Neonatal Spine

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1

How many cervical vertebrae?

7

2

How can you tell the cervical vertebrae?

Small

transverse foramen in the transverse process

3

How many thoracic vertebrae?

12

4

How can you tell the thoracic vertebrae?

articulate with the ribs

5

How many lumbar vertebrae?

5

6

How can you tell the thoracic vertebrae?

large

do not articulate with the ribs

7

How many sacrum vertebra?

5 fused

8

How many coccyx vertebra?

4 fused

9

Where are the thickest intervertebral disks?

cervical & lumbar

due to movement

10

How much length does the intervertebral disks make up?

1/4 the length of the vertebral column

11

What are the intervertebral disks consist of?

annulus fibrosus - peripheral

nucleus pulposus - central

12

Where does the spinal cord terminate in adults?

L1

13

Where does the spinal cord terminate in children?

L3

14

What is the end of the spinal cord called

conus medularis

15

What part of the spinal cord extends to the coccyx?

filum terminalis

16

What are the spinal nerves called as they leave the end of the spinal cord?

cauda equina

17

How many pairs of spinal nerves are there?

31

18

What is the outer meninges called?

Dura mater

19

What is the middle meninges called?

arachnoid mater

20

What is the inner meninges called?

pia mater

21

What is the space called between the dura and arachnoid mater?

subdura space

22

What is the space called between the arachnoid and pia mater?

subarachnoid space

23

Why is visualization of the spinal cord possible in a neonate?

incomplete ossification of the spine

24

What position is used for neonate spinal ultrasound

prone

25

What probe should be used?

high frequency no lower than 8 MHz

26

What is the single most important determination in a spinal exam?

identification of the conus medularis

27

What are the two ways to find the conus medularis?

1. the last palpable rib is usually L2

2. palpable apex of the iliac crest is often L5

28

When do defects of the spinal cord usually occur?

first 8.5 weeks of life

29

What is the term for the anomalies associated with incomplete embryologic development?

Dysraphism

30

What is the premature separation of the neural called?

lipoma

31

What is the incomplete separation of the neural tube called?

tethering

32

What is the failure of closure of the neural called?

Spinal bifida

33

What happens with a tethered cord?

mechanical stretching

distortion

ischemia

cord will be low

34

What are lipomas associated with?

tethered cord

35

How often do lipomas occur?

20 - 50% of Dysraphism

36

Where do lipomas usually located?

at the filum terminale

37

What is dilation of the central canal of the spinal cord?

Hydromelia

38

What is congenital fissures of the spinal cord called?

diastematomyelia

39

What is diastematomyelia usually associated with?

spina difida cystica

40

What are the three types of spina bifida?

occult

myelomeningocele

meningocele

41

What is spina bifida occult?

incomplete closure of the spinal cord

42

What is spina bifida meningocele

incomplete closure of the spinal cord with the dura mater protruding

43

What is spina bifida myelomeningocele?

incomplete closure of the spinal cord with the cord protruding