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288 Cards in this Set
- Front
- Back
how many vertebrae are in the vertebral column?
|
33
|
|
how many/what types of vertebrae are in the vertebral column?
|
cervical-7
thoracic- 12 lumbar-5 fused sacral-5 fused coccygeal vertebrae-4 |
|
what are the main funcs of the vertebral column?
|
-protects spinal cord
-supports weight of head and trunk -allows mvmnt of rib cage for respiration by articulating w/ the ribs |
|
where are the primary curvatures in the spine?
|
thoracic and sacral regions
|
|
when do the primary curvatures of the spine develop?
|
embryonic and fetal periods
|
|
where are the secondary curvatures of the spine?
|
cervical and lumbar regions
|
|
when do the secondary curvatures of the spine develop?
|
after birth and during infancy
|
|
what are some categories of abnormal curvature of the vertebral column?
|
kyphosis
lordosis scoliosis |
|
describe kyphosis:
|
hunchback or humpback
-abnormally increased thoracic curvature resulting from osteoperosis |
|
describe lordosis:
|
-swayback or saddleback
-abnormally increased lumbar curvature resulting from trunk muscular weakness or osteomalacia |
|
describe scoliosis:
|
-condition of lateral deviation
-results from: 1) unequal growth of the vertebral column OR 2) pathologic erosion of vertebral bodies OR 3) asymmetric paralysis or weakness of vertebral muscles |
|
what are common features for a typical vertebrae?
|
body
vertebral arch processes for muscular and articular attachments |
|
describe the body of a typical vertebrae:
|
-short cylinder
-separated and also bound by intervertebral disks -has costal facets or processes of the thoracic vertebrae anterior to the pedicles, which articulate with the heads of the corresponding and subjacent (just below) ribs |
|
what is the func of the vertebrae body?
|
supports weight
|
|
what type of joints is the body of the vertebrae part of?
|
cartilaginous joints
|
|
what is spondylolisthesis?
|
-forward displacement of vertebrae on the one below
|
|
where does spondylolisthesis usually occur?
|
fifth lumbar over the body of the sacrum
|
|
why does spondylolisthesis usually occur?
|
b/c of a developmental defect in pedicle of the migrating vertebrae
|
|
what is the result of spondylolisthesis?
|
the spinal nerve roots may be pressed on, causing low bachache, sciatica, or a shortened trunk
|
|
what is sciatica?
|
pain that radiates along the path of the sciatic nerve: back --> buttock --> leg
|
|
what are some other names for spondylitis?
|
ankylosing or rheumatoid spondylitis
|
|
what is spondylitis?
|
-inflammation of the joints b/w the vertebrae and sacroiliac joints
-form of chronic inflammatory arthritis |
|
what's the most common form of chronic inflammatory arthritis?
|
rheumatoid arthritis
|
|
what are the symptoms of spondylitis?
|
pain
stiffness (the pain and stiffness may progress to the hip, shoulder, knee and hand joints) swelling limited motion in the lower back -affected vertebrae fuse or grow together --> rigid/bamboo spine -poor posture -deformities |
|
what's another name for Scheuermann's disease?
|
kyphosis (juvenile kyphosis or vertebral epiphysitis)
|
|
what is Scheuermann's disease?
|
epiphysial osteochondrosis of vertebral bodies
-usually in thoracic vertebrae |
|
how does scheuermann's disease happen?
|
when front parts of the thoracic vertebrae don't grow as fast as the back parts --> form wedge shape --> kyphosis
|
|
what are the symptoms of Scheuermann's disease?
|
thoracic kyphosis
intermittent back pain tight hamstrings |
|
what's Pott's disease?
|
tuberculosis of the spine or vertebrae from softening and collapse of the vertebrae --> kyphosis
|
|
what's Pott's disease also called?
|
tuberculosis spondylitis
|
|
where is Pott's disease commonly localized?
|
thoracic part of spine
|
|
what are symptoms of Pott's disease?
