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Biomedical Engineering > Introduction to the Spine > Flashcards

Introduction to the Spine Flashcards

1
Q

What are the purposes of the spine?

A

The spine has several purposes, the main one being to provide support for the body, allowing it to stand upright, bend and twist whilst protecting the spinal cord from injury.

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2
Q

What can result from injury of the spinal cord?

A

Injury to the spinal cord could result in loss of control to other parts/functions of the body

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3
Q

What are the five regions of the spine?

A
  • cervical
  • thoracic
  • lumbar
  • sacral
  • coccyx
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4
Q

How many vertebrae are in the cervical spine?

A

C1-C7

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5
Q

How many vertebrae are in the thoracic spine?

A

T1-T12

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6
Q

How many vertebrae are in the lumbar spine?

A

L1-L5

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7
Q

How many vertebrae are in the sacral spine?

A

S1-S5

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8
Q

What is the coccyx?

A

The base of the spine

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9
Q

How many moveable vertebrae are there?

A

24 moveable vertebrae, the sacral and the coccyx are fused together. This is made up of the cervical, thoracic and lumbar spine.

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10
Q

What is the purpose of the cervical spine?

A

The purpose of the cervical spine is to support the weight of the head

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11
Q

What are the two important vertebrae in the cervical spine, and what do they do?

A

C1- Atlas, and C2- Axis, they allow the head to swivel and nod.

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12
Q

What sort of size are the cervical vertebrae?

A

They are quite small vertebrae in the cervical spine

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13
Q

What is the main function of the thoracic spine?

A

The main function of the thoracic spine is to hold the rib cage and protect the heart and lungs (it also helps in some capacity with breathing)

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14
Q

What is the movement like in the thoracic spine?

A

There is a limited range of motion in the thoracic spine

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15
Q

What is the main function of the lumbar spine?

A

The main function of the lumbar spine is to bear the weight of the body. This is where the biggest loads pass through the spine

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16
Q

What size are the vertebrae in the lumbar spine?

A

The vertebrae of the lumbar spine are the largest

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17
Q

What are the vertebrae in the sacrum spine like?

A

There are five vertebrae and they are fused together.

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18
Q

What type of nerves are in the lumbar and thoracic spine?

A

Peripheral nerves

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19
Q

What does the sacrum spine do?

A

It provides the solid mass of bone that attaches to the pelvis

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20
Q

What is it called if the spine is abnormal (curved) side to side?

A

Scoliosis

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21
Q

What is it called if there is abnormal curvature of the thoracic spine?

A

Kyphosis

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22
Q

What is it called if there is abnormal curvature of the lumbar spine?

A

Lordosis

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23
Q

What other defects could occur in the spine?

A

It is possible to have a combination of scoliosis, kyphosis and lordosis

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24
Q

What is the star shaped part of the vertebrae structure called, and what does it do?

A

The star shaped part is the processes, these are there for muscle attachment

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25
Q

What is the (approximately) cylindrical part of the vertebrae structure called?

A

The called the vertebral body

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26
Q

What does the vertebral body part of the vertebrae structure do?

A

It primarily withstands compression of the spine

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27
Q

What is the hole in the middle of the vertebral structure called?

A

It is the vertebral canal, it is for the spinal cord and nerves

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28
Q

Each vertebrae has two cylindrical shaped projections of hard bone that stick out from the back part of the vertebral body, called what?

A

Pedicles

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29
Q

What do the pedicles provide for the vertebrae?

A

The pedicles provide side protection for the spinal cord and nerves. They also serve as a bridge, joining the front and back parts of the vertebrae

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30
Q

What are spinous and transverse processes and what do they do ?

A

Spinous and transverse processes are bony projections and provide points of attachments for muscle and ligaments

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31
Q

What is there between the vertebral bodies of the spine?

A

Between the vertebral bodies is the tough, elastic intervertebral disc.

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32
Q

What do intervertebral discs do?

A

It provides a flexible cushion, allowing vertebrae to bend and twist

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33
Q

What is the outer ring of the intervertebral disc called?

A

The outer ring of the intervertebral disc is called the Annulus Fibrosus

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34
Q

What is the Annulus Fibrosus?

A

The Annulus Fibrosus is a tough exterior of the intervertebral disc. It is composed of a ring of ligament fibres that encases the inner core of the disc and securely connects the spinal vertebrae above and below the disc.

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35
Q

What is the inner ring of the intervertebral disc called?

A

The inner ring of the intervertebral disc is called the Nucleus Pulposus

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36
Q

What is the Nucleus Pulposus?

A

It is the softer, inner ring of the intervertebral disc.

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37
Q

What is the affect of injury to the intervertebral disc?

A

Injury can cause the disc to bulge or herniate to compress nerves and cause back pain

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38
Q

How can the Annulus Fibrosus protect the Nucleus Pulposus?

A

The annulus fibrosus fibres prevent the nucleus pulposus, compromised of a gelatinous material, from herniating or leaking out of the disc by hydraulically sealing the nucleus and evenly distributing any pressure and force imposed on the intervertebral disc.

