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Question 1

During a lumbar puncture what are the layers in which the needle passes through.

Answer 1

Skin->superficial fascia ->deep fascia->supraspinous ligament ->interspinous ligament -> inter laminar space ->epidural space ->dura ->arachnoid -> subarachnoid space

Question 2

Purpose of lumber puncture and location.

Answer 2

Lumbar puncture is used t inject anesthetic material in the epidural space or to withdrawal CSF from the subarachnoid space. L4-L5 interspace. Top of the iliac crest.

Question 3

Typical Vertebra

Answer 3

consists of an anterior body and a posterior vertebral arch consisting of 2 pedicles and 2 laminae.

Question 4

Intervertebral Foramina

Answer 4

Formed by vertebral notches and provide for and exit of the spinal nerves.

Question 5

Dorsal projection spines &lateral projecting transverse processes

Answer 5

Attachment site for muscles and ligaments.

Question 6

Intervertebral disks

Answer 6

Form cartilaginous joints between the vertebral bodies and provide limited movements between the individual vertebrae.

Question 7

Annulus Fibrosus

Answer 7

consists of the outer concentric rings of fibrocartilage and fibrous connective tissue.

Question 8

Nucleus pulposus

Answer 8

Shock absorber.Postnatal remnant of the notochord.

Question 9

Herniation of a nucleus pulpous

Answer 9

Common in a posterolateral direction.

Question 10

Anterior Longitudinal ligament

Answer 10

Prevents hyperextension of the vertebrae and is often involved in “whiplash” accidents.

Question 11

Posterior Longitudinal Ligament

Answer 11

limits flexion of the vertebral column.Causes herniation of a disc to be positioned poster laterally.

Question 12

Describe sciatica.

Answer 12

A radiating pain along the spine .The nucleus pulpous herniates through the annulus fibrosis and compresses the spinal nerve roots.

Question 13

Occurrence site of herniations.

Answer 13

Lower lumber =L4/L5 or L5/S1

Lower cervical= C5/C6 or C6/C7

Question 14

Intervertebral Foramen boundaries

Answer 14

Anterior : bodies of the vertebrae and intervertebral disks.
Posterior : Zygapophyseal joint and articular processes.
Superior and inferior : Pedicles of the vertebrae.

Question 15

Order of the Meninges

Answer 15

vertebral body ->epidural space ->dura mater ->sub-dural space -> arachnoid mater -> subarachnoid mater -> Pia mater

Question 16

Pia mater

Answer 16

• attached to the surface of the spinal cord.

- terminates at L1 or L2 vertebral levels in the adult

Question 17

Denticulate Ligament

Answer 17

separates the ventral and dorsal roots of the spinal nerves and anchor to the dura mater.

Question 18

Filum Terminale

Answer 18

• part of the cauda equina

- ventral and dorsal roots of lumbar and sacral nerves.

Question 19

Dura Mater

Answer 19

• tough, cylindrical covering
• envelops the entire spinal cord and caudal equina.
• continue through the foramen magnum and is continuous with the meningeal layer of the cranial dura.

Question 20

Arachnoid Mater

Answer 20

Lines the inner surface of the dura mater and dural sac.

-Terminates at th 2nd sacral vertebra.

Question 21

Epidural Space

Answer 21

contains fat and the internal vertebral venous plexus

Question 22

Internal vertebral plexus

Answer 22

Valveless and connects with veins of the pelvis , abdomen , and thorax. Route of metastasis of cancer.

Question 23

Subarachnoid space

Answer 23

• Pressurized space located between the arachnoid and Pia mater layers.
• Contains CSF

Question 24

L1/ L2

Answer 24

-inferior limit of the spinal cord in adult. (Conus medullaris)

Question 25

S2

Answer 25

Inferior limit of the dural sac and the subarachnoid space.

Question 26

Number of spinal nerves.

Answer 26

31 pairs

Question 27

List of spinal nerves .

Answer 27

• 8 cervical
• 12 thoracic
• 5 lumbar
• 5 sacral
• 1 coccygeal

Question 28

Dorsal root

Answer 28

• Carries sensory fibers

- dorsal root ganglion contains the pseudo unipolar cell.

Question 29

Ventral root

Answer 29

• motor neurons

- located in the ventral or lateral horns of the spinal-cord gray matter.

Question 30

Spinal nerve

Answer 30

Formed by the union of the ventral and dorsal roots.

Question 31

Dorsal rami

Answer 31

-Innervates the skin of the dorsal surface of the back, neck, zygapophyseal joints , and intrinsic skeletal muscles of the deep back.

Question 32

Ventral rami

Answer 32

-innervates the skin of the anterolateral trunk and limbs.