Vertebral canal and brain meninges Dr Wael Elsaed

VERTEBRAL COLUMN
Definition:

The vertebral column is a part of the axial skeleton which lies in the axis of the body. It
measures about 70 cm in the male and consists of 33 vertebrae which are arranged in 5
regions: cervical, thoracic, lumbar, sacral and coccygeal.

1) Cervical region: consists of 7 vertebrae.

2) Thoracic region: consists of 12 vertebrae.
3) Lumbar region: consists of 5 vertebrae.
4) Sacral region: consists of 5 vertebrae which are fused together to form the sacrum.
5) Coccygeal region: consists of 4 small vertebrae.

Function of the vertebral column:

1) It provides a central axis for the body.
2) It surrounds the spinal cord and protects it against trauma.
3) It supports the body weight and transmits it to the lower limbs.

Features of the typical vertebra:

A vertebra, in general, consists of a body, vertebral arch at vertebral foramen.

Body of the vertebra:

• Forms the anterior part of the vertebra.
Vertebral arch
• It is an arched part which is attached to the back
of the vertebral body and surrounds the
vertebral foramen.
• It consists of a pair of pedicles, a pair of laminae
in addition to 7 processes which project from the
arch (4 articular processes, 2 transverse
processes and a spine

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 Vertebral canal and brain meninges Dr Wael Elsaed

Cervical vertebra
• Characterized by the presence of a foramen
transversarium in the transverse process.
• Its body is small.
• Its vertebral foramen is triangular in outline and
is large in size.
The sacrum
• Formed of 5 vertebrae attached to each other.
• It has 4 ventral & 4 dorsal foramina.
The coccyx
• The coccyx consists of 4 small vertebrae fused
together.
• The 1st coccygeal segment usually exists as a
separate bone.
Intervertebral foramina
• These foramina are present on the lateral
aspect of the column.
• The intervertebral foramen lodges the following
structures:
1. Trunk of spinal nerve with its dural sheath.
2. Spinal artery: enters the vertebral canal to supply the spinal cord.
3. Plexus of veins.
4. Dorsal root ganglion.
Ligaments of the vertebral column:
1. Anterior longitudinal ligament (wide)
• Runs vertically along anterior surface of vertebral body
• Attaches to vertebral body and intervertebral discs
• Prevents hyperextension of the back
2. Posterior longitudinal ligament (narrow)
• Runs vertically along posterior surface of vertebral body

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• Attaches only to the intervertebral discs

• Prevents hyperflexion
3. Ligamentum flavum
• This yellow elastic bands runs from the base of the skull to the pelvis.
• Connects laminae of each vertebra to those superior and inferior.
• It is the strongest one.
4. Interspinous Ligament:
• Attaches spines of 2 vertebrae together.
• Attaches also to ligamentum flavum.
5. Supraspinous Ligament:
• Attaches the tip of each spinous process to the other.
• In the neck → ligamentum nuchae.
Vertebral canal
• It is large and triangular in the cervical and lumbar regions, but small and circular in
the thoracic region.
• Contents:
1. Spinal cord till L1/L2.
2. Cauda equina below L1/L2.
3. Posterior longitudinal ligament.
4. Meninges of the spinal cord.
5. Intervertebral venous plexus.
6. Epidural fat.

Joints of the vertebral column

1) Between vertebral bodies: these are secondary cartilaginous joints which lie in the
midline and are represented by the intervertebral discs.
2) Between the articular processes: these are synovial joints which lie one on each side of
the midline.

Intervertebral discs.
• The intervertebral discs are plates of fibrocartilage which lie between the bodies of
the vertebrae.
• The discs are avascular and receive their nourishment by diffusion from the vessels
which supply adjacent vertebrae.

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• The discs, when added together, form 1/5 of the length of the whole vertebral
column. They progressively increase in thickness from above downwards.
• Structure of the disc:
1) Annulus fibrosus: It is formed of fibrocartilage.
2) Nucleus pulposus:
 It lies nearer the posterior than the anterior
surface of the disc.
 At birth, the, nucleus pulposus is soft,
gelatinous but after middle age it loses its
elasticity and starts to undergo degeneration.
NB
In old age, the annulus fibrosus of the disc
becomes weak and the nucleus pulposus
becomes atrophic and necrotic.
A strain on the vertebral column may lead to
prolapse of the nucleus pulposus through the
degenerated annulus fibrosus.
Prolapse usually takes place in a posterolateral
direction, i.e. towards the intervertebral foramen
where the spinal nerve may be compressed.
It should be noted that the commonest sites for
disc prolapse are the lower lumbar and lower
cervical regions.

Structures connecting vertebra

1. Intervertebral disc.
2. Anterior longitudinal ligament: It is a strong
longitudinal ligament which extends along the
anterior surfaces of the bodies of the vertebrae.
Its fibers are firmly fixed to the margins of the
vertebral bodies as well as to the intervertebral discs.
3. Posterior longitudinal ligament: It is a longitudinal ligament extends along the back of
the bodies of the vertebrae and intervertebral discs. It lies within the vertebral canal.

