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MSK Week 1 > Vertebrae and Spinal Cord > Flashcards

Vertebrae and Spinal Cord Flashcards

1
Q

How many bones in the vertebral column?

A

33 Bones in the vertebral column

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2
Q

How many bones in the Cervical spine?

A

7

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3
Q

How are C1 and C2 so unique structurally when compared to other vertebrae?

A

No disc between them and no real vertebral body, they are very thin

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4
Q

Structure of C1

A

“atlas” is ringed shape and has two lateral masses that articulate with the occipital condyles of the skull base, thereby supporting the head

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5
Q

Dens of C2

A

C2 dens is held in place by the transverse ligament of C2, the axis, and allows rotation of the head around the dens.

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6
Q

Joint between C1 and C2

A

Between the C1 and C2 is the atlanto-axial joint, which allows flexion and extension and lateral tilting of the head. It has two facet joints and a “dens” (odontoid process). 50% of all neck motion occurs here.

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7
Q

Transverse foramen of C1-C6 important for what

A

vertebral artery

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8
Q

Foramen of C7?

A

C7 only has tiny foramina for tiny veins

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9
Q

Joint of luschka?

A

C3 - C6 are called uncovertebral joints or “joints of Luschka” that are beveled edges at the lateral edges of the disc joints

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10
Q

How many thoracic vertebrae?

A

12

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11
Q

Articular processes for cervical vertebrae?

A

Articular processes are just about horizontal to allow for flexion, extension, and some lateral flexion. Rotation is restricted

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12
Q

Articular processes for thoracic vertebrae?

A

T1 - T10 have coronally oriented articular processes that allow rotation and some lateral flexion

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13
Q

Most injured vertebrae?

A

T12 is the transitional vertebra between the stiff thoracic and mobile lumbar. Most frequently fractured vertebra

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14
Q

How many lumbar vertebrae?

A

5

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15
Q

Shape of lumbar vertebrae?

A

Kidney shaped

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16
Q

Why do lumbar vertebrae have suck thick bodies?

A

Bear weight

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17
Q

Order of largest foramen

A

Cervical Lumbar Thoracic

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18
Q

How many vertebrae in sacrum

A

5 fused

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19
Q

Purpose of Sacrum?

A

Transmits weight of body to pelvic girdle, wider in females

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20
Q

Sacral canal

A

Houses terminal roots of the cauda equina

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21
Q

Sacral foramina

A

Four paired openings on the dorsal and ventral surfaces with the filum terminale running through

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22
Q

filum terminale

A

a tender flexible strand that attaches the bottom of the spinal cord to the coccyx at the lower end of the vertebral column.

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23
Q

Filum terminale is an extension of what layer of the spinal cord?

A

Pia mater

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24
Q

How many vertebrae in the coccyx

A

4 fused vertebrae

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25
Q

Primary curve?

A

Kyphosis - Our first spinal curve

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26
Q

Secondary curve?

A

As infants begin to raise their heads, the cervical lordosis appears

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27
Q

Lumbar lordotic curve develops when?

A

With upright posture as a child, the lumbar lordotic curve develops

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28
Q

Symphyseal joints?

A

The intervertebral discs between the vertebral bodies

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29
Q

How much of the height of the spinal cord is discs?

A

20-25%

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30
Q

Nucleus pulposus

A

Gelatinous central mass of the disc. Highly elastic - located posteriorly with the annulus fibrosis

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31
Q

Annulus fibrosis

A

Outer portion of the disc - Made of fibrocartilage and is avascular

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32
Q

Zygopophyseal joints

A

facet joints. Synovial joints between the articulating processes of adjacent vertebrae.

