16. Back & Vertebral Column Flashcards
1
Q
What are the Cervical Vertebrae?
A
C1 - C7
2
Q
What is the 1st Cervical Vertebrae called?
A
ATLAS
3
Q
What kind of movement occurs at the Atlas?
A
Front to Back Movement
4
Q
What does the Atlas articulate with, and what Joints are formed?
A
- Articulates with the Occipital Bone forming the Atlanto - Occipital Joint.
- Articulates with the Axis (C2) forming the Atlanto - Axial Joint.
5
Q
How does the Atlas differ from other Cervical Vertebrae?
A
NO Vertebral Body
NO Spinous Process.
6
Q
What are Atlas Lateral Masses and how are they connected?
A
The Atlas has Lateral Masses.
These are connected by:
1. Anterior Arch
2. Posterior Arch.
7
Q
What are the 2 Facets on the Atlas and what do they
articulate with?
A
Superior Articular Facet: For Articulation with Occipital Condyles.
Inferior Articular Facet: For Articulation with C2.
8
Q
What does the Anterior Arch articulate with?
A
The Anterior Arch contains a Facet:
- This Articulates with the Dens of the Axis.
9
Q
Which structure secures the Atlas to the Axis?
A
Transverse Ligament of the Atlas,
Which attaches to the Lateral Masses.
10
Q
Which structures pass along the Posterior Arch of the Axis?
A
The Posterior Arch has a Groove for the:
- Vertebral Artery
- C1 Spinal Nerve.
11
Q
What is the 2nd Cervical Vertebrae called?
A
AXIS
12
Q
What is the Dens of the Axis?
A
Dens (Odontoid Process):
- Which extends Superiorly from the Anterior Portion of the Vertebra.
13
Q
How does the Axis articulate with the Atlas, what Joints?
A
- Medial Atlanto - Axial Joint:
- Dens of the Axis articulates with the Anterior Arch of the Atlas.
- Two (2) Lateral Atlanto - Axial Joints:
- Superior Articular Facets of the Axis articulate with the Inferior Articular Facets of the Atlas.
14
Q
What kind of movement occurs at the Medial Atlanto - Axial Joint?
A
Rotation of the Head (side to side) independently of the Torso.
15
Q
What are the 3 distinguishing features of the Cervical Vertebrae?
A
- Triangular Vertebral Foramen
- Bifid Spinous Process
- Transverse Foramina
16
Q
What passes through the Triangular Vertebral Foramen?
A
Spinal Cord
17
Q
What splits at the Bifid Spinous Process?
A
This is where the Spinous Process splits into two distally.
18
Q
What are the Transverse Foramina?
A
Holes in the Transverse Processes:
Form a passage for the:
- Vertebral Artery
- Vertebral Vein
- Sympathetic Nerves.
19
Q
What is the 7th Cervical Vertebrae called?
A
Vertebra Prominens
20
Q
What are the 3 distinguishing features of C7?
A
- Spinous Process ends in a Rounded Tubercle and is NOT Bifid.
- Transverse Foramina are Small, and DO NOT transmit the Vertebral Artery.
- Anterior Tubercle is Small.
21
Q
What structures attach to the Anterior Tubercule of C7?
A
Scalenus Pleuralis
Suprapleural Membrane
22
Q
What are the Thoracic Vertebrae?
A
T1 - T12
23
Q
What are the 4 distinguishing features of the Thoracic Vertebrae?
A
- Vertebral Body is Heart Shaped.
- Presence of Demi - Facets on the sides of each Vertebral Body,
- Presence of Costal Facets (on T1 - T10 only) on the Transverse Processes.
- The Spinous Processes are Long and Slant inferiorly.
24
Q
What do the Thoracic Demi - Facets articulate with?
A
Articulate with the Heads of the Ribs.
25
What do the Thoracic Costal Facets articulate with?
Articulate with the Tubercles of the Ribs.
26
What is the purpose of the Long Spinous Processes?
Increased protection to the Spinal Cord,
Preventing an object such as a knife entering the Spinal Canal.
27
What are the Lumbar Vertebrae?
L1 - L5
28
What is different about Lumber Vertebrae?
5 Distinct Vertebrae which are the Largest of the Vertebral Column.
29
What is the Main Function of the Lumbar Spine?
Weight Bearing Structure
30
How is the structure of the Lumbar Vertebrae unique?
Vertebral bodies are Large and Kidney - Shaped.
The Vertebral Foramen is Triangular in shape.
31
What is the Lumbosacral Angle?
The Angle between the Long Axis of the Lumbar Region and that of the Sacrum.
32
What feature of the Lumbar Vertebrae forms the Lumbosacral Angle?
They are Deeper Anteriorly than Posteriorly:
- Producing the Lumbosacral Angle
33
Describe the Processes found on Lumber Vertebrae?
1. Transverse Processes
- Are Long and Slender.
2. Articular Processes
- Have nearly Vertical Facets.
3. Spinous Processes
- Are Short and Broad.
4. Accessory Processes
- Can be found on the Posterior Aspect of the Base of each Transverse Process.
5. Mammillary Processes
- Can be found on the Posterior Surface of each Superior Articular Process.
34
What is one function of the Accessory and Mamillary processes?
Act as sites of Attachment for Deep Back Muscles.
