Vertebral Column, Meninges, & Spinal Cord Flashcards

1
Q

What is the superficial back muscle group called?

A

Axio-Appendicular

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2
Q

What is the intermediate back muscle group called?

A

Respiratory

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3
Q

What is the deep back muscle group called?

A

Intrinsic Back

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4
Q

What is the axial skeleton

A

bones of the cranium, vertebral column, sternum and ribs

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5
Q

What is the appendicular skeleton

A

pectoral girdle, upper extremity, pelvic girdle, lower extremity

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6
Q

Where does the vertebral column begin and end?

A

begins = foramen magnum
ends= tip of coccyx
75 cm in length (2x length of spinal cord)

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7
Q

How many vertebrae are in each section of the vertebral column?

A
Cervical = 7
Thoracic = 12
Lumbar = 5
Sacral = 5 (fused)
Coccygeal = 3-5 fused
(32-34 total)
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8
Q

What are the four curvatures of the spine?

A

Lordosis “concave” = cervical and lumbar

Kyphosis “convex” = thoracic and sacral

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9
Q

What is lateral curvature of the vertebral column called?

A

scoliosis

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10
Q

How does the intervertebral disc impact the intervertebral foramen in thoracic/lumbar vs cervical regions?

A

In thoracic/lumbar regions, the intervertebral disc makes up half of the intervertebral foramen (inferior portion)
In cervical vertebrae, the intervertebral disc spans the whole intervertebral foramen

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11
Q

Where do spinal nerves C1-C7 exit in C1-C7 vertebrae?

A

Spinal nerves in the cervical area exit the inferior portion of the intervertebral foramen above the corresponding cervical vertebrae.

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12
Q

Where does spinal nerve C8 exit the vertebral column?

A

The superior portion of the IV foramen above T1 vertebrae

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13
Q

Where do spinal nerves T1- L5 exit in T1-L5 vertebrae?

A

These spinal nerves exit in the superior portion of the IV foramen below the corresponding vertebrae

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14
Q

Where do spinal nerves S1-S4 pass through vertebral column?

A

They pass via the anterior/posterior sacral foramina

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15
Q

Where do spinal nerves S5 and Co1 pass through?

A

They pass via the sacral hiatus

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16
Q

What vertebral level does the spinal cord end?

A

L1-L2 (where it forms the conus medullaris)

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17
Q

What is the cauda equina?

A

The nerve roots below L2 descend in the vertebral canal (like a horse tail) and exit at the corresponding vertebral level

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18
Q

What three unique components are on the transverse processes of cervical vertebrae?

A

Posterior tubercle, Groove for spinal nerve, and Anterior tubercle

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19
Q

What movements do the transverse facet joints in cervical vertebrae allow?

A
Permit flexion  and extension (some lateral flexion)
NO rotation (only C1 & C2)
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20
Q

What two things are unique about C7 vertebrae

A

1) . The transverse foramen are a lot smaller because vertebral artery DOES NOT pass through, only vertebral vein
2) . Spinous process is the longest and not bifid

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21
Q

What vertebra is most commonly fractured?

A

T 12

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22
Q

What characteristic on C6 vertebra is so special?

A

The Carotid tubercle on the anterior surface of transverse process could compress carotid artery

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23
Q

What two parts of the thoracic vertebrae do the head of the ribs connect to?

A

there are two costal facets (superior and inferior) portions of adjacent vertebrae PLUS 1 on each transverse process where rib lays

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24
Q

What facet joints are the in thoracic region and what movement does it allow?

A

coronal facets

It permits rotation

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25
Q

What is important about the shape of the L5 vertebra?

A

The back is switching from lordosis to kyphosis orientation so L5 is wedge-shaped to accommodate for that lumbosacral angle

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26
Q

What direction are the lumbar facet joints and what movements do they allow?

A

sagittal

They allow for flexion/extension and Lateral flexion

27
Q

What parts of the pelvis does the sacrum make up?

A

The sacrum males up the roof and posterior wall of the pelvis

28
Q

What is the sacral promontory?

A

It is a landmark on the anterior side of the sacrum on the edge of the 1st sacral body that easily recognizes prominence of the roof of the pelvic cavity

29
Q

What spinal nerves pass through the sacral canal and exit the sacral foramina? Which rami exits anteriorly vs posteriorly?

A

S1-S4; The ventral rami (motor) exit the anterior foramina and the dorsal rami (sensory exit the posterior foramina

30
Q

What direction are the facet joints for cervical vertebrae?

A

Transverse

31
Q

What are three unique features of the cervical vertebrae?

