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YR2: Head, Neck and Spine > Session 2: Vertebral Column and Spinal Cord > Flashcards

Session 2: Vertebral Column and Spinal Cord Flashcards

1
Q

Which part is the lamina of the vertebra?

A

Between the spinous process + transverse process

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2
Q

What are the 3 main features of a typical vertebrae? What are the functions of each?

A 
Vertebral body (weight bearing)
Vertebral arch ("roof" of vertebral canal, projections for attachment of muscles + ligaments, has sites of articulation for adjacent vertebrae)
Pedicles (anchor vertebral arch to vertebral body)
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3
Q

Describe 5 distinctive features of cervical vertebrae.

A

Triangular vertebral foramen
Rectangular vertebral body
Transverse foramina in the transverse processes
Bifid spine (except C1 + C7)
Atlas + axis (C1 + C2) are specialized for movement

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4
Q

Describe 5 distinctive features of thoracic vertebrae.

A

Bigger than cervical vertebrae
Circular vertebral foramen
Heart shaped vertebral body
Spinous process pointing sharply downwards
Transverse costal facets (for rib articulation)

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5
Q

Describe 5 distinctive features of lumbar vertebrae.

A

LARGE
Articular facets are angled to limit movement
Thin, long transverse processes (except L5)
Triangular vertebral foramen
“Kidney shaped” vertebral body

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6
Q

How many bones fuse to form the sacrum?

A

5

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7
Q

Describe the structure of the sacrum.

A

Concave anterior surface
Triangular in shape
L shaped articular facets (for articulation with pelvic bones)

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8
Q

How many bones fuse to form the coccyx?

A

3-4

Vertebral arches + canal are absent

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9
Q

Between which vertebrae do you find intervertebral discs?

A

C2-S1

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10
Q

What are the 2 parts of the intervertebral disc?

A

Nucleus pulposus

Anulus fibrosus

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11
Q

Describe how problems with the intervertebral disc can lead to potential clinical problems.

A

Degenerative changes in the anulus fibrosus can lead to herniation of the nucleus pulposus, which can then impinge on spinal nerves or the spinal cord (causing pain, weakness + changes in sensation)

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12
Q

Name the 2 ligaments that rung along the length of the vertebral bodies from the skull to the sacrum.

A

Anterior + Posterior Longitudinal Ligaments

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13
Q

Which ligament is typically damaged in whiplash?

A

Anterior Longitudinal Ligament

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14
Q

What is the name given to the upper part of the posterior longitudinal ligament going from C2 to the skull?

A

Tectorial Membrane

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15
Q

Which ligament is found between the laminae of adjacent vertebrae? When is this pierced?

A

Ligamentum flavum

Pierced in a lumbar puncture

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16
Q

Which ligament runs all the way down the back of the spinous processes, connecting them

A

Supraspinous ligament

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17
Q

Which ligament lies between adjacent spinous processes?

A

Interspinous ligament

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18
Q

What determines the degree of movement in each spinal cord segment?

A

Angles of articular facets
Presence of ribs
Presence of muscles

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19
Q

What is the purpose of spinous ligaments?

A

Provide stability

Allow movement, but limit excessive movement

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20
Q

Describe the shape of the atlas (C1).

A

NO vertebral body

Consists of 2 lateral masses with an anterior + posterior arch

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21
Q

Describe the articulations of the atlas.

A

The 2 lateral masses articulate superiorly with the occipital condyles + inferiorly with the superior articular surfaces of C2

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22
Q

Describe the structure of the axis (C2).

A

A typical cervical vertebra with the body extended upwards to form the dens (odontoid process)

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23
Q

Which ligaments are attached to the dens?

A

Alar ligaments are attached to the superiolateral surfaces of the dens + the medial occipital condyles. Prevent excessive rotation of head.
Longitudinal fascicles of the cruciform ligament (crosses over the transverse ligament of the atlas to form the cruciate ligament)

24
Q

How many vertebrae are there in total?

A

30-33 depending on number of coccygeal vertebrae

25
Q

Which layer of cranial dura mater is the spinal dura mater continuous with?

A

Meningeal layer of the cranial dura

26
Q

At what vertebral level does the spinal cord (+ Pia) end?

A

L2

27
Q

What space is present in the vertebral column that you don’t find in the skull?

A

Epidural space

28
Q

What does the epidural space contain?

A

Connective tissue
Fat
Internal vertebral venous plexus

29
Q

At what vertebral level do the dura + arachnoid layers end?

A

S2

30
Q

What is the significance of the subarachnoid space between L2 and S2?

A

A needle can be inserted here to remove CSF or insert anaesthetic

31
Q

What is the difference between an epidural and a spinal block?

A

Epidural: Around dura (large volume can be infused over many hours)
Spinal: In sub-arachnoid space (particular volume, lasts for a particular duration)

32
Q

How is the sacral hiatus formed? What is the significance of this space?

A

No lamina/ spinous process on last few sacral vertebrae

Can insert needle into sacral hiatus- possible to infiltrate very low region of epidural space with anaesthetic

33
Q

Where do the denticulate ligaments attach medially and laterally?

A

Medially – spinal cord

Laterally – form a series of triangular extensions that anchor through the arachnoid membrane to the dura mater

34
Q

Why would you perform a lumbar puncture?

A

To obtain CSF (e.g. to test for meningitis)

To inject spinal anaesthesia (into the subarachnoid space)

35
Q

At which level would you perform a lumbar puncture?

A

L3/L4 in an adult

1 or 2 vertebral spaces lower in a child

36
Q

Which ligament is pierced in lumbar puncture?

A

Ligamentum flavum

37
Q

Why would you never do a lumbar puncture in the case of raised intracranial pressure?

