C Spine And T Spine Flashcards
0
Q
Total bones in vertebral column
A
Children 33
Adult 26
1
Q
What are the 5 divisions of the vertebral column
A
Cervical vertebrae Thoracic vertebrae Lumbar vertebrae Sacrum Coccyx
2
Q
When stacked what forms the spinal canal
A
The vertebral foramina
3
Q
Spinal canal
A
Begins at the base of the skull and extends to the sacrum
4
Q
What does the spinal canal contain
A
Contains spinal cord and is filled with cerebrospinal fluid
5
Q
Spinal chord
A
Enclosed and protected by the spinal canal
Begins with medulla oblongata
6
Q
The spinal chord passes through what
A
The foramen magnum of the 1st cervical vertebra and ends at the lower level of L-1
7
Q
Where does the spinal chord terminate
A
The conus medullaris
8
Q
In some people the conus medullaris may extend to as low as
A
The body of L-2
9
Q
To avoid striking the spinal chord what is a common site for lumbar puncture
A
L-3 L-4
10
Q
Intervertebral disks
A
Fibrocartilage disks that separate adult vertebrae
11
Q
Where are there no intervertebral disks?
A
C1 and C 2
12
Q
Function of intervertebral disks
A
Act as a cushion
Allow for flexibility and movement of vertebral column
14
Q
The intervertebral disks account for how much length of the vertebral column
A
One quarter the length
15
Q
what is the inner portion of the intervertebral disks
A
nucleus pulposus
16
Q
what is the outer portion of the intervertebral disks
A
annulus fibrosus
17
Q
nucleus pulposus
A
central core of disk
pulpy and gelatinous
18
Q
annulus fibrosis
A
fibrocartilage disk
surrounds nucleus pulposus
keeps nucleus material in the center
19
Q
herniated nucleus pulposus (HNP)
A
when the nucleus pulposus ruptures and protrudes into the vertebral canal and impinges on a spinal nerve
AKA slipped disk
20
Q
where does an HNP most commonly occur?
A
the lumbar region
21
Q
cervical vertebrae
A
the most superior 7 vertebrae
occupy the region of the neck
22
Q
thoracic vertebrae (dorsal)
A
next 12 bones after the cervical spine
forms the midback region
articulates with the ribs
23
Q
lumbar vertebrae
A
next 5 vertebrae after the thoracic
form the lower back
largest and strongest vertebrae
the load of the body weight increases toward the inferior end of the column which are common sites of injury
24
Q
sacrum
A
the 5th lumbar vertebrae articulates with the sacrum
articulates with the coccyx inferiorly
25
coccyx
the sacrum and coccyx develop as multiple separate bones and fuse into two distinct bones
26
vertebral curvatures
when viewed from the side the vertebral column has 4 curves
| they are either concave or convex
27
concave curve
a rounded inward or depressed surface
| like a cave
28
convex curve
rounded outward or elevated surface
29
cervical and lumbar regions have what curvatures
concave curvatures
30
thoracic and sacral regions have what curvatures
convex curvatures
31
primary curves
soon after birth the thoracic and sacral curves begin to develop
they're called primary curves
32
secondary/compensatory curves
cervical and lumbar curves because they develop after birth
33
when does the cervical curve develop
when the child begins to hold the head up at about 3-4 months
34
when does the lumbar curve develop
when the child begins to walk
35
what is the purpose of the vertebral curvatures
increase strength of vertebral column
| maintain balance in upright position
36
which curves are usually more pronounced in women
lumbar and sacral curves
37
3 abnormal distortions of the normal spinal curvature
1. lordosis
2. kyphosis
3. scoliosis
38
lordosis
bent backward "swayback"
any abnormal increase in the posterior concavity of the lumbar or cervical region
also can be a normal concavity
39
what can lordosis be caused by
pregnancy, obesity, poor posture, rickets, or tuberculosis of the spine
40
kyphosis
humpback
any abnormal increase in the posterior convexity of the thoracic curve
results in stooped posture/ reduced height
41
what can kyphosis be caused by
compression fractures, poor posture, rickets, or other spinal diseases
42
in the frontal view the vertebral column is
near straight with a little lateral curvature
43
True or false:
| a slight lateral curvature is sometimes present in the upper thoracic region
TRUE
44
True or False:
| the slight lateral curve is to the right in right handed pts. and to the left in left handed pts.
