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288 Cards in this Set

  • Front
  • Back
how many vertebrae are in the vertebral column?
33
how many/what types of vertebrae are in the vertebral column?
cervical-7
thoracic- 12
lumbar-5
fused sacral-5
fused coccygeal vertebrae-4
what are the main funcs of the vertebral column?
-protects spinal cord
-supports weight of head and trunk
-allows mvmnt of rib cage for respiration by articulating w/ the ribs
where are the primary curvatures in the spine?
thoracic and sacral regions
when do the primary curvatures of the spine develop?
embryonic and fetal periods
where are the secondary curvatures of the spine?
cervical and lumbar regions
when do the secondary curvatures of the spine develop?
after birth and during infancy
what are some categories of abnormal curvature of the vertebral column?
kyphosis
lordosis
scoliosis
describe kyphosis:
hunchback or humpback
-abnormally increased thoracic curvature resulting from osteoperosis
describe lordosis:
-swayback or saddleback
-abnormally increased lumbar curvature resulting from trunk muscular weakness or osteomalacia
describe scoliosis:
-condition of lateral deviation
-results from:
1) unequal growth of the vertebral column OR
2) pathologic erosion of vertebral bodies OR
3) asymmetric paralysis or weakness of vertebral muscles
what are common features for a typical vertebrae?
body
vertebral arch
processes for muscular and articular attachments
describe the body of a typical vertebrae:
-short cylinder
-separated and also bound by intervertebral disks
-has costal facets or processes of the thoracic vertebrae anterior to the pedicles, which articulate with the heads of the corresponding and subjacent (just below) ribs
what is the func of the vertebrae body?
supports weight
what type of joints is the body of the vertebrae part of?
cartilaginous joints
what is spondylolisthesis?
-forward displacement of vertebrae on the one below
where does spondylolisthesis usually occur?
fifth lumbar over the body of the sacrum
why does spondylolisthesis usually occur?
b/c of a developmental defect in pedicle of the migrating vertebrae
what is the result of spondylolisthesis?
the spinal nerve roots may be pressed on, causing low bachache, sciatica, or a shortened trunk
what is sciatica?
pain that radiates along the path of the sciatic nerve: back --> buttock --> leg
what are some other names for spondylitis?
ankylosing or rheumatoid spondylitis
what is spondylitis?
-inflammation of the joints b/w the vertebrae and sacroiliac joints
-form of chronic inflammatory arthritis
what's the most common form of chronic inflammatory arthritis?
rheumatoid arthritis
what are the symptoms of spondylitis?
pain
stiffness
(the pain and stiffness may progress to the hip, shoulder, knee and hand joints)
swelling
limited motion in the lower back
-affected vertebrae fuse or grow together --> rigid/bamboo spine
-poor posture
-deformities
what's another name for Scheuermann's disease?
kyphosis (juvenile kyphosis or vertebral epiphysitis)
what is Scheuermann's disease?
epiphysial osteochondrosis of vertebral bodies
-usually in thoracic vertebrae
how does scheuermann's disease happen?
when front parts of the thoracic vertebrae don't grow as fast as the back parts --> form wedge shape --> kyphosis
what are the symptoms of Scheuermann's disease?
thoracic kyphosis
intermittent back pain
tight hamstrings
what's Pott's disease?
tuberculosis of the spine or vertebrae from softening and collapse of the vertebrae --> kyphosis
what's Pott's disease also called?
tuberculosis spondylitis
where is Pott's disease commonly localized?
thoracic part of spine
what are symptoms of Pott's disease?
paravertebral swelling
abscess
paraplegia
back pain
fever
cough
sweats
anorexia
weight loss
what can paravertebral swelling and abscess in Pott's disease result in?
spinal cord compression
what makes up the vertebral arch?
paired pedicles laterally
paired laminae posteriorly
what forms the vertebral foramen?
vertebral arch and vertebral body
what is the main func of the vertebral arch?
protects spinal cord and associated strucs
what's spina bifida?
developmental anomaly char by defective closure of the vertebral arch
what causes spina bifida?
