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ESA4 > 3 - Head & Neck - Osteology + Clinical Relevance of Skull + Cervical Spine > Flashcards

3 - Head & Neck - Osteology + Clinical Relevance of Skull + Cervical Spine Flashcards

1
Q

Between which cervical vertebrae is there no intervertebral disc?

A

C1 + C2

C1 does not have a vertebral body therefore no intervertebral disc

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2
Q

What structures pass through the foramina in the transverse processes of cervical vertebrae?

A

Vertebral Artery
Vertebral Vein
Sympathetic nerves

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3
Q

Which cervical vertebrae has an atypical spinous process? What makes it atypical?

A

C7

  • Non-bifid
  • Longest spinous process
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4
Q

Which cervical vertebrae are atypical?

A
  • C1 = no vertebral body or spinous process
  • C2 = dens
  • C7 = non-bifid, long spinous process
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5
Q

Name the strongest cervical vertebrae:

A

Axis (C2)

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6
Q

Name the ligament which holds the dens in position, and prevents horizontal displacement:

A

Transverse ligament of the atlas

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7
Q

Where are the most common sites of cervical spine injuries?

A
  • C1/2
  • C6
  • C7
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8
Q

List some injuries caused by hyperflexion of the cervical spine (ie blow to back of head):

A
  • Dens fracture
  • Dislocation/subluxation of cervical vertebrae
  • Rupture of intervertebral discs (commonly C5/6 or C6/7)
  • Rupture of supraspinous ligament
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9
Q

List some injuries caused by hyperextension of the cervical vertebrae (ie rear-end vehicle collision):

A
  • Hangman’s fracture (of axis)
  • Rupture of anterior longitudinal ligament
  • Vertebral fracture
  • Disc prolapse
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10
Q

What is another name for a ‘burst fracture of C1’, and how is it caused?

A

Jefferson’s fracture of Atlas

- Axial load = vertical fall onto extended neck

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11
Q

What is the mode of imaging of choice of a patient with a suspected cervical spine injury?

A 
Adults = CT scan
Children = MRI
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12
Q

List some general symptoms of c-spine injury:

A
  • Loss of sensation
  • Loss of function (ie difficulty breathing or moving limbs)
  • Parasthesia
  • Neck pain
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13
Q

List some c-spine changes which occur in cervical spondylosis:

A
  • Osteophytes
  • Facet joint hypertrophy
  • Disc herniation
  • Disc space narrowing
  • Sclerosis of end plates of vertebrae
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14
Q

How does age affect the health of the cervical spine?

A
  • Increased risk of osteoarthritis = intervertebral foramen can narrow
  • Increased risk of intervertebral discs bulging = intervertebral foramen can narrow

= Compression of spinal nerve = pain and muscle weakness of that dermatome/myotome

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15
Q

Name the 2 main complications associated with cervical spondylosis:

A

1) Radiculopathy (nerve root impingement)

2) Myelopathy (spinal cord compression)

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16
Q

How many bones make up the neurocranium? Name as many as you can:

A

8 bones:

  • Frontal
  • Temporal x 2
  • Parietal x 2
  • Occipital
  • Sphenoid
  • Ethmoid
17
Q

How many bones make up the viscerocranium? Name as many as you can:

A

14 bones:

  • Nasal x 2
  • Maxilla x 2
  • Mandible
  • Lacrimal x 2
  • Zygomatic x 2
  • Palatine x 2
  • Vomer
  • Inferior nasal conchae x 2
18
Q

Which bones meet at the pterion?

A
  • Frontal
  • Parietal
  • Temporal
  • Sphenoid
19
Q

What artery is at risk during a blow to the pterion?

A

Anterior branch of the middle meningeal artery

20
Q

What type of haematoma may be caused by a blow to the pterion?

A

Extradural haematoma

21
Q

Name the 3 sutures of the skull:

A
  • Lambdoid
  • Coronal
  • Sagittal
22
Q

What are the main signs which suggest a basilar skull fracture?

A
  • Battle’s sign ( bruising over mastoid process)
  • Periorbital eccymosis
  • Haemotympanum
  • CSF otorrhoea
  • CSF rhinorrhoea
23
Q

What is a fontanelle?

A

Membranous areas of unfused skull of an infant, to allow flexibility during passage through birth canal, and to allow for brain growth

24
Q

How can the fontanelles be used to indicate the health of an infant?

A

If sunken = may indicate dehydration
If bulging = indicates increased intracranial pressure (ie Meningitis/hydrocephalus)
If enlarged = May be premature sign of brain damage, or due to Down’s syndrome or IUGR

25
Q

Name the last parts of an infants skull to ossify:

A
  • Anterior fontanelle

- Posterior fontanelle

26
Q

When should the fontanelles close?

A 
Anterior = between 18 - 24 months
Posterior = within 2-3 months
27
Q

What structure passes through foramen rotundum?

A

Maxillary branch of the Trigeminal nerve CN V2

28
Q

What structure passes through foramen ovale?

A

Mandibular branch of the Trigeminal nerve CN V3

29
Q

What structure passes through foramen spinosum to become intracranial?

A

Middle meningeal artery

30
Q

What structures pass through foramen magnum?

A
  • Medulla oblongata
  • Spinal root of Accessory nerve CN XI
  • Vertebral arteries
  • Anterior and posterior spinal arteries
31
Q

Through which foramen will the internal carotid artery take to become intracranial?

A

Carotid canal

ESA4 (36 decks)

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