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39
Q

What is the forward to back plane of the body called?

A

Coronal Plane

40
Q

What is the side to side plane of the body called?

A

Sagittal Plane

41
Q

What is the up and down plane of the body called?

A

Axial Plane

42
Q

What does Dorsal mean?

A

Dorsal means the back or posterior side of the body (Thoracic Spine)

43
Q

What does Ventral mean?

A

Ventral means the front or anterior side of the body

44
Q

What does Paraplegia mean?

A

Paraplegia means paralysis of legs and lower body below the arms indicating an injury to the thoracic or lumbar spine

45
Q

What does Quadriplegia mean?

A

Quadriplegia means paralysis of legs and arms indicating an injury to the cervical spine. Cervical injury/surgery is potentially more dangerous.

46
Q

In general, where is most surgery on the spine done from and why?

A

Most surgery on the spine is done from the ventral, to reduce risk.

47
Q

What is scoliosis?

A

Scoliosis is a condition that causes the spine to curve sideways

48
Q

What is it called if a child under 10 has scoliosis?

A

In children under 10 it is called Early Onset Scoliosis (EOS)

49
Q

What ages is considered an adolescent?

A

We consider adolescent from 10 to fully grown (~20)

50
Q

What is the most common type of scoliosis?

A

Idiopathic

51
Q

What does Idiopathic scoliosis mean?

A

Idiopathic scoliosis means the cause is unknown

52
Q

When do most cases of Idiopathic scoliosis occur?

A

Most cases of Idiopathic scoliosis occurs between the age 10 and fully development. Usually around puberty.

53
Q

When are cases of scoliosis detected and why?

A

Most of the time scoliosis goes un-noticed as it is rarely painful. Therefore it is mostly detected during a school screening or at a regular check up.

54
Q

Where do scoliosis curves most commonly occur?

A

Scoliosis curves most commonly occur in the upper and middle back (thoracic spine). They can develop in the lower back and occasionally will occur in both the upper and lower parts of the spine

55
Q

What are other types of scoliosis called?

A
  • Congenital Scoliosis

- Neuromuscular Scoliosis

56
Q

What is congenital scoliosis?

A

Problems in the spine sometimes develop before a baby is born. Babies with congenital scoliosis may have spinal bones that are not fully formed or fused together. It could be genetical.

57
Q

What is neuromuscular scoliosis?

A

Medical conditions that affect the nerves and muscles, such as muscular dystrophy or cerebral palsy can lead to neuromuscular scoliosis. These types of neuromuscular conditions can cause imbalance and weakness in the muscles that support the spine.

58
Q

What are the symptoms of scoliosis?

A
  • Titled, uneven shoulders, with one shoulder blade protruding more than the other
  • Prominence of the ribs on one side
  • Uneven waistline
  • One hip higher than the other
59
Q

What can the psychological impacts of scoliosis be?

A

The psychological impact of scoliosis can be very distressing for children, parents and family. They may also have the distress of financial problems.

60
Q

What can be particularly life threatening for scoliosis suffers?

A

The spine and the ribs can push against the lungs, this can be particularly life threatening for children with breathing difficulties

61
Q

Most scoliosis requires no treatment, some cases can be monitored to see if it worsens. But what non-surgical treatment can be done?

A
  • Bracing can be worn under the clothing, its removeable, usually very tight and uncomfortable.
  • Casting can be used in severe cases, applied under general anaesthetic. This is worn for variable lengths of time, subject to close monitoring.
62
Q

What angle of curve can affect your breathing?

A

Curves of greater than 70 degrees can affect your breathing

63
Q

What is the order of importance of the key functions of the biomechanics of the spine?

A
  1. Protection of the spinal cord
  2. Maintenance of trunk stability
  3. To provide mobility
  4. Aid movement in the upper and lower limbs
64
Q

How can the maximum theoretical loads of the spine be defined?

A

There are lots of different techniques that can be used to determine the maximum load that the spine can take. The maximum theoretical load of the spine can be defined by compressive loads, principally the axial strength of the individual vertebrae. This could be investigated using a cadaver.

65
Q

What are the largest and smallest individual loads of the spine?

A
  • 1300N at C3

- 8000N at L4

66
Q

There is a considerable margin of safety built in to the failure strengths of the spine. The maximum loads of the spine are usually?

A

The maximum loads of the spine are often several times the body weight.

67
Q

When is the only time the compressive load in the spine is less than the body weight?

A

The only time compressive loading in the spine is less than the body weight is when the body is in the prone position (lie flat, chest down back up)

68
Q

Where do the compressive forces of the spine arise from?

A

The compressive forces of the spine arise largely from the muscle action that produces a counter balancing moment to the weight of the upper torso and/or head that acts forward of the spine. The posterior muscles have a relatively small moment or lever arm and, therefore have to produce a considerably larger force than the weight of the upper torso to produce a counter balancing moment. The compressive load on the spine at that level is just the addition of the weight of the upper torso and the force generated by the posterior muscles.

