The document provides an overview of the anatomy of the spine including its curves, vertebrae, discs, ligaments and muscles. Key points include:
- The spine has natural curves (kyphosis in thoracic region, lordosis in cervical and lumbar regions) to absorb shock and allow flexibility.
- It consists of 33 vertebrae divided into cervical, thoracic, lumbar, sacral and coccygeal regions.
- Intervertebral discs made of annulus fibrosus and nucleus pulposus act as cushions and allow movement.
- Ligaments like the anterior longitudinal ligament maintain stability and prevent excessive movement.
- Paraspinal muscles including erector spinae control
different type of lower limb amputation with indication, peri-operative care, surgical steps, post op care complication and different type of prosthesis
Includes all the basic concepts about cell - morphology, prokaryotic vs eukaryotic, cell organelles and its functions, methods of division and commonly encountered anomalies.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
8. CURVES OF SPINE
■ PRIMARY CURVATURES:
– KYPHOTIC CURVE
– PRESENT FROM FETAL LIFE
– THORACIC (20*-40*)
– SACRAL
■ SECONDARY CURVATURES:
– LORDOTIC CURVE
– DEVELOPS DURING INFANCY OR
CHILDHOOD
– CERVICAL (20-40*)
– LUMBAR (30-50*)
Cervical(2*)
Thoracic(1*)
Lumbar(2*)
Sacral(1*)
Curvatures
9. CORONAL PLANE:
SPINE APPEARS
SYMMETRICAL AND
STRAIGHT
ABNORMAILTY SEEN IN
CORONAL PLANE:
• SCOLIOSIS
SAGITAL PLANE:
2 KYPHOTIC CURVE
(THORACIC AND
SACRAL)
2 LORDOTIC CURVE
(CERVICAL AND
LUMBAR)
ABNORMALITY SEEN
IN SAGITAL PLANE:
• LOSS OF LORDOSIS
• KNUCKLE
• KYPHOSUS
• GIBBUS
10. LEVELS OF SPINE
• ADULT SPINE IS 72 CM LONG IN MEN AND 7-10
CM LESS IN WOMEN.
• TOTAL 33 VERTEBRAE
• 5 MAIN REGION-
1) CERVICAL - C1-C7
2) THORACIC - T1-T12
3) LUMBAR - L1-L5
4) SACRAL - S1-S5
5) COCCYX - C1-C4
• THERE ARE 24 MOBILE SEGMENTS AND 9
FUSED VERTEBRAE WHICH ARE IMMOBILE.
11. VERTEBRAL ANATOMY
COMMON FEATURES SHARED BY
MOST VERTEBRAE ARE-
1. VERTEBRAL BODY
2. POSTERIOR ARCH
• PEDICLE
• LAMINA
• SPINOUS PROCESS
• TRANSVERSE PROCESS
• ARTICULAR PROCESS
13. POSTERIOR ARCH
■ 2 STOUT PILLARS BRIDGING VERTEBRAL BODY AND POSTERIOR
ARCH CALLED PEDICLE
■ PEDICLE GOES DORSALLY FUSING WITH PAIR OF ARCHED FLAT
LAMINA.
■ LAMINA DORSALLY FUSE IN MIDLINE TO FORM SPINOUS
PROCESS.
■ PEDICLE, LAMINA WITH SPINOUS PROCESS FORM VERTEBRAL
FORAMEN, COMPLETE OSSEOUS RING THAT ENCLOSE SPINAL
CORD.
■ TRANSVERSE PROCESS IS A STUCTURE EXTENDING FROM
JUNCTION OF LAMINA AND PEDICLE.
■ TRANSVERSE PROCESS ALLOW MOVEMENT OF SPINE AND
LIGAMENT AND STABALIZE THE SPINE BY GIVING ATTCHMENT TO
MUSCLES AND ARTICULATING WITH RIBS.
14. POSTERIOR ARCH
ARTICULAR PROCESS (ZYGAPOPHYSES)
ANOTHER PROJECTION FROM JUNCTION OF
PEDICLE AND LAMINA.
2 SUPERIOR ARTICULAR PROCESS
(PREZYGAPOPHYSES) AND 2 INFERIOR
ARTICULAR PROCESS (POSTZYGAPOPHYSES) IS
PRESENT.
