Vertebral Column And Spinal Cord

Front 1

Sexual Dimorphism and Evidence of it

Back 1

Definition: morphological differences between m and f
-apparent in the lumbar region
-hypothesized to be an evolutionary response to changes in center of mass that occur during pregnancy associated with obligate bipedalism
- women have wedging in the lumbar region

Front 2

Palpable Skeletal landmarks and Points of Reference for Back and Spinal Column

Back 2

Cervicothoracic Junction - located at spinous process of C7
Scapular spine - located lateral to spinous process of T3
Inferior Scapular Angle - located lateral to spinous process of T7
12th Rib - lateral of spinous process of T12
Iliac crests - spinous process of L4

Front 3

Number of Cervical Vertebrae and Cervical Nerves

Back 3

There are 7 cervical vertebrate (C1 and C2 atypical)
There are 8 Cervical Nerves
First cervical nerve exits between cranium and C1
Second one exits between C1 and C2
Eighth one exits between C7 and T1

Front 4

Typical Cervical Vertebrae

Back 4

C3-C7
Body: small wider side to side
Vertebral Foramen: triangular shaped
Transverse Foramen: have foramina
Movements: flexion, extension, lateral flexion, and rotation (greatest ROM for vertebral column)

Front 5

Cervical Ribs (supernumerary ribs)

Back 5

An extra rib or pair of ribs arising from the 7th cervical vertebrae

This can cause Thoracic Outlet Syndrome (not always)

Front 6

Thoracic Outlet Syndome (TOS)

Back 6

Impingement of Brachial Plexus and Large Arteries in the region superior to the clavicle
Anything that impinges neurological vascular structures in the region where the Thoracic Outlet is as it goes into the upper limb.
Could be caused by extra ribs, fractured clavicle, extra muscle or scar tissue in the region of scalene muscles, poor posture of the neck and shoulder regions

Front 7

Thoracic (12 vertebrae)

Back 7

Body: Larger, heart shaped, costal facets
Spinous Process: long and sharp, projecting inferiorly
Vertebral foramen- circular in shape
Transverse process - facets for the ribs except T1 and T12
Articular Processes : superior facets directed posteriorly and inferior facets directed anteriorly
Movements: rotation, lateral flexion is limited, flexion and extension are prevented

Front 8

Lumbar Vertebrae (5 Vertebrae)

Back 8

Body: Massive kidney shaped
Spinous Process: short and blunt, rectangular shape, projects posteriorly
Vertebral Foramen: thin and tapered
Articular Facets: superior directed posteromedially and inferior directed anterolaterally
Movements: flexion and extension, some lateral flexion, rotation prevented

Front 9

Sarcum: Properties and such

Back 9

Five fused vertebra, used to provide strength and stability to pelvis. Houses and anchors inferior part of spinal cord.

Has the coccyx(made of 3-4 small fused bones) attached to the inferior portion of it.

Front 10

Articulated Vertebral column: What contributes to stability?

Back 10

Stability of articulated vertebral column depends on the articular discs between the vertebral bodies, surrounding ligaments, and surrounding musculature.

Front 11

Supraspinous Ligament

Back 11

Ligament that covers the spinous processes longitudinally and superiorly running down the entire length of the vertebral column

Starts at T1

Front 12

Interspinous Ligament

Back 12

Ligament that spans in between the inferior portion of the spinous process to the superior portion of the spinous process below it.

Front 13

Ligamentum Flavum

Back 13

Connects the lamina of adjacent vertebrae. Each vertebra has them and there is also one going to the first segment of the sacrum

Front 14

Ligamentum Nuchae (or nuchal ligament)

Back 14

Runs from the External Occipital Protuberance and runs to the spinous process of C7

This is a well developed portion of the Supraspinous LIg

Front 15

Anterior longitudinal ligament

Back 15

The ligament that spans longitudinally on the anterior aspect of the vertebral column. Spans across the entire column covering the fronts of the vertebra and helps reinforce vertebral discs

Prevents hyperextension

Front 16

Posterior longitudinal Ligament

Back 16

Spans Across the posterior aspect of the bodies of the vertebra and runs along the posterior aspect of the bodies of the vertebra longitudinally throughout the whole vertebral column and helps reinforce vertebral discs

Prevents hyperflexion
Smaller than the Anterior Longitudinal Ligament

Front 17

Annulus Fibrosus

Back 17

The outer layer of the intervertebral disc. Part of it supports the joints in between the vertebral bodies.

encloses the nucleus pulposus

Front 18

Intertransverse Ligament

Back 18

Ligament that is present in between transverse processes
Runs longitudinally

Front 19

Herniation of Disks: Why does it occur and where?

