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Cervical Vertebrae Anatomy

Presentation given by Dr. Mohamed Zaazoue, Neurosurgery resident, Ain Shams University.

Farah Mowafy

on 11 October 2012

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Transcript of Cervical Vertebrae Anatomy

Cervical Vertebrae Anatomy Presented by Dr. Mohamed Zaazoue Neurosurgery Resident, Ain Shams University Hospital Number= 7 C1: Atlas C2: Axis C3, C6 and C7 Each has a vertebral body that is concave on its superior surface and convex on its inferior surface The spinous processes of C3-C6 are usually bifid whereas the spinous process of C7 is usually nonbifid and somewhat bulbous at its end The atlas is ring-shaped and does not have a body, unlike the rest of the vertebrae. Fused remnants of the atlas body have become part of C2, where they are called the odontoid process, or dens. The axis has a large vertebral body, which contains the odontoid process (dens). The odontoid process articulates with the anterior arch of the atlas via its anterior articular facet and is held in place by the transverse ligament. The atlas is made up of a thick anterior arch, a thin posterior arch, 2 prominent lateral masses, and 2 transverse processes. The transverse foramen, through which the vertebral artery passes, is enclosed by the transverse process. On each lateral mass is a superior and inferior facet joint. These superior facets articulate with the occipital condyles, while the inferior facets articulate with the superior facets of the axis (C2). C2 has a complex embryologic development. It is derived from 4 ossification centers: 1 for the body, 1 for the odontoid process, and 2 for the neural arches. The odontoid process fuses by the seventh gestational month. Embryology At birth, a vestigial cartilaginous disc space called the

separates the odontoid process from the body of C2. The synchondrosis is seen in virtually all children aged 3 years and is absent in those aged 6 years. The apical portion of the dens ossifies by age 3-5 years and fuses with the rest of the structure around age 12 years. This synchondrosis should not be confused with a fracture. neurocentral synchondrosis Articulation The atlanto-occipital joint (articulation between the atlas and the occipital bone) consists of a pair of condyloid joints. The atlanto-occipital joint is a synovial joint. This joint is responsible for the flexion and extension of the head, i.e. nodding movement. Atlanto-occipital joint The movement of shaking or rotating the head left and right happens almost entirely at the joint between the atlas and the axis, the atlanto-axial joint Atlanto-axial joint Transverse Foramen The transverse foramen (Latin: foramen transversarium) pierces the transverse processes of the seven cervical vertebrae. In the upper six vertebrae, the foramen gives passage to the vertebral artery, vertebral vein, and a plexus of sympathetic nerves. The seventh foramen lacks the artery, but contains the vein and sympathetic nerves. The Three-Column Concept 1. Anterior column - made up of the anterior longitudinal ligament and the anterior one-half of the vertebral body, disc, and annulus. 2. Middle column - made up of the posterior one-half of the vertebral body, disc, and annulus, and the posterior longitudinal ligament. 3. Posterior column - made up of the facet joints, ligamentum flavum, the posterior elements and the interconnecting ligaments. Thank you!
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