cervical vertebrae presentation by Dr Ela kinra

Cervical vertebrae

1. CERVICAL VERTEBRAE

2. INTRODUCTION There are seven cervical vertebrae They are identified by the presence of foramina transversaria They are divided in to typical and Atypical cervical vertebrae  Ist , 2nd and 7th are Atypical and 3rd to 6th are typical vertebrae.

3. TYPICAL CERVICAL VERTEBRAE Body Vertebral foramen Vertebral arch

4. BODY Small & broader Concave superior surface with upward projecting lip Anterior surface is beveled Inferior surface is saddle shaped Anterior border proiects downward & hide intervertebral disc Inter vertebral foramina (superior /inferior vertebral notches in pedicle)

5. Vertebral Foramen Larger than body Triangular in shape

6. 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

7. TRANSVERSE PROCESS Transverse process: Pierced bv 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 6th CV is large carotid tubercle

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

9. ATTACHMENTS AND RELATIONS Anterior & posterior longitudinal ligaments are attached to the upper and lower borders of the body . Upper borders and lower parts of the anterior surfaces of the lamina provide attachment to the ligament flava

10. FORAMEN TRANSVERSARIUM Foramen transversarium Vertebral artery Vertebral veins Branch of inferior cervical ganglion

11. Anterior tubercle: scalenus anterior, longus capitis oblique part of the longus colli Posterior tubercle- scalenus medius, scalenu posterior, levator scapula splenius cervicis longissimus cervicis,iliocostalis cervic Costotransverse bar- Ant. Primary Rami of the Corresponding cervical nerve.

12. FIRST CERVICAL VERTEBRAE / ATLAS Ring shaped No body No spine Short ant arch Long posterior arch Rt & Lt masses Transverse process

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

14. 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

15. ATTACHMENTS OF ATLAS VERTEBRAE Anterior tubercle- anterior longitudinal ligament On each side - longus colli Upper border of the anterior arch gives attachment to the anterior atlanto-occipital membrane Posterior tubercle provides attachment to the ligamentum nuchae in the median plane and gives origin to the rectus capitis posterior minor on each side

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

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

18. Ant. Arch Ant. atlanto-occipital membrane, Post. Arch Post. atlanto-occipital membrane T ransverse 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 nuchao Ant. Tubercle Ant. Longitudinal ligament

19. SECOND CERVICAL VERTEBRAE / AXIS Identified by the presence of dens or odontoid process (strong tooth like process projecting upwards from the body) 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

20. 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

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

22. ATTACHMENTS 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

23. Dense = odontoid process superior Articular facet Neural canal. Spinal cord Spine (short , not bifid) Interspinous ligament Ligamantum nuchae (tip) Lamina- Ligamantum flava Fora men trasversarium - Vertebral vessles (a. &v.) Alar ligamant Apical ligament. Transverse groove for tr ligament Post. Longitudinal ligament.

24. SEVENTH CERVICAL VERTEBRAE 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

25. ATTACHMENTS 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

26. 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