maternal folic acid deficiency
what's spina bifida occulta?
failure of the vertebral arch to fuse (bony defect only with a small tuft of hair over the affected area of skin)
what's meningocele?
protrusion of meninges thru unfused arch of the vertebra (spina bifida cystica)
what's meningomyelocele?
protrusion of spinal cord and the meninges
what's myeloschisis/rachischisis?
cleft spinal cord due to failure of neural folds to close
what's syringomyelocele?
protrusion of meninges and pathologic tubular cavity in the spinal cord or brain
what's lipomeningocele?
protrusion of the meninges with an overlying lipoma (lipomatous mass) in spina bifida
what's myelocele?
protrusion of substance of spinal cord in spina bifida
how should a baby w/ spina bifida be delivered?
C-section b/c passage thru the narrow birth canal can compress the meningocele and damage the spinal cord
where is the spinous process of the vertebral arch?
at junc of 2 laminae of vertebral arch
how does spinous process vary in different parts of spine?
cervical-bifid
thoracic- spine-like
lumbar-oblong
where is the transverse process of the vertebral arch?
at the junc of the pedicle and the lamina
what are some cool facts about the transverse process?
in thoracic region- articulate w/ tubercles of ribs 1-10
in cervical region- have transverse foramina
what are the articular processes of the vertebral arch?
2 superior and 2 inferior projections from the junc of lamina and pedicles
what are mamillary processes?
tubercles on the superior articular processes of the lumbar vertebrae
where are accessory processes?
project backward from the transverse process base and lateral and inferior to the mamillary process of lumbar vertebrae
what is the vertebral foramina's funcs?
-form vertebral canal
-transmit spinal cord w/ its meningeal coverings, nerve roots, and associated vessels
where are the intervertebral foramina?
b/w inferior and superior surfaces of pedicles of adjacent vertebrae
what's the purpose of the intervertebral foramina?
transmits spinal nerves and accompanying vessels as they exit vertebral canal
where are transverse foramina?
in transverse processes of cervical vertebrae
what's the func of transverse foramina?
transmit vertebral artery (except thru C7), vertebral veins and autonomic nerves
what's Klippel-Feil syndrome? symptoms?
congenital defect manifested as a short, stiff neck
-low hairline
-limited neck mvmnt
how do you get Klippel-Feil syndrome?
-reduction in the number of cervical vertebrae
-extensive fusion of cervical vertebrae
how do you get a whiplash injury of the neck?
force that drives trunk forward while head lags behind
what happens during whiplash injury of the neck?
mvmnt of head and upper part of neck hyperextend and lower part of neck hyperflexes rapidly
where does the whiplash injury normally occur?
junctuion of C4-C5
C1-C4 = lash
C5-C7= whip handle
what are the symptoms of whiplash?
neck pain
stiff neck
headache
what's the tx of whiplash?
supporting head and neck w/ cervical collar that's higher in back than in the front - the collar keeps the cervical vertebral column in a flexed position
where are intervertebral disks?
from axis to sacrum
**NO DISK B/W ATLAS AND AXIS
what makes up the intervertebral disk?
nucleus pulposus = central mucoid substance
annulus fibrosus = fibrocartilaginous lamina
how much of vertebral column length does intervertebral disk make up?
1/4
what's the purpose of intervertebral disks?
-allows mvmnts b/w vertebrae
-serves as shock absorber
do intervertebral disks get blood?
avascular except for peripheries, which are supplied from adjacent blood vessels
what does the nucleus pulposus originate from?
embryonic notochord
what's the nucleus pulposus made of?
reticular and collagenous fibers embedded in mucoid material
what's the func of nucleus pulposus?
shock absorber by equalizing pressure
how can nucleus pulposus malfunction?
may herniate or protrude thru annulus fibrosus --> impinge on spinal nerve root
what's annulus fibrosus made of?
concentric layers of fibrous tissue and fibrocartilage
what are the funcs of the annulus fibrosus?
