Spine and back

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Other than a fracture, what are the abnormal signs in this radiograph

Identify 1,2, 5

Answer 5

1. Abnormal alignment (the distance between the dens and the lateral masses of C1 on both sides is not equal)
2. Prevertebral soft tissue swelling due to fracture oedema

Question 6

What ligaments are attached to the odontoid process?

Answer 6

-Transverse atlantal ligament
-Apical odontoid ligament
-Alar ligament 9

Question 7

Answer 7

Question 8

What ligaments are attached to the odontoid process?

Answer 8

-Transverse atlantal ligament
-Apical odontoid ligament
-Alar ligament

Question 9

Answer 9

Question 10

What type of joint is the atlanto-axial joint?

Answer 10

-Synovial pivot joint

Question 11

What ligaments lie between C1 and C2?

Answer 11

-Anterior atlanto-axial ligament
-Posterior atlanto-axial ligament
-Transverse ligament

Question 12

What is the first spinous process to be felt?

Answer 12

-Spinous process of C7 (has a long spine = vertebral prominence)

Question 13

Demonstrate C7 on subject?

Answer 13

Question 14

Why can we not palpate the upper spinous processes?

Answer 14

-As they are short, bifid and attached to the nuchal ligament

Question 15

What are the atypical cervical vertebrae and the atypical features?

Answer 15

-C1 (atlas): no body, no spine
-C2 (axis): body projects upwards to form the odontoid process
-C7 (vertebra prominens): very long spine, smaller foramen transversarium

Question 16

How many vertebrae make up the spinal column: how many spinal nerves are there?

Answer 16

-7 cervical, 8 cervical
-12 thoracic, 12 thoracic
-5 lumbar, 5 lumbar
-5 fused sacral, 5 sacral
-3 fused coccygeal, 1 coccygeal

Question 17

Answer 17

Question 18

1, 2, 4, 7, 8, 10, 13

Answer 18

Question 19

1, 2, 4, 7, 8, 10, 13

Answer 19

Question 20

Answer 20

Question 21

Answer 21

Question 22

Answer 22

Question 23

what are the characteristic features of lumbar vertebrae?

Answer 23

Question 24

What are the structures passing through the intervertebral foramen?

Answer 24

-Root of each spinal nerve
-Dorsal root ganglion
-Spinal artery of the segmental artery
-Communicating veins between the internal and external plexuses
-Recurrent meningeal (sinuvertebral) nerves)
-Transforaminal ligaments

Question 25

What level would you carry out a lumbar puncture?

Answer 25

-L4-L5 (supracrestal line)

Question 26

What layers would you go through for a lumbar puncture?

Answer 26

-Skin, subcut fat, fascia -Supraspinous ligament -Interspinous ligament -Ligamentum flavum -Epidural space -Dura mater -Arachnoid mater -CSF

Question 27

What is the anatomy of an intervertebral disc?

Answer 27

-Internal nucleus pulposus surrounded by fibrocartilagenous annulus fibrosus

Question 28

What type of joint is an intervertebral joint?

Answer 28

-Secondary cartilagenous joint

Question 29

What type of movement do the lumbar vertebrae allow

Answer 29

Flexion, extension, lateral flexion, lateral rotation

Question 30

What level does the spinal cord terminate?

Answer 30

-L3 (at birth), L1/2 (adult)

Question 31

Answer 31

Question 32

Answer 32

Question 33

What are the contents of the spinal canal below L2?

Answer 33

Cauda equina

Question 34

What is the location of the paravertebral venous plexus?

Answer 34

-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

Question 35

Answer 35

Question 36

What is the contents of the epidural space?

Answer 36

-Lymphatics -Spinal nerve roots -Loose connective tissue -Fatty tissue -Small arteries -Network of internal vertebral venous plexuses

Question 37

Answer 37

Question 38

How do spinal metastases happen?q

Answer 38

-Spread from primary tumours is mainly by arterial route -Retrograde spread through batson plexus -DIrect invasion through the intervertebral foramina

Question 39

What is batson's venous plexus?

Answer 39

-network of veins with no valves that connect deep pelvic veins draining the bladder, prostate and rectum to the internal vertebral venous plexus

Question 40

What structures are found at C6?

Answer 40

-Termination of the pharynx and beginning of oesophagus -Termination of the larynx and beginning of the trachea -Entry of the vertebral artery to the foramen transversum -Intermediate tendon of the omohyoid cross the carotid sheath -Middle thyroid vein emerging from the thyroid gland -Inferior thyroid artery entering thyroid gland

Question 41

Demonstrate the hyoid bone (C3) and the cricoid cartilage (C6) on a subject?