Term
| Which set of bones constitutes the axis of the body? |
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Definition
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Term
| How many bones are in the spinal column? |
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Definition
| 33 (7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral vertebrae, and 4 fused coccygeal vertebrae) |
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Term
| Which areas of the spine represent the primary curvatures? The secondary curvatures? |
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Definition
primary = sacral/thoracic vertebrae
secondary= cervical/lumbar vertebrae |
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Term
| What is meant by primary curvature? |
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Definition
| Curvature of the spine that develops in embryo |
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Term
| What is meant by secondary curvature? |
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Definition
| Curvature that develops after birth, due to holding head erect (cervical) or by load bearing (lumbar) |
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Term
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Definition
| An exxagerated thoracic curvature, usually the result of degeneration or compression fracture of the thoracic vertebrae. Causes "humpback" |
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Term
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Definition
| It is a lateral curvature of the vertebral column. Can be caused by asymmetric weakness of supporting muscles/ligaments (myopathic) improper development of vertebrae, or unequal length of lower extremities. Causes "curved back" |
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Term
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Definition
| Exaggerated lumbar curvature seen in obese the obese or pregnant. Causes "hollow back" |
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Term
| A pregnant woman is at risk for which type of abnormal curvature of the spine? |
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Definition
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Term
| An elderly person whose thoracic vertebrae have degenerated is at risk for which type of abnormal curvature of the vertebral column? |
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Definition
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Term
| A person who has a two different sized legs is at risk for which type of abnormal curvature of the vertebral column? |
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Definition
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Term
| What are some of the unique features of the cervical vertebrae? |
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Definition
| Have transverse foramen containing vertebral artery, vein, and plexus of sympathetic nerves. Smallest body of the vertebrae |
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Term
| What are some of the unique characteristics of the thoracic vertebrae? |
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Definition
| costal facets for attachment to ribs |
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Term
| What are some of the unique characteristics of the lumbar vertebrae? |
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Definition
| Large body for structural support, large transverse processes |
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Term
| What is the purpose of the superior and inferior articular processes? |
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Definition
| Form synovial joints between contiguous vertebrae, which are surrounded by a fibrous capsule, strengthened by ligaments, filled with synovial fluid. |
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Term
| What is a zygopophysial joint? Where would one be located on the spinal column? |
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Definition
| A zygopophysial joint is a synovial joint that "glides"; located between super/infer articular facets of adjacent vertebrae |
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Term
| What are the components of an intervertebral disc? |
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Definition
nucleus pulposus=acts as a cushion, filled with fibrogelatinous pulp
anulus fibrosus=concentric circles of fibers where each layers fibers are perpendicular to the previous layer |
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Term
| How does a disc herniation occur? |
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Definition
| Tears in the anulus fibrosis cause the nucleus pulposus to push out of the disc. |
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Term
| What can the different kinds of pain (localized, chronic, sciatica or intermittent pain) tell you about the type of herniation? |
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Definition
localized=usually pressure exerted on posterior longitudinal ligament and inflammation related to leakage of nucleus pulposus
chronic pain is likely from compressed nerve root, is felt over the dermatome it supplies
sciatica= chronic/interm pain of lower back, caused by compression L5 or S1 contributions to sciatic nerve |
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Term
| Where are the most common sites of intervertebral disc herniation? |
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Definition
| Between C5-C6, C6-C7, L4-L5, L5-S1 |
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Term
| When someone has a herniated lumbar disc, how can you tell which nerve root is compressed? |
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Definition
| Back muscles spasm to immobilize the area, so the patient leans in the opposite direction of the compression. |
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Term
| What ligament runs superior-inferior, connecting the anterior sides of the spinous processes to one another? |
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Definition
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Term
| What ligament fills the space between each spinous process? |
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Definition
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Term
| What ligament runs superior-inferior along the spinal column, connecting the dorsal ends of the spinous processes to one another? |
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Definition
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Term
| What ligament runs superior-inferior along the ventral side of the vertebral bodies, connecting them to one another? |
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Definition
anterior longitudinal ligament
* prevents hyperextension |
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Term
| What ligament runs superior-inferior along the dorsal side of the vertebral bodies, connecting them to one another? |
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Definition
posterior longitudinal ligament
*prevents hyperflexion |
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Term
| Where along the spinal column does the spinal cord end? What is that ending called? |
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Definition
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Term
| What extends from the conus medullaris and is made of pia? To what is it connected? |
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Definition
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Term
| What is the bundle of dorsal and ventral roots that make up the lumbar, sacral, and coccygeal nerves called? |
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Definition
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Term
| Where does the spinal cord extend in the embryo? At birth? At maturity? |
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Definition
| full length of spinal column; L3;L2 |
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Term
| What are the 3 coverings of the spinal cord collectively known as? |
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Definition
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Term
| Cerebrospinal fluid is located between which two layers of the meninges? |
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Definition
| arachnoid layer and the pia mater; also called the subarachnoid space |
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Term
| What are the 3 layers of the meninges called, listed from the outer most layer inward? |
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Definition
1. Dura mater
2. arachnoid mater.
