Spine workshop Flashcards
What are 3 sections spine is composed of?
- Cervical
- Thoracic
- Lumbar
How many cervical vertebrae are there?
7
C1 + C2 are specialised in modified vertebrae to allow for rotation of the head
How many Thoracic vertebrae are there?
12 and 12 ribs
How many lumbar vertebrae are there?
5
In cervical level, the spine arches slightly inward the jaw, what is the curvature called?
Lordosis
What is the curvature called where the spine arches out slightly at chest level
Kyphosis
What does lumbar vertebrae have a role in?
Axial loading
What is found right at the bottom of spine below lumbar?
Sacrum [which is a fused spine]
What does sacral spine consist of?
5 segments - S1-S5 that together affect nerve communication to the lower portion of body
What is L2?
Lowest vertebral segment that contains spinal cord
What is coccyx?
Known as tail bone
Small, triangular bone
How is lumbar vertebrae located?
Longer and more posterior located
How is cervical vertebrae located?
Shorter and anterior located
Why is there a hole in the cervical spine?
Allow for the passage of vertebral arteries
What is vertebrae divided into?
Anterior and posterior portion
Anterior portion of vertebrae
Vertebral body +/- transverse process
Posterior portion of vertebrae
Linked by the pedicle
What is the pedicle?
Stub of bone that connects lamina to vertebral body to form the vertebral arch
What does pedicle form?
2 obliquely orientated bits of bone, the lamina
What makes up posterior wall of bony spinal canal?
Pair of laminae along with spinous process
What are bones attached together by?
Discs between bony elements anteriorly between vertebral body
What are posterior element linked by?
Facet joints
What does lamina link to?
Superior articulate facet and inferior articulate facet
Where is lamina difficult to see?
coronal and AP view
Lamina goes from pedicle and joins to form what?
Spinous process
T2 weighted sequence
Fluid is bright
Fat is bright
Tissues are in varying shades of grey
What is spinal befida?
A fault in the development of spinal cord and surrounding bones
What is pars interarticularis?
Small segments of bone that joins the facet joints in the back of spine
Defect = spondylolysis
Why does facet joints slide on each other?
To allow us to bend and flex
T1 weighted sequence (sagittal)
Fluid is dark
Fat is bright
Bone is a bit brighter than fluid
A bit of fat in the bone marrow
STIR = Inversion recovery pulse sequence
suppress various tissue signal
suppress fat therefore dark
When is STIR useful
Patients where there is a suspicion of fracture/trauma patients
pick up subtle fractures
What is found in between vertebral bodies?
Intervertebral discs
What does each intervertebral disc form?
Fibrocartilaginous joint - allow slight movement of vertebrae
Act as giant cushions
Gel-like substance in it
Seen on T2 weighted sequence
What is Annulus fibrosis?
Sturdy-like structure that encases a gel-like centre, nucleus pulposus
Enhances the spine’s rotational stability and helps to resist compressive stress
Layered structure consisting of water and sturdy elastic collagen fibres
What is nucleus pulposus?
Filled with gel-like elastic substance
Transmits stress and weight from vertebrae to vertebrae
What is coated on top and bottom of each vertebral body?
End-plate
What are endplates?
Complex structures that blend into intervertebral disc and help hold disc in place
What are the important spaces?
- Extra-dural space
- Sub-dural space
- Sub-arachnoid space
What is found in the intramedullary?
- Pial
- Subpial
- Grey matter
How do you characterise lesions in the spinal cord?
Whether they are intramedullary or extamedullary
What do peripheral lesion involve?
White matter
Where is compression and infarction observed in?
Anterior horn of grey matter
What are examples of inflammatory disease that affects both grey matter and white matter?
- Transverse myelitis
- Neuromyeliths optica
- Multiple sclerosis
- Cross sectional ischemia
what help differentiate what lesion it is ?
Grey matter
White matter
What gets supressed in the STIR?
Fat
Where does C8 leave spinal cord?
Below C7 vertebrae
What is ossification?
Bone overgrowth
When does the disc bulge?
more than 25% of disc circumference
<25%
Protrusion
Base is wider than apex
<25%
Extrusion
Apex is bigger than base
What are the classification of spinal lesion?
- Extra-dural: outside thecal sac (including bone lesion)
- Intradural extramedullary = within thecaql sac but outside cord
- Intramedullary = within spinal cord
What is Intramedullary?
When spinal cord is expanded
