dr.

Ayodya
Heristyorini,
SUPERIOR
MSc, MSc
EXTREMITIES &
Kuliah Anatomi
DMS – FK UPNVJ VERTEBRAE
11 Februari 2020
OSTEOLOGY
SYSTEMA SKELETAL
• Skeleton axiale:
• Cranium
• Columna vertebralis
• Costae
• Sternum
• Sacrum
• Skeleton appendiculare:
• Superior extremities
• Inferior extremities
 • Vertebrae cervicales (7)

Columna Vertebralis • Vertebrae thoracicae (12)

• Vertebrae lumbales (5-6)
(26) • Sacrum (5 fused into 1)
• Os coccigeus (4-5 fused into 1)
 COLUMNA
VERTEBRALIS
• Vertebrae/-es = plural,
vertebra = singular
• Numbered in descending
order and region
• C1-C7
• T1-T12
• L1-L5
• 4 normal curves
Normal Curves of
Vertebral Column
• Cervical and lumbar curves
(secondary curves) are convex
(bulging out)
• Thoracic and sacral curves (primary
curves) are concave (cupping in)
• Primary curves are retained from the
original fetal curvature, while
secondary curvatures develop several
months after birth.
Normal Curves of Vertebral Column
• All curves are fully developed by
age 10. Secondary curves may
be progressively lost in old age.
• Function: more strength,
flexibility, ability to absorb shock
during walking, maintain
balance in the upright position,
and protect the vertebrae from
fracture.
• Clinical connection: abnormal
curves
Abnormal Curves of Vertebral Column

• Scoliosis: lateral bending & twisting of the vertebral column, usually in the thoracic region
• Kyphosis: sometimes called humpback or hunchback; is an increase in the thoracic curve; found in the
elderly, osteoporosis, tuberculosis of spine, rickets
• Lordosis: sometimes called hollow or sway back; is an increase in the lumbar curve; found in obesity, late
pregnancy
Typical Vertebra

• Corpus
• Arcus
• Pediculus arcus vertebrae
• Lamina arcus vertebrae
• Foramen vertebralis (forms canalis vertebralis)
• Processus spinosus
• Processus transversus
• Processus articularis superior et inferior
Typical
Vertebra
• Intervertebral discs
unite the bodies of
adjacent vertebrae
• Provides padding
and allows for
movements
between adjacent
vertebrae.
Clinical connection
• Arthritic conditions with age:
osteophytes, can lead to a
narrowing (stenosis) of the
vertebral canal.
• Herniated disc
VERTEBRAE CERVICALIS
• C1 = atlas
• C2 = axis
• Short transverse processes and
long spinous processes (bifid)
• The spinous process of C7 is the
longest of all, known as the
vertebra prominens and can be
felt at the back of the neck
 • supports the skull on top of the vertebral column
Atlas • does not have a body or spinous process
• ring-shaped
• consisting of an arcus anterior & arcus posterior
Atlas
 • dens or odontoid process
Axis • permits side-to-side movement of the head, as
when you move your head to signify “no.”
• Clinical connection: whiplash injury
C3-C7
• a spinous process, two
transverse processes, two
superior articular processes, and
two inferior articular processes.
• C7 spinous process is longer
than C2-C6 and may not
bifurcate.
VERTEBRAE
THORACALIS
• progressively larger from
superior to inferior
• easily identified by their
costal facets = articular
surfaces for the ribs
• A facet = a rib articulates
with the body of one
vertebra.
• Demifacets = the head of
a rib articulates with two
adjacent vertebral bodies.
Vertebra thoracalis
VERTEBRAE
LUMBALIS
• large block-like bodies
with kidney-shaped
articular surfaces.
• lack of transverse
foramina and of costal
articular facets.
• The spinal cord ends at
about the level of L1 or L2
and the nerve roots
continue below to
innervate the pelvis and
leg as the cauda equina.
Vertebra lumbalis
SACRUM & COCCIGEUS
SYSTEMA SKELETAL
• Skeleton axiale:
• Cranium
• Columna vertebralis
• Costae
• Sternum
• Sacrum
• Skeleton appendiculare:
• Superior extremities
• Inferior extremities
SUPERIOR EXTREMITIES
• Each upper limb skeleton
consists of 32 bones, which form
two distinct regions: (1) the
pectoral girdle and (2) the free
upper limb.
• The pectoral (shoulder) girdle
bones attach each upper limb to
the axial skeleton: the scapula
and clavicula
 • The medial end (sternal end) articulates with the
manubrium of the sternum = sternoclavicular joint
• The broad, flat, lateral end (acromial end) articulates
with the acromion of the scapula = acromioclavicular
OS CLAVICULA joint
• The inferior surface of the sternal end is a rough oval
depression for the costoclavicular ligament
Os clavicula
Clinical relevance: clavicle fracture
• The clavicle is one of the most
frequently broken bones in the
body.
• Because the junction of the
clavicle’s two curves is its
weakest point, the clavicular
midregion is the site most
frequently fractured
OS SCAPULA
• located on the posterior side of
the shoulder between the levels
of the second and seventh ribs a
bit lateral to the vertebral
column
• roughly triangular in shape
• does not articulate with the ribs
of the thoracic cage
Os scapula
Clinical relevance:
fracture & os acromiale
• Fractures of the scapula are
relatively uncommon, and if they do
occur, it is an indication of severe chest
trauma.
• In about 5 – 7.5% of the population the
distal end of the acromion is separated
from the main body (os acromiale)
• Sometimes associated with pain and may
contribute to impingement syndrome.
Clinical relevance: shoulder dislocation
OS HUMERUS
Os humerus
OS ULNAE
• Medial and parallel to radius
• The proximal end of the ulna is a
large, C-shaped trochlear notch
which articulates with the
trochlea of the humerus = elbow
joint.
• acts as the stabilising bone, with
the radius pivoting to produce
movement.
Os ulnae
Clinical relevance:
ulna fractures
• Monteggia’s Fracture –The proximal shaft
of ulna is fractured, and the head of the
radius dislocates anteriorly at the elbow.
• Galeazzi’s Fracture – A fracture to the
distal radius, with the ulna head
dislocating at the distal radio-ulnar joint.
OS RADIUS
• The proximal end of the radius
has a disc-shaped head
• Articulates in 4 places:
• Elbow joint
• Proximal radioulnar joint –
between the radial head, and the
radial notch of the ulna
• Wrist joint
• Distal radioulnar joint – between
the ulnar notch and the head of
the ulna
Radius joints
Os radius
• Radial tuberosity –
the place of
attachment of the
biceps brachii muscle.
• The radial shaft
expands in diameter
as it moves distally.
• Much like the ulna, it
is triangular in shape.
Clinical relevance: radius fractures
• Colles’ Fracture – The most
common type of radial fracture.
A fracture of the distal radius.
The structures distal to the
fracture (wrist and hand) are
displaced posteriorly = ‘dinner
fork deformity’.
• Smith’s Fracture – opposite of a
Colles’ fracture, as the distal
fragment is now placed
anteriorly.
OSSA CARPALIA
Clinical relevance: carpal tunnel syndrome
• The carpal bones form a U-shaped grouping. A strong ligament called
the flexor retinaculum spans the top of this U-shaped area to
maintain this grouping of the carpal bones.
• The long flexor tendons of the digits and thumb and the median
nerve pass through the carpal tunnel. Narrowing of the carpal tunnel
may give rise to a condition called carpal tunnel syndrome
OSSA
METACARPALIA
• The metacarpal bones
are numbered I to V (or
1–5), starting with the
thumb, from lateral to
medial.
• The first metacarpal
bone, at the base of the
thumb, is separated
from the other
metacarpal bones.
Ossa metacarpalia

