00:01
Now that we've seen the
basic features of a vertebrae.
00:04
Let's look at some of the regional
characteristics of vertebrae
and how they differ from
one part of the column to the next.
00:12
Let's start with
the cervical vertebrae.
00:15
The C1 cervical vertebrae
also goes by the name atlas.
00:19
Whereas the C2 also
goes by the name axis.
00:24
C3, 4, 5, and 6,
don't actually get a special name.
00:29
But then the last one C7
gets the name vertebra prominens
because it has the most
prominent spinous process.
00:39
Let's look at a typical
cervical vertebrae.
00:43
So we still have a body that
is somewhat square shaped.
00:47
And the superior surface is concave
while the inferior
is a little bit convex.
00:53
And from a superior point of view,
we see that the vertebral foramen
is a little bit triangular.
00:59
We have a feature we don't see
in other transverse processes
called the transverse foramen.
01:06
And several of the spinous
processes are split or bifid.
01:14
Let's look at C1 or the atlas.
01:19
This looks very different
from a typical vertebrae.
01:22
We have an anterior tubercle
with an anterior arch,
a lateral mass with
the transverse process,
and it's transverse foramen.
01:33
And then we have a facet
for something called
the occipital condyle.
01:38
And if you remember,
occipital bone
is the inferior portion
of the skull.
01:44
So this is where the
skull is going to rest.
01:46
And this is how
atlas gets its name,
because it's holding up
the head essentially,
sort of like Atlas was holding
up the globe in Greek mythology.
01:56
And then posteriorly, we're
connected by the posterior arch.
02:01
And we have a posterior tubercle,
just like we have
an anterior tubercle.
02:06
The next one down is also a very
odd vertebrae, C2 or the axis.
02:13
Here we have an articular
surface for the atlas above it.
02:17
But perhaps most unique feature
is this process called the dens.
02:23
And as you can see,
it's going to form
a special type of joint with the
atlas called the atlantoaxial joint.
02:31
And there's going to be
rotation around this dens.
02:35
That rotation you can think of as
sort of the motion
when you shake your head no.
02:42
So let's look at the
Atlantco-occipital joint.
02:45
So again,
here we have C1 or the atlas.
02:49
And there are these bumps or
condyles on the occipital bone
that are going to interact with
the articular surface on C1.
02:58
And they'll come together
so that they can rest on
the vertebral column here.
03:03
And there will be a nice degree
of movement here,
particularly in flexion/extension
as if you are nodding your head yes.
03:13
Now, this is a very
important connection.
03:15
So there's going to be a lot
of very strong ligaments.
03:19
They combine the cranium
and the vertebral column.
03:24
If we look down from the
school's point of view,
looking at the occipital bone,
and its relationship to C1 and C2,
we see that there's a ligament
that actually goes around the dens
and connecting it to the skull
base called the alar ligament,
as well as this criss crossing
series of ligaments
that have longitudinal portions,
and transverse portions
and they sort of form a cross
hence the term cruciform.
03:51
And together all of these ligaments
help limit the degree of rotation
and flexion and extension
so that we don't have
damage to the passageway
from our brain into
our spinal cord here.
04:06
Similarly,
this is the tectorial membrane
we mentioned that is continuous with
the posterior longitudinal ligament.
04:13
So it serves to
strengthen the connection
through the vertebral column
up to the head.
04:19
Now let's look at the thoracic
vertebrae, which we have 12.
04:24
Here the body is a
little more heart shaped
and the vertebral foramen
is a little more circular.
04:31
And we have new features
that we didn't have
in the cervical vertebrae.
04:36
For example,
we have these costal facets.
04:40
We see their inferior ones
on the vertebrae above
superior ones on
the vertical below,
and also ones on the
transverse process
called the transverse costal facets.
And costal refers to rib.
04:54
So this is we're going to have
the costovertebral joint
with the head of the
rib and tubercle of rib
interacting with
the vertebrae here,
and these joints
are synovial joints.
05:07
So we have a good degree
of movement here.
05:10
We also have to have stability so
we don't have too much movement.
05:13
So we have the
costotransverse ligament.
05:18
We have the superior
costotransverse ligament,
and its lateral
costotransverse ligament,
all providing stability
at this joint.
05:28
Now we're down to
the lumbar vertebrae.
05:31
Where the bodies start
to look cylindrical,
and they're a bit bigger
than they are elsewhere
in the vertebral column.
05:36
The vertebral foramen is a
little bit triangular again.
05:40
And we have a slight
difference in our orientation
of our articular facets.
05:46
The spinous process is also tend
to be a little less prominent
than say the cervical ones.
05:53
There's also some differences
in the posterior spaces
between vertebrae.
05:58
So if we were to look
at the thoracic vertebrae,
we see they're pretty
small gaps here.
06:03
By the time we get down
to the lumbar vertebrae,
they're actually pretty big gaps.
06:08
And that's pretty helpful
because this is also the area
where we do lumbar punctures, and
try to access cerebrospinal fluid.
06:19
Now we're down to the
sacrum and coccyx.
06:23
The sacrum has an articular surface
for the last lumbar vertebrae
which will be L5.
06:31
And then it narrows down
to a point at the apex
where it's going to
interact with the coccyx.
06:36
The anterior surface
is very concave
and there are these openings or
anterior sacral foramina
on this side.
06:46
Similarly, there are a convex
surface on the posterior aspect.
06:51
And there are posterior
sacral foramina.
06:54
And there's a passageway
for the remnants
basically of the vertebral
foramen called the sacral canal.
07:02
And at the very inferior end
the bones don't quite
fuse all the way together
to form something called
the sacral hiatus.
07:10
And sometimes this can
be a useful opening.
07:13
If you're going to provide a
type of anesthetic block
to the sacral area.