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33
Q

Zygopophyseal joints movements

A

They permit the gliding movements between the articulating processes of adjacent vertebrae. They permit gliding movements between vertebrae during lateral flexion and extension and iwth twisting movements

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34
Q

Ligaments of the spine

A

ALL PLL Flavum Supraspinous Interspinous Nuchal

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35
Q

ALL

A

Anterior longitudinal ligament - Strong band covering the anterolateral aspects of vertebral bodies and discs. Prevents hyperextension

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36
Q

PLL

A

Posterior longitudinal ligament - Narrower and weaker, runs within the vertebral canal along the posterior surface of vertebral bodies and discs. This prevents hyperflexion

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37
Q

Ligamentum Flavum

A

Also called the yellow ligament. Part of the posterior wall of the vertebral canal

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38
Q

Supraspinous ligament

A

Cord-like, connects the spinous processes of C7 to sacrum

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39
Q

Interspinous ligaments

A

Run between the spinous processes of adjacent vertebrae

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40
Q

Nuchal ligament

A

Continuation of the supraspinous ligament, runs from C7 to the external occipital protuberence

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41
Q

Extrinsic muscles of the back

A

Trapezius Latissimus Dorsi Levator Scapulae Rhomboids

42
Q

Intrinsic muscles of the back. Superficial

A

Splenius

43
Q

Nerve supply of splenius

A

Posterior Rami of C3 and C4

44
Q

Action of splenius

A

Lateral bending and extension of the head and neck

45
Q

Intermediate intrinsic muscles of the back

A

Iliocostalis Longissimus Spinalis

46
Q

Action of the intermediate intrinsic muscles of the back

A

Extend and laterally bend the spine at their respective levels

47
Q

Spinal cord and contents

A

The part of the CNS housed in the vertebral canal, which also contains meninges which are protective coverings, and connective tissue, fat, and blood vessels

48
Q

Where does the spinal cord begin?

A

Begins at the medulla oblongata and passes downward through the foramen magnum of the occipital bone of the skull

49
Q

Termination of the spinal cord?

A

Termination taper is called the conus medullaris

50
Q

What vertebra does the cord end typically?

A

In embryos, the spinal cord runs the length of the vertebral canal, but the spine grows faster than the cord. At birth the cord ends at L4-5 region. In adults it ends at the L1-L2 vertebral disc

51
Q

Cauda Equina

A

At the terminus of the spinal cord, lumbar and sacral spinal nerve roots are the longest. Roots descend inferiorly to corresponding intervertebral foramina. This collection of roots forms the cauda equina, and it lies distal to the L2 vertebra in the adult

52
Q

Enlargements of the spinal cord?

A

Cervical Lumbosacral

53
Q

Cervical Enlargement

A

Extends from C4 - T1 segments of the spinal cord. Ventral rami from these levels form the brachial plexus which innervates the upper limbs

54
Q

Lumbosacral enlargement

A

Extends from T11 - S1 segments of the spinal cord; corresponding nerves innervate the lower limbs and form the lumbar and sacral plexuses

55
Q

C3 nerve

A

Diaphragm for breathing

56
Q

C4 nerve

A

Diaphragm for breathing and shoulder shrug

57
Q

C5 nerve

A

Deltoid, biceps

58
Q

C6 nerve

A

Wrist extension

59
Q

C7 nerve

A

Triceps

60
Q

C8 nerve

A

Hands and fingers

61
Q

T1

A

Hands and fingers

62
Q

Chest muscles innervated by what?

A

T2 - T5 exclusively Also T6-T8

63
Q

Abdominal muscles innervated by what

A

T9 - T12 exclusively Also T6 - T8

64
Q

Hip muscles

A

L1 - L2

65
Q

L3

A

Knee straighten

66
Q

L4

A

Knee and ankle muscles

67
Q

L5

A

Ankle and toe muscles

68
Q

Anal and bladder sphincters innervated by what?

A

S2 - S5

69
Q

Points the foot

A

S1

70
Q

What are meninges?

A

Associated spaces. They include dura mater, arachnoid mater, and pia mater. They sheath and support the spinal cord

71
Q

Dura mater

A

Tough, durable, outermost covering (membrane) of the spinal cord. It forms a long tube called the dural sac and extends a short distance into the intervertebral foramen with the dorsal and ventral nerve roots as the dural root sleeves, then blends with the epineurium (outermost coating) of the nerve

72
Q

Dural sac?

