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Anatomy - Head, neck and spine > Spinal Cord > Flashcards

Spinal Cord Flashcards

1
Q

What are the superficial extrinsic muscles of the back? (look at diagrams)

A
  • Trapezius
  • Latissimus dorsi
  • Levator scapulae
  • Rhomboids
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2
Q

What are the deep intrinsic muscles of the back? (look at diagrams)

A

erector spinae

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3
Q

What is the role of the levator scapulae?

A

elevates and rotates the scapula

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4
Q

What is the role of the erector spinae muscles?

A

Straighten the back and allows side-to-side rotation

EXTENSION OF VERTEBRAL COLUMN

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5
Q

What are the main ligaments of the vertebral column and where are they found?

A

Supraspinous ligaments – connects the tips of spinous processes

Interspinous ligaments – between adjacent spinous processes

Ligamenta flava – between adjacent vertebral arches

Posterior longitudinal ligament – posterior canal

Anterior longitudinal ligament – anterior of body

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6
Q

Which ligament is most likely to be injured during a hyper extended neck whip lash injury?

A

anterior longitudinal ligament

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7
Q

What are denticulate ligaments?

A

Projections of pia mater that anchors the spinal cord

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8
Q

What is filum terminale?

A

Fibrous tissue that is a modification of pia mater than runs down in the cauda equina

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9
Q

What is the conus medullaris?

A

Where the spinal cord tapers out - around L2

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10
Q

What is C1 and C2 called?

A

1 - atlas

2 -axis

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11
Q

What type of joint is the atlanto-occipital?

A

YES (nodding)

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12
Q

What type of joint is the atlanto-axial?

A

NO (shaking head)

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13
Q

Describe the blood supply to the spinal cord

A
  • One anterior and two posterior spinal arteries
  • Supplemented by radicular arteries – branches of the intercostal arteries (important during surgery as if damaged can affect spinal nerves)
  • Internal and external vertebral venous plexuses
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14
Q

What is the significance of the venous plexuses?

A

The venous plexus provides a path of metastases for cancer from the prostate gland to the brain.

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15
Q

How is C7 identified?

A

first obvious spinous process

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16
Q

How is T3 identifed?

A

Level with the medial end of scapular spine

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17
Q

How is T7 identified?

A

Level with the inferior angle of scapula

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18
Q

How is L2 identified?

A

Level of lowest part of 12th rib

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19
Q

How is L4 identified?

A

Level of iliac crest

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20
Q

Why should lumbar punctures not be taken when someone has high intracranial pressure?

A

The brainstem could fall through the foramen magnum

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21
Q

How can the lower sacral nerves by anesthetized alone?

A

through the sacral hiatus

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22
Q

What is scoliosis?

A

A bend in the spine in the lateral plane (sideways)

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23
Q

What is kyphosis?

A

An exaggerated thoracic curvature

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24
Q

What is lordosis?

A

An exaggerated lumbar curvature (from posterior to anterior curve)

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25
Q

Where is backache most common and why?

A

Lumbar as bears the most weight

26
Q

Where is disc herniation most likely?

A

L5-S1 due to the angles

27
Q

What is one of the weakest regions of the vertebral column?

A

lumbar sacral due to sharp turn - lots of disc herniations

28
Q

What are the two types of curvatures?

A

primary and secondary
primary - expected in fetus (thoracic and sacral)
secondary - formed later on (lumbar and cervical)

29
Q

What are some features of the cervical vertebrae?

A
  • have holes for vertebral arteries called transverse foramina
30
Q

Give examples of atypical vertebrae

A

atlas and axis (c1 and c2)

31
Q

Describe the features of c1

A
  • has a facet for dens
  • has foramen trasnversarium
  • has no vertebral body
  • no spinous process
  • has ligaments e.g. transverse ligament
32
Q

Describe the features of c2

A
  • has a dens (odontoid peg which allows rotation and specific movement)
33
Q

What are some of the ligaments in c1/c2?

A

cruciate ligament - has superior longitudinal band, inferior longitudinal band and transverse ligament
Alar ligament - connect the sides of the dens to tubercles on the medial side of the occipital bone

34
Q

What is the tentorial membrane?

A
  • Covers the odontoid process and ligaments
  • Continuous with the posterior longitudinal ligament
  • From the posterior surface of the body of the axis and, attached to the basilar groove of the occipital bone,
  • As it enters the cranial cavity it becomes continuous with the dura mater
35
Q

How can slipped discs affect nerves?

A

bilateral posterior herniation can affect entire spinal cord below

contralateral herniation can affect individual nerves

36
Q

Where is lumbar puncture taken?

A

in adults spinal cord ends at L2 in children at L3/4 so usually taken at L3/4 or L4/5 in adults

37
Q

What movements can the cervical spine do?

