Spine Flashcards
Describe the articular facets of the first cervical vertebra
Superior facets are concave and kidney shapes
Inferior facets are circular and almost flat
Which ligaments attach to the odontoid process?
Transverse atlantal ligament
Apical odontoid ligament
Alar ligament
What type of joint is the atlanto axial joint?
Synovial pivot
Name the ligaments between C1 and C2
Anterior atlanto axial ligament
Posterior atlanto axial ligament
Transverse ligament
What is the first spinous process to be felt?
C7 - has a long spine or vertebral prominence
Why can we not feel the spinous processes above C7?
The spinous processes are small, bifid and attached to the nuchal ligament
Name the atypical cervical vertebrae and their atypical features
C1 (atlas) - no body and no spine
C2 (axis)- Body projects upwards in the form of the odontoid process, thick spine
C7 - very long spine, smaller foramen transversum
How many vertebrae make up the spinal column and how many spinal nerves are there?
7 cervical vertebrae, 8 cervical nerves
12 thoracic vertebrae, 12 thoracic nerves
5 lumbar vertebrae, 5 lumbar nerves
5 fused sacral vertebrae, 5 sacral nerves
3 fused coccygeal vertebrae, 1 coccygeal nerve
What are the characteristics of the lumbar vertebrae?
Very large bodies, kidney shaped
They lack transverse foramina, costal facets or bifid spinous processes
They have triangular- shaped vertebral foramina (like the cervical vertebrae)
Spinous processes are shorter than those of the thoracic vertebrae and do not extend inferiorly below the level of the vertebral body
What structures pass through the intervertebral foramen?
Root of each spinal nerve
Dorsal root ganglion
Spinal artery of the segmental artery
Communicating veins between the internal and external plexuses
Recurrence meningeal nerves
Transforaminal ligaments
At what level should a lumbar puncture be done?
L4/L5
What layers are passed through when undertaking a lumber puncture?
Skin, subcutaneous fat and fascia
Supraspinous ligament
interspinous ligament
Ligamentum flavum
Epidural space
dura mater
Arachnoid mater
CSF
What is the anatomy of the intervetebral discs?
INternal nucleus pulposus surrounded by fibrocartilagenous annulus fibrosus
What type of joint is the intervetebral joint?
Secondary cartilaginous joint
What movements occur at the lumbar vertebrae?
Flexion, extension, lateral flexion and axial rotation
At what level does the spinal cord terminate in neonates and adults?
Neonates L3
Adults L1/2
What is the contents of the spinal canal below L1/2?
Cauda equina
What are the locations of the paravertebral venous plexus?
Anterior external vertebral venous plexus, the small system around the vertebral bodies
Posterior external vertebral venous plexus, the extensive system around the vertebral processes
Anterior internal vertebral venous plexus, the system running the length of the vertebral canal anterior to the dura
Posterior internal vertebral venous plexus, the system running the length of the vertebral canal posterior to the dura
What are the contents of the epidural space?
Lymphatics
Spinal nerve roots
Loose connective tissue
Fatty tissue
Small arteries
Network of internal vertebral venous plexuses
How do spinal metastases happen?
Spread from primary tumours is mainly by the arterial route
Retrograde spread through the Batson plexus
Direct invasion through the intervertebral foramina
What is Batson’s venous plexus
A network of veins with no valves that connect the deep pelvic veins draining the bladder, prostate and rectum to the internal vertebral venous plexus
Which tumours commonly metastasise to the spine?
Breast
Lung
Thyroid
GI tract
Prostate
Kidney
Lymphoma
Melanoma
Multiple myeloma
What structures are found at C6
Termination of the phayrnx and beginning of the oesophagus
Termination of the larynx and beginning of the trachea
Entry of the vertebral artery to the foramen transversum
Intermediate tendon of omohyoid crosses the carotid sheath
MIddle thyroid vein emerging from the thyroid
Inferior thyroid artery entering the thyroid gland
