Anatomy--Back Flashcards
Back pain is the second most common reason to do what 2 things?
go to the doctor & miss work
What leads into spondylolisthesis?
spondylolysis
Where does the spinal cord end? What is the significance of this for spinal cord damage w/ spondylolisthesis?
spinal cord ends @ L2.
If spondy is below that-no spinal cord damage. If above that, could damage the spinal cord.
Could damage nerve roots at any level. Can damage spinal nerves.
What are the neural ramifications of fractures?
may cause compression of nerve roots or spinal cord
What are the neural ramifications of herniating discs?
they may put pressure on exiting nerve roots b/c they narrow the intervertebral foramina w/ the degenerated disc
What is the purpose of intervertebral foramina?
to allow for passage of exiting spinal nerves.
What are osteocytes & what are its neural ramifications?
abnormal bony growths
if the bones start rubbing together they form spiny processes that impinge on spinal nerves.
Describe what causes muscular back pain.
you get this from guarding, constant tonic contractions used to keep the body in a position that alleviates pain.
Keep in mind that muscular back pain is often secondary to another injury.
Where does bone pain come from?
usu from the periosteum that surrounds the bone & is suspectible to fractures
feels like localized point tenderness
What is meningeal pain?
meninges cover parts of the nervous system
the dura is particularly well innervated
anything that pushes on the dura can cause meningeal pain
If you have an L5/S1 herniated disc, which nerve will it compress?
It will compress one down–S1.
Describe the nerve root pain of an L5/S1 herniated disc.
The person will feel non-classic referred pain down the S1 dermatome=lateral side of the thigh & leg
Is the pelvis a part of the axial skeleton?
Not really. The sacrum and coccyx are…which make up a part of the pelvic girdle. But the ilium etc are a part of the appendicular skeleton.
How many vertebrae are there in the skeleton? What are the 2 main categories of curves?
33 vertebrae
primary & secondary curvatures
Can there ever be variation in having 33 vertebrae?
Yeah, could have 32 or 34. Men are more likely to have 34. Women are more likely to have 32.
How many nerves are associated w/ 33 vertebrae?
31 nerves!
Where are the 31 nerves found?
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
How many vertebrae are in the following sections? cervical thoracic lumbar sacral coccygeal
cervical: 7
thoracic: 12
lumbar: 5
sacral: 5 segments
coccyx: 4 segments
Which type of curve of the spinal cord is associated with the fetus? Generally & specifically.
primary curves
specifically: thoracic & sacral regions
concave side faces anterior of body
How are secondary curves formed? Which sections are secondary curves?
these are formed after the baby gains some strength
include lumbar & cervical
get them when you can sit up & stand erect
get them by 4 years of age
concave side faces posterior of body
Which vertebral structures make up the vertebral foramen or vertebral arch? Which structure lies in the middle of this foramen?
body
pedicle
lamina
*spinal cord housed in here
Which parts of the vertebrae function in muscle attachment & movement?
spinous process
transverse processes
Which parts of the vertebrae function in restricting movement & connecting adjacent vertebrae together?
articular processes & facets
there is a superior & inferior one!
Which part of the vertebrae support body weight?
vertebral body
What separates the vertebral bodies that lie on top of each other?
intervertebral discs
What is laminectomy? What is the purpose for this procedure?
this is a procedure where you take off the posterior aspect of the vertebral arch.
Its purpose is to allow access to the spinal cord.
Not common now, but used to be a standard procedure for a herniated disc
T/F People often slip a vertebrae?
FALSE
What is the zygapophyseal joint?
This is the joint formed b/w the superior articular process of one lower vertebrae w/ the inferior articular facet of a higher vertebrae.
It is considered a synovial joint.
What are the components of the zygapophyseal joint?
Made up of a superior articular process & inferior articular facet
**has a joint capsule, synovial fluid, & ligamentous structures holding it together.
What forms the intervertebral foramen? What is their function?
This is a hole formed when 2 vertebrae come together. It is formed by the inferior notch of a higher vertebrae & the superior notch of a lower vertebrae. This is the space by which nerve roots leave the spinal cord.
What makes up the greater component of the intervertebral foramen? The superior or inferior notch?
The inferior notch makes up a greater proportion of the intervertebral foramen. This is also where more of the nerve roots are tucked in!
Note: as you age, this foramen gets smaller & you can sometimes compress your nerve roots.
Where are the mamillary processes found & what are their function?
These are found on the lateral surface of the superior articular facets. It is a roughened area & is a site of attachment for muscles.
