+

SPINAL CORD TERMINATION P

00-00:13 00-0 50
Short Recap
Q. Ina neonate spinal cordends at Atthe early fetal stage,
a. Lower border ofT12 o The Vertebral column and spinalcord are the same length.
b. Lower borderofLI o Coccyx bone attaches to the tip of the spinal cord.
c. Upper border ofL3 o Terminates at the Upper border of L3.
d. Lower border ofL3 At birth:
Answer: Upper border ofL3 LEwanya o The Vertebralcolumn is lengthier than the spinal cord.
drallawanya@gmeileom o Coccyx bone still attaches to the spinal cord by the filum
9871614209
The adult spinal cord terminates at the anspyoric plane. terninale (made up of collagen fibers).
o Transpyloric plane is at the lower border ofL l vertebra. o Terminates at the Lower border ofL1.
Adult level of spinal cord termination is achieved within 2
vears afier birth.

Stages of SpinalCord Termination 00:01:25

9-week tetus 14week fetus 40-week fetus Adult

Pia mater L1 L1
Spinal Dura & Spinal
Cord 3 nerve roots
arachnoid
-Meninges
Posterior
SpinalS1
Coccyx nerve L5 CSFin S1 root ganglin
Lumbar cistern
-Filum terminale

C1

" 9-week fetus:

o The length of the spinal cord is equal to the Vertebral
column.
o Fused with the coccyx bone.
As the age increases, the size of the Vertebral column
increases and reaches adult size.
o Coccyx bone moves away from the spinal cord.
Growth of the Vertebral column is faster than the Vertebral
column.
Length of Vertebralcolumn -60 cm.
Length ofthe spinal cord- 45 em.
Though the coccyx bone moves away from the spinal cord, il
keeps itself atlachedto the spinal cord by filum lerminale.
Filum terminale
Made of collagenfibers from the spinal cord.
Altaches the tip of the spinal cord to the coccyx bone.
In neonates, the spinalcord terminales at the Upper border of
L3.
" Takes less than 2 years to reach the adult level.
" Adult level is at transpyloric plane atpylorus of stomach
In adults, the spinal cord terminates al the lower border ofLI.
 SPINAL CORD: ENLARGEMENT AND imim
2 SPACES
The Enlargement ofthe Spinal Cord Includes 00:00:17
" Enlargement: Starts from C3
" Cervical enlargement
o Itgives brachial plexus to supply the upper limb and reaches the T2 (within that
Lumbosacral enlargement it gives the brachial plexus).
o Itgivcs nerves to the lower limb Lumbossacral enlargement Enlargement: LI till S3
(starts at LI spinal segment
Spaces of the spinal cord and reaches the S3 spinal
" Epidural space segment).
Subdural space The neuron bodies contribute
" Subarachnoid space towards the lower limb.
Within the five root values
Eniargenments of spinalcord 00:01:08
(L4, L5, S1, S2, S3), sciatic
nerve will arise.
The lumbosacral emlargement
is protected by T9 to T12
thoracic vertebrae (last 4).
Cervical
enlargement The root values of the sciatic nerve: L4, L5. S1. S2. and S3
(C3-T2) supplying the lower limb
Filum terminale connects the collagen fibers to the tip of the
spinal cord with the bone coccyx.
It has two parts:
o Pial part (longer)
Lumbosacral
enlargement
Conus o Dural part (shorter)
Medullaris " The boundary line is the lower border S2 vertebrae.
(L1-S3)
Vertebra The lower border of the S2 vertebrae is the demarcation line.
End of spinal
cord (L1-2 vertebra) Parts of the Filum Description
terminale
Pial part
Filum Arachnoid