• The bases articulate with the

distal row of carpal bones to
form the carpometacarpal
joints.
• The heads articulate with the
proximal phalanges to form
the metacarpophalangeal
(MP) joints.
• An interphalangeal joint is
one of the articulations
between adjacent phalanges
of the digits
Clinical relevance: metacarpals
fractures
• Boxer’s fracture – A fracture of the 5th metacarpal neck. It
is usually caused by a clenched fist striking a hard
object. The distal part of the fracture is displaced
anteriorly, producing shortening of the affected finger.
Sometimes involves fracture of knuckles and/or 4th
metacarpal
• Bennett’s fracture – A fracture of the 1st metacarpal base,
caused by forced hyperabduction of the thumb.
OSSA DIGITORUM
MANUS
• There are 14 phalanges in the five
digits of each hand.
• Like the metacarpals, the digits are
numbered I to V (or 1–5), beginning
with the thumb (pollex), from lateral
to medial.
• A single bone of a digit is referred to
as a phalanx
• The thumb has a proximal and distal
phalanx, while the rest of the digits
have proximal, middle and distal
phalanges.
REFERENCES
• Gray, H., 2017. Gray’s Anatomy: with original illustrations by Henry Carter.
London: Arcturus Publishing Limited.
• Tortora, G.J. & Nielsen, M.T. 2012. Principles of Human Anatomy 12th Edition. US:
John Wiley and Sons.
• Waldron, T. 2017. Anatomy Practical Handbook.
• White, T.D. & Folkens, P.A. 2005. The Human Bone Manual. Elsevier.
• White, T.D., Black, M.T., Folkens, P.A. 2011. Human Osteology. Elsevier.
• https://opentextbc.ca/anatomyandphysiology/
• https://teachmeanatomy.info/upper-limb/
• https://www.youtube.com/watch?v=kNxXudmTt-Y
• https://human.biodigital.com/
• https://radiopaedia.org
PRACTICE,
PRACTICE,
PRACTICE &
THANK YOU