Bones of the neck

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Bones of the neck

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Bones of the cranium
Anatomy of the cranial base
Anatomy of the orbit
Anatomy of the eye
Anatomy of the nose and paranasal sinuses
Anatomy of the oral cavity
Anatomy of the temporomandibular joint and muscles of mastication
Muscles of the face and scalp
Anatomy of the salivary glands
Nerves and vessels of the face and scalp
Anatomy of the tongue
Anatomy of the pterygopalatine (sphenopalatine) fossa
Anatomy of the cranial meninges and dural venous sinuses
Anatomy of the inner ear
Anatomy of the cerebral cortex
Anatomy of the cerebellum
Cerebellum
Anatomy of the brainstem
Anatomy of the basal ganglia
Anatomy of the blood supply to the brain
Nervous system anatomy and physiology
Anatomy of the white matter tracts
Anatomy of the limbic system
Introduction to the cranial nerves
Cranial nerve pathways
Anatomy of the olfactory (CN I) and optic (CN II) nerves
Anatomy of the oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy of the trigeminal nerve (CN V)
Anatomy of the facial nerve (CN VII)
Anatomy of the glossopharyngeal nerve (CN IX)
Anatomy of the spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy of the vagus nerve (CN X)
Bones of the neck
Superficial structures of the neck: Posterior triangle
Superficial structures of the neck: Cervical plexus
Superficial structures of the neck: Anterior triangle
Deep structures of the neck: Prevertebral muscles
Anatomy of the thyroid and parathyroid glands
Anatomy of the larynx and trachea
Anatomy of the pharynx and esophagus
Anatomy of the lymphatics of the neck
Deep structures of the neck: Root of the neck
Fascia and spaces of the neck
Eye and ear histology
Nasal cavity and larynx histology
Thyroid and parathyroid gland histology
Anatomy and physiology of the eye
Photoreception
Optic pathways and visual fields
Anatomy and physiology of the ear
Auditory transduction and pathways
Vestibular transduction
Vestibulo-ocular reflex and nystagmus
Olfactory transduction and pathways
Taste and the tongue
Thyroid hormones
Phosphate, calcium and magnesium homeostasis
Parathyroid hormone
Vitamin D
Calcitonin
Color blindness
Cortical blindness
Hemianopsia
Homonymous hemianopsia
Bitemporal hemianopsia
Cataract
Glaucoma
Retinal detachment
Age-related macular degeneration
Diabetic retinopathy
Corneal ulcer
Retinoblastoma
Retinopathy of prematurity
Periorbital cellulitis
Uveitis
Keratitis
Orbital cellulitis
Hordeolum (stye)
Conjunctivitis
Neonatal conjunctivitis
Conductive hearing loss
Eustachian tube dysfunction
Tympanic membrane perforation
Otitis externa
Otitis media
Sialadenitis
Parotitis
Ludwig angina
Aphthous ulcers
Temporomandibular joint dysfunction
Oral cancer
Warthin tumor
Sleep apnea
Gastroesophageal reflux disease (GERD)
Zenker diverticulum
Retropharyngeal and peritonsillar abscesses
Esophageal cancer
Laryngomalacia
Laryngitis
Bacterial epiglottitis
Thyroglossal duct cyst
Thyroid cancer
Hyperparathyroidism
Hypoparathyroidism
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Eye conditions: Retinal disorders: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Vertigo: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Antihistamines for allergies
Acid reducing medications
Hyperthyroidism medications
Hypothyroidism medications
Central nervous system histology
Peripheral nervous system histology
Neuron action potential
Cerebral circulation
Blood brain barrier
Cerebrospinal fluid
Cranial nerves
Ascending and descending spinal tracts
Motor cortex
Pyramidal and extrapyramidal tracts
Muscle spindles and golgi tendon organs
Spinal cord reflexes
Sensory receptor function
Somatosensory receptors
Somatosensory pathways
Sympathetic nervous system
Adrenergic receptors
Parasympathetic nervous system
Cholinergic receptors
Enteric nervous system
Basal ganglia: Direct and indirect pathway of movement
Body temperature regulation (thermoregulation)
Hunger and satiety
Spina bifida
Chiari malformation
Dandy-Walker malformation
Syringomyelia
Tethered spinal cord syndrome
Aqueductal stenosis
Septo-optic dysplasia
Cerebral palsy
Spinocerebellar ataxia (NORD)
Transient ischemic attack
Ischemic stroke
Intracerebral hemorrhage
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Saccular aneurysm
Arteriovenous malformation
Broca aphasia
Wernicke aphasia
Wernicke-Korsakoff syndrome
Kluver-Bucy syndrome
Concussion and traumatic brain injury
Shaken baby syndrome
Seizures and epilepsy
Febrile seizure
Early infantile epileptic encephalopathy (NORD)
Tension headache
Cluster headache
Migraine
Idiopathic intracranial hypertension
Trigeminal neuralgia
Cavernous sinus thrombosis
Alzheimer disease
Vascular dementia
Frontotemporal dementia
Dementia with Lewy bodies
Creutzfeldt-Jakob disease
Normal pressure hydrocephalus
Torticollis
Essential tremor
Restless legs syndrome
Parkinson disease
Huntington disease
Opsoclonus myoclonus syndrome (NORD)
Multiple sclerosis
Central pontine myelinolysis
Acute disseminated encephalomyelitis
Transverse myelitis
JC virus (Progressive multifocal leukoencephalopathy)
Adult brain tumors
Acoustic neuroma (schwannoma)
Pituitary adenoma
Pediatric brain tumors
Brain herniation
Brown-Sequard Syndrome
Cauda equina syndrome
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Friedreich ataxia
Neurogenic bladder
Meningitis
Neonatal meningitis
Encephalitis
Brain abscess
Epidural abscess
Congenital neurological disorders: Pathology review
Headaches: Pathology review
Seizures: Pathology review
Cerebral vascular disease: Pathology review
Traumatic brain injury: Pathology review
Spinal cord disorders: Pathology review
Dementia: Pathology review
Central nervous system infections: Pathology review
Movement disorders: Pathology review
Neuromuscular junction disorders: Pathology review
Demyelinating disorders: Pathology review
Adult brain tumors: Pathology review
Pediatric brain tumors: Pathology review
Neurocutaneous disorders: Pathology review
Cholinomimetics: Direct agonists
Cholinomimetics: Indirect agonists (anticholinesterases)
Muscarinic antagonists
Sympathomimetics: Direct agonists
Sympatholytics: Alpha-2 agonists
Adrenergic antagonists: Presynaptic
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
Migraine medications
General anesthetics
Local anesthetics
Neuromuscular blockers
Anti-parkinson medications
Medications for neurodegenerative diseases
Opioid agonists, mixed agonist-antagonists and partial agonists
Opioid antagonists
Anatomy clinical correlates: Spinal cord pathways