binds vertebral column together
retains nucleus pulposus
permits limited amt of mvmnt
shock absorber
what's a herniated/slipped disk?
protrusion of nucleus pulposus thru annulus fibrosus of intervertebral disk into intervertebral foramen or into vertebral canal, compressing spinal nerve root
where does herniated disk commonly occur?
posterolaterally where annulus fibrosus is not reinforced by posterior longitudinal ligament
*frequently in lumbar region
what's sciatica commonly caused by?
herniation of lower lumbar intervertebral disk
what's lumbar spondylosis?
degenerative joint disease affecting lumbar vertebrae and intervertebral disks
what does lumbar spondylosis cause/symptoms?
pain and stiffness
sometimes w/ sciatic radiation from nerve root pressure by associated protruding disks or osteophytes (bony outgrowths)
what's the func of atlas : 1st cervical vertebrae?
supports skull
describe atlas:
widest of cervical vertebrae
has no body
has no spine
has anterior/posterior arches
paired transverse processes
what joint does atlas form?
atlanto-occipital joint : w/ occipital condyles of skull
atlantoaxial joint : w/ axis
describe axis (2nd cervical vertebrae)?
smallest transverse process
has dens: odontoid process
what does dens/odontoid process of axis do?
projects superiorly from body of axis and articulates w/ anterior arch of atlas, forming pivot around which atlas rotates
what is axis supported by?
cruciform, apical and alar ligaments
tectorial membrane
what's hangman's fracture?
fracture of pedicles of axis
how can hangman's fracture happen?
hanging or automobile accidents
what is damaged in hangman's fracture?
cruciform ligament is torn
spinal cord is crushed --> death
describe C3-C6:
typical cervical vertebrae
have short spinous processes
transverse processes w/ anterior and posterior tubercles
transverse foramina for vertebral vessels
what is C7 called? why?
vertebra prominens b/c it has long spinous process that's nearly horizontal, ends in single tubercle (not bifid) and forms visible protrusion
what is C7 an attachment site for?
ligamentum nuchae
supraspinous ligaments
lots of back muscles
describe thoracic vertebrae:
have costal facets
have transverse processes
typical thoracic vertebrae: T2-T8
what does superior costal facet on thoracic vertebrae body articulate w/?
head of corresponding rib
what does inferior costal facet on thoracic vertebrae body articulate w/?
rib just below it
what does transverse process of thoracic vertebrae articulate w/?
tubercle of corresponding rib
what are char of lumbar vertebrae?
large bodies
sturdy laminae
no costal facets
strong, massive transverse process
mamillary and accessory processes
what has the largest body of the vertebrae?
L5
describe sacrum:
large, triangular, wedge-shaped bone
made of five fused sacral vertebrae
four pairs of foramina
forms posterior part of pelvis
what is purpose of sacral foramina?
exit of ventral and dorsal primary rami of 1st 4 sacral nerves
what are the sacrum parts?
promontory
ala
median sacral crest
sacral hiatus
sacral cornu or horn
what's the promontory?
prominent anterior edge of 1st sacral vertebrae
what's ala?
superior and lateral part of sacrum
formed by fused transverse processes and fused costal processes of 1st sacral vertebrae
what's median sacral crest formed by?
fused spinous processes
what's sacral hiatus formed by?
failure of laminae of vertebrae S5 to fuse
where do you give caudal/extradural anaesthesia?
sacral hiatus
what's sacral cornu/horn formed by?
pedicles of 5th sacral vertebrae
what's the coccyx?
wedge-shaped bone formed by union of 4 coccygeal vertebrae
what att to coccyx?
coccygeus and levator ani muscles
where does anterior longitudinal ligament run?
from skull (occipital bone) to sacrum on anterior surface of vertebral bodies and intervertebral disks
where is ALL widest/narrowest?
narrowest at upper end
widens as it descends
what's func of anterior longitudinal ligament?
maintains joint stability
limits vertebral column extension
supports annulus fibrosus anteriorly
resists gravitational pull
how does posterior longitudinal ligament connect to spine?
posteriorly
where is PLL widest/narrowest?
narrows as it descends
what are the funcs of PLL?
