Vertebral Column, Meninges, & Spinal Cord

Question 1

What is the superficial back muscle group called?

Answer 1

Axio-Appendicular

Question 2

What is the intermediate back muscle group called?

Answer 2

Respiratory

Question 3

What is the deep back muscle group called?

Answer 3

Intrinsic Back

Question 4

What is the axial skeleton

Answer 4

bones of the cranium, vertebral column, sternum and ribs

Question 5

What is the appendicular skeleton

Answer 5

pectoral girdle, upper extremity, pelvic girdle, lower extremity

Question 6

Where does the vertebral column begin and end?

Answer 6

begins = foramen magnum
ends= tip of coccyx
75 cm in length (2x length of spinal cord)

Question 7

How many vertebrae are in each section of the vertebral column?

Answer 7

Cervical = 7
Thoracic = 12
Lumbar = 5
Sacral = 5 (fused)
Coccygeal = 3-5 fused
(32-34 total)

Question 8

What are the four curvatures of the spine?

Answer 8

Lordosis “concave” = cervical and lumbar

Kyphosis “convex” = thoracic and sacral

Question 9

What is lateral curvature of the vertebral column called?

Answer 9

scoliosis

Question 10

How does the intervertebral disc impact the intervertebral foramen in thoracic/lumbar vs cervical regions?

Answer 10

In thoracic/lumbar regions, the intervertebral disc makes up half of the intervertebral foramen (inferior portion)
In cervical vertebrae, the intervertebral disc spans the whole intervertebral foramen

Question 11

Where do spinal nerves C1-C7 exit in C1-C7 vertebrae?

Answer 11

Spinal nerves in the cervical area exit the inferior portion of the intervertebral foramen above the corresponding cervical vertebrae.

Question 12

Where does spinal nerve C8 exit the vertebral column?

Answer 12

The superior portion of the IV foramen above T1 vertebrae

Question 13

Where do spinal nerves T1- L5 exit in T1-L5 vertebrae?

Answer 13

These spinal nerves exit in the superior portion of the IV foramen below the corresponding vertebrae

Question 14

Where do spinal nerves S1-S4 pass through vertebral column?

Answer 14

They pass via the anterior/posterior sacral foramina

Question 15

Where do spinal nerves S5 and Co1 pass through?

Answer 15

They pass via the sacral hiatus

Question 16

What vertebral level does the spinal cord end?

Answer 16

L1-L2 (where it forms the conus medullaris)

Question 17

What is the cauda equina?

Answer 17

The nerve roots below L2 descend in the vertebral canal (like a horse tail) and exit at the corresponding vertebral level

Question 18

What three unique components are on the transverse processes of cervical vertebrae?

Answer 18

Posterior tubercle, Groove for spinal nerve, and Anterior tubercle

Question 19

What movements do the transverse facet joints in cervical vertebrae allow?

Answer 19

Permit flexion  and extension (some lateral flexion)
NO rotation (only C1 & C2)

Question 20

What two things are unique about C7 vertebrae

Answer 20

1) . The transverse foramen are a lot smaller because vertebral artery DOES NOT pass through, only vertebral vein
2) . Spinous process is the longest and not bifid

Question 21

What vertebra is most commonly fractured?

Answer 21

T 12

Question 22

What characteristic on C6 vertebra is so special?

Answer 22

The Carotid tubercle on the anterior surface of transverse process could compress carotid artery

Question 23

What two parts of the thoracic vertebrae do the head of the ribs connect to?

Answer 23

there are two costal facets (superior and inferior) portions of adjacent vertebrae PLUS 1 on each transverse process where rib lays

Question 24

What facet joints are the in thoracic region and what movement does it allow?

Answer 24

coronal facets

It permits rotation

Question 25

What is important about the shape of the L5 vertebra?

Answer 25

The back is switching from lordosis to kyphosis orientation so L5 is wedge-shaped to accommodate for that lumbosacral angle

Question 26

What direction are the lumbar facet joints and what movements do they allow?

Answer 26

sagittal | They allow for flexion/extension and Lateral flexion

Question 27

What parts of the pelvis does the sacrum make up?

Answer 27

The sacrum males up the roof and posterior wall of the pelvis

Question 28

What is the sacral promontory?

Answer 28

It is a landmark on the anterior side of the sacrum on the edge of the 1st sacral body that easily recognizes prominence of the roof of the pelvic cavity

Question 29

What spinal nerves pass through the sacral canal and exit the sacral foramina? Which rami exits anteriorly vs posteriorly?

Answer 29

S1-S4; The ventral rami (motor) exit the anterior foramina and the dorsal rami (sensory exit the posterior foramina

Question 30

What direction are the facet joints for cervical vertebrae?

Answer 30

Transverse

Question 31

What are three unique features of the cervical vertebrae?