Notes

Figure 1: Overview of the bones of the neck. A. Lateral view. B. Anterior view.
Figure 2: C1 (atlas) A. Anterior view. B. Lateral view. C. Superior view.
Figure 3: C2 (axis) A. Anterior view. B. Lateral view. C. Superior view.
Figure 4: C7 A. Anterior view. B. Lateral view. C. Superior view.
Figure 5: Typical vertebra (C4) A. Anterior view. B. Lateral view. C. Superior view.
Figure 6: Hyoid bone A. Anterior view. B. Lateral view.
Illustrator: Elizabeth Nixon-Shapiro, CMI, MSMI
Editor: Andrew Horne
Editor: Cara Sandholdt, PhD

Transcript

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The neck is the anatomical region between the base of the cranium superiorly and the clavicles inferiorly and it joins the head to the trunk and limbs, serving as a major conduit for structures passing between them.

The skeleton of the neck is formed by the cervical vertebrae, the hyoid bone, and the manubrium of the sternum which are part of the axial skeleton, as well as the clavicles which are part of the appendicular skeleton.

.Alright, so let’s start with the cervical vertebrae, of which there are 7.

These are the smallest vertebrae, and they form the cervical region of the vertebral column, enclosing the cervical spinal cord and meninges.

Cervical vertebrae can be typical or atypical, and when it comes to the cervical column, the typical vertebrae are C3, C4, C5 and C6, while the atypical vertebrae are C1, C2 and C7.

Ok so, all typical vertebrae have a vertebral body, a vertebral arch and seven individual processes.

The vertebral body is situated anteriorly, and it’s small and longer from side to side than anteroposteriorly.

