Detailed data acquisition of thoracic vertebrae

Thoracic vertebra, located in the thoracic segment of the spine, has 12. From top to bottom, the vertebral body gradually increases, which is related to bearing. The thoracic vertebrae are involved in supporting the ribs and forming the thoracic cavity.

Chinese name: thoracic vertebra mbth: thoracic vertebra includes: vertebral body, pedicle, protuberant thoracic nerve: a total of 12 pairs of anatomical structure, action principle and mechanism, imaging structure, auxiliary structure, related diseases and treatment. Anatomical structure The cross section of vertebral body is heart-shaped, the upper thoracic vertebra is similar to cervical vertebra, and the lower thoracic vertebra is similar to lumbar vertebra. There are upper rib pits and lower rib pits at the posterior, upper and lower edges of the vertebral body, which are related to the rib head. The upper rib pit is generally larger than the lower rib pit. Vertebral foramen is round and smaller than cervical vertebra. In front of the end of transverse process, there is a circular transverse process costal recess related to costal tubercle. The articular surface of the upper and lower articular processes is approximately coronal (frontal), the articular surface of the upper articular process is flat, and the articular surface of the lower articular process is slightly concave. The spinous process of thoracic vertebra is long, extending backward and downward, overlapping each other in a tile shape. The spinous process of upper and lower thoracic vertebrae is flat, and the middle part is the most inclined. 1 The transverse diameter of the thoracic vertebral body is twice as large as the sagittal diameter, and the transverse diameter of the vertebral body below the second thoracic vertebra becomes smaller and the sagittal diameter increases. The transverse process gradually becomes shorter from top to bottom. The spinous process of the fifth to eighth thoracic vertebrae is the longest. 1 Thoracic vertebrae have circular upper costal recess and semicircular lower costal recess; The 9th and 10 thoracic vertebrae often have only one supracostal recess; No.65438 +0 1, No.65438 +02 has only one round costal recess, and the transverse process is short without costal recess. Mechanism of action: There are 12 vertebral bodies in the thoracic vertebra that bear compressive load, the vertebral arch mainly bears tensile load, and the vertebral lamina is short and wide in imbricate shape, which can prevent the thoracic vertebra from overstretching. The articular surface of the articular process joint is coronal, so it allows the thoracic vertebra to rotate axially in a certain range and has strong resistance to forward displacement. Spine, intervertebral disc and ligament jointly maintain the stability of thoracic spine. The stability of thoracic vertebra is obviously higher than that of other spinal regions such as thoracolumbar segment, which is mainly due to the existence of thoracic ring. At the front, costal cartilage and sternum form a sternoclavicular joint, and at the back, the costal head forms a joint with the corresponding vertebral body, intervertebral disc and transverse process. Imaging structure 1. Positive position. On the whole, 12 thoracic vertebrae are arranged neatly or slightly to the right. The vertebral body of each thoracic vertebra is square, and the upper vertebral body is smaller and gradually increases in the direction of * * * *. The upper and lower edges of the vertebral body are dense and flat, and sometimes double shadows appear. The double shadow is the result of the development of the anterior and posterior edges of the vertebral body respectively. Both sides of the vertebral body are slightly concave, so that its upper and lower ends protrude. In the shadow of each vertebral body, the elliptical dense circle on both sides is the shadow of pedicle section. Because the spinous process of thoracic vertebra is slender and different in inclination, the position of the end of spinous process is also different. Generally, the spinous process of the upper and lower thoracic vertebrae is slightly inclined, and its end sectional shadow often overlaps with the lower edge of the vertebral body; However, the spinous process of the middle thoracic vertebra is inclined greatly, and the shadow of its end section mostly falls on the upper half of the lower vertebral body. The shape of spinous process can be seen along the shadow of each end section. There is a layer of lamina between the upper end of spinous process and the root shadow of vertebral arch on both sides, and most of the laminae overlap with the vertebral body. The upper edges of the two vertebral plates together form a concave arc, and the two ends of the upper edge of this arc extend above the shadow of the pedicles on both sides to form