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Anatomy (spine/back) > Spine > Flashcards

Spine Flashcards

1
Q

Describe in general the spine

A

Cervical:
Typical 3,4,5,6
Atypical 1,2 and 7

12 thoracic vertebrae each associated with a rib
5 lumbar vertebrae
5 fused sacral vertebrae
3-5 small coccygeal vertbrae

Function:

  • weight bearing
  • posture
  • support the limb
  • protection of the spinal cord
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2
Q

Discuss intervertebral disc

A

secondary cartilaginous joint – bone, layer of hyaline cartilage sandwiching a disc of fibrocartilage

Disc lies between the two vertebral bodies
Has an inner area called the nuclues palposis which is gelatinous, on the outside is the annulus fibrosus

Nuclues pulposus is the central cors of the IV disc. At birth these contain 88% water. Soft and squishy

Annulus fibrosis have alternately arranged lamellae, attached strongly to the anterior and posterior longtidunal ligament.

On the anterior aspect of the body of the vertebrae and running right down over the anterior surface of the disc is the anterior longitidunal ligament, similarly on the posterior side is the posterior ligament.
The posterior longitidunal ligament lies in the vertebral canal

There is no IV disc between the C1 and C2

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3
Q

Discuss the general asepct of a typical vertebrae

A

Each has a centrum and a neural arch

Body
pedicle
articular process on the superior and inferior aspect
lamina
spinous process
transverse process
Vertebral foreman – runs the spinal cord and all the meninges with CSF.

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4
Q

Discuss atlas

A

Formaen transversum in the transverse process
Superior facet which articulates with the occiput to give flexion and extension only
On its inferior surface there is a much flatter facet that articulates with the axis and allows rotation
Does not have a body but instead articulates with the Dens
Much smaller anterior arch and a march larger posterior arch

Lateral masses of the atlas articulate with occipital condyles

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5
Q

Discuss axis

A

More typical appearance apart from the dens which sticks up from its body and articulates with the atlas.
Bifid spinous process
Starting to see pedicles and lamina

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6
Q

Discuss typical cervical vertebra

A

C3-6

  • bifid spinous process
  • large triangular foramen
  • short wide pedicle
  • small body
  • formane transversum through which the vertebral artery, vein and sympathetics pass.
  • C6 has a large tubercle on its transverse process

All articular process arise on a transverse plan allowing for flexion and extension and lateral flexion but not for rotation in cercvical spine apart from c1 and 2

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7
Q

Discuss C7

A

large long non bifid spinous process
formane transversium small or abscent
artery never passes through but the vein often does
C7 nerve arises above the C7 vertebrae and the c8 emerges below

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8
Q

Discuss thoracic vertebrae

A

Typical features
Facets for the ribs on the transverse process and the body
Rib and transverse process is a synovial joint except for 11 and 12 in which it is a fibrous joint
most ribs artiuculate with the vertebrae on its level and the one above except for the 1st rib and the last 2 ribs

Rib 1 has 1.5 facets to its body for its own and the one below
Ribs 2-9 have 2 hemi facets
Rib 10 has 1 hemi facet
Ribs 11,12 have 1 full facet

Facets lie on a circle allowing rotations limited by the ribs

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9
Q

Discuss the lumbar vertebral

A

Large bodies
Broad flat spinous process
Wide and short pedicles
Interlocking facets which allow flexion and extension lateral extension nil else

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10
Q

Discuss the ligaments of the vertebral column

A

Anterior longitidunal ligament

    • runs along the anterior aspect of the bodies and the disc from the sacrum to the atlas and then becomes the atalanto-occipital ligament
  • only ligament that limits extension all other limit flexion

Posterior longitidunal ligament
-Attaches to the disc and the edge of the vertebral bodies but is loose between each of those, allowing a small gap which allow the vasi-vertebral veins to exit from the posterior aspect of the vertebral bodies

Ligamentum flavum

  • high content of elastic fibres
  • joins the anterior border of the lamina above to the psoterior border of the lamina below
  • stretcehd during flexion of the spine

Supraspinous ligament

  • joins the tips of the adjacent spinous processes
  • Lax in extension, taught in flexion
  • replaced by ligamentum nuchae in the neck

Interspinous ligament

  • weak sheets of fibrous tissues between spinous processes
  • mostly in the lumber region

