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45 Cards in this Set
- Front
- Back
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What are the major features of typical cervical, thoracic, and lumbar vertebrae?
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Cervical: tranverse foramen; bifid spinous process on C3-C5; vertebral prominens on C7
Thoracic: facets for rib articulation; long spinous process Lumbar: body larger anteriorly; mammillary process |
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What are the major features of the sacrum and coccyx?
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Ventrally: fused vertebral regions called transverse ridges. 4 holes on each side called ventral sacral foramina.
Dorsally: sacral canal exists superiorly and dorsal sacral foramina |
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What features distinguish the the atlas and the axis?
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Atlas: Also known as C1, the atlas articulates with the head. Lacks a vertebral body.
Axis: Also C2, axis contains the odontoid process or dens and is grooved for the transverse atlantal ligament |
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What are the movements that occur between the atlas, axis, and skull?
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There is no intervertebral disk between axis and atlas. The atlas is ring-shaped and composed of two lateral masses. Each lateral mass articulates with an occipital condyle of the skull and below with the superior articular surfaces of the axis (C2). The atlanto-occipital joint allows head to not up and down of vertebral column.
The dens contains two facets for alar ligaments, which allow for excessive rotation of the head. |
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What are the functions of the transverse and the alar ligaments of the axis?
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The transverse ligaments acts as levers for muscles that move the head at the atlanto-axial joints. The alar ligaments allow for excessive rotation of the head.
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What is the normal curvature of the vertebral column and what is their development?
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In fetal position, the body contains 1 primary curvature that curves concavely. In an adult, the spine has alternating secondary and primary curvatures. Primary curvatures are convex, while secondary curvatures are concave.
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What are the characteristics of scoliosis, kyphosis, and lordosis?
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Scoliosis - s-shaped, can be congenital
Kyphosis - exaggerated thoracic Lordosis - exaggerated lumbar |
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Describe the movements between typical vertebrae.
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anterior longitudinal ligament, supraspinous ligament, interspinous ligament, posterior longitudinal ligament, ligamentum flavum
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Describe the joints found between typical vertebrae.
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Typical vertebra has a total of 6 joints with adjacent vertebrae: 4 sinovial joints between articular processes and 2 symphyses between vertebral bodies.
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Describe the movements between typical vertebrae.
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Movements by the vertebral column include flexion, extension, lateral flexion, rotation, and circumduction.
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What is the difference between spinal gray matter and spinal white matter?
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Gray matter is rich in nerve cell bodies.
White matter are ascending and descending tracts. |
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Describe the general anatomy of a cross section of the spinal cord.
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Deep gray matter with surrounding white matter. Central canal for CSF flow. 2 dorsal horns and 2 lateral horns. Surrounded by the dura, arachnoid, and pia mater.
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List the spinal cord segments where the dorsal (posterior) horn is found.
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It is found everywhere throughout the spinal cord (C1-S5)
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Describe the joints found between typical vertebrae.
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Typical vertebra has a total of 6 joints with adjacent vertebrae: 4 sinovial joints between articular processes and 2 symphyses between vertebral bodies.
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Describe the movements between typical vertebrae.
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Movements by the vertebral column include flexion, extension, lateral flexion, rotation, and circumduction.
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What is the difference between spinal gray matter and spinal white matter?
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Gray matter is rich in nerve cell bodies.
White matter are ascending and descending tracts. |
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Describe the general anatomy of a cross section of the spinal cord.
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Deep gray matter with surrounding white matter. Central canal for CSF flow. 2 dorsal horns and 2 lateral horns. Surrounded by the dura, arachnoid, and pia mater.
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List the spinal cord segments where the dorsal (posterior) horn is found.
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It is found everywhere throughout the spinal cord (C1-S5)
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List the spinal cord segments where the lateral horn is found.
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T1-L2
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List the spinal cord segments where the ventral (anterior) horn is found.
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Found the entire length of the spinal cord (C1-S5)
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Describe the functional modalities associated with the ventral, dorsal, and lateral horns.
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Dorsal horn: sensory
Ventral horn: motor Lateral horn: sympathetic |
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Describe the extent, attachments, and spaces of the spinal meninges.
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from outside in: spinal dura mater --> arachnoid mater --> subarachnoid space --> pia mater
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Describe the extent and the contents of the dural sac (lumbar cistern).
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The 3 meninges are continuous with that in the spinal cord and cerebral hemispheres; stabilized by the denticulate ligaments; ends at S2
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Describe the extent and the attachments of the filum terminale and denticulate ligaments.
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Denticulate ligaments: a longitudinal sheet of pia mater that extends laterally from cord and connects to the arachnoid and dura mater
Filum terminale: consists mainly of fibrous tissue and continuous of the pia mater; 20 cm in length and prolonged extension of the conus medullaris; attached to back of the first segment of coccyx |
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What are the changes in the vertebral level of the conus medullaris from 8 weeks to 24 weeks to newborn to adult?
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8 weeks: entended till end of coccyx
24 weeks: S1/S2 newborn: L3 adult: L1/L2 |
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Between which vertebrae a lumbar puncture (spinal tap) should be performed in an infant and in an adult? Why?
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Between L4 and L5 in both an adult and an infant; damage and injury to spinal cord is unlikely here
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What structures would a needle pierce in a lumbar puncture (spinal tap)?