|
paravertebral swelling
abscess paraplegia back pain fever cough sweats anorexia weight loss |
|
what can paravertebral swelling and abscess in Pott's disease result in?
|
spinal cord compression
|
|
what makes up the vertebral arch?
|
paired pedicles laterally
paired laminae posteriorly |
|
what forms the vertebral foramen?
|
vertebral arch and vertebral body
|
|
what is the main func of the vertebral arch?
|
protects spinal cord and associated strucs
|
|
what's spina bifida?
|
developmental anomaly char by defective closure of the vertebral arch
|
|
what causes spina bifida?
|
maternal folic acid deficiency
|
|
what's spina bifida occulta?
|
failure of the vertebral arch to fuse (bony defect only with a small tuft of hair over the affected area of skin)
|
|
what's meningocele?
|
protrusion of meninges thru unfused arch of the vertebra (spina bifida cystica)
|
|
what's meningomyelocele?
|
protrusion of spinal cord and the meninges
|
|
what's myeloschisis/rachischisis?
|
cleft spinal cord due to failure of neural folds to close
|
|
what's syringomyelocele?
|
protrusion of meninges and pathologic tubular cavity in the spinal cord or brain
|
|
what's lipomeningocele?
|
protrusion of the meninges with an overlying lipoma (lipomatous mass) in spina bifida
|
|
what's myelocele?
|
protrusion of substance of spinal cord in spina bifida
|
|
how should a baby w/ spina bifida be delivered?
|
C-section b/c passage thru the narrow birth canal can compress the meningocele and damage the spinal cord
|
|
where is the spinous process of the vertebral arch?
|
at junc of 2 laminae of vertebral arch
|
|
how does spinous process vary in different parts of spine?
|
cervical-bifid
thoracic- spine-like lumbar-oblong |
|
where is the transverse process of the vertebral arch?
|
at the junc of the pedicle and the lamina
|
|
what are some cool facts about the transverse process?
|
in thoracic region- articulate w/ tubercles of ribs 1-10
in cervical region- have transverse foramina |
|
what are the articular processes of the vertebral arch?
|
2 superior and 2 inferior projections from the junc of lamina and pedicles
|
|
what are mamillary processes?
|
tubercles on the superior articular processes of the lumbar vertebrae
|
|
where are accessory processes?
|
project backward from the transverse process base and lateral and inferior to the mamillary process of lumbar vertebrae
|
|
what is the vertebral foramina's funcs?
|
-form vertebral canal
-transmit spinal cord w/ its meningeal coverings, nerve roots, and associated vessels |
|
where are the intervertebral foramina?
|
b/w inferior and superior surfaces of pedicles of adjacent vertebrae
|
|
what's the purpose of the intervertebral foramina?
|
transmits spinal nerves and accompanying vessels as they exit vertebral canal
|
|
where are transverse foramina?
|
in transverse processes of cervical vertebrae
|
|
what's the func of transverse foramina?
|
transmit vertebral artery (except thru C7), vertebral veins and autonomic nerves
|
|
what's Klippel-Feil syndrome? symptoms?
|
congenital defect manifested as a short, stiff neck
-low hairline -limited neck mvmnt |
|
how do you get Klippel-Feil syndrome?
|
-reduction in the number of cervical vertebrae
-extensive fusion of cervical vertebrae |
|
how do you get a whiplash injury of the neck?
|
force that drives trunk forward while head lags behind
|
|
what happens during whiplash injury of the neck?
|
mvmnt of head and upper part of neck hyperextend and lower part of neck hyperflexes rapidly
|
|
where does the whiplash injury normally occur?
|
junctuion of C4-C5
C1-C4 = lash C5-C7= whip handle |
|
what are the symptoms of whiplash?
|
neck pain
stiff neck headache |
|
what's the tx of whiplash?
|
supporting head and neck w/ cervical collar that's higher in back than in the front - the collar keeps the cervical vertebral column in a flexed position
|
|
where are intervertebral disks?
