C & T Spine Flashcards

1
Q

Defining features of the c-spine

A
  • 2 projections on spinous process
  • 2 projections of TV process
  • TV foramen
  • Small
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2
Q

Where are the lamina and pedicle

A
  • Pedicle attached to body

- Lamina near the spine

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3
Q

Joints of the C-spine

A
  • Atlanto-occipital
  • 2 Lateral atlantoaxial
  • Medial atlantoaxial
  • Uncovertebral joint
  • Facets
  • Intervertebral joint
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4
Q

How the facets of the c-spine face

A
  • Superior: post sup/med
  • Inferior: ant inf lat

When looking sideways, ~45 degree orientation

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5
Q

Describe the special “Intervertebral joints” of the c-spine

A
  • Uncinate joints

- The vertebral bodies superiorly have a raised lip

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6
Q

The uncovertebral joints serve to:

A
  • Guide flex/ext
  • Reduce side bending
    Prevent post translation of neighbouring vertebrae
  • Reinforce the vertebral disk
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7
Q

Defining features of C1

A
  • Atlas
  • An anterior and posterior arch, connected by lateral masses
  • Has a TV foramen
  • Posterior side of superior articular facets have a grove for the vertebral artery
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8
Q

Defining features of C2

A
  • The dens, which has the anterior articular facet
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9
Q

Describe the C0/1 joint

A
  • Atlanto-occipital
  • Between the superior articular facets of C1 and the occipital condyles of the skull
  • Synovial joints
    Has a fibroadipose meniscoid between the joints
  • Has translation/gliding like the knee and shoulder
  • 50-60% flex/ext occurs here
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10
Q

Describe the C1/C2 joint

A

Lateral(s)
- At a slight angle allowing for lots of rotation

Medial

  • Between dens and anterior arch of C1
  • Pivot joint
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11
Q

Movement at the atlanto-axial joint

A
  • 50-60% of total rotation of c-spine

- Limited amount of flex/ext and lateral bending

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12
Q

Movement of the c-spine below C2

A
  • flex/ext, most at C4/5
  • Lateral flexion, most between C2-5
  • Axial rotation throughout
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13
Q

Anterior longitudinal lig (describe + attachments)

A
  • Broad fibrous band
  • Occipital bone to sacrum
  • Most developed in lordotic areas
  • Taut in ext.
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14
Q

Post. longitudinal ligament (describe, thickness)

A
  • Posterior of vertebral bodies, anterior canal
  • Narrow fibrous band
  • Well developed in kyphotic regions
  • Taut in flexion
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15
Q

The 3 ligaments of the spinous processes

A

Ant -> post

  • Ligamenta flava (between lamina)
  • Interspinous lig (between spinous processes)
  • Supraspinous ligament (on top of spinous processes
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16
Q

Ligament between lamina

A

Ligamentum flava

17
Q

Describe the ligament between TVP

A
  • Intertransverse ligament
  • Increase in size as you move inferiorly
  • Blends with surrounding musculature
  • Taut when bending away
18
Q

Special ligament of the post. neck

A

Nuchal ligament

  • A cervical extension of the supraspinous ligament
  • Attached to EOP
  • Limits flexion, also a point of attachment for muscles
19
Q

Ligaments of C0-C2

A
  • Alar ligaments
  • TV ligament of atlas
  • Tectorial membrane
  • Posterior atlantooccipital membrane
  • Apical ligament of dens
20
Q

Alar ligaments

A
  • Runs from lateral dens to occipital condyle
  • About 1 cm long, about the width of a pencil
  • Taut during front and side flexion, rotation
  • Along with TV ligament of atlas, serves to prevent separation of C1/C2
21
Q

TV ligament of atlas

A
  • Along with alar ligaments, serves to prevent separation of C1/C2
22
Q

Extension of post longitudinal lig

A

Tectorial membrane

23
Q

Extension of ligamenta flava

A

posterior atlanto-occipital membrane

24
Q

4 parts of the vertebral artery

A
  • Proximal
  • Transverse
  • Suboccipital
  • Intracranial
25
Q

Proximal aspect of vertebral artery

A
  • Runs vertically, and slightly medially/posteriorly to entry point
  • Along it’s course, it lies between the longus colli and the anterior scalene
  • Typically enters the TV foramen at C6, but this can vary from C3-7, and can vary side to side on an individual
26
Q

Transverse aspect of the vertebral artery

A
  • Runs through TV foramen
  • Surrounded by periosteal sheath attached to canal boundaries
  • At C2, the artery must run slightly laterally as the TV foramen of C1 is lateral to C2
27
Q

Suboccipital aspect of the vertebral artery

A
  • Once outside of C1 TVP, wraps around groove on superior facet, then runs ant/med/sup to enter foramen magnum
28
Q

Intracranial

A

Now becomes the intercranial vertebral artery, then meets to form the singular basillar artery at the base of the medulla oblongata

29
Q

Where the vertebral artery is susceptible to damage

A
  • C1/2 due to amount of rotation, how it needs to wrap around sup. facet
  • Extension
  • Stenosis or narrowing, where a flap-like tear can develop in the arterial wall, leading to the formation of a hematoma
30
Q

Where the head of the rib meets the body of spine

A

Costovertebral joint

31
Q

Where the neck of the rib articulates with the spine

A

Costotransverse joint

32
Q

Z-joints of the T-spine

A
  • Increase in angle as you go down (45/60 at top - 90 at bottom)
  • Superior facets of T-spine are directed posteriorly and slightly laterally, inferior is the opposite
33
Q

Movement of the T-spine

A
  • flexion/ext greater in lower t-spine due to coronal orientation in upper spine
  • Lateral flexion and rotation limited due to rib cage