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CERVICAL CERVICAL VERTEBRAEVERTEBRAE

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Prof. Saeed Abuel Makarem & Dr. Sanaa Al- Shaarawy

ObjectivesObjectives By the end of this lecture the By the end of this lecture the

student should be able to:student should be able to: Describe the 7 cervical vertebrae, Describe the 7 cervical vertebrae,

(typical & atypical).(typical & atypical). Describe the joints between the cervical Describe the joints between the cervical

vertebrae.vertebrae. Describe the movement which occur in Describe the movement which occur in

the region of the cervical vertebrae.the region of the cervical vertebrae. List the structures which connect 2 List the structures which connect 2

adjacent vertebrae together.adjacent vertebrae together.2Prof. Saeed Abuel Makarem & Dr. Sanaa Al- Shaarawy

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CERVICAL APINES

They are 7 in number.All characterized by presence of foramen transversarium in the transverse process.They are classified into:1- Typical: 3rd , 4th ,5th & 6th. 2- Atypical: 1st, 2nd and 7th.

4Prof. Saeed Abuel Makarem & Dr. Sanaa Al- Shaarawy

• The body is small, longer horizontally than antero-posteriorly

• Its spinous processes is short and bifid.

• The transverse processes has an oval foramen transversarium, through which the vertebral arteries & veins pass.

TYPICAL TYPICAL CERVICAL VERTEBRAECERVICAL VERTEBRAE

C3, C4, C5 & C 6C3, C4, C5 & C 6

The vertebral foramen is large & triangular

TYPICALTYPICAL CERVICAL VERTABRAE CERVICAL VERTABRAE

The superior The superior articular processes:articular processes:

Have a facet that Have a facet that face upward & face upward & backward.backward.

The inferior The inferior articular processes: articular processes:

Have a facets Have a facets that, face downward and face downward and forward.forward.

The transverse The transverse process has 2 process has 2 tubercles one infront tubercles one infront and one behind the and one behind the foramen foramen transversarium.transversarium.


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It has No body, No spine. It has 2 lateral masses connected together by small anterior arch & long posterior arch.Each lateral mass has articular surface on its upper and lower aspects.

C1-ATLAS

The upper articular surface is kidney-shaped articulates with occipital condyles of the skull.It forms the Atlanto-Occipital joints. This joint allows you to nod “say Yes”.

ATYPICAL


The inferior articular surface of the atlas is circular and articulates with the axis. It forms the 2 lateral Atlanto-Axial joints. This joint together with the joint between the dens of axis and the anterior small arch of atlas, they allow you to “Say No “ lateral rotation of the face.

AXIS


It acts as a pivot for the rotation of the atlas (and the skull) above. It has a large upright peg-like odontoid process, or dens, which projects upward from the superior surface of the body.Actually it represents the body of the atlas that has fused with the axis.

AXIS- C 2AXIS- C 2

7th 7th CERVICAL CERVICAL VERTEBRAVERTEBRA

ORORVertebra Vertebra

ProminensProminensIt has the It has the llongestongest spinous spinous process which is process which is not bifidnot bifid..

It is the It is the first spine first spine to be to be felt felt subcutaneouslysubcutaneously in in the root of the back of the the root of the back of the neck.neck.

The transverse process is The transverse process is large while its large while its foramen transversaium is small and is small and may be absent, and does may be absent, and does not transmit the vertebral not transmit the vertebral artery. artery. (only small (only small accessory vein)accessory vein)


Joints of Cervical Joints of Cervical VertebraeVertebrae

Atlanto-Occipital jointsAtlanto-Occipital joints:: Synovial joints between the Synovial joints between the

occipital condyles of skull occipital condyles of skull and the upper facets on the and the upper facets on the lateral mass of the atlas.lateral mass of the atlas.


Prof. Saeed Abuel Makarem & Dr. Sanaa Al- Shaarawy 11

The The Atlanto-Atlanto-occipital jointsoccipital joints are synovial are synovial joints between joints between the occipital the occipital condyles, and the condyles, and the facets on the facets on the superior surfaces superior surfaces of the lateral of the lateral masses of the masses of the atlas below.atlas below.

The The Atlanto-Atlanto-occipital jointsoccipital joints are synovial are synovial joints between joints between the occipital the occipital condyles, and the condyles, and the facets on the facets on the superior surfaces superior surfaces of the lateral of the lateral masses of the masses of the atlas below.atlas below.

atlasatlas

axisaxis

P A

M

L

Sagittal cut


MOVEMENTS IN THE MOVEMENTS IN THE ATLANTO-ATLANTO-

OCCIPITAL OCCIPITAL JOINTJOINT

The joints are capable The joints are capable of: of:

Flexion, Flexion, Extension, and Extension, and Lateral flexion; Lateral flexion; They do not rotate.

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The Atlanto-axial joints are The Atlanto-axial joints are three synovial joints: One median, between the odontoid process and the One median, between the odontoid process and the

anterior arch of atlas.anterior arch of atlas. the other two are lateral and lie between the lateral the other two are lateral and lie between the lateral

masses of the atlas and superior facets on the body of the masses of the atlas and superior facets on the body of the axis.axis.

ATLANTO-AXIAL JOINTS


MOVEMENTSMOVEMENTS

EExtensive rotation of the atlas and the of the atlas and the skull (and thus of skull (and thus of the head on the the head on the axis).axis).

That is to say That is to say NONO

JOINTS OF THE JOINTS OF THE VERTEBRAL VERTEBRAL

COLUMN BELOW COLUMN BELOW THE AXISTHE AXIS

JOINTS BETWEEN TWO VERTEBRAL

BODIES

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With exception of the first two cervical vertebrae, the other cervical vertebrae articulate with each other by means of: :

II- II- CartilaginouCartilaginouss joints joints between their between their bodies .bodies .

