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Year 1 Semester 2 Musculoskeletal System > S2) Vertebral Column > Flashcards

S2) Vertebral Column Flashcards

1
Q

What is the vertebral column?

A

The vertebral column is a vertical series of approx. 33 small vertebrae bones, which are separated by intervertebral discs

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2
Q

What are the five main functions of the vertebral column?

A

- Support: carries the weight of the body above the pelvis

- Haemopoiesis: red bone marrow production

- Axis: forms the central axis of the body

- Movement: highly flexible structure

- Protection: encloses and protects the spinal cord and the cauda equina within the spinal canal

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3
Q

Identify the sections of the vertebral column as well as the number of vertebrae found in each

A
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4
Q

All vertebrae share a basic common structure.

Describe it

A
  • Consists of an anterior vertebral body
  • Consists of a posterior vertebral arch
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5
Q

Describe the structure, function and location of the vertebral body

A
  • Structure: hyaline cartilage lines superior and inferior aspects
  • Function: weight-bearing component (size increases as the vertebral column descends)
  • Location: anterior part of the vertebrae
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6
Q

What separates adjacent vertebral bodies?

A

Adjacent vertebral bodies are separated by a fibrocartilaginous intervertebral disc (annulus fibrosis)

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7
Q

What is the vertebral foramen and why is it significant?

A
  • The vertebral foramen is an enclosed hole formed by the vertebral body and the vertebral arch

- The foramina of the all vertebrae line up to form the vertebral canal, which encloses the spinal cord

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8
Q

Identify the 5 different bony prominences on a typical vertebrae

A
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9
Q

Identify the 3 distinguishing characteristics of the cervical vertebrae

A
  • Bifid spinous processes (except C7)
  • Transverse foramina (conduct the vertebral arteries)
  • Triangular vertebral foramen
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10
Q

Identify the 4 distinguishing characteristics of the thoracic vertebrae

A
  • Two ‘demi facets‘ on each side of the vertebral body (articulate with head of the respective rib, and inferior rib)
  • Costal facets on transverse processes (articulation with respective rib)
  • Spinous processes are slanted anteroinferiorly
  • Circular vertebral foramen
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11
Q

Identify 2 distinguishing characteristics of the lumbar vertebrae

A
  • Large kidney-shaped vertebral bodies
  • Triangular vertebral foramen
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12
Q

Identify 2 distinguishing characteristics of the sacral vertebrae

A
  • Five fused vertebrae
  • Facets on lateral walls (articulation with the pelvis at the sacro-iliac joints)
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13
Q

Identify 3 distinguishing characteristics of the coccyx vertebrae

A
  • Fused vertebral bodies
  • No vertebral arches
  • No vertebral canal (does not transmit the spinal cord)
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14
Q

Identify and describe the major joints of the vertebral column

A
  • Fibrocartilaginous joints: between vertebral bodies (indirectly)
  • Facet joints: between inferior and superior articular processes
  • Costovertebral joints: between head of rib and thoracic vertebral body
  • Costotransverse joints: between tubercle of rib and thoracic transverse process
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15
Q

Identify the two ligaments that strengthen the vertebral fibrocartilaginous joints and describe their function

A
  • The anterior longitudinal ligament is thick and prevents hyperextension of the vertebral column
  • The posterior longitudinal ligament is weaker and prevents hyperflexion of the vertebral column
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16
Q

Identify the four ligaments which strengthen the facet joints in the vertebral column

A
  • Ligamentum flavum
  • Interspinous ligaments
  • Supraspinous ligaments
  • Inter transverse ligaments
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17
Q

Describe the structure and location of the ligamentum flavum

A
  • Structure: yellow in colour, composed of elastic fibres
  • Location: extends from lamina to lamina of adjacent vertebrae
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18
Q

Describe the structure and location of the interspinous ligaments

A
  • Structure: relatively weak sheets of fibrous tissue, fused with supraspinous ligaments
  • Location: extends between spinous processes of adjacent vertebrae
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19
Q

Describe the structure and location of the supraspinous ligaments

A
  • Structure: strong bands of white fibrous tissue
  • Location: extend between tips of adjacent spinous processes
20
Q

Describe the structure and location of the inter transverse ligaments

A
  • Structure: blend with intertransverse muscles

- Location: extends between transverse processes

21
Q

Describe the structure and function of the intervertebral discs

A
  • Structure: consists of nucleus pulposus (central) and annulus fibrosus (peripheral)
  • Function: account for 25% of the length of the vertebral column
22
Q

Describe the composition of the intervertebral discs

A
  • 70% Water
  • 20% Collagen
  • 10% Proteoglycans
23
Q

Describe the structure, function and location of the annulus fibrosis

A
  • Structure: outer lamellae of Type 1 collagen and fibrocartilaginous inner lamellae, avascular and aneural
  • Function: major ‘shock absorber’
  • Location: surrounds nucleus pulposus
24
Q

Describe the structure and location of the nucleus pulposus

A
  • Structure: remnant of notochord, gelatinous, Type 2 collagen
  • Location: surrounded entirely by annulus fibrosus
25
Q

A slipped disc is a herniation commonly occurring at L4/5 and L5/S1.