Terminale sheath Pial part It is above the demarcation line

and is closely covered by the pia
Termination of
mater.
-Dural part subarachnoid space The pia mater adheres to the
(S2 vertebra)
filum terminale.
Coccyx " Hence it is called the pial part of
the filum terminale.
It has a longer length.
Spinal cord Description
enlargements Dural part " lt is distally covered by the dura
mater
Cervical enlargement " It is a collection of neuron " I becomes adherent to the filum
bodies that that feed the lerminale
brachial plexus It is shorter in length
" The root value of brachial " I is present below the S2
plexus supplics the upper limb vertebrae level
with S root values
" Root values: CS, C6, C7, C8, The S2 vertebrae level is also the termination point of the
TI
subarachnoid space.
Termination of SpinalCord and Some Spaces 00-05:36
" Though the coccyx bone is moved away from the spinal cord.
it is still atachedto the filum teminale.
The filum terminale has two parts
o Pial part
o Dural part
The boundary line is present at the lower border of S2
vertebrae.
" Termination of the subarachnoid space occurs in the
boundary line.
Spinal cordterminatesin the lower border ofL1vertebrae.
" Itis also called the transpyloric plane (presence of pylorus
stomach).
But the membrane covering the spinalcord will not terminate
Pia mater covering the spinal cord continues to cover the
filum terminale.
Ulimately. it fuses with the coccyx.
Arachnoid mater converges at the S2 vertebrae
o Arachnoid sheath will stop at the 82 vertebrae lower
border.
o The space present deep to the arachnoid mater is filled
with the CSF called subarachnoid space (stop at he lower
border ofS2 vertebrae).
" Dura mater also converges at the lower border of the S2
vertebrae.
The space in the dura mater is called subdural space
(lerminales at the S2 border).
o The dura mater is fused with the filum terminale and the
bone coccyx.
Thepial part ofthe filum terminale adheres to the pia mater.
The filurm terminale below the S2 vertebrae adheres to the pia
mater and to the dura mater (additional dura mater is
present).
So, this is called the dural portion of the filum terminale
The pialpart adheres to the pia mater.
Whereas the dural part adheres to pia mater and dura mater.
Lumbar puncture
oDone for CSF aspiration (puncturing the two meninges).
o First, the CSF fluid is drained, and some anesthesia is
injected into it.
During the lumbar puncture, the needle is passed above or
below the L4vertebrae.
L Important Information
According to Harrison's 20th edition. lumbar puncture
should be done between the L3 and L4 vertebrae.
According to Gray's anatomy 4Ist edition, the puncture
should be done between the L4 and L5 vertebrae.
However, in clinical practices, both are performed.
Q. Wherc is the Lumnbar puncture done?
Ans: L4 and L5 vertebrae
Q. Following are the various structures related to the spinal cord
andtheir respective terminal extent. Choose the wrong pair
A. Adult spinal cord: Transpyloric plane
B. Pia mater: Coccyx
C. Duramater: S2 vertebra
D. Arachnoid sheath: S2 vertebra
+ +
3 VERTEBRAE
+: 00-00:14 0-04-22

IPosterior Spinous !Posterior Anterior

proce95 Superior articular Superior vertebral
Posterior process natch
Superior
Spinuos articular Lamina
procesS Lawanyass
dralllawanya@gmail.com Transvorse
procesS
Superior P87A614209 Inter
articular Lamina vertebrt
-Pedicle disk
procesS Lateral
recesS
Body
Intervertebral
Transverse Spinalcañata Body toramen
process Inferior articular Inferior vertebral
process (facet) notch
Anterior

Pedicle
Posterior- Spinous process
Lateral
recesS
Anterior- Body
o In between the body, intercalated discs are present.
Intervertebral ’ Fibrocartilage.
Spinal canal
foramen ’ Acts as a shock absorber.
Body
"Blunt spine is seen in lumbar vertebra.
" The opening between the vertebrae is called the intervertebral
Anterior foramen.
o Spinal nerves travel in these openings.
Spinalcord willpass through the spinal canal and give rise
Section ofVertebrae lo spinal nerves on either side, which pass through the
" Posterior- Spinous process intervertebral foramen.
" Anterior-Body
o Large oval body -Lumbar vertebra Vertebrae Ditferentiation 00:06:00
o Small oval body -Cervical vertebra
o Heart shaped (Triangular) oval body -Thoracic vertebra Refer Table 3.1

Spinal or vertebral canal

-Bifid tip of
o Oval-Thoracic vertebra spnous process
Vertebral
o Triangular in Lumbar region, and cervical vertebrae arch
Spinous
o The lumbar and cervical vertebrae both have the same Ver tebral process

foramen
shaped body and vertlebral canal, wherein if reversed can Lamina
be true for thoracic vertebrae. Supeior ar ticular
Pedicle process

