Term
| What does the vertebral column consist of and what parts are moveable? |
|
Definition
7 cervical vertebrae (neck)
12 thoracic vertebrae (chest)
5 lumbar vertebrae (abdomen)
5 fused sacral vertebrae (sacrum)
3-4 fused coccygeal vertebrae (coccyx).
Thus there is a total of 32-33 vertebrae, of which the first 24 (presacral) are moveable |
|
|
Term
| The presacral vertebrae are separated by __________. |
|
Definition
| intervertebral discs (IV discs) |
|
|
Term
| The intervertebral discs account for ~___ of the length of the vertebral column; the vertebral column accounts for ~ ___ of the height of the individual. |
|
Definition
| The discs account for ~1/4 of the length of the vertebral column; the vertebral column accounts for ~ 2/5 of the height of the individual. |
|
|
Term
| The bodies of adjacent vertebrae are firmly held together by ____________. The joints between adjacent vertebral bodies are termed __________. |
|
Definition
intervertebral discs
symphses |
|
|
Term
| Each IV disc consists of an outer _________ and an inner _________. |
|
Definition
| Each IV disc consists of an outer anulus fibrosus and an inner nucleus pulposus. |
|
|
Term
| The anulus fibrosus is composed of _______________. |
|
Definition
| concentric lamellae of fibrocartilage (The fibers of the lamellae run at right angles to each other and attach to the adjacent vertebral bodies_ |
|
|
Term
| In the IV disc, the __________ is a gelatinous mass which contains a high content of water (~88% water at birth). The water content decreases with age; this is one reason why older people become shorter in stature. |
|
Definition
|
|
Term
| What are two other functions of the IV discs other than binding the vertebral bodies together. |
|
Definition
1. shock absorbers
2. allow movement-Although the amount of movement between any two vertebrae is small, collectively the movements between the vertebrae along the entire length of the vertebral column is significant |
|
|
Term
| When standing erect and bearing weight, the ________ flattens and the __________ bulges outward |
|
Definition
| When standing erect and bearing weight, the nucleus pulposus flattens and the anulus fibrosus bulges outward |
|
|
Term
| The ________ of the IV discs allows them to return to their normal shape when not weight-bearing |
|
Definition
|
|
Term
| During_________ of the vertebral column (as well as during flexion/extension), the same disc is subject to both compressive and tensile forces. |
|
Definition
|
|
Term
| The vertebral arch consists of two _______ and two ________. |
|
Definition
|
|
Term
| The ____________ contains the spinal cord and its coverings; successive vertebral foramina constitute the __________. |
|
Definition
vertebral foramen
vertebral canal |
|
|
Term
| Between adjacent vertebrae (on either side) is an ___________. (where arteries and veins exit) |
|
Definition
|
|
Term
| Note the boundaries of an intervertebral foramen: ________ (superior and inferior), __________ (posterior), ___________ and the __________ (anterior). |
|
Definition
pedicles (superior and inferior)
facet joint (posterior)
intervertebral (IV) disc and the bodies of adjacent vertebrae (anterior). |
|
|
Term
| Pathology of any of the structures that form the boundaries of an intervertebral foramen can lead to ________ of a spinal nerve |
|
Definition
|
|
Term
| What are the synovial joints that allow for movement in the vertebrae? |
|
Definition
|
|
Term
| What attaches mainly to the posterior aspects of the IV discs that binds vertebrae together/? |
|
Definition
| Posterior longitudinal ligament |
|
|
Term
| The ________ may herniate (push through) the ________ which results in compression of a ___________. |
|
Definition
| The nucleus pulposus may herniate (push through) the anulus fibrosus. This can result in compression of a spinal nerve root. |
|
|
Term
HERNIATION OF A DISC may occur in any direction but is USUALLY __________.
Why is this so? |
|
Definition
posterolateral
because the anulus fibrosis is thin here and is not reinforced by the midline post. longitudinal ligament. (because it’s narrower posteriorly) |
|
|
Term
| What is the abnormal protrusion of something that causes pain and muscle weakness? |
|
Definition
|
|
Term
| Herniation of an IV disc usually occurs in the _______ region. |
|
Definition
|
|
Term
If there is a herniateion of the L4/L5 disc, what nerves are compressed?
