Bones of the neck

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Bones of the neck

MDBS 704 - Musculoskeletal system

MDBS 704 - Musculoskeletal system

Introduction to the skeletal system
Introduction to the muscular system
Bones of the neck
Bones of the vertebral column
Joints of the vertebral column
Vessels and nerves of the vertebral column
Muscles of the back
Bones of the upper limb
Fascia, vessels and nerves of the upper limb
Anatomy of the brachial plexus
Anatomy of the pectoral and scapular regions
Anatomy of the arm
Muscles of the forearm
Vessels and nerves of the forearm
Muscles of the hand
Anatomy of the sternoclavicular and acromioclavicular joints
Anatomy of the glenohumeral joint
Anatomy of the elbow joint
Anatomy of the radioulnar joints
Joints of the wrist and hand
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Bones of the lower limb
Fascia, vessels and nerves of the lower limb
Anatomy of the anterior and medial thigh
Muscles of the gluteal region and posterior thigh
Vessels and nerves of the gluteal region and posterior thigh
Anatomy of the popliteal fossa
Anatomy of the leg
Anatomy of the foot
Anatomy of the hip joint
Anatomy of the knee joint
Anatomy of the tibiofibular joints
Joints of the ankle and foot
Development of the axial skeleton
Development of the limbs
Development of the muscular system
Bone histology
Cartilage histology
Skeletal muscle histology
Skeletal system anatomy and physiology
Bone remodeling and repair
Cartilage structure and growth
Fibrous, cartilage, and synovial joints
Muscular system anatomy and physiology
Brachial plexus
Neuromuscular junction and motor unit
Sliding filament model of muscle contraction
Slow twitch and fast twitch muscle fibers
Muscle contraction
Radial head subluxation (Nursemaid elbow)
Developmental dysplasia of the hip
Legg-Calve-Perthes disease
Slipped capital femoral epiphysis
Transient synovitis
Osgood-Schlatter disease (traction apophysitis)
Rotator cuff tear
Dislocated shoulder
Winged scapula
Thoracic outlet syndrome
Carpal tunnel syndrome
Ulnar claw
Erb-Duchenne palsy
Klumpke paralysis
Iliotibial band syndrome
Unhappy triad
Anterior cruciate ligament injury
Patellar tendon rupture
Meniscus tear
Patellofemoral pain syndrome
Sprained ankle
Achilles tendon rupture
Spondylolysis
Spondylolisthesis
Degenerative disc disease
Spinal disc herniation
Sciatica
Compartment syndrome
Rhabdomyolysis
Osteogenesis imperfecta
Craniosynostosis
Pectus excavatum
Arthrogryposis
Genu valgum
Genu varum
Pigeon toe
Flat feet
Club foot
Cleidocranial dysplasia
Achondroplasia
Osteomyelitis
Bone tumors
Osteochondroma
Chondrosarcoma
Osteoporosis
Osteomalacia and rickets
Osteopetrosis
Paget disease of bone
Osteosclerosis
Lordosis, kyphosis, and scoliosis
Osteoarthritis
Spondylosis
Spinal stenosis
Rheumatoid arthritis
Juvenile idiopathic arthritis
Gout
Calcium pyrophosphate deposition disease (pseudogout)
Psoriatic arthritis
Ankylosing spondylitis
Reactive arthritis
Spondylitis
Septic arthritis
Bursitis
Baker cyst
Muscular dystrophy
Polymyositis
Dermatomyositis
Inclusion body myopathy
Polymyalgia rheumatica
Fibromyalgia
Rhabdomyosarcoma
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Sjogren syndrome
Systemic lupus erythematosus
Mixed connective tissue disease
Antiphospholipid syndrome
Raynaud phenomenon
Scleroderma
Back pain: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Gout and pseudogout: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Scleroderma: Pathology review
Sjogren syndrome: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Osteoporosis medications

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)