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How can you distinguish the cervical vertebrae from thoracic and lumbar vertebrae?
cervical vertebrae have transverse foramen!
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Which vertebrae have bifid spinous processes?
C2-C6
C1 and C7 do NOT have bifid spines (spinous processes)
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What is the spinous process referred to in C7?
Vertebra prominens
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What forms the intervertebral foramina? And what goes through these formina?
The superior and inferior vertebral notches...and they transmit spinal nerves and their accompanying vessels.
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What is unique about the atlas (C1)?
It has no vertebral body, no spinous process and it has a groove for the vertebral artery (C1 nerve)
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What is unique about the axis (C2)?
It is the strongest cervical vertebrae, it has an odontoid process (dens) that articulates with C1 where its vertebral body would be.
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The articulation of the atlas and axis is what joint?
The alanto-axial joint
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The articulation of the atlas (C1) and the occipital bone is referred to by:
The alanto-occipital joint
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Is the vertebral foramen larger or smaller in thoracic vertebrae?
smaller!
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The facets on thoracic vertebrae are referred to as what? and they articulate with what?
They are the superior, inferior and transverse costal facets and they articulate with costals (ribs)
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The spinous process of thoracic vertebrae is different from cervical vertebrae in what way?
The spinous process slopes most posteriorly (at a greater angle)
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What is the shape of the vertebral foramen in lumbar vertebrae?
triangular in shape
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The spinous processes of lumbar vertebrae are?
Short and Sturdy.
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The sacrum and coccyx are comprised of what?
fused vertebrae
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The sacral hiatus is formed how?
The failure of fusion of the fifth scaral lamina. it is located on the posterior wall of the sacral canal
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The primary curvature is comprised of what vertebrae?
The thoracic and sacral vertebrae (think infants)
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The secondary curvature is formed by what vertebrae?
The cervical and lumbar vertebrae (think 3-4 mo old raises head, and when it begins to walk, lumbar)
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Lordosis is condition which effects what curvature?
Secondary curvature exaggeration, effecting the lumbar vertebrae (think L for Lumbar)
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Kyphosis is a condition which effects what curvature?
Primary curvature exaggeration, effecting the thoracic vertebrae...leads to "hunchbacking"
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A side bend in the vertebral column is referred to as?
Scoliosis
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Scoliosis can be treated in what way? What is the origin of scoliosis?
Surgically or with braces. Thought to be congenital, idiopathic (we don't know) or neuromuscular (originating from another condition)
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Intervertebral discs are comprised of what parts?
- Outer portion - Anulus fibrosis
- Inner portion - nucleus pulposus
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The intervertebral disc is thicker in what part?
Anteriorly it is thicker
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When the Anulus fibrosus tears and the nucleus pulposus bluges out this is called what?
A prolapsed or herniated disc
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Herniated discs occur anteriorly or posteriorly?
posteriorly, because the intervertebral disc is thicker on the anterior surface.
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What ligament prevents hyperextension of the vertebral column?
The Anterior Longitudinal ligament
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What ligament prevents hyperflexion of the vertebral column?
The Posterior Longitudinal ligament
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C1-C6 is covered by what ligament?
Supraspinous ligament
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Flexion of the vertebral column is what motion?
Forward Bending
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Extension of the vertebral column is what motion?
Backward bending (think back extensions in the gym)
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The spinal cord goes from what to what?
From the foramen magnum to L2 (L1/L2) Conus medullaris
In infants it goes to L3 because your bones grow quick than your neural tissue
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The spinal cord is larger in what section(s) of the vertebral column?
Lumbar and cervical regions
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Tapering off of spinal cord is called?
Conus medullaris
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Gray matter contains what?
neural cell bodies that are not myelinated
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White matter consists of what?
myelinated axons!
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Spinal nerves exit the spinal cord through?
intervertebral foramina
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Anterior spinal nerves are referred to as?
Motor neurons (efferent)
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Posterior spinal nerves are referred to as?
Sensory nerves (afferent)
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We have 8 cervical spinal cord segments and 7 cervical vertebrae why?
Because cervical nerves leave superior to their vertebrae
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Thoracic and Lumbar vertebrae spinal nerves leave above or below the vertebrae?
below! unlike the cervical vertebrae
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The nerve that leaves above C1
C1?
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The nerve that leaves about C5?
C5
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The nerve that leaves below C5 is called?
C6.
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The nerve that leaves below T2?
T2
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The nerve that leaves below L1?
L1!
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The nerve that leaves below C7?
C8!!!
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The nerve that leaves above T1 is?
C8
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What spinal nerve leaves between C5/C6?
C6
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What spinal nerve leaves between T3 and T4?
T3
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Herniation of the disc between T1 and T2 will compress what nerve?
T1
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Herniation of the disc between L4/L5 compresses what nerve?
L5
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What are the purple and red parts of this picture?
The cauda equina
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Herniations occur in what direction?
Posteriorly and inferiorly
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Herniation between L5/S1 compresses what nerve?
S1 (posteriorly and inferiorly)
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What nerve leaves between T3/T4?
T3 (in thoracic vertebrae the neve is named by the vertebrae above it)
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What nerve leaves between T4/T5?
T4
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Joe has back pain and comes into your office. You diagnosis him as having a disc herniation between L3/L4. What nerve is being compressed?
L3
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What are three meninges coverings?
(deep) duramater > arachnoid > pia mater
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What are the projections of the piamater?
denticulate ligaments
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Pia mater is in close association with
the spinal cord
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denticulate ligaments function
provide stability for the spinal chord against motion in the vertebral column.
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What is the filum terminale?
delicate strand of fibrous tissue extends to coccyx, anchors inferior section spinal cord so it doesn't move.
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L2, S2, C2 describes what?
- Spinal cord ends L2
- Duramater ends at S2
- C2-
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Outside of duramater is what space?
Epidural Space
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Between the duramater and arachnoid mater is what space?
Subdural space
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Between arachnoid and piamater is what space?
Subarachnoid space
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The subarachnoid space holds what?
CSF
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What is the lumbar cistern?
enlargement of the subarachnoid space between the conus medullaris of spinal cord (about L2) and inferior end of subarachnoid space and dura mater
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Where are spinal taps done? (lumbar puncture)
Enter through lumbar cistern, L3/L4 ..No spinal cord in the way, cauda equina moves out of the way, and CSF collected
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Where do you do a spinal tap on an infant?
Spinal cord lower, so do L5+- one. Cause spinal cord is at L3.
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A patient presents to you needing a lumbar puncture. To collect CSF the needle is inserted between what meningeal layer?
Arachnoid mater and Pia mater
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What artery supplies the anterior portion of the spinal cord and arises from the vertebral arteries?
Anterior spinal artery
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What artery supplies the posterior portion of the spinal cord?
Posterior spinal artery.
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What is the blue blood vessel show in the picture and why is it so clinically relevant?
Internal venous plexus which is in close association with the spinal cord, common area for metastasis for cancer....cancer can go up the vertebral column to the brain
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