All right, let's discuss the vertebral column, and so
let's first of all figure out where it is on your own body and palpate.
If you touch on the back, you should feel these bumps all the way down the midline.
These are the spinous processes right here, and you can see that depending on
where you are in terms of the vertebral column, some are quite extensive.
Whereas some are quite short, and
we'll talk about some of the more extensive ones in a moment.
So you can see here we have a disarticulated, but organized vertebral
column, and we'll talk about the five main categories of the vertebral column.
You're gonna have your neck vertebrae,
which are your cervical vertebrae, up here.
There are 7 cervical vertebrae.
Your thoracic or intermediate, there are 12 here.
Lumbar, you hear lumbar pain or lumbar back pain, these are gonna be the most
inferior of your moveable vertebrae, and you have 5 lumbar vertebrae.
And how I always remember these is think about when you actually are going to eat.
So you eat breakfast at 7.
You have lunch at 12 for your 12 thoracic vertebrae.
And you catch the early bird special for the lumbar vertebrate with 5.
Now those are the movable joints, so
they have those intervertebral joints in between, allowing for
lateral flexion, flexion, extension, a little bit of hyper extension.
And then you're going to have your immovable vertebrae, so
these vertebrae have fused over time.
So in adults, you will have complete fusion,
meaning that there's no invertebral disk between the vertebrae.
So that's your sacrum, which we'll discuss in another video.
There are gonna be 5 sacral vertebrae that fuse, and then the coccyx,
that's a remnant or vestige of the tail.
You're gonna have 3 to 4 coccygeal vertebrae that are gonna fuse over time.
Okay, so let's talk a little bit before we get into the individual portions or
the individual characteristics of the vertebrae about curvatures.
Now there are normal curvature in the vertebral column.
Obviously you can have something pathological occur to have the curvature
be extended or accentuated.
But there are gonna be four main curvatures.
You're gonna have two primary curvatures, which are your thoracic and
your sacral vertebrae.
So these will occur in utero.
And then you have two secondary curvatures associated with your cervical vertebrae
and your lumbar vertebrae.
Now let's think about why these would be
considered secondary curvatures as opposed to primary.
What's something that occurs very early on, after birth,
one of the first milestones for a kid, when you think about in terms of the neck?
So you think kids, why you have to hold their heads.
After time, they eventually will be able to hold up their head on their own.
And so with that,
you'll get the creation of the natural curvature that occurs at the neck.
So that's one reason why that's a secondary curvature.
Whereas with lumbar, this occurs a little bit later on.
One of the first milestones that happen around age 1, earlier for
some individuals, later in others, is being able to locomote or actually walk.
So that's why your lumbar curvature is considered secondary.
Okay, so let's talk about how you're actually gonna be able to identify, or
distinguish, between the moveable vertebrae.
And the most obvious thing when you're talking about cervical vertebrae, and
I';m gonna bring, or actually i';m gonna use this first cervical vertebrae to show you.
You can see this hole right here, and you have one on either side,
these are referred to as your transverse foramina.
You only have transverse foramina in cervical vertebrae.
So if you have a transverse foramen,
you know you're looking at a cervical vertebrae.
Now what goes through this?
You're gonna have your vertebral vasculature that's going to be ascending
from your subclavian artery up to the brain, so one of the primary supplies for
the brain.
So you'll have foramina through 7 all the way up to 1 to get to the brain.
Now these two cervical vertebrae, this is cervical vertebrae 1,
this is cervical vertebrae 2.
They are unique in terms of their appearance.
As you can see with cervical vertebrae 1, and a lot of times,
we just refer to this as C1.
You don't have much of a spinous process here, and you do not have a body.
But you do have these very obvious and long condyles right here.
And this is what's actually articulating with the skull, or
those occipital condyles of the occipital bone.
So if you think about this right here, you put the skull here,
it's kind of holding the skull up.
And we refer to this bone as C1, but also as atlas.
So think of atlas holding the world on your shoulders, and
that's what's occurring here.
Now the joint between the occipital condyles in C1 allows for
us to do this motion.
Yes, okay?
So that flexion occurs there.
Now C2 is also an irregular vertebrae, and
the most prominent thing is what we refer to as the dens or
the odontoid process that's going to articulate with C1 like this.
And allow for a pivot motion to occur here, so allow for
us to say no, so that rotational movement right here.
All right, so these are the two uncommon or atypical cervical vertebrae.
One other thing I wanna note about cervical vertebrae, at 1, 2, 3,
4, 5, 6, 7, and about T1, we refer to these as the vertebrae prominence.
And that just means that the spinous process in this area is
going to have the longest projection posteriorly.
So if you kinda flex your neck,
you can really feel that vertebrae poking out right there.
And that gives you a good indication, if you're gonna do any type of injection in
that region, where you're at in terms of the spinal cord.
Okay, so that's cervical vertebrae.
Let's move inferiorly to the intermediate of the movable vertebrae, your thoracic.
And the most obvious and prominent thing about the thoracic vertebrae and
how you're going to be able to tell the difference between these two
is that these articulate with the ribs.
And with any articulation, you're gonna have smooth
areas where they're actually articulating with the other bone.
So you have one always on your transverse processes,
as well as associated with the body.
So the tubercle of the rib is articulating with the transverse process.
And the head of the rib with the body of the vertebrae.
So any time you have any type of costal facet, or the smooth area there,
you know you're looking at a thoracic vertebrae.
So transverse foramen and cervical vertebrae, costal facets in thoracic
vertebrae, and then lumbar vertebrae, how are you gonna tell the difference here?
Well first and foremost, it doesn't have any of the things we just discussed, so
that's one of the major ways.
One other thing I want you to note, if you look at comparison, these are just huge.
They are the most robust of your vertebrae, and
that makes sense if you think about all the weight that you're
carrying on the lower portion of your back, you need these larger vertebrae.
And you can see, in particular, the vertebral body is especially large.
So you wouldn't have any transverse foramen, any costal facets.
And they're just huge in comparison to the others, so, five lumbar vertebrae.
Now a few things I want to note that you'll have on all vertebrae.
We've discussed the spinous processes.
These are gonna project posteriorly.
On either side, you have projection laterally,
you'll have your transverse processes, okay?
So in certain vertebrae,
they're gonna be more important, articulating with the ribs.
In others, you';re gonna see that they can be quite short.
Also you're going to have, right in the middle, this huge foramen, or
your vertebral foramen.
This is of particular importance because this is where your spinal
cord is traveling through.
So if you think about a rib here,
your spinal cord is gonna be traveling through this area.
Vertebral body, depending on which type of vertebrae you'e talking about,
can be quite robust or fairly small.
And then one thing that you can really only see when you're talking about
articulated vertebrae is when they are connected together or articulating.
You're gonna have this hole that's created right here.
And we refer to this as the intervertebral foramen.
Now as we all know, things from the spinal cord, so
fibers from the spinal cord are going to have to get to the rest of the body, and
this is how they're doing it.
So you're actually gonna have the exit of your spinal nerves through this region.
So if you think about it, if you have any type of excess bone growth in this region,
or an inflammation in this region, or
even some type of herniation of the intervertebral discs here,
that can really get into this area and pinch that nerve.
So if you've heard of a pinched nerve,
it typically has something to do with this intervertebral foramen region.