MSK - Cervical And Thoracic Spine

Question 1

How many cervical vertebrae are there?

Answer 1

7

Question 2

How many thoracic vertebrae are there?

Answer 2

12

Question 3

How many lumbar vertebrae are there?

Answer 3

5

Question 4

How big are the cervical vertebrae compared to the other vertebrae?

Answer 4

They are the smallest of the discrete vertebrae

Question 5

What is different about the foramen of cervical vertebrae (except C7)?

Answer 5

It is bifid (has two ‘spikes’)

Question 6

What action is the first cervical vertebrae involved with?

Answer 6

50% of total flexion and extension of the neck

Question 7

Which two features is the first cervical vertebra missing which the other vertebrae have?

Answer 7

Vertebral body and spinous processes

Question 8

What are the two things found on the second cervical vertebrae which work together to prevent horizontal displacement of the atlas?

Answer 8

The ‘dens’ (Odontoid process) and the transverse ligament

Question 9

What are the three main features that characterise the second cervical vertebra?

Answer 9

• odontoid process/’dens’
• rugged lateral mass
• large spinous process

Question 10

What’s special about the seventh cervical vertebra?

Answer 10

It has the longest spinous process (which is not bifid), which means it can be seen from the outside very prominently. It also has a small foramen transversarium so only the accessory vertebral veins are transmitted.

Question 11

What is the ligamentum nuchae?

Answer 11

A thickening of the supraspinous ligament which attaches to the external occipital protuberance and the spinous processes of all cervical vertebrae.

Question 12

What are the functions of the ligamentum nuchae?

Answer 12

• maintains secondary curvature of the cervical spine
• helps the cervical spine support the head
• major site of attachment of trunk and neck muscles

Question 13

Which is stronger, the anterior or posterior longitudinal ligament?

Answer 13

Anterior is stronger

Question 14

What are the three movements of the cervical spine?

Answer 14

• flexion/extension
• lateral flexion
• rotation

Question 15

What shape is the vertebral foramen on the thoracic vertebrae?

Answer 15

Small and circular

Question 16

What is different about the facets for rib articulation on T2-T8 compared to T9-10?

Answer 16

They are demi-facets in the sides of the body on T2-T8 and whole facets on T9-T10

Question 17

What is the anterior cord mostly used for?

Answer 17

Sensory and motor, light touch, pinprick and pain

Question 18

What is the posterior cord mostly used for?

Answer 18

Vibration and proprioception

Question 19

True or false - mostly lateral tracts of the spinal cord move the arms?

Answer 19

False - lateral tracts move the legs, and central tracts move the arms

Question 20

What is a neural level?

Answer 20

The last functioning spinal level below an injury

Question 21

What is cervical spondylosis?

Answer 21

Degenerative osteoarthritis of intervertebral joints in cervical spine

Question 22

What are the consequences of pressure on the spinal cord leading to myelopathy?

Answer 22

• global weakness
• gait dysfunction
• loss of balance
• loss of bladder and bowel control

Question 23

What are the consequences of pressure on nerve roots leading to radiculopathy?

Answer 23

• dermatomal sensory symptoms

- myotomal motor weakness

Question 24

What is a hangman’s fracture?

Answer 24

Hyperextension of the head on the neck, leading to axis fractures through the pars interarticularis

Question 25

How is a ‘peg fracture’ most often caused?

Answer 25

By a blow to the back of the head, eg. from falling against a wall

Question 26

What is a fracture of the atlas?

Answer 26

• “Jefferson’s fracture”
• fracture of anterior and posterior arches of the atlas
• caused by an axial load, eg diving into shallow water or impact on vehicle roof
• usually pain but no neurological signs

Question 27

Why is the cervical spine prone to whiplash injury?

Answer 27

It has high mobility and low stability