Glossary of Anatomy Spine 2
Other Decks By This User
- What are the 3 major components of the spine?
- 1. the spinal column (bones and discs)
2. neural elements (spinal cord and nerve roots)
3. supporting structures (muscle and ligaments)
- How many vertebrae are there and give the breakdown of each type?
- 33 vertebrae
• cervical = 7
• thoracic = 12
• lumbar = 5
• sacrum = 5
• coccyx = 4
- How many spinal nerves are there?
- 31 pairs of spinal nerves
- Which vertebrae are lordotic?
- cervical and lumbar vertebrae
- Which vertebrae are kyphotic?
- thoracic and sacral vertebrae
- What is the function of the spine/vertebrae?
- • protection (of spinal cord and nerve roots)
• base for attachment (for ligaments, tendons, and muscles)
• structural support
• flexibility and mobility
• other (produce RBCs and mineral storage)
- What percentage of the population are seen for back pain per year?
- What percentage of people will experience back pain in their lifetime?
- What vertebrae does the spinal cord extend to?
- At what vertebrae does the spinal cord become the caudal equina?
- beyond L1
- What are the divisions of the peripheral nervous system?
- somatic and autonomic nervous system
- What are the two divisions of the autonomic nervous system?
- • sympathetic nervous system
• parasympathetic nervous system
- What is the total volume of CSF in the average adult?
- 150 ml
- What are the names of C1 and C2 vertebrae, respectively?
- • C1 is the atlas
• C2 is the axis
- True/False: Intervertebral disc have their own blood supply
- • Intervertebral disc are not vascular and depend on the end plates to diffuse needed nutrients.
• The correct answer is: False
- What is the function of intervertebral discs?
- • serve as the spine's shock absorbing system
• protect the vertebrae, brain and other structures
• allow some vertebral motion (extension and flexion)
- What are the 2 parts of the intervertebral disc?
- • annulus fibrosus - outer part
• nucleus pulposus - inner part
- Which portion of the intervertebral disc contains more fluid?
- nucleus pulposus
- How many facet joints are on each vertebra?
- 2 sets of facet joints of each vertebra
- What type of joints are facet joints?
- Synovial joints "hinge-like"
- What are the 3 important ligaments of the spine and where are they located?
- • ligamentum flavum - forms over the dura mater, inside the spinal canal
• posterior longitudinal ligament - runs in the spinal canal but posterior to the vertebra body
• anterior longitudinal ligament - runs up and down the spine; attaches to the front of each vertebra
- What are some symptoms of spinal cord injury?
- - pains, numbness, weakness, and tingling
- Generally, what do the 8 cervical nerves control?
- C1: Head and neck
C2: Head and neck
C4: Upper body muscles (e.g. Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
- What goes through the transverse foramen?
- vertebral artery
- How do you see C1 and C2 in an anterior-posterior x-ray?
- the patient would have to open their mouth during the x-ray, because the mandible obscures the view of C1 and C2
- What is subluxation?
- partial dislocation of the spine
- What are the 3 parts of the cruciate ligament in C1 and C2? what are their function?
- • superior longitudinal band
• transverse ligament of atlas
• inferior longitudinal band
* the cruciate ligaments
help hold the atlas in place
- What is whiplash?
- a nonmedical term to describe hyperextension injury to the neck resulting from an indirect force, sually a rear-end automobile collision
- Injuries from whiplash can be seen on X-ray
- Most injuries are to soft tissues such as the discs, muscles, and ligaments and cannot be seen on standard X-rays The correct answer is: False
- What is the difference between sprain and strain?
- • strain is muscule-tendon tenderness
• sprain is ligament tenderness
- What is the treatment for neck sprain/strain?
- NSAIDS, muscle relaxers, narcotics
- What are the 3 required radiographs to view a possible c-spine fracture?
- • anteroposterior view
• lateral view
• odontoid view
- What are the 5 steps of the Nexus study?
- • midline pain or bony tenderness, crepitus, or step-off
• neurologic deficit
• presence of distracting injuries
• altered mental status (including intoxication)
• compliant of paresthesia or numbness
- Describe to Canadian C-Spine rules
- • 1st question - any high-risk factor that mandate radiography (such as age > 65, dangerous mechanism, or paresthesias in extremities); if yes » Xray, if no » go to 2nd question
• 2nd question - any low-risk factor that allows safe assessment of range of motion (simple rear-end MVC, sitting positio in the ER, ambulatory at any time, delayed onset of neck pain, or absence of midline c-spine tenderness); if no » Xray, if yes » go to 3rd question
• 3rd question - able to rotate neck actively; if unable to rotate » Xray, if yes » no Xray
- True/False: A 70 year-old male with a head injury and is negative for all 5 points of the Nexus study does not need an Xray
- • The Nexus study rules apply to ages 18-55 years old. Therefore, a 70 year-old patient will get an Xray
• The correct answer is: False
- What would a high cervical lesion affect?
