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Questions and Answers
What is the function of the vertebral arch?
What is the function of the vertebral arch?
- To provide attachment points for muscles
- To protect the spinal cord (correct)
- To form the sides of the vertebral foramen
- To increase the weight of the vertebral column
What is the term for the space enclosed by the vertebral arch and body?
What is the term for the space enclosed by the vertebral arch and body?
- Vertebral canal
- Vertebral foramen (correct)
- Central cavity
- Spinal canal
How many articular processes are found in a typical vertebra?
How many articular processes are found in a typical vertebra?
- Two
- Eight
- Six
- Four (correct)
What is the direction of the spinous process in a typical vertebra?
What is the direction of the spinous process in a typical vertebra?
What is the term for the cylindrical structures that form the sides of the vertebral arch?
What is the term for the cylindrical structures that form the sides of the vertebral arch?
What is the total number of processes that arise from the vertebral arch?
What is the total number of processes that arise from the vertebral arch?
What is the shape of the sacrum?
What is the shape of the sacrum?
What is the primary reason for the formation of the cervical curve in infants?
What is the primary reason for the formation of the cervical curve in infants?
At which level does the sacral hiatus occur?
At which level does the sacral hiatus occur?
What is the usual number of vertebrae fused together to form the coccyx?
What is the usual number of vertebrae fused together to form the coccyx?
What is the characteristic of the thoracic and sacrococcygeal curves?
What is the characteristic of the thoracic and sacrococcygeal curves?
What is the result of the sacrum's wedge-shaped structure?
What is the result of the sacrum's wedge-shaped structure?
What is the term for the fusion of the fifth lumbar vertebra with the sacrum?
What is the term for the fusion of the fifth lumbar vertebra with the sacrum?
What is the result of the development of the secondary curves?
What is the result of the development of the secondary curves?
How many foramina are present on each of the anterior and posterior surfaces of the sacrum?
How many foramina are present on each of the anterior and posterior surfaces of the sacrum?
What is the characteristic of the lumbar curve in adult females?
What is the characteristic of the lumbar curve in adult females?
What is the condition when the first coccygeal vertebra is not fused or is incompletely fused with the second vertebra?
What is the condition when the first coccygeal vertebra is not fused or is incompletely fused with the second vertebra?
What is the characteristic of the fetal vertebral column during initial development?
What is the characteristic of the fetal vertebral column during initial development?
What is the term for the incorporation of the first sacral vertebra into the lumbar spine?
What is the term for the incorporation of the first sacral vertebra into the lumbar spine?
When does the lumbar curve form in infants?
When does the lumbar curve form in infants?
What can be absent from the posterior wall of the sacral canal?
What can be absent from the posterior wall of the sacral canal?
Where do the laminae of the fifth sacral vertebra and sometimes those of the fourth sacral vertebra meet?
Where do the laminae of the fifth sacral vertebra and sometimes those of the fourth sacral vertebra meet?
What does the dermatomyotome differentiate into?
What does the dermatomyotome differentiate into?
Where do the posterior and lateral outgrowths of the mesenchymal vertebral body grow?
Where do the posterior and lateral outgrowths of the mesenchymal vertebral body grow?
What forms from the fusion of the caudal half of each sclerotome with the cephalic half of the immediately succeeding sclerotome?
What forms from the fusion of the caudal half of each sclerotome with the cephalic half of the immediately succeeding sclerotome?
What is the primary reason for the increase in lumbar concavity during later months of pregnancy?
What is the primary reason for the increase in lumbar concavity during later months of pregnancy?
What is the characteristic of the vertebral column in old age?
What is the characteristic of the vertebral column in old age?
What forms from the lateral outgrowths of the mesenchymal vertebral body?
What forms from the lateral outgrowths of the mesenchymal vertebral body?
During which week of development do the mesenchymal cells of the sclerotome rapidly divide and migrate medially?
During which week of development do the mesenchymal cells of the sclerotome rapidly divide and migrate medially?
What is the typical cause of minor lateral vertebral curves in the thoracic region during late childhood?
What is the typical cause of minor lateral vertebral curves in the thoracic region during late childhood?
What is the characteristic of the cervical and lumbar curves in the adult vertebral column?
What is the characteristic of the cervical and lumbar curves in the adult vertebral column?
What surrounds the notochord during the 4th week of development?
What surrounds the notochord during the 4th week of development?
What is the term for the part of the sclerotome that gives rise to the posterior and lateral outgrowths?
What is the term for the part of the sclerotome that gives rise to the posterior and lateral outgrowths?