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Brain meninges
✓ The cranial cavity contains the
brain and the surrounding
cerebral meninges, pia mater,
arachnoid mater and dura mater.
✓ The cerebral dura mater is
formed of two layers: an inner
layer called the dura mater proper
or the meningeal layer, and an
outer layer called the endosteal layer.
✓ The inner layer of the dura is reduplicated in certain places to form dural folds.
✓ It also contains the dural venous sinuses.
Falx cerebri
✓ Shape: It is sickle-shaped
✓ Position: Between the two cerebral hemispheres.
➢ Attachments:
✓ Apex: Attached to the crista galli and the frontal crest.
✓ Base: Attached to the tentorium cerebelli.
✓ Upper convex border: Attached to the margins of the superior sagittal sulcus.
✓ Lower border: free
➢ Related sinuses
1. Superior sagittal sinus: Lies along the upper border.
2. Inferior sagittal sinus Lies along the posterior 2/3 of the inferior border.
3. Straight sinus: Lies between the base of the falx cerebri and the peak of the
tentorium cerebelli.
Tentorium cerebelli:
➢ Shape and position: It is tent-like stretching horizontally separating the posterior parts
of the cerebral hemispheres from the cerebellum.
➢ Attachments
✓ Peak: Attached to the base of the falx cerebri.
✓ Free border: It is U-shaped . It is attached to the anterior clinoid processes.
✓ Attached border: Attached to the posterior clinoid process.

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➢ Related sinuses:
1. Straight sinus: Lies between the base of the falx cerebri and the peak of the
tentorium cerebelli.
2. Transverse sinuses: Lie along transverse sulci.
3. Superior petrosal sinuses: Lie along the superior petrosal sulci.
Flax cerebelli cerebelli:
➢ Shape and position: it is a small triangular fold projecting in the posterior notch of the
cerebellum.
➢ Attachments
✓ Base: Attached to peak of the tentorium cerebelli.
✓ Attached border: Attached to the internal occipital crest.
✓ Free border: Projects in the posterior notch of the cerebellum.
✓ Apex: Reaches the posterior boundary of foramen magnum.
➢ Related sinuses
1. Occipital sinus: Lies along the attached border.
2. The posterior part of the straight sinus: Lies along its base.
Diaphragma sellae:
• A small circular fold of dura that forms a roof for the sella turcica.
• A small opening in its center allows passage of the stalk of the pituitary gland.

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Dural sinuses
Single Paired
1. Superior Sagittal Sinus. 1. Cavernous Sinus.
2. Inferior Sagittal Sinus. 2. Transverse Sinus.
3. Straight Sinus. 3. Sigmoid sinus.
4. Occipital Sinus. 4. Superior petrosal Sinus.
5. Basilar Plexus of veins. 5. Inferior petrosal Sinus.
6. Intercavernous sinuses. 6. Sphenoparietal sinus

Single:
Superior Sagittal Sinus.
✓ Beginning: at the foramen coecum
✓ Termination: in the right transverse sinus. Occasionally it ends in the left transverse
sinus and rarely in the confluence of sinuses on the internal occipital protuberance.
✓ Communications:
1. Through parietal emissary foramina.
2. Through the foramen coecum.
✓ It receives:
1. Superior cerebral veins.
2. Cerebrospinal fluid through the arachnoid villi and granulations.
Paired:
Cavernous Sinus.
✓ Beginning: behind the medial end of the superior orbital fissure
✓ Termination: apex of the petrous part of the temporal bone.
✓ Relations:
▪ Medially: Pituitary gland and sphenoidal air sinus.
▪ Laterally: Temporal lobe of the brain and trigeminal ganglion.
▪ Embedded in the lateral wall:
1. Oculomotor nerve (3)
2. Trochlear nerve (4)
3. Ophthalmic division of trigeminal (5)
4. Maxillary division of trigeminal (5)

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▪ Inside the sinus:

1. Internal carotid artery.
2. Abducent nerve (6).
✓ Communications:
▪ Anteriorly: Ophthalmic veins and sphenoparietal sinus.
▪ Posteriorly: Superior and inferior petrosal sinuses.
▪ Superiorly: Superficial middle cerebral vein.
▪ Inferiorly:
1. Emissary veins through foramen ovale: to the pterygoid plexus.
2. Emissary veins through foramen lacerum and carotid canal: to the pharyngeal
plexus.
▪ Medially: opposite cavernous sinus.
Emissary veins:
✓ Definition: They are valveless veins that connect
dural venous sinuses with extracranial veins
through emissary foramina.
✓ Function: They equalize the venous pressure
inside and outside the skull.
✓ Disadvantage: Infection may spread from outside
to inside the skull through the emissary veins.
They are:
1. Veins connected to the superior sagittal sinus:
a. Through the parietal emissary foramina: To veins of scalp.
b. Through foramen coecum: To veins of the nose.
2. Veins connected to the sigmoid sinus:
a. Through the mastoid emissary foramina: To the occipital venous plexus.
b. Through the posterior condylar canal: To the suboccipital venous plexus.
3. Veins connected to the cavernous sinus:
a. Through foramen ovale: To ptrygoid plexus of veins.
b. Through foramen lacerum and the carotid canal: To ptrygoid plexus of veins.
Accordingly, infection can pass from scalp, nose, occipital, suboccipital, ptrygoid
veins through the corresponding emissary veins to the dural sinuses.