Back 19

Herniated disks are most common in the lumbar region in the posterolateral direction mostly because the posterior olongitudinal ligament is not broad. Herinated material will take path of least resistance

Also occurs with cervical vertebrae

Front 20

Stenosis and Herniation of Cervical Region: What types are there?

Back 20

Central stenosis- when the anterior portion of the spinal cord is pressed up against by the posterior aspect of the body of the vertebra

Foraminal Stenosis - when nerves are squished in between intervertebral foramina

Herinated disk - contents of the intervertebral disk push out and cause pressure on nerves

Front 21

Thoracic Region Herniation: How does it happen?

Back 21

Not common, usually result of wear and tear/disk degen
Sudden and forceful twisting of midback region could contribute
Conditions that predispose: abnormal kyphosis (Scheuerman's disease)

Front 22

Lumbar region disc herniation: How does it happen and what?

Back 22

Common herniation here because it is most weight bearing
Bending, twisting, improper lifting increases load on tendons and discs
Sudden injury contributes to this herniation
Levels of herniation correlate to areas of pain

Front 23

Soft Tissue of Vertebral Column: What is it and where?- ACCORDING TO VASU

Back 23

This is referred to as Thoracolumbar Fascia
Posterior Lamina -encompasses posterior aspect of erector spinae muscles.
Middle lamina- occurs between the intermediate and deep layers of muscle (b/t ESM and QuadratusL
Anterior layer is deepest layer lining the anterior aspect of the deepest muscle (use some common sense dummy)

Front 24

Soft Tissue of Vertebral Column:

Back 24

Posterior lamina-where LatD arises from
Anterior lamina-anterior aspect of musculature (posterior side of body wall)
Posterior and middle lamina surround ESM
Middle lamina and anterior lamina surround QuadL

Front 25

Spinal Cord and Nerves: numbers, pairs, ventral rami, dorsal rami

Back 25

31 pairs of spinal nerves with 8 cervical pairs, 12 thoracic pairs, 5 lumbar pairs, 5 sacral pairs, 1 coccygeal pair

Ventral Rami-larger portion of nerves that innervate lateral and anterior body walls and limbs (hypaxial nerves)

Dorsal Rami- innervate the intrinsic back muscles (epaxial nerves)

Front 26

Segmental Innervation, Dermatomes, Myotomes

Back 26

Segmentally-nerves in a region will tend to innervate things in that region.
Dermatome-area of skin innervated by sensory fibers of one single nerve root
Myotome-a group of muscles that is primarily innervated by motor fibers of a single nerve root
These two overlap-don't always correspond on a one to one basis

Front 27

Denticulate Ligaments

Back 27

Tooth like ligaments that come off of the spinal cord laterally. They anchor the spinal cord to the dura mater

Front 28

Ventral Horn

Back 28

ALWAYS THINK SAME DAVE SENSORY AFFERENT MOTOR EFFERENT DORSAL AFFERENT VENTRAL EFFERENT

Horn on anterior side of Spinal cord that is responsible for motor control

Front 29

Dorsal Horn

Back 29

Horn on the posterior side of spinal cord responsible for most sensory functions of spinal cord.

SAME DAVE

Front 30

Dura Mater

Back 30

The most outer layer that will surround spinal cord which has the Arachnoid mater anchored to it medially
Encompasses the brain and spinal cord

Front 31

Arachnoid Mater

Back 31

One layer medial to dura mater, translucent and spider web like.

