VERTEBRAL COLUMN The vertebral foramen is large and triangular

 The superior articular processes have facets that face posteriorly and

33 Vetebrae o
7 cervical
superiorly
o 12 thoracic
o 5 lumbar  The inferior processes have facets that face inferiorly and
anteriorly
o 5 sacral (fused)
o 4 coccygeal (lower 3 are commonly fused)
 Note that:
Supports the skull, pectoral girdle, upper limb, thoracic cage and by way

of the pelvic girdle transmits weight to the lower limb
Protects the spinal cord  Facets are the same as your LO joint, knee joint, etc., it has an
articulating surface so it has a partner and lined with cartilage

GENERAL CHARACTERISTICS OF A VERTEBRA

 Vertebra shows regional differences
Common Structures

Vertebral Body (anteriorly)

Vertebral Arc (posteriorly) o
Vertebral Foramen
o Pair of pedicles – are notched on their superior and
inferior borders, forming the superior and inferior
vertebral notches General characteristics of a typical thoracic vertebra

 The superior notch of one vertebra and the 
The body is medium size and heart shaped.
The vertebral foramen is small and circular.
inferior notch of an adjacent vertebra together
form an intervertebral foramen  The spines are long, slender and inclined downward.

 These foramina, in an articulated skeleton, serve to  Costal facets are present on the sides of the bodies for
transmit the spinal nerves and blood vessels. articulation with the heads of the ribs.
o Pair of laminae  Costal facets are present on the transverse processes for
o 7 processes articulation with the tubercles of the ribs

One spinous – is directed posteriorly from the
junction of the two laminae  The superior articular processes bear facets that face posteriorly and

laterally
 The facets on the inferior articular processes face anteriorly and
Two transverse – directed laterally from the junction of
the laminae and the pedicles
 Both the spinous and transverse processes medially.
serve as levers and receive attachments of o EXCEPT the inferior articular processes of the 12th vertebra
muscles face laterally, as do those of the lumbar vertebrae

Four articular – are vertically arranged and consist of two o You can consider T12 as an atypical vertebra because it has
superior and two inferior processes. a different inferior facet
 Arise from the junction of the laminae and the  Movement is mainly rotation
pedicles
 Their articular surfaces are covered with hyaline
cartilage
 The two superior articular processes of one
vertebral arch articulate with the two inferior
articular processes of the arch above, forming
two synovial joints.

General characteristics of a typical cervical vertebra
 Foramen transversarium
o Hole on the transverse process
o For the passage of the vertebral artery and veins
 Not true for all parts of the cervical vertebra
 Vertebral artery is only present from C1-C6
 The spines are small and bifid
 The body is small and broad from side to side
General characteristics of a typical lumbar vertebra
 The body is large and kidney shaped.
 The pedicles are strong and directed backward.
 The laminae are short in a vertical dimension
 The vertebral foramina are triangular.
 The transverse processes are long and slender.
 The spinous processes are short, flat, and quadrangular and
project posteriorly.

The articular surfaces of the superior articular processes face

medially, and those of the inferior articular processes face
laterally.
 Movement is for flexion and extension

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
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

Used by the obstetricians as landmark to measure the size of the pelvic
cavity

The laminae of the 5th sacral vertebra, and sometimes those of the 4th
also, fail to meet in the midline, forming the sacral hiatus

Sacral canal contains the anterior and posterior roots of
the sacral and coccygeal spinal nerves, the filum terminale,
and fibrofatty material. It also contains the lower part of
ATYPICAL CERVICAL VERTEBRA the subarachnoid space down as far as the lower border of
 C1 – Atlas the second sacral vertebra.

 C2 – Axis The anterior and posterior surfaces of the sacrum each have
four foramina on each side for the passage of the anterior and
 C7 – Vertebra prominens posterior rami of the upper four sacral nerves.

