Clinical Anatomy of the Spine Flashcards
which vertebrae has no vertebral body
C1
how many vertebrae are there in total?
33
how many cervical vertebrae are there?
7
how many thoracic vertebrae are there?
12
how many lumbar vertebrae are there?
5
how many sacral vertebrae are there?
5
how many coccygeal vertebrae are there
4
function of axis and atlas?
head rotation
at what level of the spine do the vertebral arteries enter?
C6
where are all secondary cartilaginous joints found in the body?
the midline
which vertebrae are horizontally rather than vertically orientated?
cervical
which area of the spine tends to have the least flexion/extension and why?
thoracic spine due to rib constraint
which area of the spine tends to have the least rotation?
lumbar
what kind of facet joints allow greatest movement? give an example of a spinal section that has these
horizontal
cervical
what happens to the intervertebral discs with age?
lose water content and get smaller
what common finding on spinal movement suggests osteoarthritis?
can’t extend spine (lean back)
what does pain on spinal extension indicate?
osteoarthritis
facet joint-related pain
which intervertebral discs are most likely to prolapse?
L4, L5, S1
when should you treat someone with a bulging disc?
only if they show symptoms
common clinical presentation of annulus tear?
lifting heavy object, hear a twang, get pain on coughing, better in 3 months
longest cells in body?
nerve cells
where do the motor neurons originate in nerve cells?
anteriorly in anterior grey horn
where do sensory neurons originate in nerve cells?
dorsally in dorsal root ganglion
name 2 organs affected if cauda equina is damaged and why?
bladder
bowel
nerves at this area supply them
what forms the mixed spinal nerve
anterior and posterior dorsal roots of the cauda equina
at what level does the spinal cord end?
L1
is the exiting root nerve on the left or right?
left
what does the exiting root pass under to exit the vertebra
pedicle
is the transverse root inside the thecal sac?
yes
is the exiting root inside the thecal sac
no
what happens to the transverse root?
penetrates the thecal sac and becomes the next exiting nerve root
is the exiting or transversing root that is commonly affected in disc prolapse?
transversing
what happens as a result of nerve root compression?
radiculopathy resulting in pain down the sensory distribution of the dermatome + muscle weakness + weak reflexes
what is sciatica
radiculopathy (pain down sensory part of dermatome) of LOWER LEG
what nerve roots contribute to the sciatic nerve?
L4, L5, S1
cause of spinal stenosis?
osteophytes and hypertrophic ligaments from OA compresing the nerve
what features would suggest neurogenic claudication rather than vascular?
radiculopathy/burning leg pain on walking
relieved quickly by stopping
what is cauda equina syndrome?
pressure on all lumbosacral nerve roots
clinical signs of cauda equina syndrome?
bilateral lower motor neurone syndrome
bladder and bowel dysfunction
saddle anaesthesia
loss of anal tone
important examination to do in suspected cauda equina syndrome?
PR exam
name the 3 muscles that make up the erector spinae
iliocostalis
longissiumus thoracis
spinalis thoracis
what do the muscles of the erector spinae do?
arching backwards
standing straight
what do laminae flavae do?
connect the laminae of adjacent vertebrae
what is a chance fracture?
fractured vertebral body with no fractures posteriorly but disrupted ligaments posteriorly
where do you do a lumbar puncture?
posterior iliac crest at L4
bony causes of back pain?
trauma osteoporosis fracture tumour infection
joint causes of back pain?
spondylosis
OA
spinal stenosis
muscular causes of back pain?
sprain
strain
disc causes of back pain?
discogenic back pain
sciatica
cauda equina
clinical features that suggest mechanical back pain?
worse with activity
relieved with rest
relapsing/remitting
treatment for sciatica
physio for 3 months then surgery
