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Flashcards in Spine Deck (40)

How many vertebrae are there and how are they organised?

33 in total

7 cervical

12 thoracic

5 lumbar

5 sacral

4 coccygeal


What are the structures labelled 1-7?

1. Vertebral body

2. Spinous process

3. Transverse process

4. Pedicle

5. Foramen/spinal canal

6. Lamina

7. Superior facet


What kind of joints are facet joints?



What is the angle of the transverse processes at the cervical, thoracic and lumbar levels?

45, 60 and 90 degrees respectively


What do the transverse foramen in the cervical spine transmit?

Vertebral artery, vein and nerve fibres


Is there much movement in the thoracic spine?

No, due to attachment of ribs


Where is there greatest risk of injury to the spine and why?

Cervico-thoracic and thoraco-lumbar junctions

Junctions between fixed and mobile segments


Where is the risk of rupture to the vertebral disc highest?

Posterior annulus fibrosis - this is where it's thin


Which ligaments run along the surface and length of the vertebral column?

Anterior longitudinal ligament
Posterior longitudinal ligament


Which structure links the vertebral laminae?

Ligamentum flavum


Which structures link the spinous processes of the vertebrae and what strength are they?

Interspinous ligaments - between processes, relatively weak

Surpaspinous ligament - along the posterior aspect of the spinous processes, tough


What is the three column theory of Denis?

Assessment of stability of spinal injury

1 Column injured: stable
(OP wedge #)

2 columns injured: may be unstable

3 columns injured: unstable


What are the superficial/extrinsic muscles of the spine?


Latissimus dorsi

Rhomboid minor & major

Levatus scapularis


What is the function of the superficial/extrinsic muscles of the spine?

Movement of shoulder and upper limb


Which muscle is being indicated here, and what is its function and innervation?


Elevates and depresses scapula, retracts scapula

Spinal accessory nerve (CN XI)


Which muscle is being indicated here and what is its function and innervation?

Latissmus doris

Adducts, extends and internally rotates the humerus

C6, 7, 8


Which group of muscles are being indicated here and what are their names?

Erector spinae:

  Laterally - iliocostalis

  In between - longisimus thoracis

  Medially - spinalis thoracis


What is the origin and insertion of the erector spinae muscles?

Occiput of the skull

Inserts on the pelvis


What is the innervation of the erector spinae muscles?

Posterior rami of the spinal nerves


Where does the spinal cord exit the skull?

Foramen magnum


Where does the spinal cord terminate?

At the cauda equina, level L2


What is a myotome?

Muscles controlled by the motor element of the nerve root from a specific level 


What is a dermatome?

Skin sensation supplied by the sensory element of the nerve root from a specific level


What are the parts of the spinal cord labelled 1-4?

1. Grey matter

2. White matter

3. Posterior horn

4. Anterior horn


What is contained within the white matter of the spinal cord?

The ascending sensory tracts

The descending motor tracts


What is significant about the path of the crossed pyramidal or lateral cerebrospinal tract?

(This is a descending motor tract)

Crosses over in the medulla

Descends in the spinal cord on the contralateral side


What is significant about the path of the uncrossed pyramidal or anterior cerebrospinal tract?

Descend the spine on the ipsilateral side of the cord

Crosses (decussates) at the same level it exits the cord so exits from the contralateral side


What is significant about the path of the posterior & anterior spinocerebellar tracts and what do these nerves carry?

Ascend the spine on the ipsilateral side of the cord
Enter the cerebellum
Carry information relating to proprioception


What is significant about the path of the lateral and anterior spinothelamic tracts and what do they carry?

Enter then ascend the spine on the ipsilateral side of the cord for a couple of levels
Then cross and ascend the spine on the contralateral side of the cord
Enter the thalamus
Carry information relating to pain & temperature


Which ascending tracts carry fine touch and proprioception to the brain?

Posterior columns:

Fasciculus gracilis of Goll

Fasciculus cuneatus of Burdach



Which are the descending tracts which cross over and descend on the contralateral side of the brain?

Crossed pyramidal or lateral cerebrospinal tract


Which are the ascending tracts which initially ascend on the ipsilateral side of the cord but cross over to contralateral side to reach the brain?

Lateral and anterior spinothelamic tracts


What happens in the grey matter to ascending and descending tracts?

The descending tracts enter the anterior horn of the grey matter and are transmitted via the ventral root to the nerve root then the muscle of action

Sensation is transmitted via the spinal nerve root to the dorsal root and into the posterior horn of the grey matter and via the ascending sensory tracts enter the brain


Which roots of the spinal cord join to become the nerve root?

Ventral and dorsal roots


Through which foramen does the spinal nerve exit the spinal column?

Intervertebral notch


What structure forms the intervertebral notch?

The pedicle of the vertebrae has a notch above and below
When the vertebrae are stacked, the two notches form a hole


When the nerve travels through the intervertebral foramen, what is it as risk of?

Injury from facet joint osteophyte formation, disc prolapse or foraminal stenosis


What is the cauda equina?

A bundle of spinal nerves and nerve roots


What nerves are contained within the cauda equina?

L2 – L5

S1 – S5

Coccygeal nerve


What is Batson's venous plexus?

A network of valveless veins
Connect the deep pelvic veins and thoracic veins (draining the inferior end of the urinary bladder, breast and prostate) to the internal vertebral venous plexuses