Vascular Structures Of The Spine Flashcards
True or false: most capillaries feeding muscles are closed when at rest
True
True or false: channels open during exertion
True
What is the largest branch of the subclavian artery?
Vertebral artery
Into how many parts are the vertebral arteries divided?
Four
What are the boundaries of the 1st section of the vertebral artery?
*Subclavian artery to C7
Between which muscles is the 1st section of the vertebral artery?
Longus coli and anterior scalene
What structures are posterior to the 1st section of the vertebral artery?
C7 TP
Stella the ganglion (common nerve block)
What are the boundaries of the 2nd section of the vertebral arteries?
C6-C1
True or false: the 2nd section of the vertebral artery ascends through all transverse foramen
True
What are the boundaries of the 3rd section of the vertebral arteries?
C1-foramen magnum
Describe how the 3rd section of the vertebral artery passes the lateral mass of c1
VA passes medial and posterior to lateral mass of c1
Where does the 3rd section of the VA rest?
Vertebral notch of posterior arch
Through which ligament does the 3rd section of the VA pass?
Posterior Atlanta-occipital ligament
What are the boundaries of the 4th section of the vertebral arteries?
Foramen magnum to basilar artery
On what structure does the 4th section of the vertebral artery rest?
Posterior clivus
What do the left and right VA’s merge to form?
Basilar artery
What are the arteries of the spinal cord?
Anterior spinal artery
Posterior spinal artery
Radicular arteries
From which arteries does the anterior spinal artery arise?
Two medial branches from vertebral arteries
What is the approximate location of the anterior spinal artery in relation to the spinal cord?
Anterior to median fissure of cord
What does the anterior spinal artery (asa) supply and what does it NOT supply?
*anterior 2/3 of cord
Does NOT supply posterior columns and horns
What are the branches of the anterior spinal artery?
Anterior central arteries - supply ventral horn
Where does the anterior spinal artery narrow?
Conus medullaris
Where is the conus medullaris located?
Inferior border of L1
From which arteries do the posterior spinal arteries arise?
Vertebral arteries - inferior to branching of anterior spinal arteries
What portion of the spinal cord does the posterior spinal arteries supply?
Posterior 1/3 of cord
*either side of Posterolateral cord
At what portion of the spine does the posterior spinal arteries begin to be fed by the radicular arteries?
Below the upper cervical region
Which artery supplies the posterior spinal arteries below the upper cervical region?
Radicular arteries
At what part of the spinal column does the posterior spinal arteries end?
Cauda equina
What is the artery that creates a reinforcing network for the spinal cord?
Radicular arteries
Where do the radicular arteries enter?
IVFs of sacrum foramina
True or false: there are both anterior and posterior branches of the radicular arteries
True
From which arteries do the radicular arteries develop?
Vertebral artery
Deep cervical/ascending artery
Posterior intercostals
Lumbar and lateral sacral arteries
From what do lumbar arteries arise?
Abdominal aorta
What is another name for the artery of adamkiewicz?
Arteries radicularis magna (ARM)
What is the artery of adamkiewicz?
A large radicular artery
From what does the artery of adamkiewicz generally arise?
Left posterior intercostals
What percentage of artery of adamkiewicz arise from the right posterior intercostals?
~17%
At what level does the artery of adamkiewicz generally enter?
T9-L3
True or false: loss of one artery of the spinal cord can lead to widespread deficit in the thoracic spine
True
True or false: drop in pressure for 3-5 minutes in small radicular arteries can result in necrosis of neurons
True
True or false: radicular arteries supply the vertebrae, meninges, and the spinal cord
True
What is the function of the denticulate ligament?
Holds spinal cord in central position
*creates floor or shelf-like support for nerve roots
Between which two structures is the denticulate ligament?
Arachnoid mater and dura mater
The denticulate ligament runs medial to lateral or lateral to medial?
Medial to lateral
True or false: spinal veins are a network of anastomosing vessels that run the entire length of the spine
True
What are batson’s venous plexus?
Plexus separate from veins of thoracic and abdominal cavities
Do batson’s venous plexus have valves within the veins of the spinal column?
No
What is the valsalva maneuver?
Bearing down or pretending you’re blowing up a balloon
What does the valsalva maneuver cause?
An increase in intra-abdominal pressure
- blood is shunted to venous system
- Increases pressure in cord
- could cause pain in disc herniation patients
What blood returns via the baton’s venous plexus?
Blood from the pelvis and abdomen
What are the divisions of the external venous plexus?
Anterior external venous plexus
Posterior external venous plexus
With which veins do the anterior external venous plexus communicate?
Basivertebral and intervertebral veins
From what structure does the anterior external venous plexus collect blood?
Vertebral body
Where is the posterior external venous plexus located?
Posterior surface of vertebral arch and processes
Where does the internal venous plexus lie?
Within the central canal btwn osseous structures and dura mater
What are the main channels of the internal venous plexus?
Two anterior channels
Two posterior channels
Where are the basivertebral veins located?
Network of veins within the vertebral body
Is a Hahn’s venous cleft problematic?
No
What do the intervertebral veins drain?
Spinal cord
Internal venous plexus
External venous plexus