OBJECTIVES:

• 1.1.1 Identify the components of a typical and an atypical vertebra and the specific differences in the cervical, thoracic, lumbar and sacral regions.
• 1.1.2 Identify typical intervertebral articulations and identify the major ligaments connecting the vertebrae.

READINGS:

• Gray’s Anatomy Pages 64-77, 80-84. See Green Highlighted sections for clinical correlation.

SECTRA TABLE WORK: Page 1 of X

All cervical verebrae have a Foramen transversarium. Through which cervical vertebrae do these structures not pass?

Tap here for the answer

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4. 4. Tap here to view the Vertebral Column on the 3D panel: Vertebral Column
   5. Using the Highlight tool, identify the thoracic vertebra stepwise and note the orientation on the transverse, sagittal and coronal cuts.

Pay attention to local anatomical relationships.

The anterior diaphragm attaches to the xyphoid at which thoracic vertebral level?

Tap here for the answer

At what level does the posterior diaphragm attach?

Tap here for the answer

4. 4. Compare the differences of the cervical and thoracic vertebrae.

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Vertebral Column

• Highlight the lumbar vertebra stepwise and note the orientation on the transverse, sagittal and coronal cuts. Pay attention to local anatomical relationships.

QUESTION: At what vertebral level does the spinal end? ANS: Lumbar level L1-L2 (https://www.vhdissector.com/share/6kncy8)

QUESTION: Why would the spaces between the posterior L2 ,L3 and L4 vertebrae be clinically important. ANS: Doing a spinal tap would at these spaces would avoid hitting the spinal cord.

• Compare to the thoracic and cervical vertebrae.

QUESTION: A gymnast falls and has severe lower back pain. What is the most logical part of the lumbar verebra that will be injured? ANS: The areas near the the articulation of the superior and inferior articular processes of the lumbar vertebrae. (See Gray’s Anatomy page 83 “Pars interarticularis fractures”

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• Highlight the sacrum and coccyx and note the orientation on the transverse, sagittal and coronal cuts. Pay attention to local anatomical relationships. Compare the sacral foramen to those of the lumbar and thoracic foramen.

• QUESTION: The sacrum has both anterior and posterior foramen. Which set of foramen have nerves exiting from them? ANS: the anterior set.
• QUESTION: Can you speculate as to why the nerves exit from this set of foramen? ANS: This is an embryological phenomenon. The sacral nerves supply the internal pelvis and posterior parts of the thigh, leg and plantar areas of the feet. The anterior medial and lateral parts of the pelvis and leg are supplied by nerves exiting from the lumbar foramen. This is best exemplified by the sensory skin dermatomes of the pelvis and lower extremety.

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• Look at the accompanying diagram and answer the following questions:

QUESTION: In general ligaments serve to strengthen the joints between bones. The anterior longitudinal ligament is much wider that than the posterior longitudinal ligament. Why would this happen from an anatomical perspective? ANS: The posterior longitudinal ligament runs in the vertebral canal and therefore must be thinner.

QUESTION: If an intervertebral disk slips from between two vertebrae, will it slip anteriorly or posteriorly? ANS: Posteriorly, because the posterior longitudinal ligament is not as wide and connot prevent the slippage as easily. This could potentially cause compression of the spinal cord.