TRUE
45
scoliosis
any abnormal curvature of the spine
| occurs when a pronounced S-shaped lateral curve exists
46
true or false:
the vertebral column develops a second or compensatory curve in the opposite direction to keep the head centered over the feet
TRUE
47
a typical vertebrae is composed of what 2 main parts
1. body
| 2. vertebral arch
48
1. body
thick, weight bearing anterior portion of the vertebra
| cylindrical in shape
49
2. vertebral arch (neural arch)
consists of a ring or arch of bone extending posteriorly from the vertebral body
50
vertebral foramen
where the body and the arch enclose a space
51
true or false:
when the vertebrae are stacked on one another, the vertebral foramina form the vertebral canal that encloses the spinal cord
TRUE
52
pedicle
extends posteriorly from the vertebral body
little feet
form the sides of the vertebral arch
53
true or false:
| the superior and inferior borders of the pedicles are concave
True
54
the concave border of the upper surface of the pedicle is called?
superior vertebral notch
55
the concave border of the lower surface of the pedicle is called?
inferior vertebral notch
56
when the vertebrae are stacked, the inferior and superior vertebral notch line up and form the?
intervertebral foramina
57
what runs through the intervertebral foramina
spinal nerves and blood vessels
58
lamina
posterior part of vertebral arch
| extend posteriorly from the pedicle to form the spinous process
59
transverse process
project laterally from the pedicles
| between lamina and pedicles
60
spinous process
extends posteriorly from the midline
| serve as points of attachment for muscles
61
spina bifida
a congenital defect of the vertebral column when the lamina fail to unite posteriorly at the mid line
62
superior and inferior articular processes
4 processes that arise from the junction of the pedicles and lamina to articulate with the vertebra above and below
63
the articular surfaces are covered with fibrocartilage and are called
facets
64
each superior articular process has a facet on its
posterior surface
65
each inferior articular process has a facet on its
anterior surface
66
zygopophyseal joints
the articulation of the superior articular process of one vertebra to the inferior articular process of the vertebra above
67
3 joints of the vertebral column
1. intervertebral joints
2. zygopophyseal joints
3. costal joints
68
True or False
| without the costal joints respiration could NOT occur
TRUE
69
1. intervertebral joints
slightly movable
between the vertebral bodies
intervertebral disks are located in these joints
70
3. costal joints
located in the thoracic region
| articulate with the rib and the vertebra
71
costovertebral joints
head of the rib articulates with the body of the vertebra
72
costotransverse joints
tubercle of the rib articulates with the transverse process of the vertebra
73
Atypical cervical vertebrae
first 2 vertebrae and the seventh vertebrae
C1 and C2 are modified to join the skull
C7 long spinous process to join the thoracic vertebrae
74
typical cervical vertebrae
C3-C6
contain:
transverse foramina, bifid spionous process tips, overlapping vertebral bodies, 3 foramina
75
transverse foramen in cervical vertebrae
the hole in each transverse process
| vertebral artery veins and certain nerves pass through here
76
pillar
between the superior and inferior articular process is a short column of bone
77
in C1 what is the pillar called
lateral mass
78
the superior articular process of C1 contains a facet that articulates with what
the occipital condyles of the skull
79
atlantoocipital articulation
the articulation between the atlas and the occipital bone
80
Jefferson fracture
comminuted fracture that occurs as a result of axial loading AKA landing on ones head or abruptly on ones feet
the skull slams into the ring and the anterior and posterior arches of C1 are fractured
81
true or false
| thoracic vertebra have facets and demifacets on them for the ribs
TRUE
82
what is the level of the mastoid tip
C1
83
what is the level of the gonion
C3
84
