ANATOMY OF THE SPINE

VERTEBRAL COLUMN

The vertebral column is the central bony pillar

of the body. Supports the skull, pectoral girdle,
upper limbs, and thoracic cage and, by way of the
pelvic girdle, transmits body weight to the lower
limbs.

Normal Curves of the vertebral body

In posterior view the normal spine is vertical,

laterally the normal spine shows anterior and
posterior physiologic curves, at birth the vertebral
column is a single curve that is convex posteriorly
(kyphosis; primary curve). As the infant raises his
or her head from the prone position and develops
the ability to sit, the cervical spine becomes convex
anteriorly (lordosis; secondary curve). As the child
achieves standing and walking , the lumbar spine
develops an anterior convexity.

There are four curvatures in the adult spine:

 cervical (concave posteriorly)
 thoracic (convex posteriorly)
 lumbar (concave posteriorly)
 sacral (convex posteriorly).

COMPOSING THE VERTEBRAL COLUMN

Vertebral column also called the spine, back - bone , or spinal column, composed of a series
of bones called vertebrae. The total number of vertebrae during early development is 33. As a
child grows, several vertebrae in the sacral and coccygeal regions fuse. As a result, the adult
vertebral column typically contains 26 vertebrae:

 7 cervical vertebrae - in the neck region.

 12 thoracic vertebrae - posterior to the thoracic cavity.
 5 lumbar vertebrae - supporting the lower back.
 1 sacrum - consisting of the five fused sacral vertebrae.
 1 coccyx (cuckoo, because the shape resembles the bill of a cuckoo bird) usually consisting
of four fused coccygeal vertebrae.

The cervical, thoracic, and lumbar vertebrae are movable.

GENERAL CHARACTERISTICS OF A VERTEBRA

 Typical Vertebra
- consists of a rounded body anteriorly and a vertebral arch posteriorly. It enclose the
vertebral foramen, through which run the spinal cord and its covering.
 Vertebral Arch
- consists of a pair of cylindrical pedicles, which form the sides of the arch, and a pair of
flattened laminae, which complete the arch posteriorly.
- vertebral arch gives rise to seven processes: one spinous, two transverse, and four articular.
 Spinous Process or Spine
- is directed posteriorly from the junction of the two laminae.
 Transverse Process
- directed laterally from the junction of the laminae and the pedicles
- possess a foramen transversarium for the passage of the vertebral artery and veins.
 Articular Processes
- Vertically arranged
- consist of 2 superior and 2 inferior process that arises from the junction of the laminae and
pedicles, and their articular surfaces are covered by hyaline cartilage.
 Pedicles
- are notched on their superior and inferior borders, forming the superior and inferior
vertebral notches.
INTERVERTEBRAL DISC

The intervertebral discs are found between the bodies of adjacent vertebrae from the second
cervical vertebra to the sacrum. Each disc has an outer fibrous ring consisting of fibrocartilage
called the annulus fibrosus and an inner soft, pulpy, highly elastic substance called the nucleus
pulposus. The superior and inferior surfaces of the disc consist of a thin plate of a hyaline
cartilage.

PROCESSES
Seven processes arise from the vertebral arch, where lamina and pedicle join a transverse
process extends. A single spinous process (spine) projects posteriorly from the junction of the
laminae. The two superior articular processes of the a vertebra articulate with the two inferior
articular processes of the vertebra above them. The two inferior articular processes of that
vertebra articulate with the 2 superior articular processes blew them.

The articulating surfaces of the articular process, which are referred to as facets, are covered
with hyaline cartilage. The articulation formed between the vertebral bodies and articulations
formed between the vertebral bodies and articular intervertebral joints.

TYPES OF VERTEBRA;

CERVICAL VERTEBRAE
 C1 or Atlas
- Has no body or a spinous process have an anterior and posterior arch
- Ring like shaped
 C2 or Axis
- Has an odontoid process (dens)
- Projects from the superior surface of the body.
 C7 or Vertebra Prominens
- Longest spinous process and the process is not bifid
- The transverse is large, but the foramen tranversarium is small and transmits the vertebral
veins

THORACIC VERTEBRAE
 Have a medium sized body
 Heart shaped
 Small and circular vertebral foramen
 Longer spinous process
 Facets
- superior articular processes bear facets that face posteriorly and laterally
- inferior articular processes face anteriorly and medially

LUMBAR VERTEBRAE
 Have a large body
 Kidney shaped
 Pedicles are strong and directed backwards
 Laminae are short in a vertical dimension
 Vertebral foramina are triangular.
 Have a transverse processes that are long and slender.
 Spinous processes are short, flat, and quadrangular and project posteriorly.
 NO facets for articulation with ribs and no foramina in the transverse process.

SACRUM
 Have 5 sacral vertebrae fused together to form a wedge-shaped bone called the sacrum.
 5th lumbar vertebra. The narrow inferior border articulates with the coccyx. Laterally, the
sacrum articulates with the two iliac bones to form the sacroiliac joints.

COCCYX
 Is triangular in shape. It is formed by the fusion of usually four coccygeal vertebrae.

