Anatomy 1 Flashcards
How many vertebra are in the
- cervical
- thoracic
- lumbar
- sacral
- coccygeal region
- cervical = 7
- thoracic = 12
- lumbar = 5
- sacral = 1 fused (5)
- coccygeal region = 1 fused (4)
what area of the spine are primary and secondary curves
Primary - Kyphosis
Secondary - Lordosis
Primary
- thoracic spine
Secondary
- Lordosis
- Cervical
describe the features of the cervical spine
- Triangular cell body
- bifid spinous process
- Transverse foramina – holes in the transverse processes. They give passage to the vertebral artery, vein and sympathetic nerve
describe the features of the thoracic spine
- vertebral body is heart shaped
- demi facets and costal facets
- spinous process is long, has transverse spinous processes
Describe the features of lumbar
- kidney shaped vertebral body
- triangular shaped vertebral foramen
- articulating facets become interlocked, superior point medially and inferior point laterally
describe the features of sacral and coccygeal
- The sacrum is a collection of five fused vertebrae. It is described as an inverted triangle, with the apex pointing inferiorly.
- On the lateral walls of the sacrum are facets for articulation with the pelvis at the sacro-iliac joints.
- The coccyx is a small bone which articulates with the apex of the sacrum.
- It is recognised by its lack of vertebral arches. Due to the lack of vertebral arches, there is no vertebral cana
What is C1 called and describe it
atlas
- bifid spinous process
- no vertebral body
- posterior and anterior arch instead
what is C2 called
axis
- Dens
- helps form the synovial pivot joint with rotation
what can C7 be used for
easily palpable, landmark that can be identified for counting the other vertebrae from this point
what is the clinical application of T7
Xiphoid, tip of the scapula
What is the clinical application of L1
Conus medullaris
What is the clinical application of L3
aorta bifurcation
What is the clinical application of L4
iliac crest
What type of joints are in the vertebral column
- Between vertebral bodies = cartilaginous joint
2. between articular facets = synovial plane joint that is interlocking
what is a Jefferson fracture associated with
This type of fracture is associated with an impact or load on the back of the head
- force compresses anteriorly and posteriorly and breaks the weakest point in the vertebra
- breaks C1
What is a hangman’s fracture
- this is a result of hyperextension of the head on the neck breaking the dens
- severe injuries to the body of the C2 vertebra is displaced anteriorly with respect to C3 this is likely to injure the spinal cord and/or brainstem
- bhyoid bone in the neck can be damaged as well
why does osteoporosis affect the vertebral bodies
Osteoporosis affects the vertebral bodies as they have a high proportion of trabeculae bone compared to cortical bone.
what happens in osteoporosis
There is net loss of bone and as a result the quality of the remaining bone is compromised and reduced
- decrease in the density of the bone
what are the most important areas affected by osteoporosis
the most affected areas are the neck of the femur (see lower limb) and the bodies of the vertebrae, the metacarpal and the radius as these are the weight bearing parts of the body
What is osteoporosis characterised by in vertebral bodies
For the vertebral bodies early to moderate osteoporosis is characterised by vertical striation of the vertebral bodies
what happens to the pattern of osteoporosis in the later stages
In later stages of osteoporosis the striated pattern is lost as more spongy (trabeculae) bone is lost. There is uniform radiolucency in the body of the vertebrae, because of the relative sparing of the cortical bone it may appear more prominent and a white rim is seen around the vertebral bodies
What happens to the bone in middle age
- there is an overall decrease in bone density and strengthen
- the articular surface bows inwards and intervertebral disc becomes increasingly convex to fit
- loss of height with age
- loss of disc space
- vertebral bodies changing shape result in an increase in the compressive forces at the periphery of the vertebral bodies
what happens to the bone in late stage osteoporosis
- the vertebral bodies especially in the thoracic region collapse and become excessive in their hypothesis
What is the name of the type of fracture produced by osteoporosis in the vertebral column
Vertebral compression fractures
what is lumbar spinal stenosis
- this is a narrowing of the vertebral foramen
What can cause a lumbar spinal stenosis
- genetic conditions
- age related changes
as the spinal cord goes down
- the spinal nerves that exit the lumbar region increase in size but he intervertebral foramina decrease in size
what is the surgical treatment of a lumbar stenosis
- decompressive laminectomy
How does spinal enthsopathy happen
- paraspinal ligaments undergo degeneration that is secondary to attrition
- they then ossify
why is the left side of the spine not involved in DISH
For unknown reasons the left side of the spine is spared or less involved which might have to do with the pulsating aorta
What does DISH stand for
Diffuse idiopathic skeletal hyperostosis
what is the difference between DISH and analysing spondylitis
Unlike anklyosing spondylitis DISH does not involve the sacroiliac joint
what are the elements of a clinical examination of a spine
- gait
- alignment
- posture
- skin
- palpate bony structures
- palpate soft tissues
what is the positive and negative about the upper limb
positive is that it is designed for movement
negative is that is has less stability therefore it is more prone to dislocations of the joints
what is the only joint that holds the upper limb onto the axial skeleton
- sternoclavicular joint
how can clavicles have fractures
- Clavicle is designed for strength but you can either have fractures by direct or indirect force applied to it
what is one of the most commonest bone to fracture
clavicle
what happens to the clavicle when it ia fractured
After the fracture the actions of the sternocleidomastoid muscle pulls the medial fragment upwards. The tapezius muscle is unable to hold the lateral fragment up because of the weight of arm and gravity, thus the shoulder drops
what is the glenohumeral joint between
the glenoid fossa of the scapula and head of the humorous
what is the most common joint to dislocate
- the gelonhuemral joint
what dislocation is most common in the glenohumeral joint
- the anterior dislocation