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Anatomy > Vertebral Column/Canal > Flashcards

Vertebral Column/Canal Flashcards

Vertebral Column and Canal Contents

1
Q

Four Functions of the Vertebral Column

A

Protection

Support of Body’s Weight

Movement/Locomotion

Posture

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2
Q

List vertebral types, number, and curvature

A

C7 Cervical Concave Posteriorly (lordoses)

T12 Thoracic Concave Anteriorly (kyphoses)

L5 Lumbar Concave Posteriorly (lordoses)

S5 Sacral (Fused)-Concave Anteriorly (kyphoses)

C4 Coccyx (Fused)

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3
Q
A
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4
Q

Describe what makes C1 and C2 unique?

A

C1 (Atlas) has no body or spinous process, lateral masses are weight bearing, grooves for the vertebral artery, facet for dens of C2

C1 structure allows for flexion and extension of the head

C2 (Axis) has a dens (the inherited body of C1) and facet for atlas

C2 structure allows for rotation of the head

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5
Q

Describe the difference between the cervical, thoracic, and lumbar vert.

A

Cervical vert

bifid process, transverse foramen for vertebral artery, uncinate process(lipping)

Thoracic Vert.

Spinous process, larger vert. body, transverse process facets, articulated facets for ribs (full or demi)

Lumbar Vert.

Larger vert. body, mammillary processes, larger vert overall

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6
Q

Function of the intervertebral foramen

A

Allows structures to enter and exit the vertebral canal

there is space posteriorly between the vertebral arches in lumbar vert.

no space between thoracic vert. sit on top of each other tightly

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7
Q

Structure of the Sacrum and Coccyx

A

Sacral has 5 fused vert.

Coccyx has 4 fused vert.

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8
Q

Describe Pars interarticularis, Spondylolysis, and Spondylolithesis

A

Pars interarticularis is the column of bone connecting the superior and inferior articular processes of vert.

Spondylolysis is a defect or fracture in the pars interarticularis

Spondylolithesis is a dislocation between adjacent vertebrae following Spondylolysis

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9
Q

Spinal Stenosis

A

Spinal Stenosis is the narrowing of the vertebral foramen

Extreme cases may cause extreme pain or numbness as the spinal cord becomes pinch

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10
Q

Joints of the Vertebral Bodies

Intervertebral and Uncovertebral joints

A

Intervertebral Joint or symphysis joints are connected by the intervertebral discs and ligaments

Uncovertebral joints are located between the uncinate process of C3/4 to C6/7

A common site for osteophyte(spur formation)

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11
Q

Describe Disc Herniations

A

A disc herniation is a protrusion of the nucleus pulposus into or through the annulus fibrosus

They usually extend posterolaterally where annulus fibrosus is relatively thin

They tend to cause nerve compression

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12
Q

Joints of the Vertebral Arches

Facet (Zygapophysial) Joints

A

Facet joints are a plane synovial joint that determines the movement of the body

In cervical region allows flexion and extension

In thoracic region facilitates rotation

In lumbar region they limit range of motion

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13
Q

Important Ligaments of the Vertebral Column

Anterior Longitudinal

Posterior Longitudinal (tectorial membrane)

Interspinous

Supraspinous

Nuchal

Intertransverse

Ligamentum flava

A

Anterior Longitudinal maintains the stability of IV joints and limits extension

Posterior Longitudinal prevent hyperflexion of the neck

Interspinous and supraspinous limit flexion

Nuchal is an attachment site for many muscles

Intertransverse limits lateral flexion

Ligamentum flava prevents abrupt flexion and damage to vert.

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14
Q

Atlanto-occipital and Atlanto-axial Joints

A

Atlanto-occipital is a condyloid synovial joint bet atlas and occipital bone

Atlanto-axial Joints is a plane or pivot synovial joint bet atlas and axis vert.

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15
Q

Cruciate and Alar ligaments of the craniovert. joints

A

Cruciate ligament holds the dens of C2 in position

Alar ligament limits excessive rotation of the head

Both ligaments maintain the stability of the head and prevent injury due to excessive movement

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16
Q

What does each of these become?

