Vertebral Column Flashcards

1
Q

What forms the intervertebral foramen? What passes through this?

A

-Superior & inferior vertebral notches of adjacent vertebrae & intervertebral disc which the spinal nerve passes through

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2
Q

What are the variations of cervical vertebrae?

A
  • Body small with elevated uncus laterally
  • Transverse process & pedicle
  • Transverse foramina
  • Spinous process is bifid
  • Articular facets superior direction superoposteriorly and inferior direction infer-anteriorly
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3
Q

What passes through the transverse foramen?

A

-Vertebral artery and vein to/from the brain, DO NOT pass through C7

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4
Q

Describe the different severities of a dislocated cervical vertebrae?

A
(A) flexion sprain
(B) 25% subluxation
(C) 50% subluxation
(D) Complete dislocation 'facet jumping'
Vertebral foramen relatively wide so subluxation may not compress spinal cord
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5
Q

Which spinal vertebrae are prone to dislocation?

A

Cervical as relatively flat articular facets

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6
Q

Describe the Atlas

A
  • C1
  • No spinous process or body
  • Anterior & posterior arches each with a tubercle and lateral mass
  • Medial surface of lateral mass has a tubercle for the transverse ligament which holds in place the dens of the axis
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7
Q

Describe the Axis

A
  • C2
  • 2 large flat surfaces (Superior articular facets which the atlas rotates)
  • Dens or Odontoid process
  • Held in position by transverse ligament of Atlas prevents horizontal displacement of Atlas
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8
Q

Describe a fracture of the Dens

A
  • Less dense so prone to fracture
  • Caused by hyperextension or hyperflexion
  • Spinal cord not usually affected
  • 30-50% result in non-union
  • Atlantoaxial arthrodesis using bone graft from iliac crest
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9
Q

Describe the features of the thoracic vertebrae

A
  • Heart shaped body with superior & inferior costal demi-facets for articulation with head of rib
  • Long poster-inferiorly extending spinous process
  • Transverse process- costal facet for articulation with tubercle of rib
  • Articular facets
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10
Q

What does the head of the rib articulate with?

A

superior & inferior costal demi-facets

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11
Q

What does the tubercle of the rib articulate with?

A

Transverse process

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12
Q

Which rib articulates with the superior demi-facet?

A

Head of the rib with the same number as the vertbrae

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13
Q

Describe the features of the lumbar vertebrae

A
  • Large body

- spinous process short & sturdy

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14
Q

Describe the features of the Sacral vertebrae and coccyx

A
  • Sacral promontory at S1
  • Anterior & posterior sacral foramen
  • Apex below S5
  • Sacral hiatus on posterior
  • Sacral canal
  • Sacral & coccygeal cornua on posterior
  • Superior articular facet posterior of S1
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15
Q

How are the vertebrae held together?

A
  • Zygapophysial joints between superior & inferior articular processes
  • Intervertebral discs
  • Ligaments
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16
Q

What does the orientation of articular facets determine?

A

Types of movement possible

17
Q

Describe the structure of intervertebral discs

A

-Annulus fibrosis= outermost, fibrocartilage ring attached to epiphyseal rim of vertebral body
-Nucleus pulposus= centre, gelatinous substance that acts as a shock absorber
Thickness determines flexability

18
Q

Name the ligaments of the vertebral column and what they do

A
  • Ligamentum flavum- binds lamina of adjacent vertebrae (behind pedicle)
  • Posterior longitudinal ligament=C2-Sacrum, prevents posterior herniation of IV discs
  • Anterior longitudinal ligament= Occipital bone & C1-sacrum
  • Intertransverse ligament=between transverse processes
  • Interspinous ligament= between spinous processes
  • Supraspinous ligament=tips of spinous process C7-sacrum
19
Q

Which ligament resists hyperflexion which resist hyperextension

A

Anterior longitudinal ligament only one to resist hyperextension all others resist hyperflexion

20
Q

Describe what happens in whiplash

A
  • Hyperextension of cervical neck
  • Anterior longitudinal ligament torn
  • Severe cases part of vertebral body avulsed & vertebrae dislocated- compression of spinal cord
21
Q

What are the curvatures of the spine and where are they?

A
  • Thoracic & sacral kyphosis (primary)
  • Cervical & lumbar lordosis (secondary)
  • Primary curvature present in foetus
22
Q

What are the effects of ageing on vertebral bones?

A
  • Osteoporosis= loss of trabeculae=compression fracture
  • Loss of bone density=concave vertebral bodies
  • Osteophyte development=increase force on rims of vertebrae
23
Q

What are the effects of ageing on intervertebral discs?

A
  • Slipped disc/ herniation of nucleus pulposus
  • Posterolateral direction between L4/L5 or L5/S1
  • Can compress spinal nerve roots= lower back pain or sciatica
  • Severe cases compresses most of cauda equina (cauda equina syndrome)
24
Q

Where does the caudal equina descend? What is this?

A
  • Lumbar Cistern

- Subarachnoid space between termination of cord & termination of dura/arachnoid matter

25
Q

Where does the lumbar cistern extend from?

A

Conus Medullaris L1/L2-S2