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203 MEDIMAGE - HAL > 5. Thoracic & Lumbar Spine > Flashcards

5. Thoracic & Lumbar Spine Flashcards

1
Q

how does the thoracic spinal column differ from the other parts of the spine

A

articulates with the ribs

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2
Q

how many thoracic ribs are there

A

12

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3
Q

what is the curvature of the thoracic spine

A

kyphosis (primary curvature)

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4
Q

what difference do you notice in the bodies and spinous processes between T1 and T12

A

T12 looks more lumbar in form - big squared body and thick short spinous process - as it needs to support more weight further down the column

continuum of size increase and form change from T1-12

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5
Q

what passes through the intervertebral foramina

A

spinal nerves

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6
Q

each thoracic vertebra articulates with the ribs via what joint type

A

multiple synovial costovertebral joints

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7
Q

how many typical vertebral body does each rib articulate with

A

2

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8
Q

how many individual synovial joints does a typical rib form with the vertebral column

A

3

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9
Q

why do the ribs have so many small synovial joints with the vertebrae

A

stability and movement

many small joints permits movement while also maintaining stability

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10
Q

which specific parts of the vertebrae do the ribs articulate with

A

body (superior hemi-facet) and the transverse process of their own vertebrae and body of vertebrae above (inferior hemi-facet)

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11
Q

what do you notice about the position in the thoracic column in terms of the atypical thoracic vertebrae

A

they are at the extremity of either end

in transition areas from one part of the spine to another

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12
Q

what is atypical about rib 1 and therefore T1

A

there is no Thoracic vertebrae superior to it therefore the rib cannot follow the usual pattern identified above of articulating across 2 bodies

Rob 1 consequently only has one facet on its head and only articulates with T1 which has a complete - not hemi - facet

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13
Q

why are T10-12 atypical in the way that they are

A

although there are vertebrae above the lower T vertebrae bodies end up so large like lumbar vertebrae that the ribs end up only articulating with their own level vertebra

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14
Q

what is the effect that the morphology of T12 has on the 12th rib

A

one facet on body and no transverse process so more movement and instability (which is good in many ways) and less likely to fracture (protecting the kidneys)

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15
Q

the winking owl face is indicative of what type of pathology

A

lytic bone tumor

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16
Q

what kind of articulations are in a cartilaginous joint

A

bone -> cartilage -> bone

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17
Q

what kind of articulations are in a synovial joint

A

bone -> joint space -> cartilage bone

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18
Q

what kind of articulations are in a fibrous joint

A

bone -> fibrous tissue -> bone

eg sutures in the skull

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19
Q

how many joints does each vertebrae form with its adjacent counterpart

what types are these joints and where are they between

A

3

2 are zygapophyseal joints between superior and inferior articular facets of adjoining vertebrae

1 intervertebral disc between the bodies of adjoining vertebrae

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20
Q

what type of joints are the zygapophyseal joints and what does this morphology allow for

A

synovial

small sliding movements in limited planes

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21
Q

the thoracic zygapophyseal joints lock together, when compared to those of the lumbar spine what does this say about the functionality of these 2 areas of the spinal column

A

thoracic = limited flexion/extension, more twisting and lateral bending

lumbar = more flexion/extension but almost no twisting or lateral bending

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22
Q

the intervertebral disc acts as which 2 things

A

joint and ligament

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23
Q

each IV disc is composed of what 2 components and what are these components made of

A

annulus fibrosus = concentric layers of collagen running in opposing directions to eachother

nucleus pulposus = jelly like

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24
Q

what type of joint is the IV disc

A

symphysis (fibrocartilagenous/secondary cartilagenous)

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25
Q

what type of joint are all midline joints

A

symphysis (fibrocartilagenous/secondary cartilagenous)

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26
Q

what are the functions of the IV discs

A

absorb compressive forces and allow slight movement between vertebral bodies

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27
Q

what 2 ligaments run the length of the spine

A

anterior and posterior longitudinal ligaments

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28
Q

what 2 structure do the anterior and posterior longitudinal ligaments attach to

A

vertebral bodies and IV discs

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29
Q

the anterior and posterior longitudinal ligaments both originate from where and run all the way down to where

A

occipital bone down to proximal sacrum

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30
Q

the anterior and posterior longitudinal ligaments tend to be thicker and width in which part of the spine

A

anterior = thicker and narrower in the thoracic region

posterior = thicker and broader in cervical and thoracic regions than lumbar

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31
Q

what role do the anterior and posterior longitudinal ligaments play in restricting movement of the spine

A

anterior = restricts extension of spine

posterior = restricts flexion of spine

32
Q

anterior longitudinal ligaments attach to what structure of the spine

A

top and bottom of vertebral bodies

33
Q

posterior longitudinal ligaments thicken near what structure of the spine

A

thicken near the IV discs

34
Q

what secondary function do the anterior and posterior longitudinal ligaments provide

A

help prevent the anterior or posterior herniation of the IV discs

35
Q

what is herniation caused by

A

when weight isnt applied directly vertically on the IV discs

36
Q

the anterior longitudinal ligament is implicated in the development of which spinal condition

A

diffuse idiopathic skeletal hyperostosis

37
Q

what happens in DISH

A

the anterior longitudinal ligament gets ossified along its course with other spinal ligaments

