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Anatomy Unit I > GA3: Vertebral Column and Spinal Cord > Flashcards

GA3: Vertebral Column and Spinal Cord Flashcards

1
Q

Describe some main functions of the Spinal Column

A
  1. Maintenance of the erect posture and aids in locomotion.
  2. Support of the trunk, limbs, & head
  3. Protection of the spinal cord & spinal nerve roots
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2
Q

What spinal curvatures are present in a newborn?

A

Two Primary (kyphotic) curvatures: Thoracic and sacrococcygeal

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3
Q

describe the Kyphotic curvatures?

A

primary Thoracic and sacrococcygeal: Concave anteriorly; Curvature due to variation in the A-P heights of the vertebrae

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4
Q

Describe the Lordotic curvatures

A 
Secondary cervical and lumbar.
Cervical (from holding up head)
Lumbar (from developing erect posture
Both are convex posteriorly
Curvature d/t variation in A-P thickness of IV discs`
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5
Q

Describe Excessive thoracic Kyphosis

A

increase in thoracic curvature (humpback) from weakening of thoracic bodies.
Common in osteoporosis, spinal tuberculosis, osteomalacia/rickets

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6
Q

Excessive Lumbar Lordosis

A

Increase in lumbar curvature (swayback), common in late pregnancy

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7
Q

Scoliosis

A

Lateral cuvaures of the spine; may be idiopathic or can develop in association with postural imbalance d/t genetic defects and injury. Most commonly seen in adolescent girls; can be managed with PT/back brace/ insertion f steel rods

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8
Q

What is the total number of vertebrae in humans?

A

33

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9
Q

of cervical vertebrae

A

7; C1-C7

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10
Q

of thoracic vertebrae?

A

12; T1-T12

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11
Q

of Lumbar Vertebrae?

A

5; L1-L5

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12
Q

of sacral vertebrae?

A

5; S1-S5 Fused to form Sacrum

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13
Q

of coccygeal vertebrae?

A

3-4; fused to form coccyx

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14
Q

What is the Vertebral Arch Composed of?

A

2 Pedicles
2 Laminae
Vertebral Foramen which for the vertebral canal when stacked

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15
Q

What are the muscle attachments of the vertebrae?

A

Transverse Processes & Spinous Process

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16
Q

What are the Zygapophyses?

A

The Superior and Inferior Articular Processes; They have facets for articulation with vertebrae above and below.
+ Their orientation determines the types of movements allowed

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17
Q

What are the notches formed between the projection of the vertebral body and articular processes superior and inferior to the pedicles?

A

Superior and Inferior Vertebral Notches

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18
Q

Superior & inferior vertebral notches of adjacent vertebrae form _________ ________ which permit the passage of spinal nerve roots & contain spinal dorsal root ganglia & vessels

A

Intervertebral Foramina

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19
Q

Name the Boundaries of the intervertebral Foramina

A

Anterior boundary: intervertebral disc and vertebral bodies of adj vertebrae.
Superior/ Inferior: Pedicles of adjacent vertebrae
Posterior: Ligamentum flavum & capsule of Zygapophhyseal joint

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20
Q

Characteristics of cervical vertebrae

A
  1. Transverse foramina ( intransverse processes; transmit vertebral arteries)
  2. Ant/Post Tubercles on transverse foramen
  3. Bifid spinous processes (absent on C1, long and slender on C7)
  4. Small bodies (C1 has no body), delicate arches
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21
Q

Describe the shape and Characteristics of the Atlas

A

C1 is ring-shaped with NO bony or Spinous Process.
Ant/Post arches, Ant tubercule, Post tubercle.
Articular Facet for dens on the anterior arch.
Bilateral grooves in the post arch for the Vertebral Arteries
Sup/Inf articular facets on the lateral mass (not on zygapophyses)

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22
Q

Describe the shape and Characteristics of the Axis

A

C2 has a Dens (Odontoid process) with articular facet on its ant aspect.
The inf facets are on Zygapophyses (sup facets are not)

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23
Q

Describe the Differentiating Characteristics of the Thoracic Vertebrae

A
  1. Transverse Costal facet on transverse process (articulates w/ tubercle of same# rib)
  2. Costal hemifacits (sup & inf): on T2-T9 or T10 bodies. A half-articulation point in sup/inf pairs shared with adj vertebra
  3. Costal facets: larger articular surfaces on bodies for articulation with the heads of ribs (Sup facet of T1, T10-T12 have only one costal facet per side & articulate with only one rib each)
  4. Heart-shaped body; circular vertebral foramina
  5. Spinous processes are long & flat, angled down
  6. Sup articular facets face posteriorly & inferior facets face anteriorly
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24
Q

What Thoracic vertebrae do not have hemifacets?

