spinal anatomy final
TRANSCRIPT
H 2
Overview: Gross Spinal Anatomy
• Bony elements• Spinal ligaments and joints• Intervertebral discs• Neural elements• Blood supply
H 7
Vertebral Column
• 24 separate vertebrae plustwo composite vertebrae:– 7 cervical– 12 thoracic– 5 lumbar– Composites:
• Sacrum: 5 pieces• Coccyx: 4 pieces
Zygapophyseal joints
• True synovial joints:– Covered by fibrous capsule– Filled with synovial fluid– Hyaline cartilage lining bony surfaces– Innervated with nociceptive fibers
• Posterior spinal structures– Nerve root exits anterior to joint
through foramen
H 34
H
Zygapophyseal joints• Lumbar joints:
– oriented obliquely at L5-S1– Oriented increasingly more in the sagittal
plane up to thoracic levels
• Cervical joints are tilted cephalocaudad
• Joints are curved structures
H 42
Atlanto-axial and atlanto-occipital joints
• Anterior spinal structures– Nerve root exits posterior to joint– No associated neural foramen
• Do not have typical medial branch innervation
• True synovial joints
H 48
Spinal cord
• Begins at C1 and ends at L1-2• Transmits bilateral, segmental
spinal nerves:– 8 cervical– 12 thoracic– 5 lumbar– 5 sacral
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Spinal nerve
• Originate from a dorsal and ventral root– Roots originate intra-durally, exit
through dural root sleeve
• Give rise to dorsal and ventralprimary rami
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Cervical nerve roots• C5 contacts the disc in the proximal
foramen
• C6 and C7 have considerable contact with their respective discs in the middle foramen
• C8 has little contact with the C7-T1 disc
H 63
Neural foramina
• Transmit spinal nerves• First and second spinal nerves (C1,
C2) do not exit via a foramen• First neural foramen is C2-3 which
transmits the C3 spinal nerve• There are 8 cervical nerves with C8
exiting out the C7-T1 foramen
Uncovertebral joint
Uncinate process
Superiorand
inferiorarticular
processes
Foramen transversarium
Neural foramen
Disc
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Numbering of spinal nerve roots• In the cervical spine, the last number
of the foramen names the exiting nerve:– C3 exits the C2-3 foramen– C7 exits the C6-7 foramen
• C8 exits the C7-T1 foramen• From T1-2 down, the first number of
the foramen names the exiting nerve:– L3 exits the L3-4 foramen
C5-6, C6-7 joints
C4, C5 and C6articular pillars
C2 and C3spinous processes
C2-3 and C3-4foramina
C4
C3
C5
C6
C8
C7C6, C7 vertebral
bodies
C5-6 and C6-7zygapophysealjoints
C4, C5 and C6articular pillars
C2 and C3spinous processes
C2-3 and C3-4foramina
TON
Medial branch of C3
Medial branch of C4
Medial branch of C5
Medial branch of C8
C4
C3
C5
C6
C8
C7
great radicular artery of Adamkiewicz
thoracic radicular artery
Cervical radicular arteries
L and R vertebral arteries
Ascending sacral radicular artery
H87
Meninges
• The dura mater surrounds the brain and spinal cord
• The arachnoid lies just beneath the dura
• Pia mater covers and is adherent to the brain and spinal cord
• CSF flows between the arachnoid and the pia mater