-interconnects vertebral bodies and intervertebral discs posteriorly
-supports posterior aspect of vertebral bodies and annulus fibrosus
-limits flexion of vertebral column
-resists gravitational pull
where is the posterior longitudinal ligament in relation to the spinal cord?
anterior to the spinal cord w/i vertebral canal
what does ligamentum flavum conn?
laminae of 2 adjacent vertebrae
what are the funcs of ligamentum flavum?
-maintains upright posture
-forms posterior wall of vertebral canal b/w vertebrae
what normal procedure can pierce ligamentum flavum?
lumbar/spinal puncture
what's the ligamentum nuchae?
triangular shaped median fibrous septum b/w muscles on 2 sides of posterior part of neck
what forms ligamentum nuchae? where is it?
thickened supraspinous ligaments that extend from vertebra C7 to external occipital protuberance and crest
what is ligamentum nuchae attached to?
-posterior tubercle of atlas
-spinous processes of other cervical vertebrae
-external occipital protuberance
C7
describe the vertebral venous system:
valveless plexiform of veins
forms interconnecting channels
what veins are in the epidural space?
internal vertebral venous plexus
which veins are thought to be the route of early metastasis of carcinoma?
internal vertebral venous plexus
where is the epidural space?
in b/w wall of vertebral canal and dura mater
where is the external vertebral venous plexus?
ant- in front of vertebral column
post- lies on vertebral arch
where does the vertebral vein come from?
venous plexuses around foramen magnum and in suboccipital region
where does the vertebral vein run?
w/ vertebral artery thru transverse foramina of C6-C1
what vein does vertebral v empty into?
brachiocephalic vein
what vein comm w/ the cranial dural sinuses?
internal vertebral venous plexus
what's the significance of the triangle of auscultation?
site where breathing sounds can be heard most clearly w/ stethoscope
what's triangle of auscultation bounded by?
upper- latissimus dorsi
lateral-trapezius
medial-scapula
floor-rhomboid major
what's the sig of lumbar triangle of Petit?
site of an abdominal hernia
what's the lumbar triangle of Petit bounded by?
iliac crest, latissimus dorsi, post free border of external oblique abdominal muscle
floor- internal oblique abdominal muscle
what's the sig of thoracolumbar/lumbodorsal fascia?
invests deep muscles of back
what does thoracolumbar/lumbodorsal fascia att to?
ant- vertebral transverse process
post- vertebral spinous process
what nerve does the occipital artery run with?
greater occipital nerve: C2
what a does occipital a come from?
external carotid artery
what does the occipital a supply?
scalp in occipital region
what a does occipital a anastamose w/?
superficial - transverse cervical a
deep- deep cervical a (from costocervical trunk)
what a does the transverse cervical a come from?
thyrocervical trunk of subclavian a
what n does transverse cervical a run w/?
superficial descending- spinal accessory n
deep- dorsal scapular n
what's the transverse cervical a called when it branches?
superficial- superficial cervical a
deep- dorsal scapular/descending scapular a
what n supplies trapezius?
spinal accessory and C3-C4
what n supplies levator scapulae?
dorsal scapular n and C4-C5
what n supplies rhomboid minor?
dorsal scapular n: C5
what n supplies rhomboid major?
dorsal scapular n: C5
what n supplies latissimus dorsi?
thoracodorsal n
what n supplies serratus posterior-superior?
intercostal n: T1-T4
what n supplies serratus posterior- inferior?
intercostal n: T9 -T12
what muscles does accessory n supply?
sternocleidomastoid
trapezius
what does dorsal scapular n originate from?
ventral primary rami of C5
what a does the dorsal scapular n run w/?
deep branch of transverse cervical a
what muscles does dorsal scapular n supply?
rhomboid major and minor
levator scapulae muscles
what action does trapezius do?
adducts, rotates, elevates and depresses scapula
what action does levator scapulae do?
elevates scapula
rotates glenoid cavity
what action does rhomboid minor do?
