Day 7 | 12 Body Parts of Christmas
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Welcome everybody to another episode of Dr. Matt and Dr. Mark's 12 Days of Christmas Special Edition. We are...

Taking the 12 days of Christmas from the perspective of anatomy and physiologists, and we are on day seven. Day seven of our 12 days of Christmas. Matt, can you please do us the honours? On the seventh day of Christmas, my true love sent to me seven cervical vertebrae. Six extraocular muscles. Five skin layers. Just change it. Four heart chambers. Three middle ear noms. Two carotid arteries. And a spleen in a healthy body. Woo! Yeah! Wahoo!

Okay, so seven cervical vertebrae, seven cervical vertebrae. Why seven cervical vertebrae? What's going on here? Why do we have seven? That's a good question. That's a question I can't answer. No. All right, God, evolution, what?

Where do you want to begin? All right. Well, have you, this time of year, you usually visit friends and family. Well, I've only got one of those. That's family. For particularly events. Now, some visits, you try to depart quicker than others. Sounds like you're being intentionally obscure. Now, when this happens, you generally can move at a certain speed.

of departure that can cause cervical injury. So you're saying that you're leaving somebody's party so quickly you're giving yourself whiplash. That's what I'm saying. Can I ask whose party this might be? No, I can't. Is this the Dr. Mike Christmas party or it's just you and me? Oh, Mike, sorry, I've got to go. I've got to buy a hat. You hold your neck. Ah!

That's exactly. That's why I'm in a C-spine today. So that's why your whole body is in traction. So seven cervical vertebrae getting whiplash. Tell me more. All right. So your vertebra, how many do you have in your whole body, in your whole spine? Seven in my neck. Okay.

Okay, so... Whole spine, 33? So seven cervical, 12 thoracic, five lumbar, five fusacral and what? Three? Do you get three coccyx? Three fusococcyx? Yeah. Yeah, so what's that, 33? Yeah. I was right. Well done. Thank you. So when we look at the vertebrae of your cervical region... These are both. Cervical meaning neck. Yep. Okay, so this is the connection from your skull...

down into your upper back. That's the region. Okay, so here you have seven bones on top of each other and they're collectively known as the cervical vertebra. Now, obviously named one to seven, that's pretty straightforward. From top to bottom. Yeah. Now, when we look at vertebra, they generally have what we call typical features. Yes. And what these would be, the body. So the body of the vertebra, this is through the whole vertebra,

vertebral column. Oh, not just the body. Not just the body. So a typical vertebra would have a body, which is where the disc, the intervertebral disc sits. And you would say, correct me if I'm wrong here, but you would say that the function of the body is to kind of transmit forces through the column. Would you agree? Weight distribution. Yeah. Now, if you kind of go, so that is the most anterior part of your vertebra, would you say, the body? Yeah. And if you...

And if you go out kind of lateral posteriorly, you go into an area called the pedicle, which is kind of just a bony strut that kind of goes off to the side. But...

Usually speaking, there's these transverse, so these processes that stick off way laterally and they're known as the transverse processes. Like the wings of the vertebrae? Yeah. And then you bring that kind of the wing around to the back and that's kind of finishing the vertebral arch and that kind of arch part is called the laminae. And that usually will end with another vertebrae

pointy part, which is the spinous process, which is what's usually... Directly back? Directly back. And that's usually what people will, if you go to a physio or something, they kind of would manipulate or touch, not manipulate, they would palpate to kind of count the levels and so forth, right? Okay. So they're the typical features of a vertebra. I don't know how successful they would be at manipulating my... What are they called again?

Oh, spinous processes. Spinous processes, yeah. You break them off. So when you look at the seven cervical vertebra, you would say C3, C4, C5, C6, C7 would be typical. They would have those typical features. They would have a body, pedicle, transverse process, laminar, spinous process. The spinous process is a little bit different in the cervical. They have a bifid spinous process. So instead of a single one, that kind of branches off to two.

So that's a bit unique. The other thing that's unique with the cervical, but you would still call them a typical vertebra, in the pedicle slash transverse process, they have a hole. All the rest of the vertebra don't have these holes in them. So that would be the transverse foramen.

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Now, why would you have a hole there? That was going to be your next question I could see. It's about to roll out of the oil. Oh, no, I wasn't even paying attention. So you're saying that there's little holes in the cervical vertebrae either side.