A

T1, T10, T11, T12; articulate with 1 rib each

(Sup facet of T1 is NOT a hemi facet Rib 1 articulates with T1; Vertebrae T10-T12 have only one costal facet per side & articulate with only one rib each)

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25
Q

What characteristics distinguish the Lumbar Vertebrae?

A
  1. Bodies are large and kidney-shaped
  2. Spinous Processes are blunt, stocky, & project posteriorly
  3. Articular processes are large; superior articular facets medially & inferior facets face laterally
  4. Superior articular facets exhibit mammillary processes- multifidus m attachments
  5. Transverse processes are long and slender
  6. Accessory processes - located btwn & inf to the mamillary & transverse processes - attachment for longissimus m.
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26
Q

Where is the sacral Promontory?

A

The ventral projection of the base (which articulates with the L5 intervertebral disc)

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27
Q

What is the Apex of the sacrum?

A

directed inferiorly and articulates with the coccyx

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28
Q

4 pairs of ________ __ _______ ________ ________ permit passage of dorsal & ventral rami of sacral spinal nerves.

A

Dorsal & Ventral Sacral Foramina (sacral intervertebral foramina)

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29
Q

Describe the median Sacral crest

A

On the post surface of sacrum fused rudimentary spinous processes of S1-S3/S4

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30
Q

Sacral hiatus

A

Where the vertebral canal – sacral canal ends.

Can be used for extradural anesthesia

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31
Q

Sacral Cornu

A

inf horns of S5 vertebra on each side of sacral hiatus

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32
Q

Describe the Auricular surface

A

The lateral surface of the sacrum; looks like and auricle (ear); synovial part of sacroiliac joint

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33
Q

Describe the Coccygeal vertebrae (coccyx)

A
  • 4 fused rudimentary vertebrae

- No vertebral canal

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34
Q

What are intervertebral joints?

A

Symphysis-type joint between fibrocartilage intervertebral (IV) discs & articular surfaces of vertebral bodies

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35
Q

__________ are designed for weight bearing & strength; allow some mvmt at the intervertebral joints
Consist of Anulus fibrosus

A

Intervertebral discs (IV discs)

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36
Q

What is Anulus fibrosis?

A

An outer fibrous ring that inserts into the rim of the vertebral bodies; provides a strong bond btwn adj vertebrae

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37
Q

Describe the Nucleus pulposus

A

The gelatinous highly elastic central core of the IV disc; has a high water content that decreases with advancing age; acts as a shock absorber & semi-fluid ball bearing;
It is Avascular

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38
Q

What total length do Intervertebral discs contribute to the spinal column?

A

IV discs make up 1/4 to 1/3 the total length of the spinal column

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39
Q

Variance in the shape and thickness of the IV discs produce what change to the spinal column?

A

The secondary curvatures of the spine

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40
Q

Which vertebrae above the sacrum do not have an IV disc between them?

A

C1-C2

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41
Q

Where are Zygapophyseal Joints?

A

Between the Sup and inf articular facets of adj vertebrae; synovial plane joints

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42
Q

What are the different movements of the Zygapophyseal joints in the Cervical, thoracic, and lumbar regions?

A

a. Cervical joints are primarily in a horizontal plane and allow mvmt in most directions.
b. Thoracic joints line in the coronal plane which allows lateral flexion
c. Lumbar joints are in sagittal plane which allows flexion/extension

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43
Q

Joints formed by the articulation between the head of a rib and the hemifacets on bodies same-numbered and sup adj thoracic vertebrae?

A

Costovertebral joints;

synovial plane joint

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44
Q

What are the joints formed by the articulation btwn the tubercle of a rib and the transverse process of the same-numbered vertebra?
found at T1-T10 levels

A

Costotransverse joints;

Synovial plane joint

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45
Q

Describe the Anterior Longitudinal ligament

A

A broad band attached along the anterior surfaces of the vertebral bodies & IV discs from the occipital bone to the sacrum; helps prevent hyperextension of vert column;
May be dmgd or stretched as a result of whiplash

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46
Q

Posterior longitudinal ligament

A

A thin band attached along the post surfaces of the vertebral bodies and IV discs from C2 to the sacrum;
Weakly resists hyperflexion- prevents vert from slipping post into vertebral canal

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47
Q

Ligamentum Flavum (pl. ligamenta flava)

A

Paired ligaments joining the laminae of adj vertebrae on the post wall of the vertebral canal;
Their fibers contribute to post boundaries of the intervertebral foramina;
Helps in recoil from ant flexion & to maintain upright posture

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48
Q

Supraspinous ligament

A

Unites the tips of the spinous processes

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49
Q

What are the ligamentum nuchae?