69
Q

Are the forces larger through the cervical or the lumbar part of the spine?

A

The forces taken through the lumbar region (L4) are so much higher than the cervical region (C3) due to the varying size of the vertebrae

70
Q

There is a high incidence of clinically evident disc disease where in the spine?

A

There is a high incidence of clinically evident disc disease at L4-L5 and L5-S1. This may be related to the fact these areas bear the highest loads and tend to undergo the most motion in the sagittal plane.

71
Q

In the normal standing position, where does the body weight act?

A

In the normal standing position, body weight acts anterior (in front) of the spine, creating a forward bending load (moment) on the spine

72
Q

Axial compression is often combined with what when leaning backwards?

A

Axial compression is often combined with bending positions that are related to spine alignment and posture, resulting in altered internal disc stresses.

73
Q

What does herniated discs mean?

A

Herniated discs means it has ruptured between the vertebrae

74
Q

During level walking, what does the graph look like for the force on the spine?

A

During level walking, there is a double peak due to the two heal strikes

75
Q

What size force occurs at the spine during walking?

A

1.5-3 times the body weight (BW)

76
Q

Standing and sitting is associated with what size force in the spine?

A

1.5-2 times the body weight (BW)

77
Q

What are the impressively high transient loads that can occur in the spine?

A

5-6 times the body weight

78
Q

What loads can the anterior-posterior shear loads L4-L5 take?

A

The antero-posterior shear loads, which have been inferred from indirect measurement can exceed 140N during normal walking, to more that 1000N in more extreme activities. Anterior-posterior can take loads up to 20% of body weight

79
Q

How many degrees of freedom does the spine have?

A

Flexibility of motion in six degrees of freedom

80
Q

How can we consider motion of the spine?

A

We can consider movement of the entire spine, a region of the spine, or a functional spinal unit.

81
Q

What is a functional spinal unit (FSU)?

A

The functional spinal unit, is generally defined as an intervertebral disc, the vertebrae either side and the interconnecting ligaments

82
Q

What is the flexion-extension like in the cervical and lumbar region compared with the thoracic?

A

Flexion-extension is relatively high in cervical and lumbar region compared with the thoracic.

83
Q

What degree is there of lateral flexion in the spine?

A

Lateral flexion (left-right side bending) is 5-10 degrees

84
Q

What is the axial rotation degree in the lower thoracic and lumbar spine?

A

Axial rotation of 3 degrees in the lower thoracic and lumbar spine. It visually looks bigger, but this is rotation of the hips.

85
Q

Why is the spine different for adults and children?

A

There are lots of differences between the spines of children and adults, many parts of the skeleton aren’t fused together or fully developed in the child’s spine. The growth of the child may also have an effect on the forces in the body.

86
Q

What size forces are applied to the paediatric spine during walking?

A

1.5-3 times body weight

87
Q

What percentage are the anterior-posterior shear forces of a paediatrics’ bodyweight?

A

The anterior-posterior shear forces are 20% of a paediatrics body weight

88
Q

What also needs to be considered due to the growing spine of a paediatric?

A

As their spine is still growing, tensile forces must also be considered.

89
Q

Paediatric scoliotic spines are even more complex, and there is little to no research done on this. What is a method that could be used to achieve accurate/reliable loads on the paediatric scoliotic spine?

A

One method to be able to achieve accurate/reliable loads would be to put sensors such as goniometers or node transducers on to the child during surgery and record loads on the spine.

90
Q

What are some of the surgical treatment for the scoliotic spine?

A
  • Staples to squeeze vertebrae together
  • Growth guidance system-rods connected loosely to screws on the spine, the spine can slide on the rod as it grows
  • Traditional growing rods, extended manually by surgeon
  • MAGEC rods
91
Q

How often do traditional growing rods need to be extended manually by the surgeon?

A

Traditional growing rods are extended manually by surgeon during an operation every 6-9 months. Ideally this would occur even more frequently however this demands more surgery.

92
Q

What are the impacts of the surgery for the traditional growing rods?

A

During the surgery the whole spine is opened. This can cause huge psychological issues. In addition to this, there are issues with anaesthesia and wound re-opening.

93
Q

How often are MAGEC rods actuated?

A

MAGEC rods are actuated every 6-9 weeks

94
Q

How is the surgery done for the MAGEC rods?

A

Surgery is done through two openings, at the top and bottom of the spine.

95
Q

How is the MAGEC rod actuated?

A

Once in place there is no surgical intervention, a device is placed on the outside of the body, agitating the magnetic motor inside the patients spinal rod. The leadscrew will then extend the rod inside the body. The patient would be awake during this lengthening process.

96
Q

What is the issue with the information panel for the MAGEC rods?

A

The information panel on the device is known for being unreliable, the surgeons tend to apply the magnet until the motor stops working and starts to clunk in the child’s spine.

Biomedical Engineering (13 decks)

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