Ch 5 Spine Anatomy

Question 1

Sonography of the spine is limited to infants under what age? Why?

Answer 1

6 months due to ossification after

(note: diagnostic value decreases at 3 months)

Question 2

What is the m/c clinical indication for a spine u/s?

Answer 2

Sacral dimples

Question 3

What position should the baby be in for a spine u/s?

Answer 3

Prone with rolled up towel/pillow or in decubitus with legs tucked

Question 4

How many vertebrae is there in the neonatal vertebral column?

Answer 4

33

Question 5

Vertebrae is separated by ____?

Answer 5

Intervertebral discs

Question 6

Name the 4 regions of the spine + how many vertebrae they each have?

Answer 6

Cervical: 7
Thoracic: 12
Lumbar: 5
Sacrum: 5
Coccyx: 4

Question 7

Vertebrae consists of ___ + ___?

Answer 7

An anterior vertebral body + posterior vertebral arch

Question 8

The vertebral body + arch form an enclosed hole known as ___?

Answer 8

The vertebral foramen

Question 9

The vertebral foramen lines up to form the ___ which encloses the spinal cord?

Answer 9

Vertebral canal

Question 10

Does the coccyx have a vertebral arch?

Answer 10

No! Therefore it has no vertebral canal either, which means no spinal cord enters this area

Question 11

The vertebral body forms the ___ part of each vertebrae?

Answer 11

Anterior

Question 12

What is a vertebral body?

Answer 12

-Weight bearing part of vertebrae

-Lower portion of spinal column will have larger bodies to support increased weight

Question 13

The vertebral arch forms the ___ + ___ part of each vertebrae?

Answer 13

Lateral + posterior

Question 14

Vertebral arches have bony prominences which act as ___ sites for muscles + ligaments?

Answer 14

Attachment

Question 15

Each vertebra has how many spinous processes?

Answer 15

1 posteriorly

Question 16

Each vertebra has how many TRV processes?

Answer 16

2, extends laterally + posteriorly from body

Question 17

What do pedicles do?

Answer 17

Connects vertebral body to TRV processes

Question 18

What does lamina do?

Answer 18

Connects TRV + spinous processes

Question 19

What does articular processes do?

Answer 19

Forms joints b/w the stacked vertebrae

Question 20

What is the spinal cord?

Answer 20

-Long tubular structure made of nervous tissue
-Pathway for info connecting brain + peripheral nervous system
-Originates in brain stem

Question 21

Where does the spinal cord terminate?

Answer 21

At the conus medullaris b/w L1 + L2

Question 22

The conus gives way to a fibrous extension called the ___?

Answer 22

Filum terminale

Question 23

The filum terminale is surround by the echogenic strands of the ___?

Answer 23

Cauda equina

Question 24

What is the filum terminale?

Answer 24

-Fibrous band that extends from conus medullaris to coccyx
-Extension of the pia mater

Question 25

What is the filum terminale’s function?

Answer 25

To stabilize/anchor the spinal cord

Question 26

What is the cauda equina?

Answer 26

-Collection of nerve roots at end of spinal column
-“Horses tail”

Question 27

When is the conus considered abnormally low?

Answer 27

At or below L3

Question 28

At what level does the thecal sac terminate?

Answer 28

S2

Question 29

What does the thecal sac surround?

Answer 29

Whole spinal cord

Question 30

Is the filum terminale or cauda equina thicker + more echogenic?

Answer 30

Filum terminale (<2mm is normal thickness)

Question 31

What echogenicity will the coccyx be before + after it ossifies?

Answer 31

Before: hypoechoic
After: echogenic

Question 32

How to determine level of the conus?

Answer 32

-Take panorama + count backwards from S5 to L1 (there should be 10 vertebrae)

-LSJ (lumbosacral junction) is the curve in the spine where lumber ends + sacral starts (L5/S1)

-Check work by finding last rib + following it back to T12

Question 33

List 4 main things we assess during a spine u/s?

Answer 33

-Level of conus
-Normal movement of nerve roots (cauda equina) + filum terminale
-Assess for a tract/sinus
-Assess for any masses/cysts

Question 34

How many lumbar + sacral vertebrae are there?

Answer 34

5 each

Question 35

The conus normally terminates b/w which vertebrae?

Answer 35

L1 + L2