Clinical Anatomy of the Spine

Question 1

which vertebrae has no vertebral body

Answer 1

C1

Question 2

how many vertebrae are there in total?

Answer 2

33

Question 3

how many cervical vertebrae are there?

Answer 3

7

Question 4

how many thoracic vertebrae are there?

Answer 4

12

Question 5

how many lumbar vertebrae are there?

Answer 5

5

Question 6

how many sacral vertebrae are there?

Answer 6

5

Question 7

how many coccygeal vertebrae are there

Answer 7

4

Question 8

function of axis and atlas?

Answer 8

head rotation

Question 9

at what level of the spine do the vertebral arteries enter?

Answer 9

C6

Question 10

where are all secondary cartilaginous joints found in the body?

Answer 10

the midline

Question 11

which vertebrae are horizontally rather than vertically orientated?

Answer 11

cervical

Question 12

which area of the spine tends to have the least flexion/extension and why?

Answer 12

thoracic spine due to rib constraint

Question 13

which area of the spine tends to have the least rotation?

Answer 13

lumbar

Question 14

what kind of facet joints allow greatest movement? give an example of a spinal section that has these

Answer 14

horizontal

cervical

Question 15

what happens to the intervertebral discs with age?

Answer 15

lose water content and get smaller

Question 16

what common finding on spinal movement suggests osteoarthritis?

Answer 16

can’t extend spine (lean back)

Question 17

what does pain on spinal extension indicate?

Answer 17

osteoarthritis

facet joint-related pain

Question 18

which intervertebral discs are most likely to prolapse?

Answer 18

L4, L5, S1

Question 19

when should you treat someone with a bulging disc?

Answer 19

only if they show symptoms

Question 20

common clinical presentation of annulus tear?

Answer 20

lifting heavy object, hear a twang, get pain on coughing, better in 3 months

Question 21

longest cells in body?

Answer 21

nerve cells

Question 22

where do the motor neurons originate in nerve cells?

Answer 22

anteriorly in anterior grey horn

Question 23

where do sensory neurons originate in nerve cells?

Answer 23

dorsally in dorsal root ganglion

Question 24

name 2 organs affected if cauda equina is damaged and why?

Answer 24

bladder
bowel

nerves at this area supply them

Question 25

what forms the mixed spinal nerve

Answer 25

anterior and posterior dorsal roots of the cauda equina

Question 26

at what level does the spinal cord end?

Answer 26

L1

Question 27

is the exiting root nerve on the left or right?

Answer 27

left

Question 28

what does the exiting root pass under to exit the vertebra

Answer 28

pedicle

Question 29

is the transverse root inside the thecal sac?

Answer 29

yes

Question 30

is the exiting root inside the thecal sac

Answer 30

no

Question 31

what happens to the transverse root?

Answer 31

penetrates the thecal sac and becomes the next exiting nerve root

Question 32

is the exiting or transversing root that is commonly affected in disc prolapse?

Answer 32

transversing

Question 33

what happens as a result of nerve root compression?

Answer 33

radiculopathy resulting in pain down the sensory distribution of the dermatome + muscle weakness + weak reflexes

Question 34

what is sciatica

Answer 34

radiculopathy (pain down sensory part of dermatome) of LOWER LEG

Question 35

what nerve roots contribute to the sciatic nerve?

Answer 35

L4, L5, S1

Question 36

cause of spinal stenosis?

Answer 36

osteophytes and hypertrophic ligaments from OA compresing the nerve

Question 37

what features would suggest neurogenic claudication rather than vascular?

Answer 37

radiculopathy/burning leg pain on walking | relieved quickly by stopping

Question 38

what is cauda equina syndrome?

Answer 38

pressure on all lumbosacral nerve roots

Question 39

clinical signs of cauda equina syndrome?

Answer 39

bilateral lower motor neurone syndrome bladder and bowel dysfunction saddle anaesthesia loss of anal tone

Question 40

important examination to do in suspected cauda equina syndrome?

Answer 40

PR exam

Question 41

name the 3 muscles that make up the erector spinae

Answer 41

iliocostalis longissiumus thoracis spinalis thoracis

Question 42

what do the muscles of the erector spinae do?

Answer 42

arching backwards | standing straight

Question 43

what do laminae flavae do?

Answer 43

connect the laminae of adjacent vertebrae

Question 44

what is a chance fracture?

Answer 44

fractured vertebral body with no fractures posteriorly but disrupted ligaments posteriorly

Question 45

where do you do a lumbar puncture?

Answer 45

posterior iliac crest at L4

Question 46

bony causes of back pain?

Answer 46

``` trauma osteoporosis fracture tumour infection ```

Question 47

joint causes of back pain?

Answer 47

spondylosis OA spinal stenosis

Question 48

muscular causes of back pain?

Answer 48

sprain | strain

Question 49

disc causes of back pain?

Answer 49

discogenic back pain sciatica cauda equina

Question 50

clinical features that suggest mechanical back pain?

Answer 50

worse with activity relieved with rest relapsing/remitting

Question 51

treatment for sciatica

Answer 51

physio for 3 months then surgery