L21: Vertebral Column Flashcards

1
Q

Function of the vertebral column

A
  • Support weight, protect spinal cord, serve as axis and pivot point, aid posture and movement
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2
Q

Segments of vertebrae

A
  • 7 C, 12 T, 5 L, 5 S, 3-5 Coccygeal
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3
Q

General features vertebrae

A
  1. ) Vertebral body
  2. ) Vertebral arch: laminae and pedicles
    - Laminae: connect pedicles (most posterior)
    - Pedicles: join arch and body (most anterior)
    - Vertebral foramen: forms vertebral canal that houses spinal cord
    - Superior and inferior vertebral notches: form IV foramina housing spinal cord roots
  3. ) Vertebral processes
    - spinous process
    - transverse process
    - articular process/zygapophysis: 4 per vertebra (2 superior/2 inferior)
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4
Q

Characteristics of cervical vertebrae

A
  • Transverse foramina: vertebral arteries travels through foramen of C6-C1, not C7 typically
  • Anterior/posterior tubercles on transverse processes (carotid tubercle on ant tubercle of C6)
  • Vertebral foramina large for C3-7 due to cervical enlargment
  • Uncinate process: raised margins of superior border of body
  • C1: aka atlas: articulates with occipital condyles, no vertebral body, groove for vertebral artery on superior surface
  • C2: aka axis: contains dens/odontoid process (former body of C1) that is pivot for skull
  • C&: aka vertebra prominens, has long spinous process
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5
Q

Characteristics of thoracic vertebrae

A
  • Costal facets (superior and inferior off vertebral body for rib head – only T2-9, T1/10/11/12 have full facets) and (transverse costal facet off transverse process for tubercle – only T1-10).
  • Spinous processes long and slender
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6
Q

The 4th thoracic vertebrae articulates with which ribs at its costal facets

A
  • Superior costal facet articulates with the 4th rib
  • Inferior costal facet articulates with the 5th rib
  • Transverse costal facet articulates with 4th rib
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7
Q

Are transverse costal facets present on all thoracic vertebrae?

A
  • No, all except T11-12, which have floating ribs
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8
Q

Characteristics of lumbar vertebrae

A
  • Accessory process on post aspect of each transverse process that is attachment for intertransverse lumborum muscles
  • Mamillary process
  • L5 = largest vertebra in column, wedge shape
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9
Q

Characteristics of sacral vertebrae

A
  • Fused to form sacrum
  • Sacral canal
  • Sacral foramina
  • Sacral promontory
  • Median crest (fused spinous processes)
  • Medial crest (fused articular processes)
  • Lateral crest (fused transverse processes)
  • Sacral hiatus: gap in laminae
  • Sacral horns: form inferior art process of S5
  • Auricular surface: part of SI joint
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10
Q

Curvatures of vertebral column

A
  • Cervical = secondary (convex anteriorly)
  • Thoracic = primary (concave anteriorly)
  • Lumbar = secondary (convex anteriorly)
  • Sacral = Primary (concave anteriorly)
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11
Q

Difference between primary and secondary curvatures

A
  • Primary = present at birth

- Secondary = develop after birth

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12
Q

What movements is the vertebral column (or regions within it) able to do?

A
  • Flexion/Extension
  • Lateral bending
  • Rotation
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13
Q

Kyphosis, lordosis and scoliosis

A

Kyphosis, lordosis and scoliosis

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14
Q

What type of joint is the vertebral joint?

A
  • Secondary cartilaginous joint
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15
Q

Layers/composition of IV disc

A
  • Outer annulus fibrosus: fibrocartilaginous

- Inner nucleus pulposus: posteriorly positioned gelatinous elastic avascular core

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16
Q

Name of joint between uncinate process of C3-6 and adjacent body. Function?

A
  • Uncovertebral joints

- Prevents posterior/anterior slipping

17
Q

Type of joint between superior and inferior articular processes. Motion seen here?

A
  • Synovial joint

- Motion = sliding

18
Q

Longitudinal ligaments of the vertebral column. Attachments?

