C4 is a typical cervical vertebra at approximately the level of the upper border of the thyroid cartilage, contributing to neck mobility and providing attachment points for cervical muscles and ligaments.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | As per C3 vertebra pattern. |
C4 vertebra is the level of the hyoid bone anteriorly, the level where the carotid arteries bifurcate, and the landmark for the superior thyroid cartilage. C3-C4 disc pathology produces C4 radiculopathy with cape distribution numbness over the shoulder and upper arm.
Axial loading compresses the vertebral body with retropulsion of fragments into the canal; at C4 an associated cord injury can impair the phrenic nerve outflow and breathing.
Flexion-distraction injuries may produce unilateral or bilateral facet dislocation, often with nerve root or spinal cord injury.
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