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Flashcards in Vertebral column Deck (99):
1

list of vertebrae

33 total
7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccygeal

2

lumbosacral angle

junction of lumbar region of vertebral column and sacrum

3

significant motion occurs between only

superior 25 vertebrae

4

intervertebral disks

make presacral vertebral column flexible
fibrocartilage

5

zygapophysial joints

25 cervical, thoracic, lumbar and first sacral vertebrae articulate at these synovial joints which facilitate and control flexibility

6

curvatures of vertebral columns

primary: thoracic and sacral: kyphoses
secondary: cervical and lumbar: lordoses

7

osteoporosis

net demineralization of bones and results from disruption of normal balance of calcium deposition and reorption
vertebral body osteoporosis most common in thoracic

8

excessive thoracic kyphosis

humpback
erosion of anterior part of one or more vertebrae
dowager hump: when in women

9

excessive lumbar lordosis

hollow back
anterior rotation of pelvis, increase in lumbar curvature
abnormal extension deformity
weakened trunk musculature
pregnancy

10

scoliosis

curved back
abnormal lateral curvature accompanied by rotation of vetebrae
spinous processes turn toward cavity of abnormal curvature
most common deformity of vertebral column in pubertal girls
difference in length of lower limbs, hemivertebra and myopathic scoliosis are causes

11

hemivertebra

failure of half of a vertebra to develop

12

myopathic scoliosis

asymmetric weakness of intrinsic back muscles

13

sacral curvature of females

reduced so that coccyx protrudes less into pelvic outlet

14

lumbar curvature in females

more pronounced

15

vertebral body

anterior, massive part
gives strength to column and supports body weight
superior and inferiorly covered by hyaline cartilage

16

epiphysial rim

ring of smooth bone at periphery of vertebral body

17

vertebral arch

posterior to vertebral body and formed by right and left pedicles and laminae

18

pedicles

short, stout processes that join bertebral arch to vertebral body

19

laminae

broad, flat plates of bone which unite in the midline

20

vertebral foramen

formed by vertebral body and vertebral arch

21

vertebral canal

succession of vertebral foramina in articulated column
contains spinal cord, meninges, fat, spinal nerve roots and vessels

22

vertebral notches

indentations formed by projection of body and articular processes superior and inferior to pedicles

23

IV foramina

superior and inferior vertebral notches of adjacent vertebrae combine
give passage to spinal nerve roots and accompanying vessels and contain spinal ganglia

24

spinous process

projects posteriorly and usually inferiorly from vertebral arch at junction of laminae

25

transverse processes

2 project posterolaterally from junctions of pedicles and laminae

26

articular processes

2 superior, 2 inferior, arise from junctions of pedicles and laminae, each bearing articular facet

27

cervical vertebrae body

small and wider from side to side than anteroposteriorly
superior surface is concave between uncinate (adjacent) processes. inferior surface is convex

28

cervical vertebral foramen

large and triangular

29

cervical transverse processes

foramina transversaria
small or absent in C7
vertebral arteries and accompanying venous and sympathetic plexuses pass through foramina (except C7)
anterior and posterior tubercles

30

cervical articular processes

superior facets directed superoposteriorly, inferior facets direct inferoanterioly

31

cervical spinous process

C3-C5: short and bifid
C6 is long
C7 is longer

32

C7 aka

vertebral prominence

33

C1 distinctive characteristics

atlas
ring like, somewhat kidney shaped when viewed superior or inferiorly
no spinous process or body
consists of 2 lateral masses, connected by ant and post arches
concave superior articular facets for atlantooccipital joints with occipital condyle
flat inferior facets meet with C2 vertebrae to form lateral atlantoaxial joints

34

C2 distinctive characteristics

Axis
strongest cervical vertebrae
distinguishing feature is dens, which projects superiorly from body and provides pivot
articulates anteriorly with anterior arch of atlas and posteriorly with transverse ligament of atlas

35

thoracic body

heart shaped
one or 2 bilateral costal facets for articulation with head of rib

36

thoracic vertebral foramen

circular and smaller than cervical and lumbar

37

thoracic transverse process

long and strong
extends posterolaterally
length diminshes from T1 to T12
T1-T10 have transverse costal facets for tubercle of rib

38

thoracic articular processes

superior articular facets directed posteriorly and slightly laterally
inferior articular facets directed anteriorly and slightly medially

39

thoracic spinous process

long, slopes postero inferiorly, overlapping subadjacent vertebral body

40

lumbar body

massive
kidney shaped
large and heavier

41

lumbar vertebral foramen

triangular
larger than thoracic, smaller than cervical

42

lumbar transverse process

long and slender, accessory process on posterior surface of base of each process

43

lumbar articular processes

superior articular facets directed posteromedially or medially
inferior articular facets directed anterolaterally (or laterally)
mammillary process on posterior surface of each superior articular process