A

Thickening of the Supraspinous ligaments in the cervical region

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50
Q

Interspinous ligaments:

A

Located btwn the bases of adj spinous processes;

limit flexion

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51
Q

What are the two major subdivisions of the Nervous system?

A
  1. Central Nervous System (CNS)

2. Peripheral Nervous System (PNS)

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52
Q

What is the Central Nervous system?

A

Brain and spinal cord

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53
Q

What is the peripheral Nervous system?

A

All parts external to CNS
1. 12 pairs of Cranial nerves that arise from the brain
2. 31 pairs of Spinal Nerves that arise within or are attached to the spinal cord (includes Somatic Motor and Somatic Sensory nerves)
+ some spinal nerves have peripheral parts of ANS

54
Q

Where does the spinal cord begin and end?

A

It is contiguous w/ the brain stem and runs inferiorly from the Foramen magnum to the L1 or L2 Vertebrae

55
Q

Describe the Function of the Spinal cord

A
  1. involved in motor & sensory innervation of the body inferior to the head
  2. provides a two-way conduction pathway for signals btwn the body & the brain
  3. A major center for reflexes
56
Q

What tissues make up the Spinal cord?

A
  1. Gray matter - central core

2. White matter - external layer

57
Q

Describe the central core of gray matter

A

includes cell bodies of motor neurons & interneurons;

In cross-section it is H shaped w/ 2 dorsal horns (columns) & 2 ventral horns

58
Q

Describe the structure of the white matter

A

made of axons & glial cells; Does NOT contain neuronal cell bodies

59
Q

What areas of the spinal cord are enlarged?

A
  • Regions that innervate the limbs have more motor Neuron bodies
    a. Cervical enlargement (related to upper limbs)
    b. Lumbar Enlargement (related to lower limb)
60
Q

What is the tapered inferior end below the lumbar enlargement?

A

The conus medullaris

61
Q

How many segments does the spinal cord have?

1 segment = 1 pair of spinal nerves

A

31

62
Q

How many cervical segments of the spinal cord?

A

8 (starts above C1, ends below C7)

63
Q

How many thoracic segments of the spinal cord?

A

12

64
Q

How many lumbar segments of the spinal cord?

A

5

65
Q

How many sacral segments of the spinal cord?

A

5

66
Q

How many coccygeal segments of the spinal cord?

A

1

67
Q

Several _________ emerge from the dorsal & ventral surfaces of the spinal cord & unite to form the dorsal & ventral ______ of the spinal cord.

A

a. fila (filum; axons)

b. roots

68
Q

What type of axon fibers does the Dorsal root cary to the spinal cord?

A

Sensory (afferent) axon fibers toward the spinal cord

69
Q

Where are the cell bodies of the Dorsal root located?

A

In the dorsal root ganglion

70
Q

What type of axon fibers does the Ventral root cary away from the spinal cord?

A
  • motor axons (efferent axons) course away from the spinal cord.
71
Q

Where are the cell bodies of the Ventral root motor fibers located?

A

In the gray matter of the spinal cord

72
Q

What are the two types of nerves that the Ventral root (anterior root) contains?

A

a. Somatic motor nerves

b. Autonomic (visceral) motor nerves

73
Q

Describe what Somatic motor nerves control

A

voluntary muscle fibers;

these axons are found in every Ventral root

74
Q

What do the Autonomic (visceral) motor nerves control?

A

Involuntary muscke fibers & certain glands;

Their axons are only in certain ventral roots

75
Q

The Autonomic motor nerves found in what specific ventral roots?

A

a. Sympathetic fibers are in T1-L2

b. Parasympathetic fibers are S2-S4

76
Q

The ________________ is formed by the union of the dorsal & ventral nerve roots, which usually occurs just external to an intervertebral foramen or at their points of exit from the vertebral canal

A

Spinal nerve proper (mixed spinal nerve)

77
Q

What types of axons does the Spinal Nerve proper (mixed spinal nerve) contain?

A

Both motor & sensory axons

-typically only a few mm long then divides into Dorsal & ventral primary rami

78
Q

What does the Dorsal (post) primary ramus supply?

A

a. Supplies both motor & sensory innervation to deep back muscles
b. Gives off a posterior cutaneous nerve to skin of back muscles

79
Q

What does the Ventral (ant) Primary Ramus supply?

