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L10 - vertebral column Flashcards

1
Q

how many vertebrae does the adult vertebral column have

A

33

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2
Q

how many cervical vertebrae are there

A

7

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3
Q

how many thoracic vertebrae are there

A

12

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4
Q

how many lumbar vertebrae are there

A

5

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5
Q

how many sacral vertebrae are there

A

5

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6
Q

how many coccygeal vertebrae are there

A

4

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7
Q

what holds the vertebrae together?

A

facet joints
intevertebral discs
ligaments

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8
Q

facet joints

A

connect the superior and inferior articular processes of adjacent vertebrae; interlocking maintains stability

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9
Q

intervertebral foramen

A

pathway in which the spinal nerves pass

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10
Q

role of ligaments

A

bing vertebrae together and stabilise the vertebral column

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11
Q

intervertebral disc

A
  • between all non-fused vertebrae
  • provide flexibility
  • act as shock absorbers
  • adhere vertebral bodies to one another
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12
Q

functions of vertebral column

A
  • protect spinal cord
  • support body weight
  • semi-rigid axis for bodt
  • allows for pivoting of the head
  • supports posture and locomotion
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13
Q

spinal canal

A

tunnel formed by stacked up vertebrae in which the spinal cord passes through

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14
Q

primary curvature of spinal canal

A

thoracic and sacral kyphoses

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15
Q

secondary curvatures

A

cervical and lumbar lordoses

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16
Q

curvatures in babies

A
  • in foetus, primary curvature forms uniformally

- as the baby grows and supports its own head and walks, the secondary curvatures form

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17
Q

scoliosis

A

curvature of the spine so that the vertebral column is not in the midline - lateral curvature

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18
Q

excessive kyphosis

A

hunch back

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19
Q

pedicles

A

segments of the vertebral arch

  • join the spinous and transverse processes together
  • join spinous processes the body
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20
Q

laminae

A

important for ligament attachment

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21
Q

superior and inferior articular processes

A
  • form facet joints

- determines type of movement we have in our vertebral column

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22
Q

transverse processes

A
  • articulate with ribs
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23
Q

spinous process

A
  • connects directly out posterior
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24
Q

what do we feel in the midline of out back

A

spinous processes

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25
Q

smallest vertebrae

A

cervical

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26
Q

atypical features of C1

A

articulates with occiput

- allows us to nod our head up and down

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27
Q

atypical features of C1 and C2

A

C1 and C2 articulate with each other and form a pivot joint – allows us to turn our head from side to side

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28
Q

vertebra prominens

A

long spinous process on C7

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29
Q

transverse foramina of C7

A

small or absent

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30
Q

what do we feel at the bottom of our neck

A

vertebra prominens

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31
Q

how many cervical spinal nerves are there

A

8

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32
Q

why are injuries to C spine common

A
  • C spine is flexible

- head is heavy

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33
Q

movements of C spine

A
  • flex and extend
  • laterally flex
  • head rotation
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34
Q

bifid

A

splits into 2

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35
Q

which part of the cervical vertebrae is bifid

A

spinous

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36
Q

why does injury to the vertebral foramen not always affect the spinal cord

A

it is large compared to it

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37
Q

importance of transverse foramina

A

passage of vertebral artery and vein to and from brain

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38
Q

which foramina does the vertebral artery not travel through

A

C7

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39
Q

shape of C1

A

ring

- no vertebral body or spinous process

40
Q

importance of articulation between C1 and skull

A

allows us to move our head up and down

41
Q

atlantoaxial joints

A

between C1 and C2

42
Q

how many atlantoaxial joints are there

A

3

  • 2 lateral
  • 1 median
43
Q

lateral atlantoaxial joints

A

between the lateral masses of C1 and the superior facets of C2

44
Q

medial atlantoaxial joint

A

a pivot joint between the dens and atlas

Synovial – which means it can be affected by RA

45
Q

how is the atlantoaxial joint reinforced

A

transverse ligament of the atlas which holds the dens in place

46
Q

what causes fracture of the atlas

A

axial loading –> can burst fracture of C1 ring

47
Q

Jefferson fracture

A

fracture of atlas

48
Q

cause of axial loading

A

any direct blow to the top of the head

- e.g., diving into a pool and hitting head on bottom

49
Q

consequence of atlas fracture

A
  • doesn’t always cause spinal cord injury
  • wider vertebral foramen
  • spinal cord is not compressed
50
Q

how common is fracture of dens

A

10-15% of C-spine fractures

51
Q

cause of fracture of dens

A

hyeprflexion of hyperextension

52
Q

who is most affected by fracture of dens

A
  • over 70s (low-energy trauma)

