Cervical + Thoracic Spine Flashcards
Number of cervical vertebra
7
Number of cervical spinal nerves
8
Number of thoracic vertebra
12
What vertebrae are atypical?
C1, C2 + C7
Function of the cervical vertebrae transverse foramen
C1-C6 transmit the vertebral artery, vein and sympathetic nerve plexus
C7 transmits accessory vertebral vein only
Describe the cervical vertebrae
Anatomical features of lumbar spine vertebrae
Bifid spinous NOT C7
Small + broad body
Contain transverse foramen
Cervical vertebrae orientation
45°
What is the name for the C1 vertebra?
Atlas
What is the name for the C2 vertebrae?
Axis
How is the C1 vertebra atypical?
No spinous process
No vertebral body
Has anterior and posterior arch
Describe the C1vertebra
Anterior + posterior arch
No spinous process
No vertebral body
Largest lateral masses
Transverse foramen in transverse processes
Articulate facet for dens in middle of anterior arch
Widest cervical vertebrae foramen
Why are the lateral masses on the C1 vertebra the biggest?
Supports head
Spreads out the weight
What attaches to the anterior arch of C1?
Anterior longitudinal ligament
What attaches to the posterior arch of C1?
Ligamentum nuchae
What is the atlanto-occipitial joint between?
Between the occiput of skull + atlas vertebrae
What does the atlanto-occipital joint permit?
Flexion + extension
Head nodding
What is the atlanto-axis joint between?
Between atlas + axis vertebrae
Why is the C2 vertebra atypical?
Dens/Odontoid process
Describe the C2 vertebra
Largest spinous process
Dens/Odontoceti process
Other features of cervical spine
What holds the dens in place?
Transverse ligament of atlas
What does the atlanto-axis joint permit?
Rotation
Shaking head
What does the transverse ligament of atlas permit?
Rotation
‘no’
What is the function of the odontoid process?
Acts as a pivot joint
Allows rotation
What is atantoaxial instability?
Excessive movement between C1 + C2 vertebrae
What causes atlantoaxial instability?
Due to damage of transverse ligament
Causes - acute trauma e.g. C1 fracture
- erosion from inflammatory conditions e.g RA
What happens in atlantoaxial instability?
- C1 vertebra moves forwards when head moves forwards
- Compression of spinal cord
Why is the C7 vertebra atypical?
- Longest spinous process - not bifid
- Small transverse foramen - only transmits accessory vertebral veins
Name for the C7 vertebrae
Vertebrae prominens
List nerve roots and where the exit in relation to their corresponding vertebrae
C1-C7 - exit above corresponding vertebrae
C8 - between C7 + T1 vertebrae
T1-L5 - exit below corresponding vertebrae
Cervical spine nerves exit more horizontally to lumbar spine - what does this mean clinically?
- No transversing nerve roots in cervical spine
- Exiting nerve root compressed by intervertebral disc prolapse
List the ligaments in the spine
6
Anterior longitudinal ligament
Posterior longitudinal ligament
Intertransverse ligament
Ligamentum flavum
Interspinous ligament
Supraspinous ligament
Location of the anterior longitudinal ligament
Anterior vertebral body
C1 to sacrum
Broader than PLL - stronger
Function of anterior longitudinal ligament
Prevent hyperextension of vertebral column
Location of posterior longitudinal ligament
Clinical relevance
Posterior to vertebral body
C2 to sacral canal
Intervertebral disc prolapse often occurs laterally
Function of posterior longitudinal ligament
Prevent hyperflexion of vertebral column
Location of the intertransverse ligament
Between transverse processes
Location of the ligamentum flavum
Connect to lamina of vertebrae
What colour is ligamentum flavum?
Yellow
What does the ligamentum flavum contain a lot of?
Elastin
Location of the interspinous ligaments
Between spinous processes
Location of supraspinous ligament
Along tips of spinous processes
What is ligamentum nuchae?
Thickening of supraspinous ligament
Where is the ligamentum nuchae attached to?
Midline of external occipital protuberance
Spinous processes of all C vertebrae (ends at C7)
Function of ligamentum nuchae
Maintains secondary curvature of cervical spine
Helps cervical spine support head
Major site of attachment of neck + trunk muscles
Movements of cervical spine
Flexion 85°
Extension 70°
Rotation 80°
Lateral flexion 45°
Where does nodding the head take place and how?
Flexion and extension
50% atlanto-occipital joint
50% facet joints between C vertebrae
Where does shaking the head occur and how?
Rotation
50% atlanto-axial joint
50% facet joints of C vertebrae
Describe the thoracic vertebrae
Heart shaped vertebral bodies
Small + circular vertebral foramen
Spinous process angled inferiorly
No transverse foramen
Clinical relevance of small circular vertebral foramen in vertebral body
Increased likelihood of neurology in leg
Weakness + numbness
Why does the thoracic vertebrae have limited flexibility?
Ribcage is connected
List + describe the facets in the thoracic vertebrae
T2-T8 - demifacets on sides of vertebral bodies
T9-T10 - whole facets on sides of vertebral bodies
T11-T12 - whole facets on pedicles
Which head of rib does the superior demifacet articulate?
Adjacent ribs
Vertebral number = rib number
e.g. T5 superior demifacet articulates 5th rib head
Which head of rib does the inferior demifacet articulate?
Head of rib below
Vertebral number + 1 = rib number
e.g. T5 inferior demifacet articulates 6th rib
What lies within the costal groove?
Neurovascular bundle
Where does the neurovascular bundle of the rib lie?
The coastal groove
Below the rib
Location of rib articulation with vertebra
Head with vertebral body
Neck with transverse process - NOT T11+T12
Thoracic facet joint function
What does it permit and prevent?
Permits lateral flexion + rotation
Prevents flexion + extension
Function of the ribcage + sternum
Provide stability
Protect heart, lungs, liver + other vital organs
Function of T11+T12 ribs
Protection for kidneys posteriorly
What protects the kidneys?
T11+T12 ribs
Where do the ribs meet at?
1-7 attach to sternum
8-10 attach to costal cartilage
11-2 no attachment
How does CSF appear in a T2 weighted MRI?
T2 weighted - fluid is bright
Outline the attachment of the ribs
- 1-7 attach to sternum via costal cartilages
- 8-10 attach to costal cartilage of 7th rib
- 11-12 are floating ribs
TRUE RIB: 7 letters > 1-7 true ribs
FLASE RIB: 8 letters > 8-10 false ribs
FLOATING RIB: 11 letters > 11-12 floating ribs
