{"id":5866,"date":"2021-06-07T20:29:30","date_gmt":"2021-06-07T18:29:30","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/lower-limb\/bones-of-the-lower-imb\/sacrum\/"},"modified":"2021-07-27T02:01:08","modified_gmt":"2021-07-27T00:01:08","slug":"sacrum","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/lower-limb\/musculoskeletal-system\/sacrum\/","title":{"rendered":"Sacrum"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">[into]The sacrum is a large wedge bone at the posterosuperior area of the cavity of the pelvis between two hip bones. Consists of five vertebrae and creates a wedge between two hip bones.[\/intro]<\/p>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Structure<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The sacral bone has main few parts in its structure which are the:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Base- located superiorly<\/li><li>Apex- integrates with the coccyx<\/li><li>Pelvic surface- facing the viscera<\/li><li>Dorsal surface<\/li><li>Lateral surfaces- both lateral sides of the sacral bone<\/li><li>Sacral canal<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Base<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">The base is the superior side of the bone.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The&nbsp;<strong>body<\/strong>&nbsp;is wide transversally, attached to the 5<sup>th<\/sup>&nbsp;vertebra of the lumbar region at the lumbosacral angle.&nbsp;<\/li><li>The superior articular&nbsp;<strong>processes<\/strong>&nbsp;are smooth and concave medially. Articulate with the 5<sup>th<\/sup>&nbsp;lumbar vertebra together with the base. Their lateral regions are attached to the mammillary processes of the lumbar bone.<\/li><li>Sacral&nbsp;<strong>promontory<\/strong>&nbsp;lies on the anterior side of the sacrum bone.&nbsp;<\/li><li>Oblique&nbsp;<strong>laminae<\/strong>, posteromedial sides continue the spinous tubercle.&nbsp;<\/li><li>Triangular&nbsp;<strong>foramens<\/strong>&nbsp;with short and diverge pedicles on the posterolateral regions.&nbsp;<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The&nbsp;<strong>ala<\/strong>&nbsp;is formed from the transverse process, has pedicles and articular processes. It projects laterally from the sacral body. The&nbsp;<strong>grooves<\/strong>&nbsp;on the smooth area created by the lumbosacral trunk.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The base has <strong>longitudinal&nbsp;ligaments<\/strong>&nbsp;on the anterior and posterior regions. The terminal fibers, which attached to the first sacral body on the dorsal and ventral sides. The upper borders of the laminae are attached to the lowest pair of&nbsp;<strong>flava ligament<\/strong>.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Apex<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">The apex articulates with the coccyx bone and blunts in its shape.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\"><strong>Pelvic surface<\/strong><\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">The pelvic surface is the anterior side of the sacral bone. It is concave on its anteroinferior surface until the second sacral vertebra where it becomes more convex.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Laterally to the sacral vertebrae located the anterior sacral foramina, four in number. Through these foramens pass the ventral rami of the sacral spinal nerve. The first three are passing to the piriformis.&nbsp;<\/li><li>Between the sacral bodies, remain four transverse ridges. These are costal elements.&nbsp;<\/li><li>Laterally and posteriorly from the foramens, the bone fuses with transverse expand process, the ala, to form the lateral surface of the sacrum.&nbsp;<\/li><li>The first two and a part of third sacral bodies are covered by peritoneum.&nbsp;<\/li><li>On the left side of the midline, it is attached to the sigmoid mesocolon.<\/li><li>From the rest of the third until the fifth sacral bodies, they attached to the rectum and the bifurcation of the superior rectal artery.&nbsp;<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Dorsal surface<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">The dorsal side is convex; the pelvic side is concave to increase the capacity inside the pelvis.<strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>On its posterosuperior surface there is four tubercles with the median sacral crest which connects all of them together.&nbsp;<\/li><li>The hiatus is located on the bottom below the last sacral crest and the posterior surface of sacral canal.&nbsp;&nbsp;&nbsp;&nbsp;<\/li><li>Laterally to the median crest there are four pairs of dorsal sacral lamina. Through these foraminae will pass dorsal ramus of sacral spinal nerve.&nbsp;<\/li><li>The intermediate sacral crest lies medially to the dorsal sacral foraminae and laterally to the median sacral crest. They also reffered as articular processes.&nbsp;<\/li><li>The edges of the two articular processes of the intermediate sacral crest, create the sacral cornua. The scaral cornua is connected by intercornual ligaments to the coccygeal cornua.&nbsp;<\/li><li>The transverse processes between each dorsal sacral lamina fuses together with the lateral sacral crest.&nbsp;&nbsp;<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Lateral surface<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">The lateral surface connects between the transverse processes and costal elements.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Superiorly wide (auricular surface) and narrowing as it descends. Covered by hyaline cartilage.<\/li><li>The auricular surface articulates with the ilium, it contains costal elements. Its shape reminds the letter L. The posterior surface if rough and attached to ligaments. Caudally it is curved. The auricular surface becomes grooved with age. There are more ligaments below the auricular surface, the sacrotuberous and sacrospinous, which attach between gluteus maximus muscle dorsal surface and coccygeus ventral surface.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Sacral canal<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">The sacral canal is the prominent triangular part on the dorsal surface of the sacrum. Its special structure formed by the foramina of the sacral vertebrae. <br>The sacral canal starts superiorly on the sacral base and ends inferiorly with the caudal opening, hiatus.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It contains cauda equina, spinal meninges and filum terminale.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The sacral vertebral foramens form the sacral canal and in section it has triangular shape.&nbsp;<\/li><li>Lateral walls contain intravertebral foramina, four in number. Via the foramens the canal connects with both, the pelvic and dorsal surfaces of the sacrum.