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Musculoskeletal System > Vertebral Column > Flashcards

Vertebral Column Flashcards

1
Q

What are the characteristic features of cervical and thoracic vertebrae?

A

Cervical vertebrae are immobile, have bifid spinous process (except C7), have transverse foramen Thoracic vertebrae are mobile, small vertebral foreman, singular spinous process

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2
Q

How many cervical vertebrae do we have?

A

7

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3
Q

How many thoracic vertebrae do we have?

A

12

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4
Q

What is the predominant movement achieved by the thoracic vertebrae?

A

Rotation

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5
Q

Which of the thoracic vertebrae contain demi-facets and which contain whole facets?

A

Demi-facets: T2- T8 Whole facets: T9-T10

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6
Q

The first cervical vertebrae is known as what?

A

Atlas

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7
Q

The Altas articulates with what structures superiorly and inferiorly?

A

Occiput of the skull (superiorly) C2 (Axis) (inferiorly)

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8
Q

What is the joint at the occiput of the skull and C1 known as and what movement is this res[onsible for?

A

The atlanto-occipital joint 50% of total flexion and extension “nodding”

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9
Q

What is the joint between C1 and C2 known as?What movement is it responsible for?

A

Atlanto-axial joint 50% of total rotation “head shaking”

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10
Q

Te atlas has what characteristic features?

A

It has no vertebral body, no spinous process, thick lateral mass and is the widest cervical vertebrae

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11
Q

What are the characteristic features of the axis?

A

It is the strongest cervial vertebrae, has an odontoid process (dens), a rugged lateral mass and a large spinous process

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12
Q

What is the purpose of the dens and transverse ligament?

A

To prevent horizontal displacement of the atlas (independent movement of C1 and C2)

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13
Q

Reumatoid arthiritis may result in what as a result of errosion of the transverse ligament where it attaches to the vertebrae?

A

May cause neurological injury as C1 and C2 can then move independently

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14
Q

What is the seventh cervical vertebrae known as? Why?

A

Vertebrae prominens It is the most prominent spinous process and can be used to orientate clinically

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15
Q

Does C7 have a bifid spinous process?

A

No

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16
Q

How do the transverse foramen of C7 compare to that of the other cervical vertebrae?

A

They are smaller in C7 and only transmit the accessory vertebral veins (does not contain the vertebral artery)

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17
Q

What is the nuchal ligament?

A

Thickening of the supraspinous ligament that connects all the tips of the spinous processes of C2 to C7

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18
Q

What is the nuchal ligament attached to?

A

External occipital protuberance Spinous processes of all cervical vertebrae Spinous process of C7

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19
Q

What is the role of the nuchal ligament?

A

Maintains secondary curvature of the spine Helps the C spine support the head A major site of attachment of the neck and trunk (Trapezius, Rhomboids)

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20
Q

Name the ligaments of the vertebral column?

A

Supraspinous ligament Ligamentum flavum Interspinous ligament Anterior longitudinal ligament Posterior longitudinal ligament

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21
Q

Which are the major ligaments of the vertebral column?Which is the strongest of these ligaments?

A

Anterior longitudinal ligament (Strongest)Posterior longitudinal ligament

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22
Q

What is the anterior cord of the nervous system responsible for? How might we test for the function of the anterior cord (anterior cord syndrome)?

A

Sensory and motor light touch, pinprick and pain

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23
Q

What is the posterior cord (dorsal columns) responsible for sensing? How might we test for posterior cord syndrome?

A

Vibration and proptioception Tuning forkSense of where limbs are without looking at them

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24
Q

What is the difference in reference between the central and more lateral tracts?

A

Central tracts move the arms Lateral tracts move the legs

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25
Q

In reference to dermatomes, what dermatome does the middle finger indicate?

A

C7

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26
Q

What is T10 dermatome found?

A

Umbilicus

27
Q

What myotome primary supplies the deltoid?

A

C5

28
Q

Myotome- Biceps?

A

C5,6

29
Q

Myotome- wrist extensors?

A

C6

30
Q

Myotome- Wrist flexors?

A

C7

31
Q

Myotome- finger flexors?

A

C7

32
Q

Myotome finger flexors?

A

C8

33
Q

Myotome- interossei?

A

T1

34
Q

Where would you test the reflex of C5 root?

A

Biceps

35
Q

Where would you test for the reflex of C6 nerve root?

A

Brachioradialis

36
Q

Where would you test for reflex of C7 nerve root?

A

Triceps

37
Q

What is a neural level?

A

The last functioning level that occurs below an injury

38
Q

What is the relevance of the level of the nipples?

