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MSK > Cervical And Thoracic Spine And Clinical Disorder > Flashcards

Cervical And Thoracic Spine And Clinical Disorder Flashcards

1
Q

How many cervical vertebrae are there?

A

7

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2
Q

How many cervical nerves are there?

A

8

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3
Q

How many thoracic vertebrae are there?

A

12

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4
Q

Why are people more likely to develop age related problems in the cervical spine than the thoracic spine?

A

Cervical spine is mobile
Thoracic spine is immobile

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5
Q

Why does the size of vertebrae increase as you descend the spine?

A

Have to be able to bear more weight as you go down the spine

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6
Q

What cervical vertebrae have the TYPICAL characteristics of a cervical vertebra?

A

C3 - C6

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7
Q

What are the differences of a typical cervical vertebrae to a lumbar vertebra?

A

Bifid Spinous Process
Transverse Foramen

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8
Q

What is meant by the Bifid spinous process of a Typical cervical vertebra?

A

Has 2 prominences at the tip rather than just 1

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9
Q

What is a transverse Foramen?

A

Hole in the transverse processes

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10
Q

What is transmitted through the transverse Foramen of C1 - C6?

A

Vertebral artery
Vertebral vein
Sympathetic nerve plexus

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11
Q

What is transmitted through the transverse foramen of C7?

A

Accessory vertebral vein

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12
Q

What are the 3 atypical cervical vertebrae?

A

C1 (Atlas)
C2 (Axis)
C7

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13
Q

What is the atypical structure of the Atlas (C1)?

A

NO vertebral body
NO spinous process
Large lateral masses

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14
Q

What does C1 articulate with?

A

The occipital bone of the head and the Axis (C2)

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15
Q

What does the remnant of the vertebral body of C1 form?

A

The Odontoid process

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16
Q

Why is the atlas (C1) the widest cervical vertebra?

A

Lots of space for the spinal cord

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17
Q

Why does the atlas have very large lateral masses?

A

To support the heavy weight of the head

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18
Q

What attaches at the anterior arch and anterior tubercle of the atlas?

A

Anterior Longitudinal Ligament

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19
Q

What is the atypical structure of the Axis (C2)?

A

Odontoid process/dens
Broadest spinous process of the Cervical vertebra

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20
Q

What does the articulation between C1 and C2 allow for?

A

Rotation

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21
Q

Where is the Transverse ligament in the C1, C2 articulation?

A

Posterior to the odontoid process

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22
Q

What is the function of the Transverse Ligament?

A

Prevents horizontal displacement of the atlas (C1)

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23
Q

What is Atlantoaxial instability?

A

Weakness at the articulation between C1 and C2

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24
Q

What can cause Atlantoaxial instability (C1 and C2)?

A

Fracture at C1 damages the transverse ligament
General degradation

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25
Q

How can Atlantoaxial (C1 and C2) instability cause neurological issues?

A

When the neck is flexed forward C1 can move forward on C2 which can put pressure on the spinal cord

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26
Q

What is the atypical structure of C7 vertebra?

A

LONGEST spinous process
Non Bifid spinous process
Large transverse process but small transverse foramen

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27
Q

What are the ligaments of the cervical and thoracic vertebra?

A

Anterior longitudinal ligament
Posterior longitudinal ligament
Ligamentum flavum
Interspinous ligament
Supraspinous ligament

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28
Q

Where is the anterior longitudinal ligament?

A

Anterior surface of the vertebral body

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29
Q

Where is the posterior longitudinal ligament?

A

Posterior part of the vertebral body, the front of the spinal canal

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30
Q

Where is the ligamentum flavum?

A

Back of the spinal canal

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31
Q

Where is the interspinous ligament?

A

Between the spinous processes

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32
Q

Where is the supraspinous ligament?

A

At the tips of the spinous processes

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33
Q

What is the Ligamentum Nuchae?

A

A thickening of the supraspinous ligament

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34
Q

Where is the ligamentum Nuchae?

A

Splits the muscles
Inserts into the back of the head (occipital bone) and all of the spinous process of the cervical vertebrae

35
Q

What is the function of the ligamentum nuchae?

A

Maintains secondary curvature of cervical spine
Helps cervical spine support head (prevents the muscles from constantly contracting preventing fatigue))
Site of muscle attachment for neck and trunk muscles

36
Q

What movements can the cervical spine do?

A

Flexion
Extension
Rotation
Lateral Flexion

37
Q

What movement does the atlanto-occipital joint mainly contribute to? (Occipital and atlas)

A

Flexion
Extension

50% of Flexion and extension happens here, other 50% comes from the rest of the cervical spine

38
Q

What movement does the atlanto-axial joint mainly contribute to? (Atlas and axis)

A

Rotation

50% of rotation happens here, other 50% contributed by rest of cervical spine

39
Q

What is the structure of the Thoracic vertebrae similar to?

A

Lumbar vertebrae

40
Q

What is the shape of the thoracic vertebrae’s vertebral body like?

A

Heart shape

41
Q

What is the shape and size of the thoracic vertebrae’s vertebral foramen?

A

Small and circular

42
Q

What is the clinical relevance of the thoracic vertebral foramen being small?

A

Any bleeding into the thoracic segment of the spinal cord will likely lead to neurological symptoms since the spinal cord is likely to get compressed

43
Q

What is special about the facet joints of the thoracic vertebra?

A

Have demi-facets on the sides of the vertebral body to articulate with the ribs

44
Q

What is unique about the facets of T1 on the vertebral body?

