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SPINAL CORD & BACK > Spinal cord > Flashcards

Spinal cord Flashcards

1
Q

What is the role of the zygapophysial joints?

A

control the vertebral columns flexibility

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2
Q

What happens to the size of the vertebral body as it descends the spinal column?

A

Increases in size to support weight of the body

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3
Q

What components make up the vertebral arch?

A

spinous process, lamina, pedicle

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4
Q

Where are the pedicles found?

A

project posteriorly from the body to meet 2 broad, flat plates of bone called lamina

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5
Q

What forms the walls of the vertebral foramen?

A

The vertebral arch (lamina and pedicle) and the posterior surface of the vertebral body

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6
Q

The succession of vertebral foramina in the articulated vertebral column forms the…?

A

vertebral canal (spinal canal)

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7
Q

What processes interact to form the zygapophysial joint?

A

Inferior articular process and superior articular process

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8
Q

Describe the characteristics of cervical vertebrae?

A
  • smallest in size, as bear the least weight
  • oval transverse foramen in the transverse process
  • bifid spinous process except C1 and C7
  • IV discs are thinner than inferior regions but relatively thick compared to size of cervical vertebral bodies
  • nearly horizontal orientation of the articular facets –> greatest range of movment of all vertebral regions
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9
Q

What runs through the transverse foramen in the cervical region of the spine, and what is the exception to the rule?

A

vertebral arteries and veins except those in C7, which transmit only small accessory veins
foramen in C7 are smaller and sometimes absent

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10
Q

What is the purpose of the anterior and posterior tubercles in the cervical vertebrae?

A

tubercles provide attachment for a laterally placed group of cervical muscles (levator scapulae and scalenes)

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11
Q

In summary describe the characteristics of the cervical vertebrae

A

body - small
vertebral foramen - large and triangular
transverse processes - transverse foramina and anterior and posterior tubercles, vertebral arteries and accompanying venous and sympathetic plexuses pass through transverse foramen except C7 which transmits only small accessory vertebral veins
articular processes - superior facets directed superioposteriorly; inferior facets directed inferioanteriorly

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12
Q

What are the names of C1 and C2 vertebrae?

A

Atlas and axis

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13
Q

Describe the physical characteristics of of Atlas?

A

no vertebral body and no spinous process

  • has paired lateral passes which bear the weight of the cranium
  • transverse processes of the atlas arise from the lateral masses, causing them to be more laterally placed than those of the inferior vertebrae
  • has a facet and foramen for the dens of C2
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14
Q

Describe the characteristics of axis

A

-strongest of the cervical vertebrae.
- C1 carrying the cranium, rotates on C2 .e.g. when a person says no.
(atlanto-axial)
- Axis has 2 large, flat bearing surfaces - the superior articular facets, on which the axis rotates
- has the dens which projects superiorly from its body
- dens lies anterior to the spinal cord

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15
Q

How is the dens held in position?

A

held in position against the posterior aspect of the anterior arch of the atlas by the transverse ligament of the atlas

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16
Q

Describe the characteristics of the thoracic vertebrae

A
  • provide attachments for the ribs
  • costal facets
  • heart shaped vertebral body
  • one or 2 costal facets for articulation with the head of rib
  • vertebral foramen: circular and smaller than those of cervical and lumbar vertebrae
17
Q

Describe the characteristics of the lumbar vertebrae

A

Body is massive and kidney shaped
vertebral foramen are triangular and larger than thoracic but smaller than in cervical
- long slender transverse process

18
Q

What is vertebral body osteoporosis?

A

Common metabolic disease

  • osteoporosis results from a net demineralisation of the bones due to imblance between calcium resorption and deposition
  • quality of bone is reduced and atrophy of skeletal tissue occurs
  • osteoporosis most commonly affects neck of femur, bodies of vertebrae, metacarpals and radius
  • bones brittle and subject to fracture
  • osteoporosis especially affects the horizontal trabeculae of the spongy bone of the vertebral body
  • most common in thoracic vertebrae
19
Q

Where are you most likely to get a dislocation in the spinal vertebrae?