&nbsp;<\/li><li>The spinal roots and filum terminale are passing through the subarachnoid and subdural matters. Then the filum terminale continues downwards, covered with meninges towards the coccyx.<\/li><li>Fifth spinal nerve also passes through the hiatus and grooves the lateral surface of the fifth sacral vertebra.&nbsp;<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Muscle attachments<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Pelvic surface<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<ul class=\"wp-block-list\"><li>Superolaterally- iliacus.<\/li><li>Second to fourth sacral bodies- piriformis.<\/li><li>Inferolaterally- coccygeus.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\"><strong>Dorsal surface<\/strong><\/h4>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<ul class=\"wp-block-list\"><li>Covers the multifidus.<\/li><li>Attached to aponeurosis of erector spinae along spinous and transverse tubercles of vertebrae.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\"><strong>Lateral surfaces<\/strong><\/h4>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<p class=\"wp-block-paragraph\">The lateral surfaces are located below the auricles on both lateral sides of the sacrum.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Dorsally- gluteus maximus.<\/li><li>Ventrally- coccygeus to sacrotuberous and sacrospinous ligaments.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Ossification<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<p class=\"wp-block-paragraph\">The ossification of the sacrum is similar to the typical vertebra.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>10-20 weeks: primary centrum and half of the vertebral arch.<\/li><li>6-8 prenatal months: costal elements of the first three segments, later more segments on the superolateral surface of the pelvic sacral foramens.<\/li><li>2-5 years: half vertebral arch fuses anteriorly with its costal element.&nbsp;<\/li><li>8 years: the process continues posteriorly.&nbsp;<\/li><li>Then every sacral body is covering with epiphysial plate of hyaline cartilage on its upper and lower surfaces.&nbsp;<\/li><li>It also conjoined laterally, the arches of the vertebrae, in the same way.<\/li><li>After puberty: the vertebral arches and costal elements are starting to merge with the ascent. Laterally costal epiphysial center spreads to auricles.&nbsp;<\/li><li>After 20 years: sacral bodies fuse at adjacent margins. Most parts of each disc stay unossified until middle life.&nbsp;<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_13\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Variants<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_13\">\n\n\n<ul class=\"wp-block-list\"><li>Asymmetry- \u201c<em>facet tropism<\/em>\u201d. Relation of the planes of two lumbosacral facet joints are changing. It creates asymmetry on the superior.<\/li><li>Lumbarization of 1<sup>st<\/sup>&nbsp;sacral vertebra- bodies of first and second sacral vertebrae do not fuse.&nbsp;<\/li><li>Six sacral vertebrae instead of five.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_14\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Differences between sexes<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_14\">\n\n\n<p class=\"wp-block-paragraph\">The main difference between females and males is that females have wider sacral alae.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_15\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\"><strong>Females<\/strong><\/h4>\n<\/span><span class=\"block-content\" id=\"contents_15\">\n\n\n<ul class=\"wp-block-list\"><li>Wider alae <\/li><li>Less curved <\/li><li>Auricle surfaces are smaller and more oblique <\/li><li>Shorter&nbsp;<\/li><li>More cylindrical<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_16\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\"><strong>Males<\/strong><\/h4>\n<\/span><span class=\"block-content\" id=\"contents_16\">\n\n\n<ul class=\"wp-block-list\"><li>More curved<\/li><li>Longer, narrower<\/li><li>Sometimes also have additional segments to the fifth<\/li><li>Longer cavity of the pelvis<\/li><li>More cuspidal<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_17\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">References and further reading <\/h3>\n<\/span><span class=\"block-content\" id=\"contents_17\">\n\n\n<ul class=\"wp-block-list\"><li>Susan Standring (ed.), Neil R Borley, et al. Grey&#8217;s Anatomy. 40th ed., Elsevier, 2008. p. 724<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Structure<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Base<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Apex<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\"><strong>Pelvic surface<\/strong><\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Dorsal surface<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Lateral surface<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Sacral canal<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Muscle attachments<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Pelvic surface<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\"><strong>Dorsal surface<\/strong><\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\"><strong>Lateral surfaces<\/strong><\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Ossification<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Variants<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Differences between sexes<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\"><strong>Females<\/strong><\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\"><strong>Males<\/strong><\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">References and further reading <\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>[into]The sacrum is a large wedge bone at the posterosuperior area of the cavity of the pelvis between two hip bones. Consists of five vertebrae and creates a wedge between two hip bones.[\/intro] Structure The sacral bone has main few parts in its structure which are the: Base- located superiorly Apex- integrates with the coccyx [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3966,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5866","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Sacrum &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/lower-limb\/musculoskeletal-system\/sacrum\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/lower-limb\\\/musculoskeletal-system\\\/sacrum\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/lower-limb\\\/musculoskeletal-system\\\/sacrum\\\/\",\"name\":\"Sacrum &#8211; 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