Revision - Different Regions of the Spine

Question 1

How many vertebrae does the cervical spine consist of?

Answer 1

7

Question 2

What name is given to C1 and C2?

Answer 2

• C1 –> atlas
• C2 –> axis

Question 3

What are the 3 main features that distinguish cervical vertebrae from other vertebrae?

Answer 3

1. Triangular vertebral foramen.
2. Bifid spinous process
3. Transverse foramina – holes in the transverse processes.

Question 4

What does the transverse formamina allow the passage of?

Answer 4

They give passage to the vertebral artery, vein and sympathetic nerves.

Question 5

What does the ‘atlas’ articulate with?

Answer 5

The atlas is the first cervical vertebra and articulates superiorly with the occiput of the head and inferiorly with C2.

Question 6

How does the ‘atlas’ differ from other cervical vertebrae?

Answer 6

• No vertebral body
• No spinous process.
• Has lateral masses which are connected by an anterior and posterior arch.
  
  • Each lateral mass contains a superior articular facet (for articulation with occipital condyles), and an inferior articular facet (for articulation with C2).
• The anterior arch contains a facet for articulation with the dens of the axis.
  
  • This is secured by the transverse ligament of the atlas – which attaches to the lateral masses.
• The posterior arch has a groove for the vertebral artery and C1 spinal nerve.

Question 7

What connects the lateral masses of C1?

Answer 7

An anterior and posterior arch

Question 8

The lateral masses of C1 contain a superior and an inferior articular facet.

• What does the superior articular facet articulate with?
• What does the inferior articular facet articulate with?

Answer 8

• Superior articular facet articulates with the occipital condyles of the occiput
• Inferior articular facet articulates with lateral masses of C2

Question 9

How does C1 articualte with the dens of C2?

Answer 9

The anterior arch of C1 contains a facet for articulation with the dens of the axis. This is secured by the transverse ligament of the atlas (C1) which attaches to the lateral masses.

Question 10

What does the anterior arch of C1 contain? The posterior arch?

Answer 10

• Anterior arch –> contains a facet for articulation with the dens of the axis
• Posterior arch –> contains a groove for the vertebral artery and C1 spinal nerve.

Question 11

How is the axis (C2) easily identifiable?

Answer 11

Due to its dens (odontoid process) which extends superiorly from the anterior portion of the vertebra.

Question 12

What does the dens articulate with? What movement does this allow?

Answer 12

The dens articulates with the anterior arch of the atlas, in doing so creating the medial atlanto-axial joint. This allows for rotation of the head independently of the torso.

Question 13

How does the axis (C2) articulate with the atlas (C1)? What joints does this form?

Answer 13

The axis contains superior articular facets, which articulate with the inferior articular facets of the atlas to form the two lateral atlanto-axial joints.

Question 14

What are the two different joints present throughout the entire vertebral column?

Answer 14

• Between vertebral bodies –> adjacent vertebral bodies are joined by i_ntervertebral discs,_ made of fibrocartilage. This is a type of cartilaginous joint, known as a symphysis.
• Between vertebral arches –> formed by the articulation of superior and inferior articular processes from adjacent vertebrae. It is a synovial type joint.

Question 15

What joints are unique to the cervical spine?

Answer 15

• Lateral atlanto-axial joints (x2)
• Medial atlanto-axial joint (x1)
• Atlanto-occipital joints (x2)

Question 16

What forms the:

1. Lateral atlanto-axial joints (x2)
2. Medial atlanto-axial joint
3. Atlanto-occipital joints?

Answer 16

1. Lateral atlanto-axial joints (x2) – formed by the articulation between the inferior facets of the lateral masses of C1 and the superior facets of C2.
2. Medial atlanto-axial joint (x1) - formed by the articulation of the dens of C2 with the articular facet of anterior arch of C1
3. Atlanto-occipital joints (x2) - An articulation between the spine and the cranium between then superior facets of the lateral masses of C1 and the occipital condyles at the base of the cranium

Question 17

Which ligaments are present throughout the whole of the vertebral column? What do each of these ligaments connect?

Answer 17

• Anterior and posterior longitudinal ligaments –> long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs.
• Ligamentum flavum –> connects the laminae of adjacent vertebrae.
• Interspinous ligament –> connects the spinous processes of adjacent vertebrae.

Question 18

Which ligament connects the spinous processes of adjacent vertebrae?

Answer 18

Interspinous ligament

Question 19

which ligament connects the laminae of adjacent vertebrae?

Answer 19

Ligamentum flavum

Question 20

Where is the transverse ligament of the atlas present? What does it connect?

Answer 20

Present in the cervical spine only. Connects the lateral masses of the atlas, and in doing so anchors the dens in place.

Question 21

The transverse foramina of the cervical vertebrae provide a passageway by which the vertebral artery, vein and sympathetic nerves can pass. What is the only exception to this?

Answer 21

C7 - where the vertebral artery passes around the vertebra, instead of through the transverse foramen.

Question 22

How are the spinal nerves related to the cervical vertebrae? What is the exception to this?

Answer 22

• Spinal nerves extend from above their respective vertebrae, through the intervertebral foramen created by the joints at the articular processes
• C7 is an exception –> has a set of spinal nerves extending from above (C7) and below (C8) the vertebra
  
  • Therefore, there are eight spinal nerves associated with seven cervical vertebrae.

Question 23

Symptoms of cauda equina syndrome?

Answer 23

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