Superior articular
. Trapsverse process Transver se facet
procesS
o Cervical vertebrae have foramen transversarium, but the Costal Transverse
foramen
same will not be seen in Jumbar vertebrae. procesS
Vertebral body
o Foramen iransversarium makes way for the passage of
vertebral arteries.
o In the thoracic vertebra, Costal facets and rib faccts are Iihas
present, but not in the lumbar (No ribsare presentin the o Oval body.
abdomen). o Foramen transversarium in the transverse process is
premature for the passage of vertebral arteries.
o Bifid spine.
 o Superior articular facet is directed backward and upward. o Direction of the superior articular facet (Mnemonic -T
o Triangular-shaped vertebral canal. BUL)
’ Backward
Transverse
cOstal facet for
Spinous process
Lamina
’Upward
tuberle of rib
Transverse.
’ Lateral.
COsta facot
Transverse process
Other Points
Superior articular facet Cervical vertebra
Superior Superior articular process o Vertebral artery passes through the upper 6
costal face transversarium before entering the cranial cavity.
Podicle
Vertebml
Inferior cóstalacot
body Superior o C7 vertebra has a foramen transversarium but without a
Vertebral foramen. COstal
facet vertebral artery inside.
o There are 7 cervical vertebrae.
o It hasa small body.
" It has Thoracic vertebra can be identified by
o Transverse prOcess
o Body- Doesn't look triangular butis called triangular.
’ Most ofthe vertebrac are triangular, but not all. o Shapeofthe body
o Vertebral foramen-Oval. o Rib facet (Costal facet on transverse process)
’ The transverse section of the vertebra shows an oval Lumbar vertebra can be identified by
shaped vertebral foramen. o Transverse process without any
o Costal facet of the transverse process helps in the ’ Foramen transversarium
articulation of ribs. Costal facet
’ Largest body

Table 3.1
Property Vertebrae Differentiation

Cervical Vertebrae Lumbar Vertebrae Thoracic Vertebrae

Body
Small Largest
Heart-shaped (A]
Oval FT
Oval
-BU -Rib
Oval facet

Thoracic
Cervical
Vertebrae
differentiation
Lumbar

Oval
Size of the Body - Small Oval Heart-shaped (Triangular)
Size of the Body - Large Size of the Body - Internediate
Vertebral Triangular Triangular Oval
canal

Others Foramen transversarium is the
typical feature for passage of
verlebral arteries
The superior articular facet is
directed backward and upward.
The superior articular facet is directed
medial and medial.
Rib tacets are present at The
transverse portion of the body of the
vertebra is for the articulation of the
ribs.
The superior articular facet is directed
backward, upward, and lateral.
 4 LUMBAR PUNCTURE P
" Sites to do lumbar puncture 00-00:14 We have to puncture them by pushing the needle.
o L3.L4 and LS. We have to puncture the ligamentum flavum, supraspinous
ligament, and interspinous ligament to reach the spinal cord.
MCQ We have to do the puncture below the spinal cord, below the LI
Q. During aprocedure to renove cerebrospinal fluid from the vertebra.
subarachnoid space below the end of the spinal cord, the
needle was advanced too far and penetrated the ligament Procedure of lumbar puncture O0:04:15
forming the anterior border ofthe vertebral canal.Which of the
following ligaments. not normally pierced during this Skin
procedure, was accidentally penctrated?
A. Anterior longitudinal Superficial Posterior
Fascia longitudinal
B. Ligamentum Flava Ligamet
C. Posterior longitudinal Supraspinous
Ligament
D. Supraspinous Intervertebral
Interspinous
Ans: Find the answer at the end of thesession. Ligament disc

Anterior
Lumbar Puncture Ligamentum longitudinal
Flavum
Ligament
Intercristal plane Iliac crest

Push the needle between the L4 and L4 vertebra.

This space is an interspinous space.
Supraspinous, interspinous, and ligamentum flavum are
punctured.
Spine of vertebra L4 Dura mater and Arachnoid are punctured
While puncturing through the ligament, the needle gets
Lay the patient in fiexion posture by flexing the spine. resistant.
Separale the vertebral spine to insert the needle. The sudden loss of resistance to the puncturing needle is called
Mark the highest point of the lliac crest, the level of the L4 a popping sensation.
vertebra spine. 2nd popping sensation happens after puncturing the dura maier.
Push the needle at the highest point of the iliac crest. Resistance occurswhile puncturing the dura mater.
" Itis the LA,5 space. Puncturing the posterior longitudinal ligument is amistake.
New learner's do that by pushing torward.
Intervertebral liganments and dise 00:01:50 We ure nol supposed to cnter the anterior longitudinal ligument.
Reler imnge 4.1
Needle puncturing
" In Front of the verlebral body, Anterior longitudinal ligament
is present. Needle

