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The Cervical Vertebræ Vertebræ Cervicales
are the smallest of the true vertebræ, and can be readily distinguished from those of the thoracic or lumbar regions by the presence of a foramen in each transverse process. The first, second, and seventh present exceptional features and must be separately described; the following characteristics are common to the remaining four.
First Cervical Vertebra
is named the atlas because it supports the globe of the head. Its chief peculiarity is that it has no body, and this is due to the fact that the body of the atlas has fused with that of the next vertebra. Its other peculiarities are that it has no spinous process, is ring-like, and consists of an anterior and a posterior arch and two lateral masses.
Second Cervical Vertebra
is named the epistropheus or axis because it forms the pivot upon which the first vertebra, carrying the head, rotates. The most distinctive characteristic of this bone is the strong odontoid process which rises perpendicularly from the upper surface of the body.
The Seventh Cervical Vertebra
The most distinctive characteristic of this vertebra is the existence of a long and prominent spinous process, hence the name vertebra prominens. This process is thick, nearly horizontal in direction, not bifurcated, but terminating in a tubercle to which the lower end of the ligamentum nuchæ is attached.
The Thoracic Vertebræ Vertebræ Thoracales
are intermediate in size between those of the cervical and lumbar regions; they increase in size from above downward, the upper vertebræ being much smaller than those in the lower part of the region. They are distinguished by the presence of facets on the sides of the bodies for articulation with the heads of the ribs, and facets on the transverse processes of all, except the eleventh and twelfth, for articulation with the tubercles of the ribs.
First Thoracic Vertebra
has, on either side of the body, an entire articular facet for the head of the first rib, and a demi-facet for the upper half of the head of the second rib. The body is like that of a cervical vertebra, being broad transversely; its upper surface is concave, and lipped on either side.
Ninth Thoracic Vertebra
may have no demi-facets below. In some subjects however, it has two demi-facets on either side; when this occurs the tenth has only demi-facets at the upper part.
Tenth Thoracic Vertebra
has (except in the cases just mentioned) an entire articular facet on either side, which is placed partly on the lateral surface of the pedicle.
Eleventh Thoracic Vertebra
the body approaches in its form and size to that of the lumbar vertebræ. The articular facets for the heads of the ribs are of large size, and placed chiefly on the pedicles, which are thicker and stronger in this and the next vertebra than in any other part of the thoracic region. The spinous process is short, and nearly horizontal in direction. The transverse processes are very short, tuberculated at their extremities, and have no articular facets.
Twelfth Thoracic Vertebra
has the same general characteristics as the eleventh, but may be distinguished from it by its inferior articular surfaces being convex and directed lateralward, like those of the lumbar vertebræ; by the general form of the body, laminæ, and spinous process, in which it resembles the lumbar vertebræ; and by each transverse process being subdivided into three elevations, the superior, inferior, and lateral tubercles: the superior and inferior correspond to the mammillary and accessory processes of the lumbar vertebræ. Traces of similar elevations are found on the transverse processes of the tenth and eleventh thoracic vertebræ.
The Lumbar Vertebræ Vertebræ Lumbales
are the largest segments of the movable part of the vertebral column, and can be distinguished by the absence of a foramen in the transverse process, and by the absence of facets on the sides of the body.
Fifth Lumbar Vertebra
is characterized by its body being much deeper in front than behind, which accords with the prominence of the sacrovertebral articulation; by the smaller size of its spinous process; by the wide interval between the inferior articular processes; and by the thickness of its transverse processes, which spring from the body as well as from the pedicles.
The Sacral and Coccygeal Vertebræ
The sacral and coccygeal vertebræ consist at an early period of life of nine separate segments which are united in the adult, so as to form two bones, five entering into the formation of the sacrum, four into that of the coccyx. Sometimes the coccyx consists of five bones; occasionally the number is reduced to three.
