Spine workshop

Question 1

What are 3 sections spine is composed of?

Answer 1

1. Cervical
2. Thoracic
3. Lumbar

Question 2

How many cervical vertebrae are there?

Answer 2

7

C1 + C2 are specialised in modified vertebrae to allow for rotation of the head

Question 3

How many Thoracic vertebrae are there?

Answer 3

12 and 12 ribs

Question 4

How many lumbar vertebrae are there?

Answer 4

5

Question 5

In cervical level, the spine arches slightly inward the jaw, what is the curvature called?

Answer 5

Lordosis

Question 6

What is the curvature called where the spine arches out slightly at chest level

Answer 6

Kyphosis

Question 7

What does lumbar vertebrae have a role in?

Answer 7

Axial loading

Question 8

What is found right at the bottom of spine below lumbar?

Answer 8

Sacrum [which is a fused spine]

Question 9

What does sacral spine consist of?

Answer 9

5 segments - S1-S5 that together affect nerve communication to the lower portion of body

Question 10

What is L2?

Answer 10

Lowest vertebral segment that contains spinal cord

Question 11

What is coccyx?

Answer 11

Known as tail bone

Small, triangular bone

Question 12

How is lumbar vertebrae located?

Answer 12

Longer and more posterior located

Question 13

How is cervical vertebrae located?

Answer 13

Shorter and anterior located

Question 14

Why is there a hole in the cervical spine?

Answer 14

Allow for the passage of vertebral arteries

Question 15

What is vertebrae divided into?

Answer 15

Anterior and posterior portion

Question 16

Anterior portion of vertebrae

Answer 16

Vertebral body +/- transverse process

Question 17

Posterior portion of vertebrae

Answer 17

Linked by the pedicle

Question 18

What is the pedicle?

Answer 18

Stub of bone that connects lamina to vertebral body to form the vertebral arch

Question 19

What does pedicle form?

Answer 19

2 obliquely orientated bits of bone, the lamina

Question 20

What makes up posterior wall of bony spinal canal?

Answer 20

Pair of laminae along with spinous process

Question 21

What are bones attached together by?

Answer 21

Discs between bony elements anteriorly between vertebral body

Question 22

What are posterior element linked by?

Answer 22

Facet joints

Question 23

What does lamina link to?

Answer 23

Superior articulate facet and inferior articulate facet

Question 24

Where is lamina difficult to see?

Answer 24

coronal and AP view

Question 25

Lamina goes from pedicle and joins to form what?

Answer 25

Spinous process

Question 26

T2 weighted sequence

Answer 26

Fluid is bright Fat is bright Tissues are in varying shades of grey

Question 27

What is spinal befida?

Answer 27

A fault in the development of spinal cord and surrounding bones

Question 28

What is pars interarticularis?

Answer 28

Small segments of bone that joins the facet joints in the back of spine Defect = spondylolysis

Question 29

Why does facet joints slide on each other?

Answer 29

To allow us to bend and flex

Question 30

T1 weighted sequence (sagittal)

Answer 30

Fluid is dark Fat is bright Bone is a bit brighter than fluid A bit of fat in the bone marrow

Question 31

STIR = Inversion recovery pulse sequence

Answer 31

suppress various tissue signal | suppress fat therefore dark

Question 32

When is STIR useful

Answer 32

Patients where there is a suspicion of fracture/trauma patients pick up subtle fractures

Question 33

What is found in between vertebral bodies?

Answer 33

Intervertebral discs

Question 34

What does each intervertebral disc form?

Answer 34

Fibrocartilaginous joint - allow slight movement of vertebrae Act as giant cushions Gel-like substance in it Seen on T2 weighted sequence

Question 35

What is Annulus fibrosis?

Answer 35

Sturdy-like structure that encases a gel-like centre, nucleus pulposus Enhances the spine's rotational stability and helps to resist compressive stress Layered structure consisting of water and sturdy elastic collagen fibres

Question 36

What is nucleus pulposus?

Answer 36

Filled with gel-like elastic substance Transmits stress and weight from vertebrae to vertebrae

Question 37

What is coated on top and bottom of each vertebral body?

Answer 37

End-plate

Question 38

What are endplates?

Answer 38

Complex structures that blend into intervertebral disc and help hold disc in place

Question 39

What are the important spaces?

Answer 39

1. Extra-dural space 2. Sub-dural space 3. Sub-arachnoid space

Question 40

What is found in the intramedullary?

Answer 40

1. Pial 2. Subpial 3. Grey matter

Question 41

How do you characterise lesions in the spinal cord?

Answer 41

Whether they are intramedullary or extamedullary

Question 42

What do peripheral lesion involve?

Answer 42

White matter

Question 43

Where is compression and infarction observed in?

Answer 43

Anterior horn of grey matter

Question 44

What are examples of inflammatory disease that affects both grey matter and white matter?

Answer 44

1. Transverse myelitis 2. Neuromyeliths optica 3. Multiple sclerosis 4. Cross sectional ischemia

Question 45

what help differentiate what lesion it is ?

Answer 45

Grey matter | White matter

Question 46

What gets supressed in the STIR?

Answer 46

Fat

Question 47

Where does C8 leave spinal cord?

Answer 47

Below C7 vertebrae

Question 48

What is ossification?

Answer 48

Bone overgrowth

Question 49

When does the disc bulge?

Answer 49

more than 25% of disc circumference

Question 50

<25%

Answer 50

Protrusion | Base is wider than apex

Question 51

<25%

Answer 51

Extrusion | Apex is bigger than base

Question 52

What are the classification of spinal lesion?

Answer 52

1. Extra-dural: outside thecal sac (including bone lesion) 2. Intradural extramedullary = within thecaql sac but outside cord 3. Intramedullary = within spinal cord

Question 53

What is Intramedullary?

Answer 53

When spinal cord is expanded