Vertebral column and spinal cord Flashcards
Cervical vertebrae distinctive features
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
Thoracic vertebrae distinctive features
Circular foramen
Larger and stronger
Facets for rib articulation
Vertebral body is heart shaped
Lumbar vertebrae distinctive features
Triangular foramen Large size - body Rounded upper and lower facets to prevent rotation Thin long transverse processes Cylindrical body
2 major types of joints
Symphyses between vertebral bodies
Synovial joints between articular processes
A typical vertebrae has a total of…. joints with adjacent vertebrae
How many synovial and how many symphyses
6 4 synovial (2 above 2 below) 2 symphyses (1 above 1 below)
Intervertebral discs consist of
Annulus fibrosis
Nucleus pulposus
Annulus fibrosis is
role
collagen surrounded by fibrocartilage arranged in a
lamellar configuration
limit rotation
Nucleus pulposus is
role
soft gelatinous core
to absorb compressive forces between vertebrae
What can lead to herniation of the nucleus pulposus
Degeneration of the annulus fibrosis
Posterolateral herniation can
impinge on the roots of the spinal nerves in the intervertebral foramen > sensory deficits or pain
The synovial joints between superior and inferior articular processes on adjacent vertebrae are known as
zygapophysial joints
Movement in the:
Cervical
Thoracic
Lumbar regions
Cervical - flexion and extension
Thoracic - rotation
Lumbar - not much movement
Which ligament is attached superiorly to base of skull and extends along the anterior surface of the vertebral bodies to the sacrum
Anterior longitudinal ligament
Which ligament is attached superiorly to base of skull and extends along the posterior surface of the vertebral bodies to the sacrum
Posterior longitudinal ligament
Which ligament passes between the laminae of adjacent vertebrae
Ligamentum flavum
Which ligament is a triangular, sheet-like structure that forms the upper part of the supraspinous ligament, attaching from vertebrae C7 to the skull
Ligamentum nuchae
Which ligament passes along and connects the tips of the spinous processes from vertebrae CVII to the sacrum
Supraspinous ligaments
Which ligament passes between adjacent vertebral spinous processes; attach from the base to the apex of each spinous process
Interspinous ligaments
Which ligament is commonly damaged in whiplash
Anterior longitudinal ligament
The upper part of the ….. that connects C2 to the base of the skull is termed the
Posterior longitudinal ligament
tectorial membrane
Which ligament resists separation of the laminae in flexion + assist in extension
Ligamentum flavum
Which ligament is pierced during lumbar puncture
Ligamentum flavum
Which ligament supports the head
Ligamentum nuchae
Muscles of the back are organised into… they are involved in …..
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
Superficial muscles include
trapezius lattisimus dorsi rhomboid major rhomboid minor levator scapulae
Intermediate muscles include
Serratus posterior superior and inferior
The deep muscles of the back extend from
the pelvis to the skull
The deep muscles of the back are innervated by
branches of the posterior rami of spinal nerves
Deep muscles of the back and what they do
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
Movement in the:
Cervical region
and why
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
Movement in the:
Thoracic region
and why
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.
Movement in the:
Lumbar region
and why
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
names of C1 and c2
Atlas and axis
Describe shape of atlas
Lacks a vertebral body
Ring-shaped, 2 lateral masses interconnected by an anterior + posterior arch
Atlas: each lateral mass articulates with
superiorly with an occipital condyle of the skull, and inferiorly wit the superior articular surfaces of C2
Which joint allows nodding
Atlanta-occipital joint
The dens is held in position by … and acts as
the transverse ligament of atlas
acts as a pivot that allows atlas (and attached head) to rotate on axis
The two superolateral surfaces of the dens possess…. that serve as
articular impressions
attachment sites for strong alar ligaments
Alar ligaments role
connect to the medial occipital condyles and check excessive rotation of the head
Landmark at C7
prominent spinous process
Landmark at T3
at level of the medial end of the scapular spine
Landmark at T7
at level of the inferior angle of the scapula
Landmark at L2
level of lowest rib
Landmark at L4
Level of the iliac crest
epi/extradural space contains
connective tissue, fat and the internal vertebral venous plexus
The arachnoid mater is separated from the pia mater by the
and ends at the vertebral level
Subarachnoid space
S2
Vertebral level: end of spinal cord
end of subarachnoid space
SC: L1/2
Subarachnoid space: S2
What do Arachnoid trabeculae do
interconnect the arachnoid and pia mater, and suspend blood vessels within the subarachnoid space
What do the denticulate ligaments do?
Medially, denticulate ligaments attach the pia to the spinal cord
Laterally, each anchors the pia mater through the arachnoid mater to the dura mater
The difference between spinal and cranial meninges
no epidural (extradural) space in the cranium two layers of the dura mater in the cranium
Reasons for carrying out a lumbar puncture
to obtain a sample of CSF for examination (e.g. suspected meningitis)
for spinal anaesthesia (agent injected into subarachnoid space)
What is an epidural anaesthesia
a liquid agent injected into the epidural space to anaesthetise the spinal nerve roots
Lumbar puncture position in adults and children
L3-4 in adults
2 or 3 vertebral levels lower in children
If there is raised intracranial pressure, and a lumbar puncture is carried out what could happen
the sudden release of CSF could cause the brainstem to herniate through the foramen magnum into the vertebra. This is potentially fatal
Explain in anatomical terms the most common causes of back pain
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
the most common abnormalities of spinal curvature
Scoliosis – lateral deviation of the vertebral column
Kyphosis – excess thoracic curvature, “hump back”
Lordosis – excess lumbar curvature, e.g. due to obesity
