A&P Test 2 Flashcards
How many cervical vertebra are there?
7
What is the atlas named after?
a mythical god who carried the weight of the world on his shoulders
Why doesn’t C1 have a big vertebral body?
It doesn’t have to carry a lot of weight
What is the facet for dens used for on C1?
It is to connect the Dens of C2 to C1
What is the tubercle called that projects from the front and back of C1’s arches?
anterior and posterior tubercle
What is the portion of C1 that connects with the skull?
Superior articular processes’ facets
What is the large opening called at the base of the skull?
Foramen Magnum
What are the names of the downward projections are on either side of the foramen magnum?
Occipital condyle
Where is the occipital bone located?
on the base of the skull
What do the occipital condyles connect to?
C1
What are the atlantooccipital ligaments?
There are 2: anterior and posterior ligaments that connect the top of the spine(Atlas) through an opening in skull called the foramen magnum to the base of the skull (occipital bone)
What sets up a pivot point in a nodding fashion between the skull and atlas?
The curve of the superior articular process with cartilage between
What is the special structure on the Axis that is not found anywhere else?
The dens: a big bony structure on the posterior side of C2
What does the anterior articular facet rub up against?
The posterior side of the anterior arch of C1
What is on the posterior side of the dens?
Ligaments that wrap themselves around it at the top of the neck to make sure that it’s a solid connection.
Does C2 have a body?
Yes
What kind of flexibility is possible between the atlas and axis?
swivel motion side to side
What are the ligaments that run from the sacrum or pelvis to the base of the skull?
anterior longitudinal ligament
posterior longitudinal ligament
What ligaments links the tips of the transverse processes together?
intertransverse ligament (small ligament)
What ligaments sit on the tips of the spinous processes on the back of the spine?
Supraspinous ligament
What ligament is immediately deep to the Supraspinous ligament and what does it do?
Interspinous ligaments. They connect the vast bulk of the spinous processes to each other. They cover more area than the Supraspinous ligament.
The ligamentum flava connects what?
The rest of the anterior arch together from each vertebral level
Why is the Ligamentum flava a little more stretchy than the other ligaments?
The others are made of fairly rigid collagen
What are you looking for to tell if you are in the ligamentum flava?
Change in resistance
the Ligamentum flava is what color on the spinal ligament slide?
yellow
midline on the ligamentum flava is an opening, how can you avoid this when using a needle?
Approach at a slightly off midline angle
What is the expansion of the interspinous ligament called in the back of the neck?
The nuchal ligament
Where is the supraspinous ligament located in relation to the nuchal ligament?
It sits on the edge of the nuchal ligament on the outside
What is another name for the anterior atlanto-occipital ligament and posterior occipital ligament
anterior atlanto-occipital membrane and posterior occipital membrane
What is the palpable bump called on the base of the skull?
External occipital protuberance
It is where the Nuchal ligament and supraspinous ligament connects with the back of the skull
Why shouldn’t you hit people in the back of the head?
Because ligaments are good but not infallible, and you can break some of the weak points by hitting the back of the head/neck or jumping into a pool with only 1ft of water in it
What is the little palpable bump called on the back of the neck and what it is?
Vertebral prominence
Textbooks say it is C7 but it is most likely T1
Why would be T spine be hard to access at midline?
Because the vertebra point down instead of straight out, you would hit the bone
Why is the T spine more stable and strong?
It has a lot of things attached to it like the rib cage. It is very robust.
What is the most common types of back injuries?
neck and lower back injuries
What do ribs connect to on the t spine?
costal facets
Where are costal facets potentially found?
on the body and on the transverse processes
Rib one connects to which vertebra?
T1
What are the true ribs?
1-7
What are the false ribs?
8-10
What are the floating ribs?
11-12
What are the 3 parts of the sternum?
Manubrium sterni
body
xiphoid process
What connects the ribs to the sternum?
costal cartilage
What makes a false rib false?
They don’t directly attach to the sternum by a single strand of cartilage, there is a connecting piece of cartilage that attach to costal cartilage 7
Why do we need cartilage between the sternum and ribs?
It helps give us some flexibility and protects us against crush injuries
What features are unique to the thoracic vertebra?
Downward facing spinous process
costal facets
Which part of the rib attaches to the costal facet on the transverse process?
The costal tubercle
Which part of the rib attaches to the costal facet on the costal facet on the body?
The head
What is between the head and costal tubercle on the rib?
the neck
What is the shape of the body on the T spine?
Heart shaped
The left side of the t-spine vertebral body is more flat than the right side, why is that?
because of the aorta sits right there beside it and flattens it out
What are the easiest ribs to “jar loose from their connecting places”
the floating ribs, because they’re only attached at one place
Why are the L spine bodies big?
They carry a lot of weight
Why is it not a big deal to access the L spine, and what is a tip to make it even easier to access?
Because the spinous processes come straight out leaving an opening for the needle.
to make it even easier you can have the patient lean over
What does the inferior articular process of L5 connect to?
superior articular Sacrum
What makes up the intervertebral foramen?
Inferior vertebral notch
superior vertebral notch
What comes out of of the intervertebral foramen?
Spinal nerves
When do our 5 sacrum vertebra fuse together?
by the time we’re 14 or 15
What represents the fusion points on the sacrum?
the transverse lines
What sits on the top of the sacrum?
a intervertebral disc and then L5
What is the top of the sacrum called?
