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Musculoskeletal System > Session 7 - Cervical And Thoracic Spine > Flashcards

Session 7 - Cervical And Thoracic Spine Flashcards

1
Q

What are the 3 atypical cervical vertebrae?

A

C1 C2 and C7

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2
Q

What are the 4 typical cervical vertebrae?

A

C3-6

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3
Q

What are 5 characteristics of typical cervical vertebrae?

A 
Small and broad body
Large triangular vertebral foramen
Bifid spinous process
Transverse foramen in transverse process
Articular facets 45 degrees to axial plane
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4
Q

What is the atlas?

A

C1

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5
Q

What are 3 key characteristics of the atlas?

A

Widest cervical vertebrae
No vertebral body
No spinous process

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6
Q

What are 2 joints on the atlas?

A

Atlanto-occipital joint

Atlanta-axial joint

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7
Q

What is the atlanta-occipital joint made of?

A

Occiput of skull and atlas vertebra

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8
Q

What is the atlanto-axial joint made up of?

A

Atlas and axis

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9
Q

What is the axis?

A

C2

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10
Q

What are 3 key characteristics of the axis?

A

Strongest cervical vertebra
Rugged lateral mass
Large spinous process

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11
Q

What is odontoid process?

A

Dens or otondoid pegs - vestigial remnant of body of C1 projects vertically upwards from body of axias

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12
Q

What is atlantoaxial instability?

A

Excessive movement between C1 and C2 vertebrae

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13
Q

What is vertebra prominens?

A

C7

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14
Q

What are 4 key features of C7?

A

Longest spinous process
Not bifid spinous process
Large transverse process
Small foramen transversarium

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15
Q

What does the foramen transversarium transmit?

A

Accessory vertebral veins

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16
Q

Do thoracic and lumbar spinal nerve roots exit below or above named vertebrae?

A

Below

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17
Q

Do cervical nerve roots exit above or below named vertebrae?

A

Above

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18
Q

During a lumbar paracentral disc herniation, which nerve root is compressed?

A

Traversing

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19
Q

During a cervical intervertebral disc prolapse, which nerve root is compressed?

A

Exiting

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20
Q

What is ligamentum nuchae?

A

Thickening of supraspinous ligament

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21
Q

What is the anterior longitudinal ligament?

A

Ligament running in front of vertebrae

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22
Q

What is the function of anterior longitudinal ligament?

A

Prevent hyperextension

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23
Q

What is the posterior longitudinal ligament?

A

Behind vertebral bodies

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24
Q

What is the function of posterior longitudinal ligament?

A

Prevents hyper flexion

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25
Q

What are the 6 possible movements of the cervical spine?

A 
Extension 
Flexion
Left lateral flexion
Right lateral flexion
Left rotation
Right rotation
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26
Q

What are 6 key features of thoracic vertebrae?

A 
Medium and heart shape body
Small circular vertebral foramen
Prominent transverse processes w costal facets
Demi or whole facets
Long spinous process
Articular facets at 20 degrees
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27
Q

What are 2 movements of thoracic spine?

A

Lateral flexion and rotation

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28
Q

What are 5 key features of lumbar vertebra?

A 
Large kidney shaped body
Triangular shaped canal
Large blunt transverse processes
Short blunt spinous processes
Facet joints orientated at 90 degrees
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29
Q

What is cervical spondylosis?

A

Chronic degenerative osteoarthritis affecting intervertebral joints in cervical spine

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30
Q

What are costal facets?

A

Facets articulating with heads of ribs

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31
Q

Why does radiculopathy occur due to cervical spondylosis?

A

Narrowing of intervertebral foramina puts pressure on spinal nerves

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32
Q

What are 2 symptoms of radiculopathy?

A

Dermatomal sensory symptoms and myotomal motor weakness

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33
Q

How does myelopathy occur due to cervical spondylosis?

A

Narrowing of spinal canal can put pressure on spinal cord, leading to compression and dysfunction of ascending and descending tracts within spinal cord

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34
Q

What are 4 symptoms of myelopathy?

A

Global muscle weakness
Gait dysfunction
Loss of balance
Loss of bowel and bladder control

35
Q

What is Jefferson’s fracture?

A

Fracture of anterior and posterior arches of the atlas vertebra

36
Q

What is the mechanism of injury for Jefferson’s fracture?

A

Axial loading

37
Q

How does Jefferson’s fracture look like?

A

Broken polo mint

38
Q

Why is there no neurological signs for Jefferson’s fracture?

A

Bursting open of bone fragments reduces likelihood of impingement of spinal cord

39
Q

What is a Hangman’s fracture?

A

Axis vertebra fractured through pars interarticularis

40
Q

What is the mechanism of injury for Hangman’s fracture?

A

Forcible hyperextension of head on neck

41
Q

What are 2 causes of fractures of odontoid process?

A

Flexion or extension injuries

42
Q

What is whiplash injury?

A

Forceful hyperextension hyper flexion injury of cervical spine

43
Q

What is the classical mechanism of whiplash injury?

