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Neuroanatomy > The Back, Spine and Spinal Cord > Flashcards

The Back, Spine and Spinal Cord Flashcards

1
Q

Describe the bones of the vertebral column?

A 
33 vertebrae in total 
7 cervical
12 thoracic 
5 lumbar 
5 sacral (fused)
4 cocygeal (fused)
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2
Q

Moving superior to inferior the vertebrae become ___1___ as they ____2______, however they then become ___________3________________

A

1) larger
2) bear more weight
3) smaller once the weight has transferred to the hip bones

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3
Q

What are the primary and secondary curvatures of the spine? What is meant by this?

A
  • Thoracic and sacral kyphosis are primary curvatures (ie they are the same as they are in the fetus)
    • Cervical and lumbar lordosis are secondary curvatures (ie they have adapted and changed orientation from the fetus due to change in function as we begin to weight bear and lift our heads)
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4
Q

Intervertebral foramen form between ____1_______, this is only place where ______2_______

A

1) adjacent vertebrae
2) spinal nerves are found (everything closer to the spinal cord is a rootlet and everything more distal is a spinal nerve rami either anterior or posterior)

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5
Q

What are facet joints?

A

These are joints between articular processes of adjacent vertebrae, these are synovial and can be affected by arthritis

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6
Q

What are intervertebral discs?

A

These are joints between the bodies of the vertebrae, they form a strong attachment but can herniate (slipped disc)

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7
Q

Intervertebral discs are found between all vertebral bodies except between __________________

A

C1 and 2 and between the fused sacrum and coccyx

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8
Q

What percentage of the total length of the spine do intervertebral discs make up?

A

20-25%

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9
Q

What are intervertebral discs important in?

A

weight bearing and strength

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10
Q

Describe the structure of intervertebral discs?

A

They are made up of an outer fibrous ring called the annulus fibrosus which provides a strong bond
They also have an inner soft pulp called the nucleus pulposus which is up to 90% water in newborns, it provides flexibility protection

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11
Q

Describe how intervertebral discs allow large movement of the spine?

A

Each disc allows movements, small amount of movement at each disc but together this can add together to produce a large amount of movement

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12
Q

Name five ligaments of the spine?

A 
Ligamentum flavum
Anterior longitudinal ligament
Posterior longitudinal ligament
Supraspinous ligament
Interspinous ligament
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13
Q

Describe the ligamentum flavum?

A

short tough ligament that connect adjacent laminae posterior to the spinal cord

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14
Q

What spinal ligament is being described?

short tough ligament that connect adjacent laminae posterior to the spinal cord

A

Ligamentum flavum

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15
Q

Describe the anterior longitudinal ligament?

A

runs anterior to the vertebral bodies, much broader and stronger, gives a lot more protection to the intervertebral discs, provides stronger support for the discs and helps prevent overextension (because it’s at the front it stops you pulling your back backwards as much)

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16
Q

What spinal ligament is being described?

runs anterior to the vertebral bodies, much broader and stronger, gives a lot more protection to the intervertebral discs, provides stronger support for the discs and helps prevent overextension (because it’s at the front it stops you pulling your back backwards as much)

A

anterior longitudinal ligament

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17
Q

Describe the posterior longitudinal ligament?

A

runs down posterior aspect of vertebral bodies although mainly attaches to intervertebral discs, found anterior to the spinal cord, narrow and weak, not a strong support of the disc, redirects any posterior herniation of nucleus pulposus, prevents over flexion of the spine (because it’s at the back it stops you pulling your back forwards as much)

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18
Q

What spinal ligament is being described?

runs down posterior aspect of vertebral bodies although mainly attaches to intervertebral discs, found anterior to the spinal cord, narrow and weak, not a strong support of the disc, redirects any posterior herniation of nucleus pulposus, prevents over flexion of the spine (because it’s at the back it stops you pulling your back forwards as much)

A

posterior longitudinal ligament

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19
Q

Describe supraspinous ligaments?

A

strong and fibrous ligaments, connects tips of the spinous processes

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20
Q

What spinal ligament is being described?

strong and fibrous ligaments, connects tips of the spinous processes

A

supraspinous ligaments

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21
Q

Describe interspinous ligaments?

A

more membranous (weaker), runs in between the spinous processes themselves

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22
Q

What spinal ligament is being described?

more membranous (weaker), runs in between the spinous processes themself

A

interspinous ligament

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23
Q

The spinal cord begins at the ______1______ and is continuous with the _____2_______

A

1) foramen magnum

2) medulla oblongata

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24
Q

The spinal cord is divided into segments which correspond with _____________

A

each pair of spinal nerves

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25
Q

In an adult around how long is the spinal cord?

A

42-45cm long

26
Q

Where does the spinal cord usually end?

A

It usually ends about vertebral level L1/L2 but may extend to L3 or finish at T12 in some individuals

27
Q

The spinal cord ends by tapering down to a point called the ________

A

conus medullaris

28
Q

In an adult the spinal cord only occupies ________________

A

about 2/3 of the spinal canal (reason for this is difference in growth rates as we develop)

29
Q

What do the spinal nerves from L2 to coccygeal nerves have to do?

A

have to grow longer to descend down and pass through the correct intervertebral foramen where spinal nerve is located

30
Q

What is the cauda equina?

