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Anatomy - Year 1 > Back and Spinal Cord > Flashcards

Back and Spinal Cord Flashcards

1
Q

How many vertebrae are there, and how are they divided into groups?

A

7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
3-5 coccygeal (fused)

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2
Q

Name the 8 parts of a vertebra

A

Body
Pedicles
Transverse process
Lamina
Spinous process
Vertebral foramen/canal
Intervertebral notch/foramen
Articular facet

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3
Q

Which part of a vertebra is most anterior, which is most posterior?

A

Anterior: Body
Posterior: Spinous process

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4
Q

What lies in the vertebral foramen?

A

Spinal cord

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5
Q

What lies in the intervertebral foramen?

A

The transverse process of the below vertebra

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6
Q

What type of joint occurs between bodies of adjacent vertebrae? How many do we have?

A

Sympheses

24

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7
Q

What type of joint occurs between articular facets of adjacent vertebrae?

A

Zygapophyseal

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8
Q

What specific name is given to:
C1
C2
C7

A

Atlas
Axis
Prominens

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9
Q

Name 3 distinguishing features of cervical vertebrae

A

Smallest body
Bifid spinous process
Two holes (transverse foramen) which are postereolateral to body as well as ventral foramen

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10
Q

Name 2 distinguishing features of thoracic vertebrae

A

Spinous process sits downwards
Transverse processes are 90 degrees to one another

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11
Q

Name 4 distinguishing features of lumbar vertebrae

A

Largest body
Transverse processes are 180 degrees to each other
Prominent transverse process
Articular processes

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12
Q

What type of joint is between vertebrae?

A

Vertebral discs
Type of secondary (symphesis) cartilaginous joint

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13
Q

What type of joint is between spinous processes?

A

Facet joint

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14
Q

Name the 2 parts of an IV disc

A

Anulus fibrosus
Nucleus pulposus

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15
Q

What type of cartilage is found in an IV disc?

A

Fibrous cartilage (annulus fibrosus)

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16
Q

What is a slipped disc? What can it lead to?

A

Protrusion of the nucleus pulposus through the annulus fibrosis

It can impinge on emerging spinal nerves

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17
Q

What direction does nucleus pulposus tend to herniate?

A

Posterolateral

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18
Q

Name the 5 ligaments of the vertebra

A

Supraspinous ligament
Ligamentum flavum
Interspinous ligament
Anterior longitudinal ligament
Posterior longitudinal ligament

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18
Q

What does the ligamentum flavum connect

A

Lamina of adjacent vertebrae

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19
Q

What does the anterior longitudinal ligament connect

A

Connects anterior spinal column

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20
Q

What does the posterior longitudinal ligament connect

A

Inside of vertebral canal

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21
Q

What does the supraspinous ligament connect

A

Apices of spinous processes

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22
Q

What does the interspinous ligament connect

A

Spinal processes

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23
Q

What shape is a foetal spinal curve vs adult?

A

C vs double S

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24
Q

How does the cervical curvature develop?

A

When baby lifts head

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25
Q

How does the lumbar curvature develop?

A

When baby stands and walks

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26
Q

What is an exaggerated inward curve of the spine called?

A

Lordosis

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27
Q

What is an exaggerated, forward rounding of the upper back called?

A

Kyphosis

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28
Q

What is abnormal lateral curvature of the spine called?

A

Scoliosis

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29
Q

What restricts movements of the thoracic region?

A

Attachment of the ribs

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30
Q

What determines the restriction of movement of the vertebral column

A

The orientation of the vertebral articular facet joints

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31
Q

What movements are permitted by cervical vertebra? Thoracic? Lumbar?

A

Cervical - rotation
Thoracic - lateral flexion/rotation
Lumbar - flexion/extension

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32
Q

What term describes the fact that only a small amount of movement occurs at each individual joint, but it increases as successive vertebrae simultaneously move?

A

Summation

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33
Q

When posterior vertebral muscles on the left and right side contract bilaterally, what movement occurs? What if they move unilaterally?

A

Flexion/extension

Roation/lateral flexion

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34
Q

What’s the main muscle of the back?

A

Erector spinae muscles

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35
Q

What’s are the major anteriorly situated muscles that act on the vertebral column

A

Sternocleidomastoid in neck

Anterior abdominal wall muscles - obliques, transverse abdominis, rectus abdominis

Limb muscles (if immobilised)

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36
Q

When trunk flexors and extensors contract simultaneously, what happens?