what is the level of the thyroid cartilage
C4-C6
85
what is the level of the vertebra prominens
C7 or the body of T1
86
whats the level of the jugular notch
T2 T3
87
what is the level of the sternal angle
T4 T5
88
cervical spine routine projections
AP open mouth
AP axial
Obliques
Lateral
89
cervical spine special projections
```
cervicothoracic lateral, twining method, swimmers
lateral hyperflexion hyperextension
AP fuchs
PA judd
AP wagging jaw (ottonello method)
AP axial (pillar)
```
90
Thoracic spine routine projections
AP
| Lateral
91
Thoracic spine special projection
obliques
92
CERVICAL SPINE
| AP open mouth shows
fractures involving C1 and C2
| demonstrates jefferson fractures
93
CERVICAL SPINE
| AP open mouth SID/Central ray
SID = 40
8x10 IR
CR is perpendicular to the IR directed through the center of the open mouth
line from lower margin of upper incisors to mastoid tip is perpendicular to IR
taken on expiration
94
If the dens cannot be seen on the AP open mouth then what do you do
do the fuchs or the judd method
95
CERVICAL SPINE
| AP axial shows
pathology involving C3-C7
| shows clay shoveler's fracture, compression fracture and HNP
96
Clay shoveler's fracture
results from hyperextension of neck and causes avulsion fracture of spinous process of C6-T1
97
compression fracture
associated with osteoporosis
| collapse of a vertebral body
98
CERVICAL SPINE
| AP axial SID/central ray
```
SID = 40
8x10 ir
same alignment as AP open mouth
CR centered at level of thyroid (C4-C5)
angle 15 degrees cephalad when supine
angle 20 degrees caudad when upright
suspend breathing
```
99
CERVICAL SPINE
| obliques show
intervertebral foramina
100
CERVICAL SPINE
| obliques SID/central ray
```
SID = 40-72 72 preferred
8x10 or 10x12
45 degree obliquity
elevate chin
CR 15 degrees caudad at C4 for RAO/LAO
CR 15 degrees cephalad at C4 for RPO/LPO
suspend breathing
```
101
CERVICAL SPINE
obliques
Anterior oblique positions/PA oblique projections show
```
downside
RAO (right), LAO (left)
intervertebral foramina
```
102
CERVICAL SPINE
obliques
posterior oblique positions/AP oblique projections show
upside
RPO (left) LPO (right)
intervertebral foramina
103
CERVICAL SPINE
| lateral shows
```
spondylosis and osteoarthritis
C1-C7/T1
SID = 60-72
8x10 or 10x12
CR perpendicular directed to C4
suspend on full expiration
shows the zygopophyseal joints
```
104
if C7/T1 is NOT shown on a lateral C-spine you must perform what
a swimmer's lateral
105
hangman's fracture
occurs when neck is subjected to extreme hyperextension
| very unstable fracture due to the dens pressing against the brain stem
106
odontoid fracture
involves the dens and can extend into the lateral masses or arches of C1
107
teardrop burst fracture
due to compression with hyperflexion
vertebral body comminuted with triangular fragments posterior body displaced into spinal canal
quadriplegia is a high probability
108
subluxation
vertebral body appears to have jumped over the vertebral body immediately inferior to it
109
CERVICAL SPINE
swimmer's lateral cervicothoracic shows
(twining method)
SID 60-72
10x12
arm and shoulder closes to IR is elevated and rotated anteriorly
CR perpendicular to IR centered 1 inch above jugular notch
a slight caudad angle (3-5 degrees) may be necessary to help separate shoulders
suspend on expiration or use breathing technique
110
CERVICAL SPINE
| hyperflexion/hyperextension
demonstrates vertebral mobility
frequently performed to rule out whiplash injury or to follow up after spinal fusion
same positioning as lateral c spine but one pic with chin depressed one with chin pushed back
111
CERVICAL SPINE
| fuchs (AP) or Judd (PA)
Done only if you did NOT get the dens on the AP open mouth
MML needs to be perpendicular to table
adjust CR angle so it is parallel to MML
suspend breathing
112
CERVICAL SPINE
| ottonello method
mandibular shadow is blurred so you can see the C spine in its entirety
113
CERVICAL SPINE
| AP axial Pillars
```
shows pillars of C4-C7
SID = 40
supine hyperextend pts. neck
CR angled 20-30 degrees CAUDAD to enter through C5
suspend breathing
```