- 20-30s (high energy trauma)

53
Q

how is the dens held in place

A

transverse ligaments of the atlas

54
Q

is the spinal cord affected in a dens fracture

A

not usually

  • dens held in place by ligaments
  • spinal canal is much larger than spinal cord

however, if dens fractured and ligaments ruptures, dens may be driven into the brainstem

55
Q

C-spine immobilisation

A

collar
blocks / plates
tape

56
Q

lordosis

A

loss of normal curvature of spine

57
Q

shape of thoracic vertebral body

A

heart shaped with superior and inferior costal Demi-facets

58
Q

role of demi-facets in thoracic vertebrae

A

articulation with head of rib

59
Q

spinous process of thoracic vertebrae

A

long and extends postero-inferiorly

60
Q

transverse process of thoracic vertebrae

A

costal facet for articulation with tubercle of a ribe

61
Q

articular facets of thoracic vertebrae

A

superior facets posteriorly

inferior facets anteriorly

62
Q

most commonly affected areas for T-spine trauma

A

T11-12

63
Q

osteoporosis

A

metabolic disease / demineralisation where bones become weak

64
Q

compression ‘wedge; fracture

A

concavity of vertebral body (instead of them being square)

65
Q

osteoarthritis

A

wear and tear at the joints

- osteophytes: joint narrowing

66
Q

vertebral body of L vertebrae

A

large for increased weight bearing

67
Q

articular facets of L vertebrae

A
  • Superior face medially

- Inferior face laterally

68
Q

spinous process of L vertebrae

A

short and sturdy

69
Q

vertebral foramen of L vertebae

A

narrow

70
Q

ala

A

transverse processes which have fused together on either side

71
Q

movements of vertebral column

A

flexion
extension
lateral flexion (side to side)
rotation (look over shoulder)

72
Q

most flexible vertebral levels

A

C and L

73
Q

movement in T-spine

A
  • flexion limited
  • rotation possible
  • as they articulate with rubs and ribs articulate with sternum
74
Q

innervation of intrinsic muscles of back

A

posterior rami of spinal nerve

75
Q

chief extensor or vertebral column

A

erector spinae

76
Q

erector spinae

A
  • Large muscle that runs longitudinally either side of VC

- Composed of 3 separate muscles

77
Q

muscles which make up erector spinae

A
  • longissimus muscle
  • iliocostalis muscle
  • spinalis muscle
78
Q

what lies deep to erector spinae

A

smaller muscles

79
Q

location of intervertebral discs

A

between vertebral bodies

80
Q

what makes up intervertebral discs

A 
outer = annulus fibrosus
inner = nucleus pulposus
81
Q

annulus fibrosus

A

Fibrocartilage ring attached to the rim of vertebral body

82
Q

nucleus pulposus

A

Gelatinous ‘shock absorber’

83
Q

role of intervertebral discs

A

flexibility, shock absorption and stability

84
Q

slipped disc

A

when annulus fibrosus becomes stiff and nucleus pulposus herniates through, squashing the spinal nerve or spinal cord itseld

85
Q

why are the C and L spine most flexible

A

intervertebral discs are thicker here

86
Q

what happens to intervertebral discs with age

A

dehydrate

become thinner and stiffer

87
Q

sciatica

A

compression of spinal nerve roots and L5/S1 or L5/S1

88
Q

key ligaments in the vertebral canal

A
  • posterior longitudinal ligament
  • anterior longitudinal ligament
  • ligamentum flavym
89
Q

Posterior longitudinal ligament

A
  • C2 to sacrum
  • Resists hyperflexion
  • Prevents posterior herniation of IV discs
90
Q

Anterior longitudinal ligament

A
  • Runs anterior to the vertebral bodies
  • Longitudinal – runs from top to bottom
  • Occipital bone and C1 to sacrum
  • Only ligament to resist hyperextension of vertebral column, all the others resist hyperflexion
91
Q

Ligamentum flavum (L. yellow)

A
  • Binds lamina of adjacent vertebrae

- Traversed in LP; resistance felt against the needle before it ‘gives’ with a so-called “pop”

92
Q

ligaments which bind spinous processes together

A

interspinous and supraspinous ligaments

93
Q

interspinous ligaments

A

between adjacent spinous processes

94
Q

Supraspinous ligaments

A

join the tips of the spinous processes

95
Q

route of lumbar puncture

A

through the supra, through the infra, through the ligamentum flavum and into the vertebral canal

96
Q

whiplash

A

Rapid, forceful hyperextension then hyperflexion

97
Q

which ligament is torn in hyperextension

A

Anterior longitudinal ligament

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