What is the purpose of the compensatory curves in the vertebral column?
What is the purpose of the compensatory curves in the vertebral column?
What is the term for the part of the dermatomyotome that gives rise to the myotome and dermatome?
What is the term for the part of the dermatomyotome that gives rise to the myotome and dermatome?
What is the direction of the curvature of the thoracic and sacrococcygeal curves in the adult vertebral column?
What is the direction of the curvature of the thoracic and sacrococcygeal curves in the adult vertebral column?
What is the relationship between the development of minor lateral vertebral curves and handedness?
What is the relationship between the development of minor lateral vertebral curves and handedness?
What is the significance of the vertebral column curvatures in the adult?
What is the significance of the vertebral column curvatures in the adult?
Which muscles produce abduction (lateral flexion) in the neck region?
Which muscles produce abduction (lateral flexion) in the neck region?
What determines the range of movements possible in each region of the spinal column?
What determines the range of movements possible in each region of the spinal column?
Which joints permit extensive flexion and extension of the head?
Which joints permit extensive flexion and extension of the head?
Which muscles produce rotation in the thoracic region?
Which muscles produce rotation in the thoracic region?
What restricts the range of movement in the thoracic region?
What restricts the range of movement in the thoracic region?
Which muscles produce flexion in the lumbar region?
Which muscles produce flexion in the lumbar region?
What is the primary function of the atlanto-axial joints?
What is the primary function of the atlanto-axial joints?
Which muscles produce abduction (lateral flexion) in the lumbar region?
Which muscles produce abduction (lateral flexion) in the lumbar region?
What percentage of the cervical range of motion occurs at the atlanto-occipital joints?
What percentage of the cervical range of motion occurs at the atlanto-occipital joints?
In which region of the vertebral column does great mobility mainly result from circumduction and pelvic tilting?
In which region of the vertebral column does great mobility mainly result from circumduction and pelvic tilting?
What is the primary reason why dislocations without fracture occur only in the cervical region?
What is the primary reason why dislocations without fracture occur only in the cervical region?
What type of injury typically causes anterior compression fractures of the vertebral bodies?
What type of injury typically causes anterior compression fractures of the vertebral bodies?
At which sites do anterior compression fractures of the vertebral bodies typically occur?
At which sites do anterior compression fractures of the vertebral bodies typically occur?
What is the characteristic of intervertebral movement in the cervical region?
What is the characteristic of intervertebral movement in the cervical region?
What is the relationship between the atlanto-occipital joints and the cervical range of motion?
What is the relationship between the atlanto-occipital joints and the cervical range of motion?
What is the characteristic of intervertebral movement in the lumbar region?
What is the characteristic of intervertebral movement in the lumbar region?
What is the primary function of the nucleus pulposus in the intervertebral disc?
What is the primary function of the nucleus pulposus in the intervertebral disc?
What is the composition of the intervertebral disc?
What is the composition of the intervertebral disc?
What happens to the nucleus pulposus when there is a sudden increase in compression load on the vertebral column?
What happens to the nucleus pulposus when there is a sudden increase in compression load on the vertebral column?
What is the arrangement of the concentric layers of fibrocartilage in the intervertebral disc?
What is the arrangement of the concentric layers of fibrocartilage in the intervertebral disc?
What is the result of the outward thrust of the nucleus pulposus being too great for the anulus fibrosus?
What is the result of the outward thrust of the nucleus pulposus being too great for the anulus fibrosus?
What is the characteristic of the fibers in the anulus fibrosus?
What is the characteristic of the fibers in the anulus fibrosus?
What is the location of the intervertebral disc in relation to the posterior margin of the vertebral body?
What is the location of the intervertebral disc in relation to the posterior margin of the vertebral body?
What is the purpose of the anulus fibrosus in the intervertebral disc?
What is the purpose of the anulus fibrosus in the intervertebral disc?
What is the main consequence of the water content of the nucleus pulposus diminishing with age?
What is the main consequence of the water content of the nucleus pulposus diminishing with age?
What is the role of the anterior and posterior longitudinal ligaments in the vertebral column?
What is the role of the anterior and posterior longitudinal ligaments in the vertebral column?
What is the significance of the meningeal branches of the spinal nerves in the vertebral joints?
What is the significance of the meningeal branches of the spinal nerves in the vertebral joints?
What is the effect of the degeneration of the collagen fibers of the anulus on the vertebral discs?
What is the effect of the degeneration of the collagen fibers of the anulus on the vertebral discs?
