Surface anatomy of vertebral column

Question 1

Describe the spine
* Components
* Average length of different parts
* Direction of spinous processes

Answer 1

Vertebral column consists of:
* Vertebrae: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (fused together with the coccyx)
* Intevertebral discs made of fibro-cartilage

Average length:
* Total 71cm in male, 61cm in female
* Cervival: 12.5cm
* Thoracic: 28cm
* Lumbar: 18cm
* Sacrum and coccyx: 12.5cm

Spinous processes of the cervical and lumbar vertebrae are horizontal, while the thoracic vertebrae face the caudad direction.

Question 2

Describe the cervical vertebrae (number, specific features)

Answer 2

• 7 cervical vertebrae (C1-7)
• C1 = ‘atlas’, supports the head
• C2 = ‘axis’
• Spinous processes are bifid (which are absent in C7)
• Small-bodied

Question 3

Describe the thoracic vertebrae (number, specific features, size)

Answer 3

• 12 (T1-12)
• Have costal facets for the articulation of the heads of ribs
• A body is intermediate in size between the cervical and lumbar vertebrae

Question 4

Describe the lumbar vertebrae (number, size, features)

Answer 4

• 5 (L1-5)
• Large bodies
• No costal facets or transverse process foramina

Question 5

Describe the sacrum and coccyx

Answer 5

• Located at the base of the vertebral column
• Sacral 5 (fused) vertebrae (S1-5)
• Coccygeal 4 (3-5) (fused) vertebrae - i.e. the tailbone

Question 6

What vertebrae can be identified by palpation of the back?

Answer 6

• C2: first bony prominence palpable in the midline of the spine (as the atlas is impalpable)
• C6: first visible vertebra
• C7: most prominent cervical vertebra, easy to palpate
• T3: at level of medial part of root of spine of scapula
• T7: at level of inferior angle of scapula (with arms by the side)
• T12: where lower part of ribs attach to spinal column
• L4 (or L4/5 interspace): Tuffier’s line, line drawn between highest points of both iliac crests.

Question 7

At what level does the spinal cord terminate (in adults and children)

Answer 7

Adults: L1
Children: L3

Question 8

What is the ligamentum nuchae

Answer 8

Overlies and obscures the tips of the spines of the cervical vertebrae
Terminates inferiorly at the spine of C7

Question 9

What is the inion?

Answer 9

The point situated on the external occipital protruberance (of the occipital bone of the skull) in the median plane

Question 10

What viscera are found at:
C5
C7

Answer 10

C5: cricoid cartillage, start of oesophagus
C7: apex of lung

Question 11

What viscera are found at:
T3
T4
T8
T10
T12

Answer 11

T3: aorta reaches spine, tracheal bifurcation
T4: aortic arch ends, upper border of heart
T8: lower border of heart
T10: lower border of lung, cardia of stomach
T12: lowest level of pleura, pylorus

Question 12

What viscera are found at
L1
L2
L3
L4
L5

Answer 12

L1: hilum of kidney
L2: spinal cord terminates
L3: lower border of kidney
L4: bifurcation of aorta
L5: inverior vena cava begins

Question 13

Answer 13

Question 14

Answer 14