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Flashcards in Blue Boxes: Back Deck (36)
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Vertebral Body Osteoporosis 

Common metabolic bone disease that is often detected during routine radiographic studies

-characterized by vertical striations in vertebral body

-can lead to continued loss of trabecular bone (bone becomes less white)

-If osteoporosis becomes se ver, can lead to excessive thoracic kyphosis 


What is a laminectomy?

Surgical excision of one or more spinous processes and adjacent supporting vertebral laminae 

Often performed to relieve pressure on the spinal cord or nerve roots caused by a tumor, herniated IV disc, or bony hypertrophy (excess growth) 


Dislocation of Cervical Vertebrae

-Cervical vertebrae are more likely to be dislocated due to more horizontally oriented articular facets

-However, large vertebral canal means less chance of damaging spinal cord


Jefferson Fracture

Fracture of both arches of the atlas

-Usually from a diving accident or large object falling onto the head

-Does not typically injure spinal cord (Larger vertebral foramen)


Hangman's Fracture

Fracture of the vertebral arch of the axis

-Results from hyperextension of the head on the neck (not whiplash)
-One of the most common cervical vertebrae injuries


Fracture of Odontoid Process

Due to horizontal blow to the head

 -Transverse ligament is stronger than the odontoid process.

-These breaks are typically harder to heal b/because of the lack of blood supply to the odontoid process (transverse ligament limits its blood supply)

-Can also results as a complication of ostopenia 


Lumbar Spinal Stenosis

Narrowing of the Lumbar Vertebral Foramen

-Lumbar spinal nerves increase in size as the vertebral column descends, but paradoxically, the IV foramina decrease in size

-Compression of one or more spinal nerve roots occupying the inferior vertebral canal

-Complication: If IV Disc protrusion occurs along with stenosis, further compromises vertebral canal

(along w/ Arthritic Proliferation and Ligamentous Degeneration)


Cervical Ribs

Developmental costal element of C7 becomes abnormally enlarged, which can become a supernumerary (extra) rib

-Can place pressure on structures that emerge from superior thoracic aperture (notablly brachial plexus and sublcavian artery), which can thoracic outlet syndrome 


Caudal Epidural Anesthesia

Anesthetic agents are injected into the fat of the sacral canal that surrounds the proximal portions of the sacral nerves

-accomplished via sacral hiatus or posterior sacral foramina



Painful bruisng or fracture of the coccyx (tailbone)

-hard to treat and pain relief is difficult

-dislocation common

-can happen as a result of difficult childbirth



Partial or complete incorporation of L5 into sacrum

-can produce painful symptoms



Separation of S1 from sacrum and fusion with L5 vertebra


Effect of Aging on Vertebrae

Birth to Age 5: lumbar vertebra grows 3x in height

Age 5-13: lumbar vertebra grows 50%  in height

Ages 13-25: Minimual longitiduinal growth until completion

Older Age: Overall decrease in bone density, causing changes in the shape of vertebral bodies (why there is slight height loss in aging)

-can see production of osteophytes (bony spurs) and osteoarthritis 


Spina Bifida Occulta

Vertebral lamina fail to fuse and close off the vertebral canal

 -Most common in L5-S1

-Possible to have tuft of hair over this area as well



Spina Bifida Cystica

One or more vertebral arches may fail to develop completely

-Associated with herniation of meninges (meningocele) or spinal cord (meningomyelocele)


Aging of Intervertebral Discs

Nuclei pulposi dehydrate and lose elastin and proteoglycans while gaining collagen, leading to IV discs becoming stiffer and more resistant to deformation

-Can lead to degenerative disc disease


Back Pain

Second most common reason to visit doctor (after cold)

Sources of Pain:

 1. Fibroskeletal structures: periosteum, ligaments, and anuli fibrosi of IV discs.

2. Meninges: coverings of the spinal cord.

3. Synovial joints: capsules of the zygapophysial joints.

4. Muscles: intrinsic muscles of the back.

5. Nervous tissue: spinal nerves or nerve roots exiting the IV foramina.


Herniation of Nucleus Pulposus

Protrusion of nucleus pulposis through the annular fibrosis

-Most common in L4/L5 and L5/S1

-Typically occurs posterolaterally where anterior and posterior longitudinal ligaments do not support the annular fibrosis



Pain radiating from lower back into buttock down the posterior or lateral aspect of thigh into leg 

-often caused by herniated lumbar IV disc that compresses L5 or S1 component of sciatic nerve


Zygapophysial Joints

If they are injured or develop osteophytes (osteoarthritis), the spinal nerves are often affected

-Pain along the distribution patterns of the dermatomes and spasm in the muscles derived from the associated myotomes

Myotome: consists of all muscles or parts of muscles receiving innervation from one spinal nerve



Overstretching of anterior longitudinal ligament (at front of vertebral body)

-most often in rear-end motor vehicle collisions


What do you do for a patient who has had a fracture of the vertebral column?

Keep them in hyperextension. Pull of the anterior longitudinal ligament.



Calcification of edges of the vertebral bodies

-Causes joint pain and stiffness



Separation of vertebral arch from vertebral body

-Fracture of the column of bones connecting the superior and inferior articular processes (pars interarticularis)



Anterior displacement of vertebral body on inferior vertebral segment


Rupture of Alar Ligament

Alar ligaments of Axis are weaker than transverse ligaments

-Can cause increase of approximately 30% in the range of movement to the contralateral side


Primary Curvature of Spine

Cervical Lordosis

Thoracic Kyphosis 

Lumbar Lordosis

Sacral Kyphosis


Excess Thoracic Kyphosis (Kyphosis)

Humpback of thoracic vertebrae


Excessive Lumbar Lordosis (Lordosis)

Swayback of lumbar vertebrae



Lateral curvature in spine (cervical, thoracic, or lumbar)