So what's going through that hole? Blood vessels. Blood vessels and in particular the vertebral artery, which is branched kind of off the subclavian. So we spoke about the carotid artery feeding the head and neck. This also feeds the head and neck. Yeah, probably more the brain. So supplies a significant portion of blood to the brain, right? Yeah, I don't know the percentage. I think it's about 20%. Yeah, it's not huge because the internal carotid, which feeds the anterior supply to your brain.

that's going to be the circle of Willis, which is providing a lot of blood to your brain and the neurological structures inside your skull. Whereas the vertebral artery, which is coming up through these holes, transverse transfer foramina, that's going up kind of to the back to brainstem and then kind of coming to the back posterior circulation to the circle of Willis. So there's a bit of redundancy, I guess you'd say, but

You might be able to bring some blood to the anterior circulation but not so well vice versa because if you had a vertebral issue, a vertebral artery issue, because it's supplying your brainstem then into your back, like the posterior circulation of your cerebrum, you're going to have problems feeding blood supply to your brainstem. And that was seen, I'm not sure if you remember, I think it was 10 years ago now, there was a cricket play in Australia where

Phil Hughes, who got hit right in the back of the occipital region of his skull and it burst the vertebral artery and he lost. So basically had an ischemic stroke to his brainstem. And that has, what would you say, reflexive control of a lot of body systems like breathing.

like circulation, like heart rate, and he just went into an arrest. I told you, all your topics for these 12 days of Christmas. It's true, isn't it? So anyway. It's a pretty sad part. So that's the main features of the typical vertebra, but there's two atypical features.

Cervical vertebra. And that's C1, C2. Now they are named differently. The top two? Top two. They're named differently. They're sometimes known as the yes-no vertebra. Oh, okay. Because when you signal to people yes-no, not by words but by action. Head movement. Head movement. So they're nodding. That I'm doing right now. That is between skull and C1. Yep. So that would be the occipital atlas.

Excipital? What's the correct term there? Anyway, between skull and C1 is your nodding. So 50% of your nodding comes about from just those two... Bony joints. Bony joints. And then when you do no... So when you're... Shaking your head side to side. That is between C1 and C2. So that would be, again, 50% of that no-in...

is between C1, C2. Now, the difference... So what is different with the Atlas... Well, C1 is called the Atlas. Atlas turned from... Is it Greek mythology? Greek mythology. Because the Titan, Atlas held the world or the universe on its shoulders, which is basically what the Atlas does. It holds the skull on its shoulders. It doesn't have a body. It just has the vertebral arch, the whole arch. And that's kind of like... It's almost like a... What would you call it? A...

a ring, like a washer, a washer that kind of sits in a joint and just holds it there. And that's what the Atlas does is just kind of holds a skull. Whereas C2, the axis, has a dens or to doined process, which is kind of just stick straight up. Like a limb. And that is the...

The point of axis where C1 rotates on C2. It's the pivot point. The pivot point. Yeah. It's like when people do pole dancing and they grab the pole and they swing around it. Right. I don't know why I use that as the example, but I'm just picturing that that's... Especially the way you...

Image to me was also quite disturbing. I had to actually install a pole just to demonstrate that to Matt. But yes, but that's sort of... So 50% of the rotation of your cervical happens just at that C1, C2 joint. Yeah. And that also, I'm not going to get into a morbid another example, but that can be a fracture point as well there with certain injuries. Like again, flexion extension injuries like you would see in whiplash where there's a lot of force put through this joint can fracture that.

kind of projection. Absolutely. So that's the cervical. Any questions with the cervical vertebra? I think that you did a wonderful job. But with whiplash, it's just a very fast... So what would you say? So if you took off in your car... Remember Dickie Day? If you took... I had Saturday. So if you took off very fast in your car, so you've got a fast car. So if you were just... Thanks, Tracy Chapman. If you were just to plant your foot down...

I guess what would happen is your inertia is to go forward, but your head is very globus. Oh, thank you. And so it would... You sound like my dad now. It would lag... Bubble back. Well, I'm a bubble head now, am I? It would lag backwards, which is a hyperextension injury. Yeah. And then as it catches up, it flops forward. My head does not flop, that's for sure.

That was a hyperflexion injury and that will give you the whiplash. Now the whiplash, I guess what you would say has happened is a soft tissue injury. So ligaments, muscles, tendons have all been damaged and they're so small in that region that they're very hard to repair. Right, takes ages. And takes ages. So it becomes a chronic injury. And the other issue that kind of manifests with it is you get –

a neurological chronic pain syndrome. Oh. And that is kind of a central sensitization, which then makes it even harder to get rid of the sound. Constant neck pain. Yeah. Oh, okay. Well, glad you spoke about that one. So again, a happy topic. That is the seventh day. Hopefully something more joyous in the eighth.

Whoa, easy there. Yeah.

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