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MSK > Cervical , Thoracic Spine And Assosiated Disorders > Flashcards

Cervical , Thoracic Spine And Assosiated Disorders Flashcards

1
Q

How many cervical vertebrae are there ?

A

7;

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2
Q

How many thoracic vertebrae are there ?

A

12

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3
Q

What are the cervical vertebrae classified into ?

A

Atypical and typical cervical vertebrae

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4
Q

What cervical vertebrae make up the typical vertebrae ?

A

C3-C6

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5
Q

What vertebrae make up the atypical vertebrae?

A

C1,C2 and C7

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6
Q

What are two differences between the typical cervical vertebrae and lumbar vertebrae?

A
  1. Cervical typical vertebrae have bifid spinous processes.

2. Cervical typical vertebrae having a transverse foramen. ( A hole in the transverse processes)

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7
Q

What does the transverse foramen transmit ?

A

The vertebral artery , the vertebral vein and the sympathetic nerve plexus .

This occurs at all C1-C6.

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8
Q

What does the C7 and ONLY the C7 transverse foramen transmit ?

A

ONLY transmits the vertebral vein. Not the vertebral artery as it enters at the C6 transverse foramen and misses C7.

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9
Q

What is C1 also referred to as ?

A

Atlas

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10
Q

Describe features of the C1 ( Atlas) vertebrae?

A
  • has NO vertebral body
  • NO spinous processes
  • large transverse processes
  • A bony ring consisting of the anterior and posterior arch connected by two lateral masses
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11
Q

The anterior arch of the Atlas is the site of attachment for which ligament ?

A

Anterior longitudinal ligament

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12
Q

The posterior tubercle is the site of attachment for which ligament ?

A

Ligamentum nuchae

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13
Q

The superior articular facets positioned on the lateral mass of C1 articulate with that structures ?

A

Occipital condyles of the skull

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14
Q

The inferior articular facets artifulate with what structures in the C1 ?

A

They articulates with the superior articular facets of the C2 vertebrae.

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15
Q

What is the Atlanta occipital joint ? And what movement does this permit ?

A

Joint between the skull and the atlas. It permits 50% of the total range of flexion and extension of the head and neck.

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16
Q

What is the Atlanta- axial joint ? And what movement does it permit ?

A

Joint between the C1 and C2. It permits 50% of total rotation of the head and neck

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17
Q

What is C2 also referred to ?

A

Axis

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18
Q

What is the remanent of the C1 vertebral body called ?

A

Odontoid process or also known as DENS

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19
Q

Which vertebrae has the broadest spinous process?

A

C2

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20
Q

How is the dens held in place ?

A

Transverse ligament of the Atlas. This helps to prevent horizontal displacement of the atlas.

This acts as a pivot - allowing rotation.

21
Q

What is atlantoaxial instability ?

A

This is where the C and C2 move independent from eachother due to damage to the transverse ligament which holds to two together. This can occur due to old age or trauma. This can eventually result in micro injury to the spinal cord.

  • this can be congenital , or it could be due to RA too.
22
Q

Describe features of the C7 atypical vertebrae?

A

Spinous processes are not bifid

Longest spinous processes

Transverse foramen is small and only transmits the vertebral veins

23
Q

How many cervical nerve roots are there ?

A

C1-C8

24
Q

What route do nerve roots exit their vertebral bodies in the cervical region?

A

Nerve roots exit above their vertebral body. Apart from the C8 nerve root which exits at the bottom of. The C7 vertebral body.

The C1 nerve root does not exit via a foramen

The nerve roots exit more horizontally than in lumbar spine

25
Q

What is the locationof the ligamentum nuchae?

A
  • it is a thickening of the supraspinous ligament.
  • it attaches to the external occipital protuberance , travels across the spinous processes of all cervical vertebrae and to the spinous process of C7.
  • it is continuous inferiorally with the supraspinous ligament.
26
Q

What is the function of the ligamentum nuchae?

A
  1. Maintains secondary curvature of cervical spine
  2. It helps the cervical spine support the head.
  3. Major site of attachment of neck and trunk muscles.
27
Q

Movements of the cervical spine

A
  1. Atlanta-occipital joint : 50% of total flexion and extension
  2. Atlanta-axial joint :50% of total rotation
  3. Other 50% of movement is contributed by the rest of the cervical spine C2/3 to C7=T1
28
Q

What is the orientation of the facet joints in the cervical spine ?

