas; 7 - cruciate ligament of the atlas;

8 - lateral atlantoaxial joint; 9 - body of the II cervical vertebra

The joints of the vertebrae in the spinal column must, in addition to high mechanical strength, provide the spine with flexibility and mobility. These problems are solved thanks to a special method of articulation of the articular surfaces of the vertebrae, as well as the location of the ligaments that strengthen these connections. Intervertebral discs (discus intervertebralis) located between the vertebral bodies, consisting of a fibrous ring (annulus fibrosus) (Fig. 12) surrounding the so-called nucleus pulposus (nucleus pulposus) (Fig. 12), increase the resistance of the spine to vertical loads and absorb mutual displacements vertebrae

The connection of the articular processes of the vertebrae is called the arcuate joint (articulatio zygapophysialis) (Fig. 12). The joint is flat, formed by the articular surfaces of the upper articular processes of one vertebra and the articular surfaces of the lower articular processes of the other - overlying - vertebra. The articular capsule is attached along the edge of the articular surfaces. Each facet joint allows for slight gliding movements, but the addition of these movements along the entire length of the spine gives it significant flexibility.

1 - upper articular process of the third lumbar vertebra;

2 - lower articular process of the II lumbar vertebra;

3 - facet joint;

4 - yellow ligament;

5 - transverse process of the third lumbar vertebra;

6 - posterior longitudinal ligament;

7 - nucleus pulposus;

8 - fibrous ring;

9 - anterior longitudinal ligament

The arches of adjacent vertebrae are connected to each other by the yellow ligament (lig. flavum) (Fig. 12), the transverse processes are connected by intertransverse ligaments, the spaces between the spinous processes are occupied by the interspinous ligaments, forming the supraspinous ligament, passing over the tips of the spinous processes. In addition, the anterior longitudinal ligament (lig. longitudinale anterius) runs along the anterior surface of all vertebrae from the sacrum to the occipital bone (Fig. 12). The posterior surfaces of the vertebral bodies (from the sacrum to the second cervical) are connected by the posterior longitudinal ligament (lig. longitudinale posterius) (Fig. 12). The anterior and posterior longitudinal ligaments assemble the spinal column into one whole.

Connections between the occipital bone and the I-II cervical vertebrae

1 - pterygoid ligaments;

2 - occipital bone;

3 - occipital condyle;

4 - atlanto-occipital joint;

5 - transverse process of the atlas;

6 - lateral mass of the atlas;

7 - cruciate ligament of the atlas;

8 - lateral atlantoaxial joint;

9 - body of the II cervical vertebra

A special type of joint is present at the junction of the upper vertebrae with the base of the skull.

The articulation of the lateral masses of the first cervical vertebra (atlas) with the condyles of the occipital bone forms a paired elliptical atlanto-occipital joint (articulatio atlanto-occipitalis) (Fig. 13). The capsule of the atlanto-occipital joint is attached along the edge of the articular surfaces; the joint provides the ability to move in two planes - around the frontal axis (tilts the head back and forth) and around the sagittal axis (tilts left and right). The arches of the first cervical vertebra are connected to the occipital bone by the anterior and posterior atlanto-occipital membranes.

Rotation of the head is ensured by the peculiarities of the connection of the atlas with the II cervical vertebra. The atlas is connected to the II cervical vertebra through the paired lateral (articulatio atlanto-axialis lateralis) and unpaired median (articulatio atlanto-axialis medialis) atlantoaxial joints.

The flat lateral atlantoaxial joint is formed by the articular surfaces of the upper articular processes of the second cervical (axial) vertebra and the lower articular fossae of the lateral masses of the atlas. The extensive capsule of this joint, attached along the edge of the articular surfaces, provides the joint with a relatively high degree of freedom.

The median atlanto-axial joint is cylindrical in shape, formed by the connection of the tooth of the axial vertebra with the tooth fossa located on the anterior arch of the atlas. Thus, the massive process (tooth) of the II cervical vertebra serves as the axis around which the head rotates together with the I cervical vertebra.

The articulations of the occipital bone with the atlas, as well as the atlas with the second cervical vertebra, have the following ligaments: the ligament of the apex of the tooth of the axial vertebra, the pterygoid ligaments and the cruciate ligament of the atlas (lig. cruciforme atlantis) (Fig. 13).

Sagittal cut at the level of two lumbar vertebrae.

nucleus pulposus of the intervertebral disc;

anterior longitudinal ligament;

fibrous ring of the intervertebral disc;

superior articular process of the lumbar vertebra;

posterior longitudinal ligament;

articular capsule of the facet (intervertebral) joint;

Atlas of human anatomy. Akademik.ru. 2011.

See what “Vertebral connections” are in other dictionaries:

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Books

Bone joints: fixed and semi-movable joints, G. L. Bilic. Joints, vertebral joints and other bone joints are parts of the body on the health of which the quality of life depends. This complete publication on the anatomy of all types of bone joints is an indispensable... Read more Buy for 429 rubles
Bone joints: fixed and semi-movable joints, Bilich G.L., Kryzhanovsky V.A., Zigalova E.Yu.. Joints, vertebral joints and other bone joints are parts of the body on the health of which the quality of life depends. This complete publication on the anatomy of all types of bone joints is an indispensable... Read more Buy for 384 rubles
Bone joints: fixed and semi-movable joints, G. L. Bilich. Joints, vertebral joints and other bone joints are parts of the body on whose health the quality of life depends. This complete publication on the anatomy of all types of bone joints is an indispensable... Read more Buy e-book for 199 rubles

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Connections between vertebrae

The vertebrae are connected to each other using all types of connections: continuous (syndesmosis, synchondrosis and synostosis) and discontinuous (joints). There are connections between the vertebral bodies, their arches and processes.

CONNECTIONS OF VERTEBRAL BODIES

The vertebral bodies are connected to each other through continuous connections (synarthrosis, synarthroses) (Fig. 14) through:

1) fibrous tissue (syndesmosis): anterior longitudinal ligament (lig. longitudinale anterius) (1), which is located on the anterior surface of the vertebral bodies; posterior longitudinal ligament

(lig. longitudinale posterius) (2) - on the posterior surface of the vertebral bodies;

2) cartilage (synchondrosis): intervertebral discs (disci intervertebrales) (3) (after puberty). The intervertebral disc consists of the nucleus pulposus (nucleus pulposus) (4), located in the center and the fibrous ring (anulus fibrosus) (5) - on the periphery;

3) bone tissue (synostosis), which replaces the intervertebral discs between the sacral vertebrae (from 13 years of age).