Answer 31

1) . Bifid spinous processes 2) . Widest vertebral body 3) . Uncinate processes (superior side of body is concave)

Question 32

What is on C1 that holds the C2 dens in place?

Answer 32

Transverse ligament

Question 33

Where can you palpate C1?

Answer 33

Between mastoid and angle of mandible

Question 34

What are the two purposes of the dens?

Answer 34

C2 1) . axis of rotation for C1 2) . prevent displacement of C1 on C2

Question 35

What is special about C2?

Answer 35

It is the strongest cervical vertebrae

Question 36

What are two defining features of the thoracic vertebra?

Answer 36

Spinous processes are long and project downward | Costal facets

Question 37

What are two defining features of lumbar vertebrae?

Answer 37

1) . Fat/massive body that's kidney shaped | 2) . blunt/thick spinous processes

Question 38

What is the sacral canal?

Answer 38

It is the passageway for the cauda equina

Question 39

What are the five landmarks on the dorsal surface of sacrum?

Answer 39

``` Lateral crest Intermediate crest Median crest Intermediate crest Lateral crest ```

Question 40

What is the coccyx apex an attachment for?

Answer 40

the anococcygeal ligament

Question 41

How much of the vertebral column height do the IV discs make up? %

Answer 41

25%

Question 42

What portion of the intervertebral foramen does the IV disc make up?

Answer 42

The anterior, inferior portion

Question 43

Describe the anulus fibrosis

Answer 43

Concentric fibrogelantinous rings Thinner posteriorly may be incomplete in cervical

Question 44

Describe the nucleus pulposus

Answer 44

Fibrogelatinous (mostly water) avascular shock absorbing

Question 45

What are the two longitudinal ligaments?

Answer 45

Anterior and posterior

Question 46

Where does the anterior longitudinal ligament extend from and what movement does it limit?

Answer 46

It extends from sacrum to foramen magnum (covers anterior bodies and IV discs) limits extension

Question 47

Where does the posterior longitudinal ligament extend from and what movement does it limit?

Answer 47

Extends from sacrum to C2 (within vertebral canal; anterior to spinal cord) hyperflexion

Question 48

What is important about the posterior longitudinal ligament and a slipped disc?

Answer 48

It redirects posterior herniation of nucleus pulposus to spare the cauda equina (peripheral nerves get compressed though)

Question 49

What does the filium terminale do?

Answer 49

It anchors the conus medullaris and meninges to coccyx

Question 50

Name the order of three meninge layers and three spaces in order from inside to out

Answer 50

``` Pia mater Sub arachnoid space Arachnoid mater Subdural space Dura mater Epidural space ```

Question 51

What layers of the vertebral column is the lumbar cistern and what is it?

Answer 51

L2 & S2 | enlargement of subarachnoid space

Question 52

What is unique about the sub dural space?

Answer 52

It is present when observing a cadaver because they isn't CSF to compress it

Question 53

How is Arachnoid mater attached to the pia mater?

Answer 53

Arachnoid trabeculae (spider webs)

Question 54

What type of ligaments does the pia form?

Answer 54

Denticulate ligaments (20-22) to tether cord laterally to inner dural sac

Question 55

What two ways can a herniation of nucleus pulposus occur?

Answer 55

1). flexion/hyperflexion 2). degeneration of anulus fibrosis (nucleus pulposus protrudes usually posteriorly laterally through anulus fibrosis) **get referred pain in corresponding dermatome because dorsal rami are pinches

Question 56

What is steeles rule of thirds?

Answer 56

1/3 holds dens 1/3 holds spinal cord 1/3 holds empty space Important for if dens fractures then it doesn't cut off the spinal cord "silent fracture)

Question 57

Explain herniation of disc & nerve compression in cervical vs thoracic/lumbar regions

Answer 57

Cervical disc occupy whole region of intervertebral foramen; C6-C7 herniation pinches C7 nerve because nerve protrudes superior to corresponding vertebrae in inferior border Thoracic/lumbar regions- disc occupies only inferior portion; L4-L5 herniation; L4 is spared because protrudes in superior IV foramen space but L5 nerve descending down is compressed

Question 58

What is the procedure to help with herniated nucleus pulposus?

Answer 58

Laminectomy

Question 59

What space do you puncture for lumbar puncture?

Answer 59

subarachnoid space

Question 60

What space do you puncture for epidural?

Answer 60

epidural space

Question 61

What space do you puncture for spinal anesthesia

Answer 61

sub arachnoid

Question 62

What type of paraplegia at C1-C3? How about C6-C8? How about T10-L3?

Answer 62

quadriplegia, ventilator dependent paraplegia, upper limb paresis variable lower limb function

Question 63

What is spinal shock?

Answer 63

In terms of paralysis, cervical and thoracic transections might produce this which means you lose sympathetic innervation of vascular smooth muscle (cant regulate BP)