Unit 4: neuroanatomy Flashcards

1
Q

what structures are unique to c-spine vertebra?

A
  1. compound spinous processes (2 projections, AKA bifid)
    +C2-C5: almost always bifid
    +C6: 50% of the time is bifid
    +C7: usually a single spinous process (0.3% of population have a bifid C7)
  2. vertebral foramen have a larger diameter
    +the spinal cord is much larger at the top because it processes more information here than the bottom of the cord
  3. transverse foramen
    +these allow vertebral arteries to pass through
  4. transverse processes with SULCUS
    +this allows spinal nerves to pass through
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2
Q

the vertebral arteries pass through all of the transverse foramen except for:

A

C7 transverse foramen

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3
Q

in the C-spine, spinal nerves pass through the ______ and vertebral arteries pass through the ______

A

spinal nerves: transverse process SULCUS

vertebral arteries: transverse foramen

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4
Q

how is C1 different than the rest of the cervical vertebrae?

A

C1 is named “Atlas” because it “bears the weight” of the “globe” AKA our skull

also has special connections with C2 vertebra

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5
Q

what is C2’s nickname

A

axis

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6
Q

what is a major difference between C1 and C2; what structures does C1 have to help connect to C2 vertebra?

A

C1 does not have a vertebral body or a spinous process

C1 has an anterior arch comprised of the:
+anterior tubercle
+facet for dens
these structures help connect to C2

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7
Q

where do the occipital condyles lie on the atlas (C1)?

A

in the superior articular facets

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8
Q

why is the atlantoocipital ligament named like this?

A

atlanto – atlas
occipital – occipital bone
these ligaments (anterior and posterior) connect the atlas and the occipital bone

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9
Q

the occpital condyle/superior articular facets of C1allow for what type of head movement?

A

up/down – “nodding yes”

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10
Q

what structure of C2 is unique to C2?

what structures of C2 connects with C1?

A

the Dens is unique to C2

the Dens fits into the facet for Dens in C1, located in the anterior arch of C1

the anterior articular facet rubs against theposterior side of the anterior arch of C1

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11
Q

what type of movement does the head gain from the Dens of C2?

A

nodding head “no” – swiveling from side to side

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12
Q

list the generalized model of spinal ligaments

A
  1. anterior longitudinal ligament
  2. posterior longtiudinal ligament
  3. intertransverse ligament
  4. supraspinous ligament
  5. interspinous ligament
  6. ligamentum flava
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13
Q

what is special about the anterior and posterior longitudinal ligament?

A

these ligaments run all the way from the base of the skull to the sacrum/pelvis

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14
Q

how is ligamentum flava different from the rest of the spinal ligaments?

A

the ligamentum flava is stretchier than the other ligaments
+elasticity

the other ligaments are made of RIGID fibrous collagen

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15
Q

intertransverse ligament connects:

A

the vertebral transverse processes together

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16
Q

the supraspinous ligaments connect:

A

the OUTER vertebral spinous processes TIPS together

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17
Q

the interspinous ligaments connects:

A

the vertebral spinous processes together (inter = inside)

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18
Q

the ligamentum flava connects:

A

the vertebral arches together

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19
Q

when landmarking with a needle through the ligamenta flava, it is best to approach in this fashion:

A

off-midline

because there is a hollow opening in the middle of the ligamentum flava

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20
Q

the posterior atlanto-occipital ligament connects:

A

the arch of C1 and the back of the foramen magnum

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21
Q

the nuchal ligament and the supraspinous ligaments connect at this location:

A

external occipital protuberance

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22
Q

what is the vertebral prominens?

A

a landmark where the spinous process of C7 is palpable

Dr. Schmidt’s answer: where the T1 spinous process is palpable

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23
Q

t-spine curvature:

A

kyphotic/concave “)”

24
Q

what is the best approached angle for thoracic spinal anesthesia?

A

off-center d/t the downward facing spinous processes

25
Q

T-spine injuries are more prevalent than head/neck injuries: true or false?

A

false:

t-spine has more stability; it is strong and robust d/t attachment structures

26
Q

what are the 3 locations a rib can connect to the t-spine?

A
  1. transverse process costal facet
  2. inferior costal facet
  3. superior costal facet
27
Q

which rib pairs are “true ribs”

A

pairs 1-7

28
Q

which rib pairs are “false ribs”?

