Back & Vertebral Column Flashcards

1
Q

Functions of the vertebral column

A
  1. Support & Balance
  2. Protection
  3. Flexibility
  4. Shock absorber
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2
Q

How many natural curves of the vertebral column are there?

Morphology of the vertebral column

A

4

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3
Q

During the pre-natal period, our spine is _-shaped & ______ ______

A

During the pre-natal period, our spine is C-shaped (picture) & anteriorly concave

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4
Q

The spine is made of __ to __ vertebrae

The vertebrae in the lower portion of the column have larger bodies than those in the upper portion to….

A

The spine is made of 32 to 33 vertebrae

…to better support the increased weight.

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5
Q

Spine is divided into _ regions

What are the regions & levels?

A

The spine is divided into 5 regions

Cervical | C1 to C7

Thoracic | T1 to T12

Lumbar | L1 to L5

Sacrum & Coccyx | S1 to S5 | Cox1 to Cox3

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6
Q

Superior View of a cervical vertebra

A
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7
Q

Lateral View of a cervical vertebra

A
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8
Q

Ligamentum nuchae

A

The ligamentum nuchae is a large median ligament composed of tendons and fascia. It covers the spines of C1 to C7 vertebrae.

Extends from the external occipital protuberance on the skull and median nuchal line, to the spinous process of C7

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9
Q

The Atlas (C1)

[Atypical Cervical Vertebrae)

A
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10
Q

The Axis (C2)

[Atypical Cervical Vertebrae)

A

The odontoid process, or dens is something significant in comparision to other cervical vertebrae

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11
Q

The joint between the superior facet & the occipital bone

A

Atlanta occipital joint

Flexion and extension of the neck

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12
Q

What does the dens act as?

A

The dens acts as a pivot that allows the atlas + the above occipital bone + head to rotate on the axis, side to side.

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13
Q

All Atypical Vertebrae

Typical vs Atypical

A

C1, C2, C7, T1, T9, T10, T11, T12, and L5 are the atypical vertebrae

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14
Q

Structure of a typical thoracic vertebra

A
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15
Q

Structure of a typical lumbar vertebra

A
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16
Q

The sacrum & coccyx

A
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17
Q

The sacrum & coccyx Posterior view

A
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18
Q

The vertebrae: a short summary

A
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19
Q

How the vertebrae articulate

A
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20
Q

The intervertebral discs

A
  • They account for around 20-30% of the total spine length
  • Vertebral discs provide strong attachments between vertebral bodies
  • They serve as shock absorbers
  • The discs are formed by two areas; an outer anulus fibrosus and an inner nucleus pulposus
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21
Q

The filum terminale (FT)

A

Is a fibrous band that extends from the conus medullaris to the periosteum of the coccyx.

Functions: This string like structure anchors the spinal cord to the sacrum and sacral region

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22
Q

The spinal cord

A
  • A long, thin, tubular structure made up of nervous tissue

Extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (approximately L1)

From here a series of spinal nerves branch off to form a structure called “cauda equina”, which means “horse’s tail”

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23
Q

The central canal

A

The central canal hosts Cereberal Spinal Fluid (CSF)

CSF: Clear and colourless fluid in brain and spinal cord produced by specialised cells in the ventricles of the brain and is absorbed by arachnoid granulations (found in the superior saggital sinus)

24
Q

Why is the vertebral column an ideal spot for cancer to spread?

A

It is because the vetebral column is highly porous and rich in blood vessels

25
Q

The spinal cord in the spinal canal

A
26
Q

The delicate neural tissue of the spinal cord is protected, as for the brain, by 3 layers of meninges (outer to inner)

A
  1. Dura mater
  2. Arachnoid mater
  3. Pia mater

These are continuous with the cranial meninges that protect the brain

27
Q

The epidural space

A

Area between the dura mater & the vertebral wall

Contains connective and adipose tissues | blood vessels

Site for anaesthetic injections

28
Q

Dura terminating near coccyx with filum terminalae (see diagram)

Know where pia and dura terminate inferior end of spine*

A
29
Q

Arachnoid Mater

A

Most elastic

Formed by elastic collagen fibres

30
Q

Between the Arachnoid membrane & Pia mater

A

The subarachnoid space

Continuous with intracranial subarachnoid space

Relatively large space containing approx. half of total CSF

31
Q

When spinal nerve ends at L1/L2, the subarachnoid space distal to this forms an area called the…

A

Lumbar cistern

The cistern is an enlargement of the subarachnoid space in the dural sac, distal to the conus medullaris. It contains cerebrospinal fluid & the nerve roots of the cauda equina ideal

Ideal area for lumbar puncture

32
Q

What does filum terminale anchor to?