Intertransverse ligament
-weak sheets of fibrous tissue between transverse processes

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11
Q

Discuss stability of C1/C2

A

Dens stability is dependent on
-Apical ligament which joins the apex of the dens to the anterior margin of the foramen magnum

  • alar ligaments lies obliquely on either side of the apical ligament, attached to sides of dens and margins of the foramen magnum. Strong and limits rotation of the head
  • tectorial membrane upper end of the posterior longitudinal ligament. Attaches to eh body of the axis and the margin of the foramen magnum
  • Transverse ligament: broad strong band that runs from lateral mass to the other passing between the dens and the spinal cord.
  • Weaker longitudinal band runs from the back of the body of the axis to the basioociput. Prevents posterior displacement of the dens and anterior displacement of the atlas
  • Together the transverse and longitudinal band make the cruciate
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12
Q

Discuss the vertebral venous plexus

A

Made up of an internal and external venous plexus.
Internal venous plexus lies external to the dural sac and communicated with veins with the vertebral bodies
The internal and external communicate freely

Valvless and blood can travel in any direction.The internal system drains to the external system

The external system communicate with

  • cervical veins
  • azygous veins
  • ascending lumbar veins
  • lateral sacral veins
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13
Q

Discuss the exit of spinal nerves

A

C1-7 emerge above the named vetebrae
C8 emerges below as do all this level

In disc prolapse the nerve affected is the one below. For example prolapse at T5,6 is T6

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14
Q

Discuss movement of the vertebral column

A

Atlantoocciputal – flexion and extension
Atlantoaxial – rotation
Cervical: -flexion, extension and lateral felxion
Thoracic-rotation,
Lumbar - flexion/extension, lateral flexion

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15
Q

Discuss the Uncovertebral joints (of Luschka)

A

Located between the unci of the bodies of C3-6 and the beveled inferolateral surfaces of the vertebral bodies superior to them

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16
Q

Discuss the joints of the vertebral arches

A

Calles the zygapophysial joints
These articulation are plane synovial joints between the superior and the inferior artricular process of the vertebrae.
Each is surrounded by a thin loose joint capsule. Those in the cervical region are especially loose
These joints allow a gliding movement between the articular procresses

17
Q

Discuss the atlantoaxial joint

A

There are three alantoaxial articulation
Two lateral between the inferior facets of the lateral masses of C1 and the superior facets of C2
One median between the dens and the anterior arach of the atlas.

The lateral joints are gliding type synovial joints
The medial joint is a pivot joint

Rotation of C1 and the skull occur as a unit on C2

18
Q

Discuss the curvatures of the back

A

4 curvatures -cervical, thoracic lumbar and sacral
Thoracic and sacral are concave anteriorly - kyphosis
Cervical and lumbar are concave posterioly -lordosis

The thoracic and sacral are primary curvatures that develop during foetal life

The cervical and lumbar are secondary which occur when the infant begins to raise its head for the cervical area and walking for the lumbar

19
Q

Discuss the arterial supply of the vertebral column

A

Two sources which supply the verebral column

1) vertical arteries
2) segmental spinal arteries

Vertical vessels branches of the vertebral artery

  • 1 Anterior spinal artery, which anterior to the anterior median vessels
  • 2 posterior spinal artery -runs in a posterior-laterael aspect (may be a route of the posteriorinferior cerebellaartery)
Segmental vessels --- feed in at each vertebral levels. They enter via the intervertebral foramina along with the spinal nerve routes. These are given off by different vessels depending on the region of the spinla cord they supply 
Cervical
-vertebral and deep cervical arteries 
Thorax
-posterior intercostal arteries
Abdo
-lumbar arteries

Segmental arteries dived into two branches
-posterior and anterior radicular arteries and follow the nerve routes

In some areas of there is a segmental medullary artery which arise from the segmental arteries directly and attach to the vertical arteries. The largest being in the lower thoracic and upper lumbar called the arteria radicularis magna

20
Q

Discuss venous drainage of the vertebral column

A

Longtitudinal veins

  • anterolateral and posterolateral veins which sit either sides of the dorsal and ventral nerve routes (4)
  • anterior and posterior spinal vein

All drain by posterior and anteior segemental veins and drain into the internal vetebral venous plexus. Sits in the extradural space outside the duramatter . Then drains to the external vetebral plexus

Anatomy (spine/back) (2 decks)

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