Vertebral Column

Question 1

What is “humpback”?

Answer 1

excessive kyphosis

Question 2

What is “hollow back/swayback”?

Answer 2

excessive lordosis

Question 3

What is scoliosis?

Answer 3

Abnormal lateral curvature

Question 4

What is the vertebral column composed of?

Answer 4

33 vertebrae.
Cervical (7 total. C1, C2)
Thoracic (12 total. each articulates with a pair of ribs)
Lumbar (5 total, large vertebrae for support of the body’s weight)
Sacral- (five fused vertebra for stability in the transfer of weight from the trunk to the lower limbs)
Coccyx-( 4 total, Co1 is often not fused but Co2-Co4 are fused, remnant of embryonic tail)

Question 5

Name four curvatures of vertebral column.

Answer 5

cervical lordosis
thoracic kyphosis
lumbar lordosis
sacral kyphosis

Question 6

What is the cervical lordosis?

Answer 6

2ry curvature acquired when the infant can support weight of the head

Question 7

What is the thoracic kyphosis?

Answer 7

1ry curvature (fetal position)

Question 8

What is lumbar lordosis?

Answer 8

2ry curvature acquired when the infant walks and supports his own weight

Question 9

What is sacral kyphosis?

Answer 9

1 ry curvature

Question 10

What is the sacrum?

Answer 10

5 fused vertebrae that form a single, wedge shaped bone. provides support for pelvis

Question 11

What do the sacrum and coccyx form?

Answer 11

the sacroccygeal region. forms part of the pelvic girdle

Question 12

What is the coccyx?

Answer 12

Remnant of embryonic tail and usually consists of four vertebrae, with the last three often fused into a single bone. lacks vertebral arches and has no vertebral canal

Question 13

What are some features and variations of vertebrae that can vary (that clinicians must be aware of especially on radiographic imaging?)

Answer 13

cervical rib- extra rib articulating with C7
lumbar rib- extra rib articulating with L1
sacralization- L5 is partially incorporated into the sacrum
Lumbarization- S1 is partially separated from the rest of the sacrum

Question 14

Name joints of the vertebral column. (5)

Answer 14

joints of the verebral bodies
joints of the vertebral arches
craniovertebral (atlanto-axial and atlanto-occipital) joints
costovertebral joints
sacroiliac joints

Question 15

What are IV discs?

Answer 15

secondary cartilaginious joints. designed for weight bearing and strength. articulating surfaces of adjacent vertebrae are connected by IV discs and ligaments

Question 16

What does each IV disc consist of?

Answer 16

annulus fibrosus (outer fibrous part, concentric lamellae of fibro-cartilage)
nucleus pulposus ( gelatinous central mass. core of the IV disc)

Question 17

What are the joints of the vertebral arches?

Answer 17

zygapophyiscal joints (facet joints)

Question 18

Describe major features of typical vertebra.

Answer 18

Body (weight bearing portion that tends to increase in size as one descends the spine)
Vertebral arch
Articular processes 
intervertebral foramen
lamina
pedicle
transverse processes
spinous process
vertebral foramen

Question 19

Discuss differences between the cervical, thoracic and lumbar vertebrae.

Answer 19

See diagram

Question 20

What type of joints are the vertebral arches/zygapophysical joints (facet joints)?

Answer 20

plane synovial joints… between superior and inferior articular processes of adjacent vertebrae. Allows some gliding and sliding movements.

Question 21

Describe the ligaments of the vertebral column:
Anterior longitudinal ligament (AL) 
Posterior longitudinal ligament (PL)
Ligamentum flavum
Interspinous ligament
Supraspinous ligament
Intertransverse ligament

Answer 21

anterior longitudinal ligament- connects anterior vertebral bodies and IV discs
posterior longitudinal ligament - connects posterior vertebral bodies and IV discs
ligamentum flavum- connects adjacent vertebral laminae
interspinous ligament- connects vertebral spinous tips
intertransverse ligament- connects vertebral transverse processes

Question 22

What is a laminectomy?

