Vertebral column and spinal cord Flashcards

1
Q

Cervical vertebrae distinctive features

A

Triangular foramen
Vertebral body is square shaped
Foramen in each transverse process (arteries and veins)
Bifid spinous process, except C1 and C7
Atlas and axis are specialised for movement

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2
Q

Thoracic vertebrae distinctive features

A

Circular foramen
Larger and stronger
Facets for rib articulation
Vertebral body is heart shaped

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3
Q

Lumbar vertebrae distinctive features

A
Triangular foramen
Large size - body
Rounded upper and lower facets to prevent rotation
Thin long transverse processes
Cylindrical body
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4
Q

2 major types of joints

A

Symphyses between vertebral bodies

Synovial joints between articular processes

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5
Q

A typical vertebrae has a total of…. joints with adjacent vertebrae
How many synovial and how many symphyses

A
6
4 synovial (2 above 2 below)
2 symphyses (1 above 1 below)
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6
Q

Intervertebral discs consist of

A

Annulus fibrosis

Nucleus pulposus

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7
Q

Annulus fibrosis is

role

A

collagen surrounded by fibrocartilage arranged in a
lamellar configuration

limit rotation

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8
Q

Nucleus pulposus is

role

A

soft gelatinous core

to absorb compressive forces between vertebrae

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9
Q

What can lead to herniation of the nucleus pulposus

A

Degeneration of the annulus fibrosis

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10
Q

Posterolateral herniation can

A

impinge on the roots of the spinal nerves in the intervertebral foramen > sensory deficits or pain

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11
Q

The synovial joints between superior and inferior articular processes on adjacent vertebrae are known as

A

zygapophysial joints

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12
Q

Movement in the:
Cervical
Thoracic
Lumbar regions

A

Cervical - flexion and extension
Thoracic - rotation
Lumbar - not much movement

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13
Q

Which ligament is attached superiorly to base of skull and extends along the anterior surface of the vertebral bodies to the sacrum

A

Anterior longitudinal ligament

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14
Q

Which ligament is attached superiorly to base of skull and extends along the posterior surface of the vertebral bodies to the sacrum

A

Posterior longitudinal ligament

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15
Q

Which ligament passes between the laminae of adjacent vertebrae

A

Ligamentum flavum

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16
Q

Which ligament is a triangular, sheet-like structure that forms the upper part of the supraspinous ligament, attaching from vertebrae C7 to the skull

A

Ligamentum nuchae

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17
Q

Which ligament passes along and connects the tips of the spinous processes from vertebrae CVII to the sacrum

A

Supraspinous ligaments

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18
Q

Which ligament passes between adjacent vertebral spinous processes; attach from the base to the apex of each spinous process

A

Interspinous ligaments

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19
Q

Which ligament is commonly damaged in whiplash

A

Anterior longitudinal ligament

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20
Q

The upper part of the ….. that connects C2 to the base of the skull is termed the

A

Posterior longitudinal ligament

tectorial membrane

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21
Q

Which ligament resists separation of the laminae in flexion + assist in extension

A

Ligamentum flavum

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22
Q

Which ligament is pierced during lumbar puncture

A

Ligamentum flavum

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23
Q

Which ligament supports the head

A

Ligamentum nuchae

24
Q

Muscles of the back are organised into… they are involved in …..

A

Superficial, middle and deep

Superficial - movements of the upper limbs
Middle - muscles attached to ribs, involved in respiratory movements?
Deep - movements of the vertebral column and head

25
Q

Superficial muscles include

A
trapezius
lattisimus dorsi
rhomboid major
rhomboid minor
levator scapulae
26
Q

Intermediate muscles include

A

Serratus posterior superior and inferior

27
Q

The deep muscles of the back extend from

A

the pelvis to the skull

28
Q

The deep muscles of the back are innervated by

A

branches of the posterior rami of spinal nerves

29
Q

Deep muscles of the back and what they do

A

2 spinotransversales - Extensors and rotators of the head and neck

erector spinae and traversospinales - Extensors and rotators of the vertebral column

interspinales + intertransversarii - stabilisers of the vertebral column

30
Q

Movement in the:
Cervical region
and why

A

most flexible - flexion, extension, lateral flexion, rotation –> articular surfaces between vertebrae almost horizontal so rotation is possible
Neck has less surrounding tissue than rest of back so less resistance to flexion and extension

31
Q

Movement in the:
Thoracic region
and why

A

T1-6: No flexion/ extension. Some lateral flexion, some rotation.
T7-12: Some flexion/ extension. Lateral flexion and rotation.