C1 Atlas COCCYX
 Does not possess a body or a spinous process  Four vertebra fused together
 Anterior and posterior Arch
 First coccygeal vertebra not fused or is incompletely fused with the
 Lateral mass on each side with articular surfaces on its second vertebra
o Sometimes coccyx 2 and 3 is not fused as well
upper surface for articulation with the occipital condyles
(atlanto-occipital joints)
 Articular surfaces on its inferior surface for articulation with the axis VARIATIONS IN THE VERTEBRAE
(atlantoaxial joints)  Cervical rib
o A rib arising from the anterior tubercle of the transverse
th
process of the 7 cervical vertebra
o It may have a free anterior end, may be connected to the 1st
rib by a fibrous band, or may articulate with the 1st rib.
o The importance of a cervical rib is that it can cause pressure
on the lower trunk of the brachial plexus in some patients,
producing pain down the medial side of the forearm and
hand and wasting of the small muscles of the hand.
C2 Axis
o
 Odontoid process (dens) It can also exert pressure on the overlying subclavian
artery and interfere with the circulation of the upper limb.
o Peglike structure that projects from the superior surface of
the body
o Represents the body of the atlas that has fused with the JOINTS OF THE SPINE
body of the axis
 Atlanto-Occipital Joint
 Atlanto-Axial joint
 Joint of the Vertebral Colum Below the Axis
 Joints between two Vertebral Bodies

C7 Vetebra prominens
 Longest spinous process and not bifid ATLANTO-OCCIPITAL JOINTS
 Large transverse process
 Transverse foramen is small and transmits only vertebral vein Synovial joints that are formed between the occipital
condyles, which are found on either side of the foramen
SACRUM magnum superiorly and the facets on the superior surfaces of
 Wedge shaped bone, concave anteriorly 
the lateral masses of the atlas inferiorly
Enclosed by a capsule
 5 rudimentary vertebra fused together

 The upper border, or base, of the bone articulates with the 5th lumbar
Movement: Flexion, extension and lateral flexion
o No Rotation is possible
vertebra.
 The narrow inferior border articulates with the coccyx.

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Atlanto-occipital membrane JOINTS BETWEEN TWO VERTEBRAL

 Continuation of the ligaments coming from the spinal column BODIES Intervertebral Discs
 Anterior atlanto-occipital membrane  Main structure that bind the vertebral bodies together
o This is a continuation of the anterior longitudinal ligament  Extend from C2 to Sacrum
o The membrane connects the anterior arch of the atlas  25% length of the vertebral column
to the anterior margin of the foramen magnum
 Posterior atlanto-occipital membrane  Thickest in the cervical and lumbar region because this is the area of the
vertebral column where there is greater movement
o This membrane is similar to the ligamentum flavum
o Connects the posterior arch of the atlas to the Annulus fibrosus
posterior margin of the foramen magnum.  Fibrocartilage
 Collagen fibers are arranged in concentric layers or sheets
ATLANTO-AXIAL JOINT
 Articulation between C1 and C2  The collagen bundles pass obliquely between adjacent vertebral bodies,
and their inclination is reversed in alternate sheets
 Three synovial joints:  Protects the nucleus pulposus
o One is between the odontoid process and the anterior
arch of the atlas Nucleus pulposus
o Other two are between the lateral masses of the bones  Gel-like material
 The joints are enclosed by capsules  Has:
 Movement: rotation o Water
o Collagen fibers
Ligaments o Few cartilage cells
 Apical Ligament – this median-placed structure connects the
Function of the Intervertebral Disc
apex of the odontoid process to the anterior margin of the
foramen magnum  Main function is shock absorption

 Alar Ligaments – these lie one on each side of the apical

Clinical correlation: Herniated intervertebral disc
ligament and connect the odontoid process to the medial sides
of the occipital condyles  Commonly known as slip-disc
 Cruciate Ligament
o Transverse part – is attached on each side to the inner  Too much mechanical compression can cause the disc to come out
aspect of the lateral mass of the atlas and binds the
odontoid process to the anterior arch of the atlas.
 Can cause pain and impingement of nerve leading to sensation loss
and paralysis