A

The spinal cord is anchored distally by the filum terminale, a fibrous extension of the pia mater anchoring the spinal cord to the coccyx.

33
Q

Conus medullaris

A

The filum terminale (“terminal thread”) is a delicate strand of fibrous tissue, about 20 cm in length, proceeding downward from the apex of the conus medullaris. It is one of the modifications of pia mater.

{Where the filum terminale starts}

34
Q

The denticulate ligament

A

Comes off the pia mater and laterally anchors the spinal cord to the meninges

35
Q

How many spinal nerves in total?

A

There are 31 pairs of spinal nerves

(8 cervical | 12 thoracic | 5 lumbar | 5 sacral | 1 coccygeal)

36
Q

Why do we have 7 Cervical Vertebraes but 8 Cervical nerves

A

The first pair pass between the skull and C1 so we possess 7 cervical vertebrae but 8 cervical nerves

37
Q

Movements of the spine

A
38
Q

The anterior longitudinal ligament (ALL) ​

{The anterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A

Arises from the occipital bone

Structure:

  • Traverses (makes up/travels) the entire length of the spine along the anterior aspect of the body of the vertebrae and ends on the antero-superior portion of the sacrum
  • It broadens as it descends.
39
Q

The posterior longitudinal ligament (PLL)

{The posterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A

Arises from the back of the axis (C2) body

Structure:

  • Travels downward & attaches posteriorly to the vertebral bodies and intervertebral discs, attaching to the back of the sacrum.
  • It narrows as it descends.
40
Q

The interspinous ligament

{The posterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A
  • Joins the spinous processes
  • Fuses with the strong, supraspinous ligament
41
Q

The supraspinous ligament

{The posterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A
  • Joins the tips of the spinous processes.
42
Q

The ligamentum flavum

{The posterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A
  • A paired ligament which runs between the adjacent lamina of the vertebral bodies

It is a paired, yellowish, elastic ligament.

  • It starts off relatively thin in the cervical spine to progressively become thicker in the lumbar spine
43
Q

The intertransverse ligaments

{The posterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A
  • Join transverse processes of adjacent vertebrae
  • These are very thin fibrous cords
44
Q

The ligamentum nuchae

{The posterior ligament}

Purpose: Allow the flexion and extension of the spine while keeping the bones aligned

A

A large median ligament composed of tendons & fascia located between the posterior muscles of the neck

It spans from the external occipital protuberance and median nuchal line to the spinous process of C7, attaching all the posterior tips of C1 to C6 spinous processes.

It is an extension of the supraspinous ligament

It is thick & strong, limiting hyperflexion of the neck.

45
Q

Ligaments of the spine

(do questions for this later)

A
46
Q
  1. There are multiple ligaments in the spine. What do ligaments hold together?
  2. What is a ligament composed of?
  3. What function do ligaments play?
A
  1. Bone
  2. Skeletal ligaments are defined as dense bands of collagenous tissue (fibres) that span a joint.
  3. Increase stability of the spine, restrict movements that may damage the joint
47
Q

The muscles of the back

A
48
Q

What are the 2 superficial intrinsic muscles that rotate the head & extend the neck?

A

The splenius capitis & splenius colli (or splenius cervicis)

Function: rotation of the head (same side); extension of the neck; also involved in lateral flexion of the neck (same side).

49
Q

What muscle is being circled in the cadaver picture?

A

Splenius capitis

50
Q

How many intermediate intrinsic back muscles are there?

Tell me about them.

A

3

Spinalis, Longissimus & Iliocostalis,

They are quite long, large muscles running along the back of the spine. Together these muscles form a column - erector spinae.

Function

They all act unilaterally to cause lateral flexion of the vertebral column. They also contract bilaterally to extend the vertebral column and head. In addition, the connection with the pelvis also helps stabilise the column.

51
Q
A
52
Q

The deep intrinsic muscles

A

The deep intrinsic muscles are located underneath the erector spinae, and are known collectively as the transversospinales

They are a group of muscles associated with the transverse and spinous processes of the vertebral column

Function

Stabilise the spine by holding together the vertebrae; the semispinalis extend (bilateral contraction) & rotate (unilateral contraction) the head, neck and trunk

53
Q

Interspinales

There are minor deep intrinsic muscles or segmental muscles

A

Spans between adjacent spinous processes. Acts to stablise the vertebral column

54
Q

Intertranversari

There are minor deep intrinsic muscles or segmental muscles

A

Spans between adjacent transverse processes. Acts to stablise the vertebral column.

55
Q

Levatores costarum

There are minor deep intrinsic muscles or segmental muscles

A

Originates from the transverse processes of C7-T11, and attaches to the rib immediately below. Acts to elevate the ribs.

56
Q

Honourable Mentions

A