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MSK > Vertebral Canal & Spinal Cord > Flashcards

Vertebral Canal & Spinal Cord Flashcards

1
Q

Within an isolated vertebra- the body, pedicles, and laminae form the

A

vertebral foramen

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2
Q

Stacking successive vertebrae foramen together creates the ______ throughout the length of the vertebral column

A

vertebral canal

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3
Q

Vertebral canal houses and protects the _____ and ______

A

spinal cord and the meninges (spinal membranes)

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4
Q

In the adult… the cord extends from the base of the skull to

A

~ L2 vertebral level (sometimes L1)

Spinal cord only occupies the superior 2/3rds of the vertebral canal

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5
Q

In the embryo, the spinal cord occupies ______ of the vertebral column (fig A)

A

the entire length; This allows the spinal nerves to pass through their associated intervertebral foramen at their level of origin

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6
Q

As a result of this disproportionate growth- the _____ nerve roots must grow the longest

A

lumbar & sacral/coccygeal

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7
Q

As a result of this disproportionate growth- the lumbar & sacral/coccygeal nerve roots must grow the longest

They descend until they reach their corresponding intervertebral foramen

This collection of nerve roots is referred to as the ______

A

cauda equina (horse’s tail)

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8
Q

Surrounding the spinal cord and extending from the base of the skull to S2 vertebral level is the _____… a tough protective covering formed by the dura mater

A

dural sac

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9
Q

_______ extends from the medullary cone to the tip of the dural sac

A

Internal filum terminale

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10
Q

Spinal cord has two enlargements that provide additional neurons for innervation to the limbs

A
  1. Cervical enlargement-innervates the upper limbs
  2. Lumbosacral enlargement–innervates the lower limbs
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11
Q

there is/isnt a difference between vertebral column levels and spinal cord levels

A

there is

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12
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13
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16
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19
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20
Q

It also important to consider the cervical nerves…

There are 8 cervical nerves but only 7 cervical vertebrae

______ exit the vertebral canal superior to vertebra of the same number (i.e. C4 spinal nerve exits between C3 and C4 vertebrae)

_____ exits below the C7 vertebra (i.e. between C7 and T1 vertebrae)

A

Cervical nerves C1-C7 ; C8 spinal nerve

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21
Q

_____ contains Cerebral Spinal Fluid (CSF) which helps protect the spinal cord and nerve roots

A

This subarachnoid space

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22
Q

The subarachnoid space is _____ with the subarachnoid space surrounding the brain

A

continuous

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23
Q

______ is the thin innermost membrane which firmly adheres to the surface of the spinal cord

A

Pia mater

24
Q

_____ are lateral extension of pia mater between the dorsal & ventral roots which help to anchor the cord laterally

n

A

Denticulate ligaments

25
Q

Between the vertebral canal and dura mater is the ______

A

epidural space

26
Q

This epidural space contains ______ and the _____

A

adipose (fat) tissue; internal (epidural) venous plexus;

27
Q

Blood supply to the spinal cord is derived from both ______ and ________ components

Both components are necessary to insure adequate blood supply to the cord

A

vertical (longitudinal) and horizontal (segmental)

28
Q

These vertical or longitudinal arteries include:

  1. ________ which arises from the vertebral arteries
  2. _______ which arise from the vertebral arteries (or the posterior cerebellar artery)
A

a single anterior spinal artery; Paired posterior spinal arteries

29
Q

______ are irregularly spaced vessels that communicate (anastomosis) with the longitudinal spinal arteries

A

Segmental or horizontal arteries

30
Q

The largest of these segmental vessels is the ______

A

great anterior segmental artery or “artery of Adamkiewicz”

31
Q

Venous blood from the spinal cord drains into the anterior and posterior _____ which course along the surface of the cord

A

spinal veins

32
Q

Spinal veins ultimately drain into the within the vertebral canal

A

internal or epidural venous plexus

33
Q

The internal or epidural venous plexus connects with the external venous plexus via _____

A

large basivertebral veins (which drain the vertebrae)

34
Q

Vertebral Venous Plexuses

A

These interconnecting vertebral venous plexuses (VVP) run along the length of the vertebral column AND typically have very few valves (if any)…allowing blood to flow unimpeded up and/or down the vertebral column

These interconnecting VVP (Batson’s plexus) have direct venous connections with veins in the pelvis and veins along the posterior thoracic wall

In addition, these VVP communicate with veins inside the cranial cavity (i.e. surrounding the brain) called dural venous sinuses (learn about those later)

These anatomical connections may account for the fact that cancer cells from the prostate (commonly) and breast and lung (less commonly) can sequester in these venous channels resulting in vertebral column bone cancer…or travel into the cranial cavity resulting in metastatic brain cancer

35
Q

Spinal tap is performed to obtain a sample of _____; explain the process with ligaments

A

CSF

Lower lumbar region (L3, L4 or L5) is ideal access site to the subarachnoid space (CSF) because the spinal cord terminates at about L2

nPatients lie with vertebral column flexed which spreads the lamina and spinous process apart

nNeedle is inserted through the:

  1. Supraspinous ligament
  2. Interspinous ligament
  3. Ligamentum flavum and finally the dura/arachnoid membranes into the subarachnoid space where CSF can be aspirated
36
Q

____ unites the anterior surfaces of the bodies of the vertebrae

A

Anterior Longitudinal Ligament (ALL)

37
Q

____ unites the posterior surface of the bodies of vertebrae- thus located inside the vertebral canal

A

Posterior Longitudinal Ligament (PLL)

38
Q

The posterior and anterior longitudinal ligaments are closely associated with the intervertebral (IV) discs…and provide ____

A

support/strength for the discs

39
Q
A

Posterolateral Herniation

40
Q
A

Posterior Herniation

41
Q

A posterolateral disc herniation between L4 & L5 vertebral level usually affects _____

A

L5 spinal nerve roots…

42
Q

termination of the spinal cord ~ L1/L2 vertebral column level

A

Conus Medullaris

43
Q

dorsal and ventral roots of lumbar & sacral spinal nerves

A

Cauda Equina (horse’s tail)

44
Q

Spinal cord is vascularized by longitudinal arteries that arise mainly from the _____ and _____ that enter the vertebral column via the IV foramen

A

vertebral arteries; segmental medullary arteries

45
Q

____ may account for the spread of cancer cells (prostate, breast) within the vertebral column/brain

A

Vertebral venous plexus (Batson’s)

46
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47
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48
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49
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50
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51
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52
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53
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54
Q

Needle is inserted through what layers for spinal tap?

A
  1. Skin
  2. Supraspinous ligament
  3. Interspinous ligament
  4. Ligamentum flavum
  5. Epidural Space
  6. Finally through the dura & arachnoid membranes into the subarachnoid space where CSF can be aspirated
55
Q

Lets return to Walter…now a 48 year-old man that suffered a previous whiplash injury. He visits his physician assistant 3 year after his whiplash injury and complains of recent onset pain/discomfort in his neck and tingling/ numbness in his right shoulder and arm. His physician assistant suspects he might have developed a herniated disc due to the auto accident. MRI scan reveals a posterolateral prolapsed disc between C5 and C6.

Which nerve roots are likely to be affected?

A

C6

56
Q

Protrusion of nucleus pulposus generally occurs ____ … where the anulus is thin and poorly supported by the posterior longitudinal ligament

A

posterolaterally

57
Q
A

MSK (10 decks)

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