35
How is the 5th Lumbar Vertebrae unique and why?
Notably Large Vertebral Body and Transverse processes,
As it carries the weight of the entire Upper Body.
36
What is the Sacrum?
Formed by the fusion of the 5 Sacral Vertebrae: S1 - S5
It has an inverted Triangular, Concave Shape
37
What are the 2 Main Components of the Sacrum?
1. Base
2. Apex
38
What are the Surfaces of the Sacrum Bone?
Four Surfaces:
1. Left Auricular Surface
2. Right Auricular Surface
3. Anterior Surface
4. Posterior Surface
39
What does the Base of the Sacrum articulate with?
Articulates Superiorly with the 5th Lumbar Vertebra and its associated Intervertebral Disc
Here you also get the Ala (Wing) of the Sacrum.
40
How is the Apex of the Sacrum related to the Coccyx?
Abuts (leans on) the Coccyx Inferiorly.
41
Where are the Auricular Surfaces and what do they articulate with?
Located laterally on the Sacrum,
Shaped like the Outer Ear,
Each articulates with the Auricular Surface of the Ilium.
42
What do the Anterior and Posterior Surfaces provide attachment for?
Provide Attachment to Pelvic Ligaments and Muscles.
43
Where does the Central Canal continue and Terminate at the Sacrum?
Internally, the Central Canal of the Vertebral Column continues along the Core of the Sacrum,
Ends at the 4th Sacral Foramina, as the Sacral Hiatus.
44
What are the other 2 Surfaces of the Sacrum?
1. Dorsal Surface
2. Pelvic Surface
45
What is the Texture of the Dorsal Surface of the Sacrum?
Rugged due to fusion of Sacral Vertebrae.
46
What are the 3 Crests of the Dorsal Surface of the Sacrum?
1. Median Sacral Crest
2. Intermediate Sacral Crests
3. Lateral Sacral Crests
47
How is the Median Sacral Crest formed?
Formed via fusion of Spinous Processes of the first 3 Sacral Vertebrae
48
Which Ligament attaches to the Median Sacral Crest?
Gives attachment to Supraspinous Ligament.
49
How is the Intermediate Sacral Crest formed?
Formed by Fusion of Sacral Articular Processes.
50
How is the Lateral Sacral Crest formed?
Formed by Fusion of the Transverse Processes of the 5 Sacral Vertebrae.
51
Why is the Fusion of the Transverse Processes incomplete?
The incomplete fusion allows the formation of the Posterior Sacral Foramina
The Sacral Nerve to enters and leaves the Central Canal by the Posterior Sacral Foramina.
52
What is the Pelvic Surface marked by in an Adult?
4 Transverse Lines
Remnants of the Fused Sacral Intervertebral Discs
53
What is the Sacral Promontory?
Anterior Projection of Bone, On the Superior aspect of the Pelvic Surface.
54
What Margin does the Sacral Promontory form?
It forms the Posterior Margin of the Pelvic Inlet,
55
What is the Posterior Margin continuous with?
Continuous with :
- The Margin of the Ala of the Sacrum
- Arcuate line of the Ilium
- Pectin Pubis
- Pubic Crest of the Pubic Bone.
56
What is the Coccyx?
Terminal Part of the Vertebrae.
Comprised of 4 Coccygeal Vertebrae that Fuse to produce a Triangular Shape.
57
What are the 2 Main Components of the Coccyx?
1. Base
2. Apex
58
What are the Surfaces of the Coccyx Bone?
Four Surfaces:
1. Left Lateral Surface
2. Right Lateral Surface
3. Anterior Surface
4. Posterior Surface
59
What does the Base of the Coccyx articulate with?
located most superiorly and contains a facet for articulation with the sacrum.
60
Where is the Apex of the Coccyx situated?
The Apex is situated Inferiorly,
At the Terminus of the Vertebral Column.
61
Which part of the Coccyx has Transverse Processes?
The Lateral Surfaces of the Coccyx are marked by two Small Transverse Processes,
Which projects from Co1 (1st Coccygeal Verterbra).
62
What are the Coccygeal Cornua and what do they articulate with?
The Coccygeal Cornua of Co1 are the largest of the Small Articular Processes of the Coccygeal Vertebrae.
Project upwards to articulate with the Sacral Cornua.
63
List the Joints of the Vertebrae:
1. Atlanto - Axial
2. Atlanto - Occipital
3. Costotransverse
4. Costovertebral
5. Intervertebral
6. Zygapophyseal (Facet Joint)
7. Uncovertebral
64
What are the Atlanto - Axial Joints?
Complex of 3 Synovial Joints which Join the Atlas (C1) to the Axis (C2).
65
Which Joints are classed as Atlanto - Axial Joints?
Two: Paired Lateral Atlanto - Axial Joints
One: Median Atlanto - Axial (Atlanto - Dental) Joint.
66
What type of Joint are the Paired Lateral Atlanto - Axial Joints?
Classified as Planar - Type Joint.
67
Which structures make up the Paired Lateral Atlanto - Axial Joints?
Between the Lateral Masses of C1 and C2.
68
What type of a Joint is the Median Atlanto - Axial Joint?
Pivot Joint
69
Which structures make up the Median Atlanto - Axial Joint?
