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Y1 - MSK > Cervical And Thoracic Spine And Clinical Disorder > Flashcards

Cervical And Thoracic Spine And Clinical Disorder Flashcards

1
Q

How many cervical vertebrae are there?

A

7

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2
Q

How many cervical nerves are there?

A

8

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3
Q

How many thoracic vertebrae are there?

A

12

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4
Q

Why are people more likely to develop age related problems in the cervical spine than the thoracic spine?

A

Cervical spine is mobile
Thoracic spine is immobile

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5
Q

Why does the size of vertebrae increase as you descend the spine?

A

Have to be able to bear more weight as you go down the spine

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6
Q

What cervical vertebrae have the TYPICAL characteristics of a cervical vertebra?

A

C3 - C6

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7
Q

What are the differences of a typical cervical vertebrae to a lumbar vertebra?

A

Bifid Spinous Process
Transverse Foramen

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8
Q

What is meant by the Bifid spinous process of a Typical cervical vertebra?

A

Has 2 prominences at the tip rather than just 1

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9
Q

What is a transverse Foramen?

A

Hole in the transverse processes

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10
Q

What is transmitted through the transverse Foramen of C1 - C6?

A

Vertebral artery
Vertebral vein
Sympathetic nerve plexus

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11
Q

What is transmitted through the transverse foramen of C7?

A

Accessory vertebral vein

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12
Q

What are the 3 atypical cervical vertebrae?

A

C1 (Atlas)
C2 (Axis)
C7

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13
Q

What is the atypical structure of the Atlas (C1)?

A

NO vertebral body
NO spinous process
Large lateral masses

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14
Q

What does C1 articulate with?

A

The occipital bone of the head and the Axis (C2)

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15
Q

What does the remnant of the vertebral body of C1 form?

A

The Odontoid process

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16
Q

Why is the atlas (C1) the widest cervical vertebra?

A

Lots of space for the spinal cord

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17
Q

Why does the atlas have very large lateral masses?

A

To support the heavy weight of the head

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18
Q

What attaches at the anterior arch and anterior tubercle of the atlas?

A

Anterior Longitudinal Ligament

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19
Q

What is the atypical structure of the Axis (C2)?

A

Odontoid process/dens
Broadest spinous process of the Cervical vertebra

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20
Q

What does the articulation between C1 and C2 allow for?

A

Rotation

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21
Q

Where is the Transverse ligament in the C1, C2 articulation?

A

Posterior to the odontoid process

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22
Q

What is the function of the Transverse Ligament?

A

Prevents horizontal displacement of the atlas (C1)

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23
Q

What is Atlantoaxial instability?

A

Weakness at the articulation between C1 and C2

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24
Q

What can cause Atlantoaxial instability (C1 and C2)?

