Vertebral column

Question 1

What’s within the vertebral column cavity

Answer 1

Spinal cord
Roots of spinal nerves
Meninges

Question 2

How many vertebrae are there and what are they classified into

Answer 2

33 vertebrae:
7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccygeal

Question 3

How many vertebrae are discrete and how many are fused

What structures do the fused vertebra form

Answer 3

24 discrete

9 fused - forms sacrum and coccyx

Question 4

Gross functions of vertical column

Answer 4

Project body weight to pelvis and lower limbs
Attachment for bones and muscles
Protection and passage of spinal cord
Segmental Innervation of spinal cord (spinal nerves leave/join at specific points)
Shock absorption

Question 5

How does the vertebral column project body weight to pelvis and lower limbs
What is the direction of transmission

Answer 5

Vertebral bodies increase in size inferiorly
Sacral vertebrae are fused, widened and concave anteriorly (transmits weight through pelvis)

Through line that passes centrally through curvatures of VC (centre of gravity)

Question 6

What bones attach to the VC

Answer 6

Skull
Ribs
Iliac

Question 7

What muscles attach to the VC

Answer 7

Muscles of trunk (maintain erect posture and move VC)

Muscles of pelvic and pectoral girdles

Question 8

Typical structure of vertebrae

Answer 8

Anteriorly - rounded body
Posteriorly - vertebral arch
Vertebral foramen

Question 9

Features of body of vertebrae

Answer 9

Usually largest part
Main weight bearing part
Major site of contact between adjacent vertebrae
Articular surface is covered with hyaline

Question 10

Features of vertebral arch of vertebrae

Answer 10

1 spinous process
2 transverse processes 
2 superior articular processes/facets
2 inferior articular processes/facets
Formed by lamina and pedicle

Question 11

What does the lamina connect

Answer 11

Transverse process to spinous process

Question 12

What does the pedicle connect

Answer 12

Transverse process to vertebral body

Question 13

What’s formed between articular processes of adjacent vertebrae

Answer 13

Synovial joints

Question 14

What strengthens synovial joints between adjacent vertebrae

Answer 14

Ligamentum flavum

Question 15

Where do spinal nerves emerge

Answer 15

Intervertebral foramina

Question 16

What type of joint does the articulation of superior and inferior articular processes form

Answer 16

Facet joint (synovial)

Question 17

How is anterior displacement of vertebrae prevented

Answer 17

Superior and inferior articular processes interlock

Question 18

What type of joints are intervertebral discs

Answer 18

Cartilaginous symphysis joints

Question 19

What percentage of VC length is intervertebral discs

Answer 19

25%

Question 20

How are intervertebral discs kept turgid

Answer 20

High water content

Question 21

What happens to intervertebral discs with age

Answer 21

Dehydrate and get smaller

Question 22

What feature of intervertebral discs allows for secondary curvature of spine

Answer 22

Wedge shaped

Question 23

2 regions of intervertebral discs

Answer 23

Central - nucleus pulposus

Peripheral - annulus fibrosus

Question 24

What structures does the vertebral column support

Answer 24

Skull
Pectoral girdle
Upper limbs
Thoracic cage

Question 25

How does the position and size of the nucleus pulposus change with age

Answer 25

Central in infants but more posterior in adults | Shrinks with age (and over day due to compression by gravity)

Question 26

What's the nucleus pulposus a remnant of

Answer 26

Notochord

Question 27

Features of nucleus pulposus

Answer 27

Gelatinous | High osmotic pressure

Question 28

Blood and neural supply of annulus fibrosus

Answer 28

None

Question 29

Structure of annulus fibrosus

Answer 29

Lamellae of annular bands in varying orientations that entirely surround the nucleus pulposus

Question 30

Difference between outer and inner lamellae in annulus fibrosus

Answer 30

Outer - collagenous | Inner - fibrocartilaginous

Question 31

Function of annulus fibrosus

Answer 31

``` Major shock absorber Resists compression (stronger than vertebral bodies) ```

Question 32

Stages of disc herniation

Answer 32

Disc degeneration Prolapse Extrusion Sequestration

Question 33

Where does disc herniation most commonly occur

Answer 33

L4/L5 | L5/S1

Question 34

Describe disc degeneration

Answer 34

Chemical changes associated with aging causes disc to weaken

Question 35

Describe prolapse

Answer 35

Protrusion of nucleus pulposus with slight impingement into spinal canal

Question 36

Describe extrusion

Answer 36

Nucleus pulposus breaks through annulus fibrosus but remains within disc space

Question 37

Describe sequestration

Answer 37

Nucleus pulposus breaks through annulus fibrosus and lies outside disc space in spinal canal

Question 38

What direction do discs usually herniate | What is the consequence

Answer 38

Posterolaterally | Compression of spinal nerve roots

Question 39

What happens when discs herniate posteriorly

Answer 39

May cause spinal cord compression (neurological emergency)

Question 40

Effects of disc degeneration

Answer 40

Increased stress on discs Increased stress on facet joints Decreased size of vertebral foramina

Question 41

Effect of increased stress on discs with disc degeneration

Answer 41

Spondylosis deformans (growth of osteophytes around degenerating IV discs)

Question 42

Effect of increased stress on facet joints with disc degeneration

Answer 42

Osteoarthritis | pain as facet joints are innervated by meningeal branch of spinal nerve

Question 43

Effect of decreased size of intervertebral foramina with disc degeneration

Answer 43

Compression of spinal nerves e.g cervical spondylosis

Question 44

What is cervical spondylosis

Answer 44

Degenerative osteoarthritis of intervertebral joints in cervical spine causing the cervical vertebrae to stiffen (neck pain) This puts pressure on nerve roots (radiculopathy) and spinal cord (myelopathy)

Question 45

Effect of pressure on nerve roots in cervical spondylosis

Answer 45

Paraesthesia Pain Myotomal motor weakness

Question 46

Effect of pressure on spinal cord in cervical spondylosis

Answer 46

Global weakness Gait dysfunction Loss of balance Loss of bladder and bowel control