Anatomy

Front 1

what are the 5 types of vertebrae and how many of each?

Back 1

7 cervical, 12 thoracic, 5 lumbar, 5 sacral and 3-5 coccygeal

Front 2

Of the 33 vertebrae, which regions are mobile and provide considerable flexibility?

Back 2

cervical, thoracic and lumbar

Front 3

Name the curvature of each region of vertebral column

Back 3

cervical - convex anteriorly; thoracic - concave anteriorly; lumbar - convex anteriorly; sacrococcygeal - concave anteriorly

Front 4

kyphosis

Back 4

convex posteriorly; "humpback"

Front 5

lordosis

Back 5

convex anteriorly; pregnant or overweight

Front 6

Scoliosis

Back 6

any lateral curvature of spine in thoracic, lumbar or thoracolumbar area; curvature designated right or left according to convex side of major curve

Front 7

Characteristics of atlas (C1)

Back 7

lacks true body and spinous process; facet for dens of atlas; transverse foramen - unique to cervical vertebrae

Front 8

characteristics of axis or C2

Back 8

strongest of all cervical vertebrae; dens, large bifid spinous process; contains transverse ligament;

Front 9

Hangman's fracture

Back 9

fracture through the pedicles of the axis with or without sub laxation (incomplete dislocation) of axis on C3 and may injure spinal cord and/or medulla causing quadriplegia or death.

Front 10

This ligament prevents dens from crushing through spinal cord

Back 10

transverse ligament of the atlas; if the dens is fractured it may cut through this ligament; if dens becomes separated, may injure spinal cord and cause quadriplegia or injure medulla oblongata and result in death

Front 11

typical characteristics of cervical vertebrae (C3-C7)

Back 11

have large opening of vertebral foramen; kidney shaped body; transverse foramen; pedicles; articular process; vertebra prominent of C7 (spinous process); and transverse process

Front 12

pressure point to control bleeding from carotid artery

Back 12

carotid tubercle on C6

Front 13

Non-typical characteristics of thoracic vertebrae

Back 13

non-typical (T1-T4 and T9-12); T1 has long spinous process similar to C7; T1-T4 resemble cervicals with similar body shape and vertebral foramen are large and triangular; T9-T12 - have tubercles similar to accessory and mamillary processes of lumbar vertebrae

Front 14

receives the first rib

Back 14

facet of T1

Front 15

Typical characteristics of thoracic vertebrae (T5-T8)

Back 15

lack transverse foramina; heart-shaped bodies; vertebral foramina are smaller and circular; vertebral notches form intervertebral foramen - where nerves exit

Front 16

lumbar characteristics (L1-L5)

Back 16

kidney-shaped bodies (largest and most massive - to support increase in body weight); lack transverse foramina; accessory process (insertion of longissimus muscle); mamillary process (origin of multifidus) muscle); plane of articulation is sagittal -allows flexion/extension and side to side bending, but no rotation

Front 17

characteristics of sacral/coccygeal vertebrae

Back 17

promontory (landmark for OB/GYN);

Front 18

pelvic sacral foramina

Back 18

transmit the ventral rami of S1-S4 and branches of lateral sacral arteries

Front 19

transverse ridges (near foramina 2-4) on anterior side of sacrum provides what muscle origin?

Back 19

piriformis muscle

Front 20

Which surface of sacrum is concave and which is convex?

Back 20

concave = pelvic (anterior) surface; convex = posterior surface

Front 21

What transmits the dorsal rami of S1-S4?

Back 21

dorsal sacral foramina

Front 22

Median sacral crest is formed by what?

Back 22

reduced spinous processes

Front 23

The sacral hiatus exits because of what not fusing?

Back 23

lamina of the 5th segment

Front 24

what is the lateral sacral crest produced by?

Back 24

fusion of transverse processes

Front 25

the pelvic surface of the coccyx provides an attachment for what two muscles?

Back 25

coccygeus and levator ani muscles

Front 26

the posterior surface of the coccyx provides attachment for what two muscles?

Back 26

gluteus maximus and external anal sphincter

Front 27

The nucleus pulposus is a remnant of what?

Back 27

notochord

Front 28

Intervertebral Disc (between vertebrae)

Back 28

semifluid ball bearing which allows flexion, extension, and rotation; allows little movement between individual discs (cumulatively allows considerable flexibility of vertebral column); there is no disc between C1 and C2

Front 29

What are the two major components of an intervertebral disc?

