Medical Anatomy chapter 5

cervical vertebrae

small body, uncinate process, pedicles and laminae, biford spinous process, transverse process, anterior and posterior articular processes fused into a pillar, articular pillar, superior and inferior articular processes and facets, large triangular vertebral foramen

what is this

uncinate process

what is this

transverse foramen

atlas

no vertebral body, anterior arch instead. anterior tubercle for muscle attachment, superior anterior process and facet and inferior articular facet

what attaches to the anterior tubercle of the atlas

Longus colli muscles and the anterior longitudinal ligament

what goes through the transverse foramen

vertebral artery and vein

atlanto-occipital joint

articulation between the atlas and the cranium. btw occipital condyles and the superior articulating processes of the atlas.

what movement does the atlanto occipital joint have

flexion and extension no rotation

Axis

dens (odontoid process), facet for anterior arch of atlas, 3 synovial joints, paired joints btw articulating facets

atlantoaxial joint

series of three articulations between the atlas (C1) vertebra and the axis (C2) vertebra, consisting of the joints between the inferior articular processes of C1 and the superior articular processes of C2, and the articulation between the dens of C2 and the anterior arch of C1

sacrum

bone formed from five vertebrae fused together near the base of the spinal column

what are the features of the sacrum

fused transverse processes, anterior and posterior sacral foramina, passage of the primary rami of the sacral nerves, roughened dorsal surface. median sacral crest with 4 tubercles (spinous process), make up the median acral crest. The lateral sacral crest is the remnants of the transverse process. Sacral ala and body and the sacral canal is continuous with the C5 foramen.

what does S5 tubercle not have that others do

tubercle, and no posterior element that fuse opens and normal defect.

what is the sacral hiatus used for clinically

epidural as there is no spinal chord as it finishes at S2

Coccyx segments

2-4 these articulate at the sacrococcygeal joint.

lumbosacral joint

pertaining to the joint between the last lumbar vertebra and the sacrum

sacroiliac joint

the joint between the sacrum and the ilium

what movement does the sacroiliac joint have

not a great range 2-5 degrees, flexion extension and some rotation partly synovial partly syndesmotic.

on the sacral side what cartilage does the sacroiliac joint have

hyaline

on the iliac side what cartilage does the sacroiliac joint have

fibrocartilage

coccygeal cornu

hornlike projections found on each side of superior aspect of coccyx

sacrococcygeal symphysis

between sacrum and coccyx

anterior and posterior sacrococcygeal ligaments

attach sacrum to coccyx

what movement does the sacrococcygeal symphysis

anterior and posterior movement

AP lower cervical

AP open mouth

Used to visualize C1 and C2

Lateral cervical

side of neck

AP sacrum

Lateral sacrum

spinal ligaments

anterior longitudinal ligament, ligament flavum, supraspinous ligaments, interspinous ligament, capsular ligament, posterior longitudinal ligament

anterior longitudinal ligament

flow from C1 to sacrum inferiorly, anterior side of vertebral disks, assists to limit extensions of the whole spinal region

ligament flavum

between lamina to lamina. C1 to sacral canal, yellow due to elastin fibres. Restricts too much flexion

supraspinous ligament

tip of spinous process to tip of the spinous process of L5 up to become continuous with nuchal ligament, resists flexion

interspinous ligament

between spinous processes AP are long limited width. Lay largely midline resisting flexion

capsular ligament

facet joints are true synovial joints they have a capsule which is reinforced by this

posterior longitudinal ligament

C2 - sacral canal strong connection to posterior of the annulus fibrosis of the intervertebral disks. Has a gap where posterior vertebral body is. This is due to the vein that needs to drain the medullary cavity of the vertebral body,

what vein drains the medullary cavity of the vertebral body

basivertebral veins

Ossification of the anterior longitudinal ligament

ossification of the interspinous ligament and supraspinous ligament

what happens when ligaments ossificate

less movement loss of joint space

lumbosacral ligament

iliolumbar ligament, short posterior sacroiliac ligaments long posterior sacroiliac ligament, posterior sacrococcygeal ligament, anterior sacroiliac ligament, nuchal ligament, cruciform ligament alar ligament

iliolumbar ligament

from iliac crest towards the transverse process L4 to L5

short posterior sacroiliac ligaments

from iliac crest to the dorsal access of the sacrum

long posterior sacroiliac ligament

comes down to fuse with Sacro tuberous ligament

posterior sacrococcygeal ligament

between dorsal aspects of sacrum and coccygeal reinforces sacrococcygeal joint

anterior sacroiliac ligament

strong ligament between the sacrum and the ilium portions of the hip bone that supports the anterior side of the sacroiliac joint

Nunchal ligament

this is homologues to the supraspinous ligament, tips of cervical vertebrae, limits flexion of the neck and extends from external occipital tuberance process to C7. Provides attachment sites for cervical muscles

cruciform ligament

ligament longitudinal posterior side of the C2 vertebral body to anterior part of the foramen magnum transverse between lateral mass of axis to the lateral mass of the axis on contralateral side

foramen magnum

A large opening at the base of the skull through which the brain connects to the spinal cord.

