How would you characterize cervical vertebrate?
- Small bodies
- Short transverse processes with a transverse forament
- Short, typically bifid spinous processes
- Triangular vertebral foramina
- More horizontal articular facets that face posterosuperiorly and inferoanteriorly and lack costal facets
What might cause a Jefferson fracture?
A blow to the head, or a falling object.
What is a Jefferson fracture?
Fracture of both arches of the Atlas
Why doesn't a Jefferson fracture typically damage the spinal cord?
Because the vertebral foramen of the cervical spine is large.
When might a Jefferson fracture (atypically) cause damage to the spinal cord?
In the event of damage to the Transverse ligaments (anterior transverse ligament and posterior transverse ligament)
What two places is the axis prone to fracture?
The Vertebral arch and the Odontoid process (dens)
What is a Hangman's Fracture a result of?
Fracture of vertebral arch: usually a result of hyperextension of the head on the neck
(not of the Head and Neck as in whiplash)
Why does the odontoid process break during a horizontal blow to the head, and not the transverse ligament?
Because the transverse ligament is stronger than the odontoid process.
Why won't the odontoid process heal if it breaks at the base?
Because the Transverse ligament will hold it away from its blood supply
How would you characterize thoracic vertebrate?
- Medium-sized, heart-shaped vertebral bodies
- Posterolaterally angulated transverse processes
- Long, inferiorly inclined spinous processes
- Circular vertebral foramina
- Articular facets that face anteroposteriorly
- Costal facets on the bodies and most transverse processes
What is Spina Bifida Occulta?
Where does this usually happen?
What is a common sign?
A developmental abnormality in which the Vertebral Lamina fail to fuse and close off the Vertebral Canal.
L5 and S1
Hair over the defect
Why might it require less force to dislocate the cervical vertebrae than other vertebrae?
Articulating Facets are more horizontal
What does it to mean to "Jump Facets?"
Displaced and locking facets (dislocation) in cervical region
Because of the relatively flat facets in the cervical region the vertebrae may dislocate without fracture and one superior facet may “jump” and become locked over the inferior facet
How do we number ribs relative to the thoracic vertebrae?
For any given numbered rib (say, the 3rd rib), the head of that rib articulates with the inferior costal facet of the vertebral segment one number higher (T2) and with the superior costal facet of the same number (T3).
In practice, the rib is named for the numbered vertebra below it.
What is spondylosis?
Degenerative joint disease which involves calcification of edges of the vertebral body.
What is spondylolysis?
Separation of the vertebral arch from the vertebral body (fracture without anterior displacement)
What is spondylolisthesis?
Anterior displacement of the vertebral body from the vertebral arch
-Can occur secondary to spondylolysis
How would you characterize lumbar vertebrae?
- Very large bodies
- Long and slender transverse processes
- Short and blunt spinous processes
- Triangular vertebral foramina
- Articular facets that face medio-laterally
What would one call a narrowed opening of the vertebral foramen?
Where is a lumbar puncture performed?
L3/L4 or L4/L5
Level of the illiac crests
Why do physicians perform lumbar punctures in the lumbar spine?
(Besides the name!)
Because the spinal cord stops superior to that point, and you can avoid injury to it.
What cavity does one pull CSF from in a lumbar puncture?
The Lumbar Cistern
Can also be subarachnoid space
You're perfoming a lumbar puncture and you hear a 'pop.' What structure did you just puncture?
The ligamentum flavum
What is Hemisacrilization?
Fusion of L5 into the sacrum. Can be partial or complete.
What is Lumbarization?
When S1 of the sacrum is separated from the sacrum, appearing to be L6. (Congenital defect)
What is the Lumbar Sacral Angle?
The angle formed between the lumbar and sacral regions of the vertebral column in the sagittal plane
What painful disease can follow coccygeal trauma?
Extreme thoracic kyphosis can give you what type of appearance?
Extreme lumbar lordosis can give you what type of appearance?
If you were to deliver anesthesia to a woman in labor, which opening would you inject it through?
Any type of caudal/epidural anesthesia