Lecture 2: Back Osteology

Question 1

What might cause a Jefferson fracture?

Answer 1

A blow to the head, or a falling object.

Question 2

What is a Jefferson fracture?

Answer 2

Fracture of both arches of the Atlas

Question 3

Why doesn’t a Jefferson fracture typically damage the spinal cord?

Answer 3

Because the vertebral foramen of the cervical spine is large.

Question 4

When might a Jefferson fracture (atypically) cause damage to the spinal cord?

Answer 4

In the event of damage to the Transverse ligaments (anterior transverse ligament and posterior transverse ligament)

Question 5

What two places is the axis prone to fracture?

Answer 5

The Vertebral arch and the Odontoid process (dens)

Question 6

What is a Hangman’s Fracture a result of?

Answer 6

Fracture of vertebral arch, usually a result of hyperextension of the Head on the neck

(not of the Head and Neck as in whiplash)

Question 7

Why does the odontoid process break during a horizontal blow to the head, and not the transverse ligament?

Answer 7

Because the transverse ligament is stronger than the odontoid process.

Question 8

Why won’t the odontoid process heal if it breaks at the base?

Answer 8

Because the Transverse ligament will hold it away from its blood supply

Question 9

What is Spina Bifida Occulta?

Where does this usually happen?

What is a common sign?

Answer 9

A developmental abnormality in which the Vertebral Lamina fail to fuse and close off the Vertebral Canal.

L5 and S1

Hair over the defect

Question 10

Why might it require less force to dislocate the cervical vertebrae than other vertebrae?

Answer 10

Because the Articulating Facets are more horizontal.

Question 11

How do we number ribs relative to the thoracic vertebrae?

Answer 11

For any given numbered rib (say, the 3rd rib), the head of that rib articulates with the inferior costal facet of the vertebral segment one number higher (T2) and with the superior costal facet of the same number (T3).

In practice, the rib is named for the numbered vertebra below it.

Question 12

What is spondylosis?

Answer 12

Degenerative joint disease which involves calcification of edges of the vertebral body.

Question 13

What is spondylolysis?

Answer 13

Separation of the vertebral arch from the vertebral body (fracture without anterior displacement)

Question 14

What is spondylolisthesis?

Answer 14

Anterior displacement of the vertebral body from the vertebral arch.

Can occur secondary to spondylolysis.

Question 15

What would one call a narrowed opening of the vertebral foramen?

Answer 15

Spinal stenosis

Question 16

Where is a lumbar puncture performed?

Answer 16

L3/L4 or L4/L5 at the level of the illiac crests.

Question 17

Why do physicians perform lumbar punctures in the lumbar spine?

(Besides the name!)

Answer 17

Because the spinal cord stops superior to that point, and you can avoid injury to it.

Question 18

What cavity does one pull CSF from in a lumbar puncture?

Answer 18

The Lumbar Cistern

Question 19

You’re perfoming a lumbar puncture and you hear a ‘pop.’ What structure did you just puncture?

Answer 19

The ligamentum flavum

Question 20

What is Hemisacrilization?

Answer 20

Fusion of L5 into the sacrum. Can be partial or complete.

Question 21

What is Lumbarization?

Answer 21

When S1 of the sacrum is separated from the sacrum, appearing to be L6. (Congenital defect)

Question 22

What painful disease can follow coccygeal trauma?

Answer 22

Coccygodynia