Spinal cord and vertebral column

Question 1

Outline the support function of the vertebral common

Answer 1

Body weight, transmit forces, support the head, supports upper limb (and aid movement) and contain spinal cord

Question 2

Outline the movement function of the vertebral common

Answer 2

upper limbs (extrinsic muscles from vertebral column to limb for example) and postural control and movement (intrinsic muscles between vertebral column or ribs)

Question 3

Where is the greatest curvature of the vertebral column

Answer 3

between lower lumbar and beginning of sacrum

Question 4

What determines whether a spinal curvature is primary or secondary

Answer 4

Think like foetus curled forward.
So if the curvature is ‘concaved anteriorly’ (i.e. bent forward as if to curl forward) it’s primary.
If the curvature is ‘concaved posteriorly’ (i.e. opposite to the foetal curve) it’s secondary

Question 5

State which curves are primary and secondary

Answer 5

Primary- thoracic and sacral

Secondary- cervical and lumbar

Question 6

Which curve might be exaggerated in pregnancy or obesity

Answer 6

secondary (lumbar) because there is increase weight hanging anteriorly so you need to lean forward more to shift the centre of gravity backwards so the lumbar curve is accentuated

Question 7

What is exagggerated kyphosis

Answer 7

Accentuated thoracic curvature

Question 8

What is exaggerated lordosis

Answer 8

Exaggerated lumbar curvature

Question 9

What is scoliosis

Answer 9

Lateral curvature of the spine (including compression of organs and pain).. more noticeable when bent forward

Question 10

Outline how many bones in each segment

Answer 10

Cervical- 7 thoracic -12 lumbar- 5 sacral- 5 fused coccygeal- 3-5 fused

Question 11

Have to be able to label parts of each vertebra

Answer 11

…

Question 12

What is the major weight bearing part of the vertebrae

Answer 12

Vertebral body

Question 13

What is the vertebral arch

Answer 13

extends posteriorly, made up of ‘lamina’ which converge to form the spinous process.
Forms ‘roof’ of vertebral canal (image the spinal cord running along the the posterior aspect of the vertebral bodies and arch like the roof)
Attachment for muscles and ligaments and has sites for articulation of adjacent vertebrae

Question 14

What do pedicles do

Answer 14

anchor the vertebra arch to the vertebral body

Question 15

Shape of each vertbral body

Answer 15

Thoracic- heart
Lumbar- kidney shape (much bigger)
Cervical small

Question 16

Names of 2 atypical vertebral

Answer 16

C1 (atlas)

C2 (

Question 17

What is the transverse ligament of atlas’ function

Answer 17

it holds the vertebral body of C1 (which is actually on C2 but projects up) allowing turning of head from side to side

Question 18

What sits on the superior articular surface of the atlas

Answer 18

the skull (occipital condyles)

Question 19

What is the danger associated with the arrangement of the C1 vertebral body

Answer 19

The vertebral body projects up from C2 and is enclosed by the transverse ligament of the atlas (it’s called the odontoid peg) and in extreme flexion or extension of the neck, it can break free of the ligament and crush the spinal cord or lower part of the medulla causing death (mechanism of hanging or instant death in collisions)

Question 20

Distinguishing feature of cervical vertebrae

Answer 20

Transverse foramina for the vertebral arteries

Question 21

What is the equivalent of the spinous process on the atlas

Answer 21

Posterior tubercle

Question 22

What is the name of the facet on the dens of the axis

Answer 22

Posterior articular facet for the transverse ligament of the atlas

Question 23

What are the alar ligaments

Answer 23

Ligaments which go from the base of the skull to the odontoid peg
‘atlanto-occipital joint’ is the ‘YES’ joint so between skull and C1
‘Atlanto-axial joint’ is the NO joint so between C1 and C2 so the transverse ligament of the atlas is art of the median atlanto-axial joint)

(atlanto- refers to the atlas)

Question 24

What is the cruciate ligament

Answer 24

The cross shape (superior and inferior longitudinal band vertical and the transverse ligament of the atlas) from skull down to C2