|
from axis to sacrum
**NO DISK B/W ATLAS AND AXIS |
|
what makes up the intervertebral disk?
|
nucleus pulposus = central mucoid substance
annulus fibrosus = fibrocartilaginous lamina |
|
how much of vertebral column length does intervertebral disk make up?
|
1/4
|
|
what's the purpose of intervertebral disks?
|
-allows mvmnts b/w vertebrae
-serves as shock absorber |
|
do intervertebral disks get blood?
|
avascular except for peripheries, which are supplied from adjacent blood vessels
|
|
what does the nucleus pulposus originate from?
|
embryonic notochord
|
|
what's the nucleus pulposus made of?
|
reticular and collagenous fibers embedded in mucoid material
|
|
what's the func of nucleus pulposus?
|
shock absorber by equalizing pressure
|
|
how can nucleus pulposus malfunction?
|
may herniate or protrude thru annulus fibrosus --> impinge on spinal nerve root
|
|
what's annulus fibrosus made of?
|
concentric layers of fibrous tissue and fibrocartilage
|
|
what are the funcs of the annulus fibrosus?
|
binds vertebral column together
retains nucleus pulposus permits limited amt of mvmnt shock absorber |
|
what's a herniated/slipped disk?
|
protrusion of nucleus pulposus thru annulus fibrosus of intervertebral disk into intervertebral foramen or into vertebral canal, compressing spinal nerve root
|
|
where does herniated disk commonly occur?
|
posterolaterally where annulus fibrosus is not reinforced by posterior longitudinal ligament
*frequently in lumbar region |
|
what's sciatica commonly caused by?
|
herniation of lower lumbar intervertebral disk
|
|
what's lumbar spondylosis?
|
degenerative joint disease affecting lumbar vertebrae and intervertebral disks
|
|
what does lumbar spondylosis cause/symptoms?
|
pain and stiffness
sometimes w/ sciatic radiation from nerve root pressure by associated protruding disks or osteophytes (bony outgrowths) |
|
what's the func of atlas : 1st cervical vertebrae?
|
supports skull
|
|
describe atlas:
|
widest of cervical vertebrae
has no body has no spine has anterior/posterior arches paired transverse processes |
|
what joint does atlas form?
|
atlanto-occipital joint : w/ occipital condyles of skull
atlantoaxial joint : w/ axis |
|
describe axis (2nd cervical vertebrae)?
|
smallest transverse process
has dens: odontoid process |
|
what does dens/odontoid process of axis do?
|
projects superiorly from body of axis and articulates w/ anterior arch of atlas, forming pivot around which atlas rotates
|
|
what is axis supported by?
|
cruciform, apical and alar ligaments
tectorial membrane |
|
what's hangman's fracture?
|
fracture of pedicles of axis
|
|
how can hangman's fracture happen?
|
hanging or automobile accidents
|
|
what is damaged in hangman's fracture?
|
cruciform ligament is torn
spinal cord is crushed --> death |
|
describe C3-C6:
|
typical cervical vertebrae
have short spinous processes transverse processes w/ anterior and posterior tubercles transverse foramina for vertebral vessels |
|
what is C7 called? why?
|
vertebra prominens b/c it has long spinous process that's nearly horizontal, ends in single tubercle (not bifid) and forms visible protrusion
|
|
what is C7 an attachment site for?
|
ligamentum nuchae
supraspinous ligaments lots of back muscles |
|
describe thoracic vertebrae:
|
have costal facets
have transverse processes typical thoracic vertebrae: T2-T8 |
|
what does superior costal facet on thoracic vertebrae body articulate w/?
|
head of corresponding rib
|
|
what does inferior costal facet on thoracic vertebrae body articulate w/?
|
rib just below it
|
|
what does transverse process of thoracic vertebrae articulate w/?
|
tubercle of corresponding rib
|
|
what are char of lumbar vertebrae?