- A lesion on C3-C4 would affect all arm muscles and ventilation
- What would a midcervical lesion affect?
- would affect extension but not flexion at elbow
- What would a low cervical lesion affect?
- affects hand muscle function but may preserve elbow flexion and extension
- A thoracic lesions results in what?
- What are some characteristics of partial spinal cord injury?
- • may be seen with acute neck extension
• typically get central spinal cord syndrome or anterior spinal artery syndrome
- What are some characteristics of anterior cord syndrome?
- • involves the loss of motor function
• temperature sensation distal to the level of injury
• preservation of light touch, vibration, and proprioception
- What are some characteristics of central cord syndrome?
- • associated with hyperextension injuries
• presents with motor weakness
• more prominent in the arms than in the legs
• variable sensory loss
- What is the Brown-Sequard syndrome?
- • most often results from penetrating trauma
• causes by a hemisetion of the spinal cord
• loss of ipsilateral motor function, proprioception, light touch sensation, and loss of contralateral pain and temperature sensation
- What are some characteristics of cauda equina syndrome?
- • more a peripheral nerve injury than a spinal cord lesion
• presents with variable motor and sensory loss in the lower extremities, sciatic, bowel or bladder dysfunction, and "saddle anesthesia"
- How does an injury to the corticospinal tract present?
- • produces an ipsilateral upper motor neuron lesions that results in
1) increased deep tendon reflexes
4) a positive Babinski sign
- What is negative Babinski sign and a positive Babinski sign?
- • negative = toes curl down
• positive = toes fan out
- How does an injury to the dorsal column present?
- loss of ipsilateral light touch sensation and proprioception
- How does an injury to the spinothalamic tract present?
- contralateral pain and temperature sensory losses
- How does an injury to the nerve roots present?
- • produces ipsilateral lower motor neuron lesions and radiculopathy
• results in decreased deep tendon reflexes, weakness, and sensory loss in that nerve distribution
- What are characteristics of spinal shock?
- • characterized by warm, pink, dry skin
• adequate urine output
• relative bradycardia
• other signs of autonomic dysfunction (ileus or paralyzed paristalis, urinary retention, fecal incontinence, and priaprism)
- When are extension and flexion radiographs done?
- • if xray is normal, but the patient still complains of pain
• checks for cervical spine stability
- When is a CT scan used?
- • for subluxations or fractures
• when neuro abnormality is present
- When should an MRI be done?
- • any suspected injury to the spinal cord
• to demonstrate spinal cord hemorrhage or contusion
- Name 3 major C-spine fractures
- 1. Hangman's fracture
2. Jefferson fracture
3. Extension "teardrop" fracture
- Describe a Hangman's fracture
- an unstable fracture of the pedicles of the posterior arch of C2 caused by extension and distraction injury
- Describe a Jefferson fracture
- • an axial load compression fracture of the anterior and posterior arches of C1
• an unstable fracture
• lateral masses of C1 lying lateral to the lateral masses of C2 (results as a spread of the ring of C1)
- What are the 3 classifications of odontoid fractures?
- • a piece of the odontoid is fractured
• a fracture at the base of the odontoid
• a fracture including part of the vertebral body
- Describe how a patient with acute brachial plexus neuritis presents
- • a characteristic pattern of acute or subacute onset of pain
• followed by profound weakness of the upper arm and amyotrophic changes affecting the shoulder girdle and upper extremity
- What are characteristics of torticollis?
- • refers to presentation of the neck in a twisted or bent position
• manifests in involuntary contraction of the neck muscles, leading o abnormal postures and movements of the head
- Describe a extension "teardrop" fracture
- an unstable fracture where the anterior longitudinal ligament avulses the anterior-inferior corner of the vertebral body
- What is the conus medullaris?
- the area of the spinal cord below T12 and L1 where the cord transitions in to the cauda equina
- What are some characteristics of the sciatic nerve?
- • the longest and largest nerve in the body (measuring ¾ inch in diameter)
• originates in the sacral plexus
• enables movement and feeling (motor & sensory) in the thigh, knee, calf, ankle, foot and toes
- What is sciatica?
