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Flashcards in Spine (brian) Deck (56)
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1

the occiput-c1 joint provides most of what ROM?  how much?

flexion.  50%

2

c1-c2 joint provides most of what ROM? how much?

rotation.  50%

3

surface land marks:

C2-3

C3

C4-5

C2-3: mandible

C3: hyoid

C4-5: thyroid cartilage

4

surface landmarks:

C6

C7

T3

C6: cricoid cartilage

C7: vertebral prominens

T3: scapular spine

5

surface landmarks:

T4

T7

L4-5

T4: nipples (variable)

T7: distal tip of scapula

L4-5: iliac crest

6

what is a motion segment?  what is it also called?

smallest segment of spine that shows biomech characteristics of the entire spine

i.e. 2 adjacent vertebrae and intervening ligamentous tissues

 

AKA functional spinal unit

7

what spinal vertebrae have bifid spinous processes?

C2-6

8

at what level is the spinal cord largest in the c-spine?

c2

9

what shape is the vertebral body in the t-spine?

heart

10

L-spine vert bodies are what shape?

kidney

11

mamillary processes occur in what spinal region?

 

from what structure do they project from?

L-spine

from superior articular process

12

how many sacral foramina are there?

4 pairs dorsal and ventral

13

how many vertebrae fused embryologically to form the coccyx?

usually 4

14

most common site of disc herniation?

second most common?

L5/S1 first, L4/5 second

15

transverse ligament of the c-spine occurs where?

posterior to Dens, stabilizes a-a joint and keeps dens up against anterior arch of c1

 

16

alar ligaments joint what to what?

 

embryologically they are remnants of what?

from occiput to tip of dens

 

remnant of notochord

17

cruciform ligament of atlas is made of what?

includes the transverse ligament

plus inferior and superior longitudinal bands

18

annulus fibrosus is mostly what type of collagen?

type I

19

nucleus pulposis is mostly what collagen type?

type II

20

in the saggital and coronal planes, c-spine facet joints are oriented how?

saggital: 45 deg

coronal 0 deg

 

i.e. roof shingles angled posteriorly at 45 deg

21

T-spine facet joints are oriented how in the sagg and coronal planes?

saggital 60 deg

coronal 20 deg

 

i.e. similar to roof shingles but tilted 20 deg towards being saggital

22

L-spine facet joints are oriented how in the saggital and coronal planes?

saggital: 90 deg

coronal: 45 deg

i.e. straight up and down plane of joint, but tilted out 45 deg

23

amount of "intoeing" for pedicle screws is greatest where?  least where?

greatest at T1 and L5

least at T12

decreases from T1 and L5 towards T12

 

L1 approximately 5-10 deg

increases ~5 deg per level from L1 down to sacrum

24

T-spine pedicle screw start point

intersection of middle of TP and middle of inferior articular facet

25

lumbar pedicle screw start point?

midpoint of TP

midpoint of superior articular process

 

nb: pars lines up with medial aspect of pedicle

26

upper spine largest pedicle?

 

L-spine largest pedicle?

T1

L5

27

smallest pedicle?

 

smallest within L-spine?

T4

 

L1

28

post-halo: what nerve injuries can occur?

basically supraorbital nerve, CN 4,6,10,11,12

 

CN VI - abducens n

can hit it at petrosphenoidal junction.  get eyes that look down and in

 

Glossopharyngeal (4) + vagus (10) + hypoglossal (12)

dysphagia, loss of palatal/pharyngeal reflexes, weakness of tongue

from penetration of jugular foramen

 

CN eleven accessory n

 

supraorbital nerve - from anterior pins too medial

 

 

29

describe pin placement for halo

anterolateral pins: just below head equator, 1cm above orbit, in lateral 2/3 of orbit (avoid supraorbital nerve)

 

posterior pins - avoid temporalis muscle.  Usually place just directly above ear pinna

30

list the fixation options for c1-2 fusion

transarticular screw

wiring

lateral mass screw (c1) and pars screw (c2)

clamp