Vertebral column revision

Question 1

how many pairs of spinal nerves?

where are they found?

what do they connect with?

Answer 1

Question 2

where do spinal nerves emerge?

Answer 2

C1 will emerge from above C1 vertebrae

C8 will emerge below C7 vertebrae

this then continues all the way down

Question 3

Answer 3

anterior and ventral are same thing

posterior and dorsal are same thing

Question 4

sensory axon pathway spinal cord?

motor axon?

sympathetic?

spinal nerve composed of?

Answer 4

if thoracolumbar outflow will also have sympathetic outflow

spinal nerve = somatic sensory, motor + sympathetic

(visceral afferents travel alongside sympathetic nerves but are NOT part of the spinal nerve)

Question 5

Answer 5

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Question 6

function of spinal nerve?

Answer 6

each spinal nerve pair supplies a body segment with:

• general sensory supply to all structures
• somatic motor supply to skeletal muscles
• sympathetic nerve supply to skin (sweat glands) and to smooth muscle of arterioles

Question 7

dermatome vs myotome?

Answer 7

dermatome = area of skin supplied with sensory information from a single spinal nerve

(in reality, there is overlap)

myotome = skeletal muscles supplied with motor innervation from single spinal nerve

(again, most muscles not supplied by single spinal nerve)

Question 8

landmarks dermatope map?

Answer 8

nipple = T4

umbilicus = T10

posterior scalp, neck and shoulder = C2-C4

uppe rlimb = C5-T1

lower limb, gluteal region + perineum = L2-Co1

Question 9

Answer 9

B = T6

Question 10

nerve plexuses?

examples?

Answer 10

intertwined anterior rami form a number of adjacent nerves

(NOT posterior rami)

cervical plexus (C1-C4) - posterior scalp, neck, diaphragm

brachial plexus (C5-T1) - upper limb

lumbar plexus (L1-L4) - lower limb

sacral plexus (L5-S4) - lower limb, gluteal region + perineum

(can be referred to toagether as lumbosacral plexus)

Question 11

Answer 11

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Question 12

2 enlargements in spinal cord?

Answer 12

cervical (upper limb) + lumbar (lower limb)

Question 13

Answer 13

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Question 14

spinal roots fuse to form?

spinal cord terminates?

Answer 14

Roots fuse to form mixed spinal nerve which eventually produces posterior and anterior rami

Spinal cord terminated in cone shape called conus medullaris

Continues as thin connective tissue cordcalled filum terminale which is anchored at dorsum of the coccyx

(if you stand on your head your spinal cord doesn’t come crashing down)

Question 15

spinal meninges continuous with?

Answer 15

Spinal meninges are continuous with cranial meninges via foramen magnum

Question 16

meninges layers

Answer 16

Dura mater

Arachnoid mater

Pia mater

Question 17

spinal cord suspended in canal vi?

formed from?

subarachnoid space?

Answer 17

Spinal cord is suspended in the canal by the denticulate ligament (found laterally)

The ligament is formed of pial and arachnoid tissue

Note - just like in brain, subarachnoid space filled with CSF

Question 18

spinal cord made up of?

Answer 18

Question 19

central canal spinal cord?

posterior vs anterior horn position?

Answer 19

opens into 4th ventricle superiorly

posterior = extends all way up to surface of spinal cord

anterior horn does not

(just helps with orientation)

Question 20

what is present in spinal cord from T1-L2?

Answer 20

small lateral horn which contains the preganglionic sympathetic neurons

Question 21

arterial supply to spinal cord?

Answer 21

3 major longitudinal arteries

• 1 anterior
• 2 posterior
• originate from vertebral arteries and run the entire length of spinal cord

Segmental arteries

• Derived from vertebral, intercostal and lumbar arteries

Radicular arteries

• Travel along dorsal and ventral roots

Question 22

artery of adamkiewicz?

derived from?

Answer 22

also known as great anterior radiculomedullary artery

it is largest segmental artery of spinal cord

derived from 9-12th intercostal artery

Question 23

venous drainage of spinal cord?

Answer 23

Question 24

extrinsic muscles of the back?

Answer 24

Question 25

intrinsic muscles of the back?

Answer 25

Question 26

erector spinae? attachments?

Answer 26

3 vertical groups of muscles lateral to spine - intrinsic muscles inferiorly = **common** tendon attaches to the sacrum and iliac crest superiorly = **individual** tendons * a rib * transverse process of a vertebra * spinous process of a vertebra

Question 27

low back pain may be due to?

Answer 27

erector spinae strain

Question 28

transversospinalis? attachments?

Answer 28

deep intrinsic back muscle - located in grooves between transverse and spinous processes **individual** muscle fibres attach **between**: * a vertebra and the skull * a vertebra and a rib * one vertebra and anothe rvertebra * the sacrum and a vertebra

Question 29

nerve supply to intrinsic back muscles?

Answer 29

Segmental nerve supply as per dermatome/myotome * **posterior rami!!!!**

Question 30

Answer 30

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Question 31

function of erector spinae and transversospinalis muscles?

Answer 31

maintain posture support the spine extend the spine * erector spinae - contracts bilaterally * if unilateral then **lateral flexion** occurs

Question 32

movements of spine and associated muscles?

Answer 32

extension = erector spinae and transversospinalis (bilateral) lateral flexion = erector spinae and transversospinalis (unilateral) flexion of spine (forward) = **psoas major and rectus abdominus**

Question 33

**typical** cervical vertebre features? **atypical** features?

Answer 33

Question 34

atlanto-occipital joints found? what are they? movements?

Answer 34

found between occipital condyles and the superior articular facets of the atlas (3 articulations) synovial joints with loose capsule movements = flexion + extension of the neck, lateral flexion and rotation

Question 35

articulations of atlanto-occipital joints? main movement?

Answer 35

3 articulations - all synovial * 2 between inferior articular facets of atlas and superior articular facets of axis * 1 between the anterior arch of the atlas and the odontoid process of the axis main movement is rotation

Question 36

Answer 36

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Question 37

Answer 37

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Question 38

Cervical vertebrae dislocation?

Answer 38

Question 39

Answer 39

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Question 40

spinal and epidural anaesthetic?

Answer 40

Question 41

spinal anaesthetic layers passed through?

Answer 41

Question 42

epidural anaesthetic layers passed through?

Answer 42

Question 43

caudal anaesthesia?

Answer 43

Question 44

Answer 44

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