- • injury or inflammation of the sciatic nerve
• can cause intense pain along any part of the sciatica nerve pathway (from the buttocks to the toes)
• symptoms include a loss of reflexes, weakness, numbness, severe pain
• makes everydat activities (walking, sitting, and standing) difficult
- Describe the origin and location of the sciatic nerve
- • sciatic nerve fibers originate at the 4th and 5th lumbar vertebra
• passes through the sciatic foramen just below the Piriformis muscles
• goes to the back of the extension of the hip and to the lower part of the Gluteus Maximus
• runs verically downward into the back of the thigh
• behind the knee, it braches into the hamstring muscles, calf, and further downward into the feet
- What is piriformis syndrome?
- an entrapment of the sciatic nerve as it exits the greater sciatic notch in the gluteal region
- What are some characteristics of spinal stenosis?
- • a narrowing of the spinal canal, which places pressure on the spinal cord
• inflammation of the nerves on a narrow canal causes usually causes symptoms
• lumbar spinal stenosis » pain, weakness, or numbness in the legs, calves, or buttocks
• cervical spinal stenosis » similar symptoms in the shoulders, arms, and legs
- What is the treatment ofor spinal stenosis?
- 1. NSAIDS
2. corticosteroid injecyions
3. rest or restricted activity
4. physical therapy
- What is spondylolysis?
- a defect in the parts interarticularis
- What is the most common vertebra involved in spondylolysis?
- What is spondylolisthesis?
- • anterior slipping of L5 over the saccrum
• usually a result of chronic stress
• symptoms include pain in the low back, thighs, legs, muscle spasms, weakness, and/or tight hamstring muscles
- What is foot drop?
- • an abnormal neuromuscular disorder that affects the patient's ability to raise their foot at the ankle
• inability to dorsiflex (point toe to the body)
• patients exhibit Steppage Gait or Footdrop Gait
- What occurs when you have a herniated disc?
- • the nucleus pulposus breaks through the anulus fibrosis of an intervertebral disc
• usually occurs in the L4-L5 and L5-S1 region
- What are the four stages of disc herniation?
- 1. disc protrusion
2. prolapsed disc
3. disc extrusion
4. sequestered disc
- What is the test to evaluate for herniated disc?
- • the straight-leg raise test (or Lasegue Test)
• the patient lies down, the knee is extended and the hip is flexed
• pain at 15° is a positive straight-leg raise test
- What is best radiographic method to evaluated for a herniated disc?
- MRI is the best method
- What causes Cauda Equina Syndrome?
- occurs from a central disc herniation
- What are some symptoms of Cauda Equina Syndrome?
- • bilateral leg pain
• loss of perianal sensation
• paralysis of the bladder
• weakness of the anal sphincter
- What is scoliosis?
- lateral curvature of the spine
- Which gender is more likely to develop scoliosis?
- What is the treatment of scoliosis?
- treatment is dependant on the degree of curvature
• 10-15° » follow-up in 6 months
• 15-20° » serial xrays every 3-4 months
• >20° » ortho referral for possible bracing
- What is Kyphosis?
- enhanced convex curvature of thoracic spine (hunchback)
- What is Pott's Disease?
- when TB of the spine causing progressive kyphosis
- What spinal deformity is often associated with respiratory distress?
- What is Ankylosing Spondylitis?
- • inflammation with progressive fusion of the vertebrae
• a chronic, multisystem inflammatory disorder of the sacroilliac (SI) joints
- What does Ankylosing Spondylitis look like on an X-ray?
• spine looks like one piece instead of individually identifiable vertebrae
- What blood test is associated with Ankylosing Spondylitis?
- Describe a wedge fracture
- a compression fracture in which a vertebra is crushed only in the front part of the spine, causing a wedge shape
- Describe a burst fracture
- the vertebra is crushed in all directions
- What are some characteristics of a Chance Fracture?
- • seen in passengers restrained by lap belts
• commonly found in the upper lumbar spine
• represents a pure bony injury extending from posterior to anterior (through the spinous process, pedicles, and vertebral body)
- What should you be consider in a patient older than 55 y/o with non-traumatic back pain?
- always consider abdominal aortic aneurysm (AAA)
- What is Brudzinski sign?
- • passive neck or single hip flexion is accompanied by involuntary flexion of both hips
• when the neck is pulled forward, the knees are flexed
- What is Kernig sign?
- • passive knee extension in supine patient elicits neck pain and hamstring resistance
• When the patient is lying flat and you try to straighten the knee, the patient brings their head up
- Positive Brudzinski and Kernig signs are symptoms for what illness?
- A lumbar puncture is usually done at what vertebral level?
- Name 2 causes of osteoporosis
- 1. decreased sex hormones
2. Cushing's Syndrome (cortisol inhibits osteoblast activity)
You must Login or Register to add cards