Scenario 20 Flashcards
What are the main functions of the vertebral column?
Main axial support for the body preventing attachments to the skull, thorax and pelvic girdle, protection of the spinal cord and flexibility
What is the function of the vertebral body?
To transmit the load from one body to the next, outer shell of cortical bone and trabeculated internal strucure filled with blood
What part of the vertebrae is damaged in osteoporosis?
Cervical trabeculae become spindly
What is the purpose of the laminae?
Protection of the contents of the vertebral column and transmission of force from articular processes to the body
What are the function of the articular processes
Synovial joints permitting a limited ROM
Cevical pivot then vertical
Throacic are vertical (limit flex and ext but permits rotation)
Lumbar- curved (limits rotation)
What are the functions of the pedicles?
Connection between posterior element and body of vert have obliquely arranged trabeculae to withstand forces
What is typical of the cervical vert?
Ant and post tubercles for scalene muscle attachment, neurocentral articulation, FORAMEN TRANSVERSARUM (vert art and veins), large vert formaen for brachial plexus)
What cervical vert are specialised?
C1- atlas- not prominent spine and no body- transverse log
C2- axis- has a dens
C7- long prominent spinous process with no bifid end
What is specialised about the thoracic vertebrae?
Places for articulations with ribs
What is specialised about the lumbar vertebrae?
L1-L2 oval formane (spinal cord), L3-5 corda equina- triangular foramen
What is the total range of flexion and extension of the spine?
250 degrees
What is the purposed of the IVDs?
rocking rotion required for flex and ext
What are the 3 parts of the IVD?
Nucleus pulposes- toothpaste consistency, deformable but cant change volume
Annulus fibrosus- highly ordered lamellae of collagen type I thicker anteriorly and more tightly packed posteriorly, strong and resist deformation
Vertebral end plate- hyaline cartilage surrounding nucleus- permeable between nucleus and bone, prevent nucleus bulging up
Where does the ant longitudinal lig lie?
Anterior surface of the vertebral bodies attached from the occipital bone to upper sacrum
Deep layers from 1 vert to the next, superficial over several vert
Where does the post long lig lie?
inside vert column on post side of the bodies from the axis to the sacrum attaching to IVDs
Where does the ligamentum flavum lie?
Connects lamina of adj vert from articular capsule to place where lamina joins the spine mostly elastic tissue to prevent separation happening too quickly and protecting IVD
Which lig are tense in flexion?
Ant longitudinal slack post long tensed
What lig are tense in extension?
Ant tensed post slack
What is a compression fracture?
Occurs mostly in thoracic region in loading of the spine and flexion/ lat flexion or just from weakening in osteoporosis. Body of the vert most likely to suffer but repairs quickly
What are the possible causes of IVD failure?
Damage to endplate compressing the height of the IVD (happens with age), bending movement thins the annulus if compression happens simultaneously the nucleus can herniate through the annulus
What are the consequences of IVD failure?
Load sharing affected- neural arch increased loss, fluid can be lost fromthe disk or slack ligaments leading to laxity osteophytes may develop restoring stability but decreasing ROM.
What is cauda equina syndrome?
Severe back pain, saddle anaesthesia, bladder and bowel dysfunction, sciatica, lower limb and muscle weakness
What is spondylolysis and sponylolilethsis ?
Idiopathic defect developing on neural arch 85% on L5 can cause back pain. If it results from fracture of the pars interarticularis may result in forward movement of vertebra and sponylolisthesis- scoliosis in children, adult back pain (scottie dog with collar) failure of lamina
What is the outcome of an atlas fracture?
from a vert force through skull, bony ring forces open by occipital condyles need to support with a collar.
