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MBBS - Year 1 > Anatomy - Intro to the Spine > Flashcards

Anatomy - Intro to the Spine Flashcards

1
Q

Vertebral column

A

Central foundation of the skeleton

Provides support for head and trunk and attachments for muscles and protects spinal cord

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2
Q

What is the vertebral column composed of

A

33 separate vertebrae, stacked and grouped into 5 regions - neck, chest, lower back, sacrum, coccygeal

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3
Q

Vertebrae in neck

A

5 cervical vertebrae

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4
Q

Vertebrae in chest

A

12 thoracic vertebrae

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5
Q

Vertebrae in lower back

A

5 lumbar vertebrae

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6
Q

Sacral vertebrae

A

5 vertebrae fused with sacrum

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7
Q

Coccygeal vertebrae

A

4 coccygeal vertebrae are vestigial remand of tail

Provides attachment for ligament

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8
Q

Why does a healthy vertebral column have a series of gentle curves

A

Important for maintaining upright posture and help dissipate forces travelling through the spine

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9
Q

Kyphosis

A

Vertebrae in chest and sacrum curve forwards

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10
Q

Lordoses

A

Vertebrae in neck and lower back curve backwards

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11
Q

When does cervical lordosis form

A

Whole spine is kyphotic at birth, cervical lordosis forms after few months to allow baby to hold head up independently

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12
Q

When does lumbar lordosis form

A

Within year allows baby to support body weight over hips and walk

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13
Q

What does the vertebral body provide attachment for

A

The disc that sits between the vertebrae

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14
Q

Vertebral canal

A

Where spinal cord is found, safely protected by thbone around it

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15
Q

Bony projections of vertebra

A

2 lateral transverse processes and posterior spinous process provide attachments for muscles of the back
Usually, can be palpated, can feel spinous process of 7th cervical vertebrae

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16
Q

Superior and inferior articular facet

A

Form joints with articular facets of the vertebrae above and below and these joints guide movements of the spine

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17
Q

Intervertebrate foramen

A

Created by articular facets joining togethe

Creates path for spinal nerves to leave the vertebral canal and enter the body

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18
Q

Features of vertebrae

A 
Spinous process 
Lamina 
Articular facet 
Pedicles 
Vertebral body 
Vertebral canal
Transverse process 
Spinous process
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19
Q

What are cervical vertebrae characterised by

A

Foramen transversarium

Bifid spinous process

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20
Q

Foramen transversarium

A

2 small holes in their transverse processes

Provides a safe route for vertebral artery to travel along the neck

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21
Q

What are thoracic vertebrae characterised by

A

Coastal facets

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22
Q

Coastal facets

A

Form joints with heads of ribs - superior coastal facet and transversp-coastal facets
Transverso-coastal facets articulate with the tubercles of the ribs

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23
Q

Features of lumbar vertebrae

A

Most robust, with large, wide bodies and transverse/ spinous processes
Processes are particularly prominent (need powerful muscles to move them)

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24
Q

Atypical vertebrae

A

C7 has both cervical and thoracic features and T12 has mix of thoracic and lumbar
Atlas
Axis

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25
Q

Atlas

A

1st cervical vertebrae

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26
Q

Axis

A

2nd cervical vertebrae

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27
Q

Atlas and axis comparison

A

Both have transverse processes but reduced in size
Atlas doesn’t have spinous process or vertabral body
Axis has dense/ odontoid peg

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28
Q

Dense/ odontoid peg

A

Upward-pointing projection of bone

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29
Q

Movements of spine

A

Flexion
Extension
Lateral flexion (to either side)
Rotation

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30
Q

What determines types of movement available at each section of spine

A

Joints

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31
Q

Movement at thoracic spine

A

Mainly lateral flexion

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32
Q

Movement of lumbar spine

A

Mainly flexion/ extension

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33
Q

Intervertebral disc

A

Cartilaginous joints connecting vertebral bodies together

34
Q

Components of IVDs

A

Nucleus pulposus
Annulus fibrosis
Vertebral endplate

35
Q

Nucleus pulposus

A

Central gelatinous mass formed of mainly type II collagen

Equal distribution of the force so it can be resisted

36
Q

Function of IVD

A

Allow movement between adjacent vertebral bodies
Absorb shock
Transmit loads through the vertebral column

37
Q

Number of IVDs in spine

A

23

38
Q

IVDs in cervical region

A

6

39
Q

IVDs in thoracic region

A

12

40
Q

IVDs in lumbar region

A

5

41
Q

Key note about IVDs

A

There is no intervertebral disc between C1 (atlas) and C2 (axis)
Absent in sacral and coccygeal region