Rice. 14. Connections between vertebrae:

Rice. 15. Joints of the cervical vertebrae

a - sagittal cut; b - intervertebral

disk (top view); c - thoracic vertebrae

(rear view, no vertebral arches)

UNION OF VERTEBRAL ARCHES AND PROCESSES

The vertebral arches and their processes are connected to each other continuously (synarthroses) and with the help of discontinuous connections - joints (diarthroses).

1. Continuous connections (Fig. 14, 15): between the vertebral arches - yellow ligaments

(ligamenta flava) (7); between the processes - interspinous ligaments (ligamenta interspinalia) (8),

supraspinous ligament (ligamenta supraspinalia) (in the cervical region called the nuchal ligament

(lig. nuchae)) (9), intertransverse ligaments (ligamenta intertransversaria) (10).

At the junction of the sacrum with the coccyx: sacrococcygeal ventral ligament (lig. sacrococcygeum ventrale); sacrococcygeal dorsal deep ligament (lig. sacrococcygeum dorsale profundum); sacrococcygeal dorsal superficial ligament (lig. sacrococcygeum dorsale superficiale).

2. Joints: facet joint (art. zygapophysialis) (11), which is formed by the upper and lower articular processes (processus articulares superiores et processus articulares inferiores) of adjacent vertebrae; lumbosacral joint (art. lumbosacralis);

sacrococcygeal joint (art. sacrococcygea). The facet joint is a combined joint, flat and inactive.

CONNECTION OF THE SPINAL COLUMN WITH THE SKULL

The discontinuous connection of the spinal column with the skull consists of a complex of 5 joints that allow movement of the head (skull) around three axes, as in a multi-axial (ball-and-socket) joint. Continuous connections are represented by membranes and ligaments (syndesmoses).

At the connection of the spinal column and the skull, the following joints are distinguished (Fig. 16):

1. The joint between the first cervical vertebra and the occipital bone - atlanto-zaty-

elbow joint (art. atlantooccipitalis).

2. Joints between the first and second cervical vertebrae - atlantoaxial joint

Rice. 16. Connections of the spinal column with the skull: a, b, c - rear view; g - top view

The atlantooccipital joint (art. atlantooccipitalis) (1) is a combined joint. Formed by the occipital condyles (condyli occipitales) and the superior articular fossa -

mi Atlanta (foveae articulares superiores).

Syndesmoses: anterior atlanto-occipital membrane (membrana atlantooccipitalis anterior); posterior atlanto-occipital membrane (membrana atlantooccipitalis posterior).

The atlanto-occipital joint is a condylar (art. bicondylaris), biaxial joint. Movements: flexion (flexio) and extension (extensio) around the transverse axis; abduction (abductio) and adduction (adductio) around the sagittal axis and circular movement (circumductio).

The atlantoaxial joint (art. atlantoaxialis) consists of three joints: the median atlantoaxial joint (art. atlantoaxialis mediana) (2) - between the tooth of the second cervical vertebra (dens axis) and the tooth fossa (fovea dentis) of the atlas and two lateral atlanto-axial joints ( artt. atlantoaxiales laterales) (3) - between the lower articular fossa of the atlas and the upper articular surfaces of the second cervical vertebra (combined joint).

Syndesmoses: transverse ligament of the atlas (lig. transversum atlantis) (4); cruciate ligament of the atlas (lig. cruciforme atlantis) (5); pterygoid ligaments (ligamenta alaria) (6); ligament of the apex of the tooth (lig. apicis dentis) (7); covering membrane (membrana tectoria) (8).

Movements: rotation of the atlas, and with it rotation of the head left and right around a vertical axis, as in a cylindrical uniaxial joint.

The spinal column (columna vertebralis) is formed by the vertebrae and their joints. Movement between two vertebrae is limited, but the entire spinal column performs a wide variety of movements due to the addition of movements of a large number of joints between the vertebrae. The following movements are possible in the spinal column:

1) flexion (flexio) and extension (extensio) around the frontal axis;

2) bending to the side: abduction (abductio) and adduction (adductio) around the sagittal axis;

3) rotation (twisting) (rotatio): turning left and right around a vertical axis.

4) circular motion (circumductio).

The most mobile areas are the cervical and lumbar spine. The thoracic region is the least mobile, which is explained by the following factors:

1) the location of the articular processes is close to the frontal

2) thin intervertebral discs;

3) a pronounced downward inclination of the vertebral arches and spinous processes.

The spinal column is a flexible and elastic formation and has physiological curves (Fig. 17), which serve for shock absorption, that is, to reduce shocks when walking and running on the brain and spinal cord, as well as on internal organs.

The bends are located in the sagittal plane: two forward lordoses (lordosis): cervical and lumbar (a, b); two back - kyphosis: thoracic and sacral (b, d).

The formative factor for the occurrence of bends is the action of muscles.

Cervical lordosis develops at 2–3 months, when the child begins to lift and hold his head.

Thoracic kyphosis appears in children due to the work of the muscles to maintain a sitting position at 5–7 months of life.

Lumbar lordosis and sacral kyphosis develop in connection with the function of the muscles that provide balance when a child stands and walks at 11–12 months.

In old age, there is a decrease in the flexibility and elasticity of the spinal column, a decrease in the thickness of the intervertebral discs, their calcification, progression

Rice. 17. Spinal column

thoracic kyphosis, decreased mobility.

The joints of the bones of the chest include: 1 - joints of the chest (artt. thoracis); 2 - sternum connections; 3 - rib connections; 4 - vertebral connections.

FROM THE CHEST PARTS

The joints of the chest include:

1) costovertebral joints (artt. costovertebrales), which include the joints of the head-

ki ribs (artt. capitis costae) and costotransverse joints (artt. costotransversariae) (Fig. 18, a);

2) sternocostal joints (artt. sternocostales) (Fig. 18, b);

3) intercartilaginous joints (artt. interchondrales).

The joints of the rib head (artt. capitis costae) (1) from the II to the X ribs are formed by the head of the rib and the costal fossae of the bodies of two adjacent vertebrae; the heads of the I, XI and XII ribs articulate with the complete fossae of the vertebrae of the same name).

Costotransverse joints (artt. costotransversariae) (Fig. 18, a) are formed by tuberosity

lump of the rib and the costal fossa of the transverse process of the vertebra (2).