an upper articular process. Near the lower corners of both sides of the vertebral body, the lower edge of the lamina shadow protrudes downward, forming the inferior articular process. The upper and lower articular processes of two adjacent thoracic vertebrae overlap to form an intervertebral joint. There are transverse processes protruding outward on both sides of the vertebral body. Intervertebral disc is underdeveloped, showing only transparent intervertebral space. All intervertebral spaces are neat, the upper space is narrow, and they widen slightly downward one by one. 2. Horizontal position. The whole thoracic vertebra is slightly kyphosis, which constitutes thoracic curvature. Each thoracic vertebral body is rectangular, sometimes with bilateral shadows, and the left and right edges are developed separately. Generally, the front edge of the vertebral body is relatively straight, and some people have a slight depression in the middle, so that the upper and lower ends of the vertebral body protrude slightly forward. With the increase of age, the protrusion is gradually obvious, which is called the upper and lower lips. The posterior edge of the vertebral body is also relatively straight, and the cortical interruption caused by nutrient vessel penetration can be seen in the middle. The vertebral body extends backward to the pedicle. Pedicle and costal capitulum overlap, most of which are unclear, but its lower edge, that is, the notch under pedicle, is obvious. The posterior end of the upper edge of the pedicle extends upward as a pointed process, that is, the superior articular process. The lower edge of the pedicle also extends backward and downward into a pointed protrusion, that is, the inferior articular process. The adjacent superior and inferior articular processes of two vertebrae form an intervertebral joint. There is a lamina between the upper and lower articular processes, and the posterior process is spinous process. The spinous process also overlaps with costal shadow, and only the roots develop clearly. Auxiliary structure 1, thoracic spinal nerve, thoracic nerve from thoracic segment of spinal cord, a total of 12 pairs, passing through the lower edge of thoracic vertebra in the same order, all with anterior and posterior branches. 2. Thoracic sympathetic nerve and spinal nerve are neck and neck, which can be called visceral nerve, regulating and directing visceral activities. Among them, the cardiothoracic nerve, the great splanchnic nerve, the minor splanchnic nerve and the lowest splanchnic nerve are in charge of the functions of heart, stomach, liver, gallbladder, pancreas, small intestine and kidney respectively. Therefore, dislocation of thoracic vertebrae is closely related to the whole visceral function and general health. Related diseases and treatment 1. According to Hanley-Eskay classification, thoracic spine fractures can be divided into compression fractures, fracture dislocations, burst fractures and burst dislocations. 2. Classification and treatment principle: Type A is sternal fracture+thoracic vertebra fracture without spinal nerve injury (Type A 1: sternal fracture+stable thoracic vertebra fracture without spinal nerve injury; Type A2: sternal fracture+unstable thoracic fracture without spinal cord nerve injury); Type B is sternal fracture+thoracic vertebra fracture with incomplete spinal nerve injury; Type C is sternal fracture+thoracic vertebra fracture with complete spinal nerve injury (the sternal fracture referred to in the classification does not include xiphoid fracture). Type A 1 is a stable fracture of thoracic vertebra, but the combination of sternal fracture often causes potential instability. In order to reduce the possibility of thoracic kyphosis aggravating or even delaying paralysis, sternal fractures should be fixed by surgery at an early stage, and thoracic fractures can be treated by non-surgery. This treatment has more clinical significance for patients with thoracic vertebral compression fracture and osteoporosis. Type A2 thoracic vertebra is an unstable fracture. Because the nerve function is intact, decompression surgery is not needed. The sternal fracture fixation based on posterior fixation can obtain good stability. Type B complicated with incomplete spinal nerve injury should be treated with decompression surgery, including total laminectomy, total decompression and subtotal decompression of spinal canal, bone grafting and fusion between laminae or vertebral transverse processes, and internal fixation with instruments, so as to create conditions for the recovery of spinal cord function. Reduction and surgical fixation of sternal fracture are beneficial to control the pain at the fracture site and maintain the stability of thoracic spine. Complete thoracospinal cord injury rarely reports the recovery of neurological function after decompression.