Back 29

annulus fibrosus and nucleus pulposos

Front 30

Describe annulus fibrosus

Back 30

outer fibrous part of intervertebral disc; concentric lamellae of fibrocartilage; fibers run oblique and are at right angles to lamellae; attached to anterior and posterior longitudinal ligaments

Front 31

describe nucleus pulposus

Back 31

cartilagenous; highly elastic; located posteriorly - not centered; high water content, which decreases with age; shock absorbing feature of discs (axial forces)

Front 32

What's another name for facet joint?

Back 32

zygapophyseal joint

Front 33

What is a facet joint?

Back 33

synovial joint between superior and inferior articular facets of adjacent vertebrae provide varying amounts of flexion, extension, rotation or lateral bending

Front 34

What two diseases affect facet joints?

Back 34

osteoarthritis or rheumatoid arthririts; impinge on adjacent spinal nerve causing severe pain because of their proximity to intervertebral foramen

Front 35

What supplies the facet joint?

Back 35

dorsal primary rami that arise from spinal nerves outside of the intervertebral foramen and divide into medial and lateral branches

Front 36

Where does the atlantooccipital joint occur?

Back 36

between the occipital condyle and superior articular facet of the atlas

Front 37

Atlantoocciptal joint allows what actions?

Back 37

flexion and extension of head; little lateral bending; NO ROTATION!

Front 38

The posterior atlantooccipital membrane is penetrated by what artery and nerve?

Back 38

vertebral artery and suboccipital nerve

Front 39

The transverse ligament of the atlas holds what joint in place?

Back 39

atlantoaxial joint

Front 40

What are the articulations of the atlantoaxial joint?

Back 40

paired lateral atlantoaxial joints (bw inferior facet and lateral mass of C1 and superior facet of C2) and median bw dens of C2 and anterior arch of atlas

Front 41

What are some ways in which atlantoaxial dislocation or subluxation can occur? What disease may subluxation be associated with?

Back 41

after a rupture of the cruciform ligament caused by trauma or rheumatoid arthritis, or can result from a congenital absence of the dens of failure of the dens to fuse with body of axis. Down Syndrome

Front 42

The uncovertebral joint of Luschka occurs ______ in cervical vertebra. They are located between ____________.

Back 42

postnatally; lips of the bodies of adjacent vertebra

Front 43

this is a frequent site of spur formation (or osteophytes) that may cause neck pain

Back 43

uncovertebral joint (of Luschka)

Front 44

These ligaments of the vertebral column limit flexion

Back 44

supraspinous, interspinous, ligamentum flavum, posterior longitudinal ligament (prevents hyperflexion and herniation of IV discs)

Front 45

This ligament of the vertebral column may be strained or torn in a whiplash

Back 45

anterior longitudinal ligament

Front 46

This ligament of the vertebral column is yellow because of elastic tissue

Back 46

Ligamentum flavum

Front 47

Only ligament that limits extension

Back 47

anterior longitudinal ligament; prevents hyperextension

Front 48

This ligament extends from C2 and continues to the sacrum

Back 48

posterior longitudinal ligament

Front 49

This ligament has many nociceptive (pain) nerve endings

Back 49

posterior longitudinal ligament

Front 50

This ligament limits flexion and joins adjacent spinous processes

Back 50

interspinous ligament

Front 51

This ligament limits flexion and expands to form ligamentum nuchae in neck

Back 51

suprasinous ligament

Front 52

This ligament is a strong band that extends from occipital bone to sacrum

Back 52

anterior longitudinal ligament

Front 53

During sudden forced hyperextension, the spinal cord may be injured after transient inward bulging of what ligament?

Back 53

ligamentum flavum

Front 54

Which ligament reduces the chances of herniations that may compress the spinal cord and caudal equina b/c it reinforces the intervertebral disc properly?

Back 54

posterior longitudinal ligament

Front 55

This ligament is stretched when an individual is involved in a rear-end collision causing whiplash (a forceful hyperextension). What are the symptoms?

Back 55

anterior longitudinal ligament; onset of neck pain, headache, pain and numbness radiating in upper extremities

Front 56

Movements of vertebral column

Back 56

flexion, extension, lateral bending and rotation

Front 57

There are no intervertebral discs between what two vertebrae?