Rice. 18. Joints of the chest:

a - costovertebral joint; b - connections of the ribs with the sternum

The joints of the heads of the ribs and the costotransverse joints form together a combined, rotational joint, movements in which are carried out around one axis directed along the neck of the rib (3): when rotating from the outside inward, the cartilaginous ends of the ribs move down (exhalation), when rotating from the inside out, the cartilaginous ends the ribs and sternum rise up (inhale).

Ligaments of the costovertebral joints: radiate ligament of the rib head (lig. capitis costae radiatum) (4); intraarticular ligament of the rib head (lig. capitis costae intraarticulare) (5),

in the joints of the heads of the I, XI and XII pairs of ribs there are no these ligaments; costotransverse ligament (lig. costotransversarium) (6).

The sternocostal joints (artt. sternocostales) (7) are formed by the cartilage of the true ribs (from II to VII) and the costal notches of the sternum; less commonly, these connections are represented by symphyses. The cartilage of the first rib articulates with the manubrium of the sternum by cartilaginous fusion

The cartilages of the VIII, IX and X ribs are connected at their ends through syndesmosis, and in the intercostal spaces between them intercartilaginous joints (artt. interchondrales) are formed (9).

Ligaments of the sternocostal joints: intra-articular sternocostal ligament (lig. sternocostale intraarticulare) (10) (for the joint of the second rib with the sternum); radiate sternal ligaments

(ligamenta sternocostalia radiata) (11); membrane of the sternum (membrana sterni) (12).

FROM THE STERMAL CONNECTION

The following connections of the sternum are found (Fig. 19): cartilaginous connections of the sternum: synchondrosis of the manubrium of the sternum (synchondrosis manubriosternalis) (1), less often - symphysis of the manubrium of the sternum (symphysis manubriosternalis) (after 30 years it can be replaced by bone tissue -

new); synchondrosis of the xiphoid process (synchondrosis xiphosternalis) (2).

WITH RIB CONNECTION

The connections of adjacent ribs are represented by syndesmoses: the outer intercostal membrane (membrana intercostalis externa) - between the costal cartilages; internal intercostal membrane (membrana intercostalis interna) - between the posterior ends of the ribs.

The connections of the thoracic vertebrae are discussed above.

The chest (compages thoracis) (thorax) (Fig. 19) is formed by 12 pairs of ribs, the sternum and thoracic vertebrae, interconnected by various types of joints.

The chest contains: trachea, bronchi, lungs, heart and large vessels, esophagus, lymphatic vessels and nodes, nerves, thymus gland.

In the chest there are:

1) upper thoracic outlet

(apertura thoracis superior) (3), limited by the jugular notch of the sternum, the first pair of ribs, the first thoracic vertebra;

2) lower thoracic outlet

(apertura thoracis inferior) (4), limited by the body of the XII thoracic vertebra, the XII pair of ribs, the anterior ends of the IX and X pairs of ribs, the edge of the cartilaginous costal arch, the edge of the xiphoid process;

3) costal arch (arcus costalis) (5);

4) substernal angle (angulus infrasternalis) (6);

5) intercostal space (spatia intercostalia) (7);

6) pulmonary grooves (sulci pulmonales),

located on the sides of the pectoral bodies

There are 3 chest shapes:

conical (inspiratory); flat (expiratory); cylindrical - intermediate between flat and conical shapes.

In people of a brachymorphic body type, a conical shape of the chest is observed: its lower part is wider than the upper, the substernal angle is obtuse, the ribs are slightly inclined downwards, the difference between the anteroposterior and transverse dimensions is small.

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The connection of the articular processes of the vertebrae is called the arcuate joint (articulatio zygapophysialis) (Fig. 12). The joint is flat, formed by the articular surfaces of the upper articular processes of one vertebra and the articular surfaces of the lower articular processes of the other, overlying, vertebra. The articular capsule is attached along the edge of the articular surfaces. Each facet joint allows for slight gliding movements, but the addition of these movements along the entire length of the spine gives it significant flexibility.

A special type of joint is present at the junction of the upper vertebrae with the base of the skull.

Arc adjacent vertebrae are connected by the yellow ligament (lig. flavum) (Fig. 12), the transverse processes are connected mezhpoperechnymi cords, the spaces between the spinous processes occupy the interspinous ligament, forming nadostistuyu ligament, passing over the tops of the spinous process. In addition, the front surface of the vertebrae from the sacrum to the occiput is anterior longitudinal ligament (lig. longitudinale anterius) (Fig. 12). The rear surface of the vertebral bodies (from the sacrum to the cervical II) are connected to the posterior longitudinal ligament (lig. longitudinale posterius) (Fig. 12). Anterior and posterior longitudinal ligament harvested spine in a single unit.

The joints of the body bones include connections of vertebrae, ribs and sternum.

In typical vertebrae, connections of bodies, arches and processes are distinguished.

I - vertebral body; 2 - intervertebral disc; 3 - anterior longitudinal ligament; 4 - radiate ligament of the rib head; 5 - joint of the rib head; 6 - superior articular process; 7 - transverse process; 8 - intertransverse ligament; 9 - spinous process; 10 - interspinous ligaments;
II - supraspinous ligament; 12 - lower articular process; 13 - intervertebral foramen

The bodies of two adjacent vertebrae are connected by intervertebral discs (disci intervertebrales). Their total number is 23. Such a disc is absent only between the I and II cervical vertebrae. The total height of all intervertebral discs is approximately a quarter of the length of the spinal column.

The disc is built primarily from fibrous cartilage and consists of two parts that gradually transform into each other. Along the periphery there is a fibrous ring consisting of concentric plates. The fiber bundles in the plates run obliquely, while in adjacent layers they are oriented in opposite directions. The central part of the disc is the nucleus pulposus. It consists of an amorphous substance of cartilage. The nucleus pulposus of the disc is displaced somewhat posteriorly, compressed by the bodies of two adjacent vertebrae and acts as a shock absorber, i.e., it plays the role of an elastic cushion.

The area of the disc is larger than the area of the adjacent vertebral bodies, therefore, normally, intervertebral discs protrude in the form of ridges beyond the edges of the vertebral bodies. Disc thickness (height) varies significantly along the spinal column. The greatest height of individual discs in the cervical region is 5-6 mm, in the thoracic region - 3-4 mm, in the lumbar region - 10-12 mm. The thickness of the disc changes in the anteroposterior direction: between the thoracic vertebrae the disc is thinner in the front, between the cervical and lumbar vertebrae, on the contrary, it is thinner in the back.

