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Spine > final > Flashcards

final Flashcards

0
Q

1st part of the vertebral artery

A

goes from subclavian to in front of C7 TP

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1
Q

vertebral artery

A

longest branch of subclavian, has segmental cords, divides into 4 parts, does not pass through C7
supplies: vertebral bodies, posterior arch, and deep spinal muscles

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2
Q

2nd part of vertebral artery

A

C6-C, ascends through all the transverse foramen starting at C6 (NOT C7) with a slight lateral jog between C2 and C1

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3
Q

3rd part of vertebral

A

from C1 - foramen magnum, travels MEDIAL and POSTERIOR to lateral masses

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4
Q

4th part of vertebral artery

A

foramen magnum - basilar artery, rests on posterior clivus

left and right vertebral arteries merge

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5
Q

what is the nerve root at C4/5 IVF, L4/5, and disk herniation at L4/5 disk

A

5, 4, 5

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6
Q

what are the arteries of the cord

A

anterior spinal
posterior spinal
redicular

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7
Q

anterior spinal artery

A

comes from 2 medial branches of vertebral and forms 1 artery
supplies anterior 2/3 of cord, narrows at conus medllaris (inferior boarder of L1

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8
Q

posterior spinal arteries

A

there are 2, each is a branch of vertebral artery, supplies posterior 1/3 of cord, most of the blood flowing from here to spine flows through redicular arteries, ends at conus medullaris

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9
Q

redicular arteries

A

reinforcing network of arteries, enter through IVFs or sacrum foramina, develop from: vertebral, deep cervical (ascending), posterior intercostals, lumbar and lateral sacral arteries

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10
Q

Adamkiewicz artery

A

arises from left posterior intercostals, enters between T9 and L3

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11
Q

watershed area

A

loss of one artery can lead to a widespread deficit in the thoracic spine

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12
Q

redicular arteries supply

A

meninges
vertebrae
spinal cord

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13
Q

denticulate ligaments

A

between arachnoid and dura, tooth like, create “floor” for spinal nerve, function: hold spinal nerve in central position

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14
Q

Batson’s venous plexus and valsalva maneuver

A

no valves in the veins of spinal column, separate from the veins of thoracic and abdominal region, valsalva maneuver causes an increase in abdominal pressure, the plexus can lead to active neoplasms

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15
Q

anterior external venous plexus

A

collects blood from vertebral body

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16
Q

internal venous plexus

A

has 4 main channels, 2 anterior - anterior and posterior to PLL, and 2 posterior - one to left and one to right to ligamentum flavum, anastomose with posterior external venous plexus

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17
Q

basiverterbral veins

A

largest network of veins in body, Hahn’s venous clefts - shadows that are nothing serious

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18
Q

intervertebral veins

A

pass through IVFs, drains spinal cord, internal venous plexus and external venous plexus

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19
Q

what are the 3 parts of a disk

A

anulus fibrosus, nucleuss pulposis, and end plate

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20
Q

pressure on the disk leads to increased pressure within the ______ ______ which then leads to pressure being exerted radially into the ______ ______ which is then exerted onto the ______ , the pressure from here is then transferred to the __________

A

nucleus polposis , anulus fibrosus, nucleus, endplates

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21
Q

forces on the disks are balanced by what 2 things

A

anulus fibrosis and nucleus

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22
Q

force is transmitted how

A

though endplates at adjacent levels

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23
Q

disk hydration

A

need H2O to maintain disk hydration but protyoglycans can help with disk hydration as well

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24
Q

proteoglycan

A

large protein molecule, attach to and surrounds collagen fibrils which ensures hydration of ground substance

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25
Q

what happens if disks dry up

A

desiccate - occurs naturally starting around age 30

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26
Q

disk bulge

A

involves more than 1/4 of disk

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27
Q

protrusion

A

type of herniation, base is wider than outward extent, <25% of disk is involved (so it is not a bulge)

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28
Q

extrusion

A

outward extension is greater than base, <25% of disk involved, but nucelus polposis extends through torn anulus fibers

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29
Q

sequestered disk fragment

A

nucleus polposis seperates from parent disk, may extend up or down central canal

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30
Q

annular fissure

A

tear circumferentially along anulus fibrosis

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31
Q

why do disk herniations hurt

A

chemical irritation by inflammation mediators

32
Q

ligaments contain ________ which may inhibit or stimulate muscle contractions

A

proprioceptors

33
Q

yellow fibers result in

A

ligaments with more stretch and flexibility

34
Q

function of spinal ligaments

A

smooth motion and protect cord

35
Q

3 ligaments the run the length of the spine

A

anterior longitudinal ligament
posterior longitudinal ligament
ligamentum flava

36
Q

anterior longitudinal ligament (ALL)

A

VB of C2 -> sacrum
connects at mid-portion of VB
thickest fibers in the middle

37
Q

3 layers of ALL

A

superficial: 3-4 vertebral segments
intermediate: 2-3 segments
deep: 2 segments

38
Q

DISH is related to

A

ALL and diabetes

39
Q

ALL helps prevent

A

extensive extension of the spine

40
Q

Posterior longitudinal ligament (PLL)

A

extends from posterior body of C2 -> sacrum, inside the spinal canal, attaches to IVD and margins of VB, denticulate in lower thoracic and upper lumbar