A

45 degrees to axial plane

In coronal plane

29
Q

What is orientation of the facet joints in the thoracic vertebrae ?

A

60 degrees to axial plane

20 degrees to coronal plane

30
Q

What thoracic vertebrae have superior and inferior Demi facets , and what do they articulate with ?

A

T2-T8 ,the head of the adjacent rib articulates with its adjacent rib . The inferior Demi facet articulates with the head of the rib below. For example , T3 superior Demi facet would articulate with rib 3. And inferior Demi Facet would artifulate with rib 4.

31
Q

What type of facets does T1 have ?

A

A whole superior facet. And an inferior Demi facet below. This is the only vertebrae to artifulate with The first rib.

32
Q

Features of thoracic vertebrae

A

Heart shaped

Demi facets on sides of vertebral bodies for articulation with head of rib (T2-8)

VERTEBRSL foramen is small and circular

33
Q

What are the two places thr rib articulates with the vertebrae ?

A
  1. The head of the rib body articulates with the facet

2. The tubercle of the rib articulates with the transverse processes ( apart from T11-12)

34
Q

Why is the thoracic spine relativelyimmobile ?

A
  1. The facet joints are angled at 60 degrees to thr axial plane and 20 degrees to the coronal plane. This means only lateral flexion and rotation can occur. NO flexion or extension.
  2. Thr attachment to the thoracic cage,
35
Q

Do the spinous processes become longer or shorter in thoracic vertebrae as you go down ?

A

Shorter

36
Q

Function and location of the ALL?

A
  • stronger than the PLL
  • runs contiously from the atlas to the sacrum
  • United with the periosteum of the vertebral bodies and over the intervertebral discs it is loosely attached and mobile.
  • prevents hyperextention of the vertebrae.
37
Q

Function and location of the posterior longitudinal ligament

A

Runs posterior to the veterbrral bodies.

Prevents hyperflexion of the vertebral column.

38
Q

What is cervical Spondylosis?

A
  • age related changes , can happen in 3 stages
    1. Loss of disc height ( loss of water ) this occurs due to old age.
    2. Osteophytes - beaky prominences begin to emerge
    3. Facet joint osteoarthritis
39
Q

What can cervical spondylosis lead to ?

A

Can lead to either 1

  1. Radiculopathy ( osteophyte in the foramen ) which leads to compression of nerve roots
  2. Myelopathy ( osteophyte in the VERTEBRSL canal ) which leads to compression of spinal cord
40
Q

What are symptoms of radiculopathy ?

A
  1. Sensory problems- dermato,al which can lead to paraesthesia/ numbness / pain
  2. Motor problems - myotomal- weakness
41
Q

What can be a cause of radiculopathy in 30-50 year olds ?

A

Cervical prolapsed intervertebral disc

Patients often wake up with a stiff neck that doesn’t go away , arm is weak and numb

No history of injury

42
Q

What will a patient complain of with a left sided C5/6 prolapsed disc .

A

C6 nerve root affected.

Elbow flexion , wrist extension , supination will be affected

Index nd thumb will have pain

43
Q

Anatomy change of cervical myelopathy?

A

Thickening ligamentum flavum

Osteophyte

Can lead to signal cord signal change

44
Q

Cervical myelopathy symptoms

A

A progressive disorder

Clumsiness
Loss of fine movements such as buttons or cutting meats

Loss of balance

45
Q

What is a Jefferson fracture ?

A

Burst fracture of C1 . the C1 splits into two or more pieces. Fracture of the anterior and posterior arches of atlas.

This is often caused by axial load eg diving into shallow waters

46
Q

What is a hangmans fracture

A

FRACTURE OF C caused by Hyperextension of the head on neck

This causes forward displacement of C1 and C2 on C3.

Fracture is commonly between the vertebral body and the arch.

47
Q

Odontoid peg fracture #

A

Caused by hyperextension of the head on the neck.

This happens in elder population where they’ve fallen to the ground flat faced.

48
Q

What are the two commonest causes of thoracic cord compression ?

A

Fractures and tumours

Most likely to give neurology as the vertebral foramen is the smallest.

49
Q

What is spondylodiscitis

A

Infection of the spine - this is where bacteria enters spine via vertebral body nutrient artery. Lodges at the end plate and extends towards disc.

If left untreated , it develops into an epidural abscess and vertebral osteomyelitis

MSK (14 decks)

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