The vertebral bodies are connected anteriorly and posteriorly by two longitudinal ligaments. The anterior longitudinal ligament runs along the anterior surface of the vertebral bodies and intervertebral discs from the occipital bone to the first sacral vertebra. The ligament is firmly connected to the discs and periosteum of the vertebrae, preventing excessive extension of the spinal column.

The posterior longitudinal ligament runs along the posterior surface of the vertebral bodies from the clivus of the occipital bone and ends in the sacral canal. Compared to the anterior longitudinal ligament, it is narrower and widens in the area of the intervertebral discs. It loosely connects to the vertebral bodies and firmly fuses with the intervertebral discs. The posterior longitudinal ligament is an antagonist of the anterior one and prevents excessive flexion of the spinal column.

The vertebral arches are connected by the ligamentum flavum. Their color is due to the predominance of elastic fibers. They fill the gaps between the arches, leaving free the intervertebral foramina, limited by the upper and lower vertebral notches. The direction of elastic fibers in the ligaments is strictly regular: from the lower edge and inner surface of the arch of the overlying vertebra (starting from the second cervical) - to the upper edge and outer surface of the arch of the underlying vertebra. The yellow ligaments, like the intervertebral discs, have elasticity that helps strengthen the spinal column. Together with the bodies, vertebral arches and discs, they form the spinal canal, which contains the spinal cord with membranes and blood vessels.

Between the two adjacent spinous processes there are short interspinous ligaments, which are more developed in the lumbar region. Posteriorly, they directly pass into the unpaired supraspinous ligament, which ascends along the tops of all spinous processes in the form of a continuous cord.

In the cervical region, this ligament continues into the nuchal ligament, which stretches from the spinous process of the VII cervical vertebra to the external occipital protuberance. It has the appearance of a triangular plate located in the sagittal plane.

Between the transverse processes are the intertransverse ligaments. They are absent in the cervical region. When muscles contract, these ligaments limit the torso's sideways bending.

The only continuous connections between the vertebrae are the numerous intervertebral joints (articulationes intervertebrals). The inferior articular processes of each typical overlying vertebra articulate with the superior articular processes of the underlying vertebra. The articular surfaces on the articular processes of the vertebrae are flat, covered with hyaline cartilage, the articular capsule is attached along the edge of the articular surfaces. According to their function, articulationes intervertebrals are multiaxial combined joints. Thanks to them, the torso can be tilted forward and backward (flexion and extension), to the sides (adduction and abduction), circular movement (conical), torsional (twisting) and springing movement.

The fifth lumbar vertebra is connected to the sacrum using the same types of connections as free typical vertebrae.

Connection of the sacrum with the coccyx

Between the bodies of the V sacral and I coccygeal vertebrae there is also a discus intervertebral, inside of which in most cases there is a small cavity. This connection is called the symphysis. The sacral and coccygeal horns are connected by connective tissue - syndesmosis.

The lateral sacrococcygeal ligament is paired, it goes from the lower edge of the lateral sacral crest to the rudiment of the transverse process of the first coccygeal vertebra. It is analogous to the intertransverse ligaments.

The ventral sacrococcygeal ligament is located on the anterior surface of the sacrococcygeal joint and is a continuation of the anterior longitudinal ligament of the spinal column.

The deep dorsal sacrococcygeal ligament is located on the posterior surface of the body of the V sacral vertebra and the I coccygeal vertebra, i.e., it is a continuation of the posterior longitudinal ligament of the spinal column.

The superficial dorsal sacrococcygeal ligament begins from the edges of the sacral canal fissure and ends on the posterior surface of the coccyx. It almost completely covers the opening of the sacral fissure and corresponds to the supraspinous and yellow ligaments.

Connections of the 1st and 2nd cervical vertebrae to each other and to the skull

The atlantooccipital joint (articulatio atlantooccipitalis) is paired, ellipsoidal, biaxial, combined. Formed by the condyles of the occipital bone and the upper articular fossae of the first cervical vertebra. The articular surfaces are covered with hyaline cartilage, the capsule is free, attached along the edge of the articular surfaces. The atlanto-occipital joints are anatomically separate, but function together. Around the frontal axis, nodding movements are performed in them - tilting the head forward and backward. The range of movement reaches 45°. Around the sagittal axis, the head is tilted to the right and left in relation to the median plane. The volume of movement is 15-20°. Peripheral (conical) movement is also possible.

The anterior atlanto-occipital membrane is stretched between the main part of the occipital bone and the upper edge of the anterior arch of the atlas. The posterior atlanto-occipital membrane connects the posterior arch of the atlas to the posterior edge of the foramen magnum. These membranes close the wide gaps between the atlas and the occipital bone.

Between the I and II cervical vertebrae there are three joints: the median atlantoaxial joint (articulatio atlantoaxialis mediana), the right and left lateral atlantoaxial joints (articulationes atlantoaxiales laterales dextra et sinistra).

The median joint is formed by the anterior and posterior articular surfaces of the tooth of the axial vertebra, the articular fossa of the anterior arch of the atlas and the articular surface of the transverse ligament of the atlas. The anterior articular surface of the tooth articulates with the fossa of the tooth on the posterior surface of the anterior arch of the atlas. The posterior articular surface of the tooth articulates with the articular platform on the anterior surface of the transverse atlas ligament. This ligament is stretched behind the tooth of the axial vertebra between the medial surfaces of the lateral masses of the first cervical vertebra. It prevents the tooth from moving backward. From the central, slightly expanded part of the transverse ligament, the upper and lower longitudinal fascicles are directed up and down. The upper bundle ends on the anterior semicircle of the large (occipital) foramen, the lower bundle ends on the posterior surface of the body of the axial vertebra. These two bundles, together with the transverse atlas ligament, make up the cruciate ligament.

Thus, the tooth of the axial vertebra is located in an osteo-fibrous ring formed anteriorly by the anterior arch of the atlas, and posteriorly by the transverse ligament of the atlas.

The median atlantoaxial joint is cylindrical in shape, and movement in it is only possible around a vertical axis (rotation) passing through the tooth of the axial vertebra. The atlas rotates around the tooth along with the skull by 30-40° in each direction.

The lateral atlantoaxial joints (right and left) together make up the combination joints. Each is formed by the inferior articular fossa on the lateral mass of the atlas and the superior articular surface of the axial vertebra. The flat articular surfaces are covered with hyaline cartilage, the joint capsule is attached along the edge of the articular surfaces.

