Spine Facts

Question 1

annulus fibrosis

Answer 1

composed of type I collagen, water, and proteoglycans

characterized by extensibility and tensile strength

high collagen / low proteoglycan ratio (low % dry weight of proteoglycans)

Question 2

nucleus pulposus

Answer 2

composed of type II collagen, water, and proteoglycans

characterized by compressibility

low collagen / high proteoglycan ratio (high % dry weight of proteoglycans)

proteoglycans interact with water and resist compression

a hydrated gel due to high polysacharide content and high water content (88%)

Question 3

Disc aging - DECREASES (5)

Answer 3

nutritional transport

water content
absolute number of viable cells
proteoglycans
pH

Question 4

correlation between the angle of trunk rotation and the radiographic Cobb angle is considered

Answer 4

linear

Question 5

Disc aging - collagen changes

Answer 5

overall conversion to fibrocartilage

no change in absolute quantity of collagen

collagen crosslinking increases

Question 6

Disc aging - INCREASES (3)

Answer 6

keratin sulfate to chondroitin sulfate ratio
lactate
degredative enzyme activity

Question 7

Which of the following is considered a normal age-related change in the intervertebral disk in the elderly?

Answer 7

Decreased water content

Question 8

The axial skeleton is derived from what embryonic site?

Answer 8

Sclerotome of the somites

Question 9

nucleus pulposus nutrition

Answer 9

diffusion through pores in the endplates

annulus is not porous enough to allow diffusion

Question 10

innervation to superficial fibers of annulus

Answer 10

dorsal root ganglion gives rise to the sinuvertebral nerve

Question 11

Energy supply for chondrocyte-like cells of nucleus pulposus?

Answer 11

: The intervertebral disk is an avascular structure in the adult. Nucleus pulposus cells have a critical need for glucose because they obtain their energy primarily by glycolysis, even in the absence of oxygen.

Remember: diffusion through end-plates

Question 12

main offender among inflammatory modulators
potentially responsible for nerve root pain in the setting of a herniated disk

Answer 12

TNF-alpha

Question 13

TENS units mechanism

Answer 13

superficial electrical stimulation

This electrical stimulation induces analgesia via inhibitory effects at the spinal cord level. The stimulation of small myelinated afferent fibers produces a presynaptic inhibition of the nociceptive transmission
via unmyelinated C fibers, thus decreasing the transmission of pain stimuli.

Question 14

Which of the following levels of the spine is most frequently involved in ossification of the
posterior longitudinal ligament (OPLL)?

Answer 14

OPLL is a cause of spinal stenosis and myelopathy most frequently seen in the Asian population but affects other populations as well. Men are affected more often than
women and the peak age at onset is in the sixth decade of life. It is often associated with other conditions such as diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis. The levels most frequently involved are C4, C5, and C6. More than 95% of the
ossification is localized in the cervical spine.

Question 15

function with C1-C3 SCI

Answer 15

• Ventilator dependent with limited talking.
• Electric wheelchair with head or chin control

Question 16

function with C3-C4 SCI

Answer 16

• Initially ventilator dependent, but can become independent
• Electric wheelchair with head or chin control

Question 17

function with C5 SCI

Answer 17

Independent ADL’s; electric wheelchair with hand control

Question 18

function with C6 SCI

Answer 18

Independent living; manual wheelchair with sliding board transfers, can drive a car with manual controls

Question 19

function with C7 SCI

Answer 19

Daily use of a manual wheelchair with independent transfers

Question 20

Normal?

Answer 20

Yes

5 mm odointoid tip = basilar invag

(Chamberlain line)

Question 21

body positions associated with the highest intradiskal pressure

Answer 21

sitting leaning forward

Question 22

notochord function

Answer 22

transient axis of support, provides for the initial axis of orientation of the developing embryo, and most importantly, plays a vital role in the induction of the tissues that eventually form the vertebral column

Question 23

dish vs as

Answer 23

Question 24

dish vs as vs djd radiograph

Answer 24