Anatomy: Chapter 2 Flashcards
1
Q
What makes up your vertebrae? How many of each type?
A
Cervical (7), thoracic (12), lumbar (5), sacrum (5), coccyx (4-5)
2
Q
Describe the curvature of the vertebrae as well as when they are developed.
A
Primary curves: thoracic and sacral which are concave anteriorly (kyphosis)
Secondary curves: cervical and lumbar which are convex (lordosis)
Cervical curve becomes pronounced when at 3 months when the baby can hold their head erect
Lumbar curve becomes pronounced at 9-10 months when toddler tries to stand
3
Q
What are some distinct characteristics of the cervical vertebrae?
A
- large vertebral foreman
- small or no body
- have the transverse foramen
- C1-C6 have a bifid spinous process
4
Q
What is the Atlanto-Occipital articulation?
A
It is where the atlas joins the bone of the skull
5
Q
What is the Atlanto-Axial articulation?
A
Articulation between C1 and C2
6
Q
Fovea dentis
A
The depression in the atlas for the articulation of the den
7
Q
What articulations are involved with the odontoid process?
A
- one anterior for articulation with the atlas
- one posterior for connection with the transverse ligament of the atlas
8
Q
What is the purpose of the odontoid process?
A
It helps move/rotate the head
9
Q
Patient has pain on ulnar side of forearm and hand as well as ischemic muscle pain. He has:
A
a cervical rib: extra rib from C7
10
Q
What are possible effects of having a cervical rib?
A
- ischemic pain: lack of blood supply due to restriction of the subclavian artery
- pain in the ulnar (pinky side) side of forearm and hand
- palpable mass over clavicle
11
Q
Cruciate ligament
A
Transverse ligament reinforced by the superior and inferior longitudinal bands
12
Q
What are the Atlanto-Axial joints?
A
Median: dens
Lateral: articular facets on the axis
13
Q
What is a hangman fracture?
A
Fracture of pedicles/dens of C2
14
Q
What is different about C6?
A
It’s anterior tubercle is more prominent is and known as the carotid tubercle
15
Q
Uncinate processes: where? Development?
A
- C3-C7 and T1
- prevents vertebra from sliding off backwards off the vertebra below it
- initially flat but develops into uncovertebral joints during ages 5-10 yrs
16
Q
What is the vertrbra prominence and what’s different about it?
A
It’s is C7
Anterior tubercles on its transverse processes are missing.
Has a long palpable spinous process
17
Q
What are the contents of the vertebral foramen?
A
Spinal cord Meninges Nerve roots Spinal vessels Cerebrospinal fluid (CSF) Fat tissue
18
Q
What are meninges? What are the different layers?
A
Membranes that cover the brain and the spinal cord 3 layers: Dura matar (outer) Arachnoid (middle) Pia matar (inner)
19
Q
Denticulate ligaments are:
A
Extensions of the pia matar from the surface of the spinal cord to the arachnoid matar
Supports the spinal cord in the vertebral canal
20
Q
What are the intermeningeal spaces?
A
Epidural space: between bones and dura matar; wider below L2.
contains: fat, vertebral veins, nerve roots
Subdural space: between dura matar and arachnoid
Subarachnoid space: between arachnoid and pia matar
Contains: CSF
21
Q
What are cisterns
A
The subarachnoid spaces that are larger in certain areas of the vertebrae
22
Q
Lumbar cisterns: where? What? Contains?
A
Enlargement of subarachnoid space below the medullary cone
Contains: cauda equina (has nerve roots) and filum terminale (extension of pia matar) floating in CSF
23
Q
What is the medullary cone
A
The termination of the spinal cord
24
Q
Contents of the intervertebral foramen
A
Dorsal root ganglia (DRG)
Spinal roots and Vessels
25
Contents of the transverse foramen
C1-C6: vertebral artery and veins
| C7: vertebral artery turns into accessory vertebral vessel
26
Origin and Parts of the vertebral artery are:
Origin: subclavian artery
Part 1: origin to transverse foramen
Part 2: C6-C1 in transverse foramen
Part 3: turns medially on arch of atlas and goes thru the foramen magnum turning into the basilar artery
27
Explain rib articulation with the thoracic vertebrae
Costal facets
Demi-facets articulate with head of the rib forming costovertebral joints
Transverse costal facets articulate with the tubercle of the rib forming costotransverse joints
T1, 10, 11, 12 only have one articulation with ribs
28
Where is the mammillary process
Posterior surface of superior articular process of lumbar vertebrae
29
What is a lumbar puncture? How is it done in adults/newborns?
Procedure where needle is passed in between spinous process and interlamina space and into the subarachnoid space
- between L3-4 for adults and L4-5 for newborns to prevent spinal cord injury
- pressure of CSF can be measure with manometer
- spinal block or contrast medium (for myelography) can be injected
- diagnosis of bacterial meningitis (glucose down, protein up, cloudy)
30
Where does the spinal cord end for adults/newborns?
