5: Anatomy - Back, vertebral column and spinal column

Question 1

What specifically is the back?

Answer 1

Posterior aspect of the trunk

Question 2

What are the main functions of the back?

Answer 2

Maintenance of posture

Movement of upper and lower limbs; trunk

Question 3

What bony feature are dimples a landmark of?

Answer 3

PSIS

posterior superior iliac spines

Question 4

What are the extrinsic back muscles?

What is their function?

Answer 4

Levator scapulae

Rhomboids major and minor

Trapezius

Latissimus dorsi

Attach trunk to the pectoral girdle and move the upper limbs

Question 5

What are the two groups of intrinsic back muscles?

Answer 5

Erector spinae (superficial)

Transversospinalis (deep)

Question 6

What is the function of the intrinsic back muscles?

Answer 6

Maintenance of posture

Spine movement

Question 7

What is the common inferior attachment for all three erector spinae muscles on each side?

Answer 7

Sacrum and iliac crest

Question 8

How do you tell the difference between the three erector spinae muscles?

Answer 8

Where they insert superiorly

Question 9

Where are the transversospinalis muscles found?

Answer 9

Between the transverse and spinous processes i.e very close to the spinal column

Question 10

Which branch of spinal nerves supply the intrinsic back muscles?

Answer 10

Posterior rami of anterior rootlets

Motor fibres come from anterior horn but they need to get round to the back via the posterior rami of those rootlets

Question 11

What does flexion of the spine look like?

Answer 11

Bending over forwards

Any anterior movement above the knee is a flexion

Question 12

What type of joint is a facet joint?

What do they attach to?

Answer 12

Plane-type synovial joint

Articular processes of vertebrae

Question 13

Which features of the vertebral column do spinal nerves emerge from?

Answer 13

Intervertebral foramen

Question 14

Where are the rhomboids found relative to trapezius?

Answer 14

Deep

Question 15

Where is trapezius found relative to the rhomboids?

Answer 15

Superficial

Question 16

What are the three parts of trapezius?

Answer 16

Descending (superior)

Middle

Ascending (inferior)

Question 17

What gives a motor nerve supply to trapezius?

Answer 17

CN XI

Question 18

Which muscle is one of the widest in the body and is activated in pull-ups?

Answer 18

Latissimus dorsi

Question 19

What are the actions of

a) Levator scapulae
b) Trapezius
c) Latissimus dorsi
d) Rhomboids major and minor?

Answer 19

a) Elevates scapula

b) Elevates, stabilises and depresses scapula (depends)

c) Adducts and internally rotates shoulder joint, extends arm

d) Elevate scapula

Question 20

What muscles surround a vertebral body?

Answer 20

Transversospinalis - deep, spinous process to transverse process

Erector spinae - more superficial

Psoas major - medial

Quadratus lumborum - lateral

Question 21

Name the muscles of the abdominal wall from superficial to deep.

Answer 21

External oblique

Internal oblique

Rectus abdominis (anteriorly) / Transversus abdominis (laterally)

Question 22

Fill in the following using the words kyphosis or lordosis:

cervical ___

thoracic ___

lumbar ___

sacral ___

Answer 22

cervical lordosis

thoracic kyphosis

lumbar lordosis

sacral kyphosis

Question 23

The thoracic and sacral kyphoses are described as primary - what does this mean?

Answer 23

Present shortly after birth, the cervical and lumbar lordosis take longer to come in

Question 24

What are the inner and outer parts of intervertebral discs called?

Answer 24

Inner - nucleus pulposus

Outer - annulus fibrosus

Question 25

What are the **two** **ligaments** found **anterior** to the intervertebral foramen?

Answer 25

**Anterior longitudinal ligament** **Posterior longitudinal ligament**

Question 26

What are the **three ligaments** found **posterior** to the intervertebral foramen?

Answer 26

**Ligamentum flavum** **Interspinous ligament** **Supraspinous ligament**

Question 27

What hole is only found in **cervical vertebrae**? What does it transmit?

Answer 27

**Transverse foramen** **Vertebral artery, vein** and **sympathetics**

Question 28

What is special about the **spinous process** of cervical vertebrae?

Answer 28

**Bifid** Split in two

Question 29

What are the **names** and **special features** of **C1, C2 and C7**?

Answer 29

**C1** - Axis - no spinous process or vertebral body; anterior and posterior arches instead **C2** - Atlas - has **odontoid process / dens** which projects superiorly into anterior arch of C1 **C7** - Vertebrae prominens - first palpable spinous process in most people

Question 30

Which joints connect the **superior** **articular process** of **C1** to the **occipital bone**?

Answer 30

**Atlanto-occipital joints**

Question 31

Which movements occur at the **atlanto-occipital joints**?

Answer 31

**Flexion** **Extension** **Rotation** **Lateral flexion** Yes/No movements and ears to the shoulders

Question 32

Which vertebral level is the **hyoid bone** found at?

Answer 32

**C3**

Question 33

Which joints are found between **C1** and **C2**?

Answer 33

**Atlanto-axial joints**

Question 34

Which space in the **sacrum** does the **cauda equina** pass through?

Answer 34

**Sacral canal**

Question 35

Does the **cauda equina** have **meninges**?

Answer 35

**Yes**

Question 36

At which level are **lumbar punctures** usually carried out to avoid damaging the spinal cord?

Answer 36

**L3/4** **L4/5** because the spinal cord ends at **L2**

Question 37

Which brain structure is the spinal cord continuous with?

Answer 37

**Brainstem** Medulla specifically

Question 38

In relation to the spinal cord, what is the **fatty layer** found superficial to the dura mater?

Answer 38

**Epidural fat**