Spine

Question 1

What characteristics may help you identify a lumbar vertebra?

Answer 1

• Large kidney bean shaped vertebral body
• Small vertabral canal
• Large pedicles
• Large, non-sloping spinous processes

Question 2

What are the articulation between the lumbar vertebra?

Answer 2

The vertebral arches articulate one with another by superior and inferior
articular facets bilaterally

Question 3

What type of joints are the joints between the superior and inferior facets of the lumbar vertebrae and what movements do they permit?

Answer 3

They are synovial joints. They allow limited flexion and extension and lateral flexion, but no rotation.

Question 4

What are the ligaments that support the vertebral bodies?

Answer 4

The anterior and posterior longitudinal spinal ligaments

Question 5

What is the location of the ligamentum flavum?

Answer 5

The ligamentum flavum is located on the posterior boundaries of the
intervertebral foramina (against the facet joints), thereby binding together
adjacent laminae.

Question 6

What is the composition of an intervertebral disc?

Answer 6

The periphery of the discs is made of tough
fibrous tissue known as the annulus fibrosis. The centre of the disc is not
fibrous but is composed of a gelatinous matrix called the nucleus pulposus.

Question 7

What is the pathophysiology of an intervertebral disc prolapse?

Answer 7

There is a weakening in the annulus fibrosis which causes a split/fissure through which the nucleus pulposus herniates. This can cause nerve root compression?

Question 8

What is the most common pattern of an intervertebral disc herniation?

Answer 8

Disc herniation most commonly occurs in an eccentric manner, as opposed to
a central pattern, thereby more often causing compression of spinal nerve roots
rather than the spinal cord itself.

Question 9

Which are the most commonly affected nerve roots in disc herniation?

Answer 9

L4/L5 or L5/S1

Question 10

What is the content of the nucleus pulposus?

Answer 10

The nucleus pulposus consists of collagenous fibres (type II collagen) in a
mucoprotein gel containing polysaccharide.

Question 11

What features may help you identify a cervical vertebra?

Answer 11

Large vertebral foramen
Thin long lamina
Short pedicles
Bifid spinous process
Transverse foramen

Question 12

In a cervical vertebra what is an uncus and what is its significance?

Answer 12

The uncus is a small upturned lip on the upper lateral margins of the cervical
vertebrae. They form uncovertebral joints with successive vertebrae and allow
rotational movements.

Question 13

What attachments are given by the anterior and posterior tubercles of the transverse process of the cervical vertebra?

Answer 13

The scalene muscles

Question 14

Describe the ligaments of the cervical spine?

Answer 14

The vertebral bodies are strengthened by the anterior and posterior
longitudinal ligaments on their anterior and posterior surfaces, respectively.
The vertebral processes are also joined by supraspinous and interspinous
ligaments (between spinous processes) and intertransverse ligaments
(between transverse processes).

Question 15

What is a cervical rib and what is the clinical significance?

Answer 15

A cervical rib is a rib extending from the transverse process of the C7 vertebra.

This can sometimes cause impingement of nearby anatomical
structures, resulting in reduced blood flow in the subclavian vessels (see the
question on subclavian steal syndrome, p. 63) or stretching of the lower brachial
plexus nerve roots. T1 root impingement can present with weakness of the
small muscles of the hand, for example.