What is the result of the shortening of the vertebral column with age?
What is the result of the shortening of the vertebral column with age?
What is the characteristic of the vertebral discs in old age?
What is the characteristic of the vertebral discs in old age?
What is the function of the anterior longitudinal ligament in the vertebral column?
What is the function of the anterior longitudinal ligament in the vertebral column?
What is the effect of the replacement of the water content of the nucleus pulposus with fibrocartilage on the vertebral discs?
What is the effect of the replacement of the water content of the nucleus pulposus with fibrocartilage on the vertebral discs?
What is the primary function of the ligamentum flavum?
What is the primary function of the ligamentum flavum?
What is the direction of the longitudinal axis of movement of the vertebral column?
What is the direction of the longitudinal axis of movement of the vertebral column?
What is the result of the movement of flexion in the vertebral column?
What is the result of the movement of flexion in the vertebral column?
What is the significance of the ligamentum nuchae in the cervical region?
What is the significance of the ligamentum nuchae in the cervical region?
What movement is possible in the vertebral column due to the intertransevere ligaments?
What movement is possible in the vertebral column due to the intertransevere ligaments?
What is the term for the movement of circumduction in the vertebral column?
What is the term for the movement of circumduction in the vertebral column?
What is the level at which the spinal nerve runs through the intervertebral foramen?
What is the level at which the spinal nerve runs through the intervertebral foramen?
What is the source of the arterial supply to the spinal cord?
What is the source of the arterial supply to the spinal cord?
What is the relationship between the spinal nerves and the vertebrae in the thoracic, lumbar, and sacral regions?
What is the relationship between the spinal nerves and the vertebrae in the thoracic, lumbar, and sacral regions?
What is the course of the posterior spinal arteries?
What is the course of the posterior spinal arteries?
What is the exception to the rule that the spinal nerves emerge through the IVF below the same-numbered vertebra?
What is the exception to the rule that the spinal nerves emerge through the IVF below the same-numbered vertebra?
What is the relationship between the spinal nerve and the affected IVF in the cervical region?
What is the relationship between the spinal nerve and the affected IVF in the cervical region?
What is the effect of slackening of the anterior and posterior longitudinal ligaments?
What is the effect of slackening of the anterior and posterior longitudinal ligaments?
Which region has the most susceptible discs to herniation?
Which region has the most susceptible discs to herniation?
What is the location of the anterior spinal artery?
What is the location of the anterior spinal artery?
What is the number of spinal arteries that run longitudinally?
What is the number of spinal arteries that run longitudinally?
What is the result of the escape of the nucleus pulposus?
What is the result of the escape of the nucleus pulposus?
What is the relationship between the spinal nerve and the affected IVF in the thoracic or lumbar region?
What is the relationship between the spinal nerve and the affected IVF in the thoracic or lumbar region?
What is the consequence of abnormal mobility of the vertebral bodies?
What is the consequence of abnormal mobility of the vertebral bodies?
What is the location of the most susceptible discs to herniation in the cervical region?
What is the location of the most susceptible discs to herniation in the cervical region?
What is the purpose of maximizing the flexion of the lumbar spine during lumbar puncture?
What is the purpose of maximizing the flexion of the lumbar spine during lumbar puncture?
What is the usual direction of the needle during lumbar puncture?
What is the usual direction of the needle during lumbar puncture?
What is the cause of post-lumbar puncture headache?
What is the cause of post-lumbar puncture headache?
What is the significance of the imaginary line joining the highest points on the iliac crests?
What is the significance of the imaginary line joining the highest points on the iliac crests?
What is the purpose of using a small-gauge styletted needle during lumbar puncture?
What is the purpose of using a small-gauge styletted needle during lumbar puncture?
What is the significance of the supraspinous ligament during lumbar puncture?
What is the significance of the supraspinous ligament during lumbar puncture?
What is the usual depth of the needle insertion during lumbar puncture in an obese adult?
What is the usual depth of the needle insertion during lumbar puncture in an obese adult?
What is the primary function of the cerebrospinal fluid?
What is the primary function of the cerebrospinal fluid?
What is the primary precaution to take during lumbar puncture in cases of raised intracranial pressure?
What is the primary precaution to take during lumbar puncture in cases of raised intracranial pressure?
What is the approximate distance between the sacral hiatus and the lower end of the subarachnoid space at the S2 vertebra in adults?
What is the approximate distance between the sacral hiatus and the lower end of the subarachnoid space at the S2 vertebra in adults?