|
large bodies
sturdy laminae no costal facets strong, massive transverse process mamillary and accessory processes |
|
what has the largest body of the vertebrae?
|
L5
|
|
describe sacrum:
|
large, triangular, wedge-shaped bone
made of five fused sacral vertebrae four pairs of foramina forms posterior part of pelvis |
|
what is purpose of sacral foramina?
|
exit of ventral and dorsal primary rami of 1st 4 sacral nerves
|
|
what are the sacrum parts?
|
promontory
ala median sacral crest sacral hiatus sacral cornu or horn |
|
what's the promontory?
|
prominent anterior edge of 1st sacral vertebrae
|
|
what's ala?
|
superior and lateral part of sacrum
formed by fused transverse processes and fused costal processes of 1st sacral vertebrae |
|
what's median sacral crest formed by?
|
fused spinous processes
|
|
what's sacral hiatus formed by?
|
failure of laminae of vertebrae S5 to fuse
|
|
where do you give caudal/extradural anaesthesia?
|
sacral hiatus
|
|
what's sacral cornu/horn formed by?
|
pedicles of 5th sacral vertebrae
|
|
what's the coccyx?
|
wedge-shaped bone formed by union of 4 coccygeal vertebrae
|
|
what att to coccyx?
|
coccygeus and levator ani muscles
|
|
where does anterior longitudinal ligament run?
|
from skull (occipital bone) to sacrum on anterior surface of vertebral bodies and intervertebral disks
|
|
where is ALL widest/narrowest?
|
narrowest at upper end
widens as it descends |
|
what's func of anterior longitudinal ligament?
|
maintains joint stability
limits vertebral column extension supports annulus fibrosus anteriorly resists gravitational pull |
|
how does posterior longitudinal ligament connect to spine?
|
posteriorly
|
|
where is PLL widest/narrowest?
|
narrows as it descends
|
|
what are the funcs of PLL?
|
-interconnects vertebral bodies and intervertebral discs posteriorly
-supports posterior aspect of vertebral bodies and annulus fibrosus -limits flexion of vertebral column -resists gravitational pull |
|
where is the posterior longitudinal ligament in relation to the spinal cord?
|
anterior to the spinal cord w/i vertebral canal
|
|
what does ligamentum flavum conn?
|
laminae of 2 adjacent vertebrae
|
|
what are the funcs of ligamentum flavum?
|
-maintains upright posture
-forms posterior wall of vertebral canal b/w vertebrae |
|
what normal procedure can pierce ligamentum flavum?
|
lumbar/spinal puncture
|
|
what's the ligamentum nuchae?
|
triangular shaped median fibrous septum b/w muscles on 2 sides of posterior part of neck
|
|
what forms ligamentum nuchae? where is it?
|
thickened supraspinous ligaments that extend from vertebra C7 to external occipital protuberance and crest
|
|
what is ligamentum nuchae attached to?
|
-posterior tubercle of atlas
-spinous processes of other cervical vertebrae -external occipital protuberance C7 |
|
describe the vertebral venous system:
|
valveless plexiform of veins
forms interconnecting channels |
|
what veins are in the epidural space?
|
internal vertebral venous plexus
|
|
which veins are thought to be the route of early metastasis of carcinoma?
|
internal vertebral venous plexus
|
|
where is the epidural space?
|
in b/w wall of vertebral canal and dura mater
|
|
where is the external vertebral venous plexus?
|
ant- in front of vertebral column
post- lies on vertebral arch |
|
where does the vertebral vein come from?
|
venous plexuses around foramen magnum and in suboccipital region
|
|
where does the vertebral vein run?
|
w/ vertebral artery thru transverse foramina of C6-C1
|
|
what vein does vertebral v empty into?
|
brachiocephalic vein
|
|
what vein comm w/ the cranial dural sinuses?
|
internal vertebral venous plexus
|
|
what's the significance of the triangle of auscultation?
|
site where breathing sounds can be heard most clearly w/ stethoscope
|
|
what's triangle of auscultation bounded by?