Articulations of Odontoid Process/Dens of C2
Anterior Arch
Transverse Ligament of C1.
70
How are the Atlanto - Axial Joints supported?
Fibrous Capsules of the Lateral and Medial Joints are Thin and provide only minimal support,
Therefore Ligamentous Attachments provide the majority of support.
71
What movements do the Atlanto - Axial Joints allow?
Allow mostly Rotation
Some Flexion/Extension
Limited Lateral Flexion.
72
What are the Atlanto - Occipital Joints?
A Pair of Condyloid Synovial Joints that Connect the Occiput (C0) to the First Cervical Vertebra (Atlas/C1).
73
What type of Joint are the Atlanto - Occipital Joints?
Condyloid Synovial Joints
74
What are the Articulating Surfaces of the Atlanto - Occipital Joints?
Occipital Condyles
Superior Articular Facets of the Atlas.
75
What movements do the Atlanto - Axial Joints allow?
Allows mostly Flexion/Extension
Some Rotation
76
What is the Costotransverse Joint?
Articulation between the Rib's Tubercle
And the Transverse Process of the Vertebra.
77
What type of a Joint is the Costotransverse Joint?
Plane Synovial Joint.
78
What is the structure of each Costotransverse Joint?
The Facet of the Tubercle of the Rib,
Is joined to the Adjacent Facet of the Transverse Process of a Thoracic Vertebra.
79
What are the Costovertebral Joints?
Articulation between the Head of the Rib and the Vertebral Body.
80
How does the Head of the Rib articulate with the Vertebrae?
The head of the Rib has 2 facets:
1. The Lower Rib Facet articulates with the Upper Costal Facet of its own Vertebra.
2. The Upper Rib Facet articulates with the Lower Costal Facet of the Vertebral Body above.
81
What type of a Joint is the Costovertebral Joint?
Each Costal Facet is a Separate Synovial Joint.
82
What are the Intervertebral Joints?
Between each Adjacent Vertebra from the Axis to the Sacrum.
83
What type of Joint are the Intervertebral Joints?
Cartilaginous Joints
84
What movements do the Intervertebral Joints allow?
Allow Slight Movement of Vertebrae.
85
How are the Vertebral Bodies attached to the
Intervertebral Discs?
The Inferior and Superior Surfaces of the Vertebral Bodies are covered by a Layer of Hyaline Cartilage.
The Fibrocartilaginous Intervertebral Disc then adheres to these layers of Cartilage,
Between the Adjacent Vertebral Bodies.
86
Describe the shape of the Intervertebral Discs?
Discs are Wedge Shaped.
87
Where does the structure of the Intervertebral Discs change?
Slightly Thicker in the Anterior Aspect in the Cervical and Lumbar Spines.
This is what produces the Convexities of those Regions.
While fairly uniform Thickness in the Thoracic spine.
88
What are the Zygapophyseal/Facet Joints?
Symmetrical Synovial - Lined Joints
With a Fibrous Capsule that connect the Articular Facets of the Vertebrae.
89
Where are Zygapophyseal/Facet Joints located?
Located in the Middle of the Superior and Inferior Articular Processes of Adjacent Vertebrae.
90
Where on on each Vertebrae are the
Zygapophyseal/Facet Joints situated?
The Facet Joints are situated
between the Pedicle and Lamina of the same Vertebra.
91
What is the structural importance of the Zygapophyseal/Facet Joints?
Form the Articular Pillars that act to provide Structural Stability to the Vertebral Column as a whole.
92
What are the Uncovertebral Joints?
Articulation between the Uncinate Processes Bilaterally,
With the corresponding Inferior Shallow Concavity of the Vertebra above.
93
Where are Uncovertebral Joints located?
Located on each side of the Four Cervical Discs between levels C3 and C7 in the Spine.
94
What is the Shape of the Uncinate Processes?
The Uncinate Processes arise as Lips Curving Superiorly from the Lateral Borders of the Vertebral Body.
95
Which Border do the Uncovertebral Joints form?
This Articulation forms the Anterior Border of the Intervertebral Foramen.
96
What is the relation of the Uncovertebral Joint to Neurovasculature?
It lies medial to the Vertebral Artery and Spinal Nerve Roots.
97
List the Main Bony Features of the Vertebrae:
1. Articular Processes (Zygapophyses) Superior And Inferior
2. Lamina
3. Pedicle
4. Spinal Canal (Vertebral Foramen)
5. Spinous Process
6. Transverse Foramen
7. Transverse Process
8. Uncinate Process
9. Vertebral Body
98
List the Spinal Curves:
1. Cervical Spine Curve
2. Thoracic Spine Curve
3. Lumbar Spine Curve
4. Sacral Spine Curve
99
Describe the Shape of the Cervical Spine Curve:
Convex Anteriorly.
This Inward Curve is known as a Lordotic Curve.
100
Where does the Cervical Spine Curve Begin and End?
Begins at C2 at the Apex of the Dens
Ends at T2.
101
Describe the Shape of the Thoracic Spinal Curve:
Concave Anteriorly.
This Outward Curve is known as a Kyphotic Curve.
102
Where does the Thoracic Spine Curve Begin and End?
Begins at T2
Ends at T12
103
What is the most prominent point of the Thoracic Spine Curve?