A

(means horse’s tail) a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord

31
Q

What are the two enlargements of the spinal cord and why?

A

The spinal cord has a cervical enlargement and a lumbosacral enlargement (these relate to innervation of the limbs)

32
Q

Describe the protection of the spinal cord?

A

The spinal cord lies within the vertebral canal, it is surrounded by 3 layers of meninges and then by epidural fat. CSF floating in subarachnoid space (between arachnoid and pia mater). Within the epidural fat (sits in epidural space) also have internal vertebral venous plexus.

33
Q

Define what is meant by extrinsic back muscles?

A

external’
attach back to pectoral girdle
Attach out with the back themselves ie the pectoral girdle

34
Q

Give four examples of extrinsic back muscles?

A

latissimus dorsi
trapezius
levator scapulae
rhomboids

35
Q

Define what is meant by intrinsic back muscles?

A

‘internal’

entirely within back

36
Q

What is the role of the intrinsic back muscles?

A

maintain posture

move the spine

37
Q

What are the two groups of intrinsic back muscles? Which ones are superficial and which deep?

A 
erector spinae (superficial)
transversospinalis (deep)
38
Q

What are the names of the three erector spinae muscles?

A

Iliocostalis
Longissimus
Spinalis

39
Q

Describe origins and attachments of the erector spinae?

A

inferiorly - common tendon attaches to the sacrum & iliac crest

superiorly - individual muscle fibres attach (via tendon) to either:
Iliocostalis: a rib (between rib angles & tubercles)
Longissimus: a transverse process of a vertebra
Spinalis: a spinous process of vertebra

40
Q

Describe the location and attachments of transversospinalis muscles?

A

located within the grooves between the transverse & spinous processes

individual muscle fibres attach between:
- a vertebra and the skull

- a vertebra and a rib 

- one vertebra and another vertebra
- the sacrum and a vertebra
41
Q

Nerve supply of latissimus dorsi?

A

thoracodorsal nerve

42
Q

Nerve supply of rhomboids and levator scapulae?

A

dorsal scapular nerve

43
Q

Nerve supply of trapezius?

A

spinal accessory nerve

44
Q

Describe the nerve supply of intrinsic back muscles?

A

Segmental nerve supply as per the dermatome / myotome pattern. Posterior rami of spinal nerves.

45
Q

If the erector spinae contract bilaterally there is _____1___ if they contract unilaterally there is ___2_____

_______3_______ although flexion of the spine

A

1) extension of spine
2) lateral flexion
3) psoas major and rectus abdominus

46
Q

3 common features of cervical vertebrae?

A 
transverse foramen (for passage of vertebral arteries)
bifid spinous process (2 little points)
triangular shaped vertebral foramen
47
Q

What are C1 and C2 also known as?

A

C1 - the atlas

C2- the axis

48
Q

Describe the atypical features of C1?

A

does not have a body or spinous process

it has a posterior arch and an anterior arch instead

49
Q

Describe the atypical features of C2?

A

has an odontoid process/ dens projects superiorly from body

50
Q

What is the first palpable vertebral spinous process in most people?

A

C7

51
Q

Describe the atypical features of C7?

A

May be missing transverse foramen

52
Q

Describe the Atlanto-occipital joints?

A

between the occipital condyles and the superior articular facets of the atlas
synovial joints with loose capsule

53
Q

What movements does the Atlanto-occipital joints allow?

A

flexion & extension of the neck (main movement)
a little lateral flexion and rotation
Nodding your head- A YES JOINT

54
Q

Describe the Atlanto-axial joints?

A

3 articulations – all synovial
2 between the inferior articular facets of the atlas and the superior articular facets of the axis
1 between the anterior arch of the atlas and odontoid process of the axis

55
Q

What movements does the Atlanta-axial joint allow?

A

main movement is rotation
180 degrees rotation possible in the cervical spine
Shaking your head- A NO JOINT

56
Q

Instead of having intervertebral foraminae at sides of the sacrum there are ___________

A

anterior and posterior sacral foraminae, anterior and posterior rami pass through these foraminae

57
Q

Describe the safest place to insert spinal and epidural anaesthetic and why?

A

Needle is most safely inserted into the region where:
subarachnoid space surrounds the cauda equina, NOT the spinal cord
vertebrae are not fused (i.e. not the sacrum)
Usually means the L3/4 interspace

58
Q

When inserting spinal anaesthetic what layers does the needle have to pass through?

A 
supraspinous ligament
interspinous ligament
ligamentum flavum
epidural space (fat and veins)
dura mater
arachnoid mater
finally reaches subarachnoid space (contains CSF)
59
Q

When inserting epidural anaesthetic what layers does the needle have to pass through?

A

supraspinous ligament
interspinous ligament
ligamentum flavum
epidural space (fat and veins)

60
Q

What is a laminectomy?

A

a surgical operation to remove the back of one or more vertebrae, usually to give access to the spinal cord or to relieve pressure on nerves

61
Q

What is the central canal of the spinal cord?

A

cerebrospinal fluid-filled space that runs through the spinal cord. The central canal is below the ventricular system of the brain, from which it receives cerebrospinal fluid, and shares the same ependymal lining

Neuroanatomy (11 decks)

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