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Year 2 - HN&S anatomy > 2 - The vertebral column > Flashcards

2 - The vertebral column Flashcards

1
Q

State the functions of the vertebral column

A

Support & protection:
- Body weight
- Transmits forces
- Supports the head
- Supports the upper limbs (and aid movements)
- Spinal cord
Movement:
- Upper limbs and ribs (extrinsic muscles)
- Postural control and movement (intrinsic muscles)

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2
Q

Describe the general group of muscles that control the movement of the spine

A
  • Upper limbs and ribs = extrinsic muscles

- Postural control and movement = intrinsic muscles

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3
Q

Extrinsic and intrinsic muscles of the vertebral columns

A

extrinsic = superficial and intermediate
The superficial and intermediate muscles do not develop in the back, and are classified as extrinsic muscles.
- superficial extrinsic muscles involved in the movement of the upper limbs
- intermediate extrinsic muscles are involved in rib movement to aid respiration.

intrinsic = deep
The deep muscles develop embryologically in the back, and are thus described as intrinsic muscles
These muscles aid in the movement of the spine and maintain postures.

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4
Q

What is Spondylolisthesis?

A

slipping of the vertebral body

most common at the lumbosacral joint

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5
Q

Describe the curvatures of the vertebral column
1° curvature = concave
2° curvature = convex

A 
cervical = 2°
thoracic = 1°
lumbar = 2°
sacral = 1°
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6
Q

Describe how the posture changes in obesity/pregnancy relate to the curvatures of the spine

A

the secondary (lumbar) curvatures are accentuated, so people lean back

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7
Q

State 3 common deviations in spinal curvature.

A 
Scoliosis = abnormal lateral curvature of the spine 
Kyphosis = excessive outward curvature of the (thoracic) spine, causing hunching of the back  
Lordosis = excessive inward curvature of the (lumbar) spine
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8
Q

Why is scoliosis dangerous?

A

can result in compression of organs in the chest or abdomen

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9
Q

How many vertebra? Name the number in different regions

A 
33 vertebrae
7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccygeal (fused)
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10
Q

Which part is the lamina of the vertebra?

A

Between the spinous process and the transverse process

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11
Q

Which part is the pedicle of the vertebra?

A

Between the transverse process and the vertebral body

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12
Q

What are the features of typical vertebra

A
  • Vertebral body
  • —-> Major weight bearing part
  • Vertebral arch
  • —-> Forms roof of vertebral canal
  • —-> Has projections for attachment of muscles and ligaments
  • —-> Has sites of articulation for adjacent vertebrae
  • Pedicles
  • —-> Anchor the vertebral arch to the vertebral body
  • Lamina
  • Spinous process
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13
Q

Where are the intervertebral discs located?

A

between the vertebral bodies

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14
Q

Describe some distinctive features of cervical vertebrae.

A
  • Triangular vertebral foramen
  • Short, rectangular vertebral body
  • Bifid spine (except C1 and C7)

NOTE: Atlas and axis (C1 and C2) are specialised for movement

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15
Q

Describe some distinctive features of thoracic vertebrae.

A
  • Bigger than cervical vertebrae
  • Circular vertebral foramen
  • Heart shaped vertebral body
  • Spinous process pointing sharply downwards
  • Transverse costal facets (for rib articulation) - 2 on each side of the body + 1 on each transverse process
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16
Q

Describe some distinctive features of lumbar vertebrae.

A
  • LARGE
  • Articular facets are angled to limit movement
  • Thin, long transverse processes (except L5)
  • Triangular vertebral foramen
  • Cylindrical vertebral body (kidney-shaped)
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17
Q

Describe the shape of the atlas (C1).

A

It has NO vertebral body

It consists of two lateral masses with an anterior and posterior arch

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18
Q

Describe the articulations of the atlas (C1).

A

The two lateral masses articulate superiorly with the occipital condyles and inferiorly with the superior articular surfaces of C2

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19
Q

Describe the structure of the axis (C2).

A

It is a typical cervical vertebra with the body extended upwards to form the dens (odontoid process)

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20
Q

Which ligaments are attached to the dens?

A

The transverse ligament of the atlas keeps the dens in place, against the articular surface on the posterior surface of the anterior arch of the atlas.

Alar ligaments are attached to the superiolateral surfaces of the dens and the medial occipital condyles (underside of the skull).
Prevent excessive rotation of the head.

There are also longitudinal fascicles of the cruciform ligament (crosses over the transverse ligament of the atlas) - from the skull to C2

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21
Q

Name the two ligaments that rung along the length of the vertebral bodies from the skull to the sacrum.

A

Anterior and Posterior Longitudinal Ligaments

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22
Q

What is the name given to the upper art of the posterior longitudinal ligament going from C2 to the skull?

A

Tectorial Membrane

23
Q

What is the name of the ligament found between the lamina of adjacent vertebrae?