|
upper- latissimus dorsi
lateral-trapezius medial-scapula floor-rhomboid major |
|
what's the sig of lumbar triangle of Petit?
|
site of an abdominal hernia
|
|
what's the lumbar triangle of Petit bounded by?
|
iliac crest, latissimus dorsi, post free border of external oblique abdominal muscle
floor- internal oblique abdominal muscle |
|
what's the sig of thoracolumbar/lumbodorsal fascia?
|
invests deep muscles of back
|
|
what does thoracolumbar/lumbodorsal fascia att to?
|
ant- vertebral transverse process
post- vertebral spinous process |
|
what nerve does the occipital artery run with?
|
greater occipital nerve: C2
|
|
what a does occipital a come from?
|
external carotid artery
|
|
what does the occipital a supply?
|
scalp in occipital region
|
|
what a does occipital a anastamose w/?
|
superficial - transverse cervical a
deep- deep cervical a (from costocervical trunk) |
|
what a does the transverse cervical a come from?
|
thyrocervical trunk of subclavian a
|
|
what n does transverse cervical a run w/?
|
superficial descending- spinal accessory n
deep- dorsal scapular n |
|
what's the transverse cervical a called when it branches?
|
superficial- superficial cervical a
deep- dorsal scapular/descending scapular a |
|
what n supplies trapezius?
|
spinal accessory and C3-C4
|
|
what n supplies levator scapulae?
|
dorsal scapular n and C4-C5
|
|
what n supplies rhomboid minor?
|
dorsal scapular n: C5
|
|
what n supplies rhomboid major?
|
dorsal scapular n: C5
|
|
what n supplies latissimus dorsi?
|
thoracodorsal n
|
|
what n supplies serratus posterior-superior?
|
intercostal n: T1-T4
|
|
what n supplies serratus posterior- inferior?
|
intercostal n: T9 -T12
|
|
what muscles does accessory n supply?
|
sternocleidomastoid
trapezius |
|
what does dorsal scapular n originate from?
|
ventral primary rami of C5
|
|
what a does the dorsal scapular n run w/?
|
deep branch of transverse cervical a
|
|
what muscles does dorsal scapular n supply?
|
rhomboid major and minor
levator scapulae muscles |
|
what action does trapezius do?
|
adducts, rotates, elevates and depresses scapula
|
|
what action does levator scapulae do?
|
elevates scapula
rotates glenoid cavity |
|
what action does rhomboid minor do?
|
adducts scapula
|
|
what action does rhomboid major do?
|
adducts scapula
|
|
what action does rhomboid major do?
|
adducts scapula
|
|
what action does latissimus dorsi do?
|
adducts, extends, and rotates arm medially
depresses scapula |
|
what action does serratus posterior- superior do?
|
elevates ribs
|
|
what action does serratus posterior-inferior do?
|
depresses ribs
|
|
what's the origin of trapezius?
|
external occipital protuberance
superior nuchal line ligamentum nuchae spines of C7-T12 |
|
where does the dorsal scapular n come from?
|
ventral primary ramus of C5
|
|
what's the origin of the greater occipital n?
|
medial branch of dorsal primary ramus: C2
|
|
what does the greater occipital n innervate?
|
semispinalis capitis
cutaneous innerv in occipital region |
|
what does the least occipital nerve come from?
|
dorsal primary ramus: C3
|
|
what does least occipital n innerv?
|
cutaneous innerv in occipital region
|
|
where does the lesser occipital n originate from?
|
ventral primary ramus: C2
|
|
what are the deep back muscles? from outside to in
|
1) splenius capitis
splenius cervicis 2) erector spinae (sacrospinalis) 3) semispinalis multifidus rotators |
|
what muscles are of superficial layer: spinotransverse group?
|
splenius capitis
splenius cervicis |
|
what innerv splenius capitis and splenius cervicis?
|
dorsal primary rami of middle and lower cervical spinal nerves
|
|
what is the action of splenius capitis and splenius cervicis?
