Herniated Nucleus Pulposus

Question 1

superior articular process

Answer 1

lumbar vertebra (identify on diagram)

Question 2

transverse process

Answer 2

lumbar vertebra (identify on diagram)

Question 3

spinous process

Answer 3

lumbar vertebra (identify on diagram)
- for muscle attachment

Question 4

inferior articular process

Answer 4

lumbar vertebra (identify on diagram)
- attached to superior process of next vertebrae (through sinovial joints)

Question 5

pedicle

Answer 5

lumbar vertebra (identify on diagram)

Question 6

body of vertebra

Answer 6

lumbar vertebra (identify on diagram)

Question 7

lamina of lumbar vertebra

Answer 7

lumbar vertebra (identify on diagram)

Question 8

zygapophyseal joint

Answer 8

between inferior process and superior articular process

Question 9

interlaminar space (has ligamentum flavum)

Answer 9

• only exists in lumbar region
• has a lot of elastic fibers
• in sacral region - vertebrae are fused together
• in thoracic region - vertebrae overlap each other

Question 10

what is the access route for doing lumbar puncture

Answer 10

interlaminar space

Question 11

vertebral foramen

Answer 11

space for spinal cord

Question 12

intervertebral disk

Answer 12

(identify on diagram)

Question 13

intervertebral foramen

Answer 13

where spinal nerves come out from spinal cord

Question 14

anterior boundary of intervertebral foramen

Answer 14

intervertebral disk

Question 15

posterior body of intervertebral foramen

Answer 15

zygapophyseal joint

Question 16

numbering of spinal nerves

Answer 16

• thoracic and lumbar regions - spinal nerve has number of vertebrae above the foramen
• cervical region - spinal nerve has number of vertebrae below the foramen (1 extra cervical spinal nerve than cervical vertebrae)

Question 17

components of intervertebral disc

Answer 17

• nucleus pulposus (adult remnants of notochord)
• anulus fibrosus (fibrous connective tissue/ fibrous cartilage)
• layer of hyaline cartilage

Question 18

adult remnants of notochord are found in

Answer 18

nucleus pulposus of intervertebral disk

Question 19

nucleus pulposus

Answer 19

• part of intervertebral disc
• helps to spread out the force that is applied to the intervertebral disk from both sides
• adult remnants of notochord

Question 20

anulus fibrosis

Answer 20

• part of intervertebral disc
• surrounds the nucleus pulposus
• thicker in the anterior section than posterior section
• herniation of nucleus pulposus is more likely to occur in the posterior sectoin of anulus fibrosis

Question 21

common direction of herniation

Answer 21

posto-lateral

Question 22

anterior longitudinal ligament

Answer 22

covers the anterior portion of anulus fibrosis

Question 23

posterior longitudinal ligament

Answer 23

covers the posterior portion of anulus fibrosis (much smaller and thinner than anterior longitudinal ligament)

Question 24

herniated nucleus pulposus

Answer 24

• nucleus pulposus leaks out into the intervertebral foramen
• compresses spinal nerves (always compresses the spinal nerve that is lower to the intervertebral disk)

compression of sensory fibers - pain, tingling, etc
compression of muscle fibers - weakness of skeletal muscles

Question 25

cauda equina

Answer 25

where spinal cord ends (L1-L2)

Question 26

what are osteophytes and what symptoms do they cause

Answer 26

- degeneration of lumbar intervertebral discs and hypertrophic changes at vertebral margins with spur formation - osteophytes from osteoarthritic zygapophyseal joint - symptoms similar to herniated pulposus (impingment of spinal nerve)

Question 27

paresthesia

Answer 27

tingling (possible sensory symptom of nerve compression)

Question 28

hypesthesia

Answer 28

reduced sensation (possible sensory symptom of nerve compression)

Question 29

anesthesia

Answer 29

total numbness (possible sensory symptom of nerve compression)

Question 30

types of sensory deficits

Answer 30

- pain - tingling (paresthesia) - reduced sensation (hypesthesia) - total numbness (anesthesia)

Question 31

types of motor deficits

Answer 31

- muscle weakness (paresis) | - total loss of function (paralysis)

Question 32

ligamentum flavum

Answer 32

part of the lining in the intervertebral foramen

Question 33

spondylolysis

Answer 33

- fracture of vertebral column - scottie dog appears to be wearing a collar - causes nerve compression

Question 34

spondylolisthesis

Answer 34

- fracture of vertebral column - scottie dog appears decapitated - causes nerve compression

Question 35

foraminal stenosis

Answer 35

``` narrowing of intervertebral foramen could be caused by: - herniated nucleus pulposus - arthritic changes of the zygapophyseal joints - inflammation - scarring in the region of the foramen ```

Question 36

central stenosis

Answer 36

``` narrowing of the vertebral canal could be caused by: - bony abnormalities of the vertebrae - herniated nucleus pulposus - thickening of vertebral ligaments - tumors ```