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C&M Neuroanatomy > Week 5 Lecture 10: The vertebral column > Flashcards

Week 5 Lecture 10: The vertebral column Flashcards

1
Q

The adult vertebral column has 33 vertebrae. Explain how these are divided

A 
7 Cervical (C1-C7)
12 Thoracic (T1-T12)
5 Lumbar (L1-L5)
5 Sacral (S1-S5) fused into one = sacrum 
4 Coccygeal (Co) fused into one = coccyx
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2
Q

At what vertebral level foes the spinal cord typically end?

A

L1-L2

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3
Q

What 3 structures hold the vertebral column together?

A
  1. Facet joints
  2. Intervertebral discs
  3. Ligaments
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4
Q

What is the function of facet joints?

A

connect superior and inferior articular processes of adjacent vertebrae (connects adjacent vertebrae by articulating with the vertebra above and below)

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5
Q

Where are intervertebral discs found and what do they do?

A
  • between all non-fused vertebrae

- provide flexibility and act as shock absorbers

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6
Q

What passes through the intervertebral foramen?

A

spinal nerve

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7
Q

What do ligaments do?

A

bind vertebrae together and stabilise the vertebral column

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8
Q

What are the functions of the vertebral column?

A
  • protects spinal cord
  • supports body weight
  • semi-rigid axis for the body
  • allows pivoting of the head
  • attachment for supporting ligaments and muscles of the back that stabilise and move the vertebral column supports posture and locomotion
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9
Q

Which regions of the back show primary curvature?

A
  1. thoracic region

2. sacral/ coccygeal region

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10
Q

Which regions of the back show secondary curvature?

A
  1. cervical region

2. lumbar region

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11
Q

What is meant by the word kyphoses?

A
  • primary curvature
  • outward curvature
  • thoracic and sacral
  • seen in foetus
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12
Q

What is meant by the word lordosis?

A
  • secondary curvature
  • inward curvature
  • cervical and lumbar
  • developed later
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13
Q

What are 3 conditions associated with abnormal curvature?

A
  1. excessive kyphosis = ‘hunch back’
  2. excessive lordosis
  3. scoliosis - vertebral column doesn’t run in the midline
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14
Q

Which is the weight bearing portion of a vertebra that supports the VC and is connected to the IV discs

A

vertebral bodies

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15
Q

How do vertebral bodies change in size as you go down the VC

A

They get bigger as they are bearing more weight

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16
Q

What are the 5 key features that make up a vertebral arch on a vertebra?

A
  • pedicles
  • laminae
  • superior and inferior articular processes
  • transverse processes
  • spinous processes
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17
Q

What does the pedicle do?

A

attaches the transverse process to the body of the vertebra

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18
Q

What does the lamina do?

A

attaches the transverse process to the spinous process

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19
Q

Which two vertebraeare atypical?

A

C1 and C2

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20
Q

How do we turn our head from side to side?

A

C1 and the dens of C2 articulate with each other and form a pivot joint

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21
Q

How do we nod our head up and down?

A

C1 articulates with the occiput (back of the head)

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22
Q

What does bifid mean?

A

divided by a notch into two parts

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23
Q

What key distinguishing feature does C7 have?

A
  • long spinous process (vertebra prominens)

- transverse foramina might be small, or even absent

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24
Q

Explain the anatomy of a cervical vertebae

A
  • body is small
  • transverse processes and pedicle
  • transverse foramina
  • spinous process is bifid
  • articular facets
  • vertebral column is large, relative to size of cord
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25
Q

What travels through the transverse foramina?

A

vertebral artery and vein

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26
Q

Does the vertebral artery travel through the transverse foramina of C7?

A

No

27
Q

What is another name for C1 and C2?

A

C1- ‘the atlas’

C2 - ‘the axis’

28
Q

How is C1 atypical?

A
  • is a ring
  • no vertebral body or spinous process
  • has anterior and posterior arches
  • lateral masses articulate with the occipital bone of the skill
29
Q

How is C2 atypical?

A
  • no vertebral body

- forms the dens/odontoid process/peg

30
Q

Where is the atlantoaxial joint?

A

between C1 and C2

31
Q

Which key ligament holds the dens in place?

A

transverse ligament of the atlas

32
Q

What is a Jefferson fracture?

A

‘axial loading’ (big loading force onto skeleton) can cause a burst fracture of the C1 ring

33
Q

Why would a fracture at C1 not necessarily injure the spinal cord?