Its most Prominent Point is at the Spinous Process of T7.
104
Describe the Shape of the Lumbar Spinal Curve:
Convex Anteriorly (convexity of lower 3 vertebrae are much greater than that of the upper 2).
This Curve is described as a Lordotic Curve.
105
Where does the Lumbar Spine Curve Begin and End?
Begins at T12
Ends at the Sacrovertebral Angle.
106
Who has a more significant Lumbar Spine Curve?
Lumbar Spine Curve is more marked in the Female than in the Male.
107
Describe the Shape of the Sacral Spinal Curve:
Concave Anteriorly (directed downward and forward).
This Outward Curve is known as a Kyphotic Curve.
108
Where does the Sacral Spine Curve Begin and End?
Begins at the Sacrovertebral Articulation
Ends at the Point of the Coccyx.
109
Which Curves are defined as Primary Curves?
1. Thoracic Kyphotic Curve
2. Sacral Kyphotic Curve
Because they are present in the Foetus.
110
Which Curves are defined as Secondary Curves?
1. Cervical Lordotic Curve
2. Lumbar Lordotic Curve
Becasue these are compensatory and are developed After Birth.
111
When does the Cervical Curve form?
3 - 4 Months: When the infant is able to hold up its head.
9 Months: To sit upright.
112
When does the Lumbar Curve form?
12 - 18 Months: When the child begins to Walk.
113
Cervical Body:
Broader Width than Anterior/Posterior
114
Cervical Spinous Process:
Bifid
115
Cervical Transverse Process:
Contain Transverse Foramina
116
Cervical Articular Facets:
Superior Facet:
- Backward
- Upward
- Slightly Medially
Inferior Facet:
- Forward
- Downward
- Slightly Laterally.
117
Cervical Vertebral Canal/Foramen:
Large and Triangular
118
Thoracic Body:
Heart Shaped
119
Thoracic Spinous Process:
Long and Overlap Inferior Vertebrae
120
Thoracic Transverse Process:
Are Long, Thick, and each ends in a Clubbed Extremity.
121
Thoracic Articular Facets:
Plates of Bone that are practically Flat
122
Thoracic Vertebral Canal/Foramen:
Small and Circular
123
Lumbar Body:
Large and Kidney Bean shaped.
124
Lumbar Spinous Process:
Thick, Broad, and Somewhat Quadrilateral
125
Lumbar Transverse Process:
Long and Slender
126
Lumbar Articular Facets:
Superior Facet:
- Look Backward
- Concave
- Medial
Inferior Facet:
- Directed Forward
- Convex
- Lateral
127
Lumbar Vertebral Canal/Foramen:
Triangular - Larger than in Thoracic,
But Smaller than in Cervical
128
List the 3 Abnormal Curvatures of the Spine:
1. Kyphosis
2. Lordosis
3. Scoliosis
129
What is Kyphosis?
Abnormal THORACIC CURVATURE
Hunchback
AKA Dowager’s Hump
130
What is Lordosis?
Exaggerated ANTERIOR LUMBAR CURVATURE
131
Who commonly has Lordosis?
Pregnant Women
Obese Men
132
What is Scoliosis?
Abnormal LATERAL CURVATURE
133
What regions of the Spine are affected by Scoliosis?
Usually in the Thoracic Region but may involve Lumbar.
134
Where does Rotation occur in the Vertebral Column?
1. Atlanto - Axial Joint:
- C1: Atlas
- C2: Axis
2. Lumbar Vertebrae.
135
Where does Nodding occur in the Vertebral Column?
Atlanto - Occipital Joint:
- Atlas C1
- Occipital Bone
136
Where does Flexion & Extension occur in the Vertebral Column?
Cervical
Lumbar
137
Where does Lateral Flexion occur in the Vertebral Column?
Cervical
Lumbar
138
What is the function of the Transverse Foramina
of the Cervical Vertebrae?
Transmit the VERTEBRAL ARTERY
Except for C7: Vetrebral Artery doesn’t commonly go through it.
139
What is the function of the Vertebra Prominens (C7 Spinous Process)?
Projection where Muscles and Ligaments are attached.
140
How does movement occur at the Vertebrae?
Tendons, muscles, and ligaments work in tandem.
To provide balance and to enable movement.
Whilst preventing excessive movement resulting in injury.
141
What is the Blood Supply of the Vertebral Column?
Vertebral Artery
142
What is the Venous Drainage of the Vertebral Column?
Vertebral Plexus that drains into the Vertebral Vein
Veins in the the Vertebral Plexus are Valveless: blood may flow in either direction.
143
List the Ligaments Spine:
1. Nuchal Ligament
2. Anterior Longitudinal Ligament
3. Posterior Longitudinal Ligament
4. Ligamentum Flavum
5. Cruciform Ligament Of The Atlas
6. Alar Ligaments Of The Axis
7. Intertransverse Ligaments
8. Interspinous Ligaments
144
What is the Nuchal Ligament?
Large Ligament located between the Posterior Muscles of the Neck.
145
Which parts of the Spine does the Nuchal Ligament cover?
It covers the Spines of C1 to C6 Vertebrae.
146
Where does Nuchal Ligament arise from, and what does it attach?