A

extension, rotation and bending

38
Q

What movements can the thoracolumbar spine do?

A

flexion, extension and rotation

39
Q

What are some examples of spinal pathology?

A
  • low back pain
  • prolapsed disc
  • spondolysis (degeneration)
  • spondylitis (vertebrae inflammation)
40
Q

What are some common spinal injuries?

A

of atlas and axis - little space so a fracture might not kill but if dislodged can impinge on spinal cord and cause instant death

41
Q

What is the significance of the sacral hiatus in terms of anaethesia?

A

It can be used to anesthetize the sacral nerves only

42
Q

Why should a lumbar puncture not be performed in the presence of high intracranial pressure?

A

The brainstem could fall through the foramen magnum

43
Q

What things are passed when performing an epidural?

A

skin, fat, muscle, supraspinous ligament, intraspinous ligament, ligamentum flavum

44
Q

What things are passed when performing a lumbar puncture?

A

skin, fat, muscle, supraspinous ligament, intraspinous ligament, ligament flavum, epidural space, dura, arachnoid, and subarachnoid space

45
Q

Why is backache more common in the lumbar region?

A

spinal angle more sharp

46
Q

What is the filum terminale?

A

extends down from the conus medullaris (continuous with pia mater)

47
Q

What is the shape of the thoracic and lumbar vertebral body?

A

T - heart shape

L - kidney shape

48
Q

What are the roles of sheet muscles?

A
  • There are sheet muscles (the oblique muscles, rectus abdominus, transversus abdominus)
  • These help with flexion
  • They also help with increasing abdominal pressure (for expulsion, coughing, sneezing, breathing etc.)
  • The oblique muscles help with side bending as well are rotation.
49
Q

What do erector spinae muscles do?

A

On the back is the erector spinae muscles – huge column of muscles. They make the spine straight – very complex intrinsic muscles of the spine.

50
Q

Give examples of spinal injuries

A
  • Low back pain
  • Prolapsed intervertebral disc - sciatica
  • Spondylosis (degeneration)
  • Spondylolysis (stress fracture of pars interarticularis)
  • Spondylolisthesis (forward displacement of vertebra)
  • Spondylitis (inflammation of vertebrae)
51
Q

Compare the vertebral body shape, foramen shape and features of the transverse processes for thoracic, lumbar and cervical vertebrae

A

body:

  • thoracic: heart
  • cervical: short and small
  • lumbar: large

vertebral foramen:

  • thoracic: circular
  • cervical: triangle and wide
  • lumbar: triangular

transverse process:

  • thoracic: with ribs
  • cervical: foramen transversarium, bifid spinous process
  • lumbar: long and thin
52
Q

What are the 3 columns of the erector spinae muscles?

A

spinalis, longissimus, iliocostalis

53
Q

structure of intervertebral disc

A

annulous fibrosus: outer ring made of type 1/2 collagen

nucleus pulpous: inner gel like centre which distributes pressure evenly and absorbs compression forced

54
Q

disc protrusion and herniation

A
  • Degenerative changes in the annulus fibrosus can lead to protrusion of the disk and
    herniation of the nucleus pulposus
  • Central disk herniation can impinge directly on the spinal cord
  • Posterolateral herniation can impinge on the roots of a spinal nerve in the intervertebral foramen
55
Q

What is sciatica?

A

Most common disc herniation l5-s1 which can compress nerves of the sciatic nerve. Pain starts in the lower back/but and radiates to foot

56
Q

What is the Jeffereson fracture?

A

Fracture of anterior and posterior arches (4,3,2 breaks)

57
Q

What are sub occipital muscles?

A

The suboccipital muscles connectthe atlas to the axis

They also connect the atlas to the base of the skull

These often forgotten muscles are innervated by nerves from the C1 root

58
Q

Movements of the vertebral column

A
  • The cervical vertebrae can do everything
  • The thoracic vertebrae have limited flexion/extension
  • The lumbar vertebrae have limited rotation
  • These movements are a result of the restriction set in place by the shape of the
    superior and inferior articular processes
59
Q

Spinal meninges vs brain meninges

A 
Similarities
- 3 layers:
Dura Mater
Arachnoid Mater
(Sub-arachnoid space
containing CSF)
Pia Mater

Differences:
- Only one layer of dura
- Presence of denticulate ligaments (tooth-shaped extensions of pia which
stretch across the sub-arachnoid space anchoring the cord within the
vertebral foramen)
- Presence of the epidural space containing fat and venous plexi

60
Q

Complete decidious (milk) teeth set number

A

20 (complete by 2-3yrs)

Anatomy - Head, neck and spine (6 decks)

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