Question 25

Main ligaments connecting the vertebral bodies

Answer 25

Anterior longitudinal ligament (limits extension- is stronger than posterior so extension less than flexion)
posterior longitudinal ligaments (limits flexion)
Ligamentum flavum LIMIT FLEXION and help support upright posture (between the lamina) 
Interspinous ligament (weak) (between the spinous processes)
Supraspinous ALSO LIMITS FLEXION runs vertically down the back of the spinous processes (at end of the interspinous ligaments)

Question 26

What can be the consequences of intervertbral disc degeneration

Answer 26

Reduction in size of the intervertbral foramina which can cause parasthesia (tingling/pins and needles) and pain

Question 27

How do the spinal cords exit the spinal cord

Answer 27

C1-7 exit in intervertebral foramen above the verbrae

C8- coccygeal emerge below their respective vertebrae

Question 28

Name of the bundle of nerves below L2 (i.e. peripheral nerves coming out of the spinal cord and travelling down to exit throigh intevertebral foramina at the correct level)

Answer 28

Cauda equina

Question 29

Name the parts of the intervertebral disc

Answer 29

Around outside= anulus fibrosus, central= nucleus pulposus

Question 30

Why is disc herniation more common in the lower vertbral

Answer 30

Because more weight is being transferred through them than further up.

Question 31

Consequence of disc hernitation

Answer 31

Moves into the space containing the spinal cord or cauda equina so can cause pain and paraesthesia and possibly weakness and sciatica if in the lower back

Question 32

Look at the movements of the spine

Answer 32

Bend forward (flex) bend back (extend), bend side to side (lateral flexion) and also rotation

Question 33

List the 3 erector spinae muscles

Answer 33

most medial: spinalis group
More lateral: longissimus
Most lateral: iliocostalis

Keeps the spine upright

Question 34

Differentiate the muscles innervated by the posterior and anterior rami of the spinal nerves

Answer 34

posterior- intrinsic muscles

anterior- extrinsic muscles e.g. of abdominal wall and limbs etc (MUCH larger)

Question 35

Normal range of motion in cervical and thoracolumbar spine

Answer 35

cervical- 80 degrees rotation
45 degrees lateral flexion, 45 defrees flexion and extension

Thoracolumbar- 30 degrees extension and 90 degrees flecion, 30 dgrees, lateral flexion rotation (twist from waste) 30 degrees

Question 36

Which extra space is present in the vertbral column but not the skull

Answer 36

Epidural space (because the periosteal layer of the dura mater reflects back on the exterior surface of the skull to leave just the meningeal layer in the spinal cord).

Question 37

Where do the meninges end in the vertebral column

Answer 37

Arachnoid and meningeal layer of the dura continue further down the vertebral column than the spinal cord so S2 (so between L2 and S2 a huge subarachnoid space from which CSF can be taken).
The pia, which surrounds the spinal cord ends at the end of the spinal cord, but continues around the cauda equina as the filum terminale

Question 38

What is the sacral hiatus

Answer 38

Lamina of the last few sacral vertbrae are not there so no fusion so there is a hole in the bottom of the spine through which an epidural injection can be given for example in sciatica to reduce inflammation.

The caudal epidural block involves placing a needle through the sacral hiatus to deliver medications into the epidural space

VS

Spinal anaesthesia which involves inserting needle inside the subarachnoid space into the CSF.

Spinal usually one shot (i.e. in surgery), epidural may have catheter for multiple injections e.g. in labour

Spinal blocks movement below the level of injection but epidural leaves almost normal function

Question 39

Common spinal pathology

Answer 39

Low back pain
Prolapsed intervertebral disc –> sciatical
Spondolysis (degeneration)
Spondylolysis (stress fracture of pars interartcularis)
Spondylolisthesis (forward displacement of vertebra)
Spondylitis (inflammation of vertebrae)

Question 40

Common spinal injuries

Answer 40

Injuries to axis and atlas