What are the positions of the superior articular facet & inferior articular facet in the following regions?
Cervix
Thorax
Lumbar
Cervix: face superior (superior) & inferior (inferior)
Thorax: face anterior (inferior) & posterior (superior)
Lumbar: face laterally (inferior) & medially (superior)
Why are L5S1 disc herniations so common?
b/c of the prominent joint b/w the lumbar vertebrae & the sacrum
makes the internal sacral promontory landmark @ this joint
Are there any holes in the sacrum? If so, how many & what is their purpose?
Yes! There are 8 anterior sacral foramina & 8 posterior sacral foramina & 1 posterior sacral hiatus.
The anterior foramina are for the ventral rami of the sacral nerves to go to anterior structures.
The posterior foramina are for the dorsal rami of the sacral nerves to go to true back muscles posteriorly. These are for the first 4 sacral nerves.
Where does the S5 nerve exit?
thru the posterior sacral hiatus
What is the last spinal nerve? Where does it exit? Where does it go?
C1
it exits thru the posterior sacrum (sacral hiatus) & it goes to the coccyx.
Where do you feel the first bump of your spine?
first palpable point is C7 in your neck
Describe the spinous process of the following vertebrae.
Cervical
Thoracic
Lumbar
Cervical: bifid spinous process
Thoracic: not bifid, but points inferiorly
Lumbar: large spinous process for erector spinae muscles
T/F Vertebral bodies get larger as you move toward the cervical region.
FALSE They get larger as you move toward the lumbar region b/c that is an area that requires more load bearing.
How many degrees of freedom does each region have?
Cervical
Thoracic
Lumbar
Cervical: 3 degrees of freedom
Thoracic: 2 degrees of freedom
Lumbar: 1 degree of freedom
What is the main movement of the thoracic region? Which movement is restricted?
Main movement: lateral bending
Restricted Movement: posterior-anterior flexion
What is the main movement of the lumbar region? Which movement is restricted?
Main Movement: flexion & extension
Restricted Movements: lateral bending & rotation
What is a unique feature of the cervical vertebrae?
transverse foramen for vertebral arteries.
What is a unique feature of the thoracic vertebrae?
articular facets for the ribs
The head rocks on the ____ & spins on its _____.
The head rocks on the atlas & spins on its axis.
Describe the structure of the atlas.
it doesn’t have a vertebral body
it has an anterior arch for the dens of the axis to sit in, with a ligament holding it in place
dens can rotate nicely in the atlas b/c of lack of body
have anterior & posterior arch
have superior & inferior articular fovea
have transverse foramen
What allows the head to spin on the axis?
the lack of vertebral body of the atlas–doesn’t impede this movement
Where do the occipital condyles rest?
in the superior articular fovea of the atlas
Describe the structure of the axis.
has a big body, the dens, that articulates with the atlas
has superior & inferior articular surfaces
has an anterior articular surface on the anterior of the dens
has transverse processes
has transverse foramen
has vertebral body
has lamina
has bifid spinous process
What’s the deal with the atlanto-occipital joint?
this is the joint b/w the atlas & the occipital bone
it causes nodding of the head yes, flexion & extension)
it is a synovial joint
What’s the deal with the atlanto-axial joint?
this is the joint b/w the atlas & axis
it is responsible for shaking the head no (some rotation)
What is the axis of movement in the vertebral column for the following motion?
Flexion
bending forward
transverse axis
movement toward anterior side
What is the axis of movement in the vertebral column for the following motion?
Extension
bending backward
transverse axis
movement toward posterior side
What is the axis of movement in the vertebral column for the following motion?
lateral bending
anteroposterior axis
What is the axis of movement in the vertebral column for the following motion?
rotation
vertical axis
What are the 4 main factors that allow or restrict movement of the back/trunk?
- thickness of intervertebral discs
- orientation of articular facets
- attachment of ribs
- size, elasticity & orientation of back muscles & abdominal wall
How much movement is there in the following areas?
Cervical
Thoracic
Lumbar
Cervical: considerable, highest amount (also b/c such light weight)
Thoracic: less movement (ribs get in the way)
Lumbar: less movement, but considerable flexion & extension
Where are the intervertebral discs the most thin?
the cervical region
What shows up as a collar on a scotty dog?
a stress fracture of the pars interarticularis
spondylolysis
**scotty dog seen w/ oblique view of the vertebrae
Where is the pars interarticularis?
this is in the vertebrae b/w the superior & inferior articular facets