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MSK Anatomy > Spine > Flashcards

Spine Flashcards

1
Q

What makes up the vertebral column

A 
33 vertebrae:
7 cervical 
12 thoracic 
5 lumbar 
5 sacral (fused as sacrum)
4 coccygeal (fused as coccyx)
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2
Q

List the 4 curves of a healthy spine

A

Lordosis (secondary curve) in cervical region
Kyphosis (primary curve) of thoracic region Lordosis of lumbar region
Kyphosis of sacral region

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3
Q

How do the curves of the spine develop

A

As a baby you start of with 2 primary curves
When you start moving your head and neck you develop your cervical secondary curve
When you start walking you develop the secondary lumbar curve

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4
Q

What is the function of the curves in the spin

A

Helps maintain posture & balance

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5
Q

List the features of a typical vertebra

A 
Body 
Vertebral foramen
2 Pedicles 
2 laminae 
Superior, inferior and transverse costal facet 
Superior and inferior articular facet 
2 transverse processes 
1 Spinous process
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6
Q

What other name is given to the C1 vertebrae

A

Atlas

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7
Q

What other name is given to the C2 vertebrae

A

Axis

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8
Q

How is C7’s structure different

A

No foramena transeverse process

Long spinous process - first one you can feel at the back of your neck

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9
Q

What is the structure of the intervertebral discs

A

Centre is the nucleus pulposus - jelly-like material

Surrounded by the anulus fibrosis - fibrous capsule

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10
Q

Describe the movement of the facet joints

A

Carry out flexion, extension and lateral flexion alongside the discs
Less flexion/extension at thoracic spine due to constraint of ribs

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11
Q

Describe the orientation of the facet joints

A

Cervical - horizontal to allow greatest movement

Lumbar - horizontal, less rotation

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12
Q

What happens to the intervertebral discs as we age

A

Lose water content

This leads to overload on the facet joints and therefore pain particularly on extension

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13
Q

What discs are most affected by degeneration

A

L4/5 and L5/S1

Also these vertebrae are most prone to fracture

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14
Q

Where do the motor neurons originate from

A

Anteriorly from the spinal cord

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15
Q

Where do the sensory neurons originate from

A

Dorsally

Bodies in the dorsal root ganglion

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16
Q

Where does the spinal cord end

A

Level of T12/L1

Becomes the cauda equina

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17
Q

Where does the spinal cord run

A

Down the spinal canal formed by the vertebral foramina

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18
Q

What forms the spinal nerves

A

Anterior and posterior roots from the spinal cord

Exits via the intervertebral foramen

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19
Q

What symptoms appear if the upper motor neuron of the cauda equina is affected

A

weakness spasticity, increased tone, hyperreflexia

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20
Q

What symptoms appear if the lower motor neuron of the cauda equina is affected

A

weakness, flaccidity, loss of reflexes

21
Q

Describe the path of the exiting nerve root

A

Lies outside the thecal sac

Passes under the pedicle of the corresponding vertebrae

22
Q

The transversing nerve root pair lie outwith the thecal sac - true or false

A

False
Lie within the sac
Positioned anteriorly

23
Q

What are the results of nerve root compression

A

Radiculopathy which causes pain down the sensory distribution of that dermatome
Called sciatica in the lower leg
Can also cause weakness in muscle and reduced/absent reflexes

24
Q

Which nerve roots contribute to the sciatic nerve

A

L4, L5, S1,2,3

25
Q

What is sciatica

A

Radiation of nerve pain along sensory distribution of Sciatic nerve

26
Q

What is neurogenic claudication

A

Radiculopathy or burning leg pain when walking
Gets better with rest
Caused by spinal stenosis

27
Q

What can cause spinal stenosis

A

Nerve roots being compressed by osteophytes and hypertrophied ligaments in OA

28
Q

What causes cauda equina syndrome

A

Pressure on the lumbosacral nerve roots
Usually caused by a prolapsed disc
Can include the sacral nerve roots for the bladder

29
Q

What are the symptoms of cauda equina syndrome

A

Bilateral lower motor neuron signs
Bladder and bowel dysfunction
Saddle anaesthesia
Loss of anal tone

30
Q

Name the 3 main muscles of the erector spine

A

Iliocostalis
Longissimus thoracis
Spinalis thoracis

31
Q

At which sites do you inject spinal anaesthesia or do a lumbar puncture

A

Posterior iliac crest L4

PSIS S2

32
Q

What are some bone causes of back pain

A

Fracture – trauma, osteoporosis, (spondylolisthesis)
Tumour
Infection

33
Q

What are some joint causes of back pain

A

Spondylosis & OA

Spinal stenosis

34
Q

What are some muscular causes of back pain

A

Sprains

Strains

35
Q

What are some disc causes of back pain

A

Discogenic back pain
Sciatica
Cauda equina syndrome

36
Q

What is mechanical back pain

A

Related to joints, ligaments & muscles with no sinister
features
Worse on activity, relieved by rest

37
Q

Consecutive vertebrae are of similar size - true or false

A

True

Any change to this suggests pathology

38
Q

What is different about the structure of C1

A

No vertebral body

39
Q

What is different about the structure of C2

A

Has an odontoid process which projects upwards and forms a joint with C1

40
Q

When would you use CT scans on the back

A

If there is high clinical suspicion of fractures but no sign on x-ray
If you need more detail on a fracture

41
Q

What is the function of intervertebral ligaments

A

Tether vertebrae together

Responsible for spinal stability

42
Q

How would you image the intervertebral ligaments

A

Directly seen on MRI
Normal ligaments are black
Damaged ones will be lighter

43
Q

When is MRI used to image spinal trauma

A

To provide details of spinal ligaments

In patients with neurological symptoms that aren’t explained by x-ray or CT - need more soft tissue imaging

44
Q

What are some x-ray and CT signs of bony tumours in the spine

A

bone destruction - reduced bone density
Vertebral collapse - pathological fracture
Bone sclerosis - increased bone density

45
Q

What are some MRI signs of bony tumours in the spine

A

early - bone marrow infiltration

late - extradural mass and spinal cord compression

46
Q

What is the function of the intervertebral discs

A

Cushion the body from spinal stresses
Should be pliable and contain water
Diseased discs will dehydrate

47
Q

What type of imaging is required to view the discs

A

CT or MRI

MRI is best

48
Q

What type of imaging is required to view the spinal cord

A

MRI

MSK Anatomy (4 decks)

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