Cervical , Thoracic Spine And Assosiated Disorders

Question 1

How many cervical vertebrae are there ?

Answer 1

7;

Question 2

How many thoracic vertebrae are there ?

Answer 2

12

Question 3

What are the cervical vertebrae classified into ?

Answer 3

Atypical and typical cervical vertebrae

Question 4

What cervical vertebrae make up the typical vertebrae ?

Answer 4

C3-C6

Question 5

What vertebrae make up the atypical vertebrae?

Answer 5

C1,C2 and C7

Question 6

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

Answer 6

1. Cervical typical vertebrae have bifid spinous processes.

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

Question 7

What does the transverse foramen transmit ?

Answer 7

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

This occurs at all C1-C6.

Question 8

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

Answer 8

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

Question 9

What is C1 also referred to as ?

Answer 9

Atlas

Question 10

Describe features of the C1 ( Atlas) vertebrae?

Answer 10

• 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

Question 11

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

Answer 11

Anterior longitudinal ligament

Question 12

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

Answer 12

Ligamentum nuchae

Question 13

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

Answer 13

Occipital condyles of the skull

Question 14

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

Answer 14

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

Question 15

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

Answer 15

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

Question 16

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

Answer 16

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

Question 17

What is C2 also referred to ?

Answer 17

Axis

Question 18

What is the remanent of the C1 vertebral body called ?

Answer 18

Odontoid process or also known as DENS

Question 19

Which vertebrae has the broadest spinous process?

Answer 19

C2

Question 20

How is the dens held in place ?

Answer 20

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

This acts as a pivot - allowing rotation.

Question 21

What is atlantoaxial instability ?

Answer 21

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.

Question 22

Describe features of the C7 atypical vertebrae?

Answer 22

Spinous processes are not bifid

Longest spinous processes

Transverse foramen is small and only transmits the vertebral veins

Question 23

How many cervical nerve roots are there ?

Answer 23

C1-C8

Question 24

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

Answer 24

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

Question 25

What is the locationof the ligamentum nuchae?

Answer 25

- 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.

Question 26

What is the function of the ligamentum nuchae?

Answer 26

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.

Question 27

Movements of the cervical spine

Answer 27

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

Question 28

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

Answer 28

45 degrees to axial plane In coronal plane

Question 29

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

Answer 29

60 degrees to axial plane 20 degrees to coronal plane

Question 30

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

Answer 30

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.

Question 31

What type of facets does T1 have ?

Answer 31

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

Question 32

Features of thoracic vertebrae

Answer 32

Heart shaped Demi facets on sides of vertebral bodies for articulation with head of rib (T2-8) VERTEBRSL foramen is small and circular

Question 33

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

Answer 33

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)

Question 34

Why is the thoracic spine relativelyimmobile ?

Answer 34

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,

Question 35

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

Answer 35

Shorter

Question 36

Function and location of the ALL?

Answer 36

- 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.

Question 37

Function and location of the posterior longitudinal ligament

Answer 37

Runs posterior to the veterbrral bodies. Prevents hyperflexion of the vertebral column.

Question 38

What is cervical Spondylosis?

Answer 38

- 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

Question 39

What can cervical spondylosis lead to ?

Answer 39

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

Question 40

What are symptoms of radiculopathy ?

Answer 40

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

Question 41

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

Answer 41

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

Question 42

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

Answer 42

C6 nerve root affected. Elbow flexion , wrist extension , supination will be affected Index nd thumb will have pain

Question 43

Anatomy change of cervical myelopathy?

Answer 43

Thickening ligamentum flavum Osteophyte Can lead to signal cord signal change

Question 44

Cervical myelopathy symptoms

Answer 44

A progressive disorder Clumsiness Loss of fine movements such as buttons or cutting meats Loss of balance

Question 45

What is a Jefferson fracture ?

Answer 45

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

Question 46

What is a hangmans fracture

Answer 46

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.

Question 47

Odontoid peg fracture #

Answer 47

Caused by hyperextension of the head on the neck. This happens in elder population where they’ve fallen to the ground flat faced.

Question 48

What are the two commonest causes of thoracic cord compression ?

Answer 48

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

Question 49

What is spondylodiscitis

Answer 49

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