Spinal Anatomy Flashcards
How are the bones of the spine arranged
7 cervical 12 thoracic 5 lumbar 5 sacral (fused) 4 coccygeal (fused)
What part of the spine contains bifid spinous processes?
CERVICAL region
What type of joints are facet joints
synovial joints
What movements can facet joints perform?
Flexion
Extension
Lateral Flexion
What is the difference in the orientation of facet joints in the cervical and lumbar spine
cervical = horizontal
lumbar = vertical (=> means they cant twist)
Why do people get shorter as they get older?
lose water from intervertebral discs
=> spine shortens
What physical test can you use to test if a patients back pain is most likely to be arthritic?
Ask pt to extend back as this puts more stress on the facet joints
What two components make up the intervertebral disc?
Outer annulus fibrosis
inner gelatinous nucleus pulposus
How is osteoarthritis in the spine treated?
painkillers and pain minimising exercises
What can cause the intervertebral discs to affect the cauda equina?
Tear in annulus with increasing age causes nucleus to move out and affect cauda equina
MRI scans are useful for diagnosing spinal deformities. TRUE/FALSE
FALSE - MRIs are not diagnostic
Where does acute disc prolapse most commonly occur?
L4/5 or L5/S1
Where does the spinal cord end?
L1
turns into the cauda equina
What is the difference between an exiting nerve root and a transversing nerve root?
exiting nerve root = outside thecal sac passes under pedicle of the corresponding vertebra (=>L4 root passes under L4 pedicle)
traversing nerve root pair = Remain in thecal sac positioned anteriorly
=> preparation to penetrate the thecal sac and become the next exiting nerve root more distally
What causes spinal stenosis?
- Nerve roots compressed by osteophytes
- hypertrophied ligaments in OA
- radiculopathy or burning leg pain on walking = neurogenic claudication
What symptoms are indicative of cauda equina syndrome?
bilateral lower motor neuron signs
bladder and bowel dysfunction
saddle anaesthesia
loss of anal tone
What 3 muscles form the erector spinae muscle?
Iliocostalis
Longissimus thoracis
Spinalis thoracis
Where is a lumbar puncture/spinal anaesthesia usually inserted?
Posterior iliac crest L4
PSIS S2
What bone problems can cause back pain?
Fracture – trauma, osteoporosis, (spondylolisthesis)
Tumour
Infection
What joint issues can cause back pain?
Spondylosis and OA
Spinal stenosis
What disc problems can cause back pain?
Discogenic back pain
Sciatica
Cauda equina syndrome
What is mechanical back pain?
Related to joints, ligaments and muscles with no sinister (“red flag”) features
Worse with activity, relieved by rest
related to obesity, poor posture, poor lifting technique