ARTICULAR SURFACE OF PROCESS IS CALLED
FACET WHICH COVERED WITH HYALINE
CARTILAGE.
INTERVERTEBRAL FORAMEN ALLOWING SPINAL
NERVES AN EXIT POINT FROM THE CORD.
15. PARS INERARTICULARIS
PART OF ARCH THAT LIES BETWEEN
SUPERIOR AND INFERIOR ARTICULAR
FACET.
IT IS AREA OF MOST STRESSED BY
TRANSLATIONAL MOVEMENT BETWEEN
ADJACENT SEGMENT.
IT IS SUSCEPTIBLE TO TRAUMATIC AND
STRESS FRACTURE
DEFECT OF PARS INTERARTICULARIS
LEAD TO SPONDYLOLYSIS AND
SPONDYLOLISTHESIS.
16. CERVICAL VERTEBRAE
7 VERTEBRAE
DIFFERENTIATING FEATURE IS
PRESENCE OF TRANSVERSE
FORAMEN.
LORDOTIC CURVE
PROVIDES MOBILITY AND
STABILITY TO HEAD.
17. C1 (ATLAS)
■ NO BODY, NO SPINOUS PROCESS
■ DEVELOP AS A RING OF BONE WITH
ANTERIOR AND POSTERIOR
ARCHES THAT CONNECT 2 LATERAL
MSSES.
18. C2 (AXIS)
■ DURING THE DEVELOPMENT OF ATLAS, WHAT
SHOULD BE THE BODY NATURALLY FUSE TO
AXIS FORMING DENS OR ODONTOID PEG AND
PRESENTED AS BODY OF AXIS.
■ POSTERIORLY GROOVE IN THE NECK OF
ODONTOID REPRESENTS POSITION OF STRONG
TRANSVERSE ATLANTAL LIGAMMENT.
■ AT THE TIP OF ODONTOID PEG THERE IS
ATTACHMENT OF APICAL LIGAMENT. IT
CONNECTS ODONTOID TO BASE OF SKULL AT
BASION, ANTERIOR PART OF FORAMEN
MAGNUM.
19. ATLANTOAXIAL JOINT
■ IT IS A PIVOT JOINT.
■ ATLAS AND AXIS FORM COMPLEX
ARTICULAR SYSTEM THAT PERMITS
NODDING AND ROTATIONAL
MOVEMENTS OF THE HEAD.
■ DENS, TOOTH LIKE STRUCTURE ACT
AS CENTRAL POINT TO ALLOW
ROTATION FOR ATLAS.
■ NO INTERVERTEBRAL DISC BETWEEN
C1 AND C2.
21. C7 VERTEBRAE
■ C7 VERTEBRAE IS REFERRED AS
VERTEBRAE PROMINENS BECAUSE
IT HAS LONGER AND LARGER
SPINOUS PROCESS COMPARED TO
OTHER CERVICAL VERTEBRAE.
■ HERE SPINOUS PROCESS IS NOT
USUALLY BIFID.
22. THORACIC VERTEBRAE
■ 12 VERTEBRAE
■ NATURAL KYPHOTIC CURVE.
■ PEDICLE HEIGHT INCREASES T1 TO T12.
■ APEX IS PRESENT AT T7/T8, AT THIS LEVEL
DISC HAVE MAJOR ROLE IN INFLUENCING
THE CURVE.
■ DIFFERENTIATING FEATURE-PRESENCE OF
FACET FOR ARTICULATION WITH RIB
23. THORACIC VERTEBRAE
■ 2 DEMI FACET PRESENT NEAR
ROOT OF PEDICLE TO
ACCOMMODATE THE HEAD OF
CORRESPONDING RIBS.
■ SMALL COSTAL FACET PRESENT
ON TRANSVERSE PROCESS
WHICH ARTICULATE WITH
TUBERCLE OF THE RIB.
■ FROM T10-T12 ONLY SUPRIOR
COSTAL FACET PRESENT,
INFERIOR COSTAL FACET
24. LUMBAR VERTEBRAE
■ 5 VERTEBRAE
■ NATURAL LORDOTIC CURVE
■ MOST WEIGHT IS CENTERED AND
SUSTAIN GREATER STRESS.
