Cervical vertebra

Dr.Devi

1. Cervical vertebrae Dr . Devi 1 17-4-19

2. 2

3. Introduction Identified by the presence of foramina transversaria Seven cervical vertebrae 3 rd – 6 th are typical 1 st , 2 nd , 7 th – atypical 3

4. Typical cervical vertebrae Body Vertebral foramen Vertebral arch 4 Foramen transversarium Pedicle Ant tubercle Post tubercle Vertebral canal Spine lamina Superior articular facet Costotransverse bar Vertebral arch

5. Body Small & broader Concave superior surface with upward projecting lip Anterior surface is beveled 5

6. Inferior surface is saddle shaped Anterior border projects downward & hide intervertebral disc articular column Inter vertebral foramina (superior /inferior vertebral notches in pedicle) 6

7. Vertebral foramen Larger than body Triangular in shape 7 Vertebral foramen Bifid spine Transverse foramen

8. Vertebral arch Pedicles are directed backwards and laterally Superior and inferior notches are of equal sizes Laminae are relatively long and narrow, thinner above than below superior & inferior articular processes – form articular pillars , project laterally at the junction of pedicle and the lamina 8

9. Transverse process : Pierced by Foramen transversaria Each TP has two roots- ends as tubercle – ant & post tubercle Joined by costotransverse bar Costal element = tubercles + CT bar Site for articulation with ribs Ant tubercle of 6 th CV is large – carotid tubercle 9

10. Spine – short & bifid Notch is filled by ligamentum nuchae Gives origin to deep muscles of the back of the neck 10

11. Attachments and relations Anterior & posterior longitudinal ligaments are attached to the upper and lower borders of the body 11

12. Upper borders and lower parts of the anterior surfaces of the lamina provide attachment to the ligament flava 12

13. Foramen transversarium : Vertebral artery Vertebral veins Branch of inferior cervical ganglion 13

14. Anterior tubercle: scalenus anterior , longus capitis , oblique part of the longus colli 14

15. Posterior tubercle : scalenus medius , scalenus posterior, levator scapulae, splenius cervicis , longissimus cervicis,iliocostalis cervicis 15

16. Costotransverse bar – anterior primary rami of the corresponding cervical nerve 16

17. Ossification Ossifies from 3 primary & 6 secondary centers 17

18. 18 Body Intervertebral disc Transverse process Ant. Tubercle Post. Tubercle foramen transversarium Vertebral vessels (a. & v.) superior Articular facet post. Lamina Ligamentum flava Pedicle Spine (short & bifid) Interspinous ligament Ligamantum nuchae (tip) 10 Vertebral canal Spinal cord 1 8 2 3 6 5 5 7 7 4 3 2 4 10 7 9 8 Typical Cervical Vertebrae C3, C4, C5, C6

19. First cervical vertebra 19

20. First cervical vertebra- Atlas Ring shaped No body No spine Short ant arch Long posterior arch Rt & Lt masses Transverse process 20

21. Posterior arch – longer than ant arch Median posterior tubercle Lateral mass: superior articular facet, groove Atlanto -occipital joint 21

22. Inferior surface : inferior articular facet, circular, more or less flat, directed downward , medially and backward Articulates with corresponding axis vertebra to form atlanto -axial joint Medial surface has a roughened tubercle- transverse ligament transverse process projects laterally from lateral mass – long , acts as lever for rotatory movements of head , pierced by foramen transversarium 22

23. Attachments of Atlas vertebrae Anterior tubercle- anterior longitudinal ligament On each side –longus colli 23

24. Upper border of the anterior arch gives attachment to the anterior atlanto -occipital membrane 24

25. Posterior tubercle provides attachment to the ligamentum nuchae in the median plane and gives origin to the rectus capitis posterior minor on each side 25

26. Groove on the upper surface of the posterior arch is occupied by the vertebral artery and by the first cervical nerve 26

27. Transverse process- rectus capitus lteralis , superior oblique, inferior oblique , levator scapulae, splenius cervicis , scalenius medius 27

28. Ossification : 28 3 years 7 years

29. 29 Ant. Arch Ant. atlanto-occipital membrane Post. Arch Post. atlanto-occipital membrane Transverse process. superior articular facet Neural canal. Spinal cord Foramen transversarium Vertebral vessles Groove for vertebral a. Tubercle for tr. Ligament. Facet for dense of axis Post. Tubercle Ligamantum nuchae Ant. Tubercle Ant. Longitudinal ligament 1 1 1 2 2 2 3 3 4 4 5 6 6 7 7 9 11 10

30. Second cervical vertebra- Axis Identified by the presence of dens or odontoid process (strong tooth like process projecting upwards from the body ) 30

31. Axis – Body & Dens Superior surface of the body- fused with Dens Dens articulates anteriorly with ant arch of atlas, posteriorly with transverse ligament of atlas Superior articular facets Inferior surface – prominent ant margin which projects downwards 31

32. Axis- vertebral arch Pedicle- superior articular facet (circular directed upward and laterally) Inferior surface – deep wide inf vertebral notch Lamina- superior vertebral notch behind the sup articular process Lamina – thick & strong 32

33. Transverse process Spine : large , thick, very strong, grooved inferiorly, bifid 33

34. Attachments of Axis vertebrae 34

35. 35 Median atlanto axial ligament

36. Ant surface of body- longus coli, ant longitudinal ligament Post surface of body-post longitudinal ligament, cruciate ligament, membrana tectoria Tip of transverse process- levatoor scapulae, sclenus medius Spine –ligamentum nuchae, vertebral muscles 36

37. 37 1. Dense = odontoid process superior Articular facet Neural canal. Spinal cord Spine (short , not bifid) Interspinous ligament Ligamantum nuchae (tip) Lamina Ligamantum flava Foramen trnasversarium. Vertebral vessles (a. &v.) Alar ligamant Apical ligament. Transverse groove for tr. ligament Post. Longitudinal ligament. 1 2 2 5 5 4 5 6 6 9

38. 38 Cervical 7 (C7) Spinous process not bifid, large project posteriorly Vertebral Prominents

39. Seventh cervical vertebra – Vertebra Prominens Long ,thick, horizontal spinous process Not bifid , ends in a tubercle Transverse process- large , post root is larger than ant Ant tubercle is absent Small foramen transversarium - sometimes double/ absent 39

40. Attachment of vertebrae prominens Spine - ligamentum nuchae , trapezius , rhomboideus minor, serratus posterior superior, splenius capitus , semispinalis thoracis , spinalis cervicis , multifundus Transverse foramen: accessory vertebral vein, Posterior tubercle- suprapleural membrane Lower border- levator costarum 40

41. Ossification : Similar to typical to cervical vertebra Separate center for each costal process appears during sixth month of intrauterine life and fuses with the body and transverse process during fifth to sixth years of life 41

42. 42 1. Body Intervertebral disc Transverse process foramen transversarium Vertebral vein only superior Articular facet post. Lamina Ligamentum flava Pedicle Spine (long & not bifid) Interspinous ligament Ligamantum nuchae (tip) Vertebral canal Spinal cord 7 6 2 2 4 3 3 5 5 1 8 5 6 7 th Cervical Vertebrae

43. Conclusion 43 Characteristics C3-c6 c1 c2 c7 Body Ant arch Post arch Spinous process Bifid No Bifid Single long Superior articular facet Bean shaped Bean shaped oval Bean shaped

44. Thank you ! 44