what does the transverse cruciform ligament prevent

the dense from moving posteriorly into the C1 vertebral foramen and compress whatever is in it we will lose stability in the medial atlanto axial joint and too much flexion and extension

alar ligament

tip of dens to the cruciform ligament and insets onto the lateral margins of the later foramen, limits lateral flexion and rotation too much movement means risk of compression of the brain

tectorial membrane

continuation of posterior longitudinal ligament to the anterior margin of the foramen magnum

vertebral foramen boarders

by vertebral body, pedicle and intervertebral foramina, lamina and spinous process and or ligaments

what does the vertebral foramen contents

spinal chord, meninges nerve rooms epidural fat

what is the spine supplied by

anterior and posterior spinal arteries, anterior branch from vertebral artery, posterior from vertebral artery, anterior lives in the anterior median fissure, posterior just laterally to the posterior lateral sulcus basivertebral artery and internal vertebral plexus

Larynx

voice box; passageway for air moving from pharynx to trachea; contains vocal cords

pharynx

throat; passageway for food to the esophagus and air to the larynx

What are the 3 unpaired cartilages of the larynx?

thyroid, cricoid, epiglottis

What are the 6 paired cartilages in the larynx?

retinoid, corniculate, cuneiform

Where does the larynx lie?

between the pharnyx and trachea and C3-6

hyoid bone

a U-shaped bone in the neck that supports the tongue.

thyroid cartilage

made up of laminae and superior thyroid notch and laryngeal prominence

tracheal rings

rings of cartilage that provide structural support to the trachea and bronchi

cricothyroid membrane

A thin sheet of fascia that connects the thyroid and cricoid cartilages that make up the larynx.

cricotracheal ligament

connects lower border of cricoid cartilage with upper border of first tracheal ring

thyrohyoid membrane

stretches across the space between the greater cornu of the hyoid and the lateral thyroid

epiglottis

A flap of tissue that seals off the windpipe and prevents food from entering.

Paired corniculate cartilages

horn-shaped pieces of elastic cartilage, are located at the apex of each arytenoid cartilage

Paired arytenoid cartilages

ride on the high-backed upper surface of the cricoid cartilage, forming the posterior point of attachment for the vocal folds

quadrangular membrane

Submucosal sheet of elastic tissue, extending between the lateral parts of the arytenoid and epiglottic cartilages

Superior free margins in aryepiglottic folds form "Aryepiglottic Ligament"

Inferior free margins in aryepiglottic folds form "Vestibular Ligament"

vocal ligament

These are also called the true vocal folds.

what do the vocal ligaments

extends from arytenoid cartilage to the posterior laryngeal prominence. Producing sound tension and length by arotinoid cartilage, adduct or abduct changes tension pitch and quality

what does the quadrangular membrane do

lateral part of the epiglottis to the superior part of the aretoid cartilage free boarders superior and inferiorly.

vestibular ligament

make up the false vocal chords

cricothyrotomy

emergency airway procedure through an incision in the neck, through the cricothyroid membrane

tracheotomy

where the tube is introduced into tracheal rings

intubation

the insertion of a tube into a body canal or cavity, as in endotracheal intubation

costophrenic angle

extreme outermost lower corner of each lung where diaphragm meets the ribs. Where the chest and diaphragm meet

how to palpate the hyoid

move inferiorly from the mandible

palpate thyroid cartilage

extend cervical spine and palpate the thyroid cartilage

how do you palpate the thyrohyoid membrane

palpate between thyroid laminae and hyoid bone

palpating cricoid cartilage

lies inferior to the thyroid cartilage

palpate cricothyroid membrane

thyroid laminae and cricoid cartilege

jugular notch palpation

superior extent on manubrium ending at the clavicular notches laterally

palpate CCA

cricoid cartilage to thyroid

cricothyrotomy placement

laryngeal prominence and cricoid cartilage, draw a dashed line horizontally though the cricothyroid membrane

tracheotomy placement

halfway between jugular notch and cricothyroid cartilage

how to find the external jugular vein

compression of the EJV just superior to the subclavian

Valsalva manoeuvre, abdominojugular reflux compressing the liver and decreases blood flow

fovea dentis

articulates with the dens of C2; located on the posterior border of the anterior arch

nunchal ligament is continuation of what

supraspinous ligament

what restricts the extension of the ligament

anterior longitudinal

vertebrobasilar system

right and left vertebral artery and basilar artery

V1

V1: pre-foraminal segment​ origin to the transverse foramen of C6. subclavian artery inferiorly C6 transverse foramen superiorly

V2

V2: foraminal segment​ from the transverse foramen of C6 to the transverse foramen of C2

V3

V3: atlantic, extradural or extraspinal segment starts from C2, where the artery loops and turns lateral to ascend into the transverse foramen continues through C1 to pierce the dura

V4

V4: intradural or intracranial segment​ from the dura at the lateral edge of the posterior atlanto-occipital membrane to their confluence on the medulla to form the basilar artery

uncovertebral joint

Growth of the unicate processes in the cervical vertebrae that presses on the intervertebral disc and can lead to tearing of intervertebral discs in the cervical region