A

Patients car being struck from rear leading to an acceleration deceleration injury

44
Q

What is cervical myelopathy?

A

Spinal cord dysfunction due to compression of the cord is caused by narrowing of spinal canal

45
Q

What is a common cause of cervical myelopathy?

A

Degenerative stenosis of spinal canal caused by cervical spondylosis

46
Q

What is Hoffman’s test?

A

Hold patient middle finger at middle phalanx and flick fingernail, if no movement = normal

47
Q

What is Babinski sign?

A

Lateral side of sole of the foot is stroked with a blunt instrument from heel towards the toes, if flexor = normal

48
Q

What is L’Hermitte’s phenomenon?

A

Sensation of intermittent electric shocks in limbs, exacerbated by neck flexion

49
Q

What are the 2 commonest cause of thoracic cord compression?

A

Vertebral fractures and tumors in spinal canal

50
Q

What are 3 routes pathogens can spread to bones and tissues of the spine?

A

Haematogenous
Direct inoculation
Spread from adjacent soft tissue infection

51
Q

What is the most common organism to infect spinal canal?

A

Staphylococcus aureus

52
Q

What are the five parts that the brachial plexus can be divided into?

A 
Roots (real)  
Trunks (teenagers) 
Divisions (drink) 
Cords (cold) 
Branches (beer)
53
Q

What are the roots of the brachial plexus formed by?

A

Anterior rami of spinal nerves C5-T1

54
Q

What are the 3 trunks that the roots converge to form?

A

Superior trunk
Middle trunk
Inferior trunk

55
Q

What is superior trunk made of?

A

C5 and C6

56
Q

What is middle trunk made of?

A

C7

57
Q

What is the inferior trunk made of?

A

C8 and T1

58
Q

What are the 2 divisions the trunk divides into?

A

Anterior and posterior

59
Q

What are the 3 cords that the divisions combine to form?

A

Lateral
Posterior
Medial

60
Q

What are the 5 major branches of brachial plexus?

A 
Musculocutaneous
Axillary
Median
Radial
Ulnar
61
Q

What is a common cause of injuries to upper brachial plexus?

A

Excessive increase in angle between neck and shoulder

62
Q

What is Erb’s palsy?

A

Upper brachial plexus injury causes limb to hang by the side in internal rotation with addicted arm and extended elbow

63
Q

What is Klumpke’s palsy?

A

Injury to lower brachial plexus due to forced hyperextension or hyper abduction causes claw hand with hyperextension of all metacarpophalangeal joints, flexion of interphalangeal joints, abduction of thumb

64
Q

What are the spinal nerve roots for the five major brachial plexus branches?

A 
3 musketeers (musculocutaneous) C5 6 7
Assasinated (axillary) C5 6 
4 mice (median) C678T1 
5 rats (radial) C5678T1
2 unicorns (ulnar) C8T1
65
Q

Where is the pectoral region?

A

Anterior chest wall

66
Q

What are the 3 actions of pectoralis major?

A

Adduction
Flex arm at shoulder joints
Internally rotate

67
Q

What is the innervation of pectoralis major?

A

Medial pectoral and lateral pectoral

68
Q

What is the action of pectoralis minor?

A

Stabilizes scapula by drawing it anteroinferiorly against thoracic wall

69
Q

What is pectoralis minor innervated by?

A

Medial pectoral nerve

70
Q

What is serratus anterior’s action?

A

Rotates medial border anteroinferiorly

71
Q

What is serratus anterior innervated by?

A

Long thoracic nerve

72
Q

What are 2 actions of coracobrachialis?

A

Flexor

Weak adductor

73
Q

What are the 2 actions of subclavius?

A

Anchors and depresses clavicle

74
Q

What is subclavius innervated by?

A

Nerve to subclavius

75
Q

What are the 3 parts of deltoid muscle?

A

Anterior middle posterior

76
Q

What is the action of anterior fibres of deltoid muscle?

A

Flex and medially rotate arm

77
Q

What is the function of middle fibres of deltoid?

A

Abduct arm

78
Q

Wheat is the action of posterior fibres of deltoid?

A

Extend and laterally rotate arm

79
Q

What is deltoid muscle innervated by?

A

Axillary

80
Q

What is the axilla?

A

Pyramidal space at junction of upper limb and thorax

81
Q

What are 3 main routes by which structures leave axilla?

A

Into upper limb
Quadrangular space
Clavipectoral triangle

82
Q

What are the 6 lymph nodes of axilla?

A 
Anterior 
Posterior 
Infraclavicular
Central
Apical 
Lateral
83
Q

What is axillary lymphadenopathy?

A

Enlargement of axillary lymph nodes

84
Q

What are 5 causes of axillary lymphadenopathy?

A 
Infection of upper limb
Infection pectoral region and breast
Metastases from breast cancer
Leukaemia or lymphoma 
Metastases from malignant melanoma in upper limb

Musculoskeletal System (9 decks)

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