Clinical Anatomy of the Spine

Question 1

how many vertebrae do we have?

Answer 1

33

Question 2

how many sections spine are there? name them.

Answer 2

5 section

7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccygeal (fused)

Question 3

how many curves are in a healthy spine?

Answer 3

4 curves

Question 4

name the 2 atypical vertebra. what do they allow?

Answer 4

atlas
axis

allow head rotation

Question 5

what level is vertebra prominens? and what does this lack?

Answer 5

C7

No foramena transeverse process (veretbral artery)

Question 6

what is the other name given to the intervertebral fibrocartilaginous joints

Answer 6

intervertebral disc

Question 7

the intervertebral disc consists of 2 parts. name them.

Answer 7

anulus fibrosus

nucleus pulposus

Question 8

outline the degree of movement in the cervical and lumbar spine

Answer 8

cervical - greatest movements as horizontal facet joints

lumbar is least as more vertically orientated

Question 9

what do intervertebral discs lose with ageing?

Answer 9

water

Question 10

pain is worse with _________ of the spine

Answer 10

extension

Question 11

what can help spondylosis and osteoarthritis under fluoroscopy?

Answer 11

facet joint injections

Question 12

OA in one or two motion segments of the spine can be treated with…

Answer 12

localised fusion

Question 13

degeneration with age and the loss of H2O content occurs most frequently in what levels of the spine?

Answer 13

L4/5 and L5/S1

Question 14

what test is not diagnostic of conditions in the spine?

Answer 14

MRI

Question 15

acute disc prolapse in the spine most commonly at levels…

Answer 15

L4/5 or L5/S1

Question 16

annulus tear can be a result of _______ _____ _______

Answer 16

lifting heavy objects

Question 17

motor neurones originate __________ and the bodies are located in the anterior ____ ____ wheres sensory neurones originate ________ and their bodies are in the ______ ____ ________.

Answer 17

motor neurones originate ANTERIORLY and the bodies are located in the anterior GREY HORN wheres sensory neurones originate DORSALLY and their bodies are in the DORSAL ROOT GANGLION.

Question 18

the spinal cord/cauda equine runs down the what?

Answer 18

spinal canal

Question 19

what is the spinal canal formed by?

Answer 19

the vertebral foramina

Question 20

where do the anterior and posterior dorsal roots from mixed spinal nerves exit via in the vertebrae?

Answer 20

intervertebral foramen

Question 21

what is the cauda equine susceptible to?

Answer 21

compression

Question 22

what level does the spinal cord end?

Answer 22

L1

Question 23

what does the exiting nerve root pass under?

Answer 23

the pedicle of the corresponding vertebra (ie L4 root passes under L4 pedicle)

Question 24

what is the exiting nerve root outside of?

Answer 24

the thecal sac

Question 25

what does the transverse nerve root remain in?

Answer 25

the thecal sac

Question 26

where is the traversing nerve root positioned?

Answer 26

anteriorly (in an area known as the lateral recess) in preparation to penetrate the thecal sac and become the next exiting nerve root more distally

Question 27

where is the weak point on the disc?

Answer 27

posterior

Question 28

With disc prolapse it is commonly what nerve root which is compressed?

Answer 28

the traversing nerve root

i.e. L5 root for L4/5 prolapse and S1 root for L5/S1 prolapse

Question 29

what does Nerve root compression cause?

Answer 29

a radiculopathy

Question 30

what does a radiculopathy result in?

Answer 30

pain down the sensory distribution of the nerve root (dermatome), which in the lower leg is known as Sciatica

Question 31

what nerve roots contribute to the sciatic nerve?

Answer 31

L4, L5 & S1 nerve roots contribute to Sciatic nerve (along with S2 & S3)

common fibular and tibial nerve make up the sciatic nerve

Question 32

define spinal stenosis

Answer 32

Nerve roots compressed by osteophytes and hypertrophied ligaments in OA

Question 33

what does spinal stenosis result in?

Answer 33

radiculopathy or burning leg pain on walking = neurogenic claudication

Question 34

walking down hill is difficult in someone with spinal stenosis

true or false?

Answer 34

true

Compression from thickening and arthritis – nerve roots don’t have adequate blood supply

Question 35

what can spinal cord compression like a tumour or disc prolapse result in?

Answer 35

Myelopathy & upper motor neuron signs

Question 36

cauda equina syndrome is caused by _______ on all ___________ nerve roots at level of lesion including sacral nerve roots for _______ ___ _____ control

Answer 36

cauda equina syndrome is caused by PRESSURE on all LUMBOSACRAL nerve roots at level of lesion including sacral nerve roots for BOWEL AND BLADDER control

Question 37

what does cauda equine syndrome result in?

Answer 37

bilateral lower motor neuron signs
bladder and bowel dysfunction
saddle anaesthesia
loss of anal tone

Question 38

name the 3 important muscles of the spine

Answer 38

Iliocostalis
Longissimus thoracis
Spinalis thoracis

Question 39

a fractured vertebral body with disruption posterior ligaments with or without fracture of posterior elements is known as what?

Answer 39

chance fracture - very unstable

Question 40

where do you want to avoid and where are you aiming gin a lumbar puncture?

Answer 40

avoid spinal cord

aim for equina area