It has a concave superior surface and a convex inferior surface.

These surfaces are the vertebral endplates, which help form the intervertebral joints together with the intervertebral discs and the adjacent vertebra.

On the superior surface, there’s an elevated superolateral margin called the uncus of the body, or the uncinate process.

Next, there’s the vertebral arch, which is located posterior to the vertebral body and is formed by two pedicles and two laminae.

The pedicles are short, thick processes that project posteriorly from the vertebral body to meet the laminae, which are two broad, flat plates of bone, that unite in the midline and complete the vertebral arch.

The vertebral arch and the posterior surface of the vertebral body form the walls of the vertebral foramen through which the spinal cord and its meninges pass.

The vertebral foramen is rather large and, in the cervical region, triangular.

Next up, superior and inferior to the pedicles, there are shallow depressions called vertebral notches.

When the vertebrae articulate, these notches align with those on the neighboring vertebrae and form the openings of the intervertebral foramina through which the spinal nerves emerge from the vertebral column.

Finally, each typical vertebrae has seven processes that arise from the vertebral arch: a spinous process, two transverse processes and four articular processes.

So, the spinous process is located in the middle and projects posteriorly and usually inferiorly, typically overlapping the vertebra below.

Interestingly enough, even though spinous processes are typically unified, meaning they end with a single tip, C3-C6 spinous processes can also be bifid, typically in individuals of European heritage.

Next, there are the two transverse processes, which project laterally and end as two projections called the anterior and posterior tubercle, which serve as muscle attachment points.

The transverse processes of C1 - C6 also have a hole called the foramen transversarium, which serves for the passage of the vertebral arteries and veins.

The foramen transversarium of C7 only houses small accessory veins, and it can be absent.

Finally, the four articular processes, two superior and two inferior, arise from the junctions of the pedicles and laminae, and each has an articular surface or facet.

The superior facets are oriented superoposteriorly and the inferior facets are directed inferoanteriorly.

The superior and inferior articular processes articulate with the corresponding processes of the neighboring vertebrae to form the zygapophysial joints.

These joints determine the types of movement permitted and restricted between the neighboring vertebrae of each region and also they keep the vertebrae aligned, preventing one vertebra from translating, or slipping, anteriorly on the vertebra below.

Now let’s switch gears and look at the atypical vertebrae, called so because they have different characteristics from the other vertebrae.

First, vertebra C1, also called the atlas, is a ring shaped bone that doesn’t have a body or a spinous process.

So, instead of a body, it has paired lateral masses that serve as a body and sustain the weight of the globe-like cranium just like Atlas of Greek mythology, who bore the weight of the world on his shoulders.

The transverse processes of the atlas arise from the lateral masses, so these processes are placed more laterally than those of the inferior vertebrae.

This makes the atlas the widest of the cervical vertebrae.

Now, the lateral masses have two superior, concave, kidney-shaped articular surfaces.

These surfaces articulate with two large cranial protuberances on either side of the foramen magnum on the occipital bone, to form the atlanto-occipital joint.

The movements permitted in this joint are flexion and extension - think about head banging at a rock concert - and a small amount of lateral flexion and rotation, like when you look over your shoulder.

The anterior and posterior arches extend between the lateral masses and form a complete ring.

The anterior arch has an anterior tubercle and a facet for the dens, and the posterior arch has a posterior tubercle and a groove for the vertebral artery.

Key Takeaways

The bones of the neck consist of the cervical spine made up of seven vertebrae and support the weight of the head. Between each vertebra is an intervertebral disk that helps cushion the spinal cord. The spinal cord travels down the center of the spine, and branches out to form nerves that control all parts of the body. Other bones of the neck include the hyoid bone, the manubrium of the sternum, and the clavicles.

Sources

  1. "Human Anatomy & Physiology, 11th edition" Pearson (2018)
  2. "Costanzo Physiology, 7th edition" Elsevier (2021)
  3. "Moore’s Clinically Oriented Anatomy, 9th edition" Wolters Kluwer (2023)
  4. "Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature" Int J Environ Res Public Health (2021)
  5. "Cervicogenic Headache: Current Perspectives" Neurol India (2021)
  6. "Osteoporosis – risk factors, pharmaceutical and non-pharmaceutical treatment" European Review for Medical and Pharmacological Sciences (2021)