■ HAVE MAMILLARY PROCESSES WHICH
GIVE ATTACHMENT OF THICK LOWER
DIVISION OF DEEP PARASPINAL
MUSCLES.
■ SUPERIOR ARTICULAR SURFACE
DIRECTED DORSOMEDIALLY WHEREAS
INFERIOR ARTICULAR SURFACE DIRECT
TOWARDS VENTROLATERALLY.
25. LUMBAR VERTEBRAE
■ BODY LARGE, FAIRLY FLAT AND BROAD IN
SHAPE.
■ PEDICLES ARE SHORTER, THICKER AND
OVAL SHAPED.
■ SPINOUS PROCESS ARE THICKER AND
SQUARE SHAPED.
■ INTERVERTEBRAL FORAMEN ARE LARGE
BUT INCREASED INCIDENCE OF NERVE
ROOT COMPRESSION.
■ VERTEBRAL FORAMEN TRIANGULAR IN
SHAPE.
26. SACROCOCCYGEAL VERTEBRAE
■ APPEARS TRIANGULAR
■ CONSIST OF 5 FUSED SACRAL VERTEBRAE AND 4
COCCYGEAL VERTEBRAE.
■ TRANSMIT BODY WEIGHT TO HIP.
■ MEDIAL SACRAL CREST- PRESENT POSTERIORLY
OVER FUSED SPINOUS PROCESS, ARTICULAR
PROCESS AND TRANSVERSE PROCESS
■ SACRAL PROMONTORY- 1ST SACRAL VERTEBRAE
WITH PROFILE RIDGE.
■ SACRAL ALA- FLAT BROAD AREA WHERE SACRUM
ARTICULATE WITH ILIUM AND PELVIS.
28. VERTEBRAL END PALTES
■ CONSIST OF HYALINE CARTILAGE
AND FIBROCARTILAGE IN YOUNG.
■ IN ADULTS CONSIST OF
FIBROCARTILAGE
■ THICKNESS 0.6-1 MM
■ WEAKEST PART OF DISC
■ FUNCTION:
– NUTRITION OF DISC
– PREVENT BULGING OF NUCLEUS
INTO VERTEBRAL BODY
29. INTERVERTEBRAL DISC
• COMPOSED OF-
1. ANNULUS FIBROSUS- (TOUGH RING)
o CONSIST OF CONCENTRIC LAMINAL LAYER OF TYPE 1
COLLAGEN.
o IT CONTAINS AND LIMIT THE EXPANSION OF NUCLEUS.
1. NUCLEUS PULPOSUS- (SEMI FLUID GEL)
o CONSIST OFTYPE 2 CALLAGEN ARRANGED IN LOOSE MESH
SEMI FLUID PROTEIOGLYCAN GEL.
o MAKES 40- 60%.
o ABLE TO CHANGE SHAPE AND TRANSMIT PRESSURE IN
ALL DIRECTIONS.
o IT PROVIDE ELASTICITY AND COMPRESSIBILITY.
30. INTERVERTEBRAL DISC
CUSHION LIKE STRUCTURE.
PREVENT AGAINST COMPRESSIVE FORCES.
OVERALL BODY HEIGHT DECREASES BY 15-20 MM DURING
DAY WHICH IS RECUPERATED DURING NIGHT
NUTRITION- DISC IS AVASCULAR AFTER 10 YRS AND RELIES
ON DIFFUSION OF NUTRIENT SUCH AS OXYGEN, GLUCOSE
AND SULFATE.
3 BIOMECHANICAL GOAL-
WEIGHT DISTRIBUTION FROM 1 VERTEBRAE TO ANOTHER.
FLEXIBILITY ALLOW FLEXION, EXTENSION, LATERAL
BENDING AND ROTATION.
STRENGHT TO PREVENT ANY INJURY DURING MOVEMENT.
31. LIGAMENTS
■ IT IS CONNECTING TISSUE FROM 1 BONE TO
ANOTHER.
■ MAINTAIN STABILITY IN UPRIGHT POSITION PROTECT
AGAINST TENSILE FORCE.