A

a. Supplies both Motor & sensory innervation to muscles of the lateral & anterior body wall, & the limbs
b. Supplies cutaneous sensory (lateral cutaneous nerve & Ant cutaneous nerve) to these regions
c. Ventral rami that supply the limbs and neck join one another to form Plexuses (brachial plexus)

80
Q

In the Sacral regions, dorsal rami emerge through ________ _______ ________ & ventral rami emerge through ________ __________ _______

A

a. Dorsal sacral foramina

b. Ventral sacral foramina

81
Q

Except for the ____ & ____ cervical nerves, dorsal ramus of every spinal nerve is much smaller in diameter than the ventral ramus

A

A. 1st & 2nd

—> Dorsal ramus of C2 is the Greater Occipital nerve

82
Q

The Dorsal ramus of C2 is the _____________nerve

A

Greater occipital

83
Q

Ventral ramus of every spinal nerve is connected to the _____ _____ by 1 or 2 rami communicantes

A

sympathetic trunk

(Parts of the ANS)

84
Q

Spinal cord is in the ______ canal, surrounded by ______

A

a. vertebral

b. meninges

85
Q

In an embryo, the vertebral column and the spinal cord are the same length, but the vertebral column thereafter grows _______ than the spinal cord

A

Faster

86
Q

At birth, the spinal cord ends at the ______ vertebral body

A

L3

87
Q

The adult spinal cord ends at about the level of ________

A

L1-L2 intervertebral discs

88
Q

Explain where the Spinal cord segments are in relation to the corresponding vertebra in an adult

A

Spinal cord segments are at the same level as the coresponding vertebra in the upper cervical region, but all other spinal cord segments are superior to the correspondingly numbered vertebra;
a disparity that increases as you go down.Thus , cord segment T5 is at the level of vertebra T3, & the cord segment S5 is at the level of vertebra L1

89
Q

Inf to the conus medullaris, ________________ droop down, heading for lumbar & sacral intervertebral foramina.

A

long dorsal & ventral roots

Cauda equina

90
Q

What do the drooping dorsal and ventral roots (beneath L2) constitute?

A

The cauda equina (horses tail)

91
Q

Points of exit of spinal nerves from the vertebral column

A
  1. exit the vertebral canal via intervertebral foramina or sacral foramina
  2. There are 8 cervical nerve pairs & only 7 vertebrae
  3. Thoracic, lumbar, & sacral spinal nerves all exit INFERIOR to the correspondingly numbered vertebrae
92
Q

Where does the 1st spinal nerve exit?

A

btwn the skull & the C1 vertebra, post to the atlatooccipital synovial joints

93
Q

Where do the 2nd spinal nerves exit?

A

btwn the C1 & C2 vertebrae, post to the lateral atlanto-axial joints

94
Q

The last 2 spinal nere pairs S5 & the coccygeal nerves exit through the _____

A

Sacral hiatus

95
Q

Nerves C1-C7 exit ________ to correspondingly numbered vertebrae

A

SUPERIOR

96
Q

Nerve C8 emerges where?

A

Between vertebra C7 & T1

97
Q

What is a herniated disc?

A

The protrusion of the nucleus pulposus may compress spinal nerve roots or the spinal nerve proper causing pain (radicular pain) & muscle weakness along the dermatome and myotome.
Most often occurs in the cervical and lumbar regions

98
Q

A herniation in the lumbar region will usually impinge on the nerve that emerges through the ________ subadjacent intervertebra as the nerve descents past the abnormal disc.

A

a. Superior

each spinal nerve emerges through the superior part of the intervertebral foramen

99
Q

What is a Dermatome?

A

Segmental bands of cutaneous sensory innervation; one for each spinal segment

100
Q

The _______ ______ of the _____ nerve is is purely motor and has NO cutaneous sensory branches, so there is No ____ Dermatome

A

a. Dorsal ramus
b. C1
c. C1

101
Q

Does cutting a single spinal nerve (or dorsal root) produce anesthesia in its dermatome? And why?

A

No, consecutive dermatomes overlap one another ( there is only a slight reduction in sensitivity; but more noticeable if 2 dermatomes were cut)

102
Q

What are the 3 layers of the meninges

A
  1. Pia mater (most deep) “gentle mother”
  2. Arachnoid mater (middle layer) “spidery mother”
  3. Dura mater (superficial layer) “tough mother”
103
Q

Describe the Dura mater

A

The outermost layer;

made of tough fibrous connective tissue

104
Q

Where does the Dural envelope start and end?

A

extends from the brain to beyond the end of the spinal cord at S2 vertebral level.

105
Q

What is the Filum terminale externum?