Identify the four different types

A
  • Disc degeneration: aging causes disc to dehydrate and bulge

- Prolapse: protrusion of the nucleus pulposus with slight impingement into the spinal canal (contained)

- Extrusion: nucleus pulposus breaks through annulus fibrosus (undisplaced)

- Sequestration: nucleus pulposus breaks through annulus fibrosus and separates from the main body of the disc (displaced)

26
Q

What are the types of disc prolapse?

A
  • Lateral disc protrusion usually compresses the nerve root above (5%)
  • Paracentral disc protrusion usually compresses the nerve root below (95%)
27
Q

In a paracentral herniation of the L4/5 disc, why is the L5 root is most frequently compressed?

A

The L5 root is compressed as the L4 root emerges above the level of the L4/5 disc (but below the L4 vertebrae)

28
Q

What is sciatica?

A

Sciatica is the compression of the nerve roots which contribute to the sciatic nerve

29
Q

Identify the different types of sciatica and the parts of the limb affected

A
  • L4 Sciatica – anterior thigh, anterior knee, medial shin
  • L5 Sciatica – lateral thigh, lateral calf, dorsum of foot
  • S1 Sciatica – posterior thigh, posterior calf, heel, sole of foot
30
Q

What is Cauda Equina Syndrome?

A

Cauda equina syndrome is a serious condition that comes with extreme pressure and swelling of the nerves at the end of the spinal cord

31
Q

Identify 5 red flag signs/symptoms of cauda equina syndrome

A
  • Bilateral sciatica
  • Perianal numbness
  • Painless retention of urine
  • Urinary / faecal incontinence
  • Erectile dysfunction
32
Q

What is lumbar spinal stenosis?

A
  • Lumbar spinal stenosis (LSS) is a clinical condition in which the spinal canal narrows and compresses the spinal cord and nerves at the level of the lumbar vertebrae
  • It is caused by ageing, spinal disc herniation, osteoporosis or a tumour
33
Q

What is neurogenic claudication?

A

Neurogenic claudication is a common symptom of lumbar spinal stenosis or inflammation of the spinal nerves involving pain in the legs during motion

34
Q

In 5 steps, describe the pathophysiology of neurogenic claudication

A

⇒ Venous engorgement and arthritis causes osteophyte formation

⇒ Spinal canal narrows

⇒ Blood supply to nerve is limited

⇒ Nerve roots become ischaemic

⇒ Pain occurs during motion

35
Q

What is spondylolisthesis?

A

Spondylolisthesis is a slip forwards of the vertebrae above on the vertebra below due to a fracture in the pars interarticularis

36
Q

What are the different types of spondylolisthesis?

A
  • Dysplastic (abnormality in facet joint shape)
  • Isthmic (pars interarticularis defect)
  • Degenerative
  • Iatrogenic
  • Pathological
37
Q

Which part of the vertebrae is known as pars interarticularis?

A

Pars interarticularis is located between the superior and inferior articular process of the facet joint

38
Q

Distinguish between the following terms:

  • Spondylosis
  • Spondylitis
  • Spondylolysis
  • Spondylolisthesis
A

- Spondylosis: age-related wear and tear to bones of the spine

- Spondylitis: inflammation of the joints of the spine

- Spondylolysis: fractures in pars interarticularis

- Spondylolisthesis: movement of one vertebrae relative to the ones above/below it

39
Q

Describe the structure of the foetal vertebral column

A

The vertebral column is flexed in a single C-shaped curvature (primary curvature) which is concave anteriorly (kyphosis)

40
Q

Where is the primary curvature maintained in adult life?

A
  • Thoracic region
  • Sacral region
  • Coccygeal region
41
Q

Describe the structure of the vertebral column in the young adult

A

4 distinct curvatures:

  • Kyphoses (anterior flexions): thoracic and sacrococcygeal
  • Lordoses (posterior flexions): cervical and lumbar
42
Q

Describe the development of the secondary curvatures

A

- Cervical lordosis appears when young child begins to lift its head

  • Lumbar lordosis develops when child begins to standup and walk
43
Q

Senile kyphosis develops in old age.

What is this?

A

Senile kyphosis – secondary curvatures start to disappear and the continuous primary curvature is re-established

44
Q

Describe the structure of the vertebral column during pregnancy

A

Exaggeration of lumbar lordosis

45
Q

What are the weak points of vertebral column (centre of gravity)?

A
  • C1 & C2
  • C7 & T1
  • T12 & L1
  • L5 & S1

Year 1 Semester 2 Musculoskeletal System (24 decks)

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