1 - clinical anatomy of spine

Question 1

what are extrinsic back muscles? (4)

Answer 1

1. levator scapulae
2. rhomboids (major & minor)
3. trapezius
4. latissimus dorsi

Question 2

what are attachments for latissimus dorsi?

Answer 2

attaches to spinous process and inferiorly to iliac crests and superiorly to ribs & scapula and onto intertubercular groove on humerus too

Question 3

what is function of latissimus dorsi?

Answer 3

extend a flexed arm, acts to adduct and internally rotate arm

Question 4

what is attachment of trapezius? (extrinsic back muscle)

Answer 4

extends superiorly in neck to attach to occipital bone and forward to attach to clavicle

Question 5

what are the rhomboids (extrinsic back muscle) attachments?

Answer 5

from scapula to spinous process

Question 6

what are attachments of levator scapulae? (extrinsic back muscle)

Answer 6

attaches to cervical vertebrae and scapula

Question 7

what is main role of extrinsic back muscles?

Answer 7

they all move upper limb. known as immigrant muscles cause although they on back they form with upper limb and more important in moving upper limb than back

Question 8

what nerves innervate extrinsic back muscles?

Answer 8

all innervation is cervical spinal nerves, except trapezius which is CN XI

Question 9

what is main role of intrinsic back muscles?

Answer 9

entirely within back, maintain back posture, move spine

Question 10

what are the 2 groups of muscles that are intrinsic back muscles?

Answer 10

1. erector spinae (superficial) - run vertically next to spine
2. transversospinalis (deep) - run in gutter between spinous process & transverse process of vertebrae

Question 11

what is flexion movement of spine?

Answer 11

it’s bending forward (from starting in extended position, bent back)

Question 12

what happens if erector spinae contracts unilaterally?

Answer 12

then lateral flexion occurs (bend to side)

Question 12

what is extension movement of spine?

Answer 12

it’s moving back upright from bending forward (in flexed position)

Question 13

what muscles causes flexion of spine?

Answer 13

psoas major & rectus abdominis (think like use abs to sit up - same movement)

Question 14

how many vertebrae in adult vertebral column?

Answer 14

33
- 7 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
- 1 coccyx (4 coccygeal)

Question 15

what are the primary curves of spine called?

Answer 15

primary = same bend a way as baby = kyphosis
- thoracic & sacral are this shape

Question 16

what are the secondary curves of spine called?

Answer 16

opposite way to baby bend = lordosis
- lumbar & cervical are this shape

Question 17

what is name and shape of C1?

Answer 17

atlas = has no body or spinous process (has posterior & anterior arch instead)

Question 18

what is name and shape of C2?

Answer 18

axis = has odontoid process which projects superiorly from body

Question 19

what is name of C7 and it’s significance?

Answer 19

vertebrae prominens = first palpable

Question 20

what are differences in shape of vertebral body for thoracic and lumbar?

Answer 20

thoracic = heart shaped (think like at heart level) and lumbar = kidney shaped w large body

Question 21

what is difference in shape of vertebral foramen in thoracic & lumbar vertebra?

Answer 21

thoracic = circle. lumbar = small triangular

Question 22

where is intervertebral foramen?

Answer 22

form between adjacent vertebra, spinal nerves found here (like between the vertebra on top of each other)

Question 23

what are facet joints?

Answer 23

also known as zygapophyseal joints = between articular processes of adjacent vertebrae, can be affected by arthritis
- they’re synovial

Question 24

where are intervertebral discs? what is there structure?

Answer 24

joints between bodies of adjacent vertebrae, strong attachment, can herniate

• have outer fibrous ring = annulus fibrosus
• have inner soft pulp = nucleus pulposus

Question 25

what directions do cervical facet joints face?

Answer 25

cervical superior facet - faces posterosuperiorly

cervical inferior facet - faces anteroinferior

Question 26

what directions do thoracic facet joints face?

Answer 26

superior facet = face posterolateral
inferior facet = face anteromedial

Question 27

what directions do lumbar facet joints face?

Answer 27

super facet = face medially
inferior facet = face laterally

Question 28

what is pars interarticularis?

Answer 28

area in between articular processes

Question 29

what is spondylolysis?

Answer 29

stress fracture at vertebrae in pars interarticularis, can be congenital in kids but also in adults who play sports like football, gymnastics

Question 30

what is spondylolisthesis?

Answer 30

slipped disc - displacement when stress fracture weakened and shifted whole vertebra

Question 31

what are ligaments in vertebral column?

Answer 31

1. ligamentum flavum
2. anterior & posterior longitudinal ligament
3. supraspinous ligament
4. intraspinous ligament

Question 32

where is ligamentum flavum found?

Answer 32

between adjacent laminae posterior to spinal cord, it’s short & thick

Question 33

what is function anterior longitudinal ligament?

Answer 33

anterior is broader and stronger so prevents over extension (bending back to much)

Question 34

what is function posterior longitudinal ligament?

Answer 34

narrower & weaker, prevents over flexion (bend forward too much)

Question 35

what does supraspinous ligament connect?

Answer 35

• connects tips of spinous processes
• strong, fibrous

Question 36

what does intraspinous ligament connect?

Answer 36

• connect superior surface of one spinous process to inferior surfaces of spinous process above it
• weak, membranous