What is the term for the segment of the filum terminale from the conus medullaris to the end of the dura-arachnoid sac?
What is the term for the segment of the filum terminale from the conus medullaris to the end of the dura-arachnoid sac?
What is the purpose of caudal anesthesia in obstetrics?
What is the purpose of caudal anesthesia in obstetrics?
What is the location of the spinal part of the subarachnoid space?
What is the location of the spinal part of the subarachnoid space?
What is contained within the dural sac in the sacral canal?
What is contained within the dural sac in the sacral canal?
What is the origin of the cerebrospinal fluid?
What is the origin of the cerebrospinal fluid?
What is the term for the portion of the filum terminale from the sac to the coccyx?
What is the term for the portion of the filum terminale from the sac to the coccyx?
What is the significance of the posterior wall in the sacral canal?
What is the significance of the posterior wall in the sacral canal?
What is the function of the pia mater in the spinal cord?
What is the function of the pia mater in the spinal cord?
What is the relationship between the dural sac and the coccyx?
What is the relationship between the dural sac and the coccyx?
What is the direction of the circulation of cerebrospinal fluid?
What is the direction of the circulation of cerebrospinal fluid?
What is the result of the fusion of the filum terminale with the dura-arachnoid sac?
What is the result of the fusion of the filum terminale with the dura-arachnoid sac?
What is the name of the process in the sacral vertebra shown in the diagram?
What is the name of the process in the sacral vertebra shown in the diagram?
What is the term for the opening in the sacrum where the diagram shows the third posterior sacral foramen?
What is the term for the opening in the sacrum where the diagram shows the third posterior sacral foramen?
What is the structure formed by the fusion of the fourth and fifth sacral vertebrae?
What is the structure formed by the fusion of the fourth and fifth sacral vertebrae?
What is the function of the lamina of the fourth sacral vertebra?
What is the function of the lamina of the fourth sacral vertebra?
How many sacral foramina are present on each of the anterior and posterior surfaces of the sacrum?
How many sacral foramina are present on each of the anterior and posterior surfaces of the sacrum?
Study Notes
Vertebral Column Structure
- A typical vertebra consists of a rounded body anteriorly and a vertebral arch posteriorly, which enclose a space called the vertebral foramen.
- The vertebral arch gives rise to seven processes: one spinous, two transverse, and four articular.
- The laminae of the fifth sacral vertebra sometimes fail to meet in the midline, forming the sacral hiatus.
Sacrum
- The sacrum consists of five rudimentary vertebrae fused together to form a wedge-shaped bone, concave anteriorly.
- The upper border, or base, has four foramina for the passage of the anterior and posterior rami of the upper four sacral nerves.
- The sacrum plays a crucial role in maintaining the center of gravity of the body through the pelvis, allowing upright posture.
Coccyx
- The coccyx usually consists of four vertebrae fused together to form a single, small triangular bone that articulates at its base with the lower end of the sacrum.
- The first coccygeal vertebra may not be fused or is incompletely fused with the second vertebra.
Vertebral Column Curvatures
- The adult vertebral column has four regional curvatures in the sagittal plane: thoracic, sacrococcygeal, cervical, and lumbar.
- The thoracic and sacrococcygeal curves have anterior concavities, while the cervical and lumbar curves have posterior concavities.
- The curves serve to align the center of gravity of the body, allowing upright posture.
Development of Vertebral Column
- In the embryo, the vertebral column has only one continuous anterior concavity.
- As development proceeds, the lumbo-sacral angle appears, forming two anteriorly concave curves.
- The cervical curve forms in association with the child raising its head and keeping it poised on the vertebral column.
- The lumbar curve forms in association with the child sitting up and standing upright.
Development of Vertebral Body
- The mesenchymal vertebral body gives rise to posterior and lateral outgrowths on each side.
- The posterior outgrowths grow around the neural tube between the segmental nerves to form the mesenchymal vertebral arch.
- The lateral outgrowths pass between the myotomes to form the mesenchymal costal process or primordia of the ribs.
Vertebral Column Movements
- The vertebral column permits several types of movements, including flexion, extension, abduction (lateral flexion), rotation, and circumduction.
- The range of movements possible in each region of the vertebral column depends on the thickness of the intervertebral discs and the shape and direction of the articular processes.
Regional Intervertebral Movements
- In the cervical region, flexion and extension are extensive, with -50% of the cervical range of motion occurring at the atlanto-occipital joints.
- Abduction (lateral flexion) is also extensive in the cervical region.
- Rotation is extensive in the cervical region, with -50% of the cervical range of rotation occurring at the atlantoaxial joints.