|
extend, rotate, and laterally flex head and neck
|
|
what muscles make up the intermediate layer: sacrospinalis?
|
erector spinae (sacrospinalis): divided up into 3 columns
|
|
what are the 3 columns of erector spinae?
|
iliocostalis (lateral)
longissimus (intermediate) spinalis (medial) |
|
what is the erector spinae innervated by?
|
dorsal primary rami of spinal nerves
|
|
what's the func of erector spinae?
|
extend, rotate, laterally flex vertebral column and head
|
|
what muscles make up deep layer: transversospinalis grp of back?
|
semispinalis (capitis, cervicis and thoracis)
multifidus rotators |
|
what innerv transversospinalis grp?
|
dorsal primary rami of spinal nerves
|
|
what's the func of transversospinalis grp?
|
extend and rotate head, neck and trunk
|
|
what are segmental muscles of back inerv by?
|
dorsal primary rami of spinal nerves
|
|
what muscles make up segmental muscles?
|
interspinales
intertransversarii levatores costarum (longus and brevis) |
|
what is the suboccipital triangle bounded by?
|
medially- rectus capitis posterior major
laterally- obliquus capitis superior inferiorly- obliquus capitis inferior |
|
what's the roof and floor of the suboccipital triangle?
|
roof-semispinalis capitis and longissimus capitis
floor- posterior arch of atlas and posterior atlanto-occipital membrane |
|
what n or a run in suboccipital triangle?
|
vertebral a
suboccipital n |
|
where does the suboccipital n come from?
|
dorsal ramus of C1
|
|
what does the suboccipital n supply?
|
muscles of suboccipital triangle and semispinalis capitis
|
|
is suboccipital n sensory or motor?
|
motor
|
|
what n supplies rectus capitis posterior major?
|
suboccipital
|
|
what n supplies rectus capitis posterior minor?
|
suboccipital
|
|
what n supplies obliquus capitis superior?
|
suboccipital
|
|
what n supplies obliquus capitis inferior?
|
suboccipital
|
|
what's the action of rectus capitis posterior major?
|
extends, rotates, and flexes head laterally
|
|
what's action of rectus capitis posterior minor?
|
extends and flexes head laterally
|
|
what's action of obliquus capitis superior?
|
extends, rotates and flexes head laterally
|
|
what's action of obliquus capitis inferior?
|
extends and rotates head laterally
|
|
what a does vertebral a come from?
|
subclavian a
|
|
how does vertebral a get into cranial cavity?
|
ascends thru transverse foramina of upper six cervical vertebrae
pierces dura mater to enter vertebral canal goes through foramen magnum |
|
what's the origin of the vertebral veins?
|
formed in suboccipital triangle by union of tributaries from venous plexus around foramen magnum
|
|
what vein does the vertebral v empty into?
|
brachiocephalic v
|
|
do vertebral vv pass thru foramen magnum?
|
no
|
|
what type of joint is the atlanto-occipital joint?
|
condylar synovial joint b/w atlas and occipital condyles
|
|
what action is atlanto-occipital joint involved in?
|
flexion, extension, and lateral flexion of the head
|
|
what type of joint is the atlantoaxial joint?
|
synovial joints made of 2 lateral plane joints and 1 median pivot joint
|
|
where are the joints of the atlantoaxial?
|
plane: b/w articular facets of atlas and axis
pivot: b/w dens of axis and anterior arch of atlas |
|
what action is atlantoaxial joint involved in?
|
rotation of atlas and head
|
|
how does atlantoaxial dislocation (subluxation) happen?
|
-after rupture of the cruciform ligament caused by trauma
-rheumatoid arthritis -no dens (congenital) -fractured dens direct trauma from traffic accident |
|
what damage can atlantoaxial dislocation (subluxation) cause?
|
may injure spinal cord and medulla
|
|
what are symptoms of atlantoaxial dislocation (subluxation)?