Movement in the right and left lateral atlantoaxial joints is carried out together with movement in the middle atlantoaxial joint. In these combined joints, only one type of movement is possible - rotation.

In total, 6 types of movements are performed in the atlanto-occipital and atlanto-axial joints - tilting the head forward and backward, tilting the head to the sides, circular (peripheral) movement and rotation. This equates to the maximum number of possible types of motion in a multi-axis ball and socket joint.

The medial and lateral atlantoaxial joints have additional ligamentous apparatus - the pterygoid ligaments and the ligament of the apex of the tooth. The pterygoid ligaments are two strong ligaments, each of which starts from the apex and lateral surface of the tooth, runs obliquely upward and attaches to the medial sides of the condyles. These ligaments are very strong and limit rotation at the medial atlantoaxial joint. The apical ligament is a thin band that runs upward from the apex of the tooth to the anterior edge of the foramen magnum.

At the back, from the side of the spinal canal, the median atlantoaxial and lateral atlantoaxial joints and their ligaments are covered with a wide, durable fibrous plate - the integumentary membrane. It comes from the clivus of the occipital bone down and continues into the posterior longitudinal ligament.

Spinal column

The spine, or spinal column (columna vertebralis), is represented by vertebrae and their joints. It includes the cervical, thoracic, lumbar and sacrococcygeal regions. Its functional significance is extremely great: it supports the head, serves as a flexible axis of the body, takes part in the formation of the walls of the chest and abdominal cavities and pelvis, supports the body, and protects the spinal cord located in the spinal canal.

The force of gravity perceived by the spinal column increases from top to bottom. The vertebral bodies are greatest in the sacral region; upward they gradually narrow to the level of the V thoracic vertebra, then widen again to the level of the lower cervical vertebrae and narrow again in the upper cervical region. The expansion of the spine in the upper part of the thoracic region is explained by the fact that the upper limb is fixed at this level.

When the vertebrae are connected to each other from the sides, 23 pairs of intervertebral foramina (foramina intervertebralia) are formed, through which the spinal nerves exit the spinal canal.

The length of the spinal column in an adult man of average height (170 cm) is approximately 73 cm, with the cervical region accounting for 13 cm, the thoracic region - 30 cm, the lumbar region - 18 cm, and the sacrococcygeal region - 12 cm. The average spinal column for a woman 3-5 cm shorter and amounts to 68-69 cm. In old age, the length of the spinal column decreases. In general, the length of the spinal column is about 2/5 of the total length of the body.

The spinal column does not occupy a strictly vertical position. It has bends in the sagittal plane. Curves that are convex to the rear are called kyphosis, and convex to the front are called lordosis. There are physiological lordoses - cervical and lumbar; physiological kyphosis - thoracic and sacral. At the junction of the fifth lumbar vertebra with the first sacral vertebra there is a significant protrusion, or promontory.

A - spinal column of a newborn; b — spinal column of an adult: I — cervical lordosis; II - thoracic kyphosis; III - lumbar lordosis; IV - sacral kyphosis; 1 - cervical vertebrae; 2 - thoracic vertebrae; 3 - lumbar vertebrae; 4 - sacrum and coccyx; 5 - thoracic vertebra

Kyphosis and lordosis are a characteristic feature of the human spinal column: they arose in connection with the vertical position of the body and are optimally expressed in an adult performing the command “at attention” (military posture). In this case, the perpendicular, lowered from the tuberculum anterius atlantis, crosses the bodies of the VI cervical, IX thoracic and III sacral vertebrae and exits through the apex of the coccyx. With sluggish posture, thoracic kyphosis increases, cervical and lumbar lordosis decreases.

Physiological lordosis and kyphosis are permanent formations. Thoracic kyphosis and lumbar lordosis are more pronounced in women than in men. The curves of the spinal column with a horizontal position of the body decrease somewhat, with a vertical position they stand out more sharply, and with increasing load (carrying heavy objects) they noticeably increase.

The formation of the curves of the spinal column occurs after birth. In a newborn, the spinal column looks like an arch, convexly facing backwards. At 2-3 months, the child begins to hold his head up, and cervical lordosis forms. At 5-6 months, when the child begins to sit up, thoracic kyphosis takes on a characteristic form. At 9-12 months, lumbar lordosis forms as a result of the human body adapting to an upright position when the child begins to walk. At the same time, an increase in thoracic and sacral kyphosis occurs. Thus, the curves of the spinal column are functional adaptations of the human body to maintain balance in an upright position.

Normally, the spinal column has no bends in the frontal plane. Its deviation from the median plane is called scoliosis.

The movements of the spinal column are the result of the functioning of numerous combined joints between the vertebrae. In the spinal column, when skeletal muscles act on it, the following types of movements are possible: bending forward and backward, i.e. flexion and extension; bending to the sides, i.e. abduction and adduction; torsion movements, i.e. twisting; circular (conical) movement.

The body bends forward and backward (flexion and extension) around the frontal axis. The amplitude of flexion and extension is 170-245°. When the body bends, the vertebrae bend forward, the spinous processes move away from each other. The anterior longitudinal ligament of the spinal column relaxes. Tension of the posterior longitudinal ligament, ligamentum flavum, interspinous and supraspinous ligaments inhibit this movement. At the moment of extension, the spinal column deviates posteriorly. At the same time, all its ligaments relax, except for the anterior longitudinal one, which becomes tense, limiting the extension of the spinal column. Intervertebral discs change their shape during flexion and extension. Their thickness decreases slightly on the inclined side and increases on the opposite side.

Tilts of the spinal column to the right and left (abduction and adduction) occur around the sagittal axis. The range of motion is 165°.

Torsion movement (twisting) of the spinal column occurs around a vertical axis. Its volume is 120°.

With a circular (conical) movement, the spinal column describes a cone, alternately around the sagittal and frontal axes. Springing movements (when walking, jumping) are performed due to the proximity and distance of neighboring vertebrae, while the intervertebral discs reduce shocks and tremors.

The volume and types of movements realized in each part of the spinal column are not the same. The cervical and lumbar regions are the most mobile due to the greater height of the intervertebral discs. The thoracic part of the spinal column is the least mobile, which is due to the lower height of the intervertebral discs, the strong downward inclination of the spinous processes of the vertebrae, as well as the frontal location of the articular surfaces in the intervertebral joints.

Rib connections

The ribs connect to the thoracic vertebrae, to the sternum and to each other.

