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Describe the anatomy of the sacrum

Sacral vertebrae and their costal elements fuse and form the
sacrum
Sacral vertebrae become progressively smaller when
descending
Triangular in outline
Wedge shaped superinferiorly and anteroposteriorly
Curved with a concavity towards the pelvis
Base
Upper surface of the first sacral vertebra forms the base
Broad/wider transversely
Lies anterosuperiorly at the marked lumbosacral angle
Anterior margin of the 1st sacral vertebra projects forward,
therefore it is called sacral promontory
Apex
Apex tapers down
Has an oval facet for articulation with the coccyx
Anterior/pelvic surface
Concave
Smooth
Four ridges mark the line of ossification
These ridges separate the bodies of the sacral vertebrae
Remnants of intervertebral discs lie deep to these four ridges
Lateral to these ridges are the four pelvic sacral foramina on
both sides
Anterior/pelvic sacral foramina is larger than the posterior
sacral foramina
Rounded bars of bone between two foramens on one side
represent the head and neck of the ribs

the other ¾ of the circumference is costal in origin The rounded bar of bone above the first foramen continues the curved line of the ilium to form the posterior part of the pelvic brim Fusion of the costal elements (shafts of the ribs) with each other form the lateral masses that can be seen lateral to the foramina Anterior rami of the upper four sacral nerves pass laterally from the anterior sacral foramina and therefore lateral masses are deeply intended by grooves Piriformis muscles arise: from the three ridges separating the anterior foramina from the lateral mass nearby Dorsal suface Convex Irregular Rough Marked by five prominent longitudinal ridges Median sacral ridge is the central ridge. medial to the posterior foramina is a line of irregular tubercles that represent fusion of articular processes of the adjacent vertebrae. alongside the sacral hiatus.The medial boundaries of anterior sacral foramina is made by the body of the sacral vertebra. (S5 has no spinous process) Inferior to the superior articular facet of S1 that articulates with the inferior articular facets of L5. The above mentioned low ridge forms the intermediate sacral crest and it is projected below. represents fused rudimentary three or four spinous processes of vertebrae projecting dorsally from the fused laminae of the vertebrae. to end in rounded sacral cornu .

Lateral to the superior articular facets. in which all the tips of the transverse processes are fused together making a longitudinal ridge The fused costal elements lie lateral to the lateral sacral crest The gutter between the median and lateral sacral crest is filled by erector spinae The posterior layer of the lumbar fascia that covers erector spinae is attached to both median and lateral crests The superior part of the lateral surface of the sacrum looks like an auricle (external ear). because of that this area is called auricular surface It’s covered with hyaline cartilage during life It is the site of synovial part of the sacro-iliac joint between the sacrum and ilium Deep fossae between the lateral sacral crest and the auricular surface gives attachment to the posterior sacroiliac ligament Sacral canal Sacral canal is the continuation of the vertebral canal in the sacrum Triangular in cross section Curves with the sacrum The gap above the first sacral laminae/the superior opening of the sacral canal is closed by the ligament flava attached to the laminae of L5 vertebrae Sacral hiatus is the inferior opening in to the sacral canal Sacral hiatus and the sacral cornua are in the shape of an inverted U Sacral hiatus result from absence of the laminae and spinous process of S5 and sometimes S4 . the prominence of bone represent the tips of transverse processes of S1 Below this is the lateral sacral line.

Depth of the sacral hiatus varies depending on howmuch of the spinous process and laminae of S4 are present The sacral cornua represents the inferior articular processes of the S5 Sacral cornua project inferiorly on each side of the sacral hiatus and are a helpful guide to its location .