A

It will cause a sudden relieving of pressure, which could cause brainstem herniation and death.

38
Q

List 6 common spinal pathologies

A

Low back pain
Prolapsed intervertebral disc (Sciatica)
Spondolysis (degeneration)
Spondololysis (stress fracture of pars interrticularis)
Spondylolistesis (forward displacement of vertebra)
Spondylitis (inflammation of vertebrae)

39
Q

What are 2 common spinal injuries seen in car crashes?

A

Ligaments snap

Small parts of bone break off

40
Q

State 3 common deviations in spinal curvature.

A 
Scoliosis = abnormal lateral curvatures
Kyphosis = excessive thoracic curvature
Lordosis = excessive lumbar curvature
41
Q

Name 7 functions of the vertebral column

A

Hold body weight
Transmit forces
Support the head
Support the upper limbs
Protect the spinal cord
Movement of upper limbs + ribs (extrinsic muscles)
Postural control + movement (intrinsic muscles)

42
Q

What characterises primary curvatures? Which curvatures in an adult are primary?

A

They are in the direction that you would expect to see in the foetal position (concave side facing anteriorly)
Thoracic
Sacral

43
Q

What characterises secondary curvatures? Which curvatures in an adult are secondary?

A

Concave surface faces posteriorly
Cervical
Lumbar

44
Q

List 2 functions of intervertebral discs

A

Help with transmitting forces

Allow flexibility between vertebrae

45
Q

What is the name of the joint between the skull and C1? What does this allow?

A

Atlanto-occipital joint
Facets allow skull to rock back + forth (flexion + extension)
“Yes joint”

46
Q

What is the name of the joint between the C1 and C2? What does this allow?

A

Atlanto-axial joint
Allows rotation
“No joint”

47
Q

Where do the spinal nerves emerge?

A

C1-C7 nerves emerge from above their respective vertebrae

C8- Coccygeal nerves emerge below their respective vertebrae

48
Q

What is the result of the vertebral column developing at a greater rate than the spinal cord?

A

The point at which nerves emerge from the spine get progressively further away from where they emerge from the spinal cord

49
Q

Where is disc herniation more likely to occur? Why?

A

Lower spine

More weight is being transmitted by the discs (forces get greater)

50
Q

What are the 3 categories of muscles in the back and which muscles fall into each of these categories?

A

Superficial: Trapezius, Latissimus dorsi, Levator scapulae, Rhomboid minor, Rhomboid major
Intermediate: Serratus posterior superior + inferior
Deep: Spinotransversales, Erector spinae, Transversospinales, Interspinales, Intertransversarii

51
Q

State the origin, insertion and function of:

a. Trapezius
b. Latissimus Dorsi
c. Levator Scapulae
d. Rhomboid Minor
e. Rhomboid Major

A 
Trapezius 
O: external occipital protuberance, cervical + thoracic spine 
I: clavicle + scapula 
F: elevate + rotate scapula when humerus is abducted 
b. Latissimus Dorsi 
O: T7 to sacrum + thoracolumbar fasica + posterior 1/3 of iliac crest 
I: intertubercular sulcus of the humerus 
F: extends, adducts + medially rotates humerus 
c. Levator Scapulae 
O: transverse processes of C1-C4 
I: upper medial scapula 
F: elevates the scapula 
Rhomboid Minor 
O: spinous processes of C7-T1 
I: medial border of scapula 
F: adduct + elevate scapula 
e. Rhomboid Major 
O: spinous processes of T2-T5 
I: medial border of scapula 
F: adduct + elevate scapula
52
Q

State the origin, insertion and function of:

a. Serratus Posterior Superior
b. Serratus Posterior Inferior

A 
Serratus Posterior Superior 
O: C7-T3 
I: upper border of ribs 2-5 
F: elevates ribs 2-5 
Serratus Posterior Inferior 
O: T11-L3 
I: lateral inferior margins of ribs 9-12 
F: depresses ribs 9-12 + prevents lower limbs from elevating when diaphragm contracts
53
Q

State the location and function of:

a. Spinotransversales
b. Erector Spinae and Transversospinales
c. Interspinales and Intertransversarii

A

Spinotransversales
Extensors + rotators of head + neck
The 2 spinotransversales muscles run from the spinous processes up to T6 + ligamentum nuchae, running superiorly + laterally
Erector Spinae + Transversospinales
Extensors + rotators of vertebral column
Erector spinae lie posterolaterally to the vertebral column between the spinous processes medially + the angles of the ribs laterally
Transversospinales run obliquely upward + medially from the transverse process to the spinous process
Interspinales + Intertransversarii
Short segmental muscles, stabilisers of the vertebral column
Interspinales: pass between adjacent spinous processes
Intertransversarii: pass between adjacent transverse processes

54
Q

Describe the flexibility of the cervical spine in terms of flexion/extension, lateral flexion and rotation.

A

Can comfortably flex, extend, laterally flex + rotate.
Articular surfaces between vertebrae are almost horizontal, so all these movements are possible.
Neck has less surrounding tissue than other parts of spine

55
Q

Describe the flexibility of the upper thoracic spine (T1-T6).

A

NO flexion/extension
Some lateral flexion
Some rotation
Articular surfaces are almost vertical, which doesn’t allow for flexion/extension.

56
Q

Describe the flexibility of the lower thoracic spine (T7-T12).

A

Some flexion/extension
Good lateral flexion
Good rotation

57
Q

Describe the flexibility of the lumbar spine (L1-sacrum).

A

NO rotation
Good flexion/extension
Good lateral flexion
Articular surfaces curled around articular surfaces of the adjacent superior vertebrae, ensuring no rotation.

YR2: Head, Neck and Spine (6 decks)

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