Session 5 - The vertebral column Flashcards Preview

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Flashcards in Session 5 - The vertebral column Deck (93)
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1
Q

How are the vertebra held together?

A

-By ligaments

2
Q

How many bones are in the vertebral column? How are these organised?

A

-33 bones; 24 discrete single vertebrae; 9 fused vertebrae

3
Q

What are the gross functions of the vertebral column?

A
  • Centre of gravity
  • Attachments for bones of appendicular skeleton
  • Attachment for trunk muscles
  • Protection and passage of spinal cord
  • Segmental innervation
4
Q

What are possible movements of the vertebral column?

A
  • Flexion
  • Extension
  • ABduction
  • ADduction
  • Rotation
5
Q

How does the vertebral column act as the centre of gravity?

A

-The weight of the body is projected into the lower limbs about an imaginary line that passes centrally through the natural curvatures of the vertebral column

6
Q

What bones does the vertebral column act as a site of attachment for?

A
  • Skull
  • Ribs (indirectly the upper limb)
  • Hip bones (indirectly lower limb)
7
Q

How is an upright posture maintained?

A

-Continuous low level contraction of trunk muscles to support the body weight

8
Q

How does the vertebral column protect the spinal cord?

A

-Spinal cord runs through the spinal canal formed by successive vertebral foramen for its entirety

9
Q

Describe the presentation of the vertebral column in the fetus

A
  • A single flexed curvature which faces anteriorly (concave anteriorly)
  • Known as primary curvature
10
Q

-Where is the primary curvature maintained in the vertebral column thoughout life?

A

-Thoracic and sacral/coccygeal spine

11
Q

What is kyphosis?

A

-An exaggerated anterior curvature

12
Q

What is lordosis?

A

-An exaggerated posterior curvature

13
Q

What is scoliosis?

A

-Lateral deviation of the backbone

14
Q

Describe the presentation of the vertebral column in the young adult

A

-4 distinct curvatures arranged to give a sinusoidal shape
2 anterior curvatures (thoracic and sacral)
2 Posterior curvatures (cervical and lumbar)

15
Q

What are posterior curvatures of the vertebral column also known as?

A

-Secondary curvatures

16
Q

What characteristic does the sinusoidal profile of the vertebral column provide?

A

-Great resilience

17
Q

How does the vertebral column change from that in a foetus to that of a young adult?

A
  • Primary curvature becomes remodelled as the baby lifts the head, the primary curvature is replaced by a posterior curvature (cervical region)
  • The lumbar spine is then remodelled during crawling and walking to form the second posterior concavity
18
Q

Where are naturally weak points of the spine?

A

-C7/T1
-T12/L1
-L1/S5
Points of change in curvature

19
Q

Describe the presentation of the vertebral column in old age

A

-Secondary curvatures start to disappear with the vertebral column seeming to return to its original shape in the foetus and a fully continuous primary curvature re-establishes

20
Q

Name the fused vertebrae

A
  • Sacrum (5)

- Coccyx (4)

21
Q

Name the discrete vertebrae

A
  • Cervical (7)
  • Thoracic (12)
  • Lumbar (5)
22
Q

Which vertebrae are capable of individual movement?

A

-Discrete vertebrae

23
Q

What are the two segments of discrete vertebrae?

A
  • Anterior vertebral body

- Posterior vertebral arch

24
Q

What part of the discrete vertebrae is the main weight-bearing?

A

-Vertebral body

25
Q

How are adjacent vertebrae linked together?

A

-Through intervertebral discs which interdigitate with the vertebral body from C2/C3 to L5/S1 joints

26
Q

What cartilage lines the vertebral body?

A

-Hyaline

27
Q

How does the size of the vertebrae change throughout the discrete vertebrae?

A

-Increases from top-downwards

28
Q

What three processes emerge from a vertebral arch?

A
  • Two transverse processes laying laterally on either side of midline
  • One spinous process at the posterior midline
29
Q

What is the pedicle of the neural arch?

A

-The part of the neural arch between the vertebral body and the transverse process

30
Q

What is the lamina of the neural arch?

A

-The part of the neural arch between the transverse and spinous processes

31
Q

What are facets of the neural arch?

A

-Cartilage-lined articular processes which lie superiorly and inferiorly at the junction between the pedicle and the lamina

32
Q

What do facets forms

A

-Synovial joints between successive vertebrae

33
Q

What strengthens the facet joints between successive vertebrae?

