Week 1 Hitchhiker's Guide pt 2 Flashcards
Why do most IV-disc herniations occur posterolateral and what structure(s) is/are impinged?
The annulus fibrosis is thinner posteriorly; impinges spinal cord
What symptoms would you expect with an IV disc herniation?
Pain (neck, back, legs, calf, sole of foot—on one or both sides of body), sciatica, numbness (in legs, calf, feet, shoulder, elbows, forearm, fingers), muscle weakness, changes in bladder/bowel function, difficulty walking/balancing
Compare the spinal cord, conus medullaris, and cauda equina and relate these structures to the level of spinal cord in children and adults.
1) Spinal cord: goes from brainstem to L1-2 disc in adults
2) Conus medullaris: the terminal end of the spinal cord
-Terminates at L1-2 disc in adults, and L2-3 disc in newborns
3) Cauda equina: the nerves continue as the cauda equina through sacrum and coccyx, looks like a horse’s tail
Describe the general concept in the distribution of spinal cord vasculature
3 longitudinal arteries: Anterior spinal artery and paired posterior spinal arteries
Sometimes the_______________ artery is purposefully clamped during surgery, in which case patients may lose sensation and voluntary movement at and below the site of ischemia. This is secondary to neuron cell death.
anterior spinal
Define ischemia of the spinal column
Loss of blood supply to the spinal column; can be caused by fractures or dislocations. This can lead to muscle weakness or paralysis.
Give a clinical application of spinal cord ischemia
Sometimes purposefully done during surgery, in which case patients may lose sensation and voluntary movement at and below the site of ischemia. This is secondary to neuron cell death.
1) What is a positive clinical application of the vertebral venous plexuses?
2) What is a negative implication of this these plexuses?
1) Blood may return from pelvis and abdomen through this plexus when the inferior vena cava is obstructed; goes through the superior vena cava this way.
2) Can also provide a route for cancer metastasis to the vertebrae and brain from an abdominal or pelvic tumor
Describe lumbar punctures
Passes through the epidural space, dura, and arachnoid mater into the subarachnoid space. Specifically, CSF is gathered from the lumbar cistern (usually below L1)
Describe epidural anesthesia
The epidural space is entered to administer anesthesia during labor. Works on spinal nerve roots of cauda equina after they exit dural sac.
Where else can epidurals be done besides the typical location?
Can also be done from the sacral canal through sacral hiatus (called caudal epidural) or through the posterior sacral foramina (trans-sacral epidural)
Describe the locations of the trapezius muscle and its 3 parts
From external protuberance of occipital bone to lower thoracic vertebrae. Extends laterally to spine of scapula.
1) Ascending: From T4-T12 and connects to medial half of spine of scapula
2) Descending: From back of head and neck to lateral third of clavicle
3) Transverse: middle of back, travelling laterally along upper back (to under the arm)
1) Describe the locations of the rhomboids
2) Describe the location of latissimus dorsi
1) Rhomboids: upper back, between shoulder blades, running laterally. Underneath trapezius muscles.
2) Latissimus dorsis: over the lumbar and lower thoracic regions with fibers extending laterally. A very tall muscle.
Describe the location of the splenius muscles
Posterior neck. Connects to lower part of ligamentum nuchae (connective tissue from occipital bone to cervical vertebrae) to C7 – T3,T4.
1) Describe the locations of the erector spinae muscles
2) Describe the locations of the transversospinales muscle group
1) Erector spinae muscles in the groove: Run along both sides of the spine. In the “groove”. Wider than transversospinales group.
2) Transversospinales muscle group in the gutter: deep layer of back inferior to erector spinae. Between spinous process of vertebral column, bilaterally.
