HN1. Cervical_Spine.ppt

7/27/2019 HN1. Cervical_Spine.ppt

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Cervical Vertebrae,

Spine & Skull



Vertebral column



Typical vertebra



Superior & inferior articular facets

zygapophyseal / facet joints

•intervetebral disc allows secondary cartilaginous joints

between vertebrae /



The cervical vertebrae

• Triangular vertebral canal

• Foramen transversarium

– Vertebral artery (from subclavian A) passesthrough these except for C7

• Spinous processes – short & bifid

– Except C7 – VERTEBRA PROMINENS very

long & not bifid



Typical cervical vertebra



C1 Atlas

• No body - anterior & posterior arches

• No spinous process• Kidney shape facets superiorly – for

occipital condyles – allows nodding of

head up & down• Groove for vertebral artery on upper

surface



C2 - Axis

• C1 rotates on C2 – a pivot joint

• Superior articular surfaces for C1 to rotate

• Dens / odontoid process

Ligaments1. Transverse ligament of the atlas

2. Also a weaker longitudinal band from axis tobasiocciput

1+2 = the cruciate ligament

• 3. Alar ligaments from the dens to occipitalcondyles – limit rotation of the head



Or Facet joints

Joints in the vertebral column

Secondarycartilaginous joints /

symphyses



Ligaments



Curvatures of the

spine

Primary curvatures –

Thoracic & sacral

Secondary curvatures –

cervical & lumbar



Cervical enlargement

Lumbar enlargement

Spinal cord ends at

L1/L2 – adult

L3/L4 child

Subarachanoid space ends at S2

Filum terminale –

extension of pia mater to coccyx



8 pairs of

cervicalspinal

nerves



31 pairs spinal

nerves

8 cervical12 thoracic

5 lumbar

5 sacral

1 coccygeal



Intervertebral foramina – allow spinal nerves & blood vessels to passthrough



Vertebral canal

• Spinal cord

– Surrounded by meninges

• Pia mater

• Subarachnoid space – CSF.

• Arachnoid mater

• Dura mater

• Extradural / epidural space – containing loose

connective tissue, fat & venous plexus

A t i l l



Arterial supply

•1 x Anterior spinal artery

From the vertebral arteries

•2 x Posterior spinal artery

From Posterior Inferior Cerebellar

Artery (PICA)Vert ASubclavian A

•Segmental arteries. Come

into vertebral foramina sosupplu spinal cord.

• Artery of Adamkiewicz lower

thoracic or upper lumbar region

Veins

Drain in to the internal vertebral

plexus in the extradural / epidural

space

Also communicates with intracranialveins



Suboccipital muscles –important bcoz

contraction extends the head at

atlantoaxial jointInnervation – posterior ramus of C1



Greater occipital nerve

• Dorsal ramus of C2

• Large sensory nerve

• Passes up between suboccipital muscles• Then supplies skin of back of head & scalp



Lumbar puncture

• Position of patient??fetal• Usually to gain specimen of CSF also

others.must below the level of spinal cord.

• Contraindicated with raised intracranial pressure(ICP). Brain stem/medulla. sitting on top of the

foramen magnum.conin

• Fetal position – to split the vertebral bodies as

fas as possible.

• Spinal cord ends in adults … in children????

• Layers passed – skin, subcutaneous tissue,

muscle, supraspinous ligs, interspinous ligs,+/-



Go raibh míle maith agaibh

go léir

HN1. Cervical_Spine.ppt

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