It rises from the Spinous Process of C7 to the Inion of the Occipital Bone.
Attaching all the Posterior Tips of the Spinous Processes in between.
147
What is the function of the Nuchal Ligament?
It is Thick and Strong, limiting Hyperflexion of the Neck.
148
What is the Anterior Longitudinal Ligament attached to?
Runs along Anterior Surface of the Vertebral Bodies
And Intervertebral Discs
Firmly united to the Periosteum
Attaching to the Anterior Annulus
149
Where does the Anterior Longitudinal Ligament ascend from?
It ascends from the Anterosuperior Portion of the Sacrum Superiorly
150
What does the Anterior Longitudinal Ligament eventually become?
Becomes the Anterior Atlanto - Occipital Membrane at the level of the Anterior Arch of C1 (atlas).
151
What is the Posterior Longitudinal Ligament?
Long Ligament located immediately Posterior to the Vertebral Bodies
152
What is the Posterior Longitudinal Ligament attached to?
Loosely attached to the Vertebral Bodies
Firmly attached to the Intervertebral Discs
153
Where does the Posterior Longitudinal Ligament ascend from?
From the back of the Sacrum Inferiorly and gradually broadens as it ascends.
154
What does the Posterior Longitudinal Ligament eventually become?
At the Axis (C2), it spreads out and becomes the Tectorial Membrane,
Which inserts into the base of Skull.
155
What are the Ligamenta Flava?
Paired Ligaments that run between Adjacent Laminae of the Vertebral Bodies,
And are present from C2/3 to the Sacrum.
156
What are the Ligamenta Flava known as,
Between the Occipital Bone and C1?
Posterior Atlanto - Occipital Membrane.
157
What are the Ligamenta Flava known as,
Between C1 and C2?
Posterior Atlanto - Axial Membrane.
158
Which complex do the Ligamenta Flava form a part of?
Form part of the Posterior Ligamentous Complex of the Vertebral Column.
159
What is the Cruciform Ligament of the Atlas and what does it do?
Holds the Posterior Dens of C2 in Articulation at the Median Atlanto - Axial Joint.
It lies behind a Large Synovial Bursa
Surrounded by Loose Fibrous Capsule.
160
What are the 2 Bands of the Cruciform Ligament of the Atlas?
1. Longitudinal Band
2. Transverse Band
161
What structures does the Longitudinal Band attach?
Attaches the body of the C2 (axis) to the Clivus and Foramen Magnum.
It is relatively Weak and hence does not contribute any significant Stability.
162
What structures does the Transverse Band attach?
Attaches to a Small Tubercle on the C1 (Atlas) Lateral Masses on both sides.
It passes Posterior to the Dens,
With a Small Intervening Synovial Capsule,
Fixing the Dens to thePosterior Margin of the Anterior Arch of the Atlas.
163
What is the importance of the Transverse Band?
It is the Strongest Ligament in the whole Spine and arguably the most important.
164
What Joint does the Transverse Band stabilise?
With the Alar Ligament, the Transverse Band is the Primary Stabiliser of the Atlanto - Axial Joint.
165
What margins do the Alar Ligaments Of The Axis join?
Join the Lateral Margins of the Dens of C2,
To the Lateral Margins of the Foramen Magnum.
166
Describe the Shape of the Alar Ligaments Of The Axis?
They may be Oblique or Vertical
And are Thickest at the Ooccipital Attachment.
167
What are the functions of the Alar Ligaments Of The Axis?
Very Strong and Limit Axial Rotation and Contralateral Lateral Flexion of the Head.
In Conjunction with the Transverse Band of the Cruciform Ligament,
They are the Primary Stabilisers of the Atlanto - Axial Joint.
168
What are the Interspinous Ligaments?
The Interspinous Ligaments (Interspinal Ligaments) are Thin and Membranous Ligaments.
169
What structures do the Interspinous Ligaments connect?
Connect adjoining Spinous Processes of the Vertebra in the Spine.
They extend from the Root of one Spinous Process to the Apex of another Spinous Process.
170
Which other Ligaments do the Interspinous Ligaments integrate into?
They meet the Ligamenta Flava in Front
And Blend with the Supraspinous Ligament Behind
171
What are the Intertransverse Ligaments?
Ligaments that are placed between the Transverse Processes of the Spine.
172
Describe the Intertransverse Ligaments in the Cervical Region?
In the Cervical Region:
- They consist of a Few Irregular, Scattered Fibers that are often replaced by Muscles.
173
Describe the Intertransverse Ligaments in the Thoracic Region?
In the Thoracic Region:
- They are Rounded Cords intimately connected with the Deep Muscles of the Back.
174
What are the Intervertebral Discs?
Each Disc forms a Fibrocartilaginous Joint (a Symphysis),
To allow Slight Movement of the Vertebrae,
To act as a Ligament to hold the Vertebrae together,
And to function as a Shock Absorber for the Spine.
175
How much of the Spine is Intervertebral Discs?
Discs make up approximately 25% of the length of the Spine,
Though the height of the Discs declines with age.
176
What is the major function of the Intervertebral Discs?
They represent the Hydro - Mechanical System of Load Cushioning.
177
How does the Thickness of the Intervertebral Discs differ?
1. The Upper Thoracic Discs are the Thinnest,
Thoracic Discs are the same width Anteriorly as they are Posteriorly.