A
  1. ) Anterior longitudinal ligament: extends across anterior lateral vertebral bodies and IV discs (from sacrum to occiput and C1’s anterior tubercle)
  2. ) Posterior longitudinal ligament: extends along anterior aspect of vertebral canal
19
Q

Function of ALL

A
  • Prevent hyperextension of vertebral column, stabilizes vertebral body joints
20
Q

Function of PLL

A
  • Prevents hyperflexion of vertebral column, prevents herniation of discs
21
Q

Which is stronger: ALL or PLL? Clinical relevance

A
  • ALL

- Herniation seen on posterior aspect of disc (combined with fact that nucleus pulposus is more posterior)

22
Q

Accessory ligaments of the vertebral column. Attachments?

A
  1. ) Ligamenta flava
    - Connect laminae
  2. ) Interspinous ligaments
    - Connect spinous processes
  3. ) Supraspinous ligaments
    - Connects tips of spinous processes from C7 to sacrum, merges with ligamentum nuchae
  4. ) Nuchal ligament/ligamentum nuchae
    - extends from ext occipital protuberance and post foramen magnum to spinous process of cervical vertebrae
  5. ) Inter-transverse ligaments
    - connects adjacent transverse processes
23
Q

Function of ligamenta flava?

A
  • Prevent abrupt flexion of vertebral column and preventing injury to IV disc
24
Q

What motions occur at the OA and AA joints?

A
  • OA: nodding of head, some lateral bending and rotation

- AA: rotation

25
Q

Name craniovertebral joints, what membranes or ligaments are present (where do they attach), function

A
  1. ) Atlanto-occipital joint
    - Atlantooccipital membrane: from atlas to margins of foramen magnum, prevents excessive movement
    - Cruciate ligament: a.) transverse ligament of atlas (in posterior wall of dens’ socket, holds dens to arch of C1); b.) longitudinal bands: extends from transverse ligament to occiput and C2 body
    - Alar ligaments: extends from sides of dens to C1 and foramen magnum, limits head rotation
    - Tectorial membrane: extends from C2 through foramen magnum, is continuation of PLL

2.) Atlanto-axial joint: a.) C1/C2 gliding / zygapophysial joint and b.) dens/C2 = pivot joint

26
Q

What ligament(s) limits head rotation?

A
  • Alar ligaments
27
Q

What is an internal decapitation?

A
  • When cruciate ligaments holding OA joints are severed
28
Q

What arteries supply blood to the vertebral column? Discuss pathway.

A
  • Spinal arteries enter which branch off:
    a. ) Neck: vertebral and ascending cervical artery (from inf thyroid artery off thyrocervical trunk)
    b. ) Thorax: posterior intercostal arteries (from aorta)
    c. ) Abdomen: subcostal and lumbar arteries
    d. ) Iliolumbar and medial/lateral sacral arteries
  • Spinal arteries enter IV foramina and divide into terminal radicular arteries (supplying ventral and dorsal roots) and medullary segmental arteries.
29
Q

Discuss venous drainage of vertebral column

A
  • Internal and external venous plexuses (each with anterior and posterior components) drain into spinal veins and then into vena cava
30
Q

Discuss embryological development of vertebral column

A
  • Sclerotome cells migrate around spinal cord and notocord to merge with cells from opposite side. Caudal half of each sclerotome grows into and fuses with cephalic half of each subadjacent sclerotome. Therefore each vertebra is formed by combination of caudal half and cranial half of somites. These form the vertebrae. Mesenchymal cells between the cephalic and caudal parts of the sclerotome segment fill the space between the two vertebral bodies, contributing towards the IV disc. Notochord regresses to a point in center of this, persists as nucleus pulposus. Mesenchymal cells in body wall forms ribs.
  • Vertebral column is first cartilaginous and then becomes bony. Chondrification (week 6) first occurs where vertebral column is cartilaginous. 2 chondrification centers fuse to form cartilaginous centrum. 2 centers fuse to form neural arch, then arch fuses with body. Neural arch produce spinous and transverse processes. Ossification (week 7) occurs next. 2 primary ossification centers in each cartilaginous vertebra fuse to form centrum. 2 form vertebral arch. Secondary ossification centers are present: 1 at tip of spinous process and 2, one at each transverse process.