Lateral Perspective of the C4 or Fourth Vertebra

Description

Seen from a lateral perspective, the fourth cervical vertebra (C4) is presented with the vertebral body anteriorly and the vertebral arch and spinous process posteriorly. The transverse process projects laterally and is characterized by its anterior and posterior tubercles, with the foramen transversarium interposed, a key cervical landmark for the vertebral vessels. Superior and inferior articular processes form the zygapophyseal (facet) joints, oriented to permit coupled cervical rotation and lateral flexion while limiting pure axial rotation at this level. A small portion of the adjacent shoulder girdle may be included at the margin, but the bony anatomy centers on C4. C4 matters because it sits at a crossroads for motion and neurovascular risk in the mid cervical spine. Foraminal stenosis at C3 to C4 can compromise the C4 spinal nerve, classically producing neck pain with referral toward the shoulder girdle and weakness in scapular elevation via trapezius when the spinal accessory nerve complex is secondarily affected. The transverse process tubercles also guide procedural anatomy, including anterior cervical approaches and selective nerve root blocks, where depth and trajectory relative to the carotid sheath and vertebral artery demand precise bony orientation. Small landmarks. Big consequences. Use this artwork in gross anatomy and radiographic anatomy teaching to correlate lateral bony contours with plain radiographs, CT reformats, and fluoroscopic views used for facet interventions. It also fits spine surgery texts discussing anterior cervical discectomy and fusion levels, and pain medicine materials covering cervical medial branch blocks targeting the articular pillars at C3 to C5. Anatomical accuracy verified by SciePro's Medical Advisory Board.