Vertebral levels are very commonly tested on in both undergraduate and postgraduate medical examinations. The most commonly encountered landmarks and structures found at the various vertebral levels are shown in the table below:

VERTEBRAL LEVELLANDMARKS & STRUCTURES
C1Spinal root of accessory nerve crosses transverse process of atlas
C2Superior cervical ganglion
C3Body of hyoid bone
C4Superior border of thyroid cartilage
Bifurcation of common carotid arteries
C6Cricoid cartilage
Larynx ends and trachea begins
Pharynx ends and oesophagus begins
Inferior thyroid artery crosses carotid sheath
Inferior laryngeal nerve enters larynx
Vertebral artery enters transverse foramen of C6
Middle cervical ganglion
C7Vertebra prominens
Stellate ganglion
Isthmus of thyroid gland
T1Sternoclavicular joint
Highest point of lung apex
T2Superior border of scapula
T2/3Suprasternal notch
T3Medial end of spine of scapula
End of oblique fissure of lung posteriorly
T3/4Top of arch of aorta
T3-T4Manubrium sterni
T4/5Sternal angle (of Louis)
Bifurcation of trachea
Arch of aorta begins and ends
Azygous vein enters superior vena cava
T5-8Body of sternum
T6Upper border of liver
T7Inferior angle of the scapula
T8Caval opening in the diaphragm
Phrenic nerves traverse diaphragm
T8/9Xiphisternal junction
T9Xiphoid
Superior epigastric vessels traverse diaphragm
T9-L3Costal margin
T10Oesphageal opening in the diaphragm
T12Aortic opening in diaphragm
Origin of the coeliac axis (lower border)
L1Transpyloric plane of Addison
Fundus of the gallbladder
Hila of the kidneys
First part of the duodenum
Neck of the pancreas
Origin of the superior mesenteric artery
Origin of the portal vein
Pylorus of the stomach
Hilum of the spleen
Cisterna chyli
L1/2Spinal cord ends in adults
Origin of renal arteries
L2Subcostal plane
Thoracic duct begins
Azygous and hemiazygous veins begin
Duodenojejunal flexure
Ligament of Treitz (upper border)
L3Origin of inferior mesenteric artery
Spinal cord ends in infants
L3/4Umbilicus
L4Transtubercular plane
Bifurcation of the aorta
L5Formation of the inferior vena cava
S2Sacral dimples
Midpoint of sacro-iliac joints
Posterior superior iliac spines
Dural sac ends
S3Pelvic colon ends and rectum begins
Posterior inferior iliac spines
S4Sacral hiatus
Vertebral column ends

 

Surface Anatomy Map

 


Medical Exam Prep would like to thank Dr. Marc Barton for permission to reproduce this extract from his book ‘Essential Clinical Surface Anatomy’.

 

About Dr. Marc Barton

Dr. Marc Barton qualified from Imperial College School of Medicine in 2001. Since that time he has worked in a variety of different medical specialities. He worked as a GP partner from 2006 until 2008 and more recently as a higher specialist trainee in Emergency Medicine.

‘Essential Clinical Surface Anatomy’ is available for purchase here.

Essential Clinical Surface Anatomy book

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