Behind the vertebral body, the Posterior longitudinal Dura mater

ligament is present. Arachnoid mater

" Some ligaments are in front of the body and also behind the Dorsal nerve root

body.
" Ligamentum flavum is between the Lamina of the vertebra.
Spinal erve L3
Itis behind the body.
" TheLLaminalvertebra connecting with the other vertebra is
Lawanya the ligamentum flavum.
drallawanya@gmaileomhe vertcbra is connected with the supraspinous Epidural vein and fat
D87MOVA209 ligament and interspinous ligament. Caucda equina in subarachnoid space
 Needle is puncturing the two meninges, dura, and arachnoid. MCQs
You have to vacate the CSF. Q. During a procedure to remove cerebrospinal fuid from the
Popping sensations arc observed. subarachnoid space below the end of the spinal cord. the
" L4,L5. spine of vertebraare drawn. ncedle was advanced too far and penetrated the ligament
" Lamina isdrawn in between. forming the anterior border of the vertebral canal. Which of
Anterior longitudinal ligament is present in front of the the following ligaments, not normally pierced during this
vertebra. procedure, was accidentally penetrated?
Posierior longitudinal ligament is present behind the vertebra. A. Anterior longitudinal
Ligamentum fiavum is present between the Lamina. B. Ligamentum Flava
Interspinous ligament is present in between the spine. C. Posterior longitudinal
Supraspinous is present at the tip ofthespine. D. Supraspinous
Ans: C Posterior longitudinal. Lawanya
The Order toPuncture the Parts dralllawanyaagmail
" Supraspinous Important Information 9871614209
" Interspinous
" Anterior longitudinal ligament can never be reached.
" Ligamentum fiavum
Dura matter
"We would puncture the ligamentum tlavum and Supraspinous
Arachnoid
regularly.
" Ifwe reach the posterior ligament then it is accidental.
Important Information
Q. Popping sensation felt on doing Lumbar puncture is while
" If you puncture the posterior longitudinal ligament, it is piercing
accidental. A. Ligamentum flavum
" Afier puncturing the dura and arachnoid, enter the B. Supraspinous ligament
subarachnoid space to vacale the CSF and inject the anesthetic C. Interspinous ligament
agent. D. Duramater
Ans: Ligumentum tlavum (considered correet by najonty) and
Duranaler (considered comect by minority).
 VERTEBRAL CURVATURES AND P
5 SLIP DISC
00-00:13
Vertebralcurvatures: 00:02:14

Cervical (7) Cervical

Cervical (7) -
cruvature
(Lordosis)

Thoracic
Thoracic (12) cruvature
Thoracic (12)
(Kyphosis)

Lumbar (5) Lumbar

Lumbar (5) Cruvature

(Lordosis)

Sacrum Sacral
Sacrum
cruvature
Coccyx (Kyphosis),
Coccyx
Anterior view Right lateral view
Vertebral Column and Nerves
Curvature
Vertebrae Spinal Nerves (Pairs) They are oftwo types
o Primary curvature
Cervical-7 o Secondary curvature

Thoracic - 12 12 Primary curvature

Alsoknown as fetal curvature, or primary degree curvature.
orkyphosis.
Lumbar -5 5
" Presented trom birth.
" Felus presents the universal attitude of flexion, in which the
Sacral -5 5
baby's joints and everything are tlexed, like
o Wrist
Coccygeal - 4 (Depends on o Fingers
the length)
o Shoulder

Total - 33 vertebra o Elbow

31 Pairs
o Gut
" Fetal curvalures:
o Thoraciekyphosis -To keep the thoracicviscera.
o Sacral kyphosis -To keep the pelvic viscera.
o Both are concave anteriorly and convex posteriorly.
+
Secondary curvature
Also known as acquired curvature or secondarily acquired
lordosis.
Acquired after birth.
Secondary curvatures:
o Cervical lordosis
’ Formed afer a few months of the baby hiding the neck.
o Lumbar lordosis
’ Appeared because of
Sitting
- Standing
- Walking

Refer Image 5.1

Curvatures:

Cervical (2)/ In the pregnant women.