A

-Ligamentum Flavum

34
Q

What do facet joints prevent?

A

-Anterior displacement of vertebrae

35
Q

Are facet joints weight bearing?

A

-Yes when upright

36
Q

Where are the vertebral notches on the neural arch?

A
  • One superior on pedicles

- One inferior on pedicles

37
Q

What forms the interverebral foreman?

A

-Inferior vertebral notch of one vertebrae with the superior vertebra notch on the successive vertebrae on each side of the vertebral column

38
Q

What passes through the intervertebral foreman?

A

-Segmental nerves from the spinal cord

39
Q

What is an intervertebral disk?

A

-A disc of cartinaginous tissue which separates successive vertebrae between levels C2/C3 to L5/S1

40
Q

Why are intervertebral discs called symphysis?

A

-They form secondary cartilaginous joints which do not ossify

41
Q

What is responsible for the high flexibility of the vertebral column?

A

-The intervertebral disks

42
Q

What are the functions of intervertbral disks?

A
  • Join successive verterbrae
  • Provide flexibility
  • Act as a shock absorber (dampens impact to skull)
43
Q

Are IVD all the same size?

A

-No, size increases inferiorly

44
Q

Describe the morphology od the intervertebral disks in the thoracic and lumbar regions

A

-Wedge shaped with the thickest section anteriorly and the thinnest section posteriorly

45
Q

Why is it important that the intervertebral disks are wedge-shaped in the thoracic and lumbar regions?

A

-Accounts for the secondary curvatures of the spine

46
Q

What forms the bulk and turgidity of the IVD?

A

-Its high water content

47
Q

What are the two regions of an IVD?

A
  • Central nucleus pulposus

- Peripheral annulus fibrosus

48
Q

What makes the annulus fibrosus?

A
  • A series of annular bands arranged in various orientations
  • The outerbands are collagenous
  • The inner bands are fibrocartilaginous
49
Q

What characteristics does the annulus fibrosus have?

A
  • Very resilient
  • Stronger then vertebral body
  • Shock absorber
50
Q

What is the nucleus pulposus?

A

-Centre of an IVD which is the jelly-like remnant of the notochord

51
Q

Which section of an IVD holds its high water content?

A

-Nucleus pulposus -> acts as a water reservoir

52
Q

Why can the size of the nucleus pulposus change throughout the day?

A

-Depending on water distribution within the IVD

53
Q

What is the difference in the position of the nucleus pulposus in infants and adults?

A
  • Central in infants

- Found more posteriorly in adults

54
Q

What most common possible consequence of degeneration of nucleus pulposus?

A
  • The nucleus pulposus can herniate through annuar fibrosus

- Known as slipped disk (most commonly posterio-laterally)

55
Q

When can a slipped disk cause paralysis?

A

-When the nucleus pulposus herniates posteriorly into the spinal cord

56
Q

Why can degeneration of nucleus pulposus occur with age?

A

-The nucleus can dehydrate

57
Q

What is marginal osteophytosis and when can it occur in IVD?

A
  • Projections of bone which occurs at sites of cartilage degeneration
  • Occurs when nucleus pulposus degenerates, reducing the height of the IVD
  • This changes the load stresses on the IVD leading to reactive marginal osteophytosis
58
Q

Why can nucleus pulposus degeneration lead to osteoarthritis?

A

-As the IVD height decreases, increased stress is placed on the facet joints which can lead to osteoarthritis at the same level

59
Q

How can nucleus pulposus degeneration lead to compression of spinal nerves?

A

-Decrease in IVD height decreases the size of the intervertebral foramen which can lead to congestion and compression of the segmental nerves

60
Q

What is the result of degeneration of the annulus fibrosus?

A

-Marginal osteophytosis -> height of disc space largely preserved

61
Q

What is spondylosis?

A
  • Spinal condition resulting from degeneration and flattening of the IVD in the cervical, thoracic or lumbar regions. There is a narrowing of the space occupied by the disk and osteophytes present
  • Symptoms include pain and restriction of movement
62
Q

What main ligaments straps together sucessive vertebrae and IVDs?

A

-Anterior longitudial ligament and posterior longitudial ligaments which run up the anterior and posterior longitudial axis of the vertebral column, respectively

63
Q

Which of the longitudial ligaments are shorter?

A

-Anterior longitudial ligament

64
Q

Which of the longitudial ligaments are stonger?