■ 6 LIGAMENTS ARE THERE-
– ANTERIOR LONGITUDINAL LIGAMENT
– POSTERIOR LONGITUDINAL LIGAMENT
– SUPRASPINOUS LIGAMENT
– INTERSPINOUS LIGAMENT
– LIGAMENTUM FLAVUM
– FACET OR ARTICULAR CAPSULE ( SURROUNDS
ZYGAPOPHYSEAL JOINT ALLOW MOVEMENT IN
SAGITTAL PLANE)
32. ANTERIOR LONGITUDINAL LIGAMENT
■ EXTENDS FROM ANTERIOR ASPECT OF
BASE OF OCCIPUT VIA THE ATLAS DOWN
THE ANTERIOR SURFACE OF EACH
VERTEBRAE AND DISC UPTO SACRUM.
■ 20 MM WIDE
■ PREVENT ANTERIOR SEPARATION OF
EACH VERTEBRAL BODY WHEN IN
EXTENSION AND FLEXION.
33. POSTERIOR LONGITUDINAL LIGAMENT
■ POSTERIOR TO BODY AND DISC
■ EXTENDS FROM POSTERIOR
ASPECT OF BASE OF OCCIPUT VIA
ODONTOID PEG DOWN UPTO
COCCYX.
■ BROADER OVER DISC AND
NARROWER OVER BODY.
34. LIGAMENTUM FLAVUM AND INTERSPINOUS
LIGAMENT■ LIGAMENTUM FLAVUM:
– SHORT AND THICK
– PROTECT DISC BY LIMITING MOVEMENT.
– YELLOW LIGAMENT DUE TO DISTINCTIVE
COLOUR.
– MOST ELACTIC TISSUE IN BODY
■ INTERSPINOUS LIGAMENT:
– SERIES OF SHORT LIGAMENT THAT CONNECT
ADJACENT SPINOUS PROCESS
– IT LACKS CONTINUITY
35. SUPRASPINOUS LIGAMENT AND INTERTRANSVERSE
LIGAMENT
■ SUPRASPINOUS LIGAMENT:
– FIBROUS CORD ATTACHES AT TIP OF
EACH SPINOUS PROCESS.
– IT CEASES BETWEEN L4-L5 VERTEBRAE.
– BELOW THIS THORACOLUMBAR FASCIA
TAKES OVER ROLE OF PROVIDING
STRENGTH AND SAGITTAL MOVEMENT OF
LS SPINE.
■ INTERTRANSVERSE LIGAMENT:
– IT LIMITS LATERAL FLEXION OF SPINE
36. MUSCLES
■ CREATES COVER OF SOFT TISSUE
■ PERMITS MOVEMENT AND STABILITY OF SPINAL
COLUMN.
■ IT IS KNOWN AS PARASPINAL MUSCLES.
■ ROLE OF PARASPINAL MUSCLES-
– STABALIZATION OF BONES
– INFLUENCE POSTURE
– IT INFLUENCE MOVEMENT- EXTENSION, FLEXION AND
ROTATION.
37. ANTERIOR MUSCLES
■ GROUP OF MUSCLE ASSOCIATED WITH FLEXION.
■ LONGUS CAPITIS- FROM LATERAL MASSES TO
FORAMEN MAGNUM.
■ LONGUS COLI- FROM ATLAS TO T3.
■ PSOAS MAJOR- IN LUMBAR REGION AND EXTEND
TO THE HIP.
■ PSOAS MINOR- LIES ON SURFACE OF PSOAS
MAJOR FROM T12-L1.
38. POSTERIOR MUSCLES
■ DEEP LAYER-
– INTERSPINATE MUSCLES
– INTERTRANSVERSALE MUSCLE
■ INTERMEDIATE LAYER-
– TRANSVERSOSPINALIS- EXTEND FROM
TRANSVERSE PROCESS TO SPINE.
I. MULTIFIDUS
II. SEMISPINALIS CERVICIS
III. SEMISPINALIS CAPITIS
IV. SEMISPINALIS THORACIS
40. MUSCLES
■ OTHER MUSCLES- CONTROLLING MOVEMENT OF THE SPINE
– SERRATUS POSTERIOR SUPERIOR
– RHOMBOID MINOR
– TRAPEZIUS
– RHOMBOID MAJOR
– LATTISMUS DORSI
– SERRATUS POSTERIOR INFERIOR
41. SPINAL CORD
■ SPINAL CORD IS SURROUNDED BY THREE
MEMBRANES-
– DURA MATER- EXTERNAL LOOSE SHEETH WHICH
DOESNOT ADHERE TO CORD.
