VERTEBRAL COLUMN

A typical vertebra consists of:

 A body  anterior in position and is the major weight

bearing component of the bone.
o Increases in size from the Cervical vertebra (C 1) to
Lumbar vertebra (L 5)
 Vertebral foramen  Between the body and the arch  the
sum of the vertebral foramina constitutes the vertebral canal,
which houses the spinal cord.
 A vertebral arch  has several processes
 Articular
 Transverse
 Spinous
 The vertebral arch  anchored to the
posterior surface of the vertebral body by
two pedicles, which form the lateral pillars
of the vertebral arch.
 The roof of the vertebral arch is formed by
right and left laminae, which fuse at the
midline.
 Spinous process projects posteriorly and
generally inferiorly from the roof of the
vertebral arch.
 Transverse process extends laterally from the region where a lamina meets a
pedicle.
 From the same region, a superior articular process and an inferior articular
process articulate with similar processes on adjacent vertebrae.

 The vertebral arches of the vertebrae are aligned to form the lateral and
posterior walls of the vertebral canal, which extends from the first cervical
vertebra (CI) to the last sacral vertebra (sacral vertebra V).
o Bony canal contains the spinal cord and its protective membranes,
together with blood vessels, connective tissue, fat, and proximal parts
of spinal nerves.
Spinal Column

 made up of 33 vertebrae:
o 7 Cervical
o 12 Thoracic
o 5 Lumbar
o 5 Sacral vertebrae
fused known as the
sacrum.
o 4 Coccygeal vertebrae
which are rudimentary
in structure, fused into
a single coccyx.

Cervical vertebrae

 The first, second, and seventh cervical vertebrae are atypical.

First cervical vertebra (atlas)

 Supports the skull.

 Widest of the cervical vertebrae.
 Has no body and no spine but consists of anterior and posterior arches
and paired transverse processes.
 Articulates superiorly with the occipital condyles of the skull to form the
atlanto-occipital joints and inferiorly with the axis to form the
atlantoaxial joints.

The second cervical vertebra, or axis

 Characterized by the dens (odontoid process),

which projects superiorly from the body of the axis
and articulates with the anterior arch of the atlas,
thus forming the pivot around which the atlas
rotates.
 Supported by the cruciform, apical, and alar
ligaments and the tectorial membrane.
 it provides a side-to-side rotation, as in the head
movement indicating “no.”

Third to sixth cervical vertebrae

 Are typical cervical vertebrae and have short spinous

(bifid) processes and transverse processes with anterior
and posterior tubercles and transverse foramina for the
vertebral vessels.

Seventh cervical vertebra (C7)

 Called the vertebra prominens because it has a long

spinous process that is nearly horizontal, ends in a single
tubercle (not bifid).
  Provides an attachment site for the ligamentum nuchae, supraspinous ligaments, and numerous back muscles.
 Spinous process
o C3-C5 short and bifid (split in two parts);
o Process of C6 is long but that of C7 is longer (C7 is called vertebra prominens)
 NB  Each cervical vertebrae has a transverse process that has its own transverse foramen for the transmission
of the vertebral arteries from the subclavian artery to the brain

Thoracic Vertebrae

 Have the typical thoracic vertebrae, which are the second to the eighth thoracic vertebrae.
o The body is medium size and heart shaped.
o The vertebral foramen is small and circular.
o The spines are long and inclined downward.
o Costal facets are present on the sides of the
bodies for articulation with the heads of the
ribs.
 Superior costal facet on the body
articulates with the head of the
corresponding rib, whereas
 Inferior facet articulates with the
subjacent rib (just below).
o Costal facets are present on the transverse processes for articulation with the tubercles of the ribs (T11
and 12 have no facets on the transverse processes).

Lumbar

 The body is large and kidney shaped.

 The pedicles are strong and directed
backward.
 The laminae are thick.
 The vertebral foramina are triangular.
 The transverse processes are long and
slender.
 The articular surfaces of the superior
articular processes face medially, and those
of the inferior articular processes face
laterally.

Sacrum

 The sacrum consists of five rudimentary

vertebrae fused together to form a
wedge-shaped bone, which is concave
anteriorly.
 The upper border, or base, of the bone
articulates with the fifth lumbar
vertebra.
 The narrow inferior border articulates
with the coccyx.
o Laterally, the sacrum articulates
with the two iliac bones to form
the sacroiliac joints
  The anterior and upper margin of
the first sacral vertebra bulges
forward as the posterior margin of
the pelvic inlet and is known as the
sacral promontory.
 The vertebral foramina are present
and form the sacral canal.
 The laminae of the fifth sacral
vertebra, and sometimes those of
the fourth, fail to meet in the
midline, forming the sacral hiatus .
 The sacral canal contains the
o Anterior and posterior
roots of the sacral and
o Coccygeal spinal nerves,
o Filum terminale, and
o Fibrofatty material.
 It also contains the lower part of the subarachnoid space down as far as
the lower border of the second sacral vertebra.

Coccyx

 The coccyx consists of four vertebrae fused together to form a single,

small triangular bone that articulates at its base with the lower end of
the sacrum
 First coccygeal vertebra is usually not fused or is incompletely fused with
the second vertebra.

