1. Anatomy of the vertebral column

2. Objectives Describe the general structure of the vertebra
Describe the structure of the atypical cervical vertebrae
Describe the structure of typical cervical vertebrae
Describe the structure of the thoracic vertebra
Describe the structure of the lumbar vertebra
Describe the structure of the sacrum
List the differences between vertebrae in different regions of the vertebral column

3. Vertebral Column Consists of 31 vertebrae and the intervening discs
It appears as straight line anteroposteriorly, and with multiple curves laterally
According to shape and location, vertebrae can be divided into:
Cervical
Thoracic
Lumbar
Sacral
Primary vs Secondary curve
Spine abnormalities

4. Vertebral Column 7 C, 12 T, 5 L, 5 S (Fused as Sacrum), 4 coccygeal
Primary Curves
Secondary Curves

5. Secondary Curves (Lateral view)

6. Vertebral Column General structure of vertebra : Body Pedicle Lamina
Spine
Transverse process
Vertebral foramen
Vertebral notch
Superior articulating process
Inferior articulating process

7. Typical Vertebrae Body
Superior and inferior surfaces of body (plateaus)
Thickened around the rim, location of epiphyseal plates
Cartilaginous end-plates
Vertebral Arch
Pedicles, Laminae
Transverse Processes
Spinous Process
Facets – superior articular and inferior articular

8. Vertebral Foramen
Vertebral notch
Intervertebral Foramen

9. Typical Vertebrae

10. Ligaments of the Spine Anterior longitudinal Posterior longitudinal
Supraspinous
Interspinous
Ligamentum flavum

12. Vertebral Relationships

13. Intervertebal Discs Intervertebral Discs Fibrocartilaginous joints
Increase in size from C to L (3mm to 9 mm)
Make up 20-30% of length of column

14. Discs

15. Discs
Outer rim of fibrocartilage called the anulus fibrosus (attaches to cartilaginous end plate)
Connects vertebral bodies in a fibrocartilaginous joint (no capsule, little motion)
Anulus encloses a central mass called the nucleus pulposus
About 80-90% water, less with increased age
Contains a mucopolysaccharide matrix
Changes shape, releases and absorbs water.
Neither blood vessels or nerves penetrate nucleus

16. Discs
Structure deforms when pressure is put on vertebral column as in weight bearing
Acts as a shock absorber
Annulus totally encloses the nucleus and keeps it under constant pressure
With increased age, the H2O content decreases and the nucleus becomes more fibro cartilaginous, therefore less easily deformable and more easily damaged

17. Discs
Nucleus, when under extreme pressure, can herniate or extrude from the disc in a posterior or posterior-lateral direction
Usually occurs in cervical or lumbar region
Nucleus can put pressure on spinal nerve causing referred symptoms (motor and sensory)
Can cause pressure on cord itself if true posterior

18. Cervical Vertebrae 1st cervical vertebra(Atlas) No body No spine
Anterior arch
Posterior arch
2nd cervical vertebra (Axis)
Looks like typical vertebra
It has odontoid process
(Dens)

19. Typical Cervical Vertebrae
Characterized by the general structure of vertebra but each has a bifid spine
7th cervical vertebra:
Characterized by
general structure
of vertebra but
it has NO bifid spine

20. Thoracic Vertebra

21. Thoracic Vertebra Heart-shaped body Long, thin, vertical spine
Round vertebral foramen
Body/foramen ratio almost 2
Superior articulating facets
facing posteriorly
Body has impression for rib articulation( COSTAL facet)

22. Lumbar Vertebra

23. Lumbar Vertebra Kidney-shaped body Short, thick, horizontal spine
Triangular vertebral foramen
Body/foramen ratio almost 3-4
No impression for rib articulation

24. Sacrum and Coccyx

25. The Sacrum Identify the following: - Anterior sacral foramina
- Transverse lines
- Promontory
- Ala
- Posterior sacral foramina
- Median sacral crest
- Medial (Intermediate) sacral crest
- Lateral sacral crest
- Sacral hiatus
- Cornu
- Sacral canal

26. Ligaments of the Spine Anterior longitudinal Posterior longitudinal
Supraspinous
Interspinous
Ligamentum flavum

27. Ligaments of the Spine Tectorial membrane Interspinous ligaments
Supraspinous ligament
Ligamentum flavum

28. Atlanto-Occipital Joint
Two concave superior facets of atlas articulate with two convex surfaces of occipital condyles of the skull
Supported by major ligaments:
1- Ant. Atlanto-Occipital,
2- Tectorial Membrane,
3- Post. A-O
Small saddle joint
Very limited motion
nodding type motions in all directions.

30. Atlanto-Axial Joint Cruciate ligament Superior longitudinal
Atlas and Axis
Pivot
Two convex superior facets of axis with two concave inferior facets of the atlas
Atlas also posses a facet on the internal surface of the anterior arch which articulates with the dens of the axis
Major ligaments from spine support – alar ligament and cruciate ligament
Cruciate ligament
Superior longitudinal
Inferior longitudinal
Transverse

31. C1/C2