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MSK Week 3 2017/18 > 1: Clinical anatomy - spine > Flashcards

1: Clinical anatomy - spine Flashcards

1
Q

A vertebra can be split into two distinct areas - what are they called?

A

Vertebral body

Vertebral arch

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2
Q

Which hole in the vertebra transmits the spinal cord?

A

Vertebral foramen

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3
Q

What is the function of intervertebral foraminae?

A

Allow spinal nerves to leave the spinal cord

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4
Q

Which foraminae transmit vertebral arteries?

A

Transverse foramen

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5
Q

What is C1 called and how is it different from other vertebrae?

A

Atlas

Two vertebral arches, no body

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6
Q

What is C2 called and how is it different from other vertebrae?

A

Axis

Odontoid process projecting superiorly

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7
Q

What is C7 called and how is it different from other vertebrae?

A

Vertebra prominens

Very long spinous process, making it the first palpable cervical vertebra in most people

It has no transverse foramen so doesn’t transmit any vertebral arteries

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8
Q

What type of joint is an intervertebral disc?

A

Secondary cartilaginous joint

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9
Q

What are the two parts of an intervertebral disc?

A

Anulus fibrosus

Nucleus pulposus

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10
Q

Intervertebral discs are found between vertebral ___.

A

bodies

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11
Q

Apart from intervertebral discs, what other joints connect the vertebrae and allow the spine to be flexible?

A

Facet joints

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12
Q

What movements of the spine do facet joints facilitate?

A

Flexion

Extension

Lateral flexion

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13
Q

Which region of the spine is most flexible?

A

Cervical spine

Thoracic bounded by ribs, lumbar has vertically oriented facet joints

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14
Q

What does spondylosis mean?

A

Generic term meaning degeneration of the spine

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15
Q

Intervertebral discs lose ___ as we age.

What does this lead to?

A

water

Spondylosis, more specifically osteoarthritis

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16
Q

How may osteoarthritis between two vertebrae be treated?

A

Fusion

Not the perfect solution as it reduces mobility and OA will continue in other joints

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17
Q

Apart from osteoarthritis, what else may happen to intervertebral discs as they lose water?

A

Disc prolapse

Herniation of the disc outwards

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18
Q

What is the medical name for a slipped intervertebral disc?

A

Disc prolapse

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19
Q

Where do most acute disc prolapses occur?

A

L4/L5 OR L5/S1

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20
Q

What is a common cause of disc prolapse?

A

Lifting heavy objects

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21
Q

Most acute disc prolapses ___ by themselves.

A

settle

22
Q

At which aspect of the spinal cord do

a) motor neurons
b) sensory neurons

originate?

A

Motor neurons originate anteriorly

Sensory neurons originate posteriorly (dorsally)

23
Q

How do motor neurons and sensory neurons emerge from the spinal cord?

A

Motor neurons - ventral root ganglion

Sensory neurons - dorsal root ganglion

24
Q

Through which holes do the ventral and dorsal root ganglia emerge from the spine?

A

Intervertebral foramen

25
Q

What happens to the ventral and dorsal root ganglia as they exit via the intervertebral foramen?

A

Combine to form SPINAL NERVE

26
Q

The spinal cord stops at L1. What continues on inferiorly?

A

Cauda equina

sensory and motor nerve roots running together

27
Q

The spinal cord ends at __ and the nerve roots continue on as the __ __.

A

L1

cauda equina

28
Q

What sac holds motor and nerve fibres together in the spinal cord and cauda equina?

A

Thecal sac

29
Q

Nerve roots within the thecal sac are called ___ roots.

Nerve roots emerging from the thecal sac are called ___ roots.

A

traversing roots

exiting roots

30
Q

Disc prolapse tends to cause compression of the ___ nerve root.

(traversing / exiting)

A

traversing

31
Q

Which traversing nerve root is compressed in a

a) L4/5 prolapse
b) L5/S1 prolapse?

A

a) L5 traversing root

b) S1 traversing root

i.e always the last one

32
Q

What is the general name given for a neuropathy occuring at a nerve root (i.e in the spinal cord / cauda equina)?

A

Radiculopathy

(Latin name for a nerve root is a radix)

33
Q

Nerve root compression causes pain in which sensory distribution?

A

Dermatome of that spinal nerve

34
Q

What condition involves pain caused by radiculopathy of the nerve root supplying the lower leg?

Which nerve roots are compressed?

A

Sciatica

L4, L5, S1, S2, S3 i.e those supplying the sciatic nerve

35
Q

What is sciatica?

A

Radiation of nerve pain along sensory distribution of sciatic nerve i.e the lower leg

36
Q

What is the name given to the area of muscle supplied by a spinal nerve?

A

Myotome

37
Q

What happens to muscle when its spinal nerve roots have been compressed?

What happens in the dermatome?

A

Weakness in that myotome; absent reflexes

Pain

38
Q

Apart from disc prolapse, what else may cause compression of nerve roots?

A

Spinal stenosis

osteophytes and hypertrophied ligaments outside vertebral body

39
Q

Spinal stenosis causes pain on walking - this is called neurogenic ___.

A

neurogenic claudication

40
Q

If a patient experiences back pain when walking uphill, suspect ___.

If it’s experienced when walking downhill, suspect ___.

(disc prolapse / spinal stenosis)

A

Uphill - prolapse - walking downhill is easier for them

Downhill - stenosis - closed posture, neurogenic claudication

41
Q

What is the general name for disease involving the spinal cord?

A

Myelopathy

42
Q

What is cauda equina syndrome?

What are the symptoms?

A

Symptoms caused by compression of the cauda equina

Bilateral lower limb weakness

Bladder and bowel dysfunction

Saddle anaesthesia

Loss of anal tone

43
Q

What symptoms should make you suspect cauda equina syndrome?

A

Bilateral lower limb motor symptoms

Bladder and bowel dysfunction

Anaesthesia

Loss of anal tone

44
Q

Which general group of spinal muscles are commonly sprained and strained?

What is their function?

A

Erector spinae

Maintain posture, lateral flexion

45
Q

What are some spinal ligaments which contribute to stability?

A

From posterior to anterior:

Supraspinous ligament

Interspinous ligament

Ligamentum flavum

Posterior longitudinal ligament

Anterior longitudinal ligament

46
Q

What can still be damaged despite no evidence of bony fractures on a spine X-ray?

A

Ligaments

47
Q

Is the spinal cord or cauda equina pierced in a lumbar puncture?

A

Cauda equina

less chance of puncturing nerves (think putting a needle in spaghetti)

48
Q

At what level is a lumbar puncture usually carried out?

A

L3 / L4 or L4 / L5

49
Q

What can be done surgically for patients with mechanical back pain?

A

Usually nothing

50
Q

What are some surgical options for treating sciatica?

A

Discectomy

Decompression

51
Q

Which scan is superior to X-rays for diagnosing spinal pathology?

A

MRI scan

so you can see bone AND soft tissue

52
Q

What is the bottom of the spinal cord called?

A

Conus medullaris

MSK Week 3 2017/18 (7 decks)

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