This is because in the lumbar region the IV disc forms the _____ part of the anterior boundary of the IV foramen. |
|
Definition
spares the L4 spinal nerve but compresses L5 and other nerves passing to lower levels
This is because in the lumbar region the IV disc forms the lower part of the anterior boundary of the IV foramen. |
|
|
Term
| In the embryo and fetus, the vertebral column is (concave or convex) anteriorly. |
|
Definition
|
|
Term
In the adult, the vertebral column is concave anteriorly in the _______ region and the _________ region = (_______ curvatures).
In the _________ and ________ regions, the column is convex anteriorly = (_________ curvatures) |
|
Definition
In the adult, the column is also concave anteriorly in the thoracic region and the sacral/coccygeal region (primary curvatures).
In the cervical and lumbar regions the column is convex anteriorly (secondary curvatures). |
|
|
Term
| The _______ curvature becomes prominent when the infant begins to hold the head erect (~3 mos.) and the _______ curvature when the infant begins to walk (~18 mos.). |
|
Definition
|
|
Term
| The ________ curvatures allow the line of gravity to fall close to the vertebral column, thus requiring less muscular energy for support. |
|
Definition
|
|
Term
What is excessive curvature in the thoracic region that can result from erosion of the vertebral bodies due to osteoporosis or tuberculosis with subsequent collapse of the bodies due to the superimposed weight?
What is excessive curvature in the lumbar region that sometimes develops temporarily in pregnant women in an attempt to maintain their center of gravity? |
|
Definition
|
|
Term
What is the excessive curvature to one side of the vertebral column?
What may this be due to? |
|
Definition
Scoliosis
-asymetric muscle imbalance in a person whose intrinsic (deep) back muscles have been paralyzed on one side (eg., by polio
-failure of half of a vertebra to develop (hemivertebra)
-differences in the length of the lower limbs |
|
|
Term
| The vertebral column permits _________ of the trunk and provides a _____ on which the head can move. |
|
Definition
|
|
Term
| What are the 3 movements that the vertebral column permits the trunk and head? |
|
Definition
| The movements are flexion and extension (in the sagittal plane), lateral flexion (in the coronal plane) and rotation (around its longitudinal axis) |
|
|
Term
| The _____________ passes through the foramina transversaria of cervical vertebrae |
|
Definition
| vertebral artery (supply the brain) |
|
|
Term
| What cervical vertebrae is essentially a ring of bone, consisting of two lateral masses connected by ant. and post. arches |
|
Definition
|
|
Term
| The lateral masses on the atlas have concave, kidney-shaped facets superiorly for reception of the __________. |
|
Definition
|
|
Term
| The ______ (vertebrae) has no spine (just a post. tubercle on post. arch) and no body |
|
Definition
|
|
Term
The atlas posterior arch has a groove for the _______.
The anterior arch has a facet on its posterior aspect for articulation with the _____. |
|
Definition
|
|
Term
| The axis has 2 large, flat bearing surfaces, __________, for articulation with the atlas above. |
|
Definition
| superior articular facets |
|
|
Term
| _________ represents body of atlas and projects superiorly to articulate with the ant. arch of the atlas. |
|
Definition
|
|
Term
| In a thoracic vertebrae, what is the shape of the bodies and the vertebral foramina? |
|
Definition
Bodies heart-shaped
Vertebral foramina circular |
|
|
Term
| Which vertebrae region has the longest transverse process? |
|
Definition
|
|
Term
| What is the shape of the lumbar vertebrae body, vertebral foramina, and spines? |
|
Definition
Bodies massive, kidney-shaped
Vertebral foramina triangular
Spines hatchet-shaped |
|
|
Term
| What is the purpose for maxillary and accessory processes in the lumbar vertebrae? |
|
Definition
| for attachment of deep back muscles |
|
|
Term
What is the large, wedge-shaped bone of the spinal cord?
