Vertebral Column Flashcards

1
Q

How many bones make up the vertebral column?

A

32-34

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2
Q

Describe the gross functions of the vertebral column.

A
Centre of gravity
Attachment for bones
- Above bears and supports head
- Centrally ribs/scapula, indirect support for upper limbs
- Below articulates with the hip bones, together bear most of the body weight
Attachment for trunk muscle
Protection of the spinal cord
Segmental innervation of the body
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3
Q

Describe curvature of the vertebral column in the foetus

A

Anterior concave

Primary curvature throughout whole column

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4
Q

Describe kyphosis

A

Exaggerated anterior curvature

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5
Q

Describe curvature of the vertebral column in a young adult

A

Sinusoidal presentation to give great flexibility and resistance.
Two anterior and two posterior flexion
Secondary in cervical and lumbar regions
Primary in thoracic, sacral and coccyx

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6
Q

Describe curvature of the vertebral column in old age.

A

Secondary curvature disappears

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7
Q

How many vertebrae are separable from their neighbours?

A

24

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8
Q

What vertebrae are fused?

A

Sacrum (5)

Coccyx (4)

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9
Q

Describe the vertebral body

A

Usually the largest part and mainly weight bearing.
Size increases from top down
Linked adjacently by intervertebral discs
Arrangement repeated from C2/3 to L5/S1

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10
Q

Describe the structure of the vertebral arch

A

Spinous process in the midline
Transverse process laterally
Pedicle between body and transverse process
Lamina between transverse and sinous process
Articular processes at junction of lamina and pedicle, one superior and one inferior on both sides.

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11
Q

Describe the articular facets on the vertebral arch

A

One superior and one inferior on each side
Cartilage-lined to form synovial joints between adjacent vertebrae.
Strengthened by the ligamentum flavum.

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12
Q

What makes up the intervertebral foramen?

A

Superior and inferior notch of each pedicle

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13
Q

What class of joint are the vertebrae?

A

Secondary cartilagenous joints: symphyses

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14
Q

Describe changes in the intervertebral discs throughout the spine.

A

Increase in size from superior to inferior

Wedge shaped in the lumbar and thoracic levels, thickets anteriorly here

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15
Q

Approximately what percentage of the height of the vertebral column does intervertebral discs account for?

A

25%

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16
Q

What are the two regions of intervertebral discs?

A

Central nucleus pulposus and peripheral annulus fibrosis

17
Q

What is the origin of the nucleus pulposus?

A

Embryonic notochord

18
Q

Describe the nucleus pulposus

A

Jelly-like with high osmotic pressure: water reservoir

Changes size with age and position

19
Q

Describe a ‘slipped disc’

A

When the nucleolus pulposus herniates through the annulus fibrosis, can lead to degradation. Largely does so posteriolaterally.

20
Q

Describe marginal osteophytosis

A

A bony projection which develops on the exterior of the joint, most commonly secondary to osteoarthritis.
This is because load stresses on the disc alter as its size decreases.
Increased stress on the facet joints leads to osteoarthritis.
Decreasing disc height can lead to congestion of the intervertebral foramen and compression of the segmental nerves.

21
Q

Describe spondylosis deformans (senile ankylosis)

A

Progressive degeneration of the annulus, causing increasing osteophytosis at the disc space margins. Disc space is largely preserved.
Usually seen in the thoracocolumnar spine in the over-50’s.

22
Q

Describe the facet joint

A

Set of synovial plane joints between the articular processes of two adjacent vertebrae.

23
Q

Describe the anterior longitudinal ligament

A

Ends at the sacrum
Starts narrow then broadens, largely flat.
Strongest
Firmly attached to the periosteum of the vertebral bodies and free over the vertebral discs

24
Q

Describe the posterior longitudinal ligament

A

Thin at the bottom and thick at the top.
Serrated margins
Basivertebral veins separate it from the vertebral bodies, explaining why herniation mainly occurs at this point.

25
Q

Describe the ligamentum nuchae

A

Proximal attachment at the occipital protuberance.
Continuous with the supraspinous ligament.
Maintains secondary curvature.

26
Q

Describe the supraspinous ligament

A

Join tips of the adjacent spinous process
Strong bands of white fibrous tissue
Lax in the extende dspine
In flexion are drawn taut to mechanically support the spine.

27
Q

Describe the ligamentum flavum

A

Yellow in colour due to high content of elastic fibres.
Joint laminae of adjacent vertebrae
Attached to the front of the upper lamina and back of the lower lamina
Stretched by flexion of the spine

28
Q

Describe the interspinous ligament

A

Relatively weak sheets of fibrous tissue
Unites spinous processes along adjacent borders
Only well developed in the lumbar region
Fuse with supraspinatous ligament

29
Q

What are the distinguishing features of the cervical spine?

A
Smallest
Bifid spinous process
Oval transverse foramen
Vertebral artery through all except C7 (has accessory vertebral veins)
Large vertebral foramen
30
Q

What are the distinguishing features of the thoracic spine?

A

Increase in size from top downwards
Facets on the side of the body
Demi-facets for articulating with the ribs
Facets on transverse process (not T11/12) to articulate with tubercle of rib
Small and circular vertebral foramen

31
Q

What are the distinguishing features of the lumbar spine?

A

Largest of the discrete vertebrae
No costal facets
Triangular and small vertebral foramina
Spinous process not bifid

32
Q

Describe the atlas vertebra.

A
C1
Articulates with the skull
Forms the atlantooccipital and atlantoaxial joints.
No body or spinous process
Widest cervical vertebra
Body fixed within the axis
33
Q

Describe the axis vertebra.

A
C2
Strongest cervical vertebra
3 main features 
- odontoid process (dens)
- rugged lateral mass
- large spinous process
Dens prevents horizontal displacement of the atlas
34
Q

Describe a hangman’s fracture

A

Hanging causes the dens to fracture, atlantoaxial joint dislocates, compressing the spinal cord and causing death.

35
Q

What injuries is the cervical spine particularly susceptable to?

A

Whiplash

Sports injuries e.g. in a scrum

36
Q

What injury is the lumbar spine particularly susceptable to?

A

Herniation at L4/5 or L5/S1

37
Q

What is the cause of scoliosis?

A

Unbalanced muscle tone

38
Q

What is lordosis?

A

Excessive secondary curvature