1. Vertebral Column

2. The human vertebral column is built up of a series of vertebrae
7 Cervical, 12 Th., 5 Lumbar, 5 Sacral (Fused as Sacrum), 4 coccygeal (fused as coccyx).
Primary Curves:
Thoracic and sacral curves - present during fetal development
Secondary Curves:-Lumbar and –cervical curves-appear after birth

3. Vertebral Segments

4. Primary Curve

5. Secondary Curves Lateral

6. Vertebral Column

7. Intervertebral Foramen:
Typical Vertebrae
Body: central strong part. Size increases as we go down towards lumbar region
Superior and inferior surfaces of body (plateaus)
Its post. Surface showing one or more foramina for basivertebral vein.
Vertebral Arch:
Pedicles, 2 Laminae.
Seven processes:
1) Transverse Processes(2)
2) Spinous Process
3) Facets – superior articular and inferior articular (2)
Vertebral Foramen:
Intervertebral Foramen:

8. Typical Vertebrae

9. Typical Vertebrae

10. Cervical Vertebrae Contain 7 vertebrae – C1 – C7 Smallest vertebrae
Body upper surface is concave
Spinous process – bifid, shorter than diameter of vertebral foramen
Transverse process: Contain transverse foramina
Protect vertebral arteries & veins that go to the brain
Formed of ant. Root, post.root, and costo transverse bar.
Ant. And post. Roots have tubercles, the tubercle of 6th vertebra is called carotid tubercle.
Ant. root.and tubercle ,costotransverse bar represent costal element while the post. root represent the true transverse process.

11. Cervical Vertebrae

12. -Atlas (C1):
articulates with occiptal condyles of skull
has no body or spinous process lateral masses from which arise transverse processes.
-has a large, round foramen with anterior and posterior arches.
Axis (C2):
supports the atlas has he dens or odontoid process.
has heavy spinous process
to attach muscles of head and neck
Axis and atlas bodies fuse during development to form the dens

15. a traumatic dislocation of cervical vertebrae
Vertebra prominens (C7):
transitions to thoracic vertebrae
has a long spinous process ,can be felt.
The foramen transverserium for vertebral vein
a traumatic dislocation of cervical vertebrae

16. The Thoracic Vertebrae
Characteristics :
have heart-shaped bodies
larger bodies than in C1–C7
smaller vertebral foramen than in C1–C7
long, slender spinous processes
Dorsolateral surfaces of body have costal facets-which articulate with heads of ribs.
Costal facets is present also on transverse processes to articulate with tubercle of ribs (except
11th and12th ribs)

17. T1
Has an upper circular complete facet on the body to articulate with 1st rib.
Semilunar lower facet for 2nd rib spine thick ,horizontal
T10:has no lower facet on the body.
T11: kidney shaped body like lumbar vertebrae.
-single facet on the body close to upper border
-transverse process has no facet.
T12:single facet away from upper border.
-the transverse process has no facet.
-the inf. Articular processes directed laterally like lumbar vertebrae

18. Atypical Thoracic

19. The Lumbar Vertebrae -L5:large body. -T. process large bulky
Characteristics L1–L4:
largest vertebrae
oval-shaped bodies
thicker bodies than T1–T12
no costal or transverse costal facets
triangular vertebral foramen
Sup. articular process directed backwards and medially. -mammillary process.
Inf. Art. Process directed laterally.
T. process: long, tapering, has accessory process on post. Surface.
-L5:large body T. process large bulky
Attached to whole side of the pedicle

20. Typical Lumbar

21. Sacrum and Coccyx

22. The Sacrum Composed of 5 fused sacral vertebrae
Triangular have base and apex.
Anterior concave and post. Convex surfaces.
It has lateral surface and sacral canal.
Articulations:
-by the base with 5th lumbar(2nd cartilagenous).
-by apex with coccyx.(2nd cartilagenous).
-by lateral surface ( auricular surface ) with ilium (sacroiliac joint).
Ant sacral foramina: 4 pairs for ventral rami of upper 4 sacral nerves .+lateral sacral arteries.
Dorsal sacral foramina:4 pairs for dorsal rami of sacral nerves.
Intermediate area between foramina show transverse ridges that indicate fusion of vertebrae.