2. This is not the case in the Cervical and Lumbar Spine,
Where Greater Thickness Anteriorly contributes to the normal Cervical and Lumbar Lordosis.
178
What are the Vertebral Endplates?
Thin Plate of Cartilage that covers the Upper and Lower Surfaces of the Vertebral Bodies.
It is the Transition Region where a Vertebral Body and Intervertebral Disc interface with each other.
179
What is the Function of the Vertebral Endplate?
Nutrients pass into the Intervertebral Disc through the Vertebral End Plate.
180
What are the 2 Layers of the Vertebral Endplates?
1. Cartilaginous Layer (also called Cartilaginous Endplate) that fuses with the Disc.
2. Thin Layer of Porous Bone (also called Bony Endplate) that attaches to the Vertebra.
181
What are the 2 parts of the Intervertebral Discs?
1. Annulus Fibrosus
2. Nucleus Pulposus
182
What is the Annulus Fibrosus?
Tough Circular Exterior of the Intervertebral Disc,
That surrounds the Soft Inner Core (Nucleus Pulposus).
This Outer Portion is composed of a Ring of Ligament Fibres that encases the Inner Core of the Disc
And securely connects the Spinal Vertebrae above and below the Disc.
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What is the Nucleus Pulposus?
Inner Core of the Vertebral Disc.
The Core is composed of a Jelly - Like material that consists of mainly Water,
As well as a Loose Network of Collagen Fibres.
The Elastic Inner structure allows the Vertebral Disc to withstand forces of Compression and Torsion.
184
What is the function of the Nucleus Pulposus?
Elastic Inner structure allows the Vertebral Disc to withstand forces of Compression and Torsion.
185
In Herniation of the Intervertebral Disc (slipped disc),
In which direction is the Nucleus Pulposus extruded?
Infero - Laterally:
Hence the presence of the Posterior Longitudinal Ligament in the Spinal Canal.
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Which Intervertebral Disc is most commonly Herniated?
Lumbar Disc Herniation:
L4 - L5
L5 - S1
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Why are Lumbar Intervertebral Discs most commonly Herniated?
Lumbar Intervertebral Discs are Wider, Softer and most Mobile/Flexible.
This is because they are used the most for Walking/Bending/Twisting of the trunk.
This makes them most at risk to damage such as Disc Herniation.
188
List the Main Muscles of the Back & Vertebral Column:
1. Erector Spinae Group
2. Latissimus Dorsi
3. Trapezius
4. Rhomboids
5. Psoas Major
6. Quadratus Lumborum
7. External Oblique
8. Internal Oblique
9. Transversus Abdominis
10. Rectus Abdominis (6 Pack)
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What are the Erector Spinae Group Muscles?
A group of Muscles that form a Column:
1. Iliocostalis
2. Longissimus
3. Spinalis
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Where are the Erector Spinae Group Muscles found?
Found Posterolateral to Vertebral Column,
Between Vertebral Spinous Processes and Costal Angle of Ribs
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What is the Origin of the Iliocostalis Muscle?
Common Tendinous Origin
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What is the Insertion of the Iliocostalis Muscle?
Costal Angle of the RIbs
Cervical Transverse Processes
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What is the Action of the Iliocostalis Muscle?
Acts Unilaterally to Laterally Flex the Vertebral Column
Acts Bilaterally to Extend the Vertebral Column and Head
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What is the Innervation of the Iliocostalis Muscle?
Posterior Rami of the Spinal Nerves
195
What is the Origin of the Longissimus Muscle?
Common Tendinous Origin
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What is the Insertion of the Longissimus Muscle?
Lower Ribs
The Transverse Processes of C2 – T12
Mastoid Process of the Skull
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What is the Action of the Longissimus Muscle?
Acts Unilaterally to Laterally Flex the Vertebral Column
Acts Bilaterally to Extend the Vertebral Column and Head
198
What is the Innervation of the Longissimus Muscle?
Posterior Rami of the Spinal Nerves
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What is the Origin of the Spinalis Muscle?
Common Tendinous Origin
200
What is the Insertion of the Spinalis Muscle?
Spinous Processes of C2, T1 - T8
Occipital Bone of the Skull
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What is the Action of the Spinalis Muscle?
Acts Unilaterally to Laterally Flex the Vertebral Column
Acts Bilaterally to Extend the Vertebral Column and Head
202
What is the Innervation of the Spinalis Muscle?
Posterior Rami of the Spinal Nerves
203
What is the Latissimus Dorsi Muscle?
Flat Muscle on the Back that is the Largest Muscle in the Upper Body
204
What is the Origin of the Latissimus Dorsi Muscle?
Spinous Processes of T6 - T12
Iliac Crest
Thoracolumbar Fascia
Inferior Three Ribs
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What is the Insertion of the Latissimus Dorsi Muscle?
The Fibres converge into a Tendon that attaches to the Intertubercular Sulcus of the Humerus.
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What is the Action of the Latissimus Dorsi Muscle?
Extends the Upper Limb
Adducts the Upper Limb
Medially Rotates the Upper Limb
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What is the Trapezius Muscle?
Flat Triangular Muscle that is most Superficial of all the Back Muscles
208
What is the Origin of the Trapezius Muscle?
