Anatomy L15 - Vertebral Column

Question 1

What are all the curvatures of the spine?

Answer 1

Cervical: Lordosis, concave
Thoracic: Kyphosis, convex
Lumbar: Lordosis, concave
Sacral: Kyphosis, convex

Hint: Niemann PPG, “loss of cervical lordosis”

Question 2

What are the back dimples?

Answer 2

The back dimples are the surface anatomy marking for the posterior superior iliac spines (PSIS).

Question 3

What are special characteristics of cervical vertebrae?

Answer 3

Spinous processes: short, bifid

Transverse processes: have foramina (for vertebral artery)

Question 4

What are the atlas and the axis?

Answer 4

The atlas is C1 and the axis is C2.

Question 5

What are special characteristics of the atlas, C1?

Answer 5

The atlas has no body and no spinous processes. The articular surface of the atlas articulates with the occipital condyles.

Question 6

What are special characteristics of the axis, C2?

Answer 6

The axis has the dens/odontoid process.

Question 7

What is the dens?

Answer 7

The dens is a structure that lies anterior to the spinal cord and serves as a pivot joint for rotation of the head. It makes up the atlantoaxial joint that pivots the head and allows for rotation of the head.

The dens is held in place by the transverse ligament of the atlas.

Question 8

What is thoracic outlet syndrome?

Answer 8

Thoracic outlet syndrome is a group of symptoms seen with compression of the subclavian artery/vein and brachial plexus.

This can arise from a rib coming off of C7 and compressing the area. In pitchers, the scalene muscle hypertrophies and compresses the subclavian artery, and the arm becomes weak and numb.

Question 9

What are special characteristics of thoracic vertebrae?

Answer 9

Transverse processes: have facets for ribs (costal facets)

Question 10

What is the most commonly fractured vertebra?

Answer 10

T12

Question 11

What are special characteristics of lumbar vertebrae?

Answer 11

Body: is massive

Question 12

What is the sacrum?

Answer 12

The sacrum is comprised of 5 fused vertebrae and provides strength and stability to the pelvis. It also houses that anchors the inferior part of the spinal cord.

Question 13

What is the coccyx?

Answer 13

The coccyx is 3-4 small, fused vertebrae that are attached to the inferior end of the sacrum.

Question 14

What is the supraspinous ligament?

Answer 14

The supraspinous ligament is the ligamentconnecting the spinous processes of the vertebral bodies. Superiorly, it is continuous with the nuchal ligament.

Question 15

What is the ligamentum flava?

Answer 15

The ligamentum flava is connective tissue that attaches the lamina of vertebrae together.

Question 16

What is the interspinous ligament?

Answer 16

The interspinous ligament is the connective tissue that runs between adjacent spinous processes of the vertebrae. They extend from the root and apex of each spinous vertebral process and connect them.

Question 17

What is the anterior longitudinal ligament?

Answer 17

The anterior longitudinal ligament is the connective tissue that runs along the anterior aspect of the vertebral column. It is located just anterior to the annulus fibrosis of the IV disc.

Question 18

What is the posterior longitudinal ligament?

Answer 18

The posterior longitudinal ligament is situated within the vertebral canal and traverses the posterior portion of the vertebral bodies and intervertebral discs of the vertebrae of the spine. It is located anterior to the vertebral canal and spinal cord, but posterior to the vertebral bodies.

The posterior longitudinal ligament is not as broad as the anterior longitudinal ligament, thus, herniation will typically occur posteriorly. This will commonly impinge on the spinal nerve ROOT (carries both modalities)

Question 19

What is the tectorial membrane?

Answer 19

The tectorial membrane is the superior continuation of the posterior longitudinal ligament in the cranium.

Question 20

What is an osteophyte?

Answer 20

An osteophyte is a bony outgrowth associated with the degeneration of cartilage at joints. It is a “bone spur.”

Question 21

What is the arterial supply of the cervical vertebral column?

Answer 21

vertebral and cervical arteries

Question 22

What is the arterial supply of the thoracic vertebral column?

Answer 22

posterior intercostal arteries

Question 23

What is the arterial supply of the lumbar vertebral column?

Answer 23

subcostal and lumbar arteries

Question 24

What is the arterial supply of the sacral vertebral column?

Answer 24

iliolumbar arteries, medial and lateral sacral arteries.

Question 25

What is the venous drainage of the vertebral column?

Answer 25

Venous plexuses around and inside the vertebral column including internal and external vertebral venous plexus, basivertebral veins, and intervertebral veins.

Question 26

What makes up the thoracolumbar fascia and what is it's relevance?

Answer 26

The thoracolumbar fascia is made up of posterior lamina, middle lamina, and anterior lamina. This fascia adheres into the transverse and spinous processes. Abdominal muscles pull on the thoracolumbar fascia in order to maintain the integrity of the lumbar spine.

Question 27

What is spondylolysis?

Answer 27

Spondylolysis is the fancy term for broken vertebrae. It is often caused by trauma, degenerative disease, or spondylolisthesis. The site of fracture is the pars interarticularis.

Question 28

What is the radiographic finding indicatin spondylolysis?

Answer 28

Scotty Dog, the fracture is the collar.

Question 29

What is the pars interarticularis?

Answer 29

The pars interarticularis is located between the inferior and superior articular facets of two vertebra, between the lamina and pedicles. Fractures at this point are associated with spondylolysis. Radiographic image of this region looks like a "Scottie Dog," with the pars fracture indicated by the dog's collar.

Question 30

What is spondylolisthesis?

Answer 30

Spondylolysis is the anterior/ventral displacement of one vertebra on the adjacent vertebra. It is a common progression from spondylolysis, that is, spondylolysis may predispose you to spondylolisthesis. Can also be congenital (Agassi).

Question 31

What is sacralization?

Answer 31

Sacralization is the complete or partial fusion of L5 to the sacrum. It is a congenital abnormality of the vertebral column.

Question 32

What is osteopenia?

Answer 32

Osteopenia is thinning or decrease in bone mass. It is a degenerative pathology of the vertebral column.

Question 33

What is osteoporosis?

Answer 33

Osteoporosis is the condition of having diminished bone density making bones prone to fracture. It is a degenerative pathology of the vertebral column.

Question 34

What is a Burst Fracture/Jefferson Fracture?

Answer 34

A Burst, or Jefferson, Fracture, is a fracture of Atlas (C1) where the lateral masses of C1 are compressed between the occipital condyles and the axis (C2), fracturing the anterior and/or posterior arches of C1 outward. It is caused by sudden, forceful compression of C1 such as diving on your head.

Question 35

What is a Hangman's Fracture?

Answer 35

A Hangman's fracture is a fracture of the pars interarticularis of Axis (C2), essentially, a traumatic spondylolysis of C2. It is caused be forceful, extreme whiplash of the neck where the head and neck are HYPEREXTENDED (backwards).