•     Part of the axial skeleton; strong, flexible rod
      Supports the head
      Gives base to the ribs
      Encloses the spinal cord
      
  o    Vertebrae
      Consists of 34 bones composing the spinal column
  •    Cervical-7 bones
  •    Thoracic-12 bones
  •    Lumbar-5 bones
  •    Sacral- 5 bones.
  •    Coccygeal-4 to 5 bones

      In the adult the vertebrae of the sacral and coccygeal regions are united into two bones, the sacrum and me coccyx
      
  o    Curvatures-from a lateraI view there are four curves, alternately convex and concave ventrally
      Two convex curves are the cervical and lumbar
      Two concave curves are the thoracic and sacral

  o    Vertebra morphology

      Each vertebra differs in size and shape hut has similar components
      Body-central mass of bone
  •    Weight bearing
  •    Fonns anterior part of the vertebra
  •    Encloses the vertebral foramen
      Pedicles of the arch-two thick columns that extend backward from the body to meet with the laminae of the neural arch 

•     Process (7)
  •    One spinous, two transverse, two superior articular, and two inferior articular
  o    Spinous process extends backward from the point of the union of thetwo laminae
  o    Transverse processes project laterally at either side from the junction of the lamina and the pedicle
  o    Articular processes arise near the junction of the pedicle and the lamina- superior processes project upward:inferior processes project downward
  •    Surfaces of the processes are smooth

  o    Inferior articular processes of the vertebra fit into the superior articular processes below
  o    Form true joints, but the contacts established serve to restrict movement

  Distinguishing features

  Cervical region- triangular shape

  •    All have foramina in the transverse process upper six transmit the vertebral artery
  •    Spinous processes are short
      o    C3 to C5 are bifurcated
      o    C7 is long-prominence felt at the back of the neck
  •    Have small bodies (except for C1 vertebra)
  •    C1 vertebra (atlas)
  o    No body
  o    Anterior and posterior arch and two lateral masses
  o    Superiorarticular processes articulate with the condyles of the occipital bone
  •    C2 vertebra (axis)-process on the upper surface of the body (dens) forms a pivot about which the axis rotates

  Thoracic region

  •    Presence of facets for articulation with the ribs (distinguishing feature)
  •    Processes are larger and heavier than those of the cervical region
  •    Spinous process is directed downward at a sharp angle
  •    Circular vertebral foramen

   Lumbar region
   
  •    Large and heavy bodies
  •    Four transverse lines separate the bodies of the vertebrae on the pelvic surface
  •    Triangular shape-fitted between the  halves of the pelvis
  •    Four pairs of dorsal sacral foramina communicate with four pairs of pelvic sacral foramina

  Sacral vertebrae 
  •    Five (sometimes six) vertebrae are fused in the adult to form the sacrum
  •    The sacrum articulates above with L5, laterally with the hip bones, and inferiorly with the coccyx.
  •    It has a roughly triangular appearance with a pelvic and dorsal surface, a lateral mass on each side, and a base and apex.
  •    An anesthetic for the spinal nerves may be injected extradurally through the sacral hiatus (caudal analgesia)
  •    The sacral canal (which contains the dura, cauda equina, and filum terminale) extends from the base to the sacral hiatus. 
  •    The apex of the sacrum may be fused with the coccyx.

  
  Coccygeal vertebrae

  •    Four to five modular pieces fused together
  •    Triangular shape with the base above and the apex below

  F Defects

  •    Lordosis-exaggerated lumbar concavity
  •    Scoliosis-lateral curvature of any region
  •    Kyphosis-exaggerated convexity in the thoracic region

CARTILAGE

There are 3 types:

Hyaline cartilage
Elastic cartilage
Fibrocartilage

Matrix is made up by: Hyaluronic acid

Proteoglycans

- In cartilage the protein core of the proteoglycan molecule binds through a linking protein to hyaluronic acid to form a proteoglycan aggregate which binds to the fibres