38
Q

what happens in ankylosing spondylitis

A

inflammatory arthritis of the spine causes ossification of the IV disc peripheries

39
Q

what is the difference between DISH and AS on the x-ray image

A

DISH = fusion lines across vertebrae on anterior aspect usually, easily seen on lateral radiograph

AS = lateral and posterior fusion across bodies as whole IV disc periphery is involved and SI joint fusion

40
Q

bamboo spine in PA view and squaring of vertebral bodies in the lateral view appearance in an image is associated with which spinal condition

A

AS

41
Q

how many vertebrae are there in the lumbar region

A

5

42
Q

what features differentiate the lumbar from thoracic vertebrae

A

larger squarer bodies in lateral view

short and squared spinous processes

smaller transverse process

no articulation for ribs

43
Q

what are lumbar vertebrae more specialised at doing in the spine

A

supporting weight

44
Q

what kind of curvature does the lumbar spine have

A

lordosis (secondary curve)

45
Q

the spinous processes of the lumbar region differ from the thoracic vertebrae for what reason

A

creates access path to spinal canal and therefore spinal cord

eg for lumbar puncture

46
Q

the sacrum consists of ___ ____ ____ with the coccyx attaching ___

A

5 fused vertebrae

inferiorly

47
Q

the sacral vertebra have lateral bodies that fuse to form the ___

A

alae

48
Q

the sacrum foramina that the other vertebrae dont have is formed by the fusion of what

what is this foraminas name

A

fusion and alar formation

anterior and posterior sacral foramina

49
Q

the sacral hiatus marks what

and what is this useful for clincially

A

the termination of the sacral canal

access to the spinal canal contents (eg sacral nerve blockers)

50
Q

the sacrum has 3 joints which are these

A

one joint with L5 superiorly

2 with the pelvis laterally

51
Q

what part of the pelvis does the alae articulate with

what is this joint called

A

iliac bones

sacroiliac joint

52
Q

the sacroiliac joint is part ___ but mostly ___ and hence this allows for what

A

part synovial, mostly fibrous

allows for a little movement whilst predominantly maintaining a strong articulation

53
Q

the spinal cord begins where and ends at which vertebral level

what is its end called

A

base of brain stem to L1/L2 Vertebral level

conus medullaris

54
Q

below the conus medullaris are spinal nerves which emerge lower than L1/L2 level

where do these continue down to and what level of the spine do they emerge from

what is the name given to these nerves

A

down to sacral hiatus

emerge from L2-S5 and coccygeal branches

cauda equina

55
Q

what are the 3 layers that surrounds the spinal cord

what are these layers called

A

meninges

outer dura mater
intermediate arachnoid mater
inner pia mater

56
Q

what is the spinal cord bathed in

A

cerebrospinal fluid

57
Q

where is the CSF found

what is the fluids purpose

A

in the subarachnoid space

protects and nourishes spinal cord

58
Q

lumbar punctures are made to extract what from where

are they performed in the upper/lower lumbar spaces why is this? why is it not in the thoracic region

A

extract CSF from spinal canal

lower lumbar regions - below L2 - as theres less risk of damage around the cauda equina than spinal cord (smaller nerves get pushed aside more easily)

in the thoracic region there is no access to the spinal cord due to spinous processes

59
Q

what pass through the intervertebral foramina of the thoracic and lumbar vertebrae

A

spinal nerve roots

60
Q

how many thoracic and lumbar spinal nerves are there

A

thoracic = 12

lumbar = 5

61
Q

what is the relationship of the spinal nerve roots to their respective vertebrae

A

each spinal cord emerges inferior to its respective vertebra

62
Q

what are the 2 plexus that supply the lower limb and pelvis

A

the lumbar plexus and sacral plexus

63
Q

out of the 2 plexus supplying the pelvis and lower limbs which one is the more proximal

A

lumbar plexus

64
Q

what nerve roots form the lumbar plexus

A

T12, L1-4

65
Q

the lumbar plexus is associated and forms within which muscles

A

psoas major

66
Q

for the psoas which is more medial and which is more lateral in terms of major and minor

A 
major = lateral 
minor = medial
67
Q

which regions of the lower limb/pelvis does the lumbar plexus mostly supply

A

anterior thigh muscles and skin on anteromedial thigh and medial leg

68
Q

what symptoms are expected from damaging the lumbar plexus

A

burning/numbness and muscular pain in the anterior thigh muscles and skin on anteromedial thigh and medial leg regions

69
Q

the sacral plexus is made of which nerve roots

A

L4-5 and S1-4

70
Q

where is the sacral plexus located in terms of the pelvis and sacrum

A

deep within the pelvis ontop of the sacrum

71
Q

what does the sacral plexus supply

A

majority of the lower limb

72
Q

where do the sacral nerve roots contributing to the sacral plexus emerge from specifically

A

anterior sacral foramina

73
Q

which muscle does the sacral plexus form anterior to

A

piriformis

74
Q

through which space do the sacral plexus nerves exit the pelvis

A

greater sciatic foramen

75
Q

what is more common - lumbar or sacral nerve root injuries/compressions

why

A

lumbar as sacral spine is very immobile and stable so therefore less prone to OA changes/injuries that might cause nerve root compression

203 MEDIMAGE - HAL (6 decks)

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