44

lumbar spinous process

short and sturdy
hatchet shaped

45

base of sacrum

superior surface of S1 vrtebrae

46

sacral promontory

projecting anterior edge of body of first sacral vertebra

47

median sacral crest

fused spinous processes

48

interneduate sacral crests

fused articular processes

49

lateral sacral crests

fused tips of transverse processes

50

sacral hiatus

inverted and u shaped
results from absence of laminae and spinous processes of S4 S5
leads to sacral canal

51

sacral cornua

representing inferior articular processes of S5 project inferiorly on each side of sacral hiatus

52

laminectomy

surgical excision of one or more spinous processes and supporting laminae
provide access to vertebral canal to relieve pressure in spinal cord or nerve roots

53

fractures of vertebrae

usually from sudden flezxion
compression fracture usually of body
also dislocation and fracture of articulating facets

54

spina bifida occulata

most common congenital anomaly of vertebral column
laminae of L5 and or S1 fail to develop normally and fuse
24% of people
no back problems
tuft of hair

55

spina bifida cystica

one or more vertebral arches may almost completely fail to devekio
herniation of meinges and or spinal cord

56

meningocele

herniation of meninges

57

meningomyelocele

herniation of spinal cord

58

whiplash

severe hyperextension of neck
anterior longitudinal ligament severely stretched and may be torn

59

spondylolysis

fractures of interartucular parts of vertebral laminae (L5)

60

spondylolisthesis

forward displacement of L5 vertebral body relative to sacrum
may result in pressure on spinal nerves of causa equina causing back and lower limb pain

61

lumbar spinal stenosis

narrow vertebral formane in one or more lumbar vertebrae
treatment of decompressive laminectomy

62

foramina transversaria of cervical vertebrae

vertebral arteries

63

posterior median furrow

horizontal line joining highest points of iliac crests passes through tip of L4 spinous process and L4-L5 spinous disk

64

S2 spinous process

middle of line drawn between posterior superior iliac spines, indicated by skin dimples

65

sacral triangle

lines joining posterior superior iliac spines and superior part of intergluteal cleft
common area of pain

66

joints of vertebral bodies

symphyses (secondary cartilaginous joints)

67

IV discs

articulating surfaces of adjacent vertebrae connected.
provide strong attachments between the vertebral bodies
shock absorbers
permit movement between adjacent vertebrae

68

IV discs consist of

anulus fibrosus
nucleus pulposus

69

anulus fibrosus

outer fibrous part
ring consisting of concentric lamellae of fibrocartilage forming the circumference of the IV disc
anuli insert into the smooth, rounded epiphysial rims on articular surfaces of vertebral bodies
fibers forming each lamella run obliquely from one vertebra to another

70

nucleus pulposus

central core of IV disc
at birth, 85% water
pulpy nuclei become broader when compressed thinner when tensed or stresed.
dehydrate with age and lose elastin and proteoglycans while gaining collagen
thinner and stiffer
not centered in the disc but more posteriorly placed
avascular

71

most inferior functional IV disc

between L5 and S1

72

thickness of IV discs

thicker in cervical and lumbar regions
thinnest in superior thoracic region
thickness most uniform in thoracic region

73

Uncovertebral "joints" of Luschka

between uncus of the bodies of C3-C6 and the beveled inferolateral surfaces of vertebral bodies superior to them
lateral and posterolateral margins of IV discs
articulating surfaces covered with cartilage and contain a capsule filled with fluid
frequent sites of spur formation

74

anterior longitudinal ligament

strong fibrous band that covers and connects the anterolateral aspects of vertebral bodies and IV discs
extends from pelvic surface of sacrum to anterior tubercle of C1 vertebra and the occipital bone anterior to the foramen magnum
maintains stability of the IV joints and limits extension of the vertebral column

75

posterior longitudinal ligament

weaker band compared to anterior longitudinal ligament
runs within vertebral canal along posterior aspect of vertebral bodies
attached mainly to the IV discs and less so to the posterior edges of the vertebral bodies from C2 to the sacrum
helps prevent hyperflexion of the vertebral column and posterior herniation of the IV discs
well innervated with pain nerve endings

76

zygapophysial joints

facet joints
synovial plane joints between the superior and inferior articular processes of adjacent vertebra
surrounded by thin, loose, articular capsule, attached to margins of articular surfaces of articular processes of adjacent vertebrae.
accessory ligaments unite transverse and spinous processes and help stabilize the joints
permit gliding movements between articular processes
innervated y articular branches that arise from medial branches of posterior rami ofspinal nerves. each joint supplied by 2 adjacent spinal nerves

77

ligamenta flava

laminae of adjacent vertebral arches are joined by broad, pale, yellow elastic fibrous tissue which extend almost vertically from the lamina above to the lamina below
bind the laminae of adjoining vertebrae together
resist separation of the vertebral laminae by arresting abrupt flexion of the vertebral column and thereby preventing injury to the IV discs
help preserve posture and assist with straightening the column after flexing