A

pairs 8, 9, and 10

29
Q

which rib pairs are the floating ribs?

A

pairs 11 and 12

30
Q

differentiate true ribs vs false ribs

A

rib pairs 1-7 are “true ribs” because they have costal cartilage that connects directly to sternum

false rib pairs are 8, 9, and 10 because they indirectly connect to the sternum via rib pair #7’s costal cartilage

31
Q

why are rib pairs 11 and 12 “floating” ribs?

A

not connected very well to t-spine; very prone to trauma

32
Q

which 4 structures are unique to t-spine vertebra?

A
  1. transverse process costal facets
  2. superior costal facets
  3. inferior costal facets
  4. downward angled spinous processes
33
Q

the head of ONE rib connects to the thoracic vertebra via these TWO facets:

A
  1. inferior costal facet of the thoracic vertebra above the rib head
  2. the superior costal facet of the thoracic vertebra the rib head is aligned with

ex) Rib #6 will connect with inferior costal face tof T5, and superior costal facet of T6

34
Q

the neck of the rib comes into contact with the transverse process here:

A

costal tubercle

35
Q

the vertebral bodies on the t-spine are ____ shaped

A

heart

think: “thoracic cavity houses the heart”

36
Q

why is the t-spine vertebral body flatter on the L side versus a more curved right side?

A

the left side is flatter due to the aortic compression

37
Q

lumbar spine anesthesia is best approached in the fashion:

A

midline, having the patient lean forward d/t spinous processes being out of the way

38
Q

how many bones comprise the sacrum at birth?

A

5

39
Q

when does the sacrum fuse into one bone?

A

during teenage years

40
Q

where does the sacrum connect with the lumbar spine?

A

the sacrum’s superior articular processes connect with the inferior articular processes of L5

41
Q

how many sacral foramina total are there?

A

8

42
Q

what is the median sacral crest?

A

remnants of fused sacral spinous processes

43
Q

what fuses to make the mediAL sacral crest?

A

inferior and superior articular processes

44
Q

what fuses to form the lateral sacral crest?

A

transverse processes

45
Q

what is the opening of the sacrum called closest to the coccyx?

A

sacral hiatus

46
Q

how many vertebra make up the coccyx at birth? after birth?

A

4 at birth
2 after

the vertebra closest to the sacrum is one vertebral; the other 3 original vertebra fuse to form one bone after birth

47
Q

how can you landmark areas for lumbar epidural/anesthetics?

A

palpate across the most superior parts of the iliac crests, you will find L4 medially

48
Q

how can you landmark areas to estimate access to S2 posterior sacral foramina?

A

palpate the posterior-superior illiac spine and move down approximatley 1 cm distally, and 1 cm medially

PSIS - posterior-superior illiac spine

49
Q

why would you landmark the posterior S2 sacral foramina and not S1?

A

S1 has a more lateral openingl; you cannot access it midline

50
Q

where does the inguinal ligament connect?

A

it connects at the pubic tubercle and anterior superior iliac spine

ASIS

51
Q

what does the iliolumbar ligament connect?

A

L4 & L5 transverse processes to posterior pelvis

52
Q

what is the pubic symphysis made of? what does it connect?

A

cartilage
the two pelvic bones

53
Q

what structures can you palpate/landmark in the sacral/lumbar/pelvic region?

A
  1. anterior superior iliac spine (ASIS)
  2. greater trochanter
  3. iliac crests
  4. posterior-superior iliac spine (PSIS)

(landmark L3/L4 at the transumbilical plane)

54
Q

what makes up an intervertebral disc?

A

nucleus pulposus
annulus fibrosis
hyaline cartilage

55
Q

explain the differences of the anterior intervertebral disc vs the posterior intervertebral disc

A

the anulus fibrosus has a “cross-hatch” fiber system anteriorly but it is not cross-hatched in the back

the posterior intervertebral dics are more prone to herniation

56
Q

what are 3 different ways to treat a disk herniation?

A
  1. spinal fusion - screws are placed into the vertebral discs to create stability; however, this will cause stress on the immediate above and below unaffected discs
  2. discectomy - disc removal
  3. laminectomy - part of the vertebral arch (the lamina) is removed to create more space to alleivate the pressure on the spinal nerves