Lecture 4: Tutoring PP (Vertebral Column)

Question 1

Answer 1

Question 2

Rib Articulation

• Thoracic vertebrae have _____ and _____ on the vertebral body for articulation with the _____ of a rib, and a _______ for articulation with the rib ______

Answer 2

Rib Articulation

• Thoracic vertebrae have superior and inferior articular facets on the vertebral body for articulation with the head of a rib, and a transverse process facet for articulation with the rib tubercle

Question 3

Articular Facet Orientation

• Cervical Region = ____ degrees; ___ plane;
  
  • movements possible = (4)
• Thoracic Region = ____ degrees; _____ plane;
  
  • movements possible = (2)
  • movements not possible = 2
• Lumbar Region = ____ degrees; ____ plane;
  
  • movements possible = 2
  • movements not possible = 2

Answer 3

Articular Facet Orientation

• Cervical Region = 45 degrees; frontal plane;
  
  • all movements are possible: flexion, extension, lateral flexion, and rotation.
• Thoracic Region = 60 degrees; frontal plane;
  
  • lateral flexion and rotation;
  • no flexion/extension
• Lumbar Region = 90 degrees; sagittal plane;
  
  • only flexion and extension
  • no lateral flexion or rotation

​*thoracic facets are in allow for lateral flexion and the lumbar do not (lumbar allow for extension and flexion based on the fact that their facets are in the sagittal plane not the frontal).

Question 4

Laminectomy

• What is it?
• What is it for?
• Most often which section of vertebrae and why?

Answer 4

Laminectomy

• What is it?
  
  • Surgical excision of one or more spinous processes and their supporting laminae, removing most of the vertebral arch by transecting pedicles
• What is it for?
  
  • Stenotic (narrowing) of vertebral foramen in one or more lumbar vertebrae; Laminectomy relieves pressure on the spinal cord or nerve roots – commonly caused by a tumor, herniated IV disc, bony hypertrophy (excess growth)
• Most often which section of vertebrae and why?
  
  • Most often lumbar vertebrae, why?
    • Vulnerable to IV disc bulging, causing compression of spinal nerve roots

Question 5

Vertebral artery goes through the _______

Answer 5

Vertebral artery goes through the transverse foramina

Question 6

Vertebral Ligaments

1. _____

• goes from ____ to _____
• Replaces _____ in cervical region

2. _____

3. _____

4. _____

Answer 6

Vertebral Ligaments

1. Nuchal ligament (ligamentum nuchae)

• Occipital bone to C7 spinous process
• Replaces supraspinous ligament in cervical region

2. Intertransverse

3. Interspinous

4. Supraspinous

Question 7

Vertebral Ligaments

• Between laminae:
  
  • ______
    
    • meaning of name: _____
• Between vertebral bodies
  
  • ______
    
    • relation to vertebral body: _____
  • _____
    
    • relation to vertebral body: _____

Answer 7

Vertebral Ligaments

• Between laminae:
  
  • Ligamentum flavum
    
    • L. flavum = yellow or blonde
• Between vertebral bodies
  
  • Posterior longitudinal
    
    • Posterior to vertebral body
  • Anterior longitudinal
    
    • Anterior to vertebral body

Question 8

Intervertebral (IV) Discs:

• 1. ______
  
  • made of ____ and ____
  • ___% water
  • loses ___ with age
  • vascular or avascular?
• ​Annulus Fibrosis
  
  • ______ rings
  • _____ posterior section
  • _____ with age and develops _____
  • Vascular or avascular?

Answer 8

Intervertebral (IV) Discs:

• Nucleus Pulposus
  
  • Collagen and water
  • 70-90% water
  • Loses water content with age
  • Avascular
• ​Annulus Fibrosis
  
  • Fibrocartilage rings
  • Thin posterior section
  • Thicken with age and develop fissures
  • Vascular

Question 9

IV Disc Herniation

• What is it?
• Symptoms?
• Why Posterolateral?
• Most common vertebral region for disc herniation?

Answer 9

IV Disc Herniation

• What is it?
  
  • Protrusion of gelatinous nucleus pulposus into, or through, annulus fibrosus
• Symptoms?
  
  • pain and numbness
• Why Posterolateral?
  
  • Usually annulus is thinner and it’s not supported by posterior longitudinal ligament
• Most common vertebral region for disc herniation?
  
  • lumbar

Question 10

Question 1: In the event of intervertebral disk herniation in the cervical region, which of the following ligaments is in an anatomic position to protect the spinal cord from direct compression?

A. Supraspinous

B. Posterior longitudinal

C. Anterior longitudinal

D. Ligamentum flavum

E. Nuchal ligament

Answer 10

Question 1: In the event of intervertebral disk herniation in the cervical region, which of the following ligaments is in an anatomic position to protect the spinal cord from direct compression?

A. Supraspinous

B. Posterior longitudinal

Answer: The posterior longitudinal ligament is the only ligament spanning the posterior aspect of the vertebral bodies and intervertebral disks. With intervertebral disk herniation, the nucleus pulposus of the intervertebral disk protrudes posterolaterally.

C. Anterior longitudinal

D. Ligamentum flavum

E. Nuchal ligament