II- II- CartilaginouCartilaginouss joints joints between their between their bodies .bodies .

I- I- SynovialSynovial joints between joints between their articular their articular processesprocesses

I- I- SynovialSynovial joints between joints between their articular their articular processesprocesses

Prof. Saeed Abuel Makarem & Dr. Sanaa Al- Shaarawy


The upper and lower The upper and lower surfaces of the bodies surfaces of the bodies of two adjacent of two adjacent vertebrae are covered vertebrae are covered by thin plates of by thin plates of hyaline cartilagehyaline cartilage. .

Between the plates of Between the plates of hyaline cartilage is an hyaline cartilage is an intervertebral disc of of fibrocartilage.

The collagen fibers of The collagen fibers of the disc strongly the disc strongly connect the bodies of connect the bodies of the two vertebrae.the two vertebrae.

I- Intervertebral disc


LLIIGGAAMMEENNTTSS

The anteriorThe anterior and and posterior longitudinal ligaments posterior longitudinal ligaments run as run as continuous bands along the anterior & posterior surfaces of the continuous bands along the anterior & posterior surfaces of the vertebral bodies.vertebral bodies.

These ligaments hold the vertebrae firmly together but at the These ligaments hold the vertebrae firmly together but at the same time permit a small amount of movement to take place.same time permit a small amount of movement to take place.

JOINTS BETWEEN TWO JOINTS BETWEEN TWO VERTEBRAL ARCHESVERTEBRAL ARCHES


The articular facets The articular facets are covered with are covered with hyaline cartilage, hyaline cartilage, and the joints are and the joints are surrounded by a surrounded by a capsule.capsule.

The joints between two vertebral arches consist of synovial joints between the superior and inferior articular processes of adjacent vertebrae.

The joints between two vertebral arches consist of synovial joints between the superior and inferior articular processes of adjacent vertebrae.


OTHER OTHER LIGAMENTSLIGAMENTSSupraspinous Supraspinous

ligamentligament::It runs between the tips It runs between the tips of adjacent spines.of adjacent spines.

Supraspinous Supraspinous ligamentligament::It runs between the tips It runs between the tips of adjacent spines.of adjacent spines.

Interspinous Interspinous ligamentligament::

It connects adjacent It connects adjacent spines.spines.

Interspinous Interspinous ligamentligament::

It connects adjacent It connects adjacent spines.spines.Ligamentum Ligamentum flavumflavum: :

It connects the It connects the laminae of adjacent laminae of adjacent vertebrae.vertebrae.

Ligamentum Ligamentum flavumflavum: :

It connects the It connects the laminae of adjacent laminae of adjacent vertebrae.vertebrae.


Intertransverse Intertransverse ligaments:ligaments: They run between They run between adjacent transverse adjacent transverse processes.processes.

Intertransverse Intertransverse ligaments:ligaments: They run between They run between adjacent transverse adjacent transverse processes.processes.


LIGAMENTUM LIGAMENTUM NUCHAENUCHAE In the cervical region, the In the cervical region, the

Supraspinous and Supraspinous and Interspinous ligaments Interspinous ligaments are greatly thickened to are greatly thickened to form the strong form the strong ligamentum nuchaeligamentum nuchae.

It extends from the spine It extends from the spine of the seventh cervical of the seventh cervical vertebra to the external vertebra to the external occipital protuberance of occipital protuberance of the skull, with its anterior the skull, with its anterior border being strongly border being strongly attached to the cervical attached to the cervical spines in between.spines in between.

SummarySummaryThe cervical vertebrae are 7 in number, classified The cervical vertebrae are 7 in number, classified into typical & atypical vertebrae.into typical & atypical vertebrae.All the typical vertebrae All the typical vertebrae have a foramen have a foramen transversarium and bifid spinous processes.transversarium and bifid spinous processes.Atypical vertebrae (1,2,7) : Atypical vertebrae (1,2,7) : 11stst (Atlas) : (Atlas) : has no body or spine, has short anterior has no body or spine, has short anterior arch and long posterior arch.arch and long posterior arch.22ndnd (Axis): (Axis): has odontoid process (dens). has odontoid process (dens). 77thth (Cervica Prominens) : (Cervica Prominens) : has has llongestongest not bifidnot bifid spinous process, which can be felt spinous process, which can be felt subcutaneously.subcutaneously.Atlanto-Occipital joints are : Atlanto-Occipital joints are : 2 synovial joints, 2 synovial joints, the the function : function : flexion and extension, This joint allows you flexion and extension, This joint allows you to say to say “Yes”. “Yes”. Atlanto-Axial joints are : Atlanto-Axial joints are : 3 synovial joints, 3 synovial joints, the the function : function : extensive rotation, this joint allows you to extensive rotation, this joint allows you to say say “ No”“ No”. .

JOINTS BELOW THE AXIS are : JOINTS BELOW THE AXIS are : I- I- SynovialSynovial joints between joints between their their articular processes.articular processes.

II- II- CartilaginousCartilaginous joints between joints between their bodies their bodies ( intervertebral disc of fibrocartilage).( intervertebral disc of fibrocartilage).Ligaments of cervical spines:Ligaments of cervical spines:Supraspinous ligament, Supraspinous ligament, between tips of between tips of spines.spines.Interspinous ligament, Interspinous ligament, between adjacent between adjacent spines.spines.Supraspinous & Interspinous ligaments Supraspinous & Interspinous ligaments are are thickened to form thickened to form ligamentum nuchae. Ligamentum flavum, Ligamentum flavum, between laminae.between laminae.Intertransverse ligaments, Intertransverse ligaments, between between transverse processes. transverse processes.

SummarySummary