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Questions and Answers
How many cervical spinal nerves are present despite there being only seven cervical vertebrae?
How many cervical spinal nerves are present despite there being only seven cervical vertebrae?
Which lumbar spinal nerve corresponds to the thoracic vertebrae level T12?
Which lumbar spinal nerve corresponds to the thoracic vertebrae level T12?
Where does the spinal cord typically end in adults?
Where does the spinal cord typically end in adults?
What is the term used to describe the bundle of spinal nerves that run down from the end of the spinal cord?
What is the term used to describe the bundle of spinal nerves that run down from the end of the spinal cord?
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How do spinal nerves from T1 downwards emerge in relation to their corresponding vertebrae?
How do spinal nerves from T1 downwards emerge in relation to their corresponding vertebrae?
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What is the primary role of the vertebral bodies and intervertebral discs?
What is the primary role of the vertebral bodies and intervertebral discs?
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Which component of the vertebral arch helps protect the contents of the vertebral canal?
Which component of the vertebral arch helps protect the contents of the vertebral canal?
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Which of the following correctly describes the components of the vertebral arch?
Which of the following correctly describes the components of the vertebral arch?
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Which structure is contained within the vertebral canal?
Which structure is contained within the vertebral canal?
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How do the sizes of the vertebral bodies change throughout the vertebral column?
How do the sizes of the vertebral bodies change throughout the vertebral column?
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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 nerve is associated with the posterior ramus of C1?
Which nerve is associated with the posterior ramus of C1?
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What is the primary source for the anterior spinal artery?
What is the primary source for the anterior spinal artery?
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What characterizes the inferior cervical ganglion when merged with the T1 ganglion?
What characterizes the inferior cervical ganglion when merged with the T1 ganglion?
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What does the anterior spinal vein parallel?
What does the anterior spinal vein parallel?
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Which arteries enter through the intervertebral foramina for segmental spinal supply?
Which arteries enter through the intervertebral foramina for segmental spinal supply?
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How many pairs of spinal veins typically drain into the internal vertebral plexus?
How many pairs of spinal veins typically drain into the internal vertebral plexus?
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Which aspect of the cervical plexus involves anterior rami spanning C1-C4?
Which aspect of the cervical plexus involves anterior rami spanning C1-C4?
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Which of the following accurately describes the cervical vertebrae's unique features?
Which of the following accurately describes the cervical vertebrae's unique features?
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What joints are primarily involved in the cervical region's range of motion?
What joints are primarily involved in the cervical region's range of motion?
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What is the primary function of the vertebral column?
What is the primary function of the vertebral column?
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Which statement about the curvatures of the vertebral column is true?
Which statement about the curvatures of the vertebral column is true?
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Which component is NOT part of the general structure of vertebrae?
Which component is NOT part of the general structure of vertebrae?
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What typically characterizes abnormal curvatures of the spine?
What typically characterizes abnormal curvatures of the spine?
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Which of the following accurately describes the course of the vertebral arteries?
Which of the following accurately describes the course of the vertebral arteries?
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What anatomical structures are associated with lumbar punctures?
What anatomical structures are associated with lumbar punctures?
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What is the primary composition that gives the ligamentum flavum its yellow color?
What is the primary composition that gives the ligamentum flavum its yellow color?
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Which ligament is found between the laminae of the vertebrae?
Which ligament is found between the laminae of the vertebrae?
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What type of joint is formed at the atlanto-occipital joint?
What type of joint is formed at the atlanto-occipital joint?
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Which of the following arteries supply blood to the spinal cord?
Which of the following arteries supply blood to the spinal cord?
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At what vertebral level does the spinal cord end in adults?
At what vertebral level does the spinal cord end in adults?
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Which structure does NOT cover the spinal cord?
Which structure does NOT cover the spinal cord?
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Which space is located between the pia mater and arachnoid mater?
Which space is located between the pia mater and arachnoid mater?
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Cervical spine injuries caution against extending the cervical spine primarily to maintain what?
Cervical spine injuries caution against extending the cervical spine primarily to maintain what?
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What occurs when lumbar puncture is contraindicated due to raised intracranial pressure?
What occurs when lumbar puncture is contraindicated due to raised intracranial pressure?
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Which ligament is specifically associated with movement between the spinous processes of adjacent vertebrae?
Which ligament is specifically associated with movement between the spinous processes of adjacent vertebrae?
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What is the primary function of the annulus fibrosus in the intervertebral disc?
What is the primary function of the annulus fibrosus in the intervertebral disc?
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Which type of joint is formed by the connection of articular processes in the vertebral column?
Which type of joint is formed by the connection of articular processes in the vertebral column?
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What characterizes the nucleus pulposus of the intervertebral disc?
What characterizes the nucleus pulposus of the intervertebral disc?
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What is the role of ligaments in the vertebral column?
What is the role of ligaments in the vertebral column?
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Which component plays a crucial role in the stability and flexibility of the vertebral bodies?
Which component plays a crucial role in the stability and flexibility of the vertebral bodies?
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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 the vertebrae.
- Describe the vertebral arteries and their course.
- Discuss cervical spinal nerves.
- Describe the spinal meninges and relate the anatomy to lumbar puncture.
- Describe the osteology of the skull (frontal, posterior, superior, inferior views).
- Describe the cranial fossae.
Vertebral Column
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Structure:
- Composed of 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal vertebrae.
- Intervertebral discs act as cushions between vertebrae.
- Cervical, thoracic, lumbar, and sacral/coccygeal curvatures.
- Vertebral bodies increase in size from cervical to lumbar.
Functions of Vertebral Column
- Protection: Spinal cord and nerve roots, many internal organs.