42
Q

Annulus fibrosis

A

Fibrous outer ring formed of mainly type I collagen arranged in lamellae.
The annulus fibrosus is the primary load-bearing component of the intervertebral disc

43
Q

Innervation of IVDs

A

Receives innervation from the outer third portion of the annulus fibrosus

44
Q

Vertebral end plate

A

Cartilaginous layer covering the inferior and superior surfaces of the intervertebral disc

45
Q

How do IVDs receive nutrients

A

Avascular structure so endplate permits diffusion and provides the main source of nutrition for the disc

46
Q

Atlanto-occipital joint

A

Joint between C1 and occipital bone

Holds weight of head, allows head to rock backward and forward

47
Q

Atlanto-axial joint

A

Joint found between atlas and axis

48
Q

How does atlas and axis fit together

A

Odontoid peg fits into where vertebral body should be, traverse ligament passes through here and allows axis to rotate

49
Q

Actions of erector spinae

A

Extension

Lateral flexion

50
Q

Anterior nerve root

A

Ventral

51
Q

Posterior nerve root

A

Dorsal

52
Q

Function of dorsal ramus

A

Small posterior branch of spinal nerve supplies skin and muscles of back

53
Q

Function of ventral ramus

A

Larger anterior branch supplies everything else in body

54
Q

Anything distal to spinal nerve leaves …

A

Protection of bony canal

55
Q

Somatic nervous system

A

Voluntary nervous system

56
Q

Effernet nerves

A

Exit spinal cord

Motor supply

57
Q

Afferent nerves

A

Arrive at spinal cord

Sensory supply

58
Q

Dorsal root ganglion

A

Cluster of afferent cell bodies

59
Q

What do rami and spinal nerves contain

A

Mix of efferent and afferent fibres

60
Q

What do nerve roots contain

A

Eferent or afferent nerves

61
Q

Where are afferent nerves found

A

Ventral root

62
Q

Where are efferent nerves found

A

Dorsal root

63
Q

Where are symptoms of nerve damage experienced

A

Distal to injury

64
Q

What happens if spinal nerve is damaged

A

Efferent impulses can’t get out and afferent cant get in so we lose all innervation in both rami

65
Q

What happens if rami is damaged

A

Lose motor and sensory supply of that rami

66
Q

What happens if ventral root is damaged

A

Lose efferent innervation beyond that point in both rami so no motor supply but sensory supply is fine

67
Q

What happens if dorsal root is damaged

A

No sensory supply but motor is fine

68
Q

Commonest cause of back injury

A

Lifting heavy object - advised to keep back straight and let legs do the work

69
Q

How can IVDs be damaged

A

When lifting with bent spine as work best when spine is straight and forces spread out evenly. When flexed, forces are disproportionately channeled though anterior portion of the disc —> nucleus pulposus being pushed out and prolapsing though annulus fibrosis

70
Q

When do the erector spinae muscles have to work harder

A

Have to work harder to extend and support spine when not lifting with straight back

71
Q

What can cause tear of erector spinae muscles

A

Extensive strain due to smaller and more medial muscles supporting the spine as in flexion, lateral erector spinae muscles pass anteriorly and become flexors

72
Q

Cross section of lumbar IVDs

A

More elliptical shaped to help resist bending movements

73
Q

Cross section of thoracic IVDs

A

More circular, making them better suited to distributing the force of tension more equally, so stronger forces can be withstood

74
Q

Disc pathology

A

Disc bulge
Disc herniation
Desiccation
Prolapse

75
Q

Disc bulge

A

The circumference of disc extending beyond the vertebral bodies

76
Q

Disc desssication

A

Common in aging
NP shrinks as gelatinous material is replaced by fibrotic tissue and AF increases in size as a result of the additional pressure

77
Q

Disc prolapse

A

Rupture of nuclear material into the vertebral canal

78
Q

Disc sequestration

A

Herniated material break off from the body of the nucleus pulposus

79
Q

How does the spine cord arise cranially

A

As a continuation of the medulla oblongata

80
Q

Cervical enlargement

A 
1st point of enlargement on spine 
Cervical enlargement (C4-T1) 
Origin of the brachial plexus
81
Q

Lumbar enlargement

A 
2nd point of enlargement 
Lumbar enlargement (T11-L1)
Origin of the lumbar and sacral plexi
82
Q

What does film terminate attach to

A

Vertebral bodies of the coccyx, acting as an anchor for the spinal cord and meninges

MBBS - Year 1 (93 decks)

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