Clinical anatomy of the spine Flashcards
How many vertebrae are there?
33
What are the 5 sections of the spine?
Cervical Thoracic Lumbar Sacral Coccygeal
What are the 4 curvatures of a healthy spine?
Cervical Lordosis
Thoracic Kyphosis
Lumbar Lordosis
Sacral
What are the two atypical vertebrae?
Atlas (C1)
Axis (C2)
What is the vertebrae prominens?
C7
No foramena transverse process
What are the two parts of the intervertebral discs?
Annulus fibrosus
Nucleus Pulposus
What do facet joints allow?
Flexion
Extension
Lateral flexion
What part of the spine has less flexion and extension due to ribs?
thoracic
Which rotation is less than thoracic due to the orientation of facet joints?
Lumbar
Which spine allows for greatest movement?
Cervical
What happens to intervertebral water content with aging?
It decreases
How is OA in one ore two joints treated?
Localised Fusion
Where does intervertebral disc degeneration occur?
Most frequent in L4/5 and L5/S1
What can happen to intervertebral discs?
Prolapse
Annulus tear
Look at the nerve diagram on 17
xoxo gossip girl
What is the route of the spinal cord?
Down the spinal canal formed by the verebral foramina
Exits via intervertebral foramen
Where does the spinal cord end?
L1
What does L1 mark the junction between?
Upper and Lower motor neurones
What occurs with upper motor neurone failure?
Weakness
Spasticity
Increased tone
Hyperreflexia
What occurs with lower motor neurone failure?
Weakness
flaccidity
Loss of relexes
Slide 22 which i CBA reading
The exiting nerve root which is outside the thecal sac passes under the pedicle of the corresponding vertebra (ie L4 root passes under L4 pedicle)
The traversing nerve root pair whilst remaining in the thecal sac is positioned 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
Which nerve root is compressed in disc prolapse?
Transversing nerve root
What does nerve root compression cause?
Radiculopathy resulting in pain down the sensory distribution of the nerve root
What is nerve root compression that causes pain known as?
Sciatica
What is the source of the sciatic nerve?
L4, L5, S1, S2, S3
What can cause nerve root compression?
Osteophytes
Hypertrophied ligaments in OA
What is neurogenic claudication?
Burning leg pain whilst walking
What can improve spinal stenosis?
surgical decompression
What can spinal cord compression lead to?
Myelopathy
Upper motor neuron signs
What is cauda equina syndrome caused by?
Pressure (usually prolapsed disc) on all lumbosacral nerve roots at the level of the lesion including the sacral nerve roots for bladder and bowl control
What are the symptoms of cauda equina syndrome?
Bilateral lower motor neurone signs
bladder and bowel dysfunction
Saddle anaesthesia
Loss of anal tone
What are the three muscles of the erector spine?
Iliocostalis
Longissimus thoracis
Spinalis thoracis
What are causes of back pain?
Bones Fracture – trauma, osteoporosis, (spondylolisthesis) Tumour Infection Joints Spondylosis & OA Spinal stenosis Muscles & Ligaments Sprains & strains Disc Discogenic back pain Sciatica Cauda equina syndrome
What are most causes of back pain classified as?
Mechanical back pain
Where would mechanical back pain radiate to?
buttocks
Thigh
NOT below knee
