The Cervical Vertebra are smaller than those in any other region of the spine, and may readily be distinguished by the foramen in the transverse process, which does not exist in the transverse process of either the dorsal or lumbar vertebrae. The Body is small, comparatively dense, and broader from side to side than from before backward. The anterior and posterior surfaces are flattened and of equal depth; the former is placed on a lower level than the latter, and its inferior border is prolonged downward, so as to overlap the upper and fore part of the vertebras below. Its upper surface is concave transversely, and presents a projecting lip on each side; its lower surface is convex from side to side, concave from before backward, and presents laterally a shallow concavity, which receives the corresponding projecting lip of the adjacent vertebra. The pedicles are directed outward and backward, and are attached to the body midway between the upper and lower borders, so that the superior intervertebral notch is as deep as the inferior, but it is, at the same time, narrower. The laminae are narrow, long, thinner above than below, and overlap each other, enclosing the spinal foramen, which is very large, and of a triangular form. The spinous process is short, and bifid at the extremity to afford greater extent of surface for the attachment of muscles, the two divisions being often of unequal size. They increase in length from the fourth to the seventh. The articular processes are flat, oblique, and of an oval form: the superior are directed backward and upward; the inferior forward and downward. The transverse processes are short, directed downward, outward, and forward, bifid at their extremity, and marked by a groove along their upper surface, which rung downward and outward from the superior intervertebral notch, and serves for the transmission of one of the cervical nerves. They are situated in front of the articular processes and on the outer side of the pedicles. The transverse processes are pierced at their base by a foramen, for the transmission of the vertebral artery, vein, and plexus of nerves.

Each process is formed by two roots: the anterior root, sometimes called the costal process, arises from the side of the body, and is the homologue of the rib in the dorsal region of the spine; the posterior root springs from the junction of the pedicle with the lamina, and corresponds with the transverse process in the dorsal region. It is by the junction of the two that the foramen for the vertebral vessels is formed. The extremity of each of these roots forms the anterior and posterior tubercles of the transverse processes.

The peculiar vertebrae in the cervical region are the first, or Atlas; the second, or Axis; and the seventh, or Vertebra prominens. The great modifications in the form of the atlas and axis are designed to admit of the nodding and rotatory movements of the head.

The Atlas  is so named from supporting the globe of the head. The chief peculiarities of this bone are that it has neither body nor spinous process. The body is detached from the rest of the bone, and forms the odontoid process of the second vertebra; while the parts corresponding to the pedicles join in front to form the anterior arch. The atlas is ring-like, and consists of an anterior arch, a posterior arch, and two lateral masses. The anterior arch forms about one-fifth of the ring: its anterior surface is convex, and presents about its center a tubercle, for the attachment of the Longus colli muscle; posteriorly it is concave, and marked by a smooth, oval or circular facet, for articulation with the odontoid process of the axis. The upper _and lower borders give attachment to the anterior occipito-atlantal and the anterior atlanto-axial ligaments, which connect it with the occipital bone above and the axis below. The posterior arch forms about two-fifths of the circumference of the bone; it terminates behind in a tubercle, which is the rudiment of a spinous process, and gives origin to the Rectus capitis posticus minor. The diminutive size of this process prevents any interference in the movements between the atlas and the cranium. The posterior part of the arch presents above and behind a rounded edge for the attachment of the posterior occipito-atlantal ligament, while in front, immediately behind each superior articular process, is a groove, sometimes converted into a foramen by a delicate bony spiculurn which arches backward from the posterior extremity of the superior articular process. These grooves represent the superior intervertebral notches, and are peculiar from being situated behind the articular processes, instead of in front of them, as in the other vertebras. They serve for the transmission of the vertebral artery, which, ascending through the foramen in the transverse process, winds round the lateral mass in a direction backward and inward. They also transmit the suboccipital (first spinal) nerve. On the under surface of the posterior arch, in the same situation, are two other grooves, placed behind the lateral masses, and representing the inferior intervertebral notches of other vertebrae. They are much less marked than the superior. The lower border also gives attachment to the posterior atlanto-axial ligament, which connects it with the axis. The lateral masses are the most bulky and solid parts of the atlas, in order to support the weight of the head; they present two articulating processes above, and two below. The two superior are of large size, oval, concave, and approach each other in front, but diverge behind; they are directed upward, inward, and a little backward, each forming a kind of cup for the corresponding condyle of the occipital bone, and are admirably adapted to the nodding movements of the head. Not infrequently they are partially subdivided by a more or less deep indentation, which encroaches upon each lateral margin. The inferior articular processes are circular in form, flattened or slightly concave, and directed downward and inward, articulating with the axis, and permitting the rotatory movements. Just below the inner margin of each superior articular surface is a small tubercle, for the attachment of the transverse ligament, which, stretching across the ring of the atlas, divides it into two unequal parts; the anterior or smaller segment receiving the odontoid process of the axis, the posterior allowing the transmission of the spinal cord and its membranes. This part of the spinal canal is of considerable size, to afford space for the spinal cord; and hence lateral displacement of the atlas may occur without compression of this structure. The transverse processes are of large size, project directly outward and downward from the lateral masses, and serve for the attachment of special muscles, which assist in rotating the head. They are long, not bifid, and perforated at their base by a canal for the vertebral artery, which is directed from below, upward and backward.