The ribs are connected to the vertebrae using costovertebral joints (articulationes costovertebrales). These include the rib head joint and the costotransverse joint. The latter is absent from the XI and XII ribs.

The joint of the rib head (articulatio capitis costae) is formed by the articular surfaces of the upper and lower costal semi-fossae of two adjacent thoracic vertebrae (from II to X), the costal fossae of the I, XI, XII thoracic vertebrae and the articular surface of the rib head. In each of the joints of the rib head from II to X there is an intra-articular ligament of the rib head. It starts from the crest of the rib head and is attached to the intervertebral disc that separates the costal fossae of two adjacent vertebrae. The heads of the I, XI and XII ribs do not have a scallop. They articulate with the complete articular fossa located on the body of the corresponding vertebrae; therefore, these joints do not have an intraarticular ligament of the rib head. Externally, the joint capsule of the rib head is strengthened by the radiate ligament. Its bundles fan out and attach to the intervertebral disc and to the bodies of adjacent vertebrae.

The costotransverse joint (articulatio costotransversaria) is formed by the articulation of the articular surface of the tubercle of the rib with the costal fossa on the transverse process of the vertebra. The joint capsule is strengthened by the costotransverse ligament.

The ribs are connected to the sternum through joints and cartilaginous joints. Only the cartilage of the first rib directly fuses with the sternum, forming a permanent hyaline synchondrosis.

The cartilages of the II-VII ribs are connected to the sternum using the sternocostal joints (articulationes sternocostal). They are formed by the anterior ends of the costal cartilages and costal notches on the sternum. The articular capsules of these joints are a continuation of the perichondrium of the costal cartilages, which passes into the periosteum of the sternum. The radiate sternocostal ligaments strengthen the joint capsule on the anterior and posterior surfaces of the joints. Anteriorly, the radiate sternocostal ligaments fuse with the periosteum of the sternum, forming a dense membrane of the sternum.

The anterior ends of the false ribs (VIII, IX and X) are not directly connected to the sternum. Their cartilages are connected to each other, and sometimes there are modified intercartilaginous joints (articulationes interchondrales) between them. These cartilages form the costal arch on the right and left. The short cartilaginous ends of the XI and XII ribs end in the muscles of the abdominal wall.

The anterior ends of the ribs are connected to each other using the external intercostal membrane. The fibers of the outer membrane, filling the intercostal spaces, go obliquely down and forward. The opposite course of the fibers has an internal intercostal membrane, which is well expressed in the posterior sections of the intercostal spaces.

The joint of the rib head (I, XI, XII) is spherical in shape, and from II to X is saddle-shaped. The costotransverse joint is cylindrical in shape. Functionally, the joint of the rib head and the costotransverse joint are combined into a uniaxial rotational joint. The axis of movement passes through the centers of both joints and corresponds to the neck of the rib. The rear end of the rib rotates around the specified axis, while the front end rises or falls, since the rib is twisted. As a result of raising the anterior ends of the ribs, the volume of the chest increases, which, together with the lowering of the diaphragm, provides inhalation. When lowering the ribs, exhalation occurs due to the relaxation of the muscles and the elasticity of the costal cartilages. The elasticity of the chest in old age decreases, and the mobility of the ribs decreases significantly.

Whole chest

The chest (compages thoracis, thorax) is a bone-cartilaginous formation consisting of the sternum, 12 thoracic vertebrae, 12 pairs of ribs and their connections.

The rib cage forms the walls of the chest cavity, which contains the internal organs - the heart, lungs, trachea, esophagus, etc.

The shape of the chest is compared to a truncated cone, the base of which faces downwards. The anteroposterior size of the chest is smaller than the transverse size. The anterior wall is the shortest, formed by the sternum and costal cartilages. The lateral walls are the longest, they are formed by the bodies of twelve ribs. The posterior wall is represented by the thoracic spine and the ribs (up to their angles). The vertebral bodies protrude into the chest cavity, so on either side of them there are pulmonary grooves in which the posterior edges of the lungs are located.

At the top, the thoracic cavity opens with a wide opening - the upper aperture of the chest, which is limited by the manubrium of the sternum, the first rib and the body of the first thoracic vertebra. The plane of the superior aperture lies not horizontally, but obliquely: its anterior edge is lower, and therefore the jugular notch is projected at the level of the II-III thoracic vertebrae. The lower aperture of the chest is much wider than the upper one, it is limited by the body of the XII thoracic vertebra, the XII ribs, the ends of the XI ribs, the costal arches and the xiphoid process.

The spaces located between adjacent ribs, and in front between their cartilages, are called intercostal spaces. They are filled with intercostal muscles, ligaments and membranes.

The vessels, nerves, trachea and esophagus pass through the upper thoracic aperture. The lower aperture of the chest is closed by the thoraco-abdominal barrier - a thin muscle-tendon plate that separates the chest cavity from the abdominal cavity. Depending on the body type, there are three shapes of the chest: conical, cylindrical and flat. The conical shape of the chest is characteristic of the mesomorphic body type, cylindrical - dolichomorphic and flat - brachymorphic.

Joint diseases
IN AND. Mazurov

Skeleton of the body (spine, chest). Features of the structure of the cervical, thoracic, lumbar and sacral parts of the spinal column.

ANSWER: The skeleton of the body is formed by the spine and rib cage. The spine consists of 32-34 vertebrae: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 3-5 coccygeal. The vertebrae are located on top of each other and form the spinal column .

The vertebrae of different sections differ in shape and size. However, they all have common features. Each vertebra consists of a body located in front, and a vertebral arch located behind. The arch and posterior part of the vertebral body limit the wide vertebral foramen. The vertebral foramina of all vertebrae located one above the other form a long spinal canal in which the spinal cord lies.

Several processes extend from the vertebral arch. The unpaired spinous process goes backwards. The apices of many spinous processes can be easily felt in a person along the midline of the back. To the sides of the arch extend transverse processes and two pairs of articular processes: upper and lower. On the upper and lower edges of the arch, near its origin from the body, there are vertebral notches on each side of the vertebra. The inferior notch of the overlying and superior notch of the underlying vertebrae form the intervertebral foramina. The spinal nerves pass through these openings.

Features of the cervical vertebrae. The cervical vertebrae are small in size compared to the rest. In each of their transverse processes there is a small round hole for the passage of the vertebral artery, which supplies blood to the brain. The bodies of the cervical vertebrae are low, the upper articular processes face upward, the lower ones face downward. The length of the spinous processes increases from the II to the VII vertebrae, their ends are bifurcated (except for the VII vertebra).

