Anatomy of the Spine

Question 1

what are the 33 vertebrae

Answer 1

7 cervical 
12 thoracic 
5 lumbar 
5 sacral 
4 coccygeal

Question 2

how many curves does a healthy spine have

Answer 2

4
2 lordosis
2 kyphosis

Question 3

what part of a vertebrae can u feel

Answer 3

spinus process

Question 4

what vertebrae are atypical

Answer 4

atlas and axis - allow head rotation

vertebrae prominent (c7) sticks out

Question 5

what type of joint are intervertebral disks

Answer 5

fibrocartilaginous joints

Question 6

what is a facet joint

Answer 6

synovial joints 
allow movement (lateral flexion, extension) 
different sections of spine have differently orientated facet joints

Question 7

why is thoracic spin less movable

Answer 7

ribs constrain it

Question 8

what spinal joints get arthritis

Answer 8

facet joints

Question 9

what happens to intervertebral discs with ageing

Answer 9

they loose water leading to overload of facet joints and osteoarthritis

Question 10

what makes osteoarthritis in the facet joints worse

Answer 10

extension of the spine

Question 11

how do u treat OA in one or two motion segments

Answer 11

localised fusion

contraversial as OA will affect adjacent level in 5 years

Question 12

what is the outside of the intervertebral disc called

Answer 12

annulus fibrosus

Question 13

what is the inside of the intervertebral disc called

Answer 13

nucleus pulpous

Question 14

where do acute disc prolapse tend to occur

Answer 14

most at L4/5 or L5/S1

Question 15

what causes disc prolapse

Answer 15

lifting heavy objects leading to annulus tear
will heat a twang

get pain on coughing
most settle by 3 months

Question 16

where do motor neurons originate from

Answer 16

anteriorly

Question 17

where do sensory neurons originate from

Answer 17

posteriorly

Question 18

where does the spinal cord run

Answer 18

down the spinal canal formed by the vertebral foramina

Question 19

where do mixed spinal nerves exit

Answer 19

the intervertebral foramen

Question 20

what is sciatica

Answer 20

radiation of nerve pain along sensory distribution of sciatic nerve

Question 21

what is spinal stenosis

Answer 21

nerve roots compressed by osteophytes and hypertrophied ligaments in OA

Question 22

symptoms of spinal stenosis

Answer 22

radiculopathy or burning leg pain on walking = neurogenic claudication

Question 23

what is Clauda equina syndrome

Answer 23

pressure on all lumbosarcral nerve roots at level of lesion including sacral nerve roots for bladder and bowel

Question 24

symptoms of clauda equina

Answer 24

bilateral lower motor neurone signs
bladder and bowel disfunction
saddle anaesthesia
loss of anal tone

Question 25

muscles of the spine

Answer 25

iliocostalis
longissimus thoracics
spinalis thoracics

all contribute to stability

Question 26

where do u do a lumbar puncture

Answer 26

posterior iliac crest L4

or PSIS S2

Question 27

most are most cases of back pain caused by

Answer 27

mechanical back pain related to joints, ligaments and muscles with no sinister red flags

Question 28

symptoms of mechanical back pain

Answer 28

worse with activity
relieved by rest
long course of relapsing and remitting
may be related to obesity, poor posture poor lifting technique