Apex- Neuraxials Flashcards
What are the others?
A- Transverse process
B- Superior articular process
C- Lamina
D- Spinous Process
How many vertebrae in the spine?
_ cervical, _ thoracic, _ lumbar, _ fused-sacral, _ fsed-coccygeal
33
7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral, 4 fused coccygeal
The spinal nerves exit the vertebral column through what?
the intervertebral foramina
What do the facet joints do?
what can injury to a facet joint do?
they guide and restrict movement of the vertebral column
it can compress the spinal nerve as it exits the respective intervertebral foramina, causing pain and muscle spasm along the associated ermatome
Purpose of the intervertebral discs?
what happens when they degenerage?
they act as a shock absorber
the size of the intervertebral foramina reduces and can cause nerve compresion
What is the space that contains the spinal cord, nerve roots and epidural space?
vertebral foramen
label
C1 vs C2 - which one is the atlas and which one is the axis
C1- atlas
C2 - axis
atlas spins on the axis
whats the zygapophyseal joint?
the facet joint
formed by the inferior articular process of the above vertebra and the superior articular process below
What is the name (2) of the horizontal line drawn across the superior aspects of the iliaccrests and what vertebra does it correlate with?
intercristal line (Tuffier’s line)
L4
space above = L3-L4, space below = L4-5
Infants up to 1 year, the intercristal ilne correlates with what interspace?
L5-S1
What vertebral level corresponds with the spine of scapula?
What about the inferior angle of the scapula?
T3
T7
What vertebral level corresponds with the posterior superior iliac spine
What about the superior aspect of the iliac crest?
S2
L4 (intercristial line)
What vetebral level corresponds with the vertebra prominens?
C7
What vertebrae corresponds with the rib margin 10cm from midline?
L1
In the adult, which anatomic structure correlates with the termination of the dural sac?
A. Sacral cornua
B. Superior iliac spines
C. Tuffier’s line
D. L1 vertebra
B. Superior iliac spines
Superior aspects of the iliac CREST vs
Posterior suprior iliac SPINE
veretebre correlation vs landmark associate
iliac CREST : L4-5 interspace (Tuffier’s line)
iliac SPINE: S2 (Dural sac ends)
What vertebra is is the conus medullaris associated with?
L1
What provides an entry point to the epidural space that’s useful in pediatrics?
what vertebra does it coincide with? What is it covered by?
What’s the landmark for caudal anesthesia?
Sacral hiatus = entry point into the epidural space
S5 ; covered by the sacrococcygeal ligament
Sacral Cornua = landmark
The Spinal cord ends in a taper as the what?
Infant vs Adult
Conus medullaris
Adult - L1-L2
Infant: L3
What is the cauda equina?
what nerve and nerve roots is it made up of?
A bundle of spinal nerves extending from the conus medullaris to the dural sac
L2-S5 nerve and nerve roots & the coccygeal nerve
Where does the subarachnoid space end?
Landmark for adult vs infant?
dural sac
adult - S2
Infant - S3
What are the 5 ligaments of the spinal cord from superficial to deep?
which ones do you pass through with the midline approach to a spinal?
which ones what about the paramedian approach?
- supraspinous
- interspinous
- ligamentum flavum
- posterior longitudinal
- anterior longitudinal
supraspinous, interspinous, ligamentum flavum
paramedian = just the ligamentum flavum
What contributes to the loss of resistance encountered during neuraxial anesthesia?
piercing the ligamentum flavum when the needle enters the epidural space