o The baby shifts the center of gravityto the anterior.
o Exaggerated lordosis can beseen.
Thoracic (19) Lawanya The reason for swaybackwalk in pregnant women.
Lumbar (2°) drallawanya@gmail.com
981herniation between L4 and L5 involves nerve root
Sacral (19 a. L-2
b. L-3
C. L-4
d. L-5
Ans. L-5
Explanation
Trick - Select the upper vertebra in the question and add l to
get the answer.
Slip discs are usually cervical and lumbosacral.
Adult 4 years Newborn Fetus
Spinal nerves 00-08:30

" Fetus in the womb - Shows universal attitude of flexion,

forms Occipital bone
1st cervical nerve lst cervical cord
o Thoracic kyphosis
segment
o Sacral kyphosis
Newborn,4years old, and adults show
o Secondary curvalures (siting and holding neck) lst thoracic cord
Vertebra Tl
’ Cervical lordosis segment
lst thoracic nerve
’ Lumbar lordosis
+
" Cervicalregion o The C8vertebra will pass under the C7 vertebra.
o Nerves are short and straight. There on, in the thoracic region, the spinal nerves will travel
o Spinal nerves are going above or supcrior to the below the corresponding vertebrae.
corresponding vertebrae.
o The Cl spinal nerve moves superior to the Cl vertebra.
o This willchange the cervical thoracic region as there are 8
cervical spinal nerves for 7 cervical vertcbrac. 3
’ The nerves in the cervical thoracic becomc long and
oblique.
Thoracic region L3
o Nerves are long and more oblique.ol 4
o Spinalnerves go under or posterior to the corresponding
vertebrae because of even vertebral numbers after the
L4
cervical thoracic change.
" For lumbar and sacral vertebrae, the spinal nerves go under or 5
posterior to the vertebrae.
" The length ofthevertebral column =60cm. L5
The length ofthe spinal cord =45cm.
The spinal cord terminates at the L-1 lower border of the S1
verlebral column.
Thus. the fibers are long and more oblique because they have
S1
to exit at their corresponding intervertebral foramen.
o lf the slip disc is involved, the same number of nerves will
exit the vertebrae. In Lumbosacral Region;
o In the lumbosacral region, the same number of nerves The fibers became longer and more oblique at the
may no1 be involved as the nexl number of nerves are lumbosacral region.
involved. Under the L3vertebra, the L3 spinal nerve will pass through.
" Under the Sl vertebra and others, the corresponding nerves
will pass under them.
5

C6

6
4th Lumbar
Ath Lumbar pedicle
ver tebral body
C7
L4 root

7
) Protruded
L4-L5 disk
5th Lumnbar
C8 vertebral body
LS root
T1
Protruded
L5-S1 disk
T1
.Sl root

Incervical thoracic region

S2 root
" Spinal nerves are going above or superior lo the
corresponding vertebrae.
o Example - Co spinal nerve will pass above the Cóvertebra
and likewise others.
Due to additional C8 spinal nerves, the arrangement of " The cervical region nerves go above the coresponding
nerves will change from the cervical thoracic region. vertebrae.
 +
Slip disc al L4-LS level, LS nerve is involved.
" L4 root valve value passing under the L4 vertebra is not
Slip dise is presented at
o Cervicothoracic- 10%
involved as it is nerve exiting at the same level. o Lumbosacral-90%
o This is because the posterolateral herniation (PLH) at the o Thoracic - Rare.
nucleus pulposus is seen. Nerves exiting above the corresponding vertebrae (In image
o Thus, L$root valve that means LS nerve is seen.
C6-T))- Nerves involved are C6.C7. and C8.
The Posterior Laleral Herniation of Nucleus Pulposus is also " Nerves exiting under the
seen at the L$-Slvertebra (Slip disc). corresponding vertebrae (In image
L4, L5, SI)-Nerves involved are L4, L5, SI.
o The nerve cxiting under it is involved, that is, the SI
Because of this difference, the cervicothoracic is short and
nerve.
straight, whereas the lumbosacral nerves are long and
o The trick is adding +1 to the upper vertebra. That means
the next nerve.
oblique.

