The Back

Question 1

Vertebral column

Answer 1

33 vertebrae

7 cervical
12 thoracic
5 lumbar
5 sacral
Few coccygeal

Question 2

Spine Motion

Answer 2

Flexion
Extension
Lateral bending
Rotation

Question 3

2 primary curvatures of spine

Answer 3

thoracic, sacral (kyphosis, concave anteriorly)

Question 4

2 secondary curvatures spine

Answer 4

cervical, lumbar (lordosis, concave posteriorly)

Question 5

Lumbar lordosis (2 types)

Answer 5

Hyperlordosis (anterior pelvic tilt, increased lumbosacral angle) (butt sticking out)
- via weak hamstrings –> tight hip flexors, tilts pelvis ANTERIORLY

Hypolordosis (posterior pelvic tilt, decreased lumbosacral angle)
– via tight hamstrings –> straightening of lumbar spine

Question 6

Kyphoscoliosis

Answer 6

lateral bending of spine AND excessive thoracic curvature

Question 7

Caudal epidural block

Answer 7

inject into sacral canal (through sacral hiatus)

Question 8

Cervical vertebrae

Answer 8

Have transverse foramina (vertebral arteries go through)

Question 9

C1

Answer 9

atlas, no vertebral body. Has depressions for occipital condyle.

Question 10

C2

Answer 10

axis, dens (pivot for skull)

Question 11

spinal extension

Answer 11

Inc distant between anterior part of vertebral bodies

Question 12

spinal flexion

Answer 12

Dec distance between anterior part of vertebral bodies

Question 13

Stenotic intervertebral discs

Answer 13

W/ age, ligaments and bones thicken, narrowing (stenosis) impinges on nerves in spinal canal and nerve roots exiting spine to legs.

Causes pain and numbness in back of legs

Question 14

Ostephytes

Answer 14

bone spurs

• As intervertebral discs degenerate –> extra movement in spine –> osteophyte formation (bone spurs)
• Ostephytes can also be formed via osteoarthritis

Question 15

dorsal primary rami

Answer 15

supply sensation from facet joints

Question 16

Anterior longitudinal ligament

Answer 16

starts at base of skull

narrow in cervical region, broader in lumbar

prevents hyperextension of spine

Question 17

interspinous ligament

Answer 17

prevents hyperflexion

Question 18

Posterior longitudinal ligament

Answer 18

prevents hyperflexion of spine and posterior protrusion of IV discs into canal

Question 19

Ligamentum flavum

Answer 19

between lamina of vertebrae

prevent excessive flexion of spine

Question 20

spondylopathesis

Answer 20

spine slippage (anterior displacement of vertebra or vertebral column in relation to vertebrae below)

Causes: congenital, isthmus (fracture), degenerative changes, etc.

Sx: LBP, musc tightness, pain, stiffness of thighs/buttocks, tenderness

Question 21

Spondolysis

Answer 21

fracture/malformation of pars interarticularis (between inferior and superior articular process)

poss via repetitive trauma to lumbar spine or strenuous sports

SCOTTY DOG SIGN

Question 22

Ankylosing spondylitis

Answer 22

chronic inflammatory arthritis and AI disease

affects joints in spine and sacroiliac joint in pelvis –> eventual fusion of the spine –> stiff and inflexible

HLA-B27

BAMBOO SPINE

Question 23

Pott’s disease

Answer 23

Spread of TB from other sites (pulm) to spine

May lead to psoas abscess –> under fascial sheath of posas major muscle

Question 24

3 layers of meninges

Answer 24

dura mater (outer)
arachnoid mater 
pia mater (on spinal cord itself)

Question 25

major bloody supply to the lumbar and sacral region of spinal cord

Answer 25

Great vertebral radicular artery (artery of Adamkiewicz)

Question 26

movements of lumbar vertebrae

Answer 26

flexion/extension only, NO rotation

Question 27

movements of thoracic vertebrae

Answer 27

rotation only, NO flexion/extension