The I and II cervical vertebrae are significantly different from the rest. They articulate with the skull and bear the weight of the head. The first cervical vertebra, or atlas, lacks a spinous process. The middle part of the body of the atlas separated from it and grew onto the body of the second vertebra, forming it tooth. The atlas has lateral thickenings - lateral masses. Instead of articular processes of the atlas, there are articular fossae on the upper and lower surfaces of its lateral masses. The upper ones serve for articulation with the skull, the lower ones - with the II cervical vertebra.

The second cervical vertebra is called the axial vertebra. When the head turns, the atlas, together with the skull, rotates around the tooth. The tooth is a process that is located on the upper surface of the body of the second vertebra. On the sides of the tooth there are two upward-facing articular surfaces that articulate with the atlas. On the lower surface of the axial vertebra there are lower articular processes for articulation with the third cervical vertebra.

The VII cervical vertebra has a long spinous process, which can be felt under the skin at the lower border of the neck.

Thoracic vertebrae. The 12 thoracic vertebrae connect to the ribs. For this purpose, on both sides there are two pairs of costal fossae: on the lateral surfaces of the bodies for articulation with the heads of the ribs, as well as on the thickened ends of the transverse processes (only in the upper ten thoracic vertebrae) for articulation with the tubercles of the ribs corresponding to them. The spinous processes of the thoracic vertebrae are much longer than those of the cervical vertebrae and are directed sharply downward. This direction of the spinous processes prevents extension of the thoracic spine. The bodies of the thoracic vertebrae are larger than those of the cervical vertebrae and increase in size from top to bottom. The vertebral foramina have a rounded shape.

The five lumbar vertebrae are distinguished by their large body sizes and the absence of costal fossae. The transverse processes are relatively thin and long. The vertebral foramina are triangular in shape. The short spinous processes are located almost horizontally. The structure of the lumbar vertebrae ensures greater mobility of this part of the spine.

The five sacral vertebrae in an adult have fused to form a single sacral bone. The anterior surface of the sacrum is concave, showing two rows of round pelvic sacral foramina (four on each side). The posterior surface of the sacrum is convex, on it there are five longitudinal ridges formed due to the fusion of the spinous processes (median ridge), articular processes (right and left intermediate ridges) and transverse processes (lateral ridges). Inward from the lateral ridges there are four pairs of dorsal sacral foramina, which communicate with the pelvic foramina and the sacral canal. On the lateral parts of the sacrum there are ear-shaped surfaces for articulation with the pelvic bones. At the level of the auricular surfaces behind there is a sacral tuberosity, to which ligaments are attached. The sacral canal, which is the lower part of the spinal canal, contains the filum terminale of the spinal cord and the roots of the lumbar and sacral spinal nerves. The anterior branches of the sacral nerves and blood vessels pass through the pelvic (anterior) sacral foramen. The posterior branches of the same nerves emerge from the spinal canal through the dorsal sacral foramen.

The coccyx (coccyx bone) consists of 3-5 (usually 4) fused rudimentary vertebrae.

ANSWER: There are connections between the vertebral bodies, between their arches and between the processes. The bodies of two adjacent vertebrae are connected by intervertebral discs. Each intervertebral disc has the shape of a biconvex lens, in which a peripheral part is distinguished - the fibrous ring formed by fibrocartilage, and a central part - the nucleus pulposus. With the help of connective tissue fibers, the fibrous ring of adjacent vertebrae is firmly connected to each other. The elastic nucleus pulposus is located inside the annulus fibrosus and acts as a shock absorber between the two vertebrae. The diameter of the intervertebral discs is larger than the diameter of the bodies of the connected vertebrae, so the intervertebral discs act as ridges. The thickness of the intervertebral disc in the thoracic region is 3-4 mm, in the most mobile lumbar region - 10-12 mm.

Along the anterior and posterior surfaces of the vertebral bodies along the spinal column, respectively, pass the anterior and posterior longitudinal ligaments, firmly fused with the intervertebral discs. The arches of adjacent vertebrae are connected using yellow ligaments consisting of elastic connective tissue. Therefore, they have a yellow color, greater strength and elasticity. The articular processes of adjacent vertebrae form intervertebral joints reinforced by ligaments. The spinous processes are connected to each other by the interspinous ligaments and the supraspinous ligament. The supraspinous ligament, well developed in the cervical region, is called the nuchal ligament. Between the transverse processes are the intertransverse ligaments.

The connections of the sacrum with the coccyx are similar to the connections of the vertebral bodies. There is almost always a gap in the intervertebral disc of this joint, which often closes in people over 50 years of age.

Three bones are involved in the connections of the spine with the skull: the occipital, the atlas and the axial vertebra. The joints formed between these bones provide greater freedom of movement of the head around three axes, like a ball-and-socket joint.

The atlanto-occipital joint consists of two separate joints (right and left), that is, it is combined. The articular surfaces (ellipsoidal) of each joint are formed by the condyle of the occipital bone and the superior articular fossa of the cervical vertebra. Each joint is enclosed in a separate articular capsule, and together they are strengthened by the anterior and posterior atlanto-occipital membranes. In the atlanto-occipital joint, movements around the frontal and sagittal axes are possible. Flexion and extension occur around the frontal axis (head tilts forward by 20° and backward movement by 30°). Around the sagittal axis, head tilts to the sides are possible by 15–20°.

The three joints between the atlas and the axial vertebra combine to form the combined atlanto-axial joint. This joint is cylindrical in shape and movements are only possible around a vertical axis (rotation). Rotations of the atlas around the tooth are performed together with the skull by 30-40° in each direction.

The anterior articular surface of the tooth of the axial vertebra is adjacent posteriorly to the articular surface on the fossa of the tooth of the anterior arch of the atlas. The posterior articular surface of the tooth is in contact with the transverse ligament of the atlas.

The paired lateral atlantoaxial joint (combined) is formed by the glenoid fossa on the lateral mass of the atlas and the superior articular surface on the body of the axial vertebra. These joints are strengthened by two pterygoid ligaments, the cruciate ligament of the atlas and a strong fibrous covering membrane, attached above to the occipital bone, and below passing into the posterior longitudinal ligament. Movements in the right and left lateral atlantoaxial joints are performed together with movements in the medial atlantoaxial joint.

