Atlas of Human Anatomy by Netter

(Darren Dugan) #1

FACTS & HINTS


High-Yield Facts


Clinical Points
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Types of Vertebral Fractures
Compression fractures
Vertebral body collapses
Caused by osteoporosis, trauma, or tumor
Usually occur at C7 and T1
Moderate to severe pain, limitation of movement, kyphosis
Jefferson fracture
Four part fracture of the ring of C1
Caused by a fall on the vertex
Patients have upper neck pain but can be neurologically intact
Hangman fracture
Caused by hyperextension of the head on the neck
Bipedicle fracture of C2
Anterior displacement of C2 and C3
Results in quadriplegia or death

Cervical Hyperextension
Most common in young adults from trauma and sports injuries and the elderly, resulting in cord compression
Result of whiplash from car accidents
Results in soft tissue injury, fractures, dislocations, ligamentous tears, and disc disruption

Clinical Points


Spinal curvatures: The primary curvatures of the vertebral column in the thoracic and sacral regions develop during the fetal period and are
caused by differences in height between the anterior and posterior aspects of the vertebrae. The secondary curvatures are mainly a result of
anterior-posterior differences in IV disc thickness. The cervical curvature is acquired when the infant begins to lift its head, and the lumbar
curvature when the infant begins to walk.
Abnormal curvatures: Kyphosis is an increased thoracic curvature, commonly seen in the elderly ("Dowager hump"). It is usually caused by
osteoporosis, resulting in anterior vertebral erosion or a compression fracture. An excessive lumbar curvature is termed a lordosis and is
seen in association with weak trunk muscles, pregnancy, and obesity. Scoliosis is an abnormal lateral curvature of the spine, accompanied
by rotation of the vertebrae.
Spondylolisthesis: The lumbosacral angle is created between the long axes of the lumbar vertebrae and the sacrum. It is primarily because
of the anterior thickness of the L5 body. As the line of body weight passes anterior to the SI joints, anterior displacement of L5 over S1 may
occur (spondylolisthesis), applying pressure to the spinal nerves of the cauda equina.
Sacralization: In about 5% of individuals, the L5 vertebra is partially or totally fused with the sacrum. Because the L5/S1 level is now very
strong, the L4/5 level is likely to degenerate in these cases.

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Mnemonics


Memory Aids


Vertebral bodies:


Thoracic are heart-shaped since your heart is in your thorax
Lumbar are kidney-bean shaped as the kidneys are in the lumbar area

Craniovertebral joints:


Atlantooccipital joint is the yes-yes joint because it permits nodding
Atlantoaxial joint is the no-no joint because it permits turning the head from side to side
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