51 terms

GA 2 - Vertebral Column & Spinal Cord

Skipped the basics / stuff we should know from OMM unless it was starred in the lecture slides
STUDY
PLAY

Terms in this set (...)

*The intervertebral foramen is important because it
is where the spinal nerve exits the vertebral canal
Typical cervical vertebra characteristics
Transverse processes have transverse foramina

Short, often bifid spinous process

*Prominent uncinate process, uncovertebral joints - frequent site of bone spur (osteophyte) formation
C1 vertebra, aka
Atlas
C2 vertebra, aka
Axis
C7 vertebra, aka
Vertebra prominens
Atlas characteristics
Anterior arch & tubercle

Posterior arch & tubercle, groove for vertebral artery

Lateral mass with transverse processes

Articulates with skull (atalanto-occipital joint)
and axis (median and lateral atlantoaxial joints)
Axis characteristics
Dens (odontoid process), incorporated body of atlas

Otherwise similar to typical cervical vertebrae
Dens articulates with
Transverse ligament of atlas (median atlantoaxial joint)
Median atlantoaxial joint is important in
Down's syndrome, could rupture due to rheumatoid arthritis

May lead to fatal spinal cord injury
Vertebra prominens characteristics
Small or absent transverse foramina
Long spinous process

Enlarged costal process (cervical rib) may compress/stretch subclavian artery or brachial plexus
Thoracic outlet syndrome
Compression or stretching of brachial plexus by enlarged costal process of C7
*Sacral hiatus location and importance
Dorsal surface of sacrum, palpated by sacral cornua on either side

Used in caudal epidural anesthesia during childbirth, surgery, etc.
*Primary curvatures of the spine
Concave anteriorly in thoracic & sacral regions

Same direction as original fetal curvature
*Secondary curvatures of the spine
Convex anteriorly in cervical & lumbar regions
*Vertical line of gravity due to secondary curvature
Through dens of axis

In front of sacral promontory

Posterior to centers of hip joints

Anterior to knee joints

Anterior to ankle joints
*Kyphosis
Increase in abnormal increase in thoracic curvature

Common in postmenopausal women with osteoporosis
*Lordosis
Increase in lumbar curvature

Late in pregnancy or obese individuals
Types of scoliosis
Nonstructural, reversible (from poor posture)

Structural, irreversible (from hemivertebra or other idiopathic etiology)
Spondylolisthesis
Partial forward dislocation of vertebra over one below it

Most commonly between L5 / Sv1 due to bilateral fractures of pars interarticularis

Collar on scottie dog
Variations in number of vertebrae
Sacralization of L5

Lumbarization of S1
Anterior longitudinal ligament
Only ligament that helps to limit extension of vertebral column
Posterior longitudinal limit is found
along posterior aspect of bodies and intervertebral discs

helps limit flexion
Ligamenta flava join what parts of adjacent vertebrae? Function?
Laminae

Limit flexion and assist extension of flexed column
Interspinous ligaments are found between
adjacent spinous processes
Supraspinous ligaments connect
tips of spinous processes C7 to sacrum
Nuchal ligament function
expanded supraspinous ligament

Site of attachment in place of longer spinous processes
Intervertebral disc consists of
central gelatinous nucleus pulposus

outer fibrocartilaginous anulus fibrosus
Protrusion or herniation of intervertebral disc is usually in what direction? Usually at what level?
Posterolateral

L4/L5 or L5/S1

Usually spares spinal nerve exiting at that level (exiting root), but compresses the nerve root traversing to exit at the intervertebral foramen below (traversing root)
Most common cervical herniated disc is between
C5/C6 or C6/C7

Compresses the nerve root exiting at that level (exiting root) - b/c these nerve roots do not descend to exit at an intervertebral foramen
Rare posterior herniation of intervertebral disc may
push into spinal cord or cauda equina, resulting in paraplegia or quadriplegia
Fractured vertebral column and/or dislocation usually results from
flexion of neck followed by axial loading.

May also result from forced hyperflexion or hyperextension of neck
Vertebral canal contains
Meninges
CSF
Spinal cord & nerve roots
Internal vertebral venous plexus
Epidural fat
*Dura mater anchored by
filum terminale externum
*Arachnoid matter held against dura by
weak layer of cells and CSF pressure
*Pia mater has specialized projections, the
filum terminale internum

denticulate ligaments - attach to the dura mater
Subarachnoid space is found between
arachnoid and pia mater - connected by arachnoid trabeculae

contains CSF
Subarachnoid space is enlarged at the end of the spinal cord as the __, which contains
Lumbar cistern

Cauda equina & filum terminale
Lumbar cistern important for
lumbar spinal puncture

anesthetic for spinal block
Spinal cord stuff from neuro
Cervical & lumbosacral enlargements
31 pairs of spinal nerves
Usually ends at L1/2
Tapered end called conus medullaris
Cauda equina
Naming cervical nerve roots
Blood supply
Cauda equina syndrome causes & symptoms
Posterior intervertebral disc herniation, trauma, tumors, epidural abscesses, hematomas, spinal stenosis, etc.

Low back pain, unilateral or bilateral lower extremity pain, unilateral or bilateral lower extremity weakness and loss of sensation, bowel and bladder dysfunction
Great anterior segmental medullary artery (of Adamkiewicz)
Arising from lower intercostal or upper lumbar artery, usually on left

Important for blood supply to lower 2/3 of the spinal cord
Importance of vertebral venous plexus communication with throacic, abdominal, and pelvic veins
Pathway for metastasis of cancer cells to vertebral column, spinal cord, brain
common site of osteoarthritis
zygopophysial (facet) joints
what travels through the transverse foramen of the typical cervical vertebrae?
vertebral artery
what can be visualized in an oblique x-ray of the lumbar spine?
"scottie dog" = outline of inferior articular process, pars interarticularis, pedicle, superior articular processes, and transverse process

aid in the diagnosis of spondylolysis
scoliosis
lateral curvature of vertebral column
adjacent vertebrae articulate at (2)
1. bw bodies, by intervertebral discs
2. bw vertebral arches, by zygopophysial (facet) joints
where do spinal nerves exit the vertebral canal?
intervertebral foramina
if pathological changes occur in ______ and/or ______, they can compress the spinal nerve as it exits the ________.
1. intervertebral discs
2. zygapophysial (facet) joints
3. intervertebral foramina
which joint is responsible for head flexion (nodding yes)?

(a) atlanto-occipital joint
(b) atlanto-axial joint
(a)atlanto-occipital joint
which joint is responsible for head rotation (shaking no)?

(a) atlanto-occipital joint
(b) atlanto-axial joint
(b) atlanto-axial joint