vertebral column

Osteology

thoracic vertebrae
Typical

Costal facets

·      essential characteristic

·      pair of demifacets on each side

·      on upper and lower borders of posterior body

·      on morphological neural arch cf. centrum

·      make synovial joint with facet of head of rib

Body

·      concave circumference

·      left-sided excavation

·      from descending aorta

·      heart-shaped outline

·      anterior body sharply convex

·      posterior body concave

·      resultant round central canal

·      upper and lower surfaces

·      ring of cortical bone (fused ring apophysis)

·      central cancellous bone

·      covered with hyaline cartilage

·      2 foramina on posterior surface

·      for basivertebral veins

Pedicles

·      project back from upper half of body

·      upper border level with upper surface of body

·      curve upwards to superior articular process

·      form small superior vertebral notch

·      curve downwards to inferior articular process

·      form deep inferior vertebral notch

·      margin is pars interarticularis

·      adjacent pedicles enclose intervertebral foramen

Laminae

·      slope down from pedicles

·      unite posteriorly

·      form deep notch between them

·      grooved for attachment of ligamentum flavum

·      back of upper surface

·      front of lower surface

Facet joints

·      superior articular process projects backwards and laterally

·      inferior articular process projects forwards and medially

·      form synovial joints

·      joints lie on arc of circle

·      permit rotation

·      ligamentum flavum extends between joints

Spinous process

·      slopes down from junction of vertebrae

·      tips connected by supraspinous ligament

·      base receives rotator spinae from vertebra below

·      shaft receives multifidus, semispinalis and spinalis

Transverse processes

·      project backwards and laterally

·      from junction of pedicle and lamina

·      anterior ends carry costal facet

·      attachments

·      tip attaches lateral costotransverse ligament

·      root gives origin to rotator spinae to vertebra above

·      lower margin gives origin to levator costae muscle

·      lower margin recieves superior costotransverse ligament

·      posterior surface attaches erector spinae attachments

First

·      broad oval body

·      large round facet superiorly for head of 1st rib

·      demifacet inferiorly for part of head of 2nd rib

·      pedicle attached below upper margin of body

·      attachments

·      longus colli attached to anterior convexity

Eleventh

·      single costal facet on upper part of body

·      stunted transverse process

Twelfth

·      single costal facet on lower part of body

·      transverse process projected into

·      upper mamillary body

·      lower accessory tubercle

·      posterior ramus of T11 lies in groove between them

·      superior articular facet typically thoracic

·      lower articular facet typically lumbar

·      attachments

·      upper limit of psoas major attached to lower body

lumbar vertebrae
Typical

Body

·      kidney-shaped

·      posterior surface flat

·      resultant triangular central canal

·      attachments

·      psoas attached to upper and lower borders

Pedicles

·      attach to upper body

Laminae

·      less sloped

Spinous process

·      horizontal

·      hatchet-shaped

·      upper border straight

·      lower border curves down

·      attachments

·      borders attach interspinous ligaments

·      posterior border attaches supraspinous ligament

·      surface attaches interspinales and multifidus

Transverse process

·      variable length

·      4th is longest

·      spatulate

·      attachments

·      vertical ridge on anterior surface for attachment of psoas and anterior layer of lumbar fascia

·      psoas attached medial to ridge

·      quadratus lumborum attached lateral to ridge

·      tip attaches middle layer of lumbar fascia

·      posterior surface attaches erector spinae

Articular processes

·      upper facets face posteromedially

·      are concave and cylindrical

·      lower facets face anterolaterally

·      are convex and cylindrical

·      pars interarticularis is ridge between facets

·      morphological  transverse process forms two processes separated by groove

·      mamillary process

·      projects from superior articular process

·      behind margin of facet

·      accessory tubercle

·      lies at root of transverse process

·      groove between them

·      for medial branch of posterior ramus of lumbar nerve above

Fifth

·      characteristic pyramidal transverse process

·      more anterior on body

·      inferior facets face posteriorly

sacrum

·      fusion of 5 vertebrae and costal elements

·      carries whole body weight via ligaments

·      upper surface slopes down at 30o

·      superior articular facets vertical

Pelvic surface

·      prominent anterior lip of 1st sacral body called sacral promontory

·      4 ridges mark lines of ossification

·      represent intervertebral discs

·      lateral to this are 4 anterior sacral foramina

·      bone between them represents costal processes

·      bone lateral to foraminae called lateral mass or ala

·      neurovascular

·      lateral mass grooved by anterior rami of S1-S4

·      median sacral vessels lie in sacral hollow

·      sacral sympathetic trunk lies medial to foramina

·      sacral plexus lies lateral to foramina

·      lateral sacral vessels lie lateral to foramina

·      attachments

·      piriformis arises from the 3 ridges that separate the foramina and adjoining lateral mass

Dorsal

·      closed by fusion of laminae

·      leaves 2 hiatuses

·      superior hiatus closed by ligamentum flavum

·      inferior hiatus from lack of fusion of S5

·      spinous processes fused to form midline ridge

·      called median sacral crest

·      superior articular facet for L5

·      remaining articular facets fused to form ridge medial to posterior foramina