JOINTS
 Atlanto-Occiptal Joints
- Atlanto-occipital joints are synovial joints that are formed between the occipital condyles,
found on either side of foramen magnum superiorly and the facets on the superior surfaces of the
lateral masses of the atlas.
- Permit extensive flexion and extension of the head
 Atlantoaxial Joints
- Atlantoaxial joints are three synovial joints: one is between the odontoid process and the
anterior arch of the atlas, and the other two are between the lateral masses of the bones.
- Allow a wide range of rotation of the atlas and thus of the head on the axis
LIGAMENTS

 Anterior longitudinal ligament

- limits extension, runs down in the anterior surface of the vertebral column.
- Wide and strongly attached to the front and sides of the vertebral bodies and to the
intervertebral discs
 Posterior longitudinal ligament
- limits flexion, runs down in the posterior surface of the vertebral column.
- weak and narrow and is attached to the posterior borders of the discs

 Ligamenta flava
- limits flexion, connects the laminae of adjacent vertebrae.
 Interspinous Ligaments
- limits flexion, connects adjacent spine.
 Supraspinous ligaments
- limits flexion, This runs between the tips of adjacent spines.
 Apical Ligament
- Connects the apex of the odontoid process to the anterior margin of the foramen magnum.
 Alar Ligaments: Lies on each side of the apical ligament and connects the odontoid process
to the medial sides of occipital condyles.
 Cruciate Ligament
- The transverse part is attached on each side to the inner aspect of the lateral mass of the
atlas and binds the odontoid process to the anterior arch of the atlas. The vertical part runs from
the posterior surface of the body of the axis to the anterior margin of the foramen magnum.
 Membrana Tectoria
- Upward continuation of the posterior longitudinal ligament, attached above the occipital
bone within the foramen magnum. Covers the posterior surfaces of odontoid process and the
apical, alar, and cruciate ligament.

MUSCLE OF THE BACK

A large number of posterior spinal muscles are collectively called erector spinae, or
sacrospinalis muscles. These muscles are continuous from the sacrum to the occiput,and their
combined action is vertebral extension or prevention of flexion. Mediallyto-laterally from the
spinous processes,their alignment is the spinales, longissimus, and iliocostalis. These three
muscles are subtitled according to the area of the spine in which they are located with the muscle
name first and the spinal segment second.The erector spinae muscle groups are identified from
head to sacrum as capitis,cervicis,thoracis(dorsi),or lumborum.Not all erector spinae muscles
occur in each of these segments. For example,there is a longissimus thoracis,longissimus
cervicis, and a longissimus capitis but no longissimus lumborum.

The cervical erector spinae muscles include all three muscles. .The iliocostalis cervicisis the
most lateral of the cervical erector spinae muscles. The longissimus capitis and cervicis lie just
medial to the iliocostalis cervicis.The most superficial and medial layer of the cervical erector
spinae is the splenius capitisand cervicis.

MUSCLES ORIGIN INSERTION NERVE ACTION

SUPPLY
Iliocostalis Angles of third C4–C6 C1-T4 Bilaterally:
cervicis, to sixth ribs transverse extend the
Longissimus Upper 5 thoracic processes cervical spine.
capitis & transverse Mastoid process Unilaterally:
cervices processes and C2–C6 laterally flex the
transverse cervical spine.
processes Some of these
muscles may be
aligned to also
provide cervical
rotation.

Splenius capitis Lower part of Splenius capitis: C1-T4 Bilaterally:

& Cervices ligamentum mastoid process extend the
nuchae and T1– and superior cervical spine.
T3 spinous nuchal line. Unilaterally:
processes Splenius laterally flex the
cervicis: upper cervical spine.
cervical Some of these
vertebrae’s muscles may be
transverse aligned to also
processes provide cervical
rotation.

Interspinous One spinous One spinous Dorsal rami of Proprioceptors of

process of a process of an spinal nerves movement and
vertebra adjacent upper position
vertebra on
either side of the
interspinous
ligament

Multifidus Cross 4-5 A common Dorsal rami of Local spinal

segments to tendon on the spinal nerves stability. Deep
attach distally on entire spinous fasciculi of the
transverse processes muscle also
processes in T/S, protects the
mammary capsule from
processes in being pinched
lumbar area, during
posterior iliac movement
crest, sacrum.

Rotators Transverse Root of spinous Dorsal rami of Bilaterally: Local

process of one process of next spinal nerves spinal stability.
vertebra 1-2 vertebrae Unilaterally:
superiorly Rotation to the
same side.

Iliocostalis Broad tendon Upward to Dorsal rami of Bilaterally:

thoracis & and fascia from lower ribs and spinal nerves extend spine.
iliocostalis T11–S5, sacrum, transverse Unilaterally:
lumborum sacrotuberous & processes laterally flex
sacroiliac Upward to ribs spine
ligaments, and transverse
posterior iliac processes
crest,gluteus
maximus muscle
fibers

Longissimus Broad tendon Upward to lower Dorsal rami of Bilaterally:

thoracis & and fascia from ribs and spinal nerves extend spine.
longissimus T11–S5, sacrum, transverse Unilaterally:
lumborum sacrotuberous & processes laterally flex
sacroiliac Upward to ribs spine.
ligaments, and transverse
posterior iliac processes
crest,gluteus
maximus muscle
fibers
Spinalis thoracis Broad tendon Upward to Dorsal rami of Bilaterally:
& spinalis and fascia from spinous spinal nerves extend spine.
lumborum T11–S5, sacrum, processes Unilaterally:
sacrotuberous & laterally flex
sacroiliac spine
ligaments,
posterior iliac
crest,gluteus
maximus muscle
 fibers

Quadratus Iliac crest lateral 12thrib and L1– T12–L3 Depresses 12th
lumborum to erector spinae L3 transverse rib. Laterally
attachments processes flexes the trunk