– ARACHNOID- THIN DELICATE LAYER BETWEEN
DURA MATER AND PIA MATER.
– PIA MATER- INNERMOST LAYER WHICH ADHERE
TO CORD.
■ SUBDURAL SPACE CONTAIN SEROUS FLUID.
■ SUBARACHNOID SPACE CONTAIN CSF.
■ ALL NERVE DIVIDE INTO ANTERIOR AND
POSTERIOR SEGMENT WHICH CONNECT TO THE
CORD VIA ANTERIOR AND POSTERIOR NERVE
ROOT.
42. SPINAL CORD
■ HOUSED WITHIN VERTEBRAL FORAMEN AND PROTECTED BY
BONE ALL AROUND.
■ EXTENDS FROM FORAMEN MAGNUM TO WHERE IT
CONNECTS WITH MEDULLA OBLONGATA AND ENDS AT
LOWER BORDER OF L1 .
■ BELOW THIS LEVEL IT DIVIDED AS CONUS MEDULLARIS,
SEEN AS BUNDLE OF FILAMENTS.
■ BUNDLE CONSIST OF LUMBAR AND SACRAL NERVE ROOTS.
■ THEY RESEMBLE HORSE’S TAIL AND ARE CALLED CAUDA
EQUINA.
■ AT MOST DISTAL PART IT IS ATTACHED TO COCCYX BY FILUM
TERMINALE.
43. SPINAL NERVES
■ 31 PAIR OF SPINAL NERVES-
– CERVICAL: 8 PAIRS
– THORACIC: 12 PAIRS
– LUMBAR: 5 PAIRS
– SACRAL: 5 PAIRS
– COCCYGEAL: 1 PAIR
■ C1 NERVE ROOT EXIT BETWEEN OCCIPITAL AND C1
■ C2 EXIT BETWEEN C1 AND C2.
■ IN CERVICAL SPINE NERVE ROOT EXIT ABOVE THE LEVEL IT IS
NAMED.
■ WHEREAS OTHER REGION NERVE ROOT EXIT AT THE SAME
LEVEL IT IS NAMED.
44. SPINAL NERVE
■ ALL NERVE DIVIDE INTO ANTERIOR
AND POSTERIOR SEGMENT WHICH
CONNECT TO THE CORD VIA ANTERIOR
AND POSTERIOR NERVE ROOT.
■ ANTERIOR NERVE ROOT ACT AS
MOTOR NERVE WHEREAS POSTERIOR
NERVE ROOT PROVIDES SENSORY
INFORMATION.
45. SPINAL NERVE
PLEXUS NETWORK IS AN ADDITIONAL BRANCHES OF THE
NERVES.
THROUGH CONTINOUS DIVISION AND REFORMATION,
PLEXUS IS FORMED.
4 PLEXUS-
CERVICAL PLEXUS: DUE TO ANTERIOR DIVISION OF
UPPER 4 CERVICAL NERVES.
BRACHIAL PLEXUS: DUE TO MERGER OF LOWER 4
CERVICAL NERVE AND 1ST THORACIC NERVE
LUMBAR PLEXUS: DUE TO ANTERIOR DIVISION OF
UPPER FOUR LUMBAR NERVE AND 12TH THORACIC
NERVE.
SACRAL PLEXUS: DUE TO LUMBOSACRAL CORD,
ANTERIOR DIVIDION OF UPPER THREE SACRAL NERVE
AND SECTION OF 4TH SACRAL NERVE.
46. DERMATOMES
SENSORY COMPONENT OF EACH
SPINAL NERVE DISTRIBUTES TO A
SEGMENTAL PART OF SKIN CALLED
DERMATOME.
PATTERN FOLLOWS SEGMENTAL
DISTRIBUTION OF UNDERLYING
MUSCLE INNERVATIONS.
TESTING THE SENSATION ON THE SKIN
AS WELL AS TESTIONG POWER IS
USEFULL IN DETERMINING THE
PRESENCE OF A NERVE, SPINAL
TRACT OR SPINAL CORD LESION.
