CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN

VERTEBRAL COLUMN
● Consists of 33 vertebrae on babies & 26 on adults (7 cervical,
12 thoracic, 5 lumbar, 5 fused sacral, and 4 fused coccygeal
vertebrae)
● Protects the spinal cord, supports the weight of the head & the
trunk
● Allows the movement of the rib cage for respiration by
articulating with the ribs
● Separated by intervertebral disks that are connected by
ligaments
● Primary curvatures are located in the thoracic and sacral
regions and develop during embryonic and fetal periods
● Secondary curvatures are located in the cervical and lumbar
regions & develop after birth & during infancy
ABNORMAL CURVATURES OF THE VERTEBRAL COLUMN
Kyphosis
➔ Hunchback or humpback; an abnormally increased thoracic
curvature resulting from osteoporosis
Lordosis
➔ Swayback or saddleback; an abnormally increased lumbar
curvature resulting from muscular weakness or osteomalacia
Scoliosis
➔ A condition of lateral deviation resulting from unequal growth
of the vertebral column, pathologic erosion of vertebral
bodies, asymmetric paralysis of weakness of vertebral muscles

Inventor, Joanna Marie P. 1

CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN
TYPICAL VERTEBRA
● Consists of a body and a vertebral arch with several processes
for muscular and articular attachments
Body
➔ Is a short cylinder, supports weights, and is separated and also
bound together by the intervertebral disks, forming the
cartilaginous joints
Vertebral (neural) arch
➔ Consists of paired pedicles laterally and paired lamina
posteriorly
➔ Forms the vertebral foramen with the vertebral body and
protects the spinal cord and associated structures
PROCESSES ASSOCIATED WITH THE VERTEBRAL ARCH
Spinous process
➔ Projects posteriorly from the junction of the two laminae of the
vertebral arch
➔ bifid in the cervical region, spine-like in the thoracic region,
and oblong in the lumbar region
Transverse process
➔ Projects laterally from each side of the junction of the pedicle
and the lamina
➔ Articulate with the tubercles of ribs 1 to 10 in the thoracic
region
➔ Has transverse foramina in the cervical region
Articular processes (facets)
➔ Are two superior and inferior projections from the junction of
the laminae and pedicles
➔ Articulate with other articular processes of the arch above or
below, forming plane synovial joints
Inventor, Joanna Marie P.
Mammillary process
➔ Are tubercles on the superior articular processes of the lumbar
vertebrae
Accessory processes
➔ Project backward from the base of the transverse process and
lateral and inferior to the mammillary process of a lumbar
vertebra
FORAMINA ASSOCIATED WITH THE VERTEBRAL ARCH
Vertebral foramina
➔ Formed by the vertebral bodies and vertebral arches (pedicles
and laminae)
➔ Collectively form the vertebral canal and transmit the spinal
cord with its meningeal coverings, nerve roots, and associated
vessels
Intervertebral foramina
➔ Located between the inferior and superior surfaces of the
pedicles of adjacent vertebrae
➔ Transmit the spinal nerves and accompanying vessels as they
exit the vertebral canal
Transverse foramina
➔ Present in transverse processes of the cervical vertebrae
➔ They transmit the vertebral artery (except for C7), vertebral
veins, and autonomic nerves
INTERVERTEBRAL DISK
➔ Form the secondary cartilaginous joints between the bodies of
two vertebrae from the axis to the sacrum (no disc between
the atlas and axis)
➔ Consists of a central mucoid substance (nucleus pulposus) w/
a surrounding fibrocartilaginous lamina (annulus fibrosus)
➔ Comprise ¼ (25%) of the length of the vertebral column
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CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN
➔ Allow movements between the vertebrae and serves as a
shock absorber
➔ Are avascular except for their peripheries, which are supplied
from adjacent blood vessels
NUCLEUS
PULPOSUS
➔ A remnant of the embryonic notochord and is situated in the
central portion of the intervertebral disc
➔ Consists of reticular and collagenous fibers embedded in
mucoid material
➔ May herniate or protrude through the annulus fibrosus, thereby
impinging on the roots of the spinal nerves
➔ Acts as a shock absorbing mechanism be equalizing pressure
ANNULUS FIBROSUS
➔ Consists of concentric layers of fibrous tissue and fibrocartilage
➔ Binds the vertebral column together, retains the nucleus
pulposus, and permits a limited amount of movement
Inventor, Joanna Marie P.
➔ Acts as a shock absorber
LIGAMENTS OF THE VERTEBRAL COLUMN
● Anterior longitudinal ligament
● Posterior longitudinal ligament
● Ligamentum flavum
● Ligamentum nuchae
● Other ligaments:
➔ Occipitoatlantal ligament complex, Occipitoaxial
ligament, Apical ligament, Alar ligament, Iliolumbar
ligaments, Lumbosacral ligament, Sacroiliac ligaments,
coastal ligament, Intertransverse ligament, Interspinous
ligament
LIGAMENTS OF THE SPINE
Anterior longitudinal ligament
➔ Runs from the skull (occipital bone) to the sacrum on the
anterior surface of the vertebral bodies and intervertebral disc
➔ Narrowest at the upper end but widens as it descends,
maintaining the stability of the joints
➔ Limits extension of the vertebral column, supports the annulus
fibrosus anteriorly, and resists gravitational pull
Posterior longitudinal ligament
➔ Interconnects the vertebral bodies and intervertebral disc
posteriorly and narrows as it descends
➔ Supports the posterior aspect of the vertebral bodies and the
annulus fibrosus, but it runs anterior to the spinal cord within the
vertebral canal
➔ Limits flexion of the vertebral column and resists gravitational
pull
Ligamentum flavum
➔ Connects the laminae of the two adjacent vertebrae and
functions to maintain the upright posture
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CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN
➔ Forms the posterior wall of the vertebral canal between the THE MOTION SEGMENT
vertebrae and may be pierced during lumbar (spinal) ➔ The functional unit of the spine
puncture ➔ Composed of:
Ligamentum nuchae (back of neck) ◆ Two adjacent vertebrae
➔ Is a triangular-shaped medin fibrous septum between the ◆ The intervertebral disc
muscles on the two sides of the posterior aspect of the neck ◆ Connecting ligaments
➔ Formed by the thickened supraspinous ligaments that extend ◆ Two facet joints and capsules
from vertebra C7 to the external occipital protuberance and CURVATURES
crest Primary
➔ Is also attached to the posterior tubercle of the atlas and to ➔ Thoracic and Sacral regions
the spinous processes of the other cervical vertebrae ➔ Forward curvatures (Kyphosis)
FUNCTIONS OF THE VERTEBRAL COLUMN Secondary
Support ➔ Cervical and Lumbar regions
➔ Primary curvature from embryo the cervical and sacral regions ➔ Backward curvatures (Lordosis)
➔ Secondary curvature in the thoracolumbar region prevents SAGITTAL PLANE CURVES
fluctuation in the body’s center of gravity ● Cervical Lordosis ➔ 20°- 40°
Movement ● Thoracic Kyphosis ➔ 20°- 40°
➔ Extrinsic muscle move the ribs and upper limb ● Lumbar Lordosis ➔ 30°- 50°
➔ Intrinsic muscles move the vertebral column ● Sacral Kyphosis
Protection the nervous system
FUNCTIONS OF THE SPINE
➔ Flexibility of motion in six degrees of freedom
➔ To achieve theses functions, the spine must have:
● Resistance to axial loading forces, accomplished by:
○ Kyphotic and lordotic sagittal plane curves
○ Increased mass of each vertebra from C1 to the
sacrum
● Elasticity accomplished by:
○ Alternating lordotic and kyphotic curves
○ Multiple motion segments

