Clinical Anatomy of the Spine

Question 1

How many vertebrae do we have? How many sections are they organised into?

Answer 1

33 vertebrae in 5 sections (cervical, thoracic, lumbar, sacral, coccyx)

Question 2

How many cervical vertebrae are there? How many thoracic vertebrae are there?

Answer 2

Cervical = 7, Thoracic = 12

Question 3

How many lumbar vertebrae are there?

Answer 3

5

Question 4

How many sacral vertebrae are there? How many coccygeal vertebrae are there?

Answer 4

Sacral = 5 (fused), Coccygeal = 4 (fused)

Question 5

What are the 4 curves of the spine?

Answer 5

Cervical kyphosis, thoracic lordosis, lunar kyphosis, sacral lordosis

Question 6

Which vertebrae doesn’t have a vertebral body?

Answer 6

C1

Question 7

What makes C1 and C2 different from other vertebrae?

Answer 7

They allow rotation of the head and don’t have intervertebral discs between them

Question 8

What is C1 known as? What is C2 known as?

Answer 8

C1 = Atlas, C2 = Axis

Question 9

Which vertebrae is known as vertebra prominens?

Answer 9

C7

Question 10

The C7 vertebrae has no foramina in the transverse process, what is the significance of this?

Answer 10

The vertebral artery is not transmitted through here

Question 11

Intervertebral discs are what type of joint?

Answer 11

Fibrocartilagenous joints

Question 12

What type of joints are the facet joints which allow spinal movement?

Answer 12

Synovial

Question 13

What movements do facet joints allow?

Answer 13

Flexion, extension and lateral flexion

Question 14

There is less movement in which area of the spine? Why?

Answer 14

The thoracic region due to the constraints of the ribs

Question 15

Lumbar rotation is less than thoracic rotation. Why?

Answer 15

More vertically orientated facet joints

Question 16

Which part of the spine allows the most movement? Why?

Answer 16

The cervical region, due to more horizontal facet joints

Question 17

What is the outer part of an intervertebral disc known as?

Answer 17

Annulus fibrosis

Question 18

What is the inner part of an intervertebral disc known as?

Answer 18

Nucleus pulposus

Question 19

Why is there degeneration of the spine with age?

Answer 19

Loss of water content

Question 20

Where is degeneration of the spine most common?

Answer 20

L4/L5, L5/S1

Question 21

60% of people over 45 years will have what on MRI?

Answer 21

Asymptomatic bulging discs

Question 22

Where do motor neurones originate?

Answer 22

Anteriorly, bodies in the anterior grey horn

Question 23

Where do sensory neurones originate?

Answer 23

Dorsally, bodies in the dorsal root ganglion

Question 24

The spinal cord and cards equina run down the spinal canal which is formed by what?

Answer 24

The vertebral foramina

Question 25

Anterior and dorsal roots form what? Where do these exit the spinal cord?

Answer 25

They form mixed spinal nerves which exit via the intervertebral foramen

Question 26

Where does the spinal cord end? What is this known as?

Answer 26

L1- conus medullaris

Question 27

What does the spinal cord become at L1?

Answer 27

Cauda equina

Question 28

The cauda equina is the junction between what?

Answer 28

Upper and lower motor neurones

Question 29

In disc prolapse, which nerve root is most likely to be compressed? Give an example.

Answer 29

The transversing nerve i.e. L4/5 prolapse will compress L5 root

Question 30

Nerve root compression causes pain where?

Answer 30

The affected dermatome

Question 31

Iliocostalis, longissimus thoracis and spinalis thoracis make up what group of muscles?

Answer 31

Erector spinae (a source of sprains and strains)

Question 32

What is a chance fracture? When may these occur?

Answer 32

These are very unstable and may need surgical treatment, commonly occur in car accidents due to the seatbelt

Question 33

There can be disruption of the posterior ligaments of the spine in a fracture which does not affect the posterior elements. True or false?

Answer 33

True

Question 34

At what spinal level is the posterior iliac crest?

Answer 34

L4

Question 35

At what spinal level is the posterior superior iliac spine?

Answer 35

S2

Question 36

What other problems can cause referred pain to the shoulder?

Answer 36

Neck pain, angina pectoris and diaphragmatic irritation

Question 37

What conditions can cause diaphragmatic irritation?

Answer 37

Biliary colic, hepatitis or subphrenic abscess