Intervertebral joints are almost vertical which reduces flexion/extension but allows lateral flexion and rotation.

32
Q

Movement in the:
Lumbar region
and why

A

Flexion/ extension. Some lateral flexion. No rotation.

The lumbar spine’s articular surfaces are curled around the articular surfaces of the adjacent superior vertebrae, ensuring no rotation

33
Q

names of C1 and c2

A

Atlas and axis

34
Q

Describe shape of atlas

A

Lacks a vertebral body

Ring-shaped, 2 lateral masses interconnected by an anterior + posterior arch

35
Q

Atlas: each lateral mass articulates with

A

superiorly with an occipital condyle of the skull, and inferiorly wit the superior articular surfaces of C2

36
Q

Which joint allows nodding

A

Atlanta-occipital joint

37
Q

The dens is held in position by … and acts as

A

the transverse ligament of atlas

acts as a pivot that allows atlas (and attached head) to rotate on axis

38
Q

The two superolateral surfaces of the dens possess…. that serve as

A

articular impressions

attachment sites for strong alar ligaments

39
Q

Alar ligaments role

A

connect to the medial occipital condyles and check excessive rotation of the head

40
Q

Landmark at C7

A

prominent spinous process

41
Q

Landmark at T3

A

at level of the medial end of the scapular spine

42
Q

Landmark at T7

A

at level of the inferior angle of the scapula

43
Q

Landmark at L2

A

level of lowest rib

44
Q

Landmark at L4

A

Level of the iliac crest

45
Q

epi/extradural space contains

A

connective tissue, fat and the internal vertebral venous plexus

46
Q

The arachnoid mater is separated from the pia mater by the

and ends at the vertebral level

A

Subarachnoid space

S2

47
Q

Vertebral level: end of spinal cord

end of subarachnoid space

A

SC: L1/2

Subarachnoid space: S2

48
Q

What do Arachnoid trabeculae do

A

interconnect the arachnoid and pia mater, and suspend blood vessels within the subarachnoid space

49
Q

What do the denticulate ligaments do?

A

Medially, denticulate ligaments attach the pia to the spinal cord

Laterally, each anchors the pia mater through the arachnoid mater to the dura mater

50
Q

The difference between spinal and cranial meninges

A
no epidural (extradural) space in the cranium
two layers of the dura mater in the cranium
51
Q

Reasons for carrying out a lumbar puncture

A

to obtain a sample of CSF for examination (e.g. suspected meningitis)
for spinal anaesthesia (agent injected into subarachnoid space)

52
Q

What is an epidural anaesthesia

A

a liquid agent injected into the epidural space to anaesthetise the spinal nerve roots

53
Q

Lumbar puncture position in adults and children

A

L3-4 in adults

2 or 3 vertebral levels lower in children

54
Q

If there is raised intracranial pressure, and a lumbar puncture is carried out what could happen

A

the sudden release of CSF could cause the brainstem to herniate through the foramen magnum into the vertebra. This is potentially fatal

55
Q

Explain in anatomical terms the most common causes of back pain

A

The lower spine is subject to increased stresses of weight-bearing and so the lumbar region is most commonly affected

lifting heavy objects. Extending the spineunder a heavy load can inflame intervertebral joints or place unequal pressure on the intervertebral disks, leading to local
joint pain and referred neurological pain, if there is also pressure on the spinal nerve

56
Q

the most common abnormalities of spinal curvature

A

Scoliosis – lateral deviation of the vertebral column
Kyphosis – excess thoracic curvature, “hump back”
Lordosis – excess lumbar curvature, e.g. due to obesity