Cervical Vertebrae (C3-C7)
Vertebrae Cervicales
location_on Neck region, between the axis (C2) and the first thoracic vertebra
The typical cervical vertebrae (C3 through C7) are the smallest of the movable vertebrae and are characterized by the presence of transverse foramina in each transverse process, through which the vertebral arteries ascend. They have bifid spinous processes (C3-C6), relatively large triangular vertebral foramina, and small oval bodies. C7 (vertebra prominens) is transitional with a long non-bifid spinous process.
Key Anatomical Features
- Transverse foramina in each transverse process transmit the vertebral arteries (C1-C6)
- Bifid spinous processes on C3-C6 provide attachment for the ligamentum nuchae
- Uncinate processes (uncus) on the superior body create uncovertebral joints of Luschka
- C7 vertebra prominens has the first easily palpable spinous process
- Small oval bodies are wider transversely than anteroposteriorly
- Triangular vertebral foramina are the largest relative to body size in the spine
Muscle Attachments
| Muscle | Attachment | Action |
|---|---|---|
| Longus colli | Anterior bodies of C3-C7 | Flexes the cervical spine |
| Multifidus | Articular processes of C4-C7 | Stabilizes and extends the vertebral column |
| Semispinalis cervicis | Transverse and spinous processes | Extends and rotates the cervical spine |
| Rotatores cervicis | Between transverse and spinous processes | Rotates the cervical spine |
| Scalenus medius | Transverse processes of C2-C7 | Laterally flexes the neck and elevates the first rib |
| Levator scapulae | Transverse processes of C1-C4 | Elevates the scapula and laterally flexes the neck |
Joints and Articulations
| Joint | Type | Connects to |
|---|---|---|
| Intervertebral disc joints | Cartilaginous symphysis | Adjacent cervical vertebrae |
| Zygapophyseal (facet) joints | Synovial plane | Adjacent vertebrae superior and inferior articular processes |
| Uncovertebral joints (of Luschka) | Synovial-like (debated) | Uncinate process to body above |
Common Pathologies
Cervical disc herniation
Protrusion of the nucleus pulposus most commonly at C5-C6 and C6-C7 levels, causing radiculopathy with arm pain, numbness, and weakness in specific dermatomal and myotomal patterns.
Cervical spondylosis
Degenerative changes including disc narrowing, osteophyte formation at the uncovertebral and facet joints, causing neck pain and potentially cervical myelopathy from spinal cord compression.
Cervical fracture-dislocation
Typically from flexion and rotation forces. Facet joint dislocations can be unilateral (causing radiculopathy) or bilateral (causing spinal cord injury with quadriplegia).
Cervical radiculopathy
Nerve root compression from disc herniation or foraminal stenosis causing pain radiating down the arm in a dermatomal pattern, with possible weakness and reflex changes.
Clinical Relevance
The cervical spine is the most mobile spinal region and the most vulnerable to injury. The subaxial cervical spine (C3-C7) most commonly herniates at C5-C6 and C6-C7. Spurling test (head extension with rotation and axial compression) reproduces radicular symptoms. The vertebral artery travels through the transverse foramina of C1-C6 (not C7), so uncovertebral osteophytes can compromise vertebral artery blood flow.
Development and Ossification
Each cervical vertebra ossifies from three primary centers: one for the body and one for each neural arch. These appear during weeks 7-8 of fetal development. The neural arches fuse posteriorly by age 2-3 and join the body by age 3-6. Secondary ossification centers for spinous and transverse processes appear at puberty and fuse by age 25.
Did You Know?
- Almost all mammals have exactly seven cervical vertebrae, whether they are mice or giraffes
- The cervical vertebrae are the only vertebrae with transverse foramina
- The vertebra prominens (C7) got its name because it is the first spinous process easily felt at the base of the neck
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