- Circumduction is also extensive in the cervical region.
Thoracic Region
- In the thoracic region, the range of movement is limited due to the ribs, costal cartilages, and sternum.
- Unilateral semispinalis and rotatores muscles, assisted by the oblique muscles of the anterolateral abdominal wall, produce rotation.
Lumbar Region
- In the lumbar region, the rectus abdominis and psoas muscles produce flexion, whereas the postvertebral muscles produce extension.
- The postvertebral muscles, quadratus lumborum, and the oblique muscles of the anterolateral abdominal wall produce abduction (lateral flexion).
Intervertebral Discs
- Intervertebral discs are composed of a mucopolysaccharide gel with high water content (-80+%) and a small amount of collagen and cartilage.
- The discs have a fibrocartilaginous annulus and a gel-like nucleus pulposus.
- The nucleus pulposus allows for changes in shape and permits one vertebra to rock on another.
Vertebral Column Dislocation
- Dislocations without fracture occur only in the cervical region due to the obliquely oriented articular processes.
- Anterior compression fractures of the vertebral bodies are usually caused by an excessive flexion compression type of injury.
Vertebral Joint Nerve Supply
- The joints receive nerve fibers from two adjacent spinal nerves.
- Small meningeal branches of each spinal nerve innervate the joints between the vertebral bodies.
Ligaments
- The anterior and posterior longitudinal ligaments run as continuous bands down the anterior and posterior surfaces of the vertebral column.
- The ligamentum flavum connects the laminae of adjacent vertebrae.
- In the cervical region, the supraspinous and interspinous ligaments are greatly thickened to form the strong ligamentum nuchae.
Lumbar Puncture
- Lumbar puncture is performed with the patient lying on their side with the vertebral column well flexed, opening the lumbar interlaminal spaces to a maximum.
- The needle passes through the following anatomic structures before entering the subarachnoid space: skin, superficial fascia, supraspinous ligament, interspinous ligament, ligamentum flavum, areolar tissue, dura mater, and arachnoid mater.
Anatomy of Complications
- Postlumbar puncture headache starts after the procedure and lasts 24 to 48 hours, caused by a leak of CSF through the dural puncture, especially after using a wide-bore needle.
- The leak reduces the volume of CSF, which, in turn, causes a downward displacement of the brain and stretches the nerve-sensitive meninges.
- Assuming the recumbent position relieves the headache.
- Using small-gauge styletted needles and avoiding multiple dural holes reduces the incidence of headache.
Brain Herniation
- Lumbar puncture is contraindicated in cases where intracranial pressure is significantly raised.
Spinal Cord Blood Supply
- The spinal cord receives its arterial supply from two primary sources: (1) the spinal arteries, which originate from the vertebral arteries within the cranial cavity, and (2) the radicular (radiculomedullary) arteries, which branch from segmental arteries alongside the vertebral column.
- Three small spinal arteries run longitudinally: two posterior spinal arteries and one anterior spinal artery.
- The posterior spinal arteries run inferiorly down the spinal cord, close to the attachments of the posterior spinal nerve rootlets.
- The anterior spinal artery runs down within the anterior median fissure.
Spinal Cord and Spinal Nerve Development
- The spinal cord runs the entire length of the trunk of the body.
- The numerical relationships of the spinal nerves to the vertebrae are important to consider when evaluating the effects of a herniated intervertebral disc.
- Stenosis of a cervical IVF would affect the spinal nerve one number higher than the IVF itself.
- Narrowing of a thoracic or lumbar IVF would affect the spinal nerve of the same number as the affected IVF.
Cerebrospinal Fluid
- The cerebrospinal fluid (CSF) is a clear, colorless fluid formed mainly by the choroid plexuses, within the ventricles of the brain.
- CSF circulates through the ventricular system and enters the subarachnoid space through three foramina in the roof of the fourth ventricle.
- CSF provides a fluid medium that surrounds the spinal cord and effectively protects it from trauma.
Embryology Notes
- The spinal cord develops from the neural tube and runs the entire length of the trunk of the body.
- The spinal nerves develop from the posterior section of the neural tube.
Sacral Vertebrae
- The fourth sacral spinous process is a notable feature
- The third sacral spinous process is a key landmark
- The lamina of the fourth sacral vertebra is an important anatomical structure
- The third posterior sacral foramen is a distinct opening in the sacrum
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Description
Learn about the vertebral arch, its components, and the processes it gives rise to. Understand the common features of all vertebrae.
