Vertebral Column Flashcards by Carol Dumond

Forms from trying to stand/walk as a baby and counterbalancing the weight of the head/body.
-Curvatures are offset by switching directions and stacking on top of each other.
-Helps us balance weight loads placed upon it as we stand upright
-top: convexity faces forward
-Middle: convexity faces backward
-Lower Middle: convexity faces forward
-Bottom: convexity faces backward

S-Shape Curvature of Spine

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-Shifts forward with aging or disease, abnormally shaped vertebrae, etc.
-When out of sync = inc risk of falls
-Passes through upper vertebra, behind middle vertebra, and through lower vertebra, and comes to a point at the Sacral Promontory.

Line of Gravity

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The Center of Gravity is just 2-3 inches in front of this.
-Landmark on Sacrum

Sacral Promontory

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The balance point of the body. The point where all the forces acting on the body = 0.
-In a normal person, should be 2-3 inches in front of Sacral Promontory
-With aging, muscles/ligaments get weak and they lean forward, and can shift this forward and make them prone to falling.

Center of Gravity

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Spinal Column is in a C Shape
-Convexity is posterior and Concavity is anterior

Newborn

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As they start to hold their head up, the spine starts to develop secondary curvatures
-First secondary curvature formed is in the neck. In the neck, convexity is front so baby can balance head on the neck
-Without reverse curvature, then the baby couldn’t hold its head up. Helps baby balance head on its spine

3-5 months Old

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As baby starts to move, standing up forces the body to bear weight on the lumbar region of the spinal column. Start to see a reverse curvature forming there.
-Sacrum is fused and convexity is posterior
-Similar to adult spine

10-12 months old

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How long is a normal adult vertebral column?

72-75 cm (28-30 in)

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Curvatures that you are born with.
-Thoracic
-Sacral

Primary Curvatures

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Curvatures that form as a result of gravity and balance.
-Cervical
-Lumbar

Secondary Curvatures

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What is the normal number of vertebrae?

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How many cervical vertebra?

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How many thoracic vertebra?

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How many lumbar vertebra?

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How many sacral (fused) vertebra?

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How many coccygeal (fused) vertebra?

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Flexible Vertebra that give mobility to the spine

Cervical, Thoracic, and Lumbar

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Fused vertebra that provide support.

Sacrum and Coccyx

Serves as a point of attachment posteriorly to support the flat sheet of muscle found in the pelvis that covers up the pelvic outlet (birth canal). Supports pelvic diaphragm/pelvic viscera.

Coccyx

Formed by the lamina, pedicles, spinous processes, and transverse processes.
-Creates an opening called the Vertebral Canal that houses the spinal cord.
-Posterior

Neural Arch

Formed by one part of vertebra articulating with the vertebra below.
-Purpose is flexibility
-Gliding joints/Plane Joints (similar to synovial joints)
-All joints move together as a unit (summative) to give us our total flexibility in the spine

Facet Joint

The Articular Processes stick up off of the neural arch on either side. These have Articular Facets that articulate with the Articular Facet of the vertebra above.

Facet Joint

Formed by the Superior Articular Process with its facet facing inward of one vertebra, and the Inferior Articular Process with its facet facing outward of the vertebra above it.

Facet Joint

Interarticular part of the vertebra. A segment of bone located between the inferior and superior articular processes.
-Can fracture due to aging, weak bones, lots of back stretching, etc.

Pars Interarticularis

A complete fracture of the Pars Interarticularis. -Can be painful or minor symptoms -A stress fracture leads to breakdown of the bone.

Spondylolysis

A complete fracture of the Pars Interarticularis, and the upper vertebra (where fracture occurred) has slid forward onto the lower vertebra. -Very painful -Fracture with displacement of a vertebra onto another. -Requires surgery or just rest.

Spondylolisthesis

Formed by the Superior and Inferior Articular Notches. -When you put two vertebra together, the superior articular notch faces upward, and connects with the inferior articular notch of the one above it. These form a hole on the side of the vertebral column -The opening/hole allows the spinal column to transmit nerves out. Vulnerable with herniated discs. -2 per vertebra - one on each side.

