Back vivas demonstrate the bony features of the Atlas and Axis

2010-1, 2005-1

• 
  Atlas: Anterior and posterior arches
  
• 
  Axis: Dens, spinous process
  
• 
  C3-7: Body, pedicle, lamina, superior and inferior articular process, spinous process
  
• 
  Zygapophysial (facet) joint
  
• 
  Intervertebral disc space
  

• 
  Anterior Longitudinal ligament -> Anterior atlantoaxial and atlanto-occipital membrane
  
• 
  Posterior longitudinal ligament -> Tectorial membrane
  
• 
  Ligamentum flavum (between lamina) -> Posterior atlantoaxial and atlanto-occipital membrane
  
• 
  Interspinous ligaments
  
• 
  Supraspinous (tips of spinous processes) to C7, then -> nuchal ligament
  
• 
  Intertransverse ligament
  

• 
  Cruciate ligament
  
• 
  Alar ligament
  

1. 
   Prevertebral (anterior) soft tissue
   
2. 
   Anterior vertebral bodies
   
3. 
   Posterior vertebral bodies
   
4. 
   Spino-lamina line
   
5. 
   Tips of spinous processes
   

Lateral mass of Atlas (C1), Body of Axis (C2), Dens of Axis (C2), Lateral atlanto-axial joints, Spinous process of Axis (C2), Mandible w/ rami, Occiput w/ occiptal condyles, atlanto-occiptal joint

• 
  
  Stabilising structures:
  
  • 
    Anterior arch of Atlas
    
  • 
    Transverse ligament, part of the…
    
  • 
    Cruciate ligament, including superior and inferior longitudinal bands
    
  • 
    Anterior longitudinal ligament -> Anterior atlantoaxial membrane -> Anterior atlantoccipital membrane
    
  • 
    Posterior longitudinal ligament -> Tectorial membrane
    
  • 
    Alar ligaments (check rotation)
    
  • 
    Capsule of lateral atlanto-axial joints
    
  
  

• 
  Tectorial membrane (PLL): post. part of body in canal via foramen magnum to cranial cavity
  
• 
  Anterior atlanto-axial membrane (ALL): Anterior body to anterior arch of atlas
  
• 
  Posterior atlanto-axial membrane (LF): Laminae to posterior arch of atlas
  
• 
  Alar: Sides of dens to lateral margins of the foramen magnum
  
• 
  Cruciate - inferior longitudinal part: from post. body of C2 -> transverse ligament between tubercles of lateral masses of C1, and superior longitunal part to anterior rim of foramen magnum
  

1. 
   Body (smaller than triangular vertebral foramen)
   
2. 
   Transverse Process with foramen transversarum (vertebral artery and veins except C7 veins only)
   
3. 
   Lamina (w/ pedicles form the vertebral arch) – note pars interarticularis
   
4. 
   Spinous Process – often bifid
   
5. 
   Superior and Inferior Articular Processes
   

1. 
   Intervertebral Joint
   
   • 
     Symphyses (i.e. secondary cartilaginous joints)
     
   • 
     Anulus fibrosus (inserted into epiphysial rims) and nucleus pulposus
     
2. 
   Zygapophyseal aka facet joints
   
   • 
     Plane synovial joints
     
   • 
     Between adjacent superior and inferior articular surfaces
     
   • 
     Surrounded by joint capsule that is loose in the cervical region
     

1. 
   Upper facets face obliquely up and back
   
2. 
   Lower facets face down and forwards
   
3. 
   Flexion/Extension, lateral flexion (abduction)
   
4. 
   No rotation
   

2011-2, 2011-1, 2009-1, 2007-1, 2003-2

• 
  
  Identify this bone, and demonstrate its bony features.
  
  • 
    Body
    
  • 
    Pedicle
    
  • 
    Transverse processes
    
  • 
    Articular facets: Superior and inferior
    
  • 
    Costal facets: Superior/Inferior costal facets (head of rib), Transverse costal facet (tubercle of rib)
    
  • 
    Spinous process
    
  • 
    Lamina
    
  • 
    Vertebral foramen
    
  • 
    Intervertebral notch (space for intervertebral foramina)
    
  
  

• 
  Rotation: the facets joint planes are aligned vertically on arc centred on vertebral bodies
  
• 
  Some lateral flexion, very limited flexion + extension – stability is conferred though connections to sternum
  

• 
  Anterior longitudinal
  
• 
  Posterior longitudinal
  
• 
  Interspinous
  
• 
  Supraspinous
  
• 
  Ligamentum flavum
  

• 
  Body: heart to kidney shape
  
• 
  Spinous process: from long vertical to short horizontal
  
• 
  Facets on transverse process: concave to flat, A-P to lat-med directed
  
• 
  Costal facets on body: from demi to single on 10,11,12
  
• 
  Spinal canal: from round to triangular
  

• 
  
  Identify this bone, and demonstrate its bony features.
  
  • 
    Body
    
  • 
    Pedicle (to upper half)
    
  • 
    Transverse processes
    
  • 
    Superior and inferior articular facets
    
  • 
    Spinous process
    
  • 
    Lamina Vertebral foramen
    
  • 
    Intervertebral foramina
    
  • 
    Also: Groove for medial branch of post ramus spinal nerve with mamillary process above, and accessory tubercle below
    
  
  

• 
  Flexion + extension (sagitally orientated facet joint planes)
  
• 
  Lateral flexion
  
• 
  Very limited rotation
  

1. 
   Bony: Large body with intevertbral joint/discs (not really bony), orientation of facets
   
2. 
   Ligamentous: Anterior longitudinal, posterior longitudinal supraspinous, interspinous, intertransverse, ligamentum flavum
   
3. 
   Muscular: thick mass of muscle both anterior and posterior (erector spinae)
   

2005-2

• 
  Lumbar vertebra
  
• 
  No costal facets
  
• 
  No foramen transversarium
  
• 
  Triangular vertebral foramen
  
• 
  Articular facets lie in AP plane
  
• 
  Kidney shaped body
  
• 
  Large Mamillary bodies
  

Extra: The Scotty Dog on posterolateral oblique view – note the pars interacrticularis = neck

• 
  Sacrum consists of 5 fused bones and the coccyx
  
• 
  4 pairs of sacral foramina – S1-S4 anterior larger than posterior
  
• 
  Ala
  
• 
  Sacroiliac joint
  
• 
  Superior Articular facets
  
• 
  Lumbrosacral joint
  
• 
  5 Vertical lines – median, intermediate and lateral