 Responsible for the stability during the rotation of the neck Ligaments
o Vertical part – runs from the posterior surface of the body  Anterior Longitudinal Ligament
of the axis to the anterior margin of the foramen magnum. o Is wide and is strongly attached to the front and sides of the
 Membrana Tectoria vertebral bodies and to the intervertebral discs
o Continuation of the posterior longitudinal ligament  Posterior Longitudinal Ligament
o Covers the posterior surface of the odontoid process, o Weak and narrow and is attached to the posterior borders
apical, alar and cruciate ligaments of the discs

JOINTS OF THE VERTEBRAL COLUMN BELOW THE AXIS (FACET

 These ligaments hold the vertebrae firmly together but at the same
time permit a small amount of movement to take place
JOINTS)
 Cervical JOINTS BETWEEN TWO VERTEBRAL ARCHES
o Flexion/extension 
Supraspinous ligament – runs between the tips of adjacent
spines.
o Lateral flexion 
Interspinous ligament – connects adjacent spines.
o Rotation 
Intertransverse ligaments – run between adjacent transverse
 Thoracic 
processes.
Ligamentum flavum – connects the laminae of adjacent vertebrae o
o Rotation Within the neural canal
 Lumbar 
Ligamentum Nuchae – in the cervical region, the
o Flexion/extension supraspinous and interspinous ligaments are greatly
thickened forming this strong ligament

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CURVES OF THE VERTEBRAL MUSCLES OF THE BACK

COLUMN Curves in the Sagittal Plane

When we are born, we have one curve which we call primary curve
or kyphosis or posterior convex curve

In 3 to 4 months old, you develop a secondary curve on the
cervical part of the vertebral column which we call cervical
lordosis or cervical posterior concave
 O
At around 7 months, the lumbar part of the vertebral column
becomes concave posteriorly which we call lumbar lordosis
or lumbar secondary curve or lumbar posterior concave
o The development of these secondary curves results in a
modification in the shape of the vertebral bodies and
the intervertebral discs.

In the adult in the standing position, the vertebral column
therefore exhibits the following regional curves:
o Cervical, posterior concavity
o Thoracic, posterior convexity
o Lumbar, posterior concavity
o Sacral, posterior convexity.

In old age, the intervertebral discs atrophy, resulting in a loss of
height and a gradual return of the vertebral column to a
continuous anterior concavity.
SUPERFICIAL MUSCLES
 Connected with the shoulder girdle
Trapezius
Occipital bone, ligamentum nuchae, spine of 7th cervical
vertebra, spines of all thoracic vertebrae
Upper fibers into lateral third of clavicle
I
Middle and lower fibers into acromion and spine of scapula
Spinal part of accessory nerve (motor)
N
C3 and 4 (sensory)
Upper fibers elevate the scapula
A Middle fibers pull scapula medially
Lower fibers pull medial border of scapula downward
Latissiumus dorsi
Iliac crest, lumbar fascia, spines of lower six thoracic
O vertebrae, lower three or four ribs, and inferior angle of
scapula
I Floor of bicipital groove of
humerus N Thoracodorsal nerve
A Extends, adducts, and medially rotates the arm

Levator scapulae
O Transverse processes of 1st four cervical vertebrae
I Medial border of scapula
N C3 and 4 and dorsal scapular nerve A
Raises medial border of scapula

Rhomboid minor
 In the adult, the lower end of the spinal cord lies at the level O
Ligamentum nuchae and spines of 7th cervical and 1st
of the lower border of the body of the first lumbar vertebra, and thoracic vertebrae
the subarachnoid space ends at the lower border of the body of
the second sacral vertebra. I Medial border of scapula
N Dorsal scapular nerve
A Raises medial border of scapula upward and medially