What is the small, wedge-shaped bone of the spinal cord?
Is the base (superior or inferior)?
Is the apex (superior or inferior)? |
|
Definition
| Sacrum Coccyx base superior, apex inferior |
|
|
Term
| What is the anterior edge of the body of S1; it is an imp. obstetrical landmark. |
|
Definition
|
|
Term
| There are ____(#) pairs of anterior (pelvic) and posterior sacral foramina. |
|
Definition
4
(for the ventral and dorsal rami of S1 – S4 spinal nerves) |
|
|
Term
In the posterosuperior view of the sacrum, the _________ are for articulation with LV5.
The __________ for articulation with hip bones on either side. These surfaces are covered with cartilage and form the synovial parts of the sacroiliac joints.
The _______ of sacrum articulate with those of the coccyx. |
|
Definition
Superior articular facets
auricular surfaces
Cornua (horns) |
|
|
Term
| In the posterosuperior view of the sacrum, the _______ (lower end of vertebral canal) ends inferiorly in the ______ (a gap formed by the absence of the spine and laminae of the S5 vertebra (and sometimes the S4 vertebra). (can stick a needle through here)) |
|
Definition
Sacral canal
Sacral hiatus |
|
|
Term
| How can the sacral hiatus be located in a patient? |
|
Definition
| by palpating the sacral cornua and the spine of the S4 (or S3) vertebra |
|
|
Term
What type of anesthesia is it when a needle penetrate the ligament covering the hiatus in order to inject anesthetic agent into the sacral canal, thus anesthetizing the lower spinal nerves ?
What type is it when a needle is passed through a dorsal sacral foramen into the epidural space |
|
Definition
caudal epidural anesthesia
transsacral epidural anesthesia |
|
|
Term
| In the PNS, there are ___ (#) pairs of cranial nerves (which exit the cranium) and ___(#) pairs of spinal nerves (which exit the vertebral canal) |
|
Definition
|
|
Term
| The spinal cord extends from the __________ at the base of the skull (where it is continuous w/the medulla of the brain) to the _____ level. |
|
Definition
|
|
Term
What do the 31 pairs of spinal nerves divide into?
What is the part of the cord to which a pair of spinal nerves attaches to? |
|
Definition
8C., 12T, 5L, 5S, & 1Co
spinal cord segment (hence there are also 31 spinal cord segments) |
|
|
Term
_______ emerge superior to their respective vertebrae.
_____ emerges between C7 and T1 vertebrae.
Beginning with ____ spinal nerve, spinal nerves emerge inferior to their respective vertebrae. |
|
Definition
|
|
Term
| _________- where the roots of the spinal nerves become increasingly longer and more oblique as they descend to exit their respective foramina since the cord ends at LV1/LV2 |
|
Definition
|
|
Term
| Where are the two enlargements for the origin of the nerves innervating the upper and lower limbs? |
|
Definition
|
|
Term
| What is the tapered terminal part of the spinal cord? |
|
Definition
|
|
Term
What is the prolonged cord as a non nervous strand of tissue (pia mater) distal to the conus medullar is?
What surrounds the cord ends at SV2? |
|
Definition
internal filum terminale
dural sac |
|
|
Term
Dorsal, ventral, or lateral horn
-contain motor neurons whose axons leave the spinal cord to innervate skeletal (voluntary) muscles in the body wall and extremities
-contain sensory neurons which receive sensory information coming in from the spinal nerves
-contains motor neurons of the autonomic nervous system which innervates smooth and cardiac muscle and glands |
|
Definition
ventral horns
dorsal horns
lateral horns |
|
|
Term
| Where is the lateral horn present ONLY? |
|
Definition
|
|
Term
| (gray or white) matter consists of bundles of fibers either ascending or descending in the cord |
|
Definition
| white matter (myelinated axons) |
|
|
Term
*Spinal nerves attach to the cord by ____ and ____
Which one is entirely sensory and which one is entirely motor? |
|
Definition
| dorsal root (sensory) and ventral roots (motor) |
|
|
Term
| What is the swelling on the dorsal root? |
|
Definition
|
|
Term
*The dorsal and ventral roots of each spinal nerve unite to form a _____________ (which is very short and exits via an intervertebral foramen).
