Lecture 21 - Back and Vertebral Column Flashcards by Eleanor Nicklason

What are the intervertebral disks made of?

Fibro cartilage

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What are the components of the back?

From where does it run?

From T1 to coccyx

Consists of:

axis / vertebral column (intervertebral disks, intervertebral foramen)
muscle (deep, superficial)

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Where is the spinal cord located?

Posterior to the vertebral column

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Where does the spinal cord terminate?

Between L1 and L2

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What are the four divisions of the spinal cord?

How many segments are in each?

Cervical : 7
Thoracic : 12
Lumbar : 5
Sacral: 5
coccygeal : 4

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Describe how the curvature of the spine arises

Primary C curve: As a foetus
In utero: head muscle strengthen –> curve at neck
Baby: leg muscles strengthen –> curve at lumbar region

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What are the curves in the spine called?

Lordosis

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What is it called when there is abnormal curvature of the spine?

Give some examples of conditions in which this occurs

Abnormal lordosis

Scoliosis
Kyphosis

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What are some features of a typical lumbar vertebra?

Vertebral arch
Pedicel
Lamina
Spinous process
Transverse processes
Articular process
Vertebral body
Vertebral canal

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What is different about lumbar and thoracic vertebra?

Lumbar:

larger, because they carry more weight
no facets for ribs

Thoracic: facets for rib attachment

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What are the names of the facets for rib attachment?

Articular facet

Articular Demi facet

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Where does the head of the rib attach?

Articular demi facet

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What attaches to the Articular facet?

Tubercle of rib

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Where is the vertebral canal?

What is inside?

In between the vertebral body and the vertebral arch

The spinal cord runs down until L1-L2

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From which angles are the vertebral column and the intervertebral foramen visible?

Vertebral column: looking vertically down

Intervertebral foramen: looking horizontally across the spine

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What is in the intervertebral foramen?

Spinal nerve

Posterior root ganglion

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What are the two roots of the spinal cord?

Posterior: sensation
Anterior: motor

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Where are the cell bodies of the neurons connecting to the spinal cord?

Sensory neurons: Posterior root ganglion

Motor neurons: Anterior horn

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What are the joints within the spine?

The intervertebral disks

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What is the intervertebral disk made up of?

Annulus fibrosus

Nucleus pulposus

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What are the features of the nucleus pulposus?

Deformable

Incompressible

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What is the role of the intervertebral disk?

Keeps the vertebrae apart

- Weight bearing forces – resisted by the annular fibres

What are the compositions of the nucleus pulposus and annulus fibrosus?

Nucleus: jelly like
Annulus: fibrous layers – not all in the same plane

Like an onion

What type of joint are the intervertebral disks?

Secondary cartilaginous joints

What is the role of ligaments in the spine?

Support | Limits the range of movement

What are the two ligaments found in the spine? | Where are they located?

Posterior longitudinal: Running down the back of the vertebral bodies Ligamentum flavum: In between the pedicles

How does structure relate to function in the ligamentum flavum?

Elastic fibres -- stretching of the spine during flexion of the body

What types of joints are the joints of the vertebral arches? Where are they?

Synovial plane joints On the articular processes

Describe the attachments of superficial back muscles

Originate on spine | Insert on limbs

Describe the attachments of deep back muscles

Originate and terminate on the spine

What are some of the muscles in the back. | Locate them

Levator scapulae Latissimus dorsi Rhomboids Trapezius

What are some of the intrinsic muscle of the back? | What are their functions?

Erector spinae: runs up the back of the spine at keep the body erect Transversospinalis: short muscles - Fixators that prevent instability due to too much movement

What is clinically significant about transversospinalis?

They are stabilisers When they are damaged, they rapidly atrophy and it is difficult to regain function. Special physiotherapy is needed

What causes disk prolapse?

A tear in the outer annulus fibrosus, allowing the nucleus pulposus to bulge out

In which direction do tears normally occur? | Why?

They bulge out postero-lateral This is due to the posterior longditudinal ligament in the vertebral canal

Are disk prolapses painful?

Bulge: not necessarily; only if the bulge reaches the outer third where there is nervous innervation Herniation & Extrusion: yes, as the outer third of the intervertebral disk has nervous sensation

Describes what happens to intervertebral disks over the course of one's life

The amount of fluid slowly decreases and the disks get thinner and the Articular cartilage degenerates The bones start to rub against each outer --> painful The body compensates and tries to limit movement of the joints. Osteophytes grow to limit movement

What can growth of osteophytes sometimes lead to?

Encroachment on nerves in the intervertebral foramen or in the spinal canal

What is at risk in disk prolapse? | Why?

The nerve roots in the foramen Posterior lonitudinal ligament protect the spinal cord itself

Where are disk prolapses common?

At the border of the lumbar and sacral regions

What is a compression fracture and in whom is it common?

It is a collapse of a vertebra due to trauma or weakening of the vertebra It is common in the elderly

Why is rubbing bone of the vertebrae painful?

Sensory nerve supply in the bone

What is the role of the posterior longitudinal ligament?

Prevents hyperflexion of the vertebral column

Describe the joints in the vertebral column

Plane joints connect the Articular projections

Compare the joints in the thoracic and lumbar spine

Thoracic: guide rotation Lumbar: guide flexion / extension

Does twisting movement of the spine cause injury?

It may cause injury Because only 50% of annular fibres are positioned to resist load

What links the two latissimus muscles?

An aponeurosis

What are the tree levels of disc prolapse?

Bulge Herniation Extrusion

Why do osteophytes grow?

In an attempt to limit movement of the joint

Describe venous drainage of vertebrae

Basivertebral veins | Come out of the posterior aspect of vertebra

Where does the posterior longitudinal ligament expand?

Over IV disc

Describe what happens when weight is put through the spine

1. Weight bearing forces 2. Bulge of disc; incompressible, so it bulges out 3. Annular fibres hold it all together; resist load

What is the general role of annulus fibrosus when weight bearing?

Resist load