A

1) . Bifid spinous processes
2) . Widest vertebral body
3) . Uncinate processes (superior side of body is concave)

32
Q

What is on C1 that holds the C2 dens in place?

A

Transverse ligament

33
Q

Where can you palpate C1?

A

Between mastoid and angle of mandible

34
Q

What are the two purposes of the dens?

A

C2

1) . axis of rotation for C1
2) . prevent displacement of C1 on C2

35
Q

What is special about C2?

A

It is the strongest cervical vertebrae

36
Q

What are two defining features of the thoracic vertebra?

A

Spinous processes are long and project downward

Costal facets

37
Q

What are two defining features of lumbar vertebrae?

A

1) . Fat/massive body that’s kidney shaped

2) . blunt/thick spinous processes

38
Q

What is the sacral canal?

A

It is the passageway for the cauda equina

39
Q

What are the five landmarks on the dorsal surface of sacrum?

A
Lateral crest
Intermediate crest
Median crest
Intermediate crest
Lateral crest
40
Q

What is the coccyx apex an attachment for?

A

the anococcygeal ligament

41
Q

How much of the vertebral column height do the IV discs make up? %

A

25%

42
Q

What portion of the intervertebral foramen does the IV disc make up?

A

The anterior, inferior portion

43
Q

Describe the anulus fibrosis

A

Concentric fibrogelantinous rings
Thinner posteriorly
may be incomplete in cervical

44
Q

Describe the nucleus pulposus

A

Fibrogelatinous (mostly water)
avascular
shock absorbing

45
Q

What are the two longitudinal ligaments?

A

Anterior and posterior

46
Q

Where does the anterior longitudinal ligament extend from and what movement does it limit?

A

It extends from sacrum to foramen magnum (covers anterior bodies and IV discs)
limits extension

47
Q

Where does the posterior longitudinal ligament extend from and what movement does it limit?

A

Extends from sacrum to C2 (within vertebral canal; anterior to spinal cord)
hyperflexion

48
Q

What is important about the posterior longitudinal ligament and a slipped disc?

A

It redirects posterior herniation of nucleus pulposus to spare the cauda equina (peripheral nerves get compressed though)

49
Q

What does the filium terminale do?

A

It anchors the conus medullaris and meninges to coccyx

50
Q

Name the order of three meninge layers and three spaces in order from inside to out

A
Pia mater
Sub arachnoid space
Arachnoid mater
Subdural space
Dura mater
Epidural space
51
Q

What layers of the vertebral column is the lumbar cistern and what is it?

A

L2 & S2

enlargement of subarachnoid space

52
Q

What is unique about the sub dural space?

A

It is present when observing a cadaver because they isn’t CSF to compress it

53
Q

How is Arachnoid mater attached to the pia mater?

A

Arachnoid trabeculae (spider webs)

54
Q

What type of ligaments does the pia form?

A

Denticulate ligaments (20-22) to tether cord laterally to inner dural sac

55
Q

What two ways can a herniation of nucleus pulposus occur?

A

1). flexion/hyperflexion
2). degeneration of anulus fibrosis
(nucleus pulposus protrudes usually posteriorly laterally through anulus fibrosis)
**get referred pain in corresponding dermatome because dorsal rami are pinches

56
Q

What is steeles rule of thirds?

A

1/3 holds dens
1/3 holds spinal cord
1/3 holds empty space
Important for if dens fractures then it doesn’t cut off the spinal cord “silent fracture)

57
Q

Explain herniation of disc & nerve compression in cervical vs thoracic/lumbar regions

A

Cervical disc occupy whole region of intervertebral foramen; C6-C7 herniation pinches C7 nerve because nerve protrudes superior to corresponding vertebrae in inferior border
Thoracic/lumbar regions- disc occupies only inferior portion; L4-L5 herniation; L4 is spared because protrudes in superior IV foramen space but L5 nerve descending down is compressed

58
Q

What is the procedure to help with herniated nucleus pulposus?

A

Laminectomy

59
Q

What space do you puncture for lumbar puncture?

A

subarachnoid space

60
Q

What space do you puncture for epidural?

A

epidural space

61
Q

What space do you puncture for spinal anesthesia

A

sub arachnoid

62
Q

What type of paraplegia at C1-C3? How about C6-C8? How about T10-L3?

A

quadriplegia, ventilator dependent
paraplegia, upper limb paresis
variable lower limb function

63
Q

What is spinal shock?

A

In terms of paralysis, cervical and thoracic transections might produce this which means you lose sympathetic innervation of vascular smooth muscle (cant regulate BP)