Skull
Ligamentum Nuchae
Spinous Processes of C7 - T12
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What is the Insertion of the Trapezius Muscle?
Clavicle
Acromion
Scapula Spine
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What is the Action of the Trapezius Muscle?
Upper Fibres: Elevate the Scapula and Rotate it during Abduction of the Arm
Middle Fibres: Retract the Scapula
Lower Fibres: Pull the Scapula Inferiorly
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What are the Rhomboid Muscles?
Upper Back Muscles that connect between your Spine and each of your 2 Shoulder Blades
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What are the 2 Rhomboid Muscles?
1. Rhomboid Major
2. Rhomboid Minor
The Minor is found Superior to the Major.
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What is the Origin of the Rhomboid Major Muscle?
Spinous Processes of T2 - T5 Vertebrae
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What is the Insertion of the Rhomboid Major Muscle?
Medial Border of the Scapula,
Between the Scapula Spine and Inferior Angle
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What is the Action of the Rhomboid Major Muscle?
Retracts and Rotates the Scapula
216
What is the Origin of the Rhomboid Minor Muscle?
Spinous Processes of C7 - T1 Vertebrae
217
What is the Insertion of the Rhomboid Minor Muscle?
Medial Border of the Scapula,
At the level of the Spine of Scapula
218
What is the Action of the Rhomboid Minor Muscle?
Retracts and Rotates the Scapula
219
Where are the Psoas Major Muscles found?
Found near the Midline of the Posterior Abdominal Wall,
Immediately Lateral to the Lumbar Vertebrae.
220
What is the Origin of the Psoas Major Muscle?
Transverse Processes of T12 - L5
Vertebral Bodies of T12 - L5
221
What is the Insertion of the Psoas Major Muscle?
The Lesser Trochanter of the Femur.
222
What is the Action of the Psoas Major Muscle?
Flexion of the Thigh at the Hip
Lateral Flexion of the Vertebral Column
223
What is the Quadratus Lumborum Muscle?
Deepest Abdominal Muscle.
Found in Lower Back, between Top of Pelvis and Lowest Rib.
Thick Muscular Sheet which is Quadrilateral in Shape.
224
Where is the Quadratus Lumborum Muscle in relation to Psoas Major?
The Muscle is positioned Superficially to the Psoas Major.
225
What is the Origin of the Quadratus Lumborum Muscle?
Iliac Crest
Iliolumbar Ligament
226
What is the Insertion of the Quadratus Lumborum Muscle?
Transverse Processes of L1 - L4
Inferior Border of the 12th Rib
227
What is the Action of the Quadratus Lumborum Muscle?
Extension
Lateral Flexion of the Vertebral Column
Fixes the 12th Rib during Inspiration, so that the Contraction of Diaphragm is not Wasted.
228
What is the External Oblique Muscle?
The external oblique is the largest and most superficial flat muscle in the abdominal wall. Its fibres run inferomedially.
229
What is the Origin of the External Oblique Muscle?
ribs 5-12
230
What is the Insertion of the External Oblique Muscle?
the iliac crest and pubic tubercle
231
What is the Action of the External Oblique Muscle?
Contralateral rotation of the torso
232
What is the Internal Oblique Muscle?
The internal oblique lies deep to the external oblique. It is smaller and thinner in structure, with its fibres running superomedially (perpendicular to the fibres of the external oblique).
233
What is the Origin of the Internal Oblique Muscle?
inguinal ligament, iliac crest and lumbodorsal fascia,
234
What is the Insertion of the Internal Oblique Muscle?
inserts into ribs 10 - 12
235
What is the Action of the Internal Oblique Muscle?
Bilateral contraction compresses the abdomen, while unilateral contraction ipsilaterally rotates the torso.
236
What is the Transversus Abdominis Muscle?
deepest of the flat muscles, with transversely running fibres.
237
What is the Origin of the Transversus Abdominis Muscle?
the inguinal ligament, costal cartilages 7-12, the iliac crest and thoracolumbar fascia
238
What is the Insertion of the Transversus Abdominis Muscle?
conjoint tendon, xiphoid process, linea alba and the pubic crest.
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What is the Action of the Transversus Abdominis Muscle?
Compression of abdominal contents
240
What is the Rectus Abdominis Muscle?
long, paired muscle, found either side of the midline in the abdominal wall. It is split into two by the linea alba.
241
What is the Origin of the Rectus Abdominis Muscle?
crest of the pubis
242
What is the Insertion of the Rectus Abdominis Muscle?
xiphoid process of the sternum and the costal cartilage of ribs 5-7
243
What is the Action of the Rectus Abdominis Muscle?
assisting the flat muscles in compressing the abdominal viscera, the rectus abdominis also stabilises the pelvis during walking, and depresses the ribs.
244
Which Back Muscles are involved in Flexion?
1. External Oblique
2. Internal Oblique
Both Working Together
3. Rectus Abdominis
4. Psoas Major
5. Psoas Minor
6. Sternocleidomastoid
All Working Together
245
Which Back Muscles are involved in Extension?
1. Erector Spinae
2. Trapezius
3. Quadratus Lumborum
246
Which Back Muscles are involved in Lateral Flexion?
