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Questions and Answers
What is the primary function of the vertebral bodies and intervertebral discs?
What is the primary function of the vertebral bodies and intervertebral discs?
Which structures make up the vertebral arch?
Which structures make up the vertebral arch?
What anatomical structures are contained within the vertebral canal?
What anatomical structures are contained within the vertebral canal?
Which process of the vertebra is located posteriorly in the midline?
Which process of the vertebra is located posteriorly in the midline?
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What do the superior and inferior articular processes do?
What do the superior and inferior articular processes do?
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What is the primary function of the annulus fibrosus in intervertebral discs?
What is the primary function of the annulus fibrosus in intervertebral discs?
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Which part of the intervertebral disc is primarily responsible for its resilience?
Which part of the intervertebral disc is primarily responsible for its resilience?
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Which type of joints form between the articular processes of the vertebrae?
Which type of joints form between the articular processes of the vertebrae?
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What role do ligaments play in the vertebral column?
What role do ligaments play in the vertebral column?
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Which ligaments are primarily associated with the stability of the vertebral column?
Which ligaments are primarily associated with the stability of the vertebral column?
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How many cervical spinal nerves are present in the human body?
How many cervical spinal nerves are present in the human body?
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Which thoracic spinal nerves correspond to lumbar segments L1 and L2?
Which thoracic spinal nerves correspond to lumbar segments L1 and L2?
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Where does the spinal cord typically end in adults?
Where does the spinal cord typically end in adults?
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Which statement regarding the emergence of spinal nerves is true?
Which statement regarding the emergence of spinal nerves is true?
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How many spinal nerves are associated with the coccygeal vertebrae?
How many spinal nerves are associated with the coccygeal vertebrae?
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What is the primary function of the vertebral column in supporting the body?
What is the primary function of the vertebral column in supporting the body?
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Which type of spinal curvature develops in the lumbar region as a child begins to sit upright?
Which type of spinal curvature develops in the lumbar region as a child begins to sit upright?
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Which structure serves to protect both the spinal cord and nerve roots?
Which structure serves to protect both the spinal cord and nerve roots?
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What is the correct sequence of spinal curvature development during early childhood?
What is the correct sequence of spinal curvature development during early childhood?
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Which cervical vertebrae are specifically known as the atlas and axis?
Which cervical vertebrae are specifically known as the atlas and axis?
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Which of the following correctly describes the primary curve of the vertebral column?
Which of the following correctly describes the primary curve of the vertebral column?
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What anatomical feature allows for the flexibility and mobility of the vertebral column?
What anatomical feature allows for the flexibility and mobility of the vertebral column?
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Which of the following is NOT associated with the spinal meninges?
Which of the following is NOT associated with the spinal meninges?
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What is the primary structural component that gives the ligamentum flavum its yellow color?
What is the primary structural component that gives the ligamentum flavum its yellow color?
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Which ligament connects the laminae of adjacent vertebrae within the vertebral column?
Which ligament connects the laminae of adjacent vertebrae within the vertebral column?
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Which structure do the vertebral arteries pass through before entering the cranial cavity?
Which structure do the vertebral arteries pass through before entering the cranial cavity?
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At what vertebral level does the spinal cord typically end in adults?
At what vertebral level does the spinal cord typically end in adults?
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What type of joint is the atlanto-occipital joint classified as?
What type of joint is the atlanto-occipital joint classified as?
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Which layer of the meninges directly covers the spinal cord?
Which layer of the meninges directly covers the spinal cord?
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Which ligament runs along the posterior surfaces of the vertebral bodies?
Which ligament runs along the posterior surfaces of the vertebral bodies?
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Which artery branches from the vertebral arteries and supplies the cerebellum?
Which artery branches from the vertebral arteries and supplies the cerebellum?
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What is a potential complication of performing a lumbar puncture in patients with raised intracranial pressure?
What is a potential complication of performing a lumbar puncture in patients with raised intracranial pressure?
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Which cervical vertebra is known as the axis?
Which cervical vertebra is known as the axis?
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What is the location of the cervical sympathetic trunk in relation to the carotid sheath?
What is the location of the cervical sympathetic trunk in relation to the carotid sheath?
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Which cervical ganglion is located at the level of C6 vertebra?
Which cervical ganglion is located at the level of C6 vertebra?
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Which of the following spinal arteries are primarily associated with the posterior spinal supply?
Which of the following spinal arteries are primarily associated with the posterior spinal supply?
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Which of the following is true regarding the anatomical relationship of cervical spinal nerves?
Which of the following is true regarding the anatomical relationship of cervical spinal nerves?
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What is the significance of the Artery of Adamkiewicz?
What is the significance of the Artery of Adamkiewicz?
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How many pairs of veins on each side contribute to the drainage of the spinal cord?
How many pairs of veins on each side contribute to the drainage of the spinal cord?
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Which cervical nerve gives off the Third occipital nerve?
Which cervical nerve gives off the Third occipital nerve?
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What forms the anterior spinal vein?
What forms the anterior spinal vein?
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Study Notes
Cervical Spine, Cord and Nerves, and Skull Osteology
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Learning Outcomes:
- Describe the structure of cervical vertebrae, focusing on atlas and axis.
