Lecture 9; 9/16 - Spinal anatomy Flashcards
Test 2
How many C- vertebrae are there?
7
What are some special anatomy only in the C spine?
-bifid spinous process
-transverse foramen
-hollowed out transverse process (Sulcus)
What goes through the transverse foramen in the C-vertebrae?
Vertebral Arteries
Which C-vertebrae doesnt have a spinous process?
C1
What are the probabilities that a C-vertebrae will have a bifid spinous process?
C2-C5: Almost always
C6: 50%
C7: 3% Usually single spinous process
The transverse foramen add a layer of _______ to the vertebral arteries because they are feeding blood to the brain
protection
Who is the C1 spine named after?
Atlas; Mythical god who held the weight of the wold on his shoulders
What C-vertebraes are specialized?
C1 and C2
What is C1 also called?
Atlas
What is C2 also called?
Axis
What is in place of the spinous process on C1?
Posterior tubercle
Where does the skull sit?
The cartlidge on the superior articular facet
Where does C2 connect to C1?
Facet for dens
-posterior/proximal to the anterior arch/turbercle
What is the anterior arch known for?
Pivot point where C1 and C2 fit together in front of the vertebrae
T/F: all C-vertebrae have vertebral bodies
F
C1 does not
Where does the spinal cord go into the skull?
Foramen Magnum
What is the anterior tubercle?
nub in front of the anterior arch
What is the main function of C1?
To stabilize head
Where does the superior artuclar facets connect to the skull?
Occipital condyle (cartilage)
Where does Antlanto Occipital Ligaments run?
They connect the top of the spine through the foramen magnum
What is responsible for nodding?
The Alanto Occipital Ligaments which include the superior articular facet and the occipital condyle
T/F: The posterior and anterior articular facet on C2 are bone
F
Cartlidge
What on C2 connects with C1?
The Dens on C2 connects with the facet of dens on C1
Describe the Dens on C2?
Projection that sticks upward
Posterior and anterior articular facets with cartlidge
T/F: C2 has a vertebral body
T
It is small
What is special about the Dens on C2?
Dens of AXIS
AXIS IS C2
It is some flexibility and tou can swivle head from side to side.
Describe Spinal Ligaments: Anterior Longitudinal ligament
Runs down the entire front (anterior) of the spine
From Sacrum to skull
Describe Spinal Ligaments: Posterior longitudinal ligament
Runs down the back (posterior) of the vertebral body of the entire spine
Describe Spinal Ligaments: Intertransverse ligament
Links the tips of the transverse processes
Describe Spinal Ligaments: Supraspinous ligaments
Links tips of spinous processes
Describe Spinal Ligaments: Interspinous ligament
Ligments linking in between the entire spinous processes
Describe Spinal Ligaments: Ligamentum Flava
STRETCHY
Connects the remaining anterior arches together between vertebrae
What is special about ligamentum flava?
When approaching with a needle you will feel a change in resistance because it is stretchy
You can gauge how deep or where you are with the needle
What happens if the person you are working on doesnt have any ligementum flava?
Cant use that as a marker because you might misjudge your depth
What is the Nuchal ligament?
Extention of Interspinous ligaments
Where is the Anterior Antlanto Occipital membrane?
Front and top part of neck
Where is the Posterior Antlanto Occipital membrane?
ligament/fibers that connects arch of C1 to the posterior opening for the Foramen Magnum
What does Antlanto mean?
Atlas and Occipital
Describe: External Occipital Protuberance
MARKER
Small bump on the back of your head (occipital bone) where Nuchal ligament and supraspinous ligament connect
T/F: You see alot of T-Spine injuries?
F
T-spine is strong and robust structure with lots of connections
How many vertebrate in T-Spine?
12
What does the T mean in T-spine?
Thorasic
What does concave mean?
Inward
What does convex mean?
Outward
Is C-spine concave or convex?
convex
How many pairs of ribs do we have?
12
How many ribs do we have?
24
Is T-spine concave or convex?
Concave
What is the vertebral prominens?
MARKER
Large bump on the back of our neck
d/t C7 spinous process
T1 is larger than C7 so probably from T1 but book says C7
Describe the spinous processes in T-spine
Angled downward (hard to access with a needle midline) ** only in T spine**
What is connected to the Tspine?
RIBS! yum
12 T-vertebraes for
12 pairs of ribs
Where do the ribs connect to the spine?
Superior/inferior/On transverse processes Costal facets -
How many costal facets do ribs attach to?
3
T/F: Costal facets are on top of or lateral to transverse process?
T
How many ribs do we have on each side of the body?
12
Where does Rib 1 connect?
Top of T1
Which ribs have limited connections?
How many connections do they have?
11 and 12
1
What ribs are easiest to get moved out of place and why?
11 and 12
floating ribs
What ribs directly connect to the sternum? What are they called
1-7
True ribs
What ribs are indirectly connected to the sternum? what are they called?