1. Trapezius
2. Erector Spinae
3. Quadratus Lumborum
4. External Oblique
5. Internal Oblique
247
List the Nerve Structures of the Spinal Canal:
1. Cauda Equina
2. Conus Medullaris
3. Filum Terminale
4. Spinal Cord
5. Spinal Nerve
248
What is the Cauda Equina?
Bundle of Spinal Nerves and Spinal Nerve Rootlets
249
Which Nerves does the Cauda Equina consist of?
2nd - 5th Lumbar Nerve Pairs
1st - 5th Sacral Nerve Pairs
Coccygeal Nerve
250
What is the Conus Medullaris?
Tapered, Lower End of the Spinal Cord
251
What is the Shape of the Conus Medullaris?
Cone Shaped
252
Where is the Conus Medullaris located?
It occurs near Lumbar Vertebral Levels L1 & L2
Occasionally Lower
253
What is the Filum Terminale?
Delicate Strand of Fibrous Tissue,
About 20 cm in Length, proceeding downward from the Apex of the Conus Medullaris.
254
What is the Spinal Cord?
Made of Nervous Tissue and extends from the Medulla Oblongata in the Brainstem,
To the Lumbar Region of the Vertebral Column.
It encloses the central canal of the Spinal Cord.
255
What are the Spinal Nerves?
A Spinal Nerve is a Mixed Nerve, which carries:
- Motor Signals
- Sensory Signals
- Autonomic Signals
Between the Spinal Cord and the Body.
256
How many Spinal Nerves are there in the body?
31 Pairs of Spinal Nerves,
One on each side of the Vertebral Column.
257
List the Supporting Structures and
associated Spaces of the Spinal Canal:
1. Dentate Ligament
2. Dura Mater
3. Epidural Space
4. Lumbar Epidural Space
5. Subarachnoid Space
6. Thecal/Dural Sac
258
What is the Dentate Ligament?
Bilateral Triangular Lateral Extensions of Pia Mater that Anchor the Spinal Cord to the Dura Mater.
Provide stability during Spinal Cord movement within Vertebral Column.
259
What is the Dura Mater?
Outer most layer of the Meninges.
260
What is the Epidural Space?
The area between the Dura Mater (a membrane) and the Vertebral Wall,
Containing Fat and Small Blood Vessels.
The space is located just outside the Dural Sac which surrounds the Nerve Roots and is filled with CSF.
261
What is the Clinical Importance of the Lumbar Epidural Space?
Site of Lumbar Puncture to analyse CSF to diagnose Diseases such as Meningitis
262
What is the Subarachnoid Space?
Space between Arachnoid and Pia Mater that contains CSF.
263
What is the Clinical Importance of the Subarachnoid Space?
Contains Vessels and CSF Fluid.
The Primary functions of the CSF are to cushion the Brain and Spinal Cord from Trauma.
And to supply them with Nutrients and Remove Waste.
In addition to the CSF, the major arteries of the Brain run through the Subarachnoid Space.
264
What is the Thecal/Dural Sac?
Membranous Sheath (Theca)/Tube of Dura Mater which surrounds Spinal Cord and the Cauda Equina.
265
What does the Thecal/Dural Sac contain?
The Thecal Sac contains the CSF which provides Nutrients and Buoyancy to the Spinal Cord.
266
List the Divisions of the Spinal Nerve:
1. Dorsal Primary Ramus
2. Dorsal Root & Dorsal Root Ganglion
3. Ventral Primary Ramus
4. Ventral Root
267
Where do the Ventral and Dorsal Roots emerge from?
At their Distal End, the Ventral and Dorsal Roots join to form a mixed Spinal Nerve.
268
What is the Dorsal Primary Ramus?
It is the Dorsal Branch of a Spinal Nerve that Forms from the Dorsal Root of the Nerve,
After it Emerges from the Spinal Cord.
269
What is the Dorsal Root Ramus?
Dorsal Root/Posterior Root is the Afferent Sensory Root of a Spinal Nerve.
270
What is a Ganglion?
A Cluster of Neurons
271
What is the difference between the
Dorsal Root Ramus & Dorsal Root Ganglion?
Dorsal Root is what emerges from the Spinal Cord.
Root Ganglion is a cluster of Neurons in a Dorsal Root of a Spinal Nerve.
272
Which Neurons are located in the Dorsal Root Ganglion?
The Cell Bodies of Sensory Neurons known as First - Order Neurons,
Are located in the Dorsal Root Ganglia.
273
What is the Ventral Primary Ramus?
Anterior Division of a Spinal Nerve.
The Ventral Rami supply the Antero - Lateral parts of the Trunk and the Limbs.
They are mainly Larger than the Dorsal Rami.
274
What is the Ventral Root Ramus?
Ventral Root/Anterior Root is the Efferent Motor Root of a Spinal Nerve.
275
At what Vertebral Level does the Spinal Cord terminate?
L1 - L2
276
Which Vertebral level is preferred for Lumbar Puncture?
Lumbar Punctures in adults are usually performed between L3 - L5,
This is at the level of the Cauda Equina.
In order to avoid damage to the Spinal Cord.
277
How can Age affect the Spinal Cord?
Vertebral Bodies Collapse with Age
So the Spinal Cord will terminate at a Lower Level in Older Patients.
