11/6 Flashcards
Functions of the Vertebral Column and Number of Vertabre
Bony protection of spinal cord
Support for upright posture
Transmit and generate forces
Attachment site for ligaments and muscles
Child and adolescent: 33 vertebrae
Adult: 26 vertebrae
Spine Curvature
Lordotic curve: towards anterior side, cervical and lumbar
Kyphotic curve: towards posterior, thoracic and sacral
Primary curvatures: present at birth, natural shape of embryo during development
Secondary curvatures: forms after birth, due to holding head upright and keeps our center of gravity in line for bipedal stance
Kyphosis: excessive concave curvature, in elderly with osteoporosis due to compression fractures on the anterior aspect of vertebral bodies, hunchback
Scoliosis: c curve in the thoracic region
Cervical Vertebrae
Transverse foramen to allow passage of vertebral artery, bifid spinous process
Atlas (C1): facet for occipital condyle, atlanto-occipital joint allows us to shake head yes, no vertebral body or spinous process, anterior/posterior arch and tubercle
Axis (C2): dens (odontoid process) forms the atlanto-axial joint via transverse ligament to allow us to shake our head no
Ligaments of the spine for joints for top 2 vertabre
Tectorial membrane: superior extension of the posterior longitudinal ligament, runs superiority and covers the alar/transverse ligaments of the atlas
Cruciate ligaments- made up of 3 ligaments
1. Transverse ligament of the atlas: horizontal ligament that holds the dens in place
- Longitudinal ligaments (superior/inferior): transverse ligament to the occipital bone above the body of C2 inferiorly
- Alar ligaments: run diagonally, attach the body of C2 to the occipital bone, prevent excessive rotation
Joints of the Spine
6 joint: 4 synovial and 2 symphysis
Flexion, extension, lateral flexion, rotation, and circumduction
Zygapophysial (synovial) joint: articulation of superior/inferior articular facets, hyaline cartilage and joint capsule with synovial fluid, highly innervated and source of back pain
Symphysis joint: between adjacent vertebral bodies, lined with hyaline cartilage and the intervertebral disk
Ligaments of the spine
- Anterior longitudinal: runs continuously along the anterior vertebral bodies from the base of the skull to the anterior sacrum, only ligament that prevents hyperextension of the spine
- Posterior longitudinal: runs continuously along the posterior vertebral bodies, prevents hyper flexion, thinner than the anterior longitudinal, in front of spinal cord and behind nucleus pulposus
- Ligaments flava: runs segmentally from lamina to lamina, prevents hyper flexion, spinal cord is anterior to it
- Interspinous ligament: runs segmentally between adjacent spinous processes, prevents hyper flexion
- Supraspinous ligament: runs continuously from C7 to the sacrum, prevents hyperflexion
- Nuchal ligament: posterior thickening of the supraspinous ligament from the skull to C7, prevents hyperflexion and site for muscle attachment for some of the cervical vertebral muscles
Fractures of the vertebral column
Pars interarticularis: posterior arch of the vertabre posterior to the transverse/superior articular processes and anterior to the inferior/spinous processes
Spondylosis: stress fracture of pars interarticularis, Scotty the dog
Spondylolisthesis: anterior shift of the vertebral body
Typically lumbar spine, L5
Extrinsic back muscles
Superficial and intermediate muscles, migrated from ventral surface and have ventral primary rami (or cranial nerve XI) for innervation
Move upper limbs and aid in respiratory functions
Superficial group: appendicular group
1. Trapezius-
O: external occipital protuberance, nuchal ligament, and spinal processes of C7-T12
I: Upper- lateral third of the clavicle, elevates scapula, neck extension if bilateral contraction
Middle- acromion, retract scapula
Inferior- spine of the scapula, depress scapula
N: accessory nerve (CN XI), proprioceptive Function from anterior rami of C3 and C4
B: Superficial branch of transverse cervical artery
- Latissimus dorsi-
O: spinous processes of T7-T12, thoracolumbar fascia, and iliac crest
I: anterior proximal aspect of the humerus
A: shoulder adduction, medial rotation, and extension
N: thoracodorsal nerve
B: thoracodorsal artery
3. Levator scapulae- O: superior angle of the scapula I: transverse processes of C1-C4, becomes 4 slits A: elevates scapula N: dorsal scapular nerve B: dorsal scapular artery
- Rhomboid major and minor-
O: Minor- inferior portion of ligamentum nuchae and spinous processes of C7-T1
Major- spinous processes of T2-T5
I: medial border of the scapula, minor above spine and major below
A: retract or adduct the scapula, assist in scapular elevation
N: dorsal scapular nerve
B: dorsal scapular artery
Splenius Muscles
- Splenius capitis-
O: ligamentum nuchae, spinous process of C7-T4
I: mastoid process, superior nuchal line
A: unilateral does head/neck rotation on the same side, bilateral does head/neck extension
N: posterior rami of middle cervical nerves - Splenius cervicis-
O: spinous process of T3-T6
I: transverse process of C1-C3
A: unilateral does head/neck rotation on the same side, bilateral does head/neck extension
N: posterior rami of lower cervical nerves
Erector Spinae Muscles
I Love Spaghetti- lateral to medial
Action: unilateral does lateral flexion of vertebral column on the sam side, bilateral does extension of the vertebral column
- Iliocostalis: posterior ilium to ribs and extends up to lower cervical vertebrae
Lumborum, thoracis, cervicis
- Longissimus: common tendon in sacral/lumbar region and attaches to thoracic/cervical transverse processes, also posterior margin of mastoid process
Thoracis, cervicis, and capitis
- Spinalis- runs adjacent from spinous processs and attaches from spinous process to spinous process
Cervicis and thoracis
Extensor of the head, neck, and vertebral column
- Multifidus: runs entire length of spine, transverse process to spinous process every 2-4 vertabre, most developed in lumbar region and cause of back pain if deficient
Bilaterally extends spine, unilaterally rotate the spine to the opposite side
- Rotatores: deepest group of muscles, transverse process to spinous process every 1-2 vertabre
Same action as multifidus
- Semispinalis- capitis, cervicis, and thoracis
O: Capitis-transverse processes of upper thoracic and lower cervical vertebrae
Cervicis and thoracis- spinous processes of thoracic vertabre
I: Capitis- Occipital bone between superior/inferior nuchal lines
Cervicis and thoracis: spinous process of C2
A: great extensor of the neck when contract bilaterally, capitis can extend the head when bilateral or rotate the head when unilateral
Suboccipital Triangle
- Rectus capitis posterior major- medial border
O: C2 spinous process
I: lateral and inferior nuchal line on the occipital bone
A: extend the atlanto-occipital and atlanto-axial joints, rotate to the same side - Rectus capitis posterior minor-
O: posterior tubercule of C1
I: medial portion of occipital bone below inferior nuchal line
A: extend and rotate only the atlanto-occipital joint (head only) - Obliquus capitis superior- lateral border
O: transverse process of C1
I: occipital bone between the superior/inferior nuchal lines
A: extend and laterally flex the atlanto-occipital joint (head) - Obliquus capitis inferior- inferior border
O: spinous process of C2
I: transverse process of C1
A: rotate the atlanto-axial joint