The spinal nerve divides into __________ (branches) |
|
Definition
mixed (sensory and motor-GSA,GVA,GSE,GVE) spinal nerve
dorsal and ventral rami (branches). These rami are also mixed (GSA,GVA,GSE,GVE). |
|
|
Term
What fiber type would it be if you received info from skin (pain, temp, touch) and skeletal muscles?
What fiber type would it be if the smooth muscle, cardiac muscle, and glands received info?
What fiber type would it be if the skeletal muscles derived from pharyngeal arches received info?
What fiber type would it be if you received info from taste buds and olfactory mucosa (smell)? |
|
Definition
GSA
GVE
SVE
SVA
(review chart - slide 38) |
|
|
Term
| GSE fibers have cell bodies in ____ horn, exit cord via ____ root, and distribute to skeletal muscles of back (______) or body wall and limbs (________). |
|
Definition
| GSE fibers have cell bodies in ventral horn, exit cord via ventral root, and distribute to skeletal muscles of back (dorsal rami) or body wall and limbs (ventral rami). |
|
|
Term
GVE fibers (autonomic) have cell bodies (presynaptic) in ____ horn, exit via _____ root, and ultimately distribute to smooth muscle, cardiac muscle and glands
Those fibers going to smooth muscle and glands in the back or body wall and limbs will synapse in a __________ before the postsynaptic fiber distributes to the back or body wall and limbs via ____________. |
|
Definition
GVE fibers (autonomic) have cell bodies (presynaptic) in lateral horn, exit via ventral root, and ultimately distribute to smooth muscle, cardiac muscle and glands
Those fibers going to smooth muscle and glands in the back or body wall and limbs will synapse in a paravertebral ganglion before the postsynaptic fiber distributes to the back or body wall and limbs via dorsal or ventral rami. |
|
|
Term
| presynaptic fibers travel in _____ ramus communicans and postsynaptic fibers travel in _____ ramus communicans |
|
Definition
| presynaptic fibers travel in white ramus communicans and postsynaptic fibers travel in gray ramus communicans |
|
|
Term
| GVE fibers going to smooth muscle and glands of abdominal viscera will synapse in ___________ before reaching effector organ. |
|
Definition
|
|
Term
Cell bodies of GVA fibers lie in ______; their peripheral processes then distribute with ____ fibers.
Cell bodies of GSA fibers lie in _____ ; their peripheral processes distribute to the back or body wall and limbs through _________ |
|
Definition
Cell bodies of GVA fibers lie in DRG; their peripheral processes then distribute with GVE fibers.
Cell bodies of GSA fibers also lie in DRG ; their peripheral processes distribute to the back or body wall and limbs through dorsal and ventral rami |
|
|
Term
| Spinal nerves have ONLY the 4 (special or general) components? |
|
Definition
general
(special components are found only in certain cranial nerves). |
|
|
Term
| What functional components does the ventral ramus have? |
|
Definition
GSE to muscles of body wall
GSA to skin of body wall
GVE to smooth m. and glands of
body wall
GVA to blood vessels of body wall |
|
|
Term
| What functional components does the Dorsal root ganglion have? |
|
Definition
|
|
Term
| What is a strip of skin supplied by a single pair of spinal nerves? |
|
Definition
|
|
Term
What dermatome is at the level of the nipple?
umbilicus? |
|
Definition
|
|
Term
| Suppose a patient presents with paresthesia on the posterior aspect of the thigh and posterolateral aspect of the leg, where may the lesion/herniated disc be on the spinal cord? |
|
Definition
| S1 (between L5 and S1 after further testing) |
|
|
Term
| The spinal cord is supplied by ___________ (branches of the vertebral aa.) |
|
Definition
| 3 longitudinal spinal aa. (one anterior and two posterior) |
|
|
Term
| What artery course a long the spinal nerve roots and anastomose with the longitudinal spinal aa., thus supplementing the blood supply to the cord bc spinal aa are small/insufficient to supply the entire substance of the cord? |
|
Definition
|
|
Term
| Where the segmental medullary aa ultimately arise from? |
|
Definition
| either the vertebral aa. (in neck), intercostal aa. (in thorax), lumbar aa. (in abdomen) or lateral sacral aa. (in pelvis |
|
|
Term
What is the the largest of all the medullary segmental arteries, and is extremely important b/c it supplies the lumbosacral enlargement of the cord and may cause a person to be paraplegic if occluded?