Posterior longitudinal ligament

Anterior longitudinal ligament

Ligamentum Flavum

A

Posterior longitudinal ligament becomes the tectorial membrane

Anterior longitudinal ligament becomes the anterior atlanto-axial membrane and the anterior atlanto-occipital membrane

Ligamentum Flavum becomes the posterior atlanto-occipital membrane

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17
Q

What is the difference between Kyphoses and Lordoses?

A

Kyphoses indicates an anterior concave of the spine

Lordoses indicates a posterior concave of the spine

Cervical and Lumbar have secondary or lordoses curvature (concave posteriorly)

The thoracic and sacral region have primary or Kyphoses curvature (concave anteriorly)

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18
Q

Venous Drainage of the Vertebral Column

Basivertebral and Intervertebral veins

A

Spinal veins form internal and external venous plexuses

Basivertebral veins form within the vertebral bodies and drain into the internal venous plexus

Intervertebral veins receive drainage from the spinal cord veins and vertebral venous plexuses and drain themselves into the vertebral veins of the neck and segmental veins of the trunk

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19
Q

What are the components of the vertebral canal?

A

Spinal cord

Spinal meninges

Spinal vasculature

Spinal nerve roots

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20
Q

Spinal Cord Function

A

The spinal cord is the major reflex center and conduction pathway between the body and brain

21
Q

Spinal cord grey vs white matter

A

The gray matter is the central region of the spinal cord that consists of interneurons and motor neurons

The white matter is the surrounding region of the spinal cord that consists mainly of myelinated axons that connect the grey matter and carry nerve impulses.

22
Q

What are areas of the spinal cord enlarged and why?

A

Cervical enlargement at C4/5-T1

Lumbosacral enlargement at L1/2-S3

Enlargement of the grey matter occurs in these areas to accommodate the neural machinery necessary to operate the limbs

23
Q

Define the function:

Conus medullaris

Filum terminale internum/externum

Cauda equina

A

Conus medullaris is the most distal end of the spinal cord (terminates around L1/2)

Filum terminale provides longitudinal support of the spinal cord

– Internum consists of neural tissue, connective tissue, and neuroglial tissue covered by pia mater.

– Externum closely adheres to the dura mater and attaches to the coccyx

Cauda equina is a bundle of spinal nerves and spinal nerve rootlets (horsetail resemblance)

24
Q

T1 vs T2 Weighted MRIs

A

In T1 the CSF is dark (hypointense)

In T2 the CSF is light (hyperintense)

25
Q

Spinal Meninges

List the Superficial to Deep Meninges

A

Surround, support, and protect the spinal cord and nerve roots, contains CSF

Superficial to Deep:

Dura mater

Arachnoid mater

Pia mater

26
Q

Dura Mater

A

The tough outer covering of the spinal cord or the membrane that envelops the arachnoid mater

Spinal dural sac surrounds the spinal cord and the cauda equina. It contains CSF which provides nutrients and buoyancy to the spinal cord

Dural root sheaths are an extension of the dura mater that surrounds the spinal nerves roots (extend laterally)

27
Q

Arachnoid Mater

A

The delicate, avascular membrane lining of the dural sacs and dural root sheaths.

It encloses CSF-filled subarachnoid space

28
Q

Arachnoid trabeculae

A

the delicate strands of connective tissue spanning the subarachnoid space connecting the spinal arachnoid and pia matter

29
Q

Pia Mater

Denticulate ligaments

A

Thin, transparent innermost membrane of the meninges enveloping the brain and spinal cord

Denticulate ligaments (pia mater) that anchors the spinal cord in the center of the vertebral canal

30
Q

Spinal Cord Spaces

Epidural

Dural-arachnoid

Subarachnoid space

A

Epidural Space

Located between the bone and dural sac and filled with internal vertebral venous plexus and fat

Dural-arachnoid space

potential space in injured patients when dural and arachnoid membranes separate (not present in healthy patients)

Subarachnoid space

Located between arachnoid and pia mater and filled with CSF

31
Q

Myelogram

A

Uses contrast to visualize specific spinal structures

32
Q

Lumbar Puncture Procedure

A

Procedure to withdraw CSF from spinal canal

Patient is asked to flex back (curl spine forward)

Needle inserted into dural sac (lumbar cistern) usually between L3 and L4 in adults

