Back and Neck: osteology, joints and ligaments

Question 1

name the 33 vertebrae

Answer 1

7 cervical 
12 thoracic
5 lumbar
5 sacral (fused)
4 coccygeal (fused)

Question 2

functions of vertebrae

Answer 2

suport
shock absorption - intervertebral discs
Protection - of spinal cord and nerve roots
haematopoiesis - vertebrae contain red bone marrow

Question 3

curvatures of spinal column

Answer 3

primary curvature

secondary curvatures

Question 4

primary curvatures

Answer 4

flexion i.e the fetal position

Question 5

secondary curvatures

Answer 5

develop after birth

cervical lordosis - develops with upright posture

Question 6

convex curves of spinal column

Answer 6

thoracic and sacral

Question 7

concave curves of spinal column

Answer 7

cervical and lumbar

Question 8

abnormalities of spinal column

Answer 8

excess lordosis/kyphosis - excess compression of thoracic bones from osteoporosis - hump
scoliosis

Question 9

processes of vertebrae

Answer 9

spinous and transverse processes

Question 10

articular processes of vertebrae

Answer 10

superior and inferior

Question 11

vertebral arch/foramen

Answer 11

pedicles/laminae

canal

Question 12

typical cervical vertebra from C3 -C6

Answer 12

small kidney shaped body
triangular
small transverse process
small spinous process - bifid

Question 13

atypical cervical vertevra

Answer 13

C1, C2, C7

Question 14

Atypical cervical vertebrae C1

Answer 14

Atlas
No body
• Anterior arch & tubercle
• Posterior arch & tubercle 2 lateral masses
• Articular facets
• Superior & inferior
• Transverse foramen
• Groove for vertebral artery

Question 15

Atypical cervical vertebrae C2

Answer 15

Axis
• Odontoid process (dens)
• Articular facets
• Spinous process - bifid

Question 16

joints of cervical spine atlanto-occipital joint

Answer 16

• Between C1 & occipital condyles
• Synovial condyloid joint
• Movement - nodding

Question 17

joints of cervical spine

Answer 17

atlanto-occipital joint
atlanto-axial joint
plane synovial joint

Question 18

what type of joint is in the atlanto-axial joint how do they connect with cervical vertebrae

Answer 18

synovial pivot joint
dens of C2vertebrae and anterior of C2 arch are connected by joints - cruciate ligament (transverse and vertical), alar ligament

Question 19

typical thoracic vertebrae from T2 - T9

Answer 19

Body
• Heart-shaped – with costal
facets
• Vertebral canal
• Round
• Transverse process
• Facet for tubercles of ribs
• Spinous process
• Slopes inferiorly

Question 20

costal facets of thoracic vertebrae T2-T9

Answer 20

Identify costal facets
• 2 demifacets on body for head
of ribs
• Facet on transverse process for
tubercle of rib

Question 21

Atypical thoracic vertebrae T1

Answer 21

T1
• Has 1½ facets on the body for articulation with head of ribs
• Full superior facet & inferior demifacet

Question 22

Atypical thoracic vertebrae T10 T12

Answer 22

Single facet on side of vertebral body of T10 – T12
• These ribs only articulate with their own vertebrae
• No facet on transverse process of T11 & T12

Question 23

typical lumbar vertebrae L1-L4

Answer 23

Body
– Large & kidney-shaped
• Vertebral canal
– Small in comparison
– Cord ends L1 / L2
• Spinous process
– Horizontal & bulky

Question 24

Atpyical lumbar vertebrae

Answer 24

L5
wedge-shaped BODY
• Transverse process is anterior to side of body to iliolumbar ligament
• May be fused to sacrum

Question 25

typical sacrum S1-S5

Answer 25

``` – 5 sacral vertebrae – Transverse ridges present between fused bodies – “Ala” (wing) • (Transverse processes) – Anterior sacral foramina ```

Question 26

facet joints

Answer 26

– Between adjacent vertebrae • Between the superior & inferior articular facets – Small synovial plane joints

Question 27

symphyses

Answer 27

Secondary cartilaginous joints | – Hyaline & fibrocartilage

Question 28

where does the fibrocartilaginous disc lie between

Answer 28

outer annulus fibrous | inner nucleus pulposus

Question 29

annulus fibrosus

Answer 29

“coiled spring” | • Holds vertebrae together

Question 30

nucleus pulposus

Answer 30

“ball bearing” which the vertebra “roll over” | during movement

Question 31

motion segment

Answer 31

Functional unit of the spine | – 2 vertebrae & associated soft tissues

Question 32

movement of spine

Answer 32

flexion and extension lateral flexion spinal rotation forces parallel to discs

Question 33

where does flexion and extensions of spine

Answer 33

– Occurs throughout spine – Occurs in atlanto-occipital joint • (C1 & skull)

Question 34

lateral flexion of spine

Answer 34

– Maximal in lumbar region – Restricted in neck & thorax (ribs) – Atlanto-occipital joint (C1 & skull)

Question 35

spinal rotation of spine

Answer 35

– Mainly present in thoracic region – Sheer stresses – “Twist” disc fibres at periphery

Question 36

forces of parallel to discs

Answer 36

– Also sheer stresses on discs | – Slip in the direction of the force

Question 37

two types of longitudinal ligaments

Answer 37

– Anterior • Anterior vertebral bodies – Posterior • Posterior vertebral bodies

Question 38

ligamentum flavum

Answer 38

– Between laminae | – Yellow due to elastin

Question 39

Ligaments of spine

Answer 39

Interspinous ligaments • Supraspinous ligament • Ligamentum nuchae in neck

Question 40

herniated discs

Answer 40

The intervertebral disc may rupture, or herniate • This compresses the spinal nerve – i.e. sciatica or lumbar back pain

Question 41

symptoms of herniated dics of L4/5

Answer 41

leg pain weak movement

Question 42

treatment for herniated disc of L4/5

Answer 42

sciatic stretch

Question 43

symptoms of herniated discs of L5/S1

Answer 43

pain, weakness, absent tendon reflex

Question 44

treatment of herniated discs of L5/S1

Answer 44

sciatic stretch

Question 45

symptoms of herniated discs of L3/4

Answer 45

– Anterior thigh pain, weak quad, | absent tendon reflex,

Question 46

treatment of herniated disc of L3/4

Answer 46

femoral stretch

Question 47

sciatic stretch tests

Answer 47

– Supine – Leg raise – Ankle dorsiflexion

Question 48

femoral stretch test

Answer 48

- Prone – Flex knee – Extend hip

Question 49

kyphosis

Answer 49

abnormal flexion

Question 50

scoliosis

Answer 50

abnormal lateral curvature

Question 51

congenital pathologies of the spine

Answer 51

Accessory hemivertebra | – Fusion of adjacent vertebral bodies

Question 52

spina bifida

Answer 52

– Embryological defect – Range of severity • Mild – only vertebra affected • Severe – vertebra & spinal cord affected