Cervical Spine Flashcards

1
Q

How does the cervical spine differ from infancy to adulthood?

A

in infancy = neck is kyphotic/primary curvature

in adulthood = lordotic/secondary curvature

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2
Q

What are the distinguishing parts of the cervical vertebrae?

A

cervical vertebra have

  • foramen transversarium - holes that allow blood supply to brain
  • triangular vertebral canal
  • spinous processes are short and bifid (except the 7th cervical vertebra- which is very long and not bifid)
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3
Q

what are the joints between vertebrae?

A

intervertebral discs- secondary cartilaginous

superior articular facet/inferior articular facet = facet joints = synovial

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4
Q

which cervical vertebrae are ‘typical’

A

C3,4,5,6 are typical

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5
Q

Describe the first cervical vertebrae

A

C1 = ‘atlas’ which supports the ‘globe’ of the head - it doesn’t have a body at all, it has an anterior neural arch and a posterior tubercle - it has fairly substantial transverse parts - which articulate with the occipital condyle -

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6
Q

Describe the 2nd cerivcal vertebrae

A

the ‘dens’ is actuallly acting as the ‘body’ of C1 but it is actually attached to the second cervical vertebrae - you also have foramina transversarium as well for the arteries - The den’s is held in position by ‘the most important ligament in the body’ which is the transverse ligament of atlas

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7
Q

what is the transverse ligament of atlas (or cruciate ligament)

A

the most important ligament in the body

  • it holds the ‘dens’ in the place, keeping it from sitting on the spinal cord -

if this ligament snaps (particularly in the elderly) - it could compress the cord and the lower part of the brain stem - this is fatal if it happens.

*note it’s actually cruciate in shape, but the vertical portion of it isn’t very important other than to restrict the motion of your head*

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8
Q

what ligaments prevent your head movement from left to right?

A

the alar ligaments - the vertical portion of the ‘cruciate ligament’ which is combined with the transverse ligament of atlas

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9
Q

describe the ligaments of the vertebral colummn

A
  • anterior and posterior longitudinal ligaments (posterior does not attach to the body of the vertebra, but anterior does)
  • ligamenta flava - elastic yellow ligament (not complete, it only attaches from between each of the vertebrae- it’s elastic so when you lift yourself back up, it helps to pull you back into upright
  • interspinous ligament - between each spine
  • supraspinous ligament - between each spine
  • between supraspinous ligament and vertebrae in the cervical spine it thickens as the ligamentum nuchae - fills in the curvature of your neck
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10
Q

Whey does the posterior longitudinal ligmament not attach tot he body of the vertebrae?

A

becuase the body of the vertebrae produces blood this needs to leave the body of the vertebrae through vessels - if the posterior was fused to the body, there would be no space for these vessels to exit the body

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11
Q

what are the three layers of tissue that cover the nervous system?

A

meninge

  • Dura, arachnoid, and Pia

Pia is directly adherent to the surface of the spinal cord - continues all the way down to the coxcyx

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12
Q

where does the spinal cord end on an adult?

A

L1- L2

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13
Q

Where does the spinal cord end on a child?

A

L3-L4

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14
Q

where does the subarachanoid space end on an adult?

A

S2 - important if you’re sampling for fluid b/c there is no spinal cord at this level, but there is cerebral fluid. t

Note however that babies can get meningitus- and their spinal cord ends very low, so you have to be sure to go low enough

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15
Q

there are how many cervical vertebrae? How many cervical nerves?

A

7 cervical vertebrae

8 cervical nerves

*the first cervical nerve comes out above the cervical vertebrae- 8th nerve comes out below C7)

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16
Q

Where do the motor roots exit the cord?

How about the sensory roots?

A

motor root =anterior

sensory root= exits posteriorly

17
Q

what does the dorsal ramus supply?

A

the erector spinae muscle and the skin above it

18
Q

what is the epidural space?

A

space between the bone and the outer layers of meninges

19
Q
  • what space contains the cerebrospinal fluid?
A

the subarachnoid space between the pia and the arachanoid layer

20
Q

What is the spinal cord’s blood supply?

A

vertebral arteries come up and give off ‘spinal arteries’=- these arteries run down the length of the spinal cord and supply it with blood -

segemental arteries - tends to waiver as you move inferiorly b/c presumably your upper neck is getting enough blood from the cervical arteries - but sometimes a spinal cord is entirely reliant on these segmental arteries and you could paralyze the patient by compromising these

the artery of adamkiewicz= booster artery- branch of the segmental spinal artery and supplies lower down the column

21
Q

Describe the veins in the spinal column

A
22
Q

what muscles maintain the neck’s ability to raise and turn?

A

the suboccipital muscles

innervation = posterior ramus of C1

23
Q

the dorsal ramus is usually very small - what is it like in C2?

A

the dorsal ramus of C2 is rather large actually - and it can be compressed in patient with a bit of arthritis- it supplies skin of back of head and scalp so it can cause lots of headaches

24
Q

what are the contraindications of a lumbar puncture?

A

contraindicated with raised intracranial pressure

25
Q

what are the layers before you can attain cerebrospinal fluid in a lumbar punctre?

A

•Layers passed – skin, subcutaneous tissue, muscle, supraspinous ligs, interspinous ligs,+/-ligamentum flavum, dura mater, arachnoid mater

26
Q

how many cranial nerves are there?

A

12 pairs - you have to learn them all

27
Q

in general with the sympathetic nervous system, what is the organization of fibers?

A

pre-gangiolic = very long

post ganglionic = very short

28
Q

what is the organization of parasympathetc fibers?

A

come from cranial nerves- short pre-ganglionic fibers and long post-ganglionic fibers

29
Q

the lateral horn forms what?

A

the pre-ganglionic sympathetic fibers

found from T1- L2

30
Q

the cervical part of the sympathetic trunk originates from where?

A

from T1 - it originates lower and must travel up the colum to the cervical region

31
Q

What sympathetic level dilates the eye?

A

T1-T2

which is why one of the first signs of a lung tumour is a dilated pupil - becuase it interferes with the sympathetic chain in that region