NSB 4. Cervical Spine, Cord, Nerves and Skull Osteology Flashcards
What are the 3 different/unique/important cervical vertebrae?
[1] C1 - Atlas
[2] C2 - Axis
[3] C7
What are the important/defining physical traits of a cervical vertebrae?
[1] Small, Kidney-Shaped Vertebral Body (except C2 and C2)
[2] Foramen Transversarium**
- on either side (2x)
- where arterial blood supply goes through
[3] Large Triangular Canal
[4] Bifid Spinous Process (at back)
In regards to the size of the vertebral body, what happens to them as you go down the spine?
the size of the vertebral body increases (because you need more support)
What are the different parts of the typical vertebral body (e.g. lumbar)
[1] Vertebral Body [2] Pedicles [3] Lamina [4] Transverse Processes [5] Superior Articular Facet [6] Inferior Articular Facet
What is the type of joint between the vertebral bodies?
secondary cartilaginous joint
What are the parts of the C7 vertebrae?
[1] Small, Kidney Shaped Vertebral Body
[2] Triangular Vertebral Canal
[3] Vertebra Pominens
- doesn’t have a bifid spine
[4] Transverse Foramen
What are the defining part of the C1 (atlas) vertebrae?
[1] NO body
- it has anterior and posterior arches
[2] NO Spinous Process
[3] Kidney-Shaped Facets Superiorly (for Occipital Condyles)
- allows nodding of head up and down
[4] Groove for Vertebral Artery (on upper surface)
[5] Transverse Foramen
[6] Lateral Masses
What are the parts + ligaments of the C2 (axis) vertebrae?
[1] Superior Articular Surfaces (for C1 to rotate)
- a pivot joint
[2] Dens/Odontoid Process
[3] Transverse Ligament of the Atlas
[4] Alar Ligament
[5] Pedicles
[6] Lamina
[7] Transverse Process + Transverse Foramen
What are the joints between the articular processes of the adjacent vertebrae?
facet joints
Where are the facet joints in the spine cord located?
they are located between the articular processes of the adjacent vertebrae
What are the ligaments of the spinal cord?
[1] Anterior Longitudinal Ligament
[2] Posterior Longitudinal Ligament
[3] Ligamentum Flavum (Flava)
- is at the back of the spinal canal and not the spinal cord
[4] Interspinous Ligament
[5] Supraspinous Ligament
[6] Ligament Nuchae
What is the ligament nuchae?
- a thick ligament at the back of the neck
- where the cervical vertebrae are bifid, the ligament runs through the midline
What position do you need the person to be in when doing a lumbar puncture?
patient needs to be in FETAL POSITION
Why are lumbar punctures done?
to gain a specimen of CSF
Why would you not do a lumbar puncture if there is raised CSF?
- if raised ICP
- lumbar puncture can cause cerebral herniation
- this is due to decreased pressure in the spinal cord due to the removal of CSF
Where does the spinal cord end in adults?
L1/L2
Where does the spinal cord end in children?
L3/L4
What are the layers that are passed through when doing a lumbar puncture? (from outside to in)
[1] Skin [2] Subcutaneous Tissue [3] Muscle [4] Supraspinous Ligaments [5] Interspinous Ligaments [6] Ligamentum Flavum [7] Dura Mater [8] Arachnoid Mater
What are the primary curvatures of the spine?
[1] Thoracic
[2] Sacral
What are the secondary curvatures of the spine?
[1] Cervical
[2] Lumbar
What is the path that the vertebral artery takes?
- arises from the subclavian artery
- it ascends in the transverse foramen (from C6 to C1)
- – not in C7
- it runs in the groove of the atlas
- it enters the foramen magnum
Where does thickening of the spinal cord arise? Why does it occur?
[1] Cervical Enlargement
[2] Lumbar Enlargement
- thickening occurs when you have a plexus/lots of nerves supplying parts of the body (e.g. upper limb)
Where does the subarachnoid space end in the spinal cord?
S2
What is the Filum Terminale?
it is the extension of pia mater to the coccyx
Where are the cervical spinal nerves located in relation to the cervical vertebrae?
- the first 7 cervical nerves run above the cervical vertebrae
- the 8th cervical nerve runs below the cervical vertebrae
What are the layers of the vertebral canal/spinal cord from inside to out?
[1] surrounded by meninges [2] pia mater [3] subarachnoid space - CSF [4] arachnoid mater [5] dura mater [6] extradural/epidural space (containing loose connective tissue, fat + venous plexus)
What is the arterial supply of the spinal cord?
[1] Anterior Spinal Artery
- from vertebral arteries
[2] Posterior Spinal Artery
- from Posterior Inferior Cerebellar Artery (PICA)
[3] Segmental Arteries
- Artery of Adamkiewicz – lower thoracic or upper lumbar region
What is the venous drainage of the spinal cord?
- drains into the internal vertebral plexus in the extradural/epidural space
- there are NO valves (this allows cancer to spread more easily)
What are the different parts of the skull bone?
[1] Frontal [2] Parietal [3] Temporal [4] Sphenoid (GW) [5] Pterion (the junction/union of the 4 bones -- it is a weakpoint) [6] Zygomatic Arch [7] Temporal Mandibular Joint
Why is the Pterion important?
- it is important as it is a weakpoint in the skull
- the middle meningeal artery runs behind the pterion
What are the 3 main cranial fossae?
[1] Anterior Cranial Fossae
[2] Middle Cranial Fossae
[3] Posterior Cranial Fossae
What are the main parts of the Anterior Cranial Fossae?
[1] frontal lobe of brain [2] lesser wing of sphenoid bone [3] crista galli [4] cribriform plate (ethmoid plate) [5] foramen cecum
What are the main parts of the Middle Cranial Fossae?
[1] greater wing of sphenoid bone [2] foramen ovale [3] foramen spinosum [4] parts of temporal bone (medial) [5] outer ridges of parietal bone
What are the main parts of the Posterior Cranial Fossae?
[1] mainly occipital bone [2] bits of temporal + parietal bones [3] clivus [4] jugular tubercle [5] internal acoustic canal/meatus [6] jugular foramen [7] hypoglossal canal [8] foramen magnum