41
Q

2 layers of PLL

A

superficial: bridge 3-4 segments
deep: reinforce the disk, contains greatest innervation of nociceptors of all spinal ligaments

42
Q

what motion does PLL inhibit

A

flexion of spine

43
Q

central canal dimension reduction is due to

A

PLL ossification

44
Q

ligamentum flavum

A

C2-> sacrum, connects lamina on posterior aspect of central canal, increases in thickness from cervicals to sacrum, very elastic

45
Q

what does the ligamentum flavum prevent

A

excessive flexion

46
Q

supraspinous ligament

A

C7-> sacrum, expands into nuchal ligament, limits flexion and extension

47
Q

3 layers of supraspinous ligament

A

superficial: 3-4 segments
middle: 2-3 segments
deep: 2 segments

48
Q

interspinous ligament

A

root os SP to apex, C1-sacrum, limits flexion

49
Q

intertransverse ligament

A

C1-> L5, round in thoracic, thin membranous in lumbar, thin/ tenuous in cervical, limits lateral flexion and rotation

50
Q

articular capsules

A

C1/2-> L5/S1, attaches just outside of the margins of facet joints, thin and loose in Cervical, taut in T and L, has 2 capsules (outer(ligamentus) and inner( yellow lig.))

51
Q

upper cervical ligaments

A

tectorial membrane, transverse ligament of atlas, alar ligaments, apical ligament of dens, posterior atlanto-occipital ligament, posterior atlanto- axial ligament, lateral atlanto-occipital ligament, anterior atlanto-occipital ligament, nuchal ligament

52
Q

tectorial membrane

A

inside spinal canal occiput -> C2, blends with PLL, protects cord from compression

53
Q

transverse ligament

A

aka cruciate ligament, has 3 parts transverse band, superior band, and inferior band, results in ADI movement if ruptured,

54
Q

alar ligament

A

“check” ligament, left and right pairs, strong rounded cord, from upper/ later dens to medial aspect of foramen magnum, prevent excess rotation

55
Q

apical ligament

A

apex of dens to anterior foramen magnum, stabilizes the dens

56
Q

posterior atlanto-occipital ligament

A

upper boarder of posterior arch of C1 to posterior foramen magnum, forms am arch for vertebral artery, vein and C1 spinal nerve, can show up as posterior ponticle on xrays

57
Q

posterior atlanto-axial ligament

A

from posterior arch of C1 to lamina of C2, flexion

58
Q

lateral atlanto-occipital ligament

A

jugular process to C1 TP

59
Q

anterior atlanto-occipital ligament

A

anterior foramen magnum to upper boarder of anterior arch of C1

60
Q

anterior atlanto-axial ligament

A

aka epistrophic ligament

anterior arch of atlas to anterior body of axis

61
Q

nuchal ligament

A

EOP, C1 posterior tubercle, and C2-C7 SP, limits flexion of spine

62
Q

posterior sacralcoccygeal ligament

A

superficial: continuation of supraspinous ligament, protects S5 and coccygeal nerves
deep: continuation of PLL, from posterior body of S5 to posterior surface of coccyx

63
Q

illiolumbar ligament

A

L5 TPs to iliac crest
upper band:attaches to posterior portion of iliac crest
lower band: attaches to anterior lateral portion of sacral ala
calcification leads to DISH

64
Q

interosseous sacroiliac ligament

A

strongest, connect sacral and iliac tuberosities

65
Q

posterior sacroiliac ligament

A

short: horizontal fibers, connects S1-2 tubercles and iliac tuberosity to PSIS
long: verticle fibers, connects S3-4 tubercles and PSIS and sacrotuberous ligament

66
Q

articular ligament

A

margins of auricular surface of sacrum and ilium, holds them together

67
Q

anterior sacroiliac ligament

A

thickening of anterior and inferior portion of SI joint capsule

68
Q

inguinal ligament

A

connects ASIS to pubic tubercle, protects soft tissues under it

69
Q

sacrotuberous ligament

A

connects inferolateral sacrum, ischial tuberosity and blend with long posterior sacroiliac ligament

70
Q

sacrospinous ligament

A

triangular shape, connects lateral portion of sacrum and coccyx to ischial spine, helps limit movement between sacrum and ilium and ischium

71
Q

greater sciatic foramen

A

contains piriformis and sciatic nerve

72
Q

lesser sciatic foramen

A

anterior boarder: body of ischium
superior boarder: sacrospinous ligament and ischial spine
posterior boarder :sacrotuberous ligament
obturator internus and obturator nerve

73
Q

anterior sacralcocccygeal ligament

A

resembles anterior longitudinal ligament

74
Q

lateral sacrococcygeal ligament

A

lateral/ inferior sacrum with TP of coccyx, forms foramen for S5 nerve root

75
Q

intercornual ligament

A

between sacral cornu and coccygeal cornu on same side

76
Q

pubic ligaments

A

superior: across top of pubic symphysis

inferior :across bottom of pubic symphysis (aka arcuate ligament)

77
Q

mamillo-accessory ligament

A

from mamillary process to accessory process, creates foramen for medial branch of posterior ramus, main site for nerve blocks

78
Q

spinal stenosis

A

thickening of ligamentum flavum, age related

Spine (3 decks)

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