adducts scapula
what action does rhomboid major do?
adducts scapula
what action does rhomboid major do?
adducts scapula
what action does latissimus dorsi do?
adducts, extends, and rotates arm medially
depresses scapula
what action does serratus posterior- superior do?
elevates ribs
what action does serratus posterior-inferior do?
depresses ribs
what's the origin of trapezius?
external occipital protuberance
superior nuchal line
ligamentum nuchae
spines of C7-T12
where does the dorsal scapular n come from?
ventral primary ramus of C5
what's the origin of the greater occipital n?
medial branch of dorsal primary ramus: C2
what does the greater occipital n innervate?
semispinalis capitis
cutaneous innerv in occipital region
what does the least occipital nerve come from?
dorsal primary ramus: C3
what does least occipital n innerv?
cutaneous innerv in occipital region
where does the lesser occipital n originate from?
ventral primary ramus: C2
what are the deep back muscles? from outside to in
1) splenius capitis
splenius cervicis
2) erector spinae (sacrospinalis)
3) semispinalis
multifidus
rotators
what muscles are of superficial layer: spinotransverse group?
splenius capitis
splenius cervicis
what innerv splenius capitis and splenius cervicis?
dorsal primary rami of middle and lower cervical spinal nerves
what is the action of splenius capitis and splenius cervicis?
extend, rotate, and laterally flex head and neck
what muscles make up the intermediate layer: sacrospinalis?
erector spinae (sacrospinalis): divided up into 3 columns
what are the 3 columns of erector spinae?
iliocostalis (lateral)
longissimus (intermediate)
spinalis (medial)
what is the erector spinae innervated by?
dorsal primary rami of spinal nerves
what's the func of erector spinae?
extend, rotate, laterally flex vertebral column and head
what muscles make up deep layer: transversospinalis grp of back?
semispinalis (capitis, cervicis and thoracis)
multifidus
rotators
what innerv transversospinalis grp?
dorsal primary rami of spinal nerves
what's the func of transversospinalis grp?
extend and rotate head, neck and trunk
what are segmental muscles of back inerv by?
dorsal primary rami of spinal nerves
what muscles make up segmental muscles?
interspinales
intertransversarii
levatores costarum (longus and brevis)
what is the suboccipital triangle bounded by?
medially- rectus capitis posterior major
laterally- obliquus capitis superior
inferiorly- obliquus capitis inferior
what's the roof and floor of the suboccipital triangle?
roof-semispinalis capitis and longissimus capitis
floor- posterior arch of atlas and posterior atlanto-occipital membrane
what n or a run in suboccipital triangle?
vertebral a
suboccipital n
where does the suboccipital n come from?
dorsal ramus of C1
what does the suboccipital n supply?
muscles of suboccipital triangle and semispinalis capitis
is suboccipital n sensory or motor?
motor
what n supplies rectus capitis posterior major?
suboccipital
what n supplies rectus capitis posterior minor?
suboccipital
what n supplies obliquus capitis superior?
suboccipital
what n supplies obliquus capitis inferior?
suboccipital
what's the action of rectus capitis posterior major?
extends, rotates, and flexes head laterally
what's action of rectus capitis posterior minor?
extends and flexes head laterally
what's action of obliquus capitis superior?
extends, rotates and flexes head laterally
what's action of obliquus capitis inferior?
extends and rotates head laterally
what a does vertebral a come from?
subclavian a
how does vertebral a get into cranial cavity?
ascends thru transverse foramina of upper six cervical vertebrae
pierces dura mater to enter vertebral canal
goes through foramen magnum
what's the origin of the vertebral veins?
formed in suboccipital triangle by union of tributaries from venous plexus around foramen magnum
what vein does the vertebral v empty into?
brachiocephalic v
do vertebral vv pass thru foramen magnum?
no
what type of joint is the atlanto-occipital joint?
condylar synovial joint b/w atlas and occipital condyles
what action is atlanto-occipital joint involved in?
flexion, extension, and lateral flexion of the head
what type of joint is the atlantoaxial joint?
synovial joints made of 2 lateral plane joints and 1 median pivot joint
where are the joints of the atlantoaxial?
plane: b/w articular facets of atlas and axis
pivot: b/w dens of axis and anterior arch of atlas
what action is atlantoaxial joint involved in?
rotation of atlas and head
how does atlantoaxial dislocation (subluxation) happen?