A

-Anterior lingitudial ligament

65
Q

Describe the course of the anterior longitudial ligament, including its morphology and attachments

A
  • A flat band which broadens as it passes downwards
  • Extends from atlas to the upper sacrum
  • Attaches to periosteum of vertebral bodies but free over IVDs
66
Q

Describe the course of the posterior longitudial ligament, including its morphology and attachments

A
  • Extends posterior to vertebral body from axis to the canal of the sacrum
  • Narrows as it passes downwards
  • Serrated margins, largest over IVD
  • Attached to IVD but free from vertebral bodies
67
Q

What separates the posterior longitudial ligament and the vertebral bodies?

A

-Basivertebral veins

68
Q

What three ligaments are associated with the neural arch?

A
  • Ligamentum Flavum
  • Interspinous ligament
  • Supraspinous ligament
69
Q

Describe ligamentum flavum

A
  • High content of elastic fibres
  • Join the laminae of succesive verebrae
  • Attached to the front of the upper lamina and back of the lower lamina
  • Stretched by flexion of the spine
  • Re-enforce synovial facets
70
Q

Describe supraspinous ligament

A
  • Joins the tips of spinous processes
  • Strong fibrous tissue
  • Lax in the extended spine
  • Draw taut in the flexed spine
71
Q

Describe interspinous ligament

A
  • Relatively weak sheets of fibrous tissue
  • Units spinous processes along their superior and inferior border
  • Well-developed only in lumbar spine
  • fuse with supraspinous ligament
72
Q

What is the posterior longitudial legament, when continued above axis?

A

-Membrane tectoria

73
Q

What is ligament nuchae?

A
  • A ligament which maintains the secondary curvature of the cervical spine , helping the cervical spine to support the head
  • Major site of attachment for neck and trunk muscles
74
Q

Where is the ligament nuchae?

A

-From Occiput to thoracic spinal ligaments

75
Q

What are continuations of ligament nuchae?

A

-Interspinous and supraspinous ligaments

76
Q

What is occiput?

A

-Occipital protuberance (back of skull)

77
Q

How do fused vertebrae differ morphologically from discrete vertebrae?

A
  • No IVD
  • No vertebral foramen
  • Coccyx has no interverebral foramen
  • Sacrum has modified intervertebral foramen
78
Q

Describe distinguishable features of the cervical vertebrae

A
  • Smallest of discrete vertebrae
  • Has a bifid spinous process
  • Has an oval transverse foramen in the wide transverse process (foramen transversum)
  • Large triangular vertebral foramen
79
Q

What passes through the foramen transversum of cervical vertebrae?

A

-Vertebral artery

80
Q

How does C7 differ from the rest of the cervical vertebrae?

A
  • Foramen transversum passes accessory vertebral veins

- Spinous process is not bifid

81
Q

Describe distinguishable features of the thoracic vertebrae

A
  • Intermediate in size which increases downwards
  • Vertebral foramen small and circular
  • Demi-facets on side of vertebral body for articulation with head of rib
  • Has costal facets on transverse processes for articulation with tubercle of rib (except T11 and T12)
82
Q

Describe the distinguishable features of lumbar vertebrae

A
  • Largest of discrete vertebrae
  • Lack costal facets and demifacets
  • Vertebral foramen is triangular and small
83
Q

What are atlas and axis?

A

-C1 and C2, respectively

84
Q

Why are atlas and axis atypical vertebrae?

A

-They are structurally and functionally different

85
Q

What are the articulations of atlas?

A
  • Skull above (atlanto-occipital joint)

- Axis below (atlanto-axial joint)

86
Q

How does atlas structurally differ from other vertebrae?

A
  • No strict vertebral body
  • No spinous process
  • Widest cervical vertebrae
87
Q

Which is the strongest cervical vertebrae?

A

-Axis

88
Q

How is axis distinguishable from other vertebrae?

A
  • Has the dens
  • Rugged lateral masses
  • Large spinous process
89
Q

What is the function of the dens?

A

-Fuses with atlas to prevent horizontal displacement

90
Q

Which vertebrae is broken in hangmans fracture?

A

-Axis

91
Q

What types of injury is the cervical spine prone to?

A
  • Whiplash in RTA

- Sports injuries

92
Q

What injury is the lumbar spine susceptible to?

A

-Herniation of L4/L5 or L5/S1

93
Q

How long is the vertebral column?

A

-around 70-75cm (42% of the height)