Osteology of the Back

Question 1

What are the vertebral regions? How many vertebrae are in each?

Answer 1

Cervical= 7
Thoracic= 12
Lumbar= 5
Sacral= 5
Coccygeal= 4

Question 2

What are the features of a typical vertebra? Where does everything point

Answer 2

Body= anterior

Two transverse processes= lateral, lamina +pedicle

Spinous process= posterior, joins the 2 lamina

Joined by the lamina and pedicle

• pedicle= more anterior connects vertebral body to transverse processes
• lamina= connects transverse process to spinous processes, protect spinal cord

Vertebral foramen= hole in middle for spinal cord

superior and inferior articulating facets

Question 3

What are features specific to a cervical vertebrae?

Answer 3

Have transverse foramen made by costotransversebar= small holes in transverse process for vertebral artery and vein,
- anterior and posterior tubercles of transverse processes

Bifid spinous process= spinous process splits into two bumps on the end unlike in thoracic and lumbar

Large triangular vertebral foramen

Question 4

What is unique about C1 (atlas)?

Answer 4

Ring of bone with no body

Has posterior arch with posterior tubercle and anterior arch with anterior tubercle

superior side more cup shaped

Question 5

What is unique about C2 (axis)?

Answer 5

Body forms a projection called the odontoid process aka dens

Question 6

What is unique about C7 (vertebra prominens)?

Answer 6

Does not have a bifid spinous process like all other cervical vertebrae

Looks like thoracic vertebrae but can be distinguished by its transverse foramen

Question 7

What are defining characteristics of thoracic vertebrae?

Answer 7

NO transverse foramen aka little holes

Costal facets (only vertebrae that has!)
- find them on the body and transverse process 

small round vertebral foramen and heart shaped vertebral body

well pronounced lamina

strongly inferiorly directed spinous process

Question 8

Where do the articular facets face?

Answer 8

Superior= face posteriorly 
Inferior= face anteriorly towards body

Question 9

How do the ribs articulate with the thoracic vertebrae?

Answer 9

Articulates with vertebrae of the same number and the vertebrae above it

Tubercle articulates with the transverse costal facet of the same number

Head articulates with the superior costal facet of the corresponding vertebra and the inferior costal facet of the vertebrae above

EX. rib 5 articulates with the transverse process of vertebrae T5 and bodies of vertebrae T4 and T5

Question 10

What is a defining feature of lumbar vertebrae?

Answer 10

Larger than vervical and thoracic

Lack transverse foramen, bifid spinous processes and costal facets

Have mammillary process which is a bump on outside of superior articular facet (sometimes hard to appreciate so look for lack of features)

large oval shaped vertebral foramen and kidney shaped body

long slender transverse process

short sturdy hatchet shaped spinous process

accessory process on transverse

Question 11

What is the sacrum? What are defining features?

Answer 11

Formed by fusion of vertebrae S1-S5

Base part articulates with L5 at promontory

Laterally articulates with the ilium bones on either side at the articular surfaces on the wings

Inferiorly at apex articulates with coccyx

4 anterior and posterior foramina which pass the anterior and posterior division of the sacral nerves

Posteriorly has median crest (directly in middle) and 2 medial crests and 2 lateral crests

sacral cornua (horn) and sacral hiatus (gap)

sacral ala on front aka wings and transverse lines

Question 12

What is a Jefferson or burst fracture?

Answer 12

Normally caused by blow to the top of the head or a diving accident

Fracture alone will not typically injure the Spinal Cord; however, if the Transverse L. is ruptured the Odontoid Process my injure the Spinal Cord

C1/axis fracture

Question 13

What is a Hangman’s fracture?

Answer 13

Fracture of the vertebral arch of the axis

Occurs usually as a result of hyperextension of the Head at the neck (NOT whiplash)

Can be splinted depending on how much damage to the spinal cord

Question 14

What is a fracture of the odontoid process of the axis?

Answer 14

May occur after a horizontal blow to the Head, and since the transverse L. is stronger than the Odontoid Process it break

If it breaks at its base it wont heal because Transverse l. is holding it away from its blood supply, better chance of healing if breaks inferiorly to base (type I -III type III the worst because of the blood supply, includes chunk of body)

Question 15

What is Spina Bifidia Occulta?

Answer 15

Developmental abnormality in which the Vertebral Lamina fail to fuse and close off the Vertebral Canal
- incomplete formation of the posterior arch

Commonly occurs atL5 and S1, where it can go undetected due to the overlying skin, often tuft of hair over defect, fatty deposit, or hemangioma

Question 16

Why do the cervical vertebrae require less force to dislocate?

Answer 16

Articulating Facets of Cervical Vertebrae are more horizontal that the other Vertebrae

Due to the large Vertebral Foramen this does
not usually result in injury to the Spinal Cord

Question 17

What is SpondylOSIS?

Answer 17

DEGENERATION joint disease which involves calcification of the edges of the vertebral
body and can cause localized pain and stiffness

pathological condition

Question 18

What is SpondyloLISTHESIS?

Answer 18

Anterior DISPLACEMENT of the Vertebral Body on the Inferior Vertebral Segment

Can occur secondary to spondylosis
Slippage

Question 19

What is Lumbar Spinal Stenosis?

Answer 19

Narrowing of the Lumbar Vertebral Foramen because of inflammation (hole gets smaller)

May cause compression of one or ore Spinal Nerve Roots

Condition is further compounded with
Intervertebral Disc bulging, Arthritic Proliferation and Ligamentous Degeneration the Vertebral Canal is considerably more compromised

Question 20

What is a lumbar puncture?

Answer 20

AKA spinal tap= important diagnostic procedure for evaluating a variety of central nervous system disorders

A needle is inserted between either the L3/ L4 vertebrae or L4/L5 vertebrae at the level of the iliac crest
- level chosen to avoid the needle injuring through the spinal cord because cord stops around L2 and then is just roots and rootlets

As the needle passes through the liagmentum flavum it “pops” and passes into the lumbar cistern deep to the spinal dura and arachnoid mater. Cerebrospinal fluid can then be draw out and evaluated

Question 21

What is sacrilization of the L5 Vertebra (Hemisacrilization)?

Answer 21

The partial or complete incorporation of the L5 Vertebral Segment into the Sacrum

Question 22

What is Lumbarization of the S1 Vertebra?

Answer 22

separation of the S1 vertebra from the Sacrum

Question 23

What can cause coccygeal trauma?

Answer 23

Abrupt falls on the lower back and difficult child birth can result in bruising, dislocation or fracture of the Coccyx

When turns into Coccygodynia it is painful and difficult to treat

Question 24

What are the primary curvatures of the vertebral column?

Answer 24

Thoracic and Sacral Kyphoses

Question 25

What are the secondary curvatures of the vertebral column?

Answer 25

the Cervical and Lumbar Lordoses, as they result from extension from the Fetal Position

Question 26

What is Kyphosis?

Answer 26

Exaggerated curving of the Thoracic Vertebral Column resulting in “hump-back.”

Question 27

What is Lordosis?

Answer 27

Exaggerated curving of the Lumbar Vertebral Column resulting in “sway-back.”

Question 28

What is scoliosis?

Answer 28

Lateral curving of the spine, either to the right of left

Question 29

What is spyndyloLYSIS?

Answer 29

FRACTURE at lamina or pencile of arch

Separation of the Vertebra Arch from the Vertebral Body