|
pain in cervical area
pain in back of nec painful restriction of mobility |
|
what are the main components of the occipitoaxial ligament?
|
cruciform ligament
apical ligament alar ligament tectorial membrane |
|
what are the parts of the cruciform ligament?
|
transverse ligament
longitudinal ligament |
|
describe transverse ligament of cruciform ligament:
|
runs b/w lateral masses of atlas, arching over dens of axis
|
|
describe longitudinal ligament of cruciform ligament:
|
extends from dens of axis to anterior part of foramen magnum and to body of axis
|
|
describe apical ligament:
|
extends from dens apex to anterior part of foramen magnum
|
|
describe alar ligament:
|
extends from dens apex to tubercle on medial side of occipital condyle
|
|
describe tectorial membrane:
|
-upward extension of PLL from axis body to basilar part of occipital bone anterior to foramen magnum
-covers posterior surface of dens and apical, alar, and cruciform ligaments |
|
how much of vertebral canal does spinal cord occupy?
|
upper 2/3
|
|
what envelops spinal cord?
|
3 meninges
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where is gray matter in the spinal cord? brain?
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sc- interior
brain- exterior |
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where is white matter in spinal cord? brain?
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sc-exterior
brain-interior |
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how does spinal cord end?
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@ conus medullaris
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where does spinal cord end?
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L2 vertebrae
intervertebral disk b/w L1-L2 |
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what's the spinal cord's rate of growth in comparison to bony vertebral column during fetal development?
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sc grows slower
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where does spinal cord end in adult? newborn?
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a-L2
nb- L3 |
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what does spinal cord receive blood from?
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anterior spinal a
2 posterior spinal aa branches of vertebral, cervical and posterior intercostal and lumbar aa |
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what's tethered cord syndrome?
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congenital anomaly from defective closure of neural tube
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what are signs of tethered cord syndrome?
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abnormally low conus medullaris, which is tethered by a short thickened filum terminale
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what are the symptoms of tethered cord syndrome?
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progressive neurologic defects in legs and feet
scoliosis |
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what's the Arnold-Chiari (Chiari) deformity?
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congenital cerebellomedullary malformation in which cerebellum and medulla oblongata protrude down into vertebral canal thru foramen magnum
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how can spinal cord ischemia happen?
what the hell? |
blood supply to spinal cord isn't much to begin w/
-ant and post spinal aa are of small and variable diameter and reinforcing segmental aa vary in number and size |
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what causes spinal cord ischemia?
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aortic disease and surgery
regional anaesthesia pain block procedures |
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how many pairs of spinal nerves are there? how many of ea?
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31 pairs!
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal |
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how are the spinal nerves formed?
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union of ventral root and dorsal root in intervertebral foramen
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what rami are the spinal nerves divided into?
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dorsal primary rami
ventral primary rami |
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what do the dorsal primary rami innervate?
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skin and deep muscles of back
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what does ventral primary rami form?
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C1-C4 plexus
cervical plexus C5-T1 plexus brachial plexus L1-L4 plexus lumbar plexus L4-S4 plexus sacral plexus intercostal (T1-T11) nerves subcostal (T12) nerves |
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how is the spinal n connected w/ the sympathetic chain ganglia?
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rami communicantes
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what type of nerves are spinal n?
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mixed
GSA GSE GVA GVE |
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what type of nerves are in dorsal root ganglion?
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sensory (GSA and GVA) fibers w/ cell bodies
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what type of nerves are in anterior horn of spinal cord?
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motor (GSE) fibers w/ cell bodies
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what type of nerves are in the lateral horn of the spinal cord?
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preganglionic symp (GVE) fibers
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what type of fibers in the intermediolateral cell column of the spinal cord segments b/w S2 and S4?
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pregang parasymp: GVE fibers
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how do the GVE fibers leave the sacral nerves?
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via the pelvic splanchnic nerves
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where does herpes zoster (shingles) remain latent?