This artery arises on the (right or left) side in ~ 65% of people, usually from a _____________ or ____________. |
|
Definition
Great Anterior Segmental Medullary Artery (of Adamkiewicz)
left
lower intercostal or upper lumbar a. |
|
|
Term
| What is the tough, fibrous outer layer (“hard mother”) of the spinal meninges? What is it also known as? |
|
Definition
|
|
Term
What is the delicate membrane resembling a spider-web of the spinal meninges?
What is the a vascular membrane that closely adheres to the spinal cord and follows all of its grooves (sulci) (“tender mother”) |
|
Definition
|
|
Term
| The pia and arachnoid are interconnected by __________, and together the 2 membranes consitute the_________. |
|
Definition
arachnoid trabeculae
leptomeninges |
|
|
Term
The pia mater extends laterally on either side as a toothed ligament (__________).
What are the 2 functions of this ligament? |
|
Definition
denticulate lig
This ligament helps to anchor the spinal cord in place (apex of each tooth is attached to the inner surface of the dura) and it provides a useful landmark for separating dorsal and ventral nerve roots |
|
|
Term
| The dural and arachnoid sacs end inferiorly at ____ vertebra |
|
Definition
|
|
Term
| _________________ exits the sacral hiatus and is attached to the dorsum of the coccyx |
|
Definition
| dural part of terminal filum |
|
|
Term
| The subarachnoid space (a real space) contains ______ (protective function for the CNS) and also have delicate _______ in this space. |
|
Definition
|
|
Term
| Is the subarachnoid space or subdural space a potential space. |
|
Definition
|
|
Term
| The epidural space (a real space that lies between the dura mater and periosteum lining the vertebral canal) contains what 2 things? |
|
Definition
| fat and internal vertebral venous plexus |
|
|
Term
The vertebral column is drained by the ___________.
The int. vertebral plexus is drained at each level by an _________ that (has a valve or valveless) |
|
Definition
vertebral venous plexuses (internal and external)
intervertebral vein
valveless (blood can flow in either direction) |
|
|
Term
| What is a negative possibility since the intervertebral veins communicate with the segmental veins of the trunk (intercostal, lumbar, and sacral veins)? |
|
Definition
| is possible for infectious material or cancer cells to spread from these regions of the trunk (eg, prostate CA) to the internal vertebral venous plexus. The cells may then invade the vertebrae or spread superiorly into the skull. |
|
|
Term
| Internal vertebral venous plexus communicates with the _______ inside the cranium through the foramen magnum (thus affording a route for spread of infection or cancer) |
|
Definition
|
|
Term
Where is a lumbar puncture/spinal anesthesia (hollow needle inserted into subarachnoid space) performed?
Where is epidural anesthesia performed? |
|
Definition
lumbar cistern, which lies between L2 and S2 vertebrae
epidural space |
|
|
Term
| What are the boundaries of the sub occipital triangle? |
|
Definition
| rectus capitis posterior major, obliquus capitis superior and obliquus capitis inferior muscles |
|
|
Term
| What is the roof and floor of the sub occipital triangle? |
|
Definition
The ROOF is the semispinalis capitis.
The FLOOR is the post. arch of the atlas and the post. atlantooccipital membrane |
|
|
Term
| What are the contents of the sub occipital triangle? |
|
Definition
vertebral a. (which enters the skull through the f. magnum to supply the brain)
the suboccipital n. (which supplies the suboccipital mm.)
the suboccipital venous plexus |
|
|
