BCME5030 Fundamental Biomedical Science BCME5030 生物醫學基礎
Vertebral Column 椎體
Vertebral column: Parts. Curvatures 椎體：部位。曲度
Vertebral column (spine) begins at the base of the skull. It consists of the following vertebrae: 椎體（脊椎）從頭顱底部開始。它由下列脊椎骨組成：
7
C
Cervical 頸椎
12
T
Thoracic 胸腔
5
L
Lumbar 腰部
5
S
Sacral (fused as sacrum) 骶骨（融合為骶骨）
4
Co 公司
Coccygeal (frequently fused as coccyx) 尾骨（經常融合為尾骨）
7 C Cervical
12 T Thoracic
5 L Lumbar
5 S Sacral (fused as sacrum)
4 Co Coccygeal (frequently fused as coccyx)| 7 | C | Cervical |
| :--- | :--- | :--- |
| 12 | T | Thoracic |
| 5 | L | Lumbar |
| 5 | S | Sacral (fused as sacrum) |
| 4 | Co | Coccygeal (frequently fused as coccyx) |
Fetal spine is curved backward; the curvature is defined as concave. In adults, the cervical and lumbar parts of the spinal are convex, whereas the thoracic and sacral parts are concave. 胎兒的脊椎向後彎曲；弧度被定義為凹陷。在成人，頸椎和腰椎部分是凸的，而胸椎和骶椎部分是凹的。
L5 makes a sharp angle with S1. L5 與 S1 成銳角。
midterm 期中
birth 出生
adult 成人
Vertebrae 脊椎
Parts of a typical vertebra: 典型脊椎骨的各個部分：
Notches on the pedicle form the intervertebral foramen. Spinal ganglion and nerve pass through this foramen. 椎弓根上的凹槽形成椎間孔。脊髓神經節和神經通過此孔道。
The vertebral foramina of all vertebrae form the vertebral canal. The spinal cord, root filaments, and meninges run in this canal. 所有脊椎骨的椎孔形成椎管。脊髓、根絲和腦膜在此管道中運行。
Vertebrae: Special features 脊椎骨：特徵
Spinous processes of C7 and T1 are visible on surface and are palpable. 表面可見 C7 和 T1 的棘突，並可觸摸到。
When extending the neck, C6 moves away from surface and becomes less palpable; C7 stays still and palpable. 伸展頸部時，C6 會離開表面並變得不易觸及；C7 則維持不動並可觸及。
Cervical vertebrae: each transverse process has a foramen. Vertebral a. ascends into the cranium through C6 to C1 foramina. 頸椎：每個橫突都有一個孔。椎體 a. 經由 C6 至 C1 孔上升至顱內。
Sacral vertebrae are completely fused, leaving only circular gaps (foramina) on the front and back for passage of the spinal nerves. 骶椎完全融合，只在前方和後方留下圓形空隙（孔道）供脊髓神經通過。
The spines and laminae of S5 (and 4) are absent; a membrane covers the vertebral canal instead. This part of the canal is called sacral hiatus. S5 (和 4) 的棘突和椎板不存在，取而代之的是覆蓋椎管的薄膜。這部分的椎管稱為骶骨裂隙。
Vertebrae: C1, C2 and suboccipital region 椎骨：C1、C2 和枕骨下區域
C2 vertebra (called axis) has a vertical process that projects into C1 (atlas) and is firmly bound to it be a transverse ligament. C2 脊椎 (稱為軸椎) 有一垂直突起伸入 C1 (寰椎)，並以橫向韌帶與之緊密結合。
Occipital bone rotates up and down on C1 , whereas C1 rotates sideway on C2. 枕骨在 C1 上上下旋轉，而 C1 則在 C2 上側向旋轉。
post atlanto-occipital layers of muscles membrane 寰枕後層肌膜
dura & arachnoid mater 硬脊膜和蛛網膜
At the back, in the head-neck boundary (suboccipital region), arrangement of structures from outside inward is: 在後方的頭頸邊界（枕骨下區域），結構的排列由外向內：
skin and superficial fascia 皮膚和表層筋膜
muscles (many), and nuchal lig. at midline 肌肉 (許多)，以及中線的頸韌帶
occipital bone, post. part of vertebrae, joined by post. atlanto-occipital membrane 枕骨，脊椎骨的後半部，由寰枕骨後膜連接
meninges, spinal cord, and spaces enclosed 腦膜、脊髓和所包圍的空間
tectorial membrane, with vertebral arteries running on it 椎間膜，椎動脈在其上運行
ligaments including transverse lig. 韌帶，包括橫向韌帶。
ant. part of vertebrae 椎骨
Some other ligaments line the outside and inside of the vertebrae. 其他一些韌帶則排列在脊椎骨的外側和內側。