The Axis is so named from forming the pivot upon which the first vertebra, carrying the head, rotates. The most distinctive character of this bone is the strong, prominent process, tooth-like in form (hence the name odontoid), which rises perpendicularly from the upper surface of the body. The body is deeper in front than behind, and prolonged downward anteriorly so as to overlap the upper and fore part of the next vertebra. It presents in front a median longitudinal ridge, separating two lateral depressions for the attachment of the Longus colli muscle of either side. The odontoid process presents two articulating surfaces: one in front, of an oval form, for articulation with the atlas; another behind, for the transverse ligament - the latter frequently encroaching on the sides of the process. The apex is pointed, and gives attachment to the middle fascicules of the odontoid or checks ligaments (ligamentum suspentorium). Below the apex the process is somewhat enlarged, and presents on either side a rough impression for the attachment of the lateral fasciculi of the odontoid or check ligaments, which connect it to the occipital bone; the base of the process, where it is attached to the body, is constricted, so as to prevent displacement from the transverse ligament, which binds it in this situation to the anterior arch of the atlas. Sometimes, however, this process does become displaced, especially in children, in whom the ligaments are more relaxed: instant death is the result of this accident. The internal structure of the odontoid process is more compact than that of the body. The pedicles are broad and strong, especially their anterior extremities, which coalesce with the sides of the body and the root of the odontoid process. The laminae are thick and strong, and the spinal foramen large, but smaller than that of the atlas. The transverse processes are very small, not bifid, and perforated by the foramen for the vertebral artery, which is directed obliquely upward and outward. The superior articular surfaces are round, slightly convex, directed upward and outward, and are peculiar in being supported on the body, pedicles, and transverse processes. The inferior articular surfaces have the same direction as those of the other cervical vertebrae. The superior intervertebral notches are very shallow, and lie behind the articular processes; the inferior in front of them, as in the other cervical vertebrae. The spinous process is of large size, very strong, deeply channeled on its under surface, and presents a bifid, tubercular extremity for the attachment of muscles which serve to rotate the head upon the spine.

Seventh Cervical - The most distinctive character of this vertebra is the existence of a very long and prominent spinous process; hence the name ‘vertebra prominens." This process is thick; nearly horizontal in direction, not bifurcated, and has attached to it the lower end of the ligamentum nuchae. The transverse process is usually of large size, its posterior tubercles are large and prominent, while the anterior are small and faintly marked; its upper surface has usually a shallow groove, and it seldom presents more than a trace of bifurcation at its extremity. The foramen in the transverse process is sometimes as large as in the other cervical vertebrae, but is usually smaller on one or both sides, and sometimes wanting. On the left side it occasionally gives passage to the vertebral artery; more frequently the vertebral vein traverses it on both sides; but the usual arrangement is for both artery and vein to pass in front of the transverse process, and not through the foramen. Occasionally the anterior root of the transverse process exists as a separate bone, and attains a large size. It is then known as a "cervical rib."