A

Whole facet joint superiorly
Demi-facet inferiorly

45
Q

What is the structure of the facet joints on the vertebral bodies of T2-T8?

A

Demi facets above and below

46
Q

What is the structure of the facet joints on the vertebral bodies of T9-T10?

A

Back to full facets above and below

47
Q

What is the overal structure of a thoracic vertebrae?

A

Small circular vertebral foramen
Triangular shaped vertebral body
Demi facets (facet joints to articulate with the ribs

48
Q

What 2 places of the thoracic vertebra does a rib articulate with?

A

Head of rib with vertebral body
Neck of rib with the transverse process (not at T11 and T12 tho)

49
Q

Where does a neurovascular bundle run with the rib?

A

In the costal groove

50
Q

What movements do the facet joints allow for and then limit in the thoracic spine?

A

Allows for rotation
Limits Flexion

51
Q

What movement should be assessed for if you suspect the thoracic vertebra are damaged?

A

Rotation

52
Q

Where is the Anterior Longitudinal Ligament found?

A

Runs along the front of the vertebral bodies

53
Q

Where is the Posterior Longitudinal Ligament found

A

Back of the vertebral bodies at the front of the spinal canal

54
Q

What is cervical spondylosis?
(Osteoarthritis)

A

Neck pain as a result of age-related changes of the cervical spine

55
Q

What is the usual triad for cervical spondylosis (osteoarthritis)?

A

Loss of disc height
Facet joint arthritis (more pressure on facet joints)
Osteophytes (Syndesmophytes)

56
Q

How can cervical spondylosis lead to myelopathy?

A

Osteophyte in the vertebral/spinal canal

57
Q

How can cervical spondylosis lead to radiculopathy?

A

Osteophyte in the intervertebral foramen

58
Q

What normally happens when nerve roots get compressed (Radiculopathy)

A

Paraesthesia in the affected Dermatome (pins and needles/numbness)
Pain which radiates from the compression to the affected dermatome

Motor/muscle weakness in affected dermatome
Paralysis in affected Dermatome

59
Q

What age do Prolapsed intervertebral discs usually happen? (Cervical spine)

A

30 - 50yrs

60
Q

Why is tearing the annulus fibrosis bad in a cervical prolapsed intervertebral disc?

A

Nucleus pulposus is acidic which will irritate the spinal cord

61
Q

If somebody has a prolapsed C5/C6 intervertebral disc what spinal nerve root is compressed?

A

C6

62
Q

If somebody has a prolapsed C5/C6 intervertebral disc where do they experience pain?

A

Radiates from neck down the anterior arm into the lateral forearm thumb and index finger

63
Q

If somebody has a prolapsed C5/C6 intervertebral disc what motor weakness do they have?

A

C6 myotome responsible for:
-Elbow Flexion
-Wrist extension
-Supination

64
Q

If somebody has a prolapsed C5/C6 intervertebral disc where do they experience sensory loss/numbness?

A

Lateral forearm thumb and index finger
Only in the C6 dermatome

65
Q

What age range does cervical myelopathy typical affect?

A

50 - 80 yrs

Usually because of cervical cord compressed by spondylosis

66
Q

What anatomically changes with cervical myelopathy?

A

Thickening of Ligamentum Flavum
Osteophytes

67
Q

What are the symptoms of cervical myelopathy?

A

Progressive
Clumsiness
Loss of fine movements
Loss of balance

68
Q

What will a patient with C4 myelopathy complain of?
Pain?
Motor weakness?
Sensory loss?

A

Pain at neck
Motor weakness of Shoulder abduction (C5) and other myotomes distally
Numbness/parasthesia from the shoulder distally, trunk and lower limbs

69
Q

What is a Jefferson Fracture?

A

Burst fracture of C1 (atlas)

70
Q

What causes a Jefferson fracture (C1)?

A

Axial loading:
Hitting top of the head driving the skull into the cervical spine

71
Q

What part of the atlas breaks in a Jefferson fracture (C1)?

A

Front and back arches can break

72
Q

What is a Hangman’s fracture?

A

Fractured C2

Fracture through the pars interarticularis usually due to hyper extension of the Neck

73
Q

How can you see a Hangman’s fracture on an x-ray?

A

Forward displacement of C1 and C2 on C3

74
Q

What is an Odontoid Peg fracture?

A

Hyperextension injury of the Odontoid of C2

75
Q

How are odontoid peg fractures usually caused?

A

Older person falls and does react quick enough to use there hands to stop themselves

76
Q

What are the 2 common causes of thoracic cord compression?

A

Fractures
Tumours

77
Q

Why are fractures and tumours likely to cause neurological problems in the thoracic spine?

A

Small vertebral Foramen in thoracic spine

78
Q

What will a patient with Thoracic cord compression at T10 complain of?
Pain?
Motor weakness?
Sensory effects?

A

Lower thoracic pain
Weakness in all muscles of the legs (T10 myotome and below)
Numbness just below umbilicus (T10)

79
Q

What is Spondylodiscitis?

A

Infections of the spine

80
Q

What part of the spine usually gets infected in Spondylodiscitis?

A

Intervertebral disc

81
Q

Why does the intervertebral disc usually get infected in Spondylodiscitis?

A

Doesn’t have a direct blood supply so has few white cells

82
Q

How do bacteria usually enter the intervertebral disc?

A

Diffuse from the vertebral body nutrient artery

83
Q

What can happen if Spondylodiscitis goes untreated?

A

Epidural abscess and vertebral osteomyelitis

MSK (36 decks)

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