A

Increase intra-abdominal pressure. It aids things like coughing, defecation, giving birth, lifting etc

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37
Q

Where is the vertebral prominence bony surface landmark found?

A

Spinous process of C7

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38
Q

What level is the spine of scapula found

A

Spine of T3

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39
Q

What level is the inferior angle of scapula found?

A

T7

40
Q

What level is the summit of iliac crest found?

A

L4

41
Q

What does a lumbar puncture obtain and what can it diagnose? Why else might it be used?

A

Cerebrospinal fluid

e.g. meningitis, bleeding in the brain

Anaesthetic purposes, e.g. epidural anaesthesia

42
Q

At what level is a lumbar puncture performed in an adult and child?

A

Between spinous processes of L3 and L4 in adults

Between L4 and L5 in child

43
Q

Why are lumbar punctures performed between L3-L4 in adults?

A

It’s below the spinal cord so less risk of causing nerve damage

44
Q

Which interspinous distance is greatest - cervical, thoracic, lumbar?

A

Lumbar - bears the most weight so needs most space for thickest discs

45
Q

When carrying out a lumbar puncture the patient is normally requested to flex their lumbar spine.
How does this aid access of the needle between the L3 and L4 vertebrae?

A

Increases the space between spinal processes, so easier to insert needle

46
Q

Why is a lumbar puncture performed at a slightly lower level in a child (between L4 and L5) compared to an adult (between L3 and L4)?

A

Because their spinal cord extends down to a lower level in the spinal column compared to adults. Their cord grows slower than their column, so it’s harder to avoid damage.

In adults, we don’t typically do LPs between L4-L5 because it’s easier to access the CSF without risking damage by hitting nerve roots and causing cauda equina, and L3-L4 has more space. There’s also more bony landmarks.

47
Q

What 3 things can cause IV discs to herniate?

A

Excessive pressure

Degeneration of discs

Ligament weakening

48
Q

A transverse CT scans of a cervical vertebrae looks like…

A

:D

The foramen look like the eyes of a smiley face

49
Q

Where does the spinal cord begin? Where does it end?

A

Occipital bone of the skull

IV disc between L1-L2

50
Q

The distal end of the spinal cord forms the _____ and terminates in a fibrous extension called _____, the tip of which is called ____

A

Conus medullaris

Cauda equina

Filum terminale

51
Q

Where is the spinal cord enlarged? Why?

A

Cervical and lumbar

Enlargement of grey matter to supply limbs

52
Q

Which spinal nerves form the cauda equina and from which structure do they emerge?

A

L2-L5 from conus medullaris

53
Q

Where does the filum terminale attach inferiroly and what is its function?

A

Conus medullaris to stabilise spinal cord

54
Q

Sectioning the spinal cord in which region causes immediate death?

A

Cervical

55
Q

Name the 6 regions of the spinal cord

(Clue: 3 horns, what’s in the middle and 2 colours)

A

Anterior horn
Posterior horn
Lateral horn
Central canal
Area of white matter
Area of grey matter

56
Q

What makes up grey matter of the spinal cord? What makes white matter?

A

Cell bodies - grey
Axons - white

57
Q

Which end of a transverse spinal cord looks like w

A

Anterior ahs a deeper groove between horns

58
Q

What type of nerve impulses are associated with anterior horn cells?

A

Motor

59
Q

What type of nerve impulses are associated with posterior horn cells

A

Sensory

60
Q

What nerve impulses are associated with lateral horn cells?

A

Interneurons

61
Q

Name the 3 layers of meninges and their primary function

A

Dura mater
Arachnoid mater
Pia mater

Protect and cushion CNS

62
Q

In adults, at what level does the dural sac terminate? What about the termination of the spinal cord

A

S2 - dural sac ends

L1-2 - spinal cord ends

63
Q

What’s the space between the dura mater and arachnoid mater called? What do they form distally?

A

Subdural space

Dural sac

64
Q

What’s the space between the arachnoid mater and pia mater? What does it contain?

A

Subarachnoid space

Cerebrospinal fluid

65
Q

The space between the dura mater and vertebral bone is called what?

A

Epidural/extradural space

66
Q

To which level does the arachnoid mater descend?

A

S2

67
Q

Where does arterial blood supply to the spinal cord come from?

A

Spinal arteries arising from the aorta and its branches

68
Q

What drains the vertebrae and spinal cord? Where is it found?