Upper Limb Cases can be seen in

0. Disc herniation between L4 and LS involves
nerve root Slip disc is between C6 and C7- The nerve involved is
A. L-2 C7
B. L-3 (Using the trick).
Slip disc between C7&TI-C8 nerve is involved.
C. L4
D. L-5
Lower Limb Cases can be seen in
Slip disc between L4 & L5-L5 nerve is involved.
Slip DisCs Herniated Dise Compressed Slip disc between L5 & SI -Slnerve is involved.
Between Nerve Root
Upper Limb Slip C4 and C5 CS cô
Discs

C5 and C6 C6

C6 and C7 C7 C8
C7

Lower Limb Slip L3 and L4 L4

Discs

Lewaryaand LS L5
dallawanyaagmai.eom
987A61420P sI Case - Burning sensation in the hand's middle inger.
SI

Lpper limb lower limb slip disc injuries Explanation

(MO:16:57 " The middle three tingers of the hand are innervated with C7
dermatonme.
Vertebra SN JUV+1
C-6

10% C-7
Cx

T-1

Sup
Disc

90% L-4
LS L-5
L-5 X
L-6
S-1 S-1
 16

470

Checking C7 myotome -Triceps reflex.

Confims that MRI should be focused on slip Refer Table5.2
disc and is
presented between C6-C7(Using trick). MRÍ should be based on the lip disc
Refer TableS.I SI.whcre PLH at NP is seen. presented between L5
Gastrocnemius soleus is the sole muscle for frontal flexion.
Decreased triceps jerk - Extensors are compromised. Tibial nerve - At calf region for frontal
o C7 is the root valve
flexion.
ofthe radial nerve for
’ Elbow extensors Herniated Disc between Lawanya
dralllawanya@gmail:com 0ot
’ Wrist extensors
C4 and C5
9871614209.
’ Finger extensors CS

CS and C6
C6

C6 andC7 C7

L3-L4 L3 and L4 L4

L4 and LS LS

L5 andS1 SI
L4-51

S1-2 Upper limb slip discs - Cervical thoracic slip discs are
between
o C4 and CS
o CS and C6
o C6and C7
Lower limb slip disCS - LumbOsacral slip discs are between
o L3 and L4
Case - Burning sensation in the little finger and the lateral o L4 and L5
margins of the foot. o L5and S1
Explanation
" Sldermalome and myowme are involved.
Hit the ankle for ankle reflex at the lendun axial.
o This enables the frontal flexion to be seen.
o Ifnot, Sl root injury.
’ Frontal flexion is absent.
’ SIflexion is absent.
+
Image 5.I

Cervical

Lawanya
dralllawanya@gmail.com Thoracic
9871614209 vertebrae
Thoracic

Lumbar Lumbar
vertebrae

Intervetebral
Sacral disc

Sacral
Coccygeal
veteorae

Table 5.1

Herniated dise Dermatome Muscle affected Movement Nerve and reftex

Compressed weakness involved
between Nerve root Alfected

Extension of Radial nerve

C6 and CT C7 C7 middle finger Triceps forearm
Wrist extensors Decrease
Extension of wrist triceps jerk

Table 5.2

Muscle atlected Movement weakness Nerve and

Herniated disc Compressed
root
Nerve Dermatome
Alected
rellex involved
between

SI Gastrocnemius soleus Plantar flexion of the Tibial nerve

L5 and Si Si
ankle (Patient cannot
stand on toes) Decreased ankle
Heel
jerk
Little toe Flexion of toes

18
 6 CRANIO-VERTEBRALJOINTS
+
Clvertebra 00-00:14
" C2, axisvertebra may get the body of the upper
" TheOdontoid process or dens of the axis is the
vertebra.
body of the CI
vertebra.
The body of the CI vertebra is fusing with the body ofthe C2
vertebra.
Posterior tubercle " It produces an elevation called the Odontoid process of the
Vertebral
foramen
Posterior arch dens of the axis.
-facet for dens Axis vertebra has its own body. The other body is attached to
Transverse prOCess
its own body.
Transverse foramen
Supenor
articular tacet Costal process
" The vertebral artery is passing through the Foramen
Superior Anterior arch transversarium
articular process
Anteriortubercle
Atlas. Superior view
Yes movement
O0:04:4s