A

Fracture at C1 damages the transverse ligament
General degradation

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25
How can Atlantoaxial (C1 and C2) instability cause neurological issues?
When the neck is flexed forward C1 can move forward on C2 which can put pressure on the spinal cord
26
What is the atypical structure of C7 vertebra?
LONGEST spinous process Non Bifid spinous process Large transverse process but small transverse foramen
27
What are the ligaments of the cervical and thoracic vertebra?
Anterior longitudinal ligament Posterior longitudinal ligament Ligamentum flavum Interspinous ligament Supraspinous ligament
28
Where is the anterior longitudinal ligament?
Anterior surface of the vertebral body
29
Where is the posterior longitudinal ligament?
Posterior part of the vertebral body, the front of the spinal canal
30
Where is the ligamentum flavum?
Back of the spinal canal
31
Where is the interspinous ligament?
Between the spinous processes
32
Where is the supraspinous ligament?
At the tips of the spinous processes
33
What is the Ligamentum Nuchae?
A thickening of the supraspinous ligament
34
Where is the ligamentum Nuchae?
Splits the muscles Inserts into the back of the head (occipital bone) and all of the spinous process of the cervical vertebrae
35
What is the function of the ligamentum nuchae?
Maintains secondary curvature of cervical spine Helps cervical spine support head (prevents the muscles from constantly contracting preventing fatigue)) Site of muscle attachment for neck and trunk muscles
36
What movements can the cervical spine do?
Flexion Extension Rotation Lateral Flexion
37
What movement does the atlanto-occipital joint mainly contribute to? (Occipital and atlas)
Flexion Extension 50% of Flexion and extension happens here, other 50% comes from the rest of the cervical spine
38
What movement does the atlanto-axial joint mainly contribute to? (Atlas and axis)
Rotation 50% of rotation happens here, other 50% contributed by rest of cervical spine
39
What is the structure of the Thoracic vertebrae similar to?
Lumbar vertebrae
40
What is the shape of the thoracic vertebrae’s vertebral body like?
Heart shape
41
What is the shape and size of the thoracic vertebrae’s vertebral foramen?
Small and circular
42
What is the clinical relevance of the thoracic vertebral foramen being small?
Any bleeding into the thoracic segment of the spinal cord will likely lead to neurological symptoms since the spinal cord is likely to get compressed
43
What is special about the facet joints of the thoracic vertebra?
Have demi-facets on the sides of the vertebral body to articulate with the ribs
44
What is unique about the facets of T1 on the vertebral body?
Whole facet joint superiorly Demi-facet inferiorly
45
What is the structure of the facet joints on the vertebral bodies of T2-T8?
Demi facets above and below
46
What is the structure of the facet joints on the vertebral bodies of T9-T10?
Back to full facets above and below
47
What is the overal structure of a thoracic vertebrae?
Small circular vertebral foramen Triangular shaped vertebral body Demi facets (facet joints to articulate with the ribs
48
What 2 places of the thoracic vertebra does a rib articulate with?
Head of rib with vertebral body Neck of rib with the transverse process (not at T11 and T12 tho)
49
Where does a neurovascular bundle run with the rib?
In the costal groove
50
What movements do the facet joints allow for and then limit in the thoracic spine?
Allows for rotation Limits Flexion
51
What movement should be assessed for if you suspect the thoracic vertebra are damaged?
Rotation
52
Where is the Anterior Longitudinal Ligament found?
Runs along the front of the vertebral bodies
53
Where is the Posterior Longitudinal Ligament found
Back of the vertebral bodies at the front of the spinal canal
54
What is cervical spondylosis? (Osteoarthritis)
Neck pain as a result of age-related changes of the cervical spine
55
What is the usual triad for cervical spondylosis (osteoarthritis)?
Loss of disc height Facet joint arthritis (more pressure on facet joints) Osteophytes (Syndesmophytes)
56
How can cervical spondylosis lead to myelopathy?
Osteophyte in the vertebral/spinal canal
57
How can cervical spondylosis lead to radiculopathy?
Osteophyte in the intervertebral foramen
58
What normally happens when nerve roots get compressed (Radiculopathy)
Paraesthesia in the affected Dermatome (pins and needles/numbness) Pain which radiates from the compression to the affected dermatome Motor/muscle weakness in affected dermatome Paralysis in affected Dermatome
59
What age do Prolapsed intervertebral discs usually happen? (Cervical spine)
30 - 50yrs
60
Why is tearing the annulus fibrosis bad in a cervical prolapsed intervertebral disc?
Nucleus pulposus is acidic which will irritate the spinal cord
61
If somebody has a prolapsed C5/C6 intervertebral disc what spinal nerve root is compressed?
C6
62
If somebody has a prolapsed C5/C6 intervertebral disc where do they experience pain?
Radiates from neck down the anterior arm into the lateral forearm thumb and index finger
63
If somebody has a prolapsed C5/C6 intervertebral disc what motor weakness do they have?
C6 myotome responsible for: -Elbow Flexion -Wrist extension -Supination
64
If somebody has a prolapsed C5/C6 intervertebral disc where do they experience sensory loss/numbness?
Lateral forearm thumb and index finger Only in the C6 dermatome
65
What age range does cervical myelopathy typical affect?
50 - 80 yrs Usually because of cervical cord compressed by spondylosis
66
What anatomically changes with cervical myelopathy?
Thickening of Ligamentum Flavum Osteophytes
67
What are the symptoms of cervical myelopathy?
Progressive Clumsiness Loss of fine movements Loss of balance
68
What will a patient with C4 myelopathy complain of? Pain? Motor weakness? Sensory loss?
Pain at neck Motor weakness of Shoulder abduction (C5) and other myotomes distally Numbness/parasthesia from the shoulder distally, trunk and lower limbs
69
What is a Jefferson Fracture?
Burst fracture of C1 (atlas)
70
What causes a Jefferson fracture (C1)?
Axial loading: Hitting top of the head driving the skull into the cervical spine
71
What part of the atlas breaks in a Jefferson fracture (C1)?
Front and back arches can break
72
What is a Hangman’s fracture?
Fractured C2 Fracture through the pars interarticularis usually due to hyper extension of the Neck
73
How can you see a Hangman’s fracture on an x-ray?
Forward displacement of C1 and C2 on C3
74
What is an Odontoid Peg fracture?
Hyperextension injury of the Odontoid of C2
75
How are odontoid peg fractures usually caused?
Older person falls and does react quick enough to use there hands to stop themselves
76
What are the 2 common causes of thoracic cord compression?
Fractures Tumours
77
Why are fractures and tumours likely to cause neurological problems in the thoracic spine?
Small vertebral Foramen in thoracic spine
78
What will a patient with Thoracic cord compression at T10 complain of? Pain? Motor weakness? Sensory effects?
Lower thoracic pain Weakness in all muscles of the legs (T10 myotome and below) Numbness just below umbilicus (T10)
79
What is Spondylodiscitis?
Infections of the spine
80
What part of the spine usually gets infected in Spondylodiscitis?
Intervertebral disc
81
Why does the intervertebral disc usually get infected in Spondylodiscitis?
Doesn’t have a direct blood supply so has few white cells
82
How do bacteria usually enter the intervertebral disc?
Diffuse from the vertebral body nutrient artery
83
What can happen if Spondylodiscitis goes untreated?
Epidural abscess and vertebral osteomyelitis

Y1 - MSK (36 decks)

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