FUNCTIONAL ANATOMY FOR NEURAXIAL ANESTHESIA (LECTURE) WEEK 2 Flashcards
Functions of the vertebral column:
-support head
-protect spinal cord
-attachment point for extremities
-transmission of weight from trunk to lower extremities
33 Vertebrae are broken down into:
-cervical
-thoracic
-lumbar
-sacral
-coccygeal
Cervical = 7
Thoracic = 12
Lumbar = 5
Sacral = 5 (fused)
Coccygeal = 4 (fused)
Sacral Hiatus is the opening of the incomplete posterior fusion of the _ th sacral vertebra
5th
The coccyx is the union of the last _ vertebrae
4
Which structure provides access to the caudal end of the epidural space? What are the two bony structures called on either side of it?
sacral hiatus
sacral cornu
Important landmarks C7, T7, L4-L5
Which is: the most prominent spinal process, found opposite of the inferior angle of the scapula, and which is the line connecting the iliac crest to Tuffier’s line?
C7 = most prominent
T7 = opposite of the inferior angle of scapula
L4-L5 = line connecting the iliac crest to Tuffier’s line
Of the anatomical curves which are conVEX anteriorly?
cervical and lumbar
-trick: just think about how most people slouch and why that’s comfortable, then imagine that region of the body and what is curved elsewhere
Of the anatomical curves, which are conCAVE anteriorly?
Thoracic and Sacral
-trick: just think about how most people slouch and why that’s comfortable, then imagine that region of the body and know each vertebral region goes opposite of what is before it
When a patient is supine, which anatomical curves create hills and which create valleys if you were viewing them laterally? Which levels specifically are the high and low points and why does this matter?
Hills: cervical and lumbar
high points = C5, L5
Valleys: thoracic and sacral
low points = T5, S2
Depending on its baricity, LA will tend to settle in hills or valleys more unless it’s isobaric
The spinal canal contains: (3)
SC
spinal nerves
epidural space
The boundaries of the spinal canal are: (3)
-ant
-lat
-post
Anteriorly: vertebral body
Laterally: pedicles
Posteriorly: spinous processes and laminae
Vertebral _ joints or _ joints articulate posterior elements of adjacent vertebrae
vertebral facet joints or zygapophyseal joints
The junction of lamina and pedicles gives rise to _ and _ _ _
inferior and superior articular processes
Fibrocartilaginous disks containing a _ _ separate each vertebra
nucleus pulposus
-avascular gelatinous body
5 main ligaments reinforcing verterbal column:
anterior and posterior longitudinal ligaments
supraspinous
interspinous
ligamentum flavum
Anterior and Posterior Longitudinal ligaments
-location and function
-along each side of vertebral body
-reinforce column
Supraspinous Ligament
-location and function
- strong fibrous cord connecting apices of spinous processes of C7 to sacrum
-may be calcified if old and need paramedian approach
Interspinous Ligament
-location and function
-thin membranous cord connecting each spinous process
Ligamentum Flavum
-location and function
-dense, yellow elastin ligament
-right before spinal canal
Spinal cord extends from above with the _ _ and extends to the _ region
medulla oblongata
lumbar region
SC ends at _ at birth and _ in adults. Why is this important?
Birth: L3
Adult: L1
-spinal needles need to be placed BELOW L2 to avoid damaging the spinal cord
The SC tapers and terminates at the _ _ at the level of _ - _
conus medullaris
L1-L2 intervertebral disk
The _ _ is a bundle of nerve roots in the SA space distal to the conus medullaris
cauda equina
The _ _ is a fibrous extension of the SC and extends to the _
filum terminale
coccyx