A

A slender ligament that continues inf from the dura mater & anchors the dura to the coccyx

106
Q

Describe the structure of the arachnoid mater?

A

it is a delicate transparent membrane lining dura.

Slender strands called Arachnoid trabeculae (resembles cobweb stands) connect to pia mater

107
Q

Describe the structure of Pia mater

A

Thin layer adhered directly to the brain, spinal cord & spinal nerve roots

108
Q

What are Denticulate ligaments?

A

Strong lateral extensions of the pia that anchor the spinal cord laterally to the dura; located btwn the dorsal and ventral roots;
These ligaments pin the arachnoid membrane to the dura btwn the spinal nerves

109
Q

What is a Filum Terminale Internum?

A

A strong strand of pia that extends inferiorly beyond the conus medullaris to the terminal end of the dural-arachnoid sac

110
Q

Injury to spinal cord above C3

A

may require a ventilator for breathing

111
Q

Injury to spinal cord above C4

A

means loss of mvmt & sensation in all limbs, but shoulder & neck mvmts are often available

112
Q

C5 injuries

A

Often spare shoulder and biceps control, but loss of wrist or hand mvmts

113
Q

Name the spaces associated with the Meninges

A
  1. Epidural space (extradural space)
  2. Subdural space
  3. Subarachnoid space
114
Q

Where is the epidural space?

A
  1. btwn the dura mater & wall of vertebral canal
  2. Within the braincase, dura is fused to the periosteum of the skull, which is considered part of the cranial dura. (there is no fat fuesed epidural space here)
115
Q

What are the soft,fat & and thin-walled veins in the epidural space called?

A

Internal Vertebral Venous Plexus

116
Q

Describe what an epidural injection is

A

A local anesthetic that c an be injected into the epidural space to numb pinal nerves located inferior to the injection site (done at sacral region in infants and lumbar regions in adults )

117
Q

Describe the subdural spance

A

A potential space btwn the dura and arachnoid mater;

normally only contains a film of watery liquid

118
Q

Describe the subarachnoid space

A
  1. located btwn the arachnoid & pia mater

2. Full of cerebrospinal fluid (CSF)

119
Q

What is the lumbar cistern

A

The large space btwn the tip of the spinal cord & tip of dural-arachnoid sac

120
Q

What does the CSF do?

A

a. Pressure of the CSF pushes arachnoid membrane against dura
b. buoys up the spinal cord and brain

121
Q

What is in the Lumbar Cistern?

A

a. the Cauda equina

122
Q

What is the safest place to sample the CSF?

A

In the Lumbar cistern because the cauda equina is unlikely to be injured by the needle

123
Q

Descripe a lumbar puncture (spinal tap)

A

A needle is inserted btwn lower lumbar spinous processes or laminae into the lumbar cistern

124
Q

What are intrathecal injections

A

(theca = sheath)
injections given to the subarachnoid space; typically useful in spinal anesthesia, chemotheraoy, or pain mgmt;
Also to administer drugs to CNS to avoid the blood-brain barrier

125
Q

What are the 6 arteries that the spinal cord arteries arise from?

A 
branches of the:
1. Vertebral 
2. Ascending Cervical 
3. Deep cervical
4. Intercostal
&
5, Lateral sacral arteries
126
Q

Name the 3 longitudinal arteries of the spinal cord

A
  1. Anterior spinal artery

2. Paired (2) Posterior spinal arteries

127
Q

What does the Anterior Spinal Artery originate from in the spinal cord and where does it branch to?

A

a. It is formed by union of branches of vertebral arteries

b. It courses inferiorly in ventromedian fissure on pia mater

128
Q

What do the Paired Posterior Spinal Arteries originate from and where do they branch to? (in spinal cord)

A

a. they are each a branch of a vertebral artery

b. they course inferiorly on the pia mater

129
Q

Where do the Segmental Spinal Arteries enter and what branches do they give off? (in spinal cord)

A

a. enter each vertebral foramen
b. gives off 2 sets of branches:
1. One to the vertebrae, epidural fat, and dura
2. and dorsal & ventral radicular (medullary) branches to spinal nerve roots

130
Q

Describe the venous drainage of the spinal cord

A
  1. Radicular veins drain into internal vertebral venous plexus
  2. Venous plexus drains (via intervert foramina) into vertebral, intercostal, lumbar, and lateral sacral veins
  3. The valveless nature of these veins permits blood to flow in both directions
131
Q

What contributes to the spread of cancerous or infectious agents from the spinal cord to the vertebrae, brain or skull?

A

The valveless (valve-less) nature of the spinal cord veins

Anatomy Unit I (8 decks)

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