LIGAMENTS OF SPINAL COLUMN

 Ligaments reinforce and support joints

between the vertebrae in the spinal cord.
 They pass between vertebral bodies and interconnect components
of the vertebral arches.
 The ligaments include:
o Anterior longitudinal ligament
o Posterior longitudinal ligament
o Ligamenta Flava
o Suprasinous ligament- Ligamentum Nuchae
o Interspinous ligament
ANTERIOR AND POSTERIOR LIGAMENTS

 The anterior longitudinal ligament is attached superiorly to the base of the

skull and extends inferiorly to attach to the anterior surface of the
sacrum.
 The anterior longitudinal ligament is attached superiorly to the base of the
skull and extends inferiorly to attach to the anterior surface of the
sacrum.
 Both ligaments are attached along their length to the vertebral bodies and
intervertebral discs.

LIGAMENTA FLAVA

 The ligamenta flava, on each side, pass between the laminae of

adjacent vertebrae.
 These thin, broad ligaments consist mainly of elastic tissue and form part
of the posterior surface of the vertebral canal.
 Each ligamentum flavum runs between the posterior surface of the
lamina on the vertebra below to the anterior surface of the lamina of
the vertebra above.
 The ligamenta flava resist separation of the laminae in flexion and assist
in extension back to the anatomic position.

SUPRASPINOUS LIGAMENT AND LIGAMENTUM NUCHAE

 The supraspinous ligament connects and passes along the tips of the
vertebral spinous processes from vertebra C7 to the sacrum.
 From vertebra C7 to the skull, the ligament becomes structurally distinct
from more caudal parts of the ligament and is called the ligamentum
nuchae.
 The ligamentum nuchae is a triangular, sheet like structure in the
median sagittal plane:
o the base of the triangle is attached to the skull, from the
external occipital protuberance to the foramen magnum;
o the apex is attached to the tip of the spinous process of
vertebra C7;
o the deep side of the triangle is attached to the posterior
tubercle of vertebra CI and the spinous processes of the other
cervical vertebrae.
The ligamentum nuchae
supports the head.

It resists flexion and facilitates returning the

head to the anatomic position.

Provide attachment for adjacent muscles.

INTERSPINOUS LIGAMENTS

Interspinous ligaments pass between

adjacent vertebral spinous processes.

They attach from the base to the apex of each spinous process and blend with the
supraspinous ligament posteriorly and the ligamenta flava anteriorly on each side.
Joints of Vertebral Column

 The joints of the vertebral column include the

o Joints of vertebral bodies
o Joints of the vertebral arches
o Craniovertebral joints
o Costovertebral joints
o Sacroiliac joints.

Joints of the Vertebral Bodies

 The joints of the vertebral bodies are symphyses (secondary cartilaginous joints)
 Designed for weight bearing and strength.
 The articulating surfaces of adjacent vertebrae are connected by IV discs and ligaments and they provide strong
attachments between the vertebral bodies.
o The discs also serve as shock absorbers.
 Each IV disc consists of an anulus fibrosus, an outer fibrous part, composed of concentric lamellae of
fibrocartilage and a gelatinous central mass, the nucleus pulposus.
o Clinical Relevance
 Damage to the anulus fibrosus may allow the softer nucleus pulposus to bulge or herniate,
which may compress the segmental nerve roots.
 This is often referred to as a “slipped disc.”
 Symptoms of this condition will depend upon the level at which the rupture occurs and the
structures that are affected.

Joints of the Vertebral Arches

 The joints of the vertebral arches are the facet joints.

 These articulations are synovial plane joints between the superior
and the inferior articular processes of adjacent vertebrae.
 Each joint is surrounded by a thin, loose joint (articular) capsule,
which is attached to the margins of the articular surfaces of the
articular processes of adjacent vertebrae.
 Accessory ligaments unite the laminae, transverse processes, and
spinous processes and help stabilize the joints.
 The joints permit gliding movements.

Craniovertebral Joints
  The craniovertebral joints include the atlanto-occipital joints, between the atlas (C1 vertebra) and the occipital
bone of the cranium, and the atlantoaxial joints, between the C1 and the C2 vertebrae.
 These craniovertebral articulations are synovial joints that have no IV discs.

Atlanto-Occipital Joints

 Permit nodding of the head, (flexion and extension) indicating approval (the yes movement).
 Also allows a little lateral flexion (bending), rotation and sideways tilting of the head.

Atlantoaxial Joints

 There are three atlantoaxial articulations : two (right and left) lateral atlantoaxial joints between the lateral
masses of C1 and the superior facets of C2, and one median atlantoaxial joint between the dens of C2 and the
anterior arch and transverse ligament of the atlas.
 The median atlantoaxial joint is a pivot joint, whereas the lateral atlantoaxial joints are gliding-type synovial
joints.
 Movement at all three atlantoaxial joints permits the head to be turned from side to side, as occurs when
rotating the head to indicate disapproval (the no movement).
 During rotation of the head, the dens of C2 is the pivot, which is held in a socket formed anteriorly by the
anterior arch of the atlas and posteriorly by the transverse ligament of the atlas.
 Movement at all three atlantoaxial joints permits the head to be turned from side to side, as occurs when
rotating the head to indicate disapproval (the no movement).
 During rotation of the head, the dens of C2 is the pivot, which is held in a socket formed anteriorly by the
anterior arch of the atlas and posteriorly by the transverse ligament of the atlas.


Movements of Vertebral Column

 Flexion, extension, lateral flexion (bending), and rotation.