23. Sacral Apex – narrow, inferior portion
The Sacrum
Sacral Apex – narrow, inferior portion
Base – broad, superior surface
Sacral Promontory
Important landmark in females –
Used during pelvic exams and during labor & delivery
A prominent anterior tip of base
Ala – a wing extending on either side of sacrum

24. The Sacrum Sacral Canal Auricular Surface Sacral Tuberosity
Ala of sacrum
Auricular Surface
Sacral Tuberosity
Sacral promontery

25. -lateral mass: part of sacrum lateral to foramina represents costal element ant. And T. processes post.
-Sacral canal
Extends the length of sacrum – nerves & membranes are in this canal
-The auricular surface
Thickened, flattened area (on lateral surface) – where articulation w/ pelvic girdle is (sacroiliac or SI joint)
-Sacral tuberosity
Site of attachment for ligaments that stabilize the SI joint.
-median sacral crest…..fused spines.
-intermediate sacral crest……fused articular processes.
-lateral sacral crest………. fused T. processes.
-sacral hiatus: at lower end of median crest…. Lamina of 5th vertebra failed to fuse leaving a jap.
-sacral cornu: free inf. Art. Process of 5th vertebra

26. Base
Sacral Promontory
Ala
Sacral Apex

27. Vertebral Relationships

28. Intervertebral Discs -2nd cartilaginous joints. -number 23.
-Increase in size from C to L (3mm to 9 mm).
-Make up 20-30% of length of column.
-the 1st disc between C2 and C3 and the last betweenL5 and S1.
- discs are avascular except periphery supplied from adjacent vessels.
-disc prolapse commonly occur between L4,5 or between L5 and S1.
-PROLAPSE COMMONLY OCCUR IN POSTEROLATERAL DIRECTION WHERE IT IS NOT SUPPORTED BY POST. LONGTUDINAL LIGAMENT.

29. Intervertebal Discs

30. Two Components
Outer rim of fibrocartilage called the anulus fibrosus.
Connects vertebral bodies in a fibrocartilaginous joint (no capsule, little motion).
Anulus encloses a central mass called the nucleus pulposus.
N.P. About 80-90% water, less with increased age
Contains a mucopolysaccharide matrix
Neither blood vessels or nerves penetrate nucleus

31. 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
As you get older, the H2O content decreases and the nucleus becomes more fibrocartilaginous, therefore less easily deformable and more easily damaged

32. 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 refereed symptoms (motor and sensory)
Can cause pressure on cord itself if true posterior

33. Major Ligaments of the Spine
Anterior Longitudinal Ligament - ALL
Dense band along anterior and lateral surface of the vertebral bodies from C2 to sacrum
Superficial - bridge several vertebrae
Deep – short, run from V to V, blends with fibers of anulus fibrosus
Limits extension of V column
From C1 to skull, called anterior Atlanto-Occipital Membrane

34. ALL

35. A and P Longitudinal Ligament

36. Major Ligaments Posterior Longitudinal Ligament
Runs along posterior surface of vertebral bodies (anterior to spinal canal)
C2 to Sacrum
Short fibers attach ligament to posterior disc, reinforce disc posteriorly
Superiorly, continues to occiput, called Tectorial Membrane
Limits flexion

37. Ligaments Supraspinous Limits flexion
Spinous process to spinous process – tip to tip
C7 to sacrum
Limits flexion
In cervical region, becomes much thicker with a greater elastic content
Called Ligamentum Nuchae

38. Supraspinous

39. Ligaments Interspinous Found between spinous processes
Most well developed in lumbar region
support

40. Interspinous

41. Ligaments Ligamentum Flavum
Connects lamina of one to lamina of the other
Found from axis to sacrum
Limit flexion
Continuation to the skull is called Posterior Atlanto-Occipital membrane

42. Ligamentum Flavum

43. Ligaments Intertransverse Between transverse processes
Limit lateral flexion.
PEDICLE IS HE ONLY PART OF VERTEBRAL ARCH HAVE NO LIGAMENTS TO FORM INTERVERTEBRAL FORAMINA FOR SPINAL NERVES

44. Sacralization
Where 5th lumbar vertebrae takes on characteristics of the sacrum and may be partially or completely fused with sacrum
Lumbarization:Superior aspect of the sacrum assumes characteristics of the 5th lumbar vertebrae

45. Atlanto-Axial Joint 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 – Ant. Atlanto-Occipital, Tectorial Membrane, Post. A-O

46. C1/C2

47. C1/C2

48. C1/C2

49. A-A Joint Alar – from dens to occiput Transverse - around dens
Cruciate
Sup. Longitudinal Band
Inferior Longitudinal Band
Transverse

50. Atlanto-Occipital Joint
Two concave superior facets of atlas articulate with two convex surfaces of occipital condyles of the skull
Supported by major ligaments
Small saddle joint
Very limited motion – nodding type motions in all directions.

51. Atlanto-Occipital