Spinal cord. Subarachnoid space 脊髓。蛛網膜下腔
Developmental process is such that the vertebral column and meninges grow longer than the spinal cord. The spinal cord eventually grows only to vertebrae L1 /L2 level. 發育過程是脊椎骨和腦膜的長度比脊髓長。脊髓最終只長到脊椎骨 L1 / L2 的位置。
The combined dura and arachnoid wrapping is called dural / thecal sac. 結合硬膜和蛛網膜包覆的部分稱為硬膜/蛛網囊。
The subarachnoid space is larger below L1/L2 than above. This larger part is named lumbar cistern. L1/L2 以下的蛛網膜下腔比 L1/L2 以上的大。這個較大的部分稱為腰椎蓄水池。
Spinal root filaments lengthen in order to catch up with the growing vertebrae. The bundle of long filaments is called cauda equina. 脊椎根部的纖維會延長以趕上成長中的脊椎。這束長絲稱為「馬尾腱」。
The tough filament that consists mainly of pia is named filum terminalis. 主要由 pia 組成的堅韌細絲被命名為末端細絲。
Epidural anesthesia. Lumbar puncture 硬膜外麻醉。腰椎穿刺
Epidural anesthesia: anesthetic is injected into the epidural space at the sacral hiatus for surgical procedures. 硬膜外麻醉：將麻醉劑注入骶骨裂縫處的硬膜外腔，以進行外科手術。
Lumbar puncture: needle is injected between L3/4 or L4/5 for withdrawal of CSF (cerebrospinal fluid) for diagnosis, administration of medications, etc. (Not suitable for patients with high intracranial pressure.) 腰椎穿刺：針頭注射於 L3/4 或 L4/5 之間，以抽取 CSF（腦脊髓液）用於診斷、給藥等（不適合高顱內壓患者）。
Intervertebral disc 椎間盤
Adjacent vertebrae are united by: 相鄰的脊椎骨以下列方式結合：
ligaments between various parts of the vertebrae 脊椎骨各部分之間的韌帶
synovial joints between articular facets 關節面之間的滑膜關節
an intervertebral disc between vertebral bodies. 椎體之間的椎間盤。
This is due to degenerative changes resulting from wear-and-tear over age; may also be due to previous injuries. More common in L than C spine; rare in T. 這是由於年齡增長造成的磨損和撕裂引起的退行性變化，也可能是由於以前受傷所致。L 型脊椎比 C 型脊椎常見；T 型脊椎罕見。
Nucleus pulposus bulges out or protrudes, usually laterally. Nerve roots that run over it (arrow) may be compressed. 髓核凸出或突出，通常向側面突出。其上的神經根（箭頭）可能會受到壓迫。
If this happens at higher level and centrally, it may compress spinal cord. 如果發生在較高層次和中央位置，可能會壓迫脊髓。
As disk becomes narrow, changes like those in spondylosis may occur. 當椎間盤變窄時，可能會發生類似脊椎病的變化。
Showing prolapse (arrow) affecting an exiting L5L 5 nerve. 顯示脫垂（箭頭）影響出血性神經。
L1-L4 roots exit close to top of intervertebral foramen. Hence a prolapse will not affect the nerve roots exiting at its level, but will affect those passing over it. L1-L4 神經根的出口接近椎間孔的頂部。因此，椎體下垂不會影響在其水平出路的神經根，但會影響經過其上方的神經根。
Bone and disc conditions 骨與椎間盤狀況
Spondylosis: This is degenerative changes of the spine resulting from wear-and-tear with age; can also be due to previous injuries. 脊椎病：這是由於年齡增長造成的磨損而引起的脊椎退行性變化；也可能是由於以前受過傷害。
Disc becomes narrow 圓盤變窄
Articular cartilage wears away 關節軟骨磨損
Osteophytes form 骨增生形成
Foramen becomes narrow 孔變窄
Nerve may be compressed at F, or irritated at O . 神經可能在 F 處受到壓迫，或在 O 處受到刺激。
Spondylolisthesis: This is slipping forward of a vertebra (L4 or L5) over the underlying vertebra or sacrum, as a result of (a) fracture in the vertebra, or (b) degeneration of the articular facets or disc. 脊椎滑脫：這是由於 (a) 脊椎骨骨折，或 (b) 關節面或椎間盤退化，造成脊椎骨 (L4 或 L5) 在下層脊椎骨或骶骨上向前滑動。
When a spinal root or nerve is compressed, pain is felt on its dermatome, which can be verified with a dermatome map. 當脊髓根或神經受到壓迫時，疼痛會在其皮膜上感覺到，這可以用皮膜圖來驗證。
