Vertebral column

Question 1

Number of vertebrae in each section

Answer 1

Cervcial- 7
Thoracic-12
Lumbar- 5
Sacral- 5 fused
Coccygeal- 4

Question 2

Curvatures of the spine

Answer 2

Primary- same direction as foetal- Thoracic and sacral

Secondary- opposite to foetal -Cervical and lumbar

Question 3

Typical features of a vertebrae

Answer 3

Vertebral body
Vertebral arch
Pedicle joins them
Lamina

Articular process- visible.on the side- can be rotated sideways- superior articulates with inferior articulate process of superior vertebrae

Question 4

Intervertebral discs

Answer 4

Water filled structures with cartilage/collagen rings around them and gel in the middle
Allow flexibility

Question 5

Features of different type of vertebrae

Answer 5

Cervical- Foramen transversarium
Rectangular bodies
Bifid spinous process

Thoracic- heart shaped body
Long downward pointing spinous process

Lumbar- large kidney shaped body
Short blunt spinous process

Question 6

Features of atlas

Answer 6

No vertebral body

No spinous process

Question 7

Features of axis

Answer 7

Dens of axis on top of vertebral body

Question 8

Ligaments of atlas and axis

Answer 8

• ALAR LIGAMENTS: come from the underside of the skull, across to the odontoid peg (dens)
• CRUCIATE LIGAMENT: Goes from the skull down to the C2 vertebra, and across from the C2 to the other side
• Anterior to dens

Question 9

Joints of axis, atlas and the skull

Answer 9

• ATLANTO-OCCIPITAL JOINT: between skull and C1 – the ‘yes’ joint – allows nodding – Flexion/extension
• ATLANTO-AXIAL JOINT: between C1 and C2 – the ‘no’ joint – allows rotation (odontoid peg)

Question 10

Ligaments in the vertebral column

Answer 10

Supraspinous
Intraspinous
Ligamentum flavum
Anterior and posterior longitudinal

Question 11

Impact of height of the intervertebral disc

Answer 11

If height is reduced too much

Nerves emerging from foramina are impinged- resulting in pain, weakness, changes in sensation and paraesthesia

Question 12

Where nerves emerge relative to the vertebra

Answer 12

Cervical emerge above vertebrae- except C8

Rest emerge below vertebrae

Question 13

Discrepancy between growth of vertebral column and spinal cord

Answer 13

Column grows at greater rate
Point at which nerves emerge from spine get progressively further from where they exit the spinal cord
Below L2 no spinal cord- bundle of nerves- caudal equina

Question 14

Use of caudal equina

Answer 14

Give spinal anaesthetic

Take CSF- lumbar punture

Question 15

Prolapsed disc

Answer 15

Disc can rupture and the contents can emerge into the space occupied by nerve or spinal cord- causing pain and paraesthesia

Question 16

Movements of the spine

Answer 16

Extension and flexion
Lateral flexion
Rotation

Question 17

Muscles aiding movement of spine

Answer 17

Oblique
Rectus abdominus
Transverse abdominus

Question 18

Spinal nerve origin and what each rami suplly

Answer 18

Ventral horn/root contains motor neurones and the dorsal contains sensory

These then form a spinal nerve with an anterior and posterior ramus
Anterior- supplies limbs and abdominal wall
Posterior– innervates intrinsic muscles of back

Question 19

Dura mater in the caudal equina

Answer 19

Dura mater and arachnoid mater travel further down the vertebral column than the spinal cord

The pia mater is adherent to the spinal cord – it ends essentially surrounding the spinal cord at L2

*A small filament extends down from the base of the spinal cord – the filum terminale

Question 20

Where spinal and epidural anaesthetic are given

Answer 20

Epidural- outside dura
Spinal- subarachnoid space

Both at caudal equina

Question 21

Epidural space

Answer 21

Space between dura mater and vertebral column

Created since the periosteal layer isn’t in the vertebral column

Question 22

Superficial extrinsic muscles of the back

Answer 22

• Trapezius
• Latissimus dorsi
• Levator scapulae
• The rhomboids

Question 23

Blood supply of spinal cord

Answer 23

1 anterior spinal artery
2 posterior spinal arteries

Aorta gives intercostal which branches to radicular (travel across spinal nerves)- which supplies spinal arteries - these travel down the spinal cord