78

interspinous ligaments

weak, almost membranous ligaments that unite adjacent spinous processes

79

suprspinous ligaments

strong fibrous ligaments that attach adjacent spinous processes

80

nuchal ligament

strong median ligament of the neck
composed of thickened fibroelastic tissue extending from EOP and posterior border of foramen magnum to spinous processes of cervical vertebrae

81

craniovertebral joints

atlanto-occipital
atlanto-axial
synovial joints with no IV discs

82

atlanto occipital joints

between C1 and occipital condyles
permit nodding of head
mainly flexion, little lateral flexion, some rotation, permit sideways tilting og head
condyloid, synovial joints

83

anterior and posterior atlanto occipital membranes

extend from anterior and posterior arches of C1 to the anterior and posterior margins of the foramen magnum
help prevent excessive movement of joint

84

Atlanto Axial joint types

Two lateral atlanto-axial joints (right and left) between the lateral masses of C1 and superior facets of C2, plane type synovial joint
and one median atlanto axial joint between the dens of C2 and the anterior arch and transverse ligament of the atlas. pivot joint

85

movement of atlanto axial joint

no movement
cranium and c1 vertebra rotate on C2 vertebra as a unit. dens of C2 is the pivot

86

transverse ligament of atlas

strong band extending between tubercles on medial aspects of the lateral masses of C1 vertebrae

87

longitudinal bands

vertically oriented but much weaker superior and inferior. pass from transverse ligament to occipital bone superiorly and to the body of C2 inferiorly

88

Cruciate ligament

transverse ligament and longitudinal bands form it

89

alar ligaments

stout, extend from sides of dens to lateral margins of foramen magnum
attach cranium toC2 vertebra and serve as check ligaments, preventing excessive rotation

90

tectorial membrane

strong superior continuation of posterior longitudinal ligament across median atlanto-axial joint through foramen magnum to central floor of cranial cavity
body of C2 to the internal surface of occipital bone and covers the alar ligaments and transverse ligaments of atlas

91

blood supply of vertebrae

periosteal and equatorial branches of major cervical and segmental arteries
spinal branches of vertebral and ascending cervical arteries in neck, posterior intercostal arteries in thoracic, subcostal and lumbar arteries in abdomen, iliolumbar and lateral and medial sacral arteries in pelvis

periosteal and equatorial branches arise from above arteries as they cross external surfaces of vertebrae
spinal branches enter IV foramina and divide into anterior and posterior vertebral canal branches that pass to vertebral body and vertebral arch respectively
give rise to ascending and descending branches that anastamose with spinal canal branches of adjacent levels. spinal branches continue as terminal radicular arteries distributed to posterior and anterior roots of spinal nerves and coverings or as segmental medullary arteries that continue to spinal cord

92

venous supply

spinal veins form venous plexuses inside (internal vertebral epidural venous plexus) and outside (externnal vertebral venous plexus) the vertebral canal. basivertebral veins form within vertebral bodies and emerge from foramina on surfaces of vertebral bodies and drain into internal and external vertebral venous plexuses. intervertebral veins receive veins from spinal cord and vertebral venous plexuses as they accompany spinal nerves through IV foramina to drain into vertebral veins of neck and segmental veins of trunk

93

other than zygapophysial joints, vertebral column innervation

meningeal branches of spinal nerves
some branches remain outside canal: branches ouside supply anuli fibrosi and anterior longitudinal ligament
recurrent branches supply periosteum, ligamenta flava, anuli fibrosi posteriorly, posterior longitudinal ligament, spinal dura mater, and blood vessels within the vertebral canal

94

herniation of nucleus pulposus

herniation into or through anulus fibrosus: causes lower back and limb pain
degeneration of posterior longitudinal ligament and wearing of analus fibrosus allows herniation which compresses spinal cord or nerve roots of spinal nerves in cauda equina
usually posterolaterally
herniation most common in lumbar region\
sciatica

95

rupture of transverse ligament of atlas

dens is set free, resulting in atlanto-axial subluxation or incomplete dislocation of median atlanto axial joint. with complete dislocation, dens may be driven into upper cervical region of spinal cord: quadriplegia or the medulla: death

96

rupture of alar ligaments

combined flexion and rotation of the head
results in an increas of approx 30% in range of moement to opposite side

97

aging of vertebrae and intervertebral discs

overall decrease in bone density and strength
nuclei pulposi become stiffer
lamellae of anulus thicken and develop fissures and cavities
IV discs increase in diameter and covexity
increase in compressive forces at periphery of vertebral bodies

98

injury and disease of zygapophysial joints

related spinal nerves are affected
causes pain along dermatomes and spasm in the muscles derived from associated myotomes
denervation of lumbar zygapophysial joints is procedure for treatment

99

types of back pain causes

1. fibroskeletal structures: periosteum, ligaments and anulu fibrosi of IV discs
2. meninges: coverings of spinal cord
3. synovial joints: capsules of zygapophysial joints
4. muscles: intrinsic muscles of back
5. Nervous tissue: spinal nerves or nerve roots exiting IV foramina