- In the matrix there are spaces, lacunae in which one to three of the cells of cartilage, chondrocytes, are found

- The matrix around the lacuna is the territorial matrix

- Type II collagen fibrils are embedded in the matrix

- The type of fiber depends on the type of cartilage

- Cartilage is surrounded by perichondrium which is a dense CT

- Apositional growth takes place in the perichondrium

- The fibroblasts of the perichondrium change to elliptic chondroblasts which later change to round chondrocytes

- Interstitial growth takes place around the lacunae

- Nutrients diffuse through the matrix to get to the chondrocytes   this limits the thickness of cartilage

Hyaline cartilage

Found: Rib cartilage,  articulating surfaces,  nose,  larynx, trachea, embryonic skeleton, Articulating cartilage has no perichondrium

 Bluish-white and translucent

Contains type II collagen that is not visible

Elastic cartilage

Found:  external auditory canal,  epiglottis

Similar to hyaline except that it contains many elastic fibres ,Yellow in colour,  Can be continuous with hyaline

Fibrocartilage

Found: Intervertebral disk, symphysis pubis

Always associated with dense CT,  Many collagen fibres in the matrix, No perichondrium

- Chondrocytes tend to lie in rows, Can withstand strong forces

Mylohyoid Muscle

• Origin: Mylohyoid line of the mandible.
• Insertion: Median raphe and body of the hyoid bone.
• Nerve Supply: Nerve to mylohyoid (branch of the trigeminal nerve, CN V3).
• Arterial Supply: Sublingual branch of the lingual artery and submental branch of the facial artery.
• Action: Elevates the hyoid bone, base of the tongue, and floor of the mouth; depresses the mandible.

The Medial Pterygoid Muscle

• This is a thick, quadrilateral muscle that also has two heads or origin.
• It embraces the inferior head of the lateral pterygoid muscle.
• It is located deep to the ramus of the mandible.

• Origin: deep head—medial surface of lateral pterygoid plate and pyramidal process of palatine bone, superficial head—tuberosity of maxilla.
• Insertion: medial surface of ramus of mandible, inferior to mandibular foramen.
• Innervation: mandibular nerve via medial pterygoid nerve.

• It helps to elevate the mandible and closes the jaws.
• Acting together, they help to protrude the mandible.
• Acting alone, it protrudes the side of the jaw.
• Acting alternately, they produce a grinding motion.

The Lateral Pterygoid Muscle

• This is a short, thick muscle that has two heads or origin.
• It is a conical muscle with its apex pointing posteriorly.

• Origin: superior head—infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone, inferior head—lateral surface of lateral pterygoid plate.
• Insertion: neck of mandible, articular disc, and capsule of temporomandibular joint.
• Innervation: mandibular nerve via lateral pterygoid nerve from anterior trunk, which enters it deep surface.

• Acting together, these muscles protrude the mandible and depress the chin.
• Acting alone and alternately, they produce side-to-side movements of the mandible.

3 basic functions
o    protection of respiratory tract during swallowing food/air pathways cross.
    epiglottis provides protection
o    control intra-thoracic pressure (in coughing) -    close off airway to build pressure then rapidly open to release stuff
o    production of sound (in speaking, singing, laughing)

Important structures

o    hyoid bone
o    thyroid cartilage
o    arytenoids cartilage: vocal and muscle process
    sits on slope on posterior side of cricoid - spin and slide
o    cricoid cartilage: signet ring
o    thyroepiglottic ligament

Membranes and ligaments

o    membrane: general; ligament: thickening of membrane
o    folds: free edges of membranes or ligaments
o    names: tell you where located

Important membranes:
    quandrangular/vestibular membrane—from epiglottis to arytenoids
•    inferior edge: false vocal fold
    thyrohyoid membrane
    conus elasticus = cricothyroid = cricovocal
•    superior/medial edge = vocal fold
•    vocal ligaments: true folds, top of cricothyroid membrane