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Musculoskeletal I > Anat of back > Flashcards

Anat of back Flashcards

1
Q

How many cervical vertebrae are there?

A

7

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2
Q

How many thoracic vertebrae are there?

A

12

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3
Q

How many lumbar vertebrae are there?

A

5

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4
Q

How many sacral vertebrae are there?

A

5

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5
Q

How many coccygeal vertebrae are there?

A

3-4

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6
Q

What are bony landmarks of the spine?

A

Vertebral prominence - C7 spinous process
Highest point of iliac crest - crosses L4 and L4-L5 IV disc
Inferior angle of scapula - T7
Posterior superior iliac spine - S2

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7
Q

What are the 7 processes of the vertebra?

A

2 superior articular processes
1 spinous process
2 transverse processes
2 inferior articular processes

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8
Q

What are the typical vertebrae with a body, arch, and 7 processes?

A

C3-L5

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9
Q

Why is C1 considered an atypical vertebrae?

A

No body or spine
Superior facet that forms atlanto-occipital joint
Inferior facet forms atlantoaxial joint

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10
Q

What is typically fractures in a fracture of atlas?

A

Anterior and/or posterior arches of C1

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11
Q

Between which two vertebrae is there no IV disc?

A

C1 and C2

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12
Q

What is C2 considered an atypical vertebrae?

A

Odontoid/dens process - pivot for head
Superior articular facet - antlantoaxial joint
Bifid spinous process - muscular attachement

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13
Q

What is fracture and dislocation most often seen on C2?

A

Bony column between superior and inferior processes

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14
Q

What is the function of anterior atlanto-occipital ligament?

A

Connects foramen magnum of skull to atlas
Continues as anterior longitudinal ligament

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15
Q

What is the function of apical ligament?

A

Attaches dens of C2 to anterior part of foramen magnum

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16
Q

What is the function of alar ligment?

A

Attaches dens of C2 to occipital condyles

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17
Q

What will occur with damage to the alar ligament?

A

Increase in axial rotation between occiput and atlas axis

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18
Q

What is the function of the transverse ligment?

A

Between ring of atlas to keep odontoid process in contact with atlas. Prevents anterior displacement of C1 over C2. Prevents posterior migration of odontoid process onto spinal cord

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19
Q

What will occur with a transverse ligament tear?

A

Increase flexion angle of head

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20
Q

What is the function of the anterior longitudinal ligament?

A

Limit hyperextension of spine
Maintain stability between vertebral bodies

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21
Q

What is the function of posterior longitudinal ligament?

A

Limits flexion of spine
Stabilizes vertebral column during flexion

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22
Q

What is the function of ligamentum flavum?

A

Stabilizes vertebral arch joint in flexion

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23
Q

What can occur with hypertrophy of ligamentum flavum?

A

Stenosis

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24
Q

What is the function of nuchal ligament and where does it end?

A

Limits flexion of cervical spine, stability to neck
C7

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25
Q

What are general characteristics of cervical vertebrae?

A

Foramen transversarium
Large, triangular vertebral foramen
Small and wide body
Bifid spinous process

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26
Q

What is the unique characteristic of C7?

A

Long spine

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27
Q

What is the function of foramen transversarium?

A

Passageway for vertebral arteries, veins, and sympathetic plexus

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28
Q

What are general characteristics of the thoracic spine?

A

1-2 facets for articulation with head of rib
Long spinous process with posteroinferior slope
Long and strong transverse process that gets smaller down the spine
Small and circular vertebral foramen

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29
Q

What are general characteristics of the lumbar spine?

A

Massive, kidney shaped body
Triangular foramen
Long, slender transverse process
Supero-inferomammillary facets on articular processes
Short, sturdy, and broad spinous process

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30
Q

What occurs with a laminectomy?

A

Surgical excision of one or more spinous processes

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31
Q

What causes a cervical rib?

A

Overdevelopment of C7 transverse processes

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32
Q

What is the intervertebral joint?

A

Between to vertebral bodies
Cartilaginous - symphyses
Weight bearing, strength, movement

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33
Q

What is the zygapophysial joint?

A

Between processes of vertebrae
Plane synovial
Gliding movement

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34
Q

What are the movements done by the spine?

A

Extension (lean back)
Flexion (bow)
Lateral flexion (lean to the side)
Lateral extension (upright)
Rotation of head and neck
Rotation of upper trunk

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35
Q

What is the most inferior functional IV disc?

A

L5-S1

36
Q

What are the two parts of an IV disc?

A

Outer - annulus fibrosus
Inner - nucleus pulposus

37
Q

What is the annulus fibrosus?

A

Concentric lamellae of fibrocartilage

38
Q

What are the characteristics of nucleus pulposus?

A

Avascular
Gelatinous
Shock absorber - resilient

39
Q

What happens to the nucleus pulposus with age?

A

Dehydrates
Looses elastin and proteoglycans, while gaining collagen
Becomes dryer and granular

40
Q

What is the supraspinatus ligament and its function?

A

From C7 to sacrum, continues from nuchal ligament
Limits hyperflexion

41
Q

What is the function of the interspinous ligament?

A

Connect adjoining spinous processes of vertebae

42
Q

When does the cervical lordosis begin to form and why?