A

Vertebral venous plexus in the epidural space

69
Q

What is a spinal nerve?

A

A mixed nerve carrying motor, sensory and autonomic signals between the spinal cord and the rest of the body

70
Q

How many spinal nerves are there in the human body?

A

31 pairs (one on each side of the vertebral column)

71
Q

What do somatic fibres supply?

A

Voluntary muscles and body wall structures, e.g. bones and joints

72
Q

What do autonomic fibres supply?

A

Involuntary structures, e.g. organs, involuntary muscles and glands

73
Q

Where do sympathetic nerve fibres emerge from? In which spinal segments are they?

A

Lateral horn cells

T1 - L2

74
Q

Which levels can the grey ramus communicans be found? What about the white ramus communicans?

A

Grey - all levels of spinal cord

White - T1 to L2

75
Q

The white ramus communicans carry ____ fibres from the ____ to the _____

A

The white ramus communicans carry SYMPATHETIC fibres from the SPINAL NERVE to the SYMPATHETIC

76
Q

The grey ramus communicans carry ____ fibres from the ____ to the _____

A

The grey ramus communicans carry SYMPATHETIC fibres from the SYMPATHETIC GANGLION to the VENTRAL RAMUS

77
Q

Is a white ramus communicans myelinated? What about grey?

A

White - myelinated
Grey - unmyelinated

78
Q

What’s the alternate name for sympathetic chains?

A

Paravertebral ganglia

79
Q

Define ganglion

A

Collection of nerve cell bodies

80
Q

What 3 things can sympathetic fibres do?

A
  1. synapse in a chain ganglion at the same spinal level before exiting the chain (mainly to the skin).
  2. ascend and descend within the sympathetic chain before synapsing in a different ganglion to the one it lies next to and exiting the chain.
  3. run through the chain without synapsing and synapse instead in a prevertebral (preaortic) ganglion in
    the abdomen (= splanchnic nerves to abdominal organs – “splanchnic” = organ).
81
Q

What 2 places are parasympathetic nerves found?

A

Some cranial nerves
S2-4

82
Q

Do parasympathetic nerves enter the sympathetic chain?

A

No

83
Q

Which spinal cord levels give rise to the sympathetic nerves? What about parasympathetic nerves?

A

Sympathetic - thoracolumbar
Parasympathetic - crainosacral

84
Q

Name 5 locations of large autonomic nerve plexuses

A

Cardiac (thorax)
Pulmonary
Coeliac (abdomen)
Superior hypogastric (abdomen)
Inferior hypogastric (pelvic)

85
Q

The upper and lower limbs receive autonomic supply from which nerves?

A

Sympathetic ONLY

86
Q

Name the 8 major pulse points

A

Carotid
Brachial
Radial
Ulnar
Femoral
Popliteal
Posterior tibial
Dorsalis pedis

87
Q

What is lymph?

A

Plasma filtrate leaked from capillary beds due to high hydrostatic pressure

88
Q

Where does lymph ultimately go? What’s it for (one normal, one pathology)?

A

Circulatory system

It’s important for immunity and cancer spread

89
Q

Name the 6 major groups of lymph nodes

A

Axilla
Inguinal region
Pectoral
Bifurcation of trachea
Lumbar and pelvic
Cervical

90
Q

Name 5 parts of a lymph node

A

Germinal centre
Follicle
Medulla
Paracortex
Cortex

91
Q

What type of cells are found in lymphoid nodes?

A

Lymphocytes (B and T cell)

92
Q

What process occurs in lymph nodes?

A

Filtering harmful substances

93
Q

Define sentinel node

A

Lymph node where cancer spreads. If we suspect metastasis, we can remove a sentinel node and test it to look for metastasis

94
Q

Efferent lymphatic vessels can lead to one of which two places?

A

Thoracic duct
Right lymphatic duct

95
Q

Where does the thoracic duct commence, ascend and cross?

A

L1, at the cisterna chyli

Ascends on the vertebral bodies between the azygos vein and aorta on the right side, and posterior thoracic wall below T4

At T4 it crosses the vertebral column to the left side of the thoracic vertebral bodies and drains into the medial end of the left subclavian vein

96
Q

Name the 4 main lymph nodes on face and neck

A

Parotid
Occipital
Supraclavicular
Submandibular

Also: Posterior auricular, tonsillar, cervical, submental

97
Q
A

Anatomy - Year 1 (10 decks)

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