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From superficial to deep: skin -> subcutaneous tissue -> spinous process -> interspinous ligaments -> ligamentum flavum -> epidural space -> dura mater -> subarachnoid space
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Describe the blood supply of the spinal cord and its clinical significance.
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Comes from 2 sources: longitudinally oriented vessels, arising superior to the cervical portion of the cord, which descend on the surface of the cord
- 1 anterior spinal artery - originates within cranial cavity - 2 posterior spinal arteries, originate in cranial cavity segmental spinal arteries arising from - vertebral and deep cervical arteries in the neck - posterior intercostal arteries in thorax - lumbar arteries in abdomen - largest = artery of Adamkiewicz - reinforces arterial supply to lower spinal cord |
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Describe the location and function of the internal vertebral venous plexus (of Batson) and its role in the spread of infections and/or cancer.
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plexus is valveless and connects the deep pelvic and thoracic veins that drain the inferior end of the bladder, breast, and prostate. Because its valveless and its location, its believed to provide a route to the spread of cancer metastases; commonly arise from cancer of pelvic organs (rectum, prostate) and may spread to to the vertebral column or brain. UTI's are known to spread and cause osteomyelitis (bone infection) of the vertebrae.
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Describe the nerve impingments, and their consequences, resulting from disc herniations in the cervical, thoracic, and lumbar regions.
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Cervical: usually occurs from forcible hyperflexion (think football tackle); can cause a rupture of disk C5/C6 with nucleus pulposus compressing C6 spinal nerve roots
Thoracic: uncommon, but a herniation at the T4/T5 level would cause impingement at the T4 nerve Lumbar: If impingement occurred between L4/L5, then the L5 nerve would be affected (L4 nerve has already left the cord at this point) |
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Describe the structure of the intervertebral disc.
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- outer anulus fibrosus made up of sheets of CT; made up of collagen and fibrocartilage -> limits rotation between vertebrae
- inner nucleus pulposus core; gelatinous and absorbs compression forces between vertebrae |
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Describe the anatomical landmarks used for lumbar and sacral epidural anesthesia.
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Patient sits in sitting position; patient is asked to slouch forward. Palpate patients back and identify suitable gap between spinous process. Local anasthetic is given, and needle is inserted into the ligamentum flavum. When there is loss of resistance, needle has reached epidural space.
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What are the neurological signs and symptoms of spondylolysis and spondylolisthesis of the L5 vertebra?
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Spondylolysis - only fracture of the pedicles
Spondylolisthesis -hyperextension and sliding forward of the vertebra |
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What are the embryological origins of the vertebrae and the intervertebral disks?
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The vertebrae are embryologically derived from somites, which differ into scleratomes to form vertebrae. Intervertebral disks arise from the notocord.
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How does the neural plate form and what is the neuroectoderm?
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Arises from a flat thickening opposite to the primitive streak of the ectoderm.
Neuroectoderm - ectoderm that leads to the development of the nervous system |
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What is involved in the formation of the neural tube and neural crest?
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Neural tube: formed by the fusion of neural folds in the surface ectoderm
Neural crest: crest cells detach after junction of skin ectoderm and sit above the neural tube |
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Describe the three zones which form in the neural tube.
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Neural tube is lined by the thick layer of neuroepithelium that forms the ventricular zone. Marginal zone is formed on the inside of the ventricular zone. Cells in the ventricular zone multiply and newly formed cells migrate to form the intermediate zone between ventricular and marginal zones
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How do each of these zones contribute to the formation of the spinal cord?
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Intermediate zone thickens to 4 regions (2 alar plates dorsally and 2 basal plates ventrally. The sulcus limitans seperates the alar and basal plates.
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Outline the embryological origins of the cellular components of the spinal cord
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Intermediate layer forms spinal gray matter. Marginal layer forms white matter. Cavity of neural tube forms central canal. Ventricular zone forms ependymal lining of central canal.
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List the nervous system derivatives of the neural crest cells.
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- ganglion cells of the peripheral NS
- schwann cells (myelin producing cells in PNS) - leptomeninges (pia-arachnoid) |
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List the derivatives of the neural tube.
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- cavity of neural tube forms central canal
- alar plates form dorsal horns - basal plates form ventral and lateral horns |
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List common causes of neural tube defects.
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Varying degree of failure of neural tube formation with accompanying defects in formation of the meninges and neural arch of vertebrae.
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Describe the basic anatomy, mechanisms, and severity of spina bifida occulta, spina bifida with meningocele, spina bifida with meningomyelocele and spina bifida with myeloschisis.
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Spina bifuda occulta - defect in vertebral arch with normal cord; tuft of hair may be present; no neurological defects
Spina bifida memingocele - bulge over defect contains meninges and CSF in subarachhnoid space Spina bifida meningomyelocele - bulgs over defect that contains meninges, spinal cord, and nerves Spina bifida myeloschisis - skin and bony defect with open spinal cord; seen as a mass of neural tissue |
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Describe the anatomical location and mechanism of a Jefferson (burst) fracture.
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Posterior arch is fractured; usually caused by compression from above (impact from hit or fall)
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Describe the anatomical location and mechanism of a Hangman's fracture.
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Pedicles are broken or fractured; can occur via a forward displacement, avulsion-dislocation, or a compression fracture
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