(L4 is about level with inter-illiac crest line)

At or below L4 in children

33
Q

Adult vs Newborn Spinal Cord Location

A

Longitudinal growth of the spinal cord lags behind that of the vertebral column during development

conus medullaris (distal end of the spinal cord) ends around L3 in a child, L1/2 in adults

34
Q

Spinal Cord Arterial Supply

A

Anterior spinal artery

Located in anterior median fissure, branches off from the vertebral artery and gives rise to sucul arteries

Posterior spinal arteries

Located in posterolateral sulci, branches off of either vertebral or posterior inferior cerebellar artery

By themselves, the anterior and posterior spinal arteries supply only the short superior part of the spinal cord​

35
Q

Segmental spinal arteries

A

Arise from ascending cervical, deep cervical, vertebral, posterior intercostal, and lumbar arteries just depending on their location

Enter vertebral canal via intervertebral foramina

36
Q

Anterior and posterior radicular arteries

Anterior and posterior segmental medullary arteries

A

radicular arteries supply blood to spinal nerve roots

segmental medullary arteries supply blood to the cervical and lumbosacral enlargements areas of the spinal cord

37
Q

Great anterior segmental medullary artery

A

Reinforces circulation to 2/3 of the spinal cord

If this artery is narrowed or obstructed, the patient may lose all sensation and voluntary movement inferior to the level of impairment

38
Q

Spinal Cord Venous Drainage

Internal vertebral venous plexus

A

Internal vertebral venous plexus are valve-less veins are located in epidural space

They communicate with intracranial veins and dural venous sinuses

39
Q

clinically importance of internal vertebral venous plexus

A

a potential route on infection

40
Q

Spinal Nerves

A

C1-C7 emerges superior to vert.

C8 spinal nerve emerges inferior to C7 vert.

Thoracic, Lumbar, Sacral spinal nerves emerge inferior to its corresponding vert.

41
Q

Disc Herniation Rule of Thumb for PLL

A

Cervical and lumbosacral disc herniations involve the nerve root that corresponds to the lower adjacent vertebrae

42
Q

Three Types of Disc Herniation

A

Posterolateral

Most common due to posterior longitudinal ligament

Far lateral

Impingement of next higher nerve root

Central

At the level of cauda equine can impinge on nerve roots lower than the level of herniation

43
Q

Structure and Function of

Anterior rootlets and root

Posterior rootlets and root

Posterior (dorsal) root ganglion (DRG)

Anterior (Ventral) ramus

Posterior (Dorsal) ramus

A

Anterior (ventral) rootlets and root

motor signals

Posterior (dorsal) rootlets and root

sensory signals

Posterior (dorsal) root ganglion (DRG)

House sensory neuron cell bodies

Anterior (Ventral) ramus

mixed signals from the anterior portion of body

Posterior (Dorsal) ramus

mixed signals from the posterior portion of body

44
Q

Recurrent Meningeal Nerves

A

Each spinal nerve gives rise to 2-4 small recurrent meningeal (sinuvertebral) nerves

They reenter the intervertebral foramen to supply the dura, ligaments, intervertebral discs, and blood vessels with innervation

45
Q

Cutaneous innervation

A

skin areas innervated by particular peripheral nerves

issue with a spinal nerve will affect its corresponding cutaneous innervation

46
Q

Dermatomes

A

bandlike areas of skin innervated by sensory fibers from a single spinal nerve

issue with the spinal cord will affect the corresponding dermatome

47
Q

Effect of Cervical Cord Lesion

C1–C3

C4–C5

C6–C8

A

C1–C3

no function below head level, unable to maintain respiration

C4–C5

quadriplegia, able to respiration

C6–C8

loss of lower limb function combined with upper limb function

48
Q

Effects of Thoracic/Lumbar Cord Lesion

T1–T9

T10–L1

L2–L3

A

T1–T9

paraplegia

T10–L1

some thigh muscle function

L2–L3

retention of most leg muscle function

49
Q

Laminectomy

A

Removal of one or more spinous processes and the adjacent supporting laminae to gain access to vertebral contents

used to relieve pressure on the spinal cord or nerve roots caused by a tumor, herniated IV disc, or bony hypertrophy

Anatomy (7 decks)

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