Present below the skullbone 10'flexion

25Extension

Has no body
Iigets fused to C2.
Altanto occipital joint is for yes movement.
Ellipsoid joint or condylar.
Transverse foramen is for the passage of the vertebral artery.
The relation between the vertebral artery and atlas vertebra is
having a groove and passing through that groove to enter the
cranial cavity.
Vertebral artery comes fromn the transverse foramen and arches
anya@graakdonis the superior surface of the atlas vertebra (posterior
4209 arch).
Then it enters the foramen magnum and cranial cavity upward. " While doing the yes movement, the atlanto occipital joint
Anterior tubercle and posterior tubercle are present. moves.
Superior Aricular facet for the cervical vertebra are directed " This joint is ellipsoid or condylar because there are occipital
backward and upward. condyles.
C2,axis vertebra 00:03:27
Atlanto Oeeipitaljoint
Spinous process Articular facet for
Lamina dens of axis
Dens
Transverse
Vertebral ligament
foramen
Transverse foranen
-Atlas (C1)
Superior
articular facet Verteb Transverse procesS
body
Pedicle -Axis (C2)
Dens

Axis, Superior view

 Articular facet for No movement happens at C1and C2 vertehbra
dens of axis Skulland atlas vertebra together as a unit rotates on the axis
vertebra.
Dens
Occipital and atlas become a unit, rotating on the axis vertebra.
Transverse
ligament Atlantoaxial joint

Atlas (C1) Axis of rotation

Dens
Axis (C2)
CAtlas

" Cl,C2are atlas and axis joints.

" Densor Odontoidprocess, the body ofC2 is seen. Transverse
Odontoid process appears to be the body of the Cl vertebra ligament Axis
fusing with the C2 vertebra.
The assumption is that it got broken from there and fused here.
Itgoes to the anterior arch of the atlas
Transverse ligament holds the Odontoid process. Atlantoaxial joint
C2 gives the Odontoid process held by the transverse
ligament of theC1 vertebra anteriorly.
This is a rotatory joint.
Nomovement
00:06:35 " Central axis is present, and rotation occurs here.
awanya
drallawanya@gmailcom
It is calleda pivotor trochoid synovial joint. axis
9871614209 Skull and atlas are a unit that started rotating on the
vertebra.
This is the atlantoaxialjoint.
As the skull moves, the atlas also moves.
the axis
Transverse ligament holds the Odontoid process of
vertebra.
on the anterior arch ofthe atlas
Atlanto ax ialjoint is for yes movement.
" Pivotor Trochoid is tor no mnovement.
 Lawanya
dallawaNya@gmaileom
7 VERTEBRAL LANDMARKS AND TRIANGLES
+
00:00:13
Therc are some vertebrallandmarks
Spine of the vertebra at the supcrior angle of the scapula or
where is the inferior angle of thescapula.
Angles ofscapula
C7 spinous process
(Vertebral prominens)
Cervicothoracic junction
-T3 spinous
proces
T7 spinous
procesS
Inferior angle
of scapula
T12 spinous
procesS
Spine of scapula is T3, and angle is T2.
T2 is the superior angle.
T7is the inferior angie.
Highest point ofthe iliac crest is the spine ofthe L4 vertebra.
L4,5 especially.
" Triangles are present in the back region.
-T12 spinous
proces6
12th rib
-L4 spinous process
Iliac crest
Posterior superior
iliac spine
$2 spinaus process
Triangles
Trapezius
Scapula
Rhomboid major
Triangle of ausculatation Latissimus dorsi
Externai oblique
Lumbar triangle
(Petit's triangie)
Triangle of auscultation 00:01-58
" Stethoscope is kept from the back to listen to the abdomen
region's sounds in the auscultation triangle.
Boundaries are the medial border of the scapula and the
triangular muscle, the Trapezius.
"Itforns the boundary for the triangle ofauscultation.
"It is the Muscle of the upper back.
Latissimus Dorsi is the muscle of the lower back.
It also forms the boundary.
Scapula is on the lateral side, Latissimus dorsi on the inferior
side, and trapezius on the superomedial side.
" At the floor: Rhomboideus major is present.
" Lobe ofthe lungs is also present.
Lower lumbar triangle or petit's triangle has a lady trom the
lower back or Latissimusdorsi.
Iliac crestof the hip bone and muscle torm anterior abdomen
wall, external oblique is present.
Latissimus dorsi is present posterior.
Lumbar or
" Base is the iliac crest ofthe hip bone, which is the
Pelil's triangle.
" Ilhas less number ot muscles,and hernias can occur.
Normally, muscles prevent the hernia by strengthening.
As there is no strength, a hernia can occur.