8-10
false ribs
What ribs arent connected to the sternum? What are they called?
11-12
floating ribs
What connects the ribs to the sternum?
Costal cartlidge
How do the false ribs connect to the sternum?
The costal cartlidge connects to the rib 7’s costal cartlidge
What sits in between vertebral bodies?
intervertebral disks
How many vertebrae does a rib connect to?
2
What part of the rib about connects to the costal facets?
Head
Describe the body of T-spine vertebrae
L side of the body flat/compressed d/t the aorta of the heart being right there
What does the L in lumbar stand for?
LARGE
large vertebraes
Is the L-spine convex or concave?
convex
T/F: The L spine is okay to access midline with a needle
T
The L spine supports lots of ______
weight
What is the most popular part of the spine for epidurals and spinals?
L spine
How do we get more room for access between the spinous processes in the L spine?
Ask the pt to round their back and lean forward
What is the intervertebral foramen?
Consist of inferior and superior vertebral notch where spinal nerves come out
What does lordotic mean?
Convex
What does kyphotic mean?
Concave
What are transverse lines in S spine
Where the fusion of vertebrae took place
What are the sacral foramina?
Where the spinal nerves exit.
How many sacral foramina and spinal nerves are there in the S spine?
8 sacral foramen
10 spinal nerves
Where does the last intervertebral disk sit on the S spine?
Promontory
this is the weight supporting structure on top of the sacrum
What is the Superior articular process on the S Spine?
MARKER
How many vertebrae were fused in the S spine?
5
Where can we give drugs in the S spine?
Posterior Sacral foramina
What are the fused spinous processes of the S spine called?
Median Sacral Crest
what are the fused transverse processes of the S spine called?
Lateral sacral crest
Where does the spinal nerves exit the S spine for coccygeal?
Sacral hiatus
How many actual vertebrae does the Coccyx have?
2
The area around the Median sacral crest is…
Medialllllll sacral crest or intermediate
How many vertebrae does the coccyx start with?
4
When you palpate the top of your pelvis what is that?
Illiac crest
Horizontal line should put you at L4
** Under will give you L4/L5
abouve will give you L3/L4 **
How do you give drugs through the Sacrum?
Throught the S2 posterior sacral foramina.
You can SEE and Palpalate the Superior illiac spines on your lower back.
Looks like 2 little bumps
from there go DOWN 1 cm
go to MIDLINE 1 cm
Why dont we use S1 sacral foramina for drugs?
turned to the side; harder access
What are palpable markers in the anterior pelvis?
Anterior superior and inferior iliac spines
pubic tubercles
What is a palpable on the femur?
greater trochanter
What is the difference in anatomy of a female vs male pelvis?
Female is wider
What connects the 2 sides of the anterior pelvis?
Pubic symphysis (cartlidge)
What is significant about the inguinal ligament?
Where we normally see fat fold over from the stomach area
What connects the transverse processes of L4 and L5?
Iliolumbar ligament
The pelvis is a part of the _____ spine?
S-Sacral
Where does the umbilicus put you?
L3/L4
Why isnt umbilicus a good marker?
Different weights
The greater trochanter is our 2nd set of ____
hips
Describe: Intervertebral disks
Gel filled cushion (pulosus)
outside is fibrous
sandwhiched in between cartlidge (Not cartlidge itself)
gets lost with fushion
What type of pattern does the intervertebral disks have?
Crosshatch
Describe the Posterior Longitudinal ligament
No crosshatch
Very weak
Where most herniated disks are
How do herniated disks happen?
Loss of nucleous pulposus (gel) and weak spots in the fiber surrounding it.
Herniation can happen from trauma or genetics
Gel comes through the fiber mostly in the posterior longitudinal ligaments
What are treatments for a herniated disk?
Discesctomy
Spinal fusion
Laminectomy
Which procedure is the best for herniate disk?
Laminectomy by a neurosurgeon
only removing a very small part of the bone thats causing the problem
Best treatment for lower back pain?
PT
Hamstring workouts/stretches
intervertebral foramen usually compressed from hamstring tension from ligaments being pulled.
What part if the spine is being affected by lower back problems?
Lumbar
What are the 3 layers of connective tissue that surround the CNS?
Pia mater
Arachnoid layer
Dura later
Mater =
Layer
Describe the Pia Mater
1st layer directly on top of brain.
On top of neurons and glial cells
Describe the Arachnoid layer
2nd layer: Superficial to pia mater, blood vessles of the CNS, CFS filled compartment
translucent
Where are the spinal arteries and veins located in the Spine?
Superior to pia mater but inferior to arachnoid layer.
Describe the Dura mater
3rd and outtermost later- superficial to arachnoid layer
tough and robust
What is the “potential space” in the connetive tissues
Space between arachnoid layer and dura layer
“Subdural space”
There”s nothing there…..