The Sacrum (os sacrum
The sacrum is a large, triangular bone, situated in the lower part of the vertebral column and at the upper and back part of the pelvic cavity, where it is inserted like a wedge between the two hip bones; its upper part or base articulates with the last lumbar vertebra, its apex with the coccyx. It is curved upon itself and placed very obliquely, its base projecting forward and forming the prominent sacrovertebral angle when articulated with the last lumbar vertebra; its central part is projected backward, so as to give increased capacity to the pelvic cavity.
Pelvic Surface (facies pelvina
is concave from above downward, and slightly so from side to side. Its middle part is crossed by four transverse ridges, the positions of which correspond with the original planes of separation between the five segments of the bone. The portions of bone intervening between the ridges are the bodies of the sacral vertebræ. The body of the first segment is of large size, and in form resembles that of a lumbar vertebra; the succeeding ones diminish from above downward, are flattened from before backward, and curved so as to accommodate themselves to the form of the sacrum, being concave in front, convex behind. At the ends of the ridges are seen the anterior sacral foramina, four in number on either side, somewhat rounded in form, diminishing in size from above downward, and directed lateralward and forward; they give exit to the anterior divisions of the sacral nerves and entrance to the lateral sacral arteries. Lateral to these foramina are the lateral parts of the sacrum, each consisting of five separate segments at an early period of life; in the adult, these are blended with the bodies and with each other. Each lateral part is traversed by four broad, shallow grooves, which lodge the anterior divisions of the sacral nerves, and are separated by prominent ridges of bone which give origin to the Piriformis muscle.
Dorsal Surface (facies dorsalis
is convex and narrower than the pelvic. In the middle line it displays a crest, the middle sacral crest, surmounted by three or four tubercles, the rudimentary spinous processes of the upper three or four sacral vertebræ. On either side of the middle sacral crest is a shallow groove, the sacral groove, which gives origin to the Multifidus, the floor of the groove being formed by the united laminæ of the corresponding vertebræ. The laminæ of the fifth sacral vertebra, and sometimes those of the fourth, fail to meet behind, and thus a hiatus or deficiency occurs in the posterior wall of the sacral canal. On the lateral aspect of the sacral groove is a linear series of tubercles produced by the fusion of the articular processes which together form the indistinct sacral articular crests. The articular processes of the first sacral vertebra are large and oval in shape; their facets are concave from side to side, look backward and medialward, and articulate with the facets on the inferior processes of the fifth lumbar vertebra. The tubercles which represent the inferior articular processes of the fifth sacral vertebra are prolonged downward as rounded processes, which are named the sacral cornua, and are connected to the cornua of the coccyx. Lateral to the articular processes are the four posterior sacral foramina; they are smaller in size and less regular in form than the anterior, and transmit the posterior divisions of the sacral nerves. On the lateral side of the posterior sacral foramina is a series of tubercles, which represent the transverse processes of the sacral vertebræ, and form the lateral crests of the sacrum. The transverse tubercles of the first sacral vertebra are large and very distinct; they, together with the transverse tubercles of the second vertebra, give attachment to the horizontal parts of the posterior sacroiliac ligaments; those of the third vertebra give attachment to the oblique fasciculi of the posterior sacroiliac ligaments; and those of the fourth and fifth to the sacrotuberous ligaments.
Lateral Surface
The lateral surface is broad above, but narrowed into a thin edge below. The upper half presents in front an ear-shaped surface, the auricular surface, covered with cartilage in the fresh state, for articulation with the ilium. Behind it is a rough surface, the sacral tuberosity, on which are three deep and uneven impressions, for the attachment of the posterior sacroiliac ligament. The lower half is thin, and ends in a projection called the inferior lateral angle; medial to this angle is a notch, which is converted into a foramen by the transverse process of the first piece of the coccyx, and transmits the anterior division of the fifth sacral nerve. The thin lower half of the lateral surface gives attachment to the sacrotuberous and sacrospinous ligaments, to some fibers of the Glutæus maximus behind, and to the Coccygeus in front.
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