Rhomboid major
O Second to 5th thoracic
spines I Medial border of scapula
N Dorsal scapular nerve
A Raises medial border of scapula upward and medially

INTERMEDIATE MUSCLE
 Involved with movements of the thoracic cage

Levatores costarum
O Tip of transverse process of C7 and T1–11 vertebrae
I Rib below
N Posterior rami of thoracic spinal nerves
A Raises ribs and therefore inspiratory muscles
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
Serratus posterior superior Deepest Muscles o
Interspinales
O Lower cervical and upper thoracic spines o Intertransversarii
I Upper ribs
N Intercostal nerves
A Raises ribs and therefore inspiratory muscles

Serratus posterior inferior

O Upper lumbar and lower thoracic spines
I Lower ribs
N Intercostal nerves
A Depresses ribs and therefore expiratory muscles

Splenius
 Splenius is a detached part of the deep muscles of the back
 Similar in origin
 It consists of two parts:
o Splenius capitis
 Arises from the lower part of the ligamentum nuchae and
the upper four thoracic spines
 Inserted into the superior nuchal line of the occipital bone
and the mastoid process of the temporal bone.
o Splenius cervicis
DEEP MUSCLES OR POSTVERTEBRAL MUSCLE
 The deep muscles of the back form a broad, thick
 Arises from the lower part of the ligamentum nuchae and
the upper four thoracic spines
column of muscle tissue, which occupies the hollow on each
side of the spinous processes of the vertebral column  Inserted into the transverse processes of the upper
 They extend from the sacrum to the skull. cervical vertebrae

 Each individual muscle may be regarded as a string, which,

 Action: Neck extension, lateral flexion and rotation to the
ipsilateral side
when pulled on, causes one or several vertebrae to be extended
or rotated on the vertebra below
MUSCULAR TRIANGLES OF THE BACK
The deep muscles of the back may be classified as follows: Auscultatory Triangle

Superficial Vertically Running Muscles o  Bounded by:
Erector spinae o Latissimus dorsi
 Iliocostalis o Trapezius
 Longissimus o Medial border of the scapula


 Spinalis  Where breath sounds most easily heard
Intermediate Oblique Running Muscles
o Transversospinalis Lumbar Triangle
 Semispinalis  Bounded by:
 Multifidus
o Latissimus dorsi
 Rotatores o External oblique
o Iliac crest
 Site where pus may emerge from the abdominal wall

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MOVEMENTS OF THE VERTEBRAL COLUMN SCOLIOSIS

 Coronal deformity of the spine
 A lateral deviation of the vertebral column

 This is most commonly found in the thoracic region and may be caused
by muscular or vertebral defects
 Progressive and can compress the heart and lungs

VERTEBRAL COLUMN DISLOCATION/FRACTURE


Dislocations without fracture occur only in the cervical region
because the inclination of the articular processes of the
cervical vertebrae permits dislocation to take place without
fracture of the processes.

In the thoracic and lumbar regions, dislocations can occur only if the
vertically placed articular processes are fractured.
 th
Dislocations commonly occur between the 4th and 5th or 5 and 6th
cervical vertebrae, where mobility is greatest

KYPHOSIS
 Exaggeration in the sagittal curvature present in the thoracic part of the
vertebral column
 It can be caused by muscular weakness or by structural changes in the
vertebral bodies or by intervertebral discs.
 More common in post-menopausal women due to decrease in
estrogen

Potts Disease
 Also known as tuberculous spondylitis
 Due to untreated tuberculosis bacilli that can target your bone leading
to a deformity called gibbus deformity

LORDOSIS

 Exaggeration in the sagittal curvature present in the lumbar region

 May be caused by an increase in the weight of the abdominal
contents, as with the gravid uterus or a large ovarian tumor
 May be caused by disease of the vertebral column such as
spondylolisthesis

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