Inventor, Joanna Marie P. 4

CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN
TYPES OF BONES TISSUE ➔ The atlantoaxial joint is supported by the cruciform, apical, and
Cortical Bone alar ligaments and the tectorial membrane, which is a
➔ Dense, outer shell of the vertebra continuation of the posterior longitudinal ligament.
Cancellous Bone ATLANTOAXIAL JOINT
➔ inner , spongy bone Three synovial joints between atlas and axis
FIRST CERVICAL VERTEBRA: ATLAS ➔ Laterally ,paired joints between articulating facets
➔ Supports the skull, thus the name ➔ Median joint between dens of axis and anterior arch of atlas
➔ Widest of the cervical vertebrae Supported by ligaments
➔ Has no body and no spine but consists of anterior and posterior ➔ Apical ligament of dens
arches, two lateral articular masses (which support the skull), ➔ Alar ligament
and two prominent transverse processes ➔ Transverse ligament of atlas
➔ Superior facets articulate with the occipital condyles of the ➔ Tectorial membrane
skull to form the atlanto-occipital joints, and inferior facets slide Action - allow atlas (and head) to pivot on the axis and vertebral
over the axis to form the atlantoaxial joints column
3rd to 6th CERVICAL VERTEBRAE
➔ Typical cervical vertebrae with short bifid spinous processes,
anterior and posterior tubercles, and transverse foramina for
the vertebral vessels
LOWER CERVICAL VERTEBRAE
C3 to C7
➔ May be referred to as the subaxial region
➔ Disc at every level
➔ Vertebral structures are similar
TYPICAL CERVICAL VERTEBRAE
From C4 to C7
SECOND CERVICAL VERTEBRA: AXIS
➔ Characterized by the general structure of vertebra but each
➔ Has the smallest transverse processes
has a bifid spine
➔ The dens (odontoid process) of C2 projects superiorly from the
7th cervical vertebra
body of the axis and articulates with the anterior arch of the
➔ Characterized by general structure of vertebra but it has NO
atlas
bifid spine
➔ The dens forms the pivot around which the atlas rotates

