Anatomy - Introduction To The Vertebral Column

Question 1

Normal curvatures

Answer 1

• primary curvatures reflect in utero shape of vertebral column, remain in thoracic and sacral regions
• Secondary curvatures develop after birth in the neck to bring the head above trunk and in the lumbar region to bring trunk above lower limbs for efficient bipedal locomotion

Question 2

Kyphosis
Lordosis
Scoliosis

Answer 2

• Kyphosis: increase in primary curvature
• Lordosis: increase in secondary curvature
• Scoliosis: abnormal lateral curvature

Question 3

Intervertebral disc

Answer 3

• the thicker the disc relative to the vertebral body, the greater the range of movement between adjacent verterbrae
• C>L>T

Question 4

Zygapophysial joint

Answer 4

• between articular processes on Left and Right sides
• capsule innervated by posterior rami
• Proprioception: joint position/movement
• Nociception: Injury/Inflammation - local and referred pain

Question 5

Intervertebral disc

Answer 5

• 35 % of length of vertebral column
• tie vertebral bodies together, transfer weight, allow movement, shock absorb
• secondary cartilaginous joint or symphisis
• endplate: comprised of cartilage - allows diffusion of nutrients from vessels in vertebral body to nucleus pulposus
• anulus Fibrosus: ties vertebrae together and retains nucleus pulposus. Only the outer third received blood and nerve supply
• nucleus pulposus: semifluid, mucoid, toothpaste-like consistency, shock absorber. Largest avascular structure in the body. High water content which reduces with age

Question 6

Posterior rami supply

Answer 6

• skin of back
• Z joints
• intrinsic back muscle

Question 7

Anterior rami supply

Answer 7

• skin, joints of muscles and neck, limbs and trunk
• larger than posterior rami
• contributes to plexuses
• continue as intercostal nerves or subcostal nerve

Question 8

Epidural and subarachnoid spaces

Answer 8

• epidural space: between dura mater and boundary of vertebral canal. Contains epidural fat and a plexus of veins
• subarachnoid space: between pia and arachnoid, contains nerve roots and CSF

Question 9

Internal vertebral venous plexus

Answer 9

• within vertebral canal
• valveless plexus of veins that communicate with valveless veins in trunk and cranial cavity
• is a vehicle for metastatic spread between these cavities and into vertebrae themselves

Question 10

Spinal anesthesia - lumbar puncture

Answer 10

• into CSF of subarachnoid space
• smaller needle to penetrate dura
• smaller dose required as it spreads easily within CSF
• faster to act
• single injection

Question 11

Epidural anesthesia

Answer 11

• into epidural space
• larger diameter needle
• larger doses of anesthetic
• slower to act

Question 12

Spinal tap/lumbar spinal puncture

Answer 12

• used as a diagnostic tool for evaluating certain CNS disorder
• not performed if there is increases intracranial pressure