Intervertebral Foramen

-Body: egg shaped, not that big (not supporting much weight) -Large, triangular shaped spinal canal (spinal cord at this level is big due to axons for brachial plexus) -Bifid Spinous Process (muscles attach here to pull head/spinal column into extension - causes remodeling of the bone) -Transverse Processes have a hole - transverse foramina (contain vertebral arteries on either side) -Has an Uncus on the body of the Cervical Vertebra

C3-C6

Come off of Subclavian Artery, Skips C7, enters vertebral column at C6, travels up neck, passes through C1, goes medially, and enters the foramen magnum

Vertebral Arteries

-Has a long, horizontally pointed spinous process with a tubercle on the end of it -Has transverse processes with transverse foramina -Has a large spinal canal -Has an Uncus on the body of the Cervical Vertebra

Found on the body of the Cervical Vertebra. -Makes body look like a canoe. Sticks up on either side -Purpose is to allow cervical vertebra to interlock together and keeps them from sliding around each other

Uncus (Uncinate Processes)

Facets are in the transverse plane in their articulations -Most conducive for maximum movement of the cervical spine. -Turns head, flex/extend neck, put ear to shoulder, look right/left, etc. -Cervical spine has the greatest mobility of all the spine

Facets have changed orientation to an upright position and articulate in the coronal plane. -Difficult to flex/extend, rotate, etc. because they block each other -Can only move from one side to the other in the coronal plane -Has the vertebral prominence: Spinous process sticks way far out, makes a bump making the root of the neck where the shoulders and the neck join together.

-Heart shaped bodies -Smaller, rounder vertebral canal -Long, caudally pointing spinous processes -Facets are oriented in the coronal plane (can only get lateral movement) -Facets are facing backwards, and articulate with another facet on a vertebra that is facing anteriorly -Have demifacets: half on each vertebra, creating a cup.

Thoracic Vertebra

Superior and Inferior Costal Demifacets -Two vertebra put together puts the demifacets together, forming a costal cup where the head of the rib attaches. -Ribs attaching to these vertebra restricts movement -Number of rib corresponds with the number of the lower thoracic vertebra. (ex: 5th rib articulates with T4 and T5) -Ribs also articulate on the Transverse Processes- called the Head-Vertebral Articulation

Demifacets of thoracic vertebra

-Body looks more like an egg -Has a short, stubby spinous process -Superior facet faces posteriorly (coronal plane), and inferior facet faces externally (sagittal plane)

T12

-Big, thick bodies -Triangular shaped, larger spinal canal (axons for lumbosacral plexus) -Facets are in the sagittal or semi-sagittal plane for articulation (praying hands) -Flexion/extension. Bending over, standing up straight, etc. -Have Mammillary Processes on the Superior Articular Processes due to back muscles attaching here to pull back into extension (remodeling) -Have Accessory Processes on the base of the Transverse Processes -also for the attachment of big muscles that pull back into extension

Lumbar Vertebrae

-Has 4 pairs of foramina -Has a Median Sacral Ridge (spinous processes of fused vertebra) and 2 Lateral Sacral Ridges -Has the Sacral Canal running through it - extension of the spinal canal -Canal ends inferiorly in the apex of this in an opening called the Sacral Hiatus

Sacrum

Formed by two Sacral Cornu (horns) located on either side, laterally of this. -The inferior ending of the sacral canal in the sacrum

Sacral Hiatus

Formed by 4 fused segments -Has a Body, transverse processes, and coccygeal cornu (horns) -Coccygeal Cornu articulate with the sacral cornu to complete formation of the sacral hiatus, and establish an articulation point between the coccyx and the sacrum itself. -Pelvic Diaphragm attachment

Coccyx

Joint formed by the articulation of the sacral cornu with the coccygeal cornu -Can get arthritis - pain with sitting down

Sacrococcygeal Joint

Ligaments that hold the Sacrococcygeal joint together. -1 Posterior and 2 Lateral -Helps the joint to be stable. Major issues occur with falling, arthritis, etc.

Sacrococcygeal Ligaments

Done for surgery on the anal canal or perineal region or genitalia. -Insert needle past posterior sacrococcygeal ligament to enter Sacral Hiatus. Inject anesthetic into sacral canal to anesthetize the roots flowing there, that supply sensation to the anal canal, perineum, and genitalia

Caudal Block