A

This is the junction between C4 and T4

39
Q

What is the difference in the way that nerve roots exit in the C spine compared to the T spine?

A

The C spine nerve roots exit more horizontally The T spine nerve roots exit more vertically and then travel outwards

40
Q

At what point does the exit of the nerve root change from exiting below their vertebral body, to exiting above?

A

C7/T1 junction

41
Q

How many C nerve roots are there? How many C vertebrae are there?

A

8 C nerve roots 7 C vertebrae

42
Q

What is cervical spondylosis?

A

Degenerative osteoarthritis of the intervertebral joints in the cervical spine

43
Q

How does cervical spondylosis present in patients depending on whether it leads to pressure on the nerve root or the cord?

A

Pressure on the nerve root causes radiculopathy-dematomal sensory symptoms- paraesthesia, pain-myotomal motor weakness Pressure on the cord causes myelopathy -global weakness-gait dysfunction -loss of balance -loss of bladder and bowel control

44
Q

What is a hangman’s fracture? How is it caused?

A

Axis fracture through the pars interarticularis of C2 Caused by hyperextension of the head on the neck

45
Q

What does a hangman’s fracture result in?

A

The forward displacement of C1 and body of C2 on C3 because it is unstable

46
Q

What is an Odontoid fracture and how it it otherwise known?

A

Fracture through the adontoid process of C2 Known as a peg fracture or a dens fracture

47
Q

How does a peg fracture usually occur?

A

Can occur with both hyperflexion and hyperextension of the neck Usually hyperextension

48
Q

What is a Jefferson’s fracture? How might this be acquired?

A

Fracture of the anterior and posterior arches of the atlas Diving into shallow water, impact against the roof of a vehicle

49
Q

How might a Jefferson’s fracture present?

A

Pain, neurological signs usually not present due to the wide vertebral foramen Damage to arteries at the base of the skull may occur with neurological consequence- ataxia, Horner’s syndrome

50
Q

A whiplash injury is caused by _______ mobility, ______ stability impact

A

High Low

51
Q

How does a whiplash injury occur?

A

Hyperextension of the neck followed by hyperflexion

52
Q

How and why might a cervical prolapsed disc develop?

A

Lifting, whiplash, “woke up like this” Cause by tear to the annulus fibrosis which causes the nucleus pulposus to leak out and push into the spinal canal

53
Q

What will a patient complain of with a left sided C5/6 prolapsed disc? Which nerve root is affected?

A

Pain: biceps into thumb and index finger Motor weakness: biceps and wrist extension Sensory: numbness/pins and needles in thumb and index finger C6

54
Q

Which nerve root is affected if the patient has a prolapsed disc at C7/T1

A

C8

55
Q

How will the patient present if they have a C7/T1 intervertebral disc prolapse?

A

Pain: Down to little and ring fingers Motor weakness: long finger flexors Sensory: Numbness/pins and needles in little and ring fingers

56
Q

What is cervical myelopathy?

A

A condition caused by the narrowing of the spinal canal leading to whole cord dysfunction

57
Q

What is cervical radiculopathy?

A

A problem that results when a nerve in the neck is irritates as it leave the spinal canal- usually at the nerve root (not whole cord)

58
Q

How might cervical myelopathy occur?

A

Osteoarthritis of the cervical spine leading to the formation of osteophytes and therefore thinking of the ligamentum flavum - which then increased pressure to push on the spinal cord

59
Q

What will a patient complain of with a cervical myelopathy at C3/C4?

A

Pain: Neck Motor weakness: Shoulder abduction Sensory: Numbness/pins and needles from shoulder down to feet

60
Q

What will a patient complain of with a cervical myelopathy at C5/C6

A

Pain: Neck pain Motor weakness: Elbow flexion, wrist movements and finger movements Sensory: Numbness/ pins and needles from elbows down to feet

61
Q

Is cervical myelopathy an acute or progressive condition?

A

Progressive (age-related degeneration)

62
Q

How might thoracic cord compression occur?

A

As a result of a fracture of the vertebrae giving bony fragments or a tumour developing in the canal which compresses the spinal cord

63
Q

How might a patient with thoracic cord compression at T10 present?

A

Pain: Thoracic pain Motor weakness: All leg muscles Sensory: Numbness/pins and needles from umbilicus down Loss of sphincter control

64
Q

How would a patient with a T5 cord compression present?

A

Pain: High thoracic pain Motor weakness: All muscles in the legs and intercostals Sensory: Numbness/ pins and needles just below the nipples Loss of sphincter control

Musculoskeletal System (4 decks)

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