A

Cervical vertebrae due to their more horizontally oriented articular facets
cervical vertebrae as a result are less tightly interlocked

20
Q

Describe the fracture and dislocation of axis

A

C1 is a bony ring, with 2 wedge shaped lateral masses

- vertical forces compressing the lateral masses between the occipital condyles and the axis drive them apart

21
Q

What is lumbar spinal stenosis?

A

stenoic (narrowed) vertebral foramen in one or more lumbar vertebrae

  • can be hereditary or due to age related changes e.g. IV disc bulgin
  • lumbar spinal nerves increase in size as the vertebral column descends but the IV foramina decrease in size
  • stenosis can cause compression of spinal nerve
22
Q

Describe the effect of ageing on vertebrae

A

Between birth and age 5, body of a typical lumbar vertebra increases in height 3 fold. Between ages 5-13 increases another 45%. Growth completed age 25.
During middle and older age there is an overall decrease in bone density and strength particularly centrally within the vertebral body
- IVD become increasing convex
- osteophytes develop around the margins of the vertebral body

23
Q

Where are the ligametum flavum found?

A

Lamina of adjacent vertebral arches are joined by broad elastic tissue - ligamentum flavum
- thickest in the lumbar region

24
Q

Where are the interspinous ligaments found?

A

interspinous ligaments connect adjoining spinous processes

25
Q

Where is the supraspinous ligament found

A

connects the tips of the spinous processes from C7 to the sacrum
- merge superiorly with nuchal ligament at back of the neck

26
Q

Describe the atlanto-occipital joint

A

articulation between superior articular surfaces of lateral masses of the atlas and occipital condyles
- joints permit nodding of the head, e.g. ‘yes’ and sideways

27
Q

What are the primary curvatures of the spine?

A

Thoracic and sacral

28
Q

What are the secondary curvatures of the spine?

A

Cervical and lumbar

29
Q

What are kyphoses and lordoses (normal)?

A

thoracic and sacral kyphoses are primary anterior curvatures

cervical and lumbar lordoses are secondary concave posteriorly

30
Q

Describe the process of aging in regard to the IV discs

A

nuclei pulposi dehydrate and lose elastin and proteoglycans while gaining collagen

  • IVD lose their turgor and become stiffer
  • nucleus becomes dry and granular
  • annulus fibrosis assumes an increasingly greater share of the vertical load and the stresses and strains that come with it
  • lamellae of annulus thickens and develops fissures
  • IVD actually increase in size with age despite vertebral bodies moving closer together (reason for decrease in height)
31
Q

Describe the process of IVD herniation

A
  • herniation of the gelatinous nucleus pulposus into or through the anulus fibrosus is a well recognised cause of LL pain and LB pain
  • flexion of teh vertebral column produces compression anteriorly and stretching or tension posteriorly, squeezing the nucleus pulposus further posteriorly towards the thinnest part of the anulus fibrosis
  • herniations usually extend postero-laterally. Likely to be symptomatic due to close proximity of spinal nerve roots
32
Q

What causes localised back pain in a herniated disc?

A

usually presents as acute pain results from pressure on the longitudinal ligaments and periphery of the annulus fibrosis and from local inflam cuased by chemicals released from ruptured nucleus pulposus

33
Q

What causes chronic pain in slipped disc?

A

chronic pain as a result of compression of the spinal nerve roots –> referred pain –> dermatome

34
Q

Where are disc herniations most common?

A

L4/L5 and L5/S1

35
Q

What is sciatica?

A

Sciatica is pain the lower back and hip radiating down the back of the thigh into the leg, often caused by a herniated lumbar IV disc that compresses and compromises the L5 or S1 component of the sciatic nerve

  • the IV foramen decrease in size in lumbar region whilst spinal cord thickens –> increased chance of compression
  • movements that stretch the sciatic nerve, such as flexing the thigh with knee extended (straight leg raise test) –> produce or exacerbate sciatic
36
Q

Discuss whiplash injury in regards to ligaments/

A

Severe hyperextension of the neck in rear end RTA

anterior longitudinal ligament severely stretched and may be torn

37
Q

What is the zygapophysial joint?

A

The joint between the superior articular process and the inferior articular process
- synovial, plane joints between articular processes of 2 adjacent vertebrae

SPINAL CORD & BACK (1 decks)

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