15. Chest, structure of the sternum and ribs. Connection of the ribs to the vertebrae and sternum. Specific structural features of the spinal column and sternum in connection with the vertical position.

ANSWER: The chest is formed by twelve pairs of ribs, the sternum, and the thoracic spinal column connected to each other.

The ribs are long, flat, curved plates located to the right and left of the thoracic vertebrae. In the posterolateral sections, the ribs consist of bone tissue, and in the anterior sections, they are made of cartilage. The upper seven ribs are called true ribs because each of them reaches the sternum through its own cartilage. The ribs from the eighth to the tenth are false, since their cartilages grow together and with the cartilages of the lower ribs, forming a costal arch. The eleventh and twelfth ribs are called fluctuating; their anterior ends do not reach the sternum and are lost in the upper parts of the anterior abdominal wall. The bony part of the rib consists of the head, on which there is an articular surface for articulation with the vertebral bodies, neck and body. On the body of the ten upper ribs there is a tubercle, also equipped with an articular surface for articulation with the transverse process of the vertebra. On the inner surface of each rib along its lower edge there is a groove to which the intercostal nerve, artery and veins are adjacent. In an adult, the ribs are directed from back to front and from top to bottom.

The sternum is a flat bone, in which three parts are distinguished: a wide manubrium at the top, an elongated body and the xiphoid process at the bottom. In the middle of the upper edge of the manubrium of the sternum there is a jugular notch, which is easily palpable in humans. On each side of the jugular notch are the clavicular notches for connection to the clavicles. On the lateral sides of the sternum there are costal notches for the attachment of the cartilage of the upper seven ribs. The xiphoid process has no notches, and the ribs are not attached to it.

Connections between the ribs and the vertebral column and sternum. The ribs are connected to the vertebrae by costovertebral joints. These include the joints of the rib heads and the costotransverse joints. Thus, the rib is attached to the vertebra at two points. The line connecting these points is the axis of rotation around which the rib rotates during breathing. As you inhale, the ribs rise and take a more horizontal position, due to which the chest increases in the frontal and sagittal planes. As you exhale, the ribs, on the contrary, lower and the chest shrinks.

The XI and XII ribs do not form costotransverse joints. The ribs articulate with the sternum using joints and cartilaginous joints. The cartilage of the first rib fuses with the sternum, forming synchondrosis. The cartilages of the II-VII ribs are connected to the sternum using the sternocostal joints, supported by ligaments. The anterior ends of the false ribs (VIII, IX, X) are not directly connected to the sternum; they are connected to the cartilage of the overlying ribs by intercartilaginous joints and form a costal arch.

The chest as a whole. The rib cage is an osteochondral formation consisting of the thoracic vertebrae, twelve pairs of ribs and the sternum, connected to each other. The chest has four walls (anterior, posterior and two lateral) and two openings (upper and lower apertures). The anterior wall is formed by the sternum and costal cartilages, the posterior wall by the thoracic vertebrae and posterior ends of the ribs, and the lateral walls by the ribs. The ribs are separated from each other by intercostal spaces.

The superior aperture is limited by the upper edge of the sternum, the first ribs and the anterior surface of the first thoracic vertebra. The anterolateral edge of the lower aperture, formed by the connection of the anterior ends of the VII-X ribs (false), is called the costal arch. The right and left costal arches limit the sides of the substernal angle, which is open downwards. On the sides behind, the lower aperture is limited by the twelfth ribs and the twelfth thoracic vertebra. The trachea, esophagus, vessels, and nerves pass through the upper aperture.

The inferior aperture is closed by a diaphragm, which has openings for the passage of the aorta, esophagus and inferior vena cava. The human chest is shaped like an irregular truncated cone. It is expanded in the transverse direction and flattened in the anteroposterior direction; it is shorter in front than in the back.

Vertebral connections. In free typical vertebrae, connections of bodies, arches and processes are distinguished. The bodies of two adjacent vertebrae are connected by intervertebral discs, disci intervertebrales(Fig. 4.7). Their total number is 23. Such a disc is absent only between the I and II cervical vertebrae.

Rice. 4.7. Connections of adjacent free vertebrae (horizontal section between the II and III lumbar vertebrae).

1 – processus spinosus; 2 – lig. flavum; 3 – art. intervertebrales; 4 – processus transversus; 5 – annulus fibrosus; 6 – lig. longitudinale anterius; 7-nucleus pulposus; 8 – lig. longitudinale posterius.

intervertebral disc,discus intervertebralis it is built predominantly of fibrous cartilage, and consists of two parts that gradually transform into each other. Located on the periphery fibrous ring,anulus fibrosus, consisting of concentric plates. The central part of the disk is nucleus pulposus, nucleus pulposus consisting of an amorphous substance.

The vertebral bodies are connected anteriorly and posteriorly by two longitudinal ligaments. Anterior longitudinal ligament,lig. longitudinale anterius, runs along the anterior surface of the vertebral bodies and discs from the pharyngeal tubercle of the occipital bone and tuberculum anterior atlantis to the first sacral vertebra. The ligament is firmly connected to the discs and periosteum of the vertebrae, preventing excessive extension of the spinal column. Posterior longitudinal ligament, lig. longitudinale posterius, runs on the posterior surface of the vertebral bodies from the clivus of the occipital bone and ends in the sacral canal. This ligament is an antagonist of the anterior one and prevents excessive flexion of the spinal column.

The vertebral arches are connected by yellow ligaments, ligg. flava. Their color is due to the predominance of elastic fibers.

The yellow ligaments, like the intervertebral discs, have elasticity that helps strengthen the spinal column. Together with the bodies, vertebral arches and discs, they form the spinal canal, which contains the spinal cord with membranes and blood vessels.

Between two adjacent spinous processes there are short interspinous ligaments,ligg. interspinalia They are well developed in the lumbar region. Posteriorly they become unpaired supraspinous ligament, lig. supraspinale – these are longitudinal fibrous cords connecting the apices of the spinous processes (Fig. 4.8).

The continuation of the supraspinous ligament is nuchal ligament,lig. nuchae - triangular-shaped plate in the upper parts of the neck. It runs from the spinous process of the VII cervical vertebra to the external occipital protuberance. All ligaments connecting the spinous processes of the vertebrae inhibit flexion of the spinal column.

Between the transverse processes (Fig. 4.8, 4.9) there are intertransverse ligaments,ligg. intertransversaria, they are absent in the cervical region. When muscles contract, these ligaments limit the torso's sideways bending.