Promontory
What is the weight supporting structure of the top of the sacrum?
promontory
What does the vertebral foramen terminate into?
the Sacral canal
What are sacral foramina?
the 4 Holes found in the sacrum where spinal roots exit the sacral canal
What is the median sacral crest?
a combination of fused spinous processes rom the original sacro verterbrum.
What is the ridge on the far sides of the sacrum called? What is it formed by?
Lateral sacral crests
fusion of our transverse processes
The medial sacral crests are formed by the fusion of______. Where are they found?
superior and inferior articular processes
Between the median sacral crests and lateral sacral crests
What is the exit point at the base of the sacrum called? What is it used for?
Sacral hiatus
To allow our coccygeal spinal nerves to exit the sacrum
and to allow ligaments to exit the sacrum and connect to the coccyx
What are the ridges called on the sacral hiatus?
sacral cornua
Which bones of the coccyx are fused together?
Coccyx 2-4
How can we get drugs in to the sacral canal?
By putting drugs into the sacral foramina
What is the most superior ridge of the pelvis?
the iliac crest
Where does the line cross between the iliac crests?
L4
What is the iliac crest marker usually used for?
epidurals
What are visible and palpable ridges on a persons back who is wearing low rise jeans or a bathing suit?
posterior superior iliac spines
What are the posterior iliac spine markers used to find?
the S2 posterior sacral foramina
Why is S2 easier to hit with a needle than S1?
S1 is kind of angled up, not a whole circle.
S2 is more straight forward and has a bigger hole
Which lesser used marker is located below the posterior superior iliac spine?
the posterior inferior iliac spine. This is much harder to palpate
Why would you want to access the posterior sacral foramina?
To shut down pain sensation in the legs
Which palpable markers are found on the front of the pelvis?
the anterior superior and inferior iliac spines
What is the ligament called that attaches the pubic tubercles to the anterior superior iliac spines?
Inguinal ligaments
are the inguinal ligaments easily identifiable?
Yes, under the flap of adipose tissue coming down from the stomach of larger patients.
Which ligament is continuous down the entire spine?
anterior and posterior longitudinal ligament
What ligament attaches the transverse processes of L4 and L5 with the top of the pelvis?
The iliolumbar ligament
Differences between male and female pelvis?
Females have a wider opening and broader hips
What is the pubic symphysis?
A piece of cartilage that holds the two hip bones together in the front
What is the lower set of hips?
the top of the femurs or greater trochanter
What is the lower hips?
the top sides of the pelvis
The umbilicus can be a marker for what?
The L3-L4 intervertebral disk
should you use the umbilicus as a maker?
No, it’s not very good d/t people carrying weight there
What are intervertebral discs used for?
serve as a cushion between the vertebra
Where are no vertebral discs found?
between the fused bones in the spine like the sacrum
What are vertebral discs made of?
Fibrous housing called the analus fibrosus that is filled with a gel like substance called nucleus pulposus. These are sandwiched between 2 pieces of hyaline cartilage endplates.
How are analus fibrosus structured?
a crisscross pattern on the front of our vertebral bodies. it is very** strong**. The back is not crisscrossed so it is not strong
What causes a weakness in the analus fibrosis
trauma or bad genetics
Where in the analus firbrosis does the nucleus puposus usually leak out?
on the posterior side between our vertebral bodies and spinal nerve
Why is it very painful when a intervertebral disc ruptures?
The nucleus pulposus leaks out and compresses spinal nerves in their limited space
What are the 3 solutions to relieving pain caused by a ruptured disc?
Discectomy
Laminectomy
Fusing of vertebra
What is a discectomy?
removal of the entire disk causes the issue- minimally invasive
What is a laminectomy
Opening of the vertebral foramina by removing the lamina on part of the bone
What is the fusion of vertebra?
going through the front of the patient (very invasive) to place rods and screws on the vertebra above and below the problem disc to eliminate movement in hopes that the nucleus pulposus does not compress the nerve anymore
Why does fusion of vertebra not last forever?
When you fuse 2 vertebra together, you place more stress on the discs above and below those vertebra, causing them to wear down faster. In 6-7 years you may have to redo the surgery on those discs.
Which ruptured disc solution has the highest success rate, assuming you have a smooth surgery and a good surgeon?
fusion of vertebra
The less lamina you remove in a laminectomy, the
more successful the procedure is likely to be
Who should do a back surgery?
a neurosurgeon
what percent of back problems could be fixed with PT and life changes?
80%
Why does PT help with back problems?
Hamstring stretches especially make your muscles less tight (hamstrings attach to the lower back) and therefore relieve some of the pressure being placed on the Lumbar spine
What are the 3 layers of meninges?
Pia Mater
Arachnoid Mater
Dura Mater
Where does the Pia Mater sit?
against the neurons and supporting cells, glial cells that make up the CNS
Where does the Arachnoid Mater sit?
superficial to the pia and large vessels that supply the CNS, the spinal arteries and veins
What is in the subarachnoid layer?
CSF and blood vessels
Where does the Dura mater sit?
superficial to the Arachnoid space
What is between the arachnoid and dura maters?
Subdural space- a potential space, nothing is actually here