48. GOAL OF X-RAYS OF SPINE
■ TO DIAGNOSE
– CAUSE OF BACK PAIN OR NECK PAIN
– FRACTURE
– ARTHRITIS
– SPONDYLOLISTHESIS
– DEGENERATION OF DISC
– TUMOR
– ABNORMALITIES OF CURVATURE
– CONGENITAL ABNORMALITIES
49. X-RAYS OF CERVICAL SPINE
■ DIFFERENT VIEW FOR CERVICAL SPINE:
– ANTEROPOSTERIOR VIEW
– LATERAL VIEW
– ODONTOID (OPEN MOUTH) VIEW
– SWIMMERS VIEW
– LATERAL VIEW WITH TRACTION OF BOTH ARM
– FUNCTIONAL VIEW (LATERAL FLEXION AND EXTENSION VIEW)
50. NORMAL RADIOLOGICAL FINDING IN C-SPINE
■ LATERAL VIEW CERVICAL SPINE
■ F: FACET JOINT
■ SP: SPINOUS PROCESS
■ H: HYOID BONE
■ Ph: PHARYNX
■ Tr: TRACHEA
■ PREDENTAL SPACE
■ RETROPHARYNGEAL SPACE
■ RETROTRACHEAL SPACE
■ POSTERIOR CERVICAL LINE FROM C1 TO C3
51. NORMAL RADIOLOGICAL FINDING IN C-
SPINE
■ ANTEROPOSTERIOR VIEW OF
CERVICAL SPINE
■ D: INTERVERTEBRAL DISC
■ U: UNCOVERTEBRAL JOINT
■ T: TRANSVERSE PROCESS
■ SP: SPINOUS PROCESS
55. X-RAYS OF THORACOLUMBAR SPINE
■ DIFFERENT VIEW FOR THORACOLUMBAR SPINE:
– ANTEROPOSTERIOR VIEW
– LATERAL VIEW
– FUNCTIONAL VIEW (LATERAL FLEXION AND EXTENSION VIEW)
– OBLIQUE VIEW
– FERGUSON VIEW: 20* CAUDOCEPHALIC ANTEROPOSTERIOR
– ANGLED CAUDAL VIEW: FOR FACET OR LAMINAR PATHOLOGICAL CONDITION
56. RADIOGRAPHIC ANATOMY OF LUMBAR
SPINE
■ LATERAL VIEW OF LUMBAR SPINE
– B: BODY OF VERTEBRAE
– D: INTERVERTEBRAL DISC
– P: PEDICLE
– F: FACET
– Fo: INTERVERTEBRAL FORAMEN
– I: INFERIOR ARTICULAR PROCESS
– S: SUPERIOR ARTICULAR PROCESS
– SP: SPINOUS PROCESS
57. RADIOGRAPHIC ANATOMY OF LUMBAR
SPINE
■ ANTEROPOSTERIOR VIEW OF
LUMBAR VERTEBRAE
– I: INFERIOR ARTICULAR PROCESS
– S: SUPERIOR ARTICULAR PROCESS
– P: PEDICLE
– L: LAMINA
– T: TRANSVERSE PROCESS
– SP: SPINOUS PROCESS
58. RADIOGRAPH OF LS SPINE- AP/ LATERAL/ LATERAL
FLEXION AND LATERAL EXTENSION VIEW
59. RADIOGRAPHIC ANATOMY OF THORACIC
SPINE ■ ADDITIONAL
FEATURE IN
THORACIC SPINE IS
ARTICULATION OF
RIB WITH FACET
PRESENT OVER
VERTEBRAL BODY.
60. DENNIS THREE COLUMN CLASSIFICATION
■ FOR TREATMENT OF SPINAL INJURIES, IT IS
CRUCIAL TO ASSESS STABILITY OF SPINE .
■ IN 3 COLUMN CLASSIFICATION, SPINE IS
DIVIDED INTO 3 COLUMN.
■ WHEN ONLY 1 COLUMN IS DISRUPTED ,
SPINE IS STABLE.
■ WHEN 2 OR MORE THAN 2 COLUMN IS
INVOLVED, SPINE IS UNSTABLE.
63. SCOLIOSIS
■ ABNORMAL CURVATURE OF SPINE WITH LATERAL
COMPONENT OF MORE THAN 10*.
■ ASSESSED RADIOLOGICALLY WITH SINGLE AP LONG
FILM OF THORACIC AND LUMBAR SPINE TAKEN IN
PATIENT WITH ERECT POSITION.