- Describe the joints between vertebrae.
- Describe vertebral arteries and their course.
- Discuss cervical spinal nerves.
- Describe spinal meninges and relate anatomy to lumbar puncture procedure.
- Describe skull osteology in frontal, posterior, superior, and inferior views.
- Describe cranial fossae.
Vertebral Column
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Structure:
- Cervical curvature
- Thoracic curvature
- Lumbar curvature
- Sacral/coccygeal curvature
- 7 Cervical vertebrae (C1-C7)
- 12 Thoracic vertebrae (T1-T12)
- 5 Lumbar vertebrae (L1-L5)
- 5 Sacral vertebrae (fused) (S1-S5)
- 4 Coccygeal vertebrae (fused) (Co1-Co4)
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Functions:
- Protection of spinal cord and nerve roots.
- Supports head, shoulders, and thorax.
- Connects upper and lower body.
- Provides balance and weight distribution.
- Enables flexibility and mobility (flexion, extension, lateral flexion, rotation)
Curvatures of the Vertebral Column
- Kyphosis: The primary or first-formed curve in the vertebral column.
- Lordosis: Secondary curves that develop as the child sits upright (lumbar lordosis), and when the child holds its head up (cervical lordosis).
General Structure of Vertebrae
- Vertebral bodies: The weight-bearing components, increasing in size from cervical to lumbar.
- Vertebral arches: Protect the contents of the vertebral canal.
- Vertebral canal: Contains the spinal cord, meninges, blood vessels, and dorsal root ganglia.
Vertebral Arch
- Pedicle: Latin for "foot"; part of the vertebral arch.
- Lamina: Latin for "thin plate"; part of the vertebral arch.
- Spinous process: Projects posteriorly.
- Transverse process: Projects on each side.
Joints of the Vertebral Column
- Zygapophysial joints (Facet joints): Plane joints between articular processes.
- Intervertebral discs: Fibrocartilaginous joints between vertebral bodies; crucial for stability, flexibility, pressure regulation and acting as cushions.
Intervertebral Disc
- Annulus fibrosus: Outer zone with high tensile strength - connects adjacent vertebral bodies; fibrocartilage attached to vertebral bodies cartilage endplate.
- Nucleus pulposus: Inner zone, high resilience, gelatinous structure, 80-85% water.
Spinal Cord
- Continuation of the brain stem: It extends into the spinal canal.
- Foramen magnum: Where it begins, at the base of the skull.
- Ends at lower border: Of the first lumbar vertebra in adults and L4 in young children.
Meninges
- Pia Mater: Thin, delicate membrane covering the cord.
- Arachnoid Mater: Middle layer, web-like appearance.
- Dura Mater: Outermost layer, tough and fibrous.
- Subarachnoid space: Filled with Cerebrospinal Fluid (CSF).
- Epidural space: Filled with fat outside dura mater
Spinal Cord Segments and Spinal Nerves
- Cervical (8): Emerge above their vertebrae
- Thoracic (12): Emerge below their vertebrae
- Lumbar (5): Emerge below their vertebrae
- Sacral (5): Emerge below their vertebrae
- Coccygeal (1): Emerge below their vertebrae
Clinical Correlates
- Cervical Spine Injury: Avoid extending the cervical spine during airway management in trauma patients; could lead to severe spine injury
- Lumbar Tap (Puncture): Contraindicated in presence of raised intracranial pressure (ICP).
Arterial Supply
- Anterior spinal artery: Arises from vertebral arteries, descending down the spinal cord.
- Posterior spinal arteries: Branch off from other vessels.
- Segmental spinal arteries: Supply the vertebral column.
Venous Drainage
- Anterior and posterior spinal veins: Drain into the internal vertebral plexus in the extradural space.
Cervical Vertebrae
- Atlas (C1): Atypical vertebra with no body or spinous process
Cervical Spinal Nerves
- Numbered: 8, despite only 7 cervical vertebrae.
- Emergence: Through intervertebral foramina.
- C1: Emerges between skull and C1 vertebrae
- C8: Emerges below the C7 vertebra.
- All other nerves (except C1): Emerge below their relative vertebrae
- Emerges from intervertebral foramina
Cervical Plexus
- Nerves: Lesser occipital nerve, great auricular nerve, transverse cervical nerve, supraclavicular nerve, ansa cervicalis (superior and inferior roots).
- Distribution: Primarily to the head and neck
Brachial Plexus
- Nerves: Phrenic nerve, (to diaphragm), axillary nerve, suprascapular nerve...etc.
- Distribution: Primarily to upper limb(arm, shoulder), and related structures
Cervical Sympathetic Trunk
- Ganglia: Superior, middle, inferior cervical ganglia
- Function: Innervates structures in the head, neck and shoulders
Practical Questions
- Practical questions from the lecture, potentially available to be answered.
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Description
Test your knowledge on the anatomy of the cervical spine, including the atlas and axis vertebrae, spinal nerves, and their functions. Explore the structure of the skull from different views and understand the concept of cranial fossae. This quiz covers key learning outcomes related to the vertebral column and its protective role.
