vertebral column, spinal cord

Question 1

what type of curvature is the thoracic spine and sacrum/coccyx?

Answer 1

primary

Question 2

what type of curvature is the cervical and lumbar curves?

Answer 2

secondary

Question 3

cruciate ligament function:

Answer 3

holds the dens in place during rotation of the head
looks like a cross in front of the dens

parts of the cross:
superior longitudinal band
transverse ligament of atlas band
inferior longitudinal band

Question 4

apical ligament function:

Answer 4

deep to the cruciate ligament
attaches dens to the skull

Question 5

alar ligaments function:

Answer 5

attaches the dens to the skull, laterally

Question 6

what are the costal facets?

Answer 6

on the sides of the vertebrae, articulate with the ribs
thoracic region

Question 7

zygapopphysial joints:

Answer 7

articulation between the superior and inferior facets
AKA facet joints

Question 8

components of the vertebral disc:

Answer 8

annulus fibrosis
nucleus pulposus
layer of hyaline cartilage underneath

Question 9

which foramen do the spinal nerves exit?

Answer 9

the intervertebral foramen
(visible on lateral view)

Question 10

distinguishing factor of cervical vertebrae:

Answer 10

transverse foramina
(transmit the vertebral arteries)
bifid spinous process

Question 11

distinguishing feature of thoracic vertebrae:

Answer 11

articular facets for ribs
very pointy spinous processes
spinous process points downwards

Question 12

distinguishing feature of lumbar vertebrae:

Answer 12

looks like a moose:
blunted/rounded spinous process

Question 13

where does the ligamentum nuchae attach?

Answer 13

occipital protuberance and the spinous process of C7

Question 14

what does the ligamentum nuchae turn into when it passes the C7 attachment point?

Answer 14

supraspinous ligament

Question 15

what are the 2 ligaments that cover the vertebral bodies?

Answer 15

anterior and posterior longitudinal ligaments

Question 16

what ligament connects the spinous processes of stacked vertebrae?

Answer 16

interspinous ligament

Question 17

what is a compression fracture?

Answer 17

when the vertebral is compressed or cracked as a result of an injury or disease (i.e. car crash, fall from heights, osteoporosis, or tuberculosis (Pott’s disease))

Question 18

what happens to the dorsal end of the spinal cord during development?

Answer 18

spinal extends full length of spine at 8 weeks pre-natal
S1 spinal nerve protrudes but the spinal cord begins to retract upwards, leaving dural sac behind
newborn: conus medullaris is at L3, filum terminale is formed
adult: conus medullaris at L1, dural sac ends at S2

Question 19

where does the filum terminale end?

Answer 19

coccyx

Question 20

what is the lumbar cistern?

Answer 20

subarachnoid space in the lower lumbar canal
contains CSF and the nerve roots of the cauda equina
a space where spinal nerves continue to come out of their respective intervertebral foramina

Question 21

what is contained in the epidural space?

Answer 21

spinal nerve roots, loose fatty tissue, small arteries, the internal vertebral venous plexus of Batson

Question 22

at what spinal levels can the denticulate ligaments be found?

Answer 22

cranio-vertebral junction through T12

Question 23

what do the pia and arachnoid matters originate from?

Answer 23

neural crest cells
leptomeninges

Question 24

at which level are the gray and white rami (sympathetic fibers) located?

Answer 24

T1-L2

Question 25

what level is a lumbar puncture taken from?

Answer 25

L3 and L4, near the level of the upper border of the iliac crest

Question 26

what is the “popping” felt by the needle during a lumbar puncture?

Answer 26

when the dura is pierced

Question 27

what are the layers (in order) that the needle pierces during a lumbar puncture)?

Answer 27

skin - ligament flavum - dura mater - arachnoid mater

needle enters the subarachnoid space (lumbar cistern) and extracts CSF

Question 28

where can an epidural anesthetic needle be inserted?

Answer 28

trans-sacral epidural - through the sacral foramina
caudal epidural -inserted from underneath, up the bottom part of the space

Question 29

what are the arteries of the spinal cord, what is the branching pattern?

Answer 29

descending thoracic aorta –> posterior intercostal –> spinal branch –> anterior and posterior spinal arteries

Question 30

main vertebral vein plexuses?

Answer 30

anterior external vertebral venous plexus (in front of vertebral bodies)
anterior internal venous plexus
posterior internal venous plexus
posterior external vertebral venous plexus (laying on the spinous processes)

Question 31

what is Batson’s plexus?

Answer 31

the anterior and posterior internal venous plexuses inside of the extra dural fatty space

Question 32

what is the clinical downside of the vertebral veins?

Answer 32

the veins don’t have valves
therefore, CA in a lower level (i.e. prostate) can travel up and affect the cranial level (i.e. brain)

Question 33

what happens during a herniated disc?

Answer 33

the annulus fibrosis bursts, the nucleus pulposus leaks out and compresses a nerve
this will affect the nerve BELOW the disk
e.g. L3/L4 disc herniation will compress the L4 nerve

Question 34

purpose of a lumbar laminectomy

Answer 34

surgical exposure of the lower lumbar disc herniation
relieves some of the pressure on the pinched nerve/spinal cord