A

because there is extra space in the foramen to prevent compression

34
Q

What is a fracture of the dens of C2 caused by?

A

hyperflexion or hyperextension

35
Q

Why is the associated spinal cord injury following a dens fracture infrequent?

A

due to the relatively larger size of the spinal canal in the upper C-spine compared to the size of the cord and because the dens is held in place by the transverse ligament of the atlas

36
Q

If the dens fractures and the transverse ligament of atlas ruptures, what might happen?

A

the dens may be driven into the brainstem

37
Q

What measure is taken when there are concerns of C-spine injury?

A

C-spine immobilisation

38
Q

Why are the thoracic vertebrae the least flexible vertebrae?

A

because of their attachment to the ribs (which are attached to the sternum)

39
Q

How is the vertebral body of the thoracic vertebrae unique?

A
  • heart-shaped

- with superior and inferior costal demi-facets for articulation with the head of the rib

40
Q

Give the features of the spinous and transverse process of the thoracic vertebrae

A

spinous process - long and extends postero-inferiorly

transverse process - has a costal facet for articulation with tubercle of a rib

41
Q

Which vertebrae does osteoporosis usually effect?

A

thoracic

42
Q

Which thoracic vertebrae are most commonly injured

A

T11 and T12

43
Q

What occurs in osteoarthritis?

A

osteophytes, sclerotic changes and joint space narrowing (and often asymmetry)

44
Q

Give key features of lumbar vertebrae

A
  • vertebral body is large for increased weight beating

- spinous process short and sturdy

45
Q

How are the vertebral bodies in the sacrum organised?

A
  • they are fused together

- no intervertebral discs

46
Q

What are the ala/ ‘wings’ of the sacrum?

A

transverse processes of the sacrum that have fused together

47
Q

Where do the spinal nerves exit from in the sacrum?

A

anterior sacral foramina

48
Q

What are the possible movements of the vertebral column?

A
  • flexion (bending forward)
  • extension (backwards)
  • lateral flexion (side to side)
  • rotation
49
Q

What are the intrinsic muscles of the back innervated by?

A

posterior rami of spinal nerves

50
Q

What is the name of the chief extensor of the vertebral column?

A

erector spinae

51
Q

What is the erector spinae composed of?

A
  1. longissimus muscle
  2. iliocostalis muscle
  3. spinalis muscle
52
Q

What are the two parts of the vertebral bodies?

A
  1. outer annulus fibrosus

2. inner nucleus pulposus

53
Q

What does the thickness of the intervertebral discs correspond to?

A
  1. the flexibIlity of the VC
    -relatively thicker in C and L spine, hence why these regions are most flexible
    also
  2. age
    -high water content the dehydrate which age which makes them thinner and stiffer
54
Q

What is a ‘slip disc’?

A

when the annulus fibrosis becomes dry or stiff, it can develop cracks/ fissures that allows the nucleus pulposus to herniate through
this can squash the spinal cord or even the spinal nerve

55
Q

Where do slipped disc occur most commonly?

A

L4/L5 or L5/S1

56
Q

What is sciatica?

A
  • pain/ paraesthesia down the root of the sciatic nerve if it is compressed
  • lower back down to leg
57
Q

What is cauda equina syndrome?

A

compression of the cauda equina (bundle of nerves in the lower part of the vertebral body)

58
Q

What are the 3 key ligaments that course the VC?

A
  1. posterior longitudinal ligament
  2. anterior longitudinal ligament
  3. ligament flavum
59
Q

Where does the posterior longitudinal ligament run and what does it do?

A
  • C2 to sacrum
  • resists hyperflexion
  • preventions posterior herniation of IV discs
60
Q

Where does the anterior longitudinal ligament run and what does it do?

A
  • runs anterior to vertebral bodies
  • occipital bone and C1 to sacrum
  • resists hyperextension
61
Q

Where are the ligamentum flavum found?

A

bound to lamina of adjacent vertebrae

62
Q

Which ligament binds adjacent spinous processes together?

A

interspinous ligament

63
Q

Which ligament binds the tops of all spinous ligaments together?

A

supra spinous ligament

64
Q

What is ‘whiplash’

A

rapid, forceful hyperextension then hyperflexion (backwards then forward)

C&M Neuroanatomy (44 decks)

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