A

Ligamentum flavum

24
Q

Name the triangular sheet-like structure found in the upper vertebral column. Where is it attached?
(not in slides)

A

Ligamentum nuchae – attached from C7 to the occipital bone

25
Q

Name the ligament that connects the spinous processes from C7 to the sacrum
(it is continuous with the ligamentum nuchae)

A

Supraspinous ligament

It is connects to the spinous processes from C7 to the sacrum

26
Q

Which ligament lies between adjacent spinous processes?

A

Interspinous ligament

27
Q

What are the two parts of the intervertebral disc?

A

Nucleus pulposus - gel

Annulus fibrosus - contains circular collagen

28
Q

Between which vertebrae do you find intervertebral discs?

A

C2-S1

There is no intervertebral disc between C1 and C2 (you instead get atlanto-axial joint capsules)

29
Q

Describe the relation between vertebra and spinal nerves

A

above C7 - nerves emerge above the vertebra
8 cervical neves
below C7 - nerves emerge below the vertebra

30
Q

Describe the changes in where a spinal nerve emerges from the spinal chord and where it emerges from the vertebral column as you go down the spine

A

at the top of the spine, the nerve emerges from the vertebra at a very similar level to there is emerged from the spinal chord
as you go down the spine, the where the nerves emerge from the vertebra become further away from where it emerge from the spinal chord

31
Q

At what level does the spinal chord end, and what is found beneath this?

A

below L2, the spinal chord ends

only spinal nerves are found below here

32
Q

Describe how problems with the intervertebral disc can lead to potential clinical problems.

A

Degenerative changes in the annulus fibrosus can lead to herniation of the nucleus pulposus, which can then impinge on spinal nerves or the spinal cord

33
Q

State the movements of the spine

A

extension + flexion
lateral flexion
rotation

34
Q

Which muscles are involved in extension of the spine?

A

erector spinae

gluteus maximus

35
Q

Which muscles are involved in lateral flexion and rotation of the spine?

A

oblique muscles

36
Q

Extrinsic and intrinsic muscles

A 
extrinsic = superficial and intermediate
intrinsic = deep
37
Q

Describe the innervation of the muscles of the back

A

extrinsic = superficial and intermediate
innervated by anterior rami of spinal nerves

intrinsic = deep
innervated by posterior rami of spinal nerves

38
Q

Describe the flexibility of the cervical spine in terms of flexion/extension, lateral flexion and rotation.

A

Cervical spine can comfortably flex, extend, laterally flex and rotate.

The articular surfaces between vertebrae are almost horizontal, so all these movement are possible.
Also the neck has less surrounding tissue than other parts of the spine.

39
Q

Describe the flexibility of the thoracolumbar spine in terms of flexion/extension, lateral flexion and rotation.

A
  • flexion up to 90°
  • extension (less- up to 30°)
  • comfortable lateral flexion and rotation
40
Q

Describe the changes in the meninges between the brain and the spinal chord

A

2 layers of dura in the brain - 1 is reflected at the foramen magnum - only one in the vertebral column

no epidural space within the cranial cavity, but one in the vertebral column

41
Q

What is the difference between epidural and spinal anaesthesia?

A 
epidural = inside epidural space
spinal = inside subarachnoid space
42
Q

What space is present in the vertebral column that you don’t find in the skull?

A

Epidural space

43
Q

What does Epidural space contain?

A

Connective tissue
Fat
Internal vertebral venous plexus

44
Q

What is the filum terminale?

A

an extension of the pia mater that extends from the terminal end of the spinal cord (L2) to the tailbone. it helps to anchor the spinal cord in place

Pia mater firmly adheres to the surface of the spinal cord

45
Q

What is the arachnoid membrane and where does it end?

A

It is a thin, delicate membrane that is against but not adherent to the deep surface of the dura mater.
It ends at S2

46
Q

What thin structures interconnect the arachnoid and pia mater?

A

Arachnoid trabeculae – these also suspend vessels in the subarachnoid space

47
Q

Where does the subarachnoid space end?

A

S2

48
Q

At what vertebral levels do lumbar puncture take place? why?

A

at L3/L4 or L4/L5 interspinous levels

there is a huge subarachnoid space between L2 and S2

49
Q

State common spinal pathology

A

Low back pain
Prolapsed intervertebral disc - sciatica
Spondolysis (degeneration)
Spondylolysis (stress fracture of pars interarticularis)
Spondylolisthesis (forward displacement of vertebra)
Spondylitis (inflammation of vertebrae)

50
Q

What is Spondylosis?

A

degeneration of the spine

51
Q

What is spondylitis?

A

inflammation of the vertebrae

52
Q

What is Spondylolysis?

A

Stress fracture of pars interarticularis

53
Q

What is Spondylolisthesis?

A

Forward displacement of vertebra

Year 2 - HN&S anatomy (7 decks)

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