Answer 22

surgical extension of one or more spinous processes and the adjacent supporting vertebral laminae in a particular region of the vertebral column

Question 23

Where does the spinal cord begin and end?

Answer 23

Begins as a continuation of the medulla oblongata (caudal part of the brainstem)

Ends as inferior tapering end called the conus medullaris

Question 24

Where does the spinal cord lie and where does it extend?

Answer 24

Lies in the vertebral canal and it extends from the foramen magnum to the level of the L1 or L2 vertebra in adults and L3 in children

Question 25

What is the cauda equina?

Answer 25

a loose bundle of nerve roots arising from the lumbosacral enlargement and the conus medullaris. Resembles a horse tail.

Question 26

What fissures and sulci mark the spinal cord externally?

Answer 26

the anterior median fissure, the posterior median sulcus and posterolateral sulcus

Question 27

What is grey matter? Where?

Answer 27

surrounds a small central canal in internal spinal cord. H shaped appearance and rich in nerve cell bodies

Question 28

What is white matter?

Answer 28

rich in nerve cell processes, which form large bundles or tracts that ascend and descend in the cord to other spinal cord levels or carry information to and from the brain

Question 29

What are the spinal cord enlargements and where are they?

Answer 29

2 enlargements.
Cervical enlargement occurs in the region associated with the origins of spinal nerves C5 to T1, which innervate the upper limbs

lumbosacral enlargement- region associated with origins of spinal nerves L1 to S3, innervate the lower limbs

Question 30

Discuss the arterial supply to the spinal cord.

Answer 30

One anterior spinal artery

Two posterior spinal arteries

Question 31

Discuss the two posterior spinal arteries of the spinal cord.

Answer 31

They are branches of the vertebral artery superiorly. As they descend the cord, the anterior and posterior spinal arteries receive blood from radicular arteries

Question 32

Where are radicular arteries derived from?

Answer 32

posterior intercostal, lumbar, iliolumbar, lateral sacral

Question 33

Discuss venous drainage in regards to the blood supply of spinal cord.

Answer 33

veins that drain the spinal cord form a number of longitudinal channels. These channels drain into an extensive internal vertebral plexus in the extradural (epidural) space of the vertebral canal.

Question 34

From where does the dura mater of the spinal meninges extend?

Answer 34

from the margin of foramen magnum to the level of S2.

Question 35

Describe three components of spinal meninges.

Answer 35

dura mater (tough mother)
arachnoid mater
pia mater

Question 36

What is filum terminale?

Answer 36

is a delicate ligament, which extends from the conus medullaris of the spinal cord down to the coccyx. Composed mainly from pia matter. At level of S2, the dura and arachnoid fuse with it to transverse the sacral canal to end on the back of the coccyx.

Question 37

What is the denticulate ligament?

Answer 37

toothed ligament formed by pia matter. extends laterally pierces the arachnoid to be attached to the dura between the two spinal roots.

Question 38

What are the two parts of the filum terminale?

Answer 38

pial part (filum terminal internal
dural part (filum terminal exernum)

Question 39

Where do you place a lumbar puncture (spinal tap) ?

Answer 39

between L3 and L4 verebrae

Question 40

What is the arrangement of the structures at the vertebral canal from outside to inside?

Answer 40

epideral space
dura mater
subdural space
arachnoid mater
subarachnoid space with CSF
pia mater
spinal cord and cauda equina

Question 41

What is the conus medullaris?

Answer 41

the end of spinal cord. inferior tapering end

Question 42

Describe the dura mater and where it extends.

Answer 42

Forms a tough, outer protective layer. Provides tubular sheath for each dorsal and ventral nerve root. Extends from the margin of foramen magnum to the level of S2.

Question 43

Describe the formation of the two rami branches.

Answer 43

The posterior and anterior nerve roots unite (within or proximal to intervertebral foramen) to form a mixed spinal nerve which immediately divides into two rami branches

Question 44

What are the two rami branches?

Answer 44

dorsal (posterior) ramus - small ramus

Ventral (anterior) ramus -larger ramus