Anatomy Flashcards
(21 cards)
What are the lumbar para spinal muscles?
Multifidus. Erector Spinae. Quadratus Lumborum. Psoas.
https://images.app.goo.gl/u5mRtmd8cqu5p7N39.
What are the medial lateral angulations for thoracic pedicel screw placement?
Doug says:
T1-3 Different.
T12 Different.
T11 either T12 like or T10 like.
T4 to 10 ~15 degrees.
What are the landmarks for thoracic pedicle screw entry?
Confluence of TP, Para and Superior Articulating Process.
Within confluence optimal starting point varies by level:
https://musculoskeletalkey.com/40-posterior-spinal-instrumentation-and-fusion-using-pedicle-screws/
What are the optimal starting points for thoracic pedical screws?
Within the confluence of TP, SAP and Pars:
What is the entry point for lumbar pedical screw?
What is the anatomical entry point for the Thoracic pedical screw?
Intersection of mid TP and lateral border of SAP.
You are intending to operate on a L4/5 disc. What level is this at?
Key thing is that the Swedish is vertical underneath the laminae, pointing therefore at the correct disc space.
It’s at the correct level
Describe the relationship of the lumbar DRG, to the foramen.
The DRG sits in line with the pedicle, ie the foramen, extending extra formami.
What is the relationship of the lumbar DRG to the foramen?
See image.
What is the anatomy of the sympathetic chain / DRG interaction?
See image.
Describe
Ventral and Dorsal Rami
Spinal Nerve
Sympathetic Ganglion
Grey Ramus
DRG
Ventral and Dorsal Root
What are the skin landmarks for approaches to the cervical spine.
C2/3 Hypod.
C3 - Space between hyoid and thyroid
C4/5 Thyroid
C6 Cricoid
How much rotation of the head occurs at the C1/2 joint?
~50%
What are the ligaments that connect C1 to C2?
Apical
Alar x2
Cruciate Ligament: Horizontal Portion = Transverse. Small Vertical Componenr.
What are the types of Atlantoaxial Subluxation?
Rotatory
Anterior (rupture transverse ligament or fracture of odontoid process)
Posterior
What is the classification for Rotatory Subluxation?
Fielding and Hawkins.
Type 1- Odontoid Process as pivot, with no anterior displacement.
Type 2 - One lateral process as pivot, with anterior displacement 3-5mm
Type 3 - Rotary fixation with anterior displacement > 5mm
Type 4 - Rotary fixation with posterior displacement
What is Grisels Syndrome?
Rare cause of non-traumatic subluxation.
Sometimes after a viral urti or following ENT surgery, inflammation around C1/2 can lead to Rotatory subluxation.
What is Os Odontoideum?
Congenital non union - free floating dens.
What is Os Terminale?
Failure of ossification dens tip.
Smaller than Os Odontoideum.
What is Morquio Syndrome?
Muccopolusaccharidosia associated with Odontoid hyperplasia or Aplasia leading to Atlanto axial instability.
Is Down’s syndrome a risk factor for Atlanto Axial Instability?
Yes - laxity of transverse ligament.
What is the Cock Robin Position?
20 degree lateral tilt, 20 degreee rotation to the other side, 10 degree flexion.
Torticolis picture.