■ COBBS ANGLE OF 10* OR MORE IS CONSIDERED
ABNORMAL.
■ ROTATION OF VERTEBRAE WITH 1 PRIMARY AND 2
SECONDARY CURVES.
■ FULCRUM BENDING RADIOGRAPH TO DETERMINE
FLEXIBILITY OF SCOLIOTIC CURE
64. SCOLIOSIS
■ HOW TO MEASURE COBBS
ANGLE?
1. DRAW A LINE PARALLEL TO
SUPERIOR END PLATE OF
MOST TILTED VERTEBRAE AT
UPPER END OF CURVE.
2. DRAW A LINE PARALLEL TO
INFERIOR END PLATE OF
MOST TILTED VERTEBRAE AT
LOWER END OF CURVE.
■ ANGLE BETWEEN THESE TWO
LINE OR ANGLE BETWEEN
TWO LINE PERPENDICULAR
TO ABOVE TWO LINE IS COBBS
ANGLE.
66. KYPHOSIS
■ EXCESSIVE BACKWARD CONVEXITY OF SPINE.
■ ASSESSED RADIOLOGICALLY WITH SINGLE
LATERAL LONG FILM OF THORACIC AND LUMBAR
SPINE TAKEN IN PATIENT WITH ERECT POSITION.
■ COBBS ANGLE IS MEASURE TO EVAVLUATE
SEVERITY.
■ HYPEREXTENSION FILM TO DETERMINE
FLEXIBILITY ON HYPEREXTENSION.
68. SPONDYLOSIS
■ DEFECT IN PARS
INTERARTICULARIS
■ OBLIQUE VIEW OF SPINE IS
IMPORTANT TO SHOW DEFECT IN
PARS INTERARTICULARIS.
■ SCOTTISH DOG WITH COLLAR SIGN
SEEN IN X-RAY
69. SPONDYLOLISTHESIS
■ DEFECT IN PARS INTERARTICULARIS
WITH DISPLACEMENT OF ONE
VERTEBRAE OVER OTHER (ANTERIOR
> POSTERIOR)
■ OBLIQUE VIEW OF SPINE IS
IMPORTANT TO SHOW DEFECT IN
PARS INTERARTICULARIS.
■ SCOTTISH DOG HEAD AWAY FROM
THE BODY SIGN SEEN IN X-RAY
70. POTT’S SPINE
■ X-RAY FINDING IN TB OF SPINE:
EARLY CASE, MINIMAL LOSS OF DISC SPACE
COMPLETE LOSS OF DISC SPACE
DESTRUCTION OF VERTEBRAL BODIES WITH LOSS OF DISC SPACE
ADVANCED DESTRUCTION AND WEDGING OF VERTEBRAE
PARAVERTEBRAL ABSCESS
PSOAS ABSCESS
RETROPHARYNGEAL ABSCESS
SPONDYLOSIS- STRESS FRACTURE IN PARS INTERARTICULARIS
SPONDYLOLISTHESIS- FRACTURE AT PARS INTERCULARIS WITH SLIDING OF VERTEBRAE
TRANSVERSE FORAMEN TRANSMIT VERTEBRAL ARTERIES.
CERVICAL PEDICLE HEIGHT RANGES FROM 5.1 TO 9.5 MM.
CERVICAL PEDICLE WIDHT RANGES FROM 3 TO 7.5 MM.
PEDICLE IS ANGLED MEDIALLY BETWEEN 90 AND 110*
BIFID SPINOUS PROCESS RECEIVE INSERTION OS SEMISPINALIS CERVICIS MUSCLES
IT IS ACHIEVED BY
BLOOD VESSEL AROUND ANNULUS FIBROSUS
CAPILLARY PLEXUS UNDER END PLATE
FILUM TERMINALE- NONNERVOUS STRUCTURE , AN EXTENSION OF PIA MATER AND ENCASED BT DURA MATER.
UNCOVERTEBRAL JOINT: SEEN IN CERVICAL SPINE FORMED BY RIDGE OR LIP OF BONE FROM LATERAL EDGE OF VERTEBRAL BODY AND ARTICULATES WITH LATERAL EDGE OF VERTEBRAL BODY OF THE VERTEBRAL BODY ABOVE.