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N931 Advanced Principles of Anesthesia I > Neuraxial Anatomy > Flashcards

Neuraxial Anatomy Flashcards

1
Q

how many bones are in the vertebral column?

A

33 bones

extends from the base of the skull to the tip of the coccyx

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2
Q

how many of each type of vertebrae are there?

A
  • 7 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 1-5 coccygeal
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3
Q

vertebral column functions

A
  • protects spinal cord

- allows us to stand upright

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4
Q

what are the four natural curves of the vertebral column?

A
  • anterior curves - cervical and lumbar

- posterior curves - thoracic and sacral

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5
Q

how many spinal nerves are there?

A

31 spinal nerves

NOTE - 8 cervical (one extra above C1)

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6
Q

C7

A

vertebra promins

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7
Q

T7

A

inferior angle of the scapula

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8
Q

L4-L5

A

Tuffier’s line

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9
Q

common elements of vertebrae

A
  • body
  • pedicle
  • lamina
  • transverse process
  • spinous process
  • vertebral foramen
  • intervertebral foramen
  • superior articulating process
  • inferior articulating process
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10
Q

features of cervical vertebrae

A
  • spinous process bifid
  • small body
  • vertebral foramen large and triangular
  • transverse foramen for vertebral artery
  • facets flat, open and dorsal facing, LARGE rotation
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11
Q

atlas

A

C1; supports the head, practically fused to the base of the skull (occipital condyles) and has no body

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12
Q

axis

A

C2; the body of C1 is fused to C2 to form the dens; dens is held in place by ligaments and pivots to allow the head to turn

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13
Q

features of thoracic vertebrae

A
  • long spinous processes
  • heart-shaped body
  • long transverse process
  • rib facets; flat and upward
  • vertebral foramen round
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14
Q

features of thoracic vertebrae

A
  • large bodies, kidney shaped
  • vertebral foramen triangular
  • thick short transverse processes
  • thick, short spinous processes
  • facets face medially and are cupped/curved; limited rotation
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15
Q

sacrum

A
  • five fused vertebrae
  • posterior sacral foramina
  • posterior wall of pelvic cavity
  • sacral promontory aka base
  • area toward coccyx is the apex
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16
Q

coccyx

A
  • tiny little pebble-like bones

- tailbone made up of 3-4 fused segments

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17
Q

lumbarization

A

L5 and S1 fused

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18
Q

sacralization

A

S1 and S2 fused

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19
Q

what are the three posterior ligaments

A
  • supraspinous
  • interpinous
  • ligamentum flavum
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20
Q

supraspinous

A

-thick major ligament in C & T area

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21
Q

interspinous

A

-3 layers, connects spinous processes, thin in lumbar region

22
Q

ligamentum flavum

A

-strongest in thoracic, yellow/elastic tissue

23
Q

Structures traversed with spinal needle

A
  • skin
  • subcutaneous tissue and fat
  • supraspinous ligament
  • intraspinous ligament
  • ligamentum flavum
  • epidural space
  • dura
  • subarachnoid space
24
Q

Structures traversed with epidural needle

A
  • skin
  • subcutaneous tissue and fat
  • supraspinous ligament
  • intraspinous ligament
  • ligamentum flavum
  • epidural space
25
Q

how long is the spinal cord?

A

43 cm in women, 45 cm in men

26
Q

what is the diameter of the spinal cord?

A
  • 1 cm in diameter

- wider in the cervical region, more extremities and more cell bodies

27
Q

dura mater

A
  • outermost, tough fibrous layer
  • tough mother
  • extends from foramen magum to S2-S3
28
Q

arachnoid mater

A
  • delicate middle layer
  • looks like spider web
  • non vascular
  • between dura and pia
  • ends at S2
29
Q

pia mater

A
  • fine and thin; tender mother
  • highly vascular
  • lies directly on the brain and spinal cord
30
Q

how far does the spinal cord extend

A
  • adults = L1

- children = L3

31
Q

conus medularis

A

the cone-like end of the spinal cord

32
Q

filum terminale

A
  • a delicate strand of fibrous tissue, about 20 cm in length, proceeding downward from the apex of the conus medullaris
  • inserts onto first sacral vertebral body
  • extension of pia
33
Q

dorsal horn

A
  • posterior horn

- sensory information received here

34
Q

ventral horn

A
  • anterior horn
  • motor information originates here
  • cell bodies exist here at all levels
35
Q

lateral horn

A

-interomediolateral column
-autonomic
-cell bodies here bot not at all levels
T1-L2, S1-S2

36
Q

dorsal root

A

sensory only

37
Q

ventral root

A

motor only

38
Q

mixed spinal nerve

A

where the dorsal and ventral roots come together

39
Q

dorsal ramus

A

sensory and motor

40
Q

ventral ramus

A

sensory and motor

41
Q

cauda equina

A
  • horses tail
  • end of spinal cord past L1
  • nerve roots hang freely within thecal sac
  • like noodles in chicken noodle soup
42
Q

subarachnoid space

A
  • between pia and arachnoid
  • CSF found here
  • site of spinal anesthesia
  • smaller amount of anesthesia (subarachnoid, intrathecal)
43
Q

epidural space

A
  • potential space

- continuous space within vertebral canal

44
Q

what does the epidural space contain?

A
  • fat
  • arteries
  • veins
  • lymphatics
  • nerve roots
45
Q

what is the average distance form skin to lumbar epidural space?

A

5cm

RANGE 2.5 - 8 cm

46
Q

CSF

A
  • clear, colorless fluid
  • selective filtrate of the blood
  • function - mechanical buffer to protect brain and spinal cord
47
Q

Total CSF volume in adult

A

150 mL

-produce 21 mL/hr

48
Q

how much CSF does spinal subarachnoid space hold?

A

20-35 mL

49
Q

what is the sp gravity of CSF?

A

1.003-1.009

50
Q

arterial blood supply to spinal cord

A
  • segmental arteries
  • longitudinal arteries (1 anterior, 2 posterior)
  • radicular
51
Q

artery of adamkiewicz

A
  • supplies blood to distal 2/3 of spinal cord

- dominant thoracolumbar segmental medullary artery

52
Q

venous blood to spinal cord

A
  • epidural veins
  • valveless plexus
  • most prominent lateral

N931 Advanced Principles of Anesthesia I (19 decks)

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