·      called intermediate sacral crest

·      projected inferiorly as sacral cornu

·      transverse processes fused to form ridge lateral to posterior foramina

·      called lateral sacral crest

·      auricular surface is for articulation with ilium

·      postauricular surface is rough area between lateral crest and auricular surface

·      inferior to this is triangle where lateral crest meets lateral border of sacrum

·      ala of sacrum projects laterally from upper border of S1

·      neurovascular

·      sympathetic trunk crosses base of ala

·      ala crossed by (M to L) lumbosacral trunk, iliolumbar artery and obturator nerve

·      attachments

·      erector spinae between median and lateral crests

·      posterior layer of lumbar fascia attached to both

·      sacroiliac ligaments attached to postauricular surface

·      part of sacrotuberous ligament attaches to triangle inferior to postauricular area

·      sacrospinous ligament and cocccygeus attach to lateral border of sacrum inferior to triangle

·      ventral sacroiliac ligament attaches to ala

Canal

·      triangular

·      closed in front and behind

·      contains meninges down to S2

·      each DRG lie inside its intervertebral foramen

·      filum terminale runs down and blends with periosteum of coccyx

·      S1-S4 emerge from sacral foramina

·      S5 emerges from foramen formed by sacral cornu and coccyx

·      completed by lateral SC ligament

·      may be ossified

Coccyx

·      represents tail

·      fusion of 4 pieces

·      sacrococcygeal joint is symphysis with fibrocartilagenous disc

·      may be synovial joint

·      reinforced by

·      ventral SC ligament

·      deep dorsal SC ligament

·      lateral SC ligament

cervical vertebrae
Typical

Body

·      kidney-shaped

·      projected upwards into posterolateral lip (uncus)

·      reciprocal bevel on lower surface

·      these represent neural arch contribution to body

Pedicle

·      attached to midbody

·      below uncus

Transverse process

·      attached to pedicle laterally

·      in front of articular processes

·      perforated by foramen transversarium

·      contains vertebral artery

·      posterior bar ends in posterior tubercle

·      anterior bar ends in anterior tubercle

·      of C6 is carotid tubercle (of Chassaignac)

·      tubercles joined by intertubercular lamella

·      syn. costotransverse bar

·      true transverse process forms proximal part of posterior bar

·      costal element forms

·      anterior bar and tubercle

·      intertubercular lamella

·      posterior tubercle

·      attachments

1.   anterior tubercle gives rise to

·      longus capitus

·      scalenus anterior

·      longus colli

2.   posterior tubercle gives rise to

·      scalenus medius

·      levator scapulae C3,4)

·      scalenus posterior (C5,6,7)

Laminae

·      enclose large triangular intervertebral foramen

Articular processes

·      at junction of pedicle and lamina

·      form cylindrical column

·      upper facets face up and back

·      lower facets face down and forward

·      joints in same plane

Spinous process

·      bifid

·      attachments

·      inferior concavity for semispinalis cervicis

Prominens

·      spinous process not bifid

·      rounded tubercle

·      foramen does not transmit vertebral artery

·      transmits posterior vein when vein double

·      anterior tubercle smalll

Atlas

·      lacks a centrum

·      vertebral arch forms lateral mass on each side

·      joined by anterior and posterior arch

Lateral mass

·      carries articular facets

·      upper facets

·      kidney-shaped

·      deeply concave

·      lower facets

·      round

·      gently concave

·      hilum of each kidney has tubercle

·      for attachment of transverse ligament

·      anterior ramus of C1 passes behind facet joint

·      attachments

·      lateral mass attaches rectus capitis anterior and lateralis

Transverse process

·      projected from lateral mass

·      perforated by foramen transversarium

·      foramen transmits vertebral artery

·      internal jugular vein lies on transverse process

·      attachments

·      obliquus capitis superior and inferior

·      splenius cervicis

·      levator scapulae

Anterior arch

·      short

·      posterior surface has facet for dens

·      attachments

·      anterior tubercle attaches longus colli

·      upper border attaches anterior alanto-occipital membrane

Posterior arch

·      semicircle

·      upper surface grooved at root

·      for vertebral artery and C1

Axis

·      odontoid process (dens) projects up from body

·      flanked by weight-bearing facets on lateral mass

Dens

·      anterior cylindrical facet

·      makes synovial joint with anterior arch of atlas

·      smooth posterior surface

·      bursa between it and transverse ligament

·      attachments

·      tip of apex attaches apical ligament

·      sides of apex attach alar ligaments

Body

·      typical inferior surface

·      anterior surface projects down a little

·      upper surface carries pair of large facets

·      slope down from dens and extend

·      posteriorly over pedicle

·      laterally over lateral mass

·      attachments (posterior)

·      vertical limb of cruciate ligament

·      tectorial membrane

Transverse process

·      prominent tubercle

·      represents posterior tubercle

·      foramen directed up and out

·      attachments

·      scalenus medius

·      splenius cervicis

·      levator scapulae

Articular facet

·      typical inferior facet extends from junction of pedicle and lamina

Spinous process

·      large

·      upper surface ridged

·      lower surface bifurcated

·      attachments

·      semispinalis capitis inserts into concavity

·      rectus capitis posterior major and inferior oblique attach to sides