A

extends from the foramen magnum to the level of the 2nd sacral vertebrae, encasing the spinal cord and cauda equina and anchored by the filum terminale.

73
Q

Epidural space

A

lies between the bony wall of the vertebral canal and dura mater. It contains the internal vertebral plexus of veins, fat, and the loose connective tissue that supports them

74
Q

Subdural space

A

This is a potential space between the dura mater and the arachnoid mater. Not usually occupied by anything

75
Q

Arachnoid mater

A

Delicate, filamentous, avascular middle layer (covering) of the spinal cord that is connected to the pia mater by delicate strands of connective tissue called arachnoid trabeculae. It ensheaths the cauda equina and lines dural sac and dural sheaths.

76
Q

Arachnoid mater on a cadaver looks like what?

A

These are spiderweb-like and can be seen in a cadaver

77
Q

Subarachnoid space

A

Between arachnoid mater and the pia mater. Filled with CSF when you are alive that puts pressure on the arachnoid mater which then rests against the duramater.

78
Q

What are you hitting with a lumbar puncture?

A

you are tapping a space called the lumbar cistern, which is an enlargement of the subarachnoid space distal to the conus medullaris

79
Q

Pia mater

A

Innermost, transparent layer made up of connective tissue. It encloses a network of blood vessels and covers the spinal roots and blood vessels. Cannot be detached from the spinal cord.

80
Q

Denticulate ligament

A

20-22 saw-like ligaments that extend between the pia mater and the inner surface of the dura mater along each lateral “seam” of the cord. They seaparate the ventral from the dorsal roots and extend from the foramen magnum to the T12-L1 vertebrae

81
Q

Anterior spinal arteries

A

Formed by segmental branches from the aorta that run the length of the spinal cord in the anterior mdeian fissure. They supply the anterior ⅔ of the spinal cord

82
Q

Posterior spinal arteries

A

Small branches of vertebral arteries. They run the length of the spinal cord on either/both sides of the dorsal medican sulcus and anastamose with the anterior spinal arteries, supplying the posterior ⅓ of the spinal cord

83
Q

Radicular arteries

A

Small arteries that supply the nerve roots, some reaching through the intervertebral foramina to reach the spinal cord

84
Q

Anterior and posterior segmental medullary arteries

A

Provide segmental blood supply to the spinal cord from branches of the aorta

85
Q

The Great Anterior Segmental Medullary Artery

A

Largest of the segmental vessels. Arises from the left interior intercostals or superior lumbar artery. This provides the main blood supply to the anterior ⅔ of the caudal spinal cord

86
Q

Paraplegia

A

paralysis from the waist down

87
Q

What is a common cause of paraplegis as related to blood flow?

A

Blockage of blood flow through the Great Anterior Segmental Medullary Artery

88
Q

Where do the anterior and posterior spinal veins drain to?

A

the internal vertebral venous plexus which lies within the epidural space

89
Q

Epidural anesthesia/injections

A

Insert anesthetics into the epidural space usually at L4/5 via the caudal canal (sacral hiatus)

90
Q

Spinal stenosis

A

Narrowing of the spinal canal and/or intervertebral foramen - Combination of DDD (Degenerative Disc Disease), osteoarthritis and/or hypertrophy of spinal ligaments

91
Q

Effect of spinal stenosis?

A

Leads to pain, radiculopathy and limping. Pain worse with standing, better with sitting

92
Q

Treatment for spinal stenosis

A

Surgical decompression

93
Q

Herniated disc

A

Tearing of the disc anulus with nucleosus pulposus material filling the void in the posterior lateral direction.

94
Q
A
95
Q
A
  1. Conus medullaris
  2. Filum Terminale
  3. Cauda Equina
96
Q
A
97
Q

Nerve plexus

A

Formed by the interlacing of nerves or nerve fibers by means of numerous communicating branches or fibers

98
Q

Dermatome

A
99
Q

Myotome

A

All muscles derived from one somite and innervated by one segmental spinal nerve

100
Q
A

MSK Week 1 (14 decks)

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