Vasculature

Question 1

describe the arteries located throughout the vertebral column

Answer 1

posterior spinal arteries - 2 travel on posterolateral surfaces from the VA
anterior spinal artery - in anterior sulcus

Question 2

what do segmental arteries branch into

Answer 2

radicular arteries

Question 3

what does radicular arteries supply

Answer 3

spinal arteries, dura and nerve roots

Question 4

describe the VA segments

Answer 4

V1 - SCA - C6
V2- C6-C2
V3 - C2-dura
V4 - dura to pontomedullary junction

Question 5

describe the deep and ascending cervical arteries

Answer 5

deep artery more medial
both from thyrocervical trunk
deep branches to C5-T1 and posterior radicular branch
ascending branches to C3-5 and anterior radicular branch

Question 6

which 2 thoracic specific arteries were presented

Answer 6

posterior intercostal arteries - 11 pairs, between oesophagus and vertebrae
thoracic vertebral arteries - upports cervical VA

Question 7

describe the lumbar arteries

Answer 7

4 pairs
from lumbar aorta

Question 8

describe the sacral artery

Answer 8

median - supplies sacrum, coccyx and some rectal area
lateral - superiorly anastomoses w/ median, inferior supplies lower sacrum

Question 9

why do lumbar and cervical regions have extra supply

Answer 9

access to major arteries - VA and lumbar aorta
lots of muscles in regions

Question 10

describe how arterial supply affects DDD

Answer 10

calcification of CEP - insufficient diffusion to disc
results in compression of disc -> inflammation
neovascularisation -> fissure formation

Question 11

how does arterial supply affect Schmorl’s nodes

Answer 11

poor healing
nodes recognised as foreign body - inflammatory response
infection spread

Question 12

what artery most commonly affected in anterior spinal artery syndrome

Answer 12

artery of Adamkiewicz

Question 13

list causes of ASAS

Answer 13

direct via compression or iatrogenic
cardiac e.g atherosclerosis or cardiac emboli

Question 14

describe ASAS clinically

Answer 14

back pain, spinothalamic loss, motor and autonomic dysfunction
diagnosis from MR/CT angiography

Question 15

describe the effects of PSAS

Answer 15

ipsilateral vibration and proprioception loss
sensory loss

Question 16

describe fibrocartilage embolism

Answer 16

rupture of IV disc leading to vessel occlusion
more common in females
irreversible damage

Question 17

describe the intrinsic venous system

Answer 17

radial and sulcal veins drain to extrinsic veins
sulcal veins drain grey commissure, white matter and anterior horn

Question 18

describe the extrinsic venous system

Answer 18

posterior and anterior spinal veins
collect from intrinsic veins and pial venous network
drained by radiculomedullary veins

Question 19

describe the internal vertebral venous plexus

Answer 19

links extrinsic system with external plexus
sits within spinal canal, outside the dura
thickening of 4 longitudinal channels

Question 20

describe the external vertebral venous plexus

Answer 20

sits on lamina and outer vertebral body
receives blood from internal plexus, transfers to major veins

Question 21

describe the basivertebral vein

Answer 21

may be 3rd plexus
runs in vertebral body between plexuses

Question 22

why does disease spread through venous plexus systems

Answer 22

valveless
bidirectional flow
re-routing of blood from major veins

Question 23

describe spinal lymphatic drainage

Answer 23

spinal lymphatic vessels drain epidural space and dura matter
dorsally and ventrally
connect to cervical, mediastinal and renal nodes

Question 24

is lymphatic or haematogenous spread of mets more common

Answer 24

haematogenous