- Base for attachment: Ligaments, tendons, and muscles.
- Structural support: Connects upper and lower body; supports balance and weight distribution.
- Flexibility and Mobility: Flexion, extension, lateral flexion, rotation, and combinations.
Curvatures of the Vertebral Column
- Primary (Kyphosis): First-formed curve in the vertebral column.
- Secondary (Lordosis): Develop in lumbar region (upright posture) and cervical region (head erect).
General Structure of Vertebrae
- Vertebral Bodies: The weight-bearing portion.
- Vertebral Arches: Protect the vertebral canal contents.
- Vertebral Canal: Houses the spinal cord, meninges, blood vessels, and roots of spinal nerves.
Vertebral Arch
- Pedicle: Part of the vertebral arch, resembling a foot.
- Lamina: Attached to the pedicle, shaped like a thin flat structure.
- Spinous Process: Posteriorly projecting portion.
- Transverse Process: Projects laterally.
- Superior & Inferior Articular Processes: Facilitate articulation with adjacent vertebrae.
Joints in the Vertebral Column
- Zygapophysial (Facet) Joints: Plane joints between articular processes.
- Secondary Cartilaginous Joints (Symphyses): Intervertebral discs connect the vertebral bodies.
Intervertebral Disc
- Annulus Fibrosus: Outer zone with high tensile strength connective tissue to attach to the adjacent vertebral bodies.
- Nucleus Pulposus: Inner, gelatinous structure composed of high resilience and 80-85% fluid cushioning.
- Cartilaginous Endplate: Fibrocartilage attaching to the vertebral body cartilaginous endplate.
Ligaments of the Vertebral Column
- Longitudinal Ligaments: (Anterior and Posterior) run along the anterior and posterior vertebral bodies.
- Ligamentum Flavum: Located between laminae, elastic in composition.
- Interspinous Ligament: Between the spinous processes.
- Supraspinous Ligament: Extends along the spinous processes.
- Ligamentum Nuchae: In the neck, thickened part of the supraspinous ligament.
Intervertebral Foramina
- Function: Allow spinal nerves and blood vessels to pass through.
Typical Cervical Vertebrae
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Characteristics:
- Oval body, transverse foramina, and unique processes (e.g., anterior and posterior tubercles, a bifid spinous process).
Atypical Cervical Vertebrae
- Atlas (C1): Lacking a body and spinous process, characterized by superior and inferior articular facets, lateral masses.
- Axis (C2): Has a dens (odontoid process), which projects superiorly into the ring of the atlas: superior and inferior articular facets, and a prominent spinous process.
- Cervical 7 (C7): Known as the vertebra prominens, characterized by a long spinous process.
Atlanto-occipital Joint
- Synovial condyloid joints: Permit nodding flexion and extension.
Atlantoaxial Joint
- Synovial joints: Permit rotation.
Vertebral Arteries
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Function: Supply blood to the brain and spinal cord.
- Arise from subclavian arteries, ascend through transverse foramina, enter foramen magnum, and branch into various vessels supplying the brain and spinal cord.
Cervical Spine Injury
- Clinical Considerations: In trauma patients, maintaining a neutral or stable neck position is essential to avoid spinal cord damage during airway management.
Spinal Cord
- Spinal cord continues from the brain stem, extends from the foramen magnum of the base of the skull to the lower edge of the first lumbar vertebra. Further divided by different sections.
Spinal Cord Segments and Spinal Nerves
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Cervical: 8 spinal nerves originate from the upper portion of the spinal cord
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Thoracic: 12 spinal nerves originate from the mid-portion of the spinal cord
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Lumbar: 5 spinal nerves originate from the lower portion of the spinal cord
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Sacral: 5 spinal nerves originate from the lower portion of the spinal cord
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Coccygeal: 1 spinal nerves originate from the coccygeal area
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Important Note: Spinal cord segments do not correspond exactly with spinal vertebra, with spinal cord segments lying above the vertebra; for example, the 1st spinal nerve originates above the 1st vertebra (C1).
Spinal Meninges
- Dura Mater: Outermost layer.
- Arachnoid Mater: Middle layer.
- Pia Mater: Innermost layer, closely adhered to the substance of the spinal cord.
Spinal Spaces
- Epidural/Extradural Space: Space containing fat and venous plexuses.
- Subdural Space: Space containing serous fluid.
- Subarachnoid Space: Contains CSF.
Lumbar Puncture (Tap)
- This procedure involves inserting a needle into the subarachnoid space to extract cerebrospinal fluid.
- Indications and Contraindications should be carefully considered for this procedure.
Cervical Plexus and Branching Spinal Nerves
- Formed from the anterior rami of C1-C4 spinal nerves
- innervate the muscles of the neck, head, and shoulders.
- Brachial Plexus: formed from the anterior rami of C5-T1 spinal nerves, responsible for providing innervation to the arms and hands.
- Posterior Rami: Innervate the deep back muscles.
Cervical Sympathetic Trunk
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Network of sympathetic nerve fibers that connects to the spinal cord and to various areas throughout the body.
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Arterial and Venous Drainage
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Anterior and posterior spinal arteries (and their branches) supply blood to the spinal cord
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Veins draining the spinal cord form longitudinal channels.
- One midline channel parallels anterior median fissure (anterior spinal vein)
- one midline channel passes along the posterior median sulcus (posterior spinal vein)
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Description
Test your knowledge on the cervical vertebrae, spinal nerves, and the osteology of the skull. This quiz covers the anatomy, structure, and functions related to the cervical spine and skull, including detailed descriptions of the atlas, axis, and cranial fossae. Challenge yourself and deepen your understanding of this important area in anatomy.