Front 32

Pia Mater

Back 32

Adheres tightly to the spinal cord tissue itself

Front 33

Subarachnoid Space (including CSF)

Back 33

Space in between the arachnoid and the pia mater that contains cerebrospinal fluid

Front 34

Gray matter

Back 34

Corresponds to the neuronal cell bodies in the middle of the spinal cord. with white matter insulating those gray matters.

Front 35

ANATOMY OF SPINAL CORD

Back 35

brainstem comes out and becomes part of spinal cord.
There is a cervical enlargement, lumbosacral enlargement, ends with a filum terminale

Front 36

Cervical Enlargement

Back 36

Area where the cervical plexus and brachial plexus come from

Front 37

Lumbar Enlargement/Lumbosacral Enlargement

Back 37

Area where lumbar and sacral plexuses come from

Front 38

Filum Terminale

Back 38

Terminal end of spinal cord that appears as a thin string which helps anchor the spinal cord.

It is a piece of pia mater that comes off the tip of the conus medullaris which travels down the sacral canal to anchor inferiorly.

Front 39

Conus Medullaris

Back 39

End of spinal Cord Ending at about L2

Front 40

Cauda Equina

Back 40

bundle of spinal nerves and spinal nerve roots which originate in the Conus Medullaris

Front 41

Growth of Vertebral Column vs Growth of Spinal Cord?
Why do we have a cauda equina?

Back 41

The spinal cord grows at a slower rate than the spinal column. Therefore, these nerves get pulled down and elongate while the conus medullaris retracts/stays where.

Front 42

Neural Tube Defect/Incomplete Development of Vertebral arch: what happens

Back 42

You get spina bifida-many different types of spina bifida,
May or may not have protrusion of spinal contents
May have a meningocele or meningomyelocele

Front 43

Dorsal Ramus/Rami Information and what it does and composition

Back 43

Dorsal Rami is expaxial and smaller. It travels posteriorly
On the posterior side of spinal cord: You have dorsal rootlets forming the dorsal root/ganglion
This dorsal root will come together with the ventral root to form the Spinal Nerve at that level of vertebrae
REMEBER SAME DAVE

Front 44

Ventral Ramus/Rami Information and what it does and composition

Back 44

hypaxial: larger and goes lateral and anteriorly
Rootlets from the ventral/anterior side come together to form the ventral root ganglion which will combine with the dorsal root ganglion to form the spinal nerve at that level. ALWAYS REMEMBER SAME DAVE>

Front 45

Types of nerves at RAMI/RAMUS

Back 45

At the Ramus, there are both sensory and motor neurons.
All the nerves from the upper limb will be coming from spinal nerve roots which have a mixture of sensory and motor nerves.

Front 46

Kyphosis and Lordosis: what is it and what can cause it?

Back 46

Kyphosis is convexity posteriorly of the thoracic region while Lordosis is concavity posteriorly of the cervical and lumbar regions.
Lordosis-associated with congenital abnormalities, musculoskeletal problems, degenerative disease.
Kyphosis-results from developmental abnormalities, trauma, or degenerative disease.

Front 47

Spondylolysis and Spondylolisthesis: What is it?

Back 47

Broken vertebtra caused by trauma or degenerative disease.

It is a common cause of spondylolisthesis: anterior displacement of vertebra or vertebral column in relation to the vertebra below.

Front 48

Pars Interarticularis: what is it?

Back 48

Pars is located in between superior and articular facets: in between the lamina and pedicles of vertebrae so to speak.
Fractures here are associated with spondylolsis
KNOWN AS SCOTTIE DOG WITH DOG COLLAR

Front 49

Compression Fracture: what is it and where does it happen?

Back 49

It is a collapse of bone of the vertebral body. This can be caused by trauma or degenerative disease

Front 50

Sacral Abnormalities: What happens?

Back 50

Fusion or partial fusion of L5 to the sacrum.

This would be a congenital defect.

There can also be a condition where S1 does not fuse with the rest of the sacral bodies.

Front 51

Osteopenia and Osteoporosis: what are they?

Back 51

Osteopenia-process of thinning or decrease in bone mass
Osteoporosis - condition of having diminished bone densitry making bones prone to fracture

These are both degenerative diseases.