Vertebrae and Spinal Cord Flashcards Preview

MSK Week 1 > Vertebrae and Spinal Cord > Flashcards

Flashcards in Vertebrae and Spinal Cord Deck (100):
1

How many bones in the vertebral column?

33 Bones in the vertebral column

2

How many bones in the Cervical spine?

7

3

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

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

4

Structure of C1

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

5

Dens of C2

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

6

Joint between C1 and C2

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.

7

Transverse foramen of C1-C6 important for what

vertebral artery

8

Foramen of C7?

C7 only has tiny foramina for tiny veins

9

Joint of luschka?

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

10

How many thoracic vertebrae?

12

11

Articular processes for cervical vertebrae?

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

12

Articular processes for thoracic vertebrae?

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

13

Most injured vertebrae?

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

14

How many lumbar vertebrae?

5

15

Shape of lumbar vertebrae?

Kidney shaped

16

Why do lumbar vertebrae have suck thick bodies?

Bear weight

17

Order of largest foramen

Cervical Lumbar Thoracic

18

How many vertebrae in sacrum

5 fused

19

Purpose of Sacrum?

Transmits weight of body to pelvic girdle, wider in females

20

Sacral canal

Houses terminal roots of the cauda equina

21

Sacral foramina

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

22

filum terminale

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

23

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

Pia mater

24

How many vertebrae in the coccyx

4 fused vertebrae

25

Primary curve?

Kyphosis - Our first spinal curve

26

Secondary curve?

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

27

Lumbar lordotic curve develops when?

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

28

Symphyseal joints?

The intervertebral discs between the vertebral bodies

29

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

20-25%

30

Nucleus pulposus

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

31

Annulus fibrosis

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

32

Zygopophyseal joints

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

33

Zygopophyseal joints movements

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

34

Ligaments of the spine

ALL PLL Flavum Supraspinous Interspinous Nuchal

35

ALL

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

36

PLL

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

37

Ligamentum Flavum

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

38

Supraspinous ligament

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

39

Interspinous ligaments

Run between the spinous processes of adjacent vertebrae

40

Nuchal ligament

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

41

Extrinsic muscles of the back

Trapezius Latissimus Dorsi Levator Scapulae Rhomboids

42

Intrinsic muscles of the back. Superficial

Splenius

43

Nerve supply of splenius

Posterior Rami of C3 and C4

44

Action of splenius

Lateral bending and extension of the head and neck

45

Intermediate intrinsic muscles of the back

Iliocostalis Longissimus Spinalis

46

Action of the intermediate intrinsic muscles of the back

Extend and laterally bend the spine at their respective levels

47

Spinal cord and contents

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

Where does the spinal cord begin?

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

49

Termination of the spinal cord?

Termination taper is called the conus medullaris

50

What vertebra does the cord end typically?

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

Cauda Equina

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

Enlargements of the spinal cord?

Cervical Lumbosacral

53

Cervical Enlargement

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

54

Lumbosacral enlargement

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

55

C3 nerve

Diaphragm for breathing

56

C4 nerve

Diaphragm for breathing and shoulder shrug

57

C5 nerve

Deltoid, biceps

58

C6 nerve

Wrist extension

59

C7 nerve

Triceps

60

C8 nerve

Hands and fingers

61

T1

Hands and fingers

62

Chest muscles innervated by what?

T2 - T5 exclusively Also T6-T8

63

Abdominal muscles innervated by what

T9 - T12 exclusively Also T6 - T8

64

Hip muscles

L1 - L2

65

L3

Knee straighten

66

L4

Knee and ankle muscles

67

L5

Ankle and toe muscles

68

Anal and bladder sphincters innervated by what?

S2 - S5

69

Points the foot

S1

70

What are meninges?

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

71

Dura mater

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

Dural sac?

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

Epidural space

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

Subdural space

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

75

Arachnoid mater

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

Arachnoid mater on a cadaver looks like what?

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

77

Subarachnoid space

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

What are you hitting with a lumbar puncture?

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

79

Pia mater

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

Denticulate ligament

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

Anterior spinal arteries

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

Posterior spinal arteries

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

Radicular arteries

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

84

Anterior and posterior segmental medullary arteries

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

85

The Great Anterior Segmental Medullary Artery

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

Paraplegia

paralysis from the waist down

87

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

Blockage of blood flow through the Great Anterior Segmental Medullary Artery

88

Where do the anterior and posterior spinal veins drain to?

the internal vertebral venous plexus which lies within the epidural space

89

Epidural anesthesia/injections

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

90

Spinal stenosis

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

91

Effect of spinal stenosis?

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

92

Treatment for spinal stenosis

Surgical decompression

93

Herniated disc

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

94

95

1. Conus medullaris

2. Filum Terminale

3. Cauda Equina

96

97

Nerve plexus

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

98

Dermatome

99

Myotome

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

100

Q image thumb

A image thumb