Back 57

C1&C2

Front 58

Movements of vertebral column are limited by what?

Back 58

intervertebral disc (thickness), ratio of disc shape to centrum thickness and plane of articulation

Front 59

What contributes to the wide range of motion of the vertebral column?

Back 59

articular capsule joint

Front 60

In the cervical region, describe the discs and how are the articular processes oriented?

Back 60

thick; horizontally- allows flexion, extension, lateral bending and rotation

Front 61

In the thoracic region, movement is limited by what factors?

Back 61

thin discs, attachment of ribs, attachment of sternum, frontal orientation of articular processes, overlapping laminae and spinous processes, flexion and extension is limited; lateral bending and rotation limited by ribs and sternum

Front 62

In the lumbar region, what permits flexion and extension?

Back 62

Thickness of discs and sagitally-oriented articular processes (facet joints)

Front 63

This is the region between the superior and inferior articulating facets of vertebra. it is frequently the site of fracture in spondylolysis

Back 63

pars interarticularis

Front 64

_____ refers to a defect in lamina formation so that L5 is displaced anteriorly. The articular processes hold only the posterior portion of the vertebrae in place. The anterior sliding is known as ___________.

Back 64

spondylolysis; spondylolisthesis

Front 65

What level does the spinal cord generally terminate?

Back 65

L2 (range T12-T2)

Front 66

This is the terminal end of the spinal cord proper

Back 66

conus medullaris

Front 67

Why is there a cervical enlargement and lumbosacral enlargement?

Back 67

Cervical enlargement is related to brachial plexus (innervation of upper limb) and lumbosacral enlargement is related to the lumbosacral plexus

Front 68

This ligament supports the spinal cord with intervertebral foramen; structural support for cord

Back 68

denticular ligament

Front 69

This spinal meninge continues inferiorly from the conus medulla as the filum terminale; laden with vessels and attaches to brain and spinal cord

Back 69

pia mater

Front 70

procedure where a needle is inserted into epidural space and injects anesthetic around roots of lower lumbar and sacral spinal nerve without entering subarachnoid space

Back 70

caudal epidural anesthesia

Front 71

procedure where a needle is placed in subarachnoid space to extract CSF (spinal tap) or to inject anesthesia (spinal block) or contrast medium

Back 71

Lumbar puncture; needle is usually inserted bw L3-L4 or L4-L5

Front 72

Prior to lumbar puncture, patient needs to be examined for what?

Back 72

signs of increased intracranial pressure (e.g. papilledema) b/c cerebellar tonsils (rounded lobules on undersurface of each cerebellar hemisphere) may herniate through foramen magnum

Front 73

Where does spinal cord end for adults and children?

Back 73

about L2 in adults and L3 in children

Front 74

Typically, when a disc ruptures (posterolaterally) the nerve root compressed is the root that passes ______to the disc

Back 74

inferior

Front 75

Herniated nucleus purposes may cause lower back pain and motor weakness of lower limbs, except in _________ regions

Back 75

cervical and thoracic

Front 76

Most common affliction of the sciatic nerve

Back 76

sciatica

Front 77

Irritation of any root from _____ can produce sciatica to a varying degree.

Back 77

L4-S3

Front 78

most common cause of sciatica; what happens to the IV foramina in the lumbar region and nerves of this region?

Back 78

lumbar disc protrusion; intervertebral foramina decrease in size while nerves of this region increase in size

Front 80

This venous plexus provides a pathway for tumor cells to metastasize from pelvic, abdominal and thoracic viscera to vertebrae, spinal cord and brain

Back 80

paravertebral venous drainage of vertebral column

Front 81

These cancers can spread to the brain via the paravertebral venous drainage of vertebral column

Back 81

breast, lung and prostate cancer

Front 82

The spread of bacteria via open wounds on back may spread to the ________ of the cranial cavity by way of venous plexus

Back 82

dural venous sinuses

Front 83

stenosis at L5 causes what?

Back 83

compression of spinal nerve and of the cauda equina

Front 84

stentotic (narrow) vertebral canal that may be caused by a hereditary anomaly (resulting in age related degenerative changes such as intervertebral disc bulging

Back 84

lumbar stenosis

Front 85

Surgical treatment of lumbar stenosis

Back 85

decompressive laminectomy (excision of vertebral laminae on entire vertebral arch)