Inventor, Joanna Marie P. 5

CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN
7th CERVICAL VERTEBRA ● Characterized by strong, massive transverse processes and
➔ The vertebra prominens is a long spinous process that is nearly have mammillary and accessory processes. Muscles attach to
horizontal, ends in a single tubercle (not bifid), and forms a these processes
visible protrusion in the back ● Kidney-shaped body
➔ Provides an attachment site for the ligamentum nucha, ● Short, thick, horizontal spine
supraspinous ligaments, and numerous back muscles ● Triangular vertebral foramen
THORACIC VERTEBRAE ● Body/foramen ratio almost 3-4
● Have costal facets; the superior costal facet on the body ● No impression for rib articulation
articulates with the head of the corresponding rib, whereas the ● Body
inferior costal facet articulates with the head of the subjacent ➔ L1 to L5 progressive increase in mass
rib (just below) ● Pedicles
● Have transverse process that articulates with the tubercle of ➔ Longer and wider than thoracic; oval shaped
the corresponding rib ● Spinous processes
● The body and the spinous process of the first thoracic vertebra ➔ Horizontal, square shaped
resemble the seventh cervical vertebra ● Transverse processes
● Body ➔ Smaller than in thoracic region
➔ Progressive increase in mass from T1 to T12 ● Intervertebral foramen
● Pedicles ➔ large, with increased incidence of nerve root
➔ Smaller diameter compression
● Laminae SACRUM
➔ vertical , with “roof tile” arrangement ● Large, triangular, wedge-shaped bone composed of five fused
● Spinous processes sacral vertebrae
➔ long , overlapping, projected downward ● Has four pairs of ventral foramina for the exit of the ventral
● Intervertebral foramen primary rami of the first four sacral nerves and four pairs of
➔ Larger, less incidence of nerve compression dorsal foramina for the exit of the dorsal primary rami
LUMBAR VERTEBRAE ● Forms the posterior part of the pelvis and provides strength and
● Distinguished by their large bodies, sturdy laminae and stability to the pelvis
absence of the costal facets ● Characterized by the following structures:
● 5th lumbar vertebra has the largest body of the vertebrae 1. Promontory
➔ The prominent anterior edge of the first sacral
vertebra
Inventor, Joanna Marie P. 6
CPT 2: ANATOMY LEC - DOC BARREDO – VERTEBRAL COLUMN
2. Ala
➔ The superior and lateral parts of the sacrum, which is
formed by the fused transverse processes and fused
costal processes of the first sacral vertebra
3. Median sacral crest
➔ Formed by the fused spinous processes
4. Sacral hiatus
➔ Formed by the failure of the laminae of the vertebra
S5 to fuse in the midline
5. Sacral cornu or horn
➔ Formed by the pedicles of the fifth sacral vertebrae
➔ Important landmark for locating the sacral hiatus
COCCYX
● Wedge-shaped bone formed by the union of four coccygeal REGIONS OF THE SPINE
vertebrae ● Auricle of the ear
● Provides attachment for the coccygeus and levator ani ● Odontoid
muscles, the gluteus maximus, and the anococcygeal ● Body of C7
body/ligament ● Anterior to thoracic spine
● Inverted triangular in shape ● Posterior to L3
● Fusion of 4 coccyx vertebrae ● Mid femoral heads
● Dorsal surface, 2 projection called coccygeal
cornua-attachment for sacrococcygeal ligament and also
attachment for pelvic floor muscles (levator ani)
SACROILIAC JOINT
● The superior lateral surface on either side of the sacrum
articulates with the inner aspects of the pelvis. This area forms
the capsular, synovial SACROILIAC JOINT
● In some cases the sacroiliac joint is a hidden source of back
pain

Inventor, Joanna Marie P. 7