-after rupture of the cruciform ligament caused by trauma
-rheumatoid arthritis
-no dens (congenital)
-fractured dens
direct trauma from traffic accident
what damage can atlantoaxial dislocation (subluxation) cause?
may injure spinal cord and medulla
what are symptoms of atlantoaxial dislocation (subluxation)?
pain in cervical area
pain in back of nec
painful restriction of mobility
what are the main components of the occipitoaxial ligament?
cruciform ligament
apical ligament
alar ligament
tectorial membrane
what are the parts of the cruciform ligament?
transverse ligament
longitudinal ligament
describe transverse ligament of cruciform ligament:
runs b/w lateral masses of atlas, arching over dens of axis
describe longitudinal ligament of cruciform ligament:
extends from dens of axis to anterior part of foramen magnum and to body of axis
describe apical ligament:
extends from dens apex to anterior part of foramen magnum
describe alar ligament:
extends from dens apex to tubercle on medial side of occipital condyle
describe tectorial membrane:
-upward extension of PLL from axis body to basilar part of occipital bone anterior to foramen magnum
-covers posterior surface of dens and apical, alar, and cruciform ligaments
how much of vertebral canal does spinal cord occupy?
upper 2/3
what envelops spinal cord?
3 meninges
where is gray matter in the spinal cord? brain?
sc- interior
brain- exterior
where is white matter in spinal cord? brain?
sc-exterior
brain-interior
how does spinal cord end?
@ conus medullaris
where does spinal cord end?
L2 vertebrae
intervertebral disk b/w L1-L2
what's the spinal cord's rate of growth in comparison to bony vertebral column during fetal development?
sc grows slower
where does spinal cord end in adult? newborn?
a-L2
nb- L3
what does spinal cord receive blood from?
anterior spinal a
2 posterior spinal aa
branches of vertebral, cervical and posterior intercostal and lumbar aa
what's tethered cord syndrome?
congenital anomaly from defective closure of neural tube
what are signs of tethered cord syndrome?
abnormally low conus medullaris, which is tethered by a short thickened filum terminale
what are the symptoms of tethered cord syndrome?
progressive neurologic defects in legs and feet
scoliosis
what's the Arnold-Chiari (Chiari) deformity?
congenital cerebellomedullary malformation in which cerebellum and medulla oblongata protrude down into vertebral canal thru foramen magnum
how can spinal cord ischemia happen?
what the hell?
blood supply to spinal cord isn't much to begin w/
-ant and post spinal aa are of small and variable diameter and reinforcing segmental aa vary in number and size
what causes spinal cord ischemia?
aortic disease and surgery
regional anaesthesia
pain block procedures
how many pairs of spinal nerves are there? how many of ea?
31 pairs!
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
how are the spinal nerves formed?
union of ventral root and dorsal root in intervertebral foramen
what rami are the spinal nerves divided into?
dorsal primary rami
ventral primary rami
what do the dorsal primary rami innervate?
skin and deep muscles of back
what does ventral primary rami form?
C1-C4 plexus
cervical plexus
C5-T1 plexus
brachial plexus
L1-L4 plexus
lumbar plexus
L4-S4 plexus
sacral plexus
intercostal (T1-T11) nerves
subcostal (T12) nerves
how is the spinal n connected w/ the sympathetic chain ganglia?
rami communicantes
what type of nerves are spinal n?
mixed
GSA
GSE
GVA
GVE
what type of nerves are in dorsal root ganglion?
sensory (GSA and GVA) fibers w/ cell bodies
what type of nerves are in anterior horn of spinal cord?
motor (GSE) fibers w/ cell bodies
what type of nerves are in the lateral horn of the spinal cord?