3. pia mater |
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Term
| What are the outcroppings of the pia mater that attach to the dura mater and are associated with the dorsal and ventral roots? |
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Definition
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Term
| The extradural(epidural) space separates which two bodies within the spinal cord or column? |
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Definition
| Separates the vertebral arch (bone) from the dura mater; internal vertebral venous plexus is located here |
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Term
| Where are the ideal sites for lumbar puncture in an adult? In a pediatric patient? |
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Definition
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Term
| What is the lumbar cistern? |
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Definition
| Region of subarachnoid space between L2-S2, contains no spinal cord and only the cauda equina. |
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Term
| Why do people who get a lumbar puncture get headaches following the procedure? |
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Definition
| The change in intercranial pressure from having CSF extracted and leaking |
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Term
| What tissues will a lumbar needle pass through during a lumbar puncture? |
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Definition
| Skin->superficial fascia->supraspinous ligament->interspinous ligament-> ligamentum flavum->epidural space->dura->subdural space->arachnoid mater |
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Term
| What is the toughest portion of the meninges? |
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Definition
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Term
| Where do the dura and acrachnoid end? |
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Definition
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Term
| What is the process for obtaining CSF from a patient? |
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Definition
| Patient assumes fetal position to allow lumbar region to be flexed. Iliac crest is used as marker to approx L4, then needle is placed between L3/L4 or L4/L5 |
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Term
| What venous plexus is particularly susceptible to spreading infections and metastases? Why? |
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Definition
| the Internal vertebral venous plexus can spread disease because it communicates with numerous veins in the thorax, abdomen, and pelvis and has no valves. |
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Term
| What arteries supply the cervical region of the spinal cord? |
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Definition
| Vertebral arteries, which run within the transverse foramen, give off anterior and posterior spinal arteries. |
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Term
| Which arteries are associated with the thoracic region of the spinal cord? |
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Definition
| Posterior intercostal arteries give off to segmental/spinal or radicular branches |
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Term
| What does it mean to form an anastomotic connection? |
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Definition
| When arteries connect with other arteries instead of ending in a capillary bed |
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Term
| What do the posterior intercostal arteries anastomose with? |
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Definition
| with the anterior and posterior spinal arteries, branches of the vertebral artery |
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Term
| What problems may arise when adequate blood supply to the spinal cord is not maintained? |
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Definition
| muscle weakness, paralysis, decreased or lost sensation due to death of nerve cells |
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Term
| How are the extent and pattern of spinal cord injuries determined? |
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Definition
1) The position, direction, duration, and magnitude of the force
2) The position of the torso, neck, and head. |
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Term
| Where does the majority of back pain associated with vertebral column trauma come from? |
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Definition
| the pain is usually the result of injury to the periosteum, ligaments, intervertebral discs, or joints and is conveyed by meningeal branches of spinal nerves or the spinal nerves themselves, depending on the site/extent of injury |
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Term
| What region of the spinal column is most susceptible to damage? Why? |
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Definition
| The cervical portion of the vertebral column is most susceptible to damage do to its high degree of flexibility and inherent instability |
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Term
| When do flexion injuries occur? What typical injuries result? |
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Definition
Following rapid deceleration (head-on collision)
Compression fracture (collapse of anterior part of vertebral wall), injury to posterior longitudinal ligament, or displacement of a vertebra (which can break adjacent facets, rupture ligaments, and usually results to permanent injury to spinal cord) |
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Term
| What type of injuries to the spinal column are likely to result from a head on collision or rapid deceleration? |
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Definition
| Compression fracture (collapse of anterior part of vertebral wall), injury to posterior longitudinal ligament, or displacement of a vertebra (which can break adjacent facets, rupture ligaments, and usually results to permanent injury to spinal cord) |
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Term
| What typically results from vertical compression injuries to the spinal column? |
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Definition
| They usually cause burst fractures where fragments from the vertebral body enter the vertebral canal and damage the spinal cord. quadriplegia is a frequent outcome. Damage like this will compromise blood flow to the spinal cord and be accompanied by swelling in the surrounding muscles since lymph drainage is interrupted too |
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Term
| Extension injuries usually arise from which type of accident? What kind of damage do they produce? |
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Definition
| Extension injuries occur when rear-ended. Usually produce compression fractures of vertebral arch, fragments of which can damage spinal cord. Strain on anterior longitudinal ligament may result in avulsion of a segment of the vetebral body, called a teardrop fracture |
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Term
| What can happen in traumatic hyperextension injuries? |
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Definition
| A vertebra might become displaced anteriorly. This can cause fractures of the articular facets, tearing of the interspinous ligaments, and damaging the cervical nerves or spinal cord. |
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Term
| Where would osteophytes be located? What are they? What can they complicate? |
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Definition
| Osteophytes are tiny projections of bone that arise during old age when bone density decreases. They can project into the vertebral canal and other areas. Traumatic vertebral injuries may be exascerbated by osteophytes. |
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Term
| What are the consequences of the decrease in bone density in the vertebrae as people age? |
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Definition
| Causes the vertebral body to become concave on both sides, which changes the structure and composition of the IV discs and result in an increase in compressive forces around the periphery of vertebrae. This can cause the formation of osteophytes |
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