A

Around 6 mo of infancy
When head control develops

43
Q

When does the lumbar lordosis begin to form and why?

A

Around 1 year
With standing and walking

44
Q

What is kyphosis?

A

Abnormal increase in thoracic curvature - hunch/humpback

45
Q

What are causes of kyphosis?

A

Osteoporosis, compression fracture, disc degeneration

46
Q

What is lordosis?

A

Abnormal increase of lumbar curvature - sway/hollow back

47
Q

What are causes lordosis?

A

Weak trunk muscles, pregnancy, obesity, spondylolisthesis (pot belly)

48
Q

What is scoliosis?

A

Abnormal lateral curvature of spine with rotation of vertebrae

49
Q

What cause scoliosis?

A

Weakness of intrinsic muscles of back, congenital or habitual from poor posture, leg length discrepancy, hip disease

50
Q

What are clinical features of Jefferson’s/burst fracture of C1?

A

Neck pain, cervical muscle spasm, limited neck ROM, LOC, vertigo (may affect vertebral artery)

51
Q

What fracture can occur with hyperextension of the head and neck?

A

Fracture of C2 - Hangman’s fracture

52
Q

When are compression fractures of vertebrae typically seen?

A

Osteoporosis
Bone cancer/metastasis

53
Q

What part of the spine is commonly affected by compression fractures?

A

Thoracic

54
Q

What is a wedge compression fracture of vertebrae?

A

Anterior part of body collapses
Hyperflexion injury
Common in cervical spine

55
Q

What is a crush fracture of vertebrae?

A

Break of entire vertebra

56
Q

What are the subtypes of vertebral compression fractures?

A

Wedge
Crush
Burst

57
Q

What is a burst fracture of vertebrae?

A

Loss of height in both front and back wall of body
Can cause neurologic deficits

58
Q

What are clinical features of whiplash injury?

A

Neck pain, stiffness, limited ROM of neck, neurological deficits

59
Q

What is spondylosis?

A

Stress fracture of column bones connecting superior and inferior processes

60
Q

What is spondylolisthesis and its common cause?

A

Forward displacement of vertebra
Spondylosis

61
Q

What are clinical features of spondylolysis and spondylolistheisis?

A

Acute pain after athletic activity, radiation of pain into buttocks, symptoms relieved with rest

62
Q

What are the characteristics and function of the superficial back muscles?

A

Connect upper limb to vertebral column

63
Q

What are the superficial back muscles?

A

Trapezius
Latissimus dorsi
Levator scapulae
Rhomboid minor and major

64
Q

What is the function of the intermediate back muscles?

A

Involved with respiration

65
Q

What is the function of deep back muscles?

A

Vertebral column
Erector spinae

66
Q

What nerve innervates the trapezius?

A

Spinal accessory CNXI

67
Q

What nerve innervates the latissimus dorsi?

A

Thoracodorsal nerve from posterior cord of brachial plexus

68
Q

What muscles are innervated by the dorsal scapular nerve?

A

Levator scapulae
Rhomboid minor
Rhomboid major

69
Q

What is the importance of the auscultatory triangle of the back?

A

Only area of back not covered by muscle. Breath sounds are easily heard with stethoscope.

70
Q

What are the muscles that make up the erector spinae?

A

Spinalis
Longissimus
Iliocostalis

71
Q

What is the action of the erector spinae muscles?

A

Extension and lateral flexion of the vertebral column

72
Q

What is the innervation of the erector spinae muscles?

A

Posterior/dorsal rami of spinal nerves

73
Q

At what level does the spinal cord end?

A

At L1-L2 IV disc

74
Q

Where does the dural sac end?

A

S2

75
Q

Where does the dura mater attach?

A

Coccyx

76
Q

What are clinical signs of a herniated/prolapsed IV disc?

A

Localized pain that radiates into region affected by nerve roots. Tingling, weakness, paralysis

77
Q

What are clinical signs of cauda equina impingement?

A

Loss of bladder and bowel control. Sexual dysfunction

78
Q

What is the area of lumbar puncture and how do you find it?

A

Above or below L4 - vertebra at level of superior iliac crest

79
Q

When is lumbar puncture not performed?

A

In the presence of increased cranial pressure

80
Q

What layers does the needle go through during lumbar puncture?

A

Skin, subcutaneous tissue and fascia, supraspinous ligament, interspinous ligament, flavum, dura, arachnoid, into subarachnoid space

81
Q

What layers does the needle go through for epidural anesthesia?

A

Skin, subcutaneous tissue and fascia, supraspinous ligament, interspinous ligament, flavum, into epidural space

82
Q

Why is epidural anesthesia done in the epidural space?

A

Presence of vasculature

83
Q

What are the contents of the occipital triangle?

A

Vertebral artery
First cervical nerve
Suboccipital plexus of veins

84
Q

What makes up the suboccipital plexus of veins?

A

Occipital vein
Transverse sinus through emissary veins
Blood from neighboring muscles
Internal vertebral venous plexus

85
Q

Where is a suboccipital/cisternal puncture done?

A

Midline just above spine of axis(C2) through suboccipital triangle into cisterna magna

86
Q

When would a sub

A

Musculoskeletal I (14 decks)

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