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dorsal root ganglia of spinal nerves
sensory ganglia of cranial nerves |
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what cond is herpes zoster commonly ass w/?
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spina bifida
short neck obstructive hydrocephalus |
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what does multiple sclerosis do?
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causes myelin destruction in spinal cord and brain --> sensory disorders and muscle weakness
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what can cause MS?
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autoimmune disease b/c immune system (lymphocyte) attacks myelin around CNS axons
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what's the innermost meningeal layer?
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pia mater
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how close is pia mater to spinal cord?
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can't be dissected from it
enmeshes blood vessels on surfaces of spinal cord |
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what are denticulate ligaments part of?
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pia mater
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where are the denticulate ligaments?
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lateral extensions of pia mater
b/w dorsal and ventral roots of spinal nerves and filum terminale |
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describe arachnoid mater:
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filmy, transparent, spidery layer connected to pia mater by web-like strucs
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what is the subarachnoid space?
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space b/w arachnoid layer and pia mater
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where is CSF?
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subarachnoid space
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how far does subarachnoid space extend to?
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S2
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what's dura mater?
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tough, fibrous outermost layer of meninges
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where's subdural space?
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b/w arachnoid and dura
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what's in the epidural space?
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internal vertebral venous plexus
epidural fat |
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what nerves does a caudal anaesthesia block?
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spinal nerves in epidural space
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where is the caudal anaesthesia injected?
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sacral hiatus
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what is caudal anaesthesia used for?
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surgery on rectum, anus, genitals, urinary tract, child birth
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where does the anaesthesia go in a saddle block?
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dural sac
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what regions does saddle block affect?
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butt
perineum medial parts of thighs |
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where does a lumbar puncture penetrate?
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subarachnoid space
b/w L3 and L4 or b/w L4 and L5 |
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what forms cauda equina?
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great lash of dorsal and ventral roots of lumbar and sacral spinal nerves surrounding filum terminale
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where is the cauda equina?
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in subarachnoid space below level of conus medullaris
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is cauda equina damaged during spinal tap?
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no
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what's the purpose of the denticulate ligaments?
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holds spinal cord in position w/i subarachnoid space
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what layers does denticulate ligament cross?
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from pia through arachnoid to dura mater
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what's the filum terminale?
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prolongation of pia mater from conus medullaris at L2
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what level does filum terminale end at?
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S2
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what does filum terminale att to at its end?
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att to apex of dural sac
then dura continues downward as filum terminale externum, att to dorsum of coccyx |
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what layers is CSF b/w?
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arachnoid and pia mater
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what forms CSF?
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vascular choroid plexuses in ventricles of brain
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what's path of CSF?
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circulates thru ventricles
enters subarachnoid space filters into venous system thru arachnoid villi projecting into dural venous sinuses.. esp superior sagittal sinus |
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what's a dermatome?
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area of skin innervated by sensory fibers from certain spinal nerve or segment of spinal cord
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what's a myotome?
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grp of muscles innerv by motor fibers derived from single spinal nerve segment
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what's a sclerotome?
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area of bone innervated from single spinal segment
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what's diff b/w axial skeleton and appendicular skeleton?
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axial- long axis of body, skull, vertebral column and bony thorax
appendicular- pectoral and pelvic girdles, long bones of limbs |
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what a does the vertebral a come from?
*vertebral a ASCENDS up transverse foramina |
subclavian a
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what does internal vertebral venous plexus comm w/?
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superiorly- cranial dural sinuses
inferiorly- pelvic veins and both azygos and caval systems in thoracic and abdominal regions |
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where's the external vertebral venous plexus located?
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in front of the vertebral column and on the vertebral arch
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what does the external vertebral venous plexus comm w/?
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internal vertebral venous plexus
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what are the parts of the accessory n?
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cranial part- joins vagus
spinal part- supplies SCM and trapezius |
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what muscles does accessory n supply?
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SCM
trapezius |
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what muscles does suboccipital n supply?
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muscles of suboccipital region
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