Vertebral Column Anatomy

Question 1

Where is the primary curvature of the spine?

Answer 1

Thoracic and sacral

Question 2

Where is the secondary curvature of the spine?

Answer 2

Cervical and lumbar

Question 3

What is kyphosis?

Answer 3

Increased curvature of the thoracic vertebrae with age

Question 4

What is scoliosis?

Answer 4

L to R curvature of the back, often thoracic or lumbar. May be corrected with hardware.

Question 5

What is spondylolisthesis?

Answer 5

The L5 body has slid forward (defect in intervertebral arch) allowing the column to slide forward.

Question 6

What are the first and second vertebrae called?

Answer 6

Atlas and axis

Question 7

What makes the atlas unique?

Answer 7

No vertebral body, just arch

A portion of the axis will sit in this area and allow for mobility in the neck.

Question 8

What makes the axis unique?

Answer 8

The dens act as the vertebral body and insets into the atlas to provide mobility.

Question 9

What is unique about the cervical vertebrae?

Answer 9

They have a transverse foramen where we find the vertebral artery! Major blood supply to the brain stem.

Question 10

What is the function of the erector spinae? What nerve are they supplied by?

Answer 10

These are muscles that straighten up the vertebral body, very deep. Supplied by the DORSAL RAMI of the spinal nerves.

Question 11

What important structure is contained within the epidural fat? Why is this significant?

Answer 11

The internal vertebral plexus of veins–> VALVELESS meaning blood can flow in either direction! This is a common site of cancer metastasis!

Question 12

What are they three layers of the cord?

Answer 12

Dura mater, arachinoid, pia mater

Question 13

What is the dura mater?

Answer 13

A connective tissue covering over the spinal cord, the “tough mother”. This is continuous through the intervertebral foramen and surrounds the spinal nerve!

Question 14

What is outside of the dura mater?

Answer 14

The epidural space- containing the intervertebral plexus of viens

Question 15

What is located under the arachinoid membrane?

Answer 15

The subacachnoid space which contains the CSF!

Question 16

What layer is intimately attached to the spinal cord?

Answer 16

The pia mater, very flimsy connective tissue.

Question 17

What are denticulate ligaments? What is their function?

Answer 17

Ligaments formed by the pia, pierce the arachnoid and attach to the dura mater. These anchor the spinal cord and provide lateral stability.

Question 18

Where does the spinal cord end? What is this called?

Answer 18

The cord itself ends at approximately L2, this is called the conus medullaris.

Question 19

What do you call nerves below the conus medullaris? What surround them? This is an extension of what?

Answer 19

The caudal equina, surrounded by the internal/external medullary filum which ultimately anchor the nerves to the coccyx.

Question 20

What is the lumbar cistern?

Answer 20

Term given to the subarachnoid space with its CSF after the cord has ended. The cauda equina of nerves are within.

Question 21

Structure of the intervertebral disc

Answer 21

Dense connective tissue on the outside called the anulus fibrosus, and inside is a jelly-like substance called the nucleus pulposus. This nucleus pulposus is the substance that ruptures out with a herniated disc.

Question 22

Why is the weak spot of the disc significant?

Answer 22

Common site of disc bulging/herniation– this is where the nerves run so a herniation is likely to compress a nerve.

Question 23

If L4 herniation, which nerve gets compressed? Where would you see symptoms?

Answer 23

L5, the medial foot.

Question 24

Where do you inject spinal anesthesia?

Answer 24

Into the subarachnoid space, aka the lumbar cistern, where the CSF is.