preganglionic symp (GVE) fibers
what type of fibers in the intermediolateral cell column of the spinal cord segments b/w S2 and S4?
pregang parasymp: GVE fibers
how do the GVE fibers leave the sacral nerves?
via the pelvic splanchnic nerves
where does herpes zoster (shingles) remain latent?
dorsal root ganglia of spinal nerves
sensory ganglia of cranial nerves
what cond is herpes zoster commonly ass w/?
spina bifida
short neck
obstructive hydrocephalus
what does multiple sclerosis do?
causes myelin destruction in spinal cord and brain --> sensory disorders and muscle weakness
what can cause MS?
autoimmune disease b/c immune system (lymphocyte) attacks myelin around CNS axons
what's the innermost meningeal layer?
pia mater
how close is pia mater to spinal cord?
can't be dissected from it
enmeshes blood vessels on surfaces of spinal cord
what are denticulate ligaments part of?
pia mater
where are the denticulate ligaments?
lateral extensions of pia mater
b/w dorsal and ventral roots of spinal nerves and filum terminale
describe arachnoid mater:
filmy, transparent, spidery layer connected to pia mater by web-like strucs
what is the subarachnoid space?
space b/w arachnoid layer and pia mater
where is CSF?
subarachnoid space
how far does subarachnoid space extend to?
S2
what's dura mater?
tough, fibrous outermost layer of meninges
where's subdural space?
b/w arachnoid and dura
what's in the epidural space?
internal vertebral venous plexus
epidural fat
what nerves does a caudal anaesthesia block?
spinal nerves in epidural space
where is the caudal anaesthesia injected?
sacral hiatus
what is caudal anaesthesia used for?
surgery on rectum, anus, genitals, urinary tract, child birth
where does the anaesthesia go in a saddle block?
dural sac
what regions does saddle block affect?
butt
perineum
medial parts of thighs
where does a lumbar puncture penetrate?
subarachnoid space
b/w L3 and L4 or
b/w L4 and L5
what forms cauda equina?
great lash of dorsal and ventral roots of lumbar and sacral spinal nerves surrounding filum terminale
where is the cauda equina?
in subarachnoid space below level of conus medullaris
is cauda equina damaged during spinal tap?
no
what's the purpose of the denticulate ligaments?
holds spinal cord in position w/i subarachnoid space
what layers does denticulate ligament cross?
from pia through arachnoid to dura mater
what's the filum terminale?
prolongation of pia mater from conus medullaris at L2
what level does filum terminale end at?
S2
what does filum terminale att to at its end?
att to apex of dural sac
then dura continues downward as filum terminale externum, att to dorsum of coccyx
what layers is CSF b/w?
arachnoid and pia mater
what forms CSF?
vascular choroid plexuses in ventricles of brain
what's path of CSF?
circulates thru ventricles
enters subarachnoid space
filters into venous system thru arachnoid villi projecting into dural venous sinuses.. esp superior sagittal sinus
what's a dermatome?
area of skin innervated by sensory fibers from certain spinal nerve or segment of spinal cord
what's a myotome?
grp of muscles innerv by motor fibers derived from single spinal nerve segment
what's a sclerotome?
area of bone innervated from single spinal segment
what's diff b/w axial skeleton and appendicular skeleton?
axial- long axis of body, skull, vertebral column and bony thorax
appendicular- pectoral and pelvic girdles, long bones of limbs
what a does the vertebral a come from?
*vertebral a ASCENDS up transverse foramina
subclavian a
what does internal vertebral venous plexus comm w/?
superiorly- cranial dural sinuses
inferiorly- pelvic veins and both azygos and caval systems in thoracic and abdominal regions
where's the external vertebral venous plexus located?
in front of the vertebral column and on the vertebral arch
what does the external vertebral venous plexus comm w/?
internal vertebral venous plexus
what are the parts of the accessory n?
cranial part- joins vagus
spinal part- supplies SCM and trapezius
what muscles does accessory n supply?
SCM
trapezius
what muscles does suboccipital n supply?
muscles of suboccipital region