L1 for adults and L3 for newborns
31
How can you locate L4?
The intercrestal line: a line drawn between the iliac crests is located at L4
32
What is a spinal block? Side effects?
Anesthesia for numbing injected by doing a lumbar puncture
| Side effects: headaches, numbing, paralysis primarily of lower limbs
33
What is a caudal epidural and how is it given?
Anesthesia given thru the sacral hiatus into epidural space to block pelvic nerves
- numbs the pubic region
- used for labor
34
What is Vertebrobasilar Syndrome? Treatment?
When patient looks up and faints (usually the elderly) due to lack to blood of the brain
- treatment from fainting: lifting legs to promote circulation
35
hemivertebrae, block vertebra, spondylolisthesis are all:
vertebral anomalies
36
What is spina bifida and how does it occur? Different types?
Congenital disorder due to a failure of development and/or fusion of the vertebral arches of the L5 or S1 vertebrae.
- can also result from neural tube defect when the caudal neuropore fails to close in the 4th intrauterine week
- Spina bifida occulta: vertebrae doesn't close completely and malformation is covered by skin
- Spina bifida cystica: more severe; one or more vertebral arches fail to develop
- Disorder may be accompanied by: sensory, motor, and autonomic syndromes including paralysis of limbs
37
What is spina bifida associated with?
Meningocele (herniation of the meninges)
| Meningomyelocele (herniation of the meninges and roots/spinal cord)
38
What can be done to prevent spina bifida?
Taking a folic acid supplement in early pregnancy
39
What is anencephaly?
absence of part of the brain
40
Sacralization is:
fusion of L5 to the sacrum
41
Lumbarization:
S1 separates from sacrum
42
What different about Co1 compared to the other coccyx vertebrae?
It has a transverse process and may remain separated from the rest.
43
What is coccydynia?
Medical term for pain in the coccyx. Can be caused by falling on butt or painful delivery (birth pushed coccyx back)
44
How do you measure the distance of the pelvic?
Place hand up vagina and touch the promontory (S1). Then measure the length by checking the end of the blood on your glove. Subtract 1.5 and that is the true distance.
45
Function of intervertebral discs? They make up how much of the vertebral column?
- 20-25%
- bears weight
- facilitate movement
- absorb shock to vertebral column and spinal cord
46
Where is the intervertebral discs located?
Between the vertebrates.
There is no disc between C1 + C2
Lowest disc is between L5 + S1
47
What are symphyses?
Secondary cartilaginous joints made up of intervertebral discs + supporting ligaments.
48
What parts make up a intervertebral disc?
- Annulus fibrosus: outer tense part made of collagen and fibrocartilage tissues arraged in rings
- Nucleus pulposus: jellylike remnant of the embryonic notochord
49
Give more info on nucleus pulposus? What happens to it as one ages?
- its avascular and receives nutrition by diffusion from surround blood vessels
- distributes pressure
- shrinks with age making the tension on the annulus fibrosus decrease
- this can make discs more prone to rupture
50
Where do discs herniation occur?
- mostly posterolateral where the annulus fibrosis is thinner
- common in lower lumbar (L3-L5)
- less common in C5-C7
51
What occurs in a lumbar disc herniation?
Sciatica: during to injury of sciatic nerve affecting lower back and legs downt to feet
- L5: weak dorsiflexion
- S1: plantar flexion
52
What occurs in a central disc herniation?
Compression of the whole cauda equina, causing paraplegia
53
What occurs in a cervical disc herniation?
lateral protrusions compress spinal nerve (above the vertebra) causing pain in lovwer neck and shoulders
54
anterior longitudinal ligament: where? function?
- ALL
- atlas to sacrum on anterior side of body
- prevents hyperextension of vertebral column
- strong, broad
55
What is ALL called from Occippital bone to C1 and from C1 to C2
- occ to C1 = atlanto-occipital membrane
| - C1 to C2 = atlanto-axial membrane
56
Uncovertebral joints:
- secondary joints between uncinate processes on C3-C7
| - also known as luschka's joints
57
Why are uncovertebral joints considers degenerative conditions?
- these joints can cause gap in intervertebral discs increasing chance of formation of pathologic cleft or a split/tear in disc (common in C5)
- uncovertebral athrosis
58
Zygapophysial joints:
- articulation between facets of articular processes from C2-S1; have a tense capsule that is lax (loose) in cervical joints and permits meniscoid infoldings
59
What is osteoporosis?
- bone mineral density is reduced, microarchitecture deteriorates, and risk for fracture is increased
60
What is an osteophyte?
- bone projections that form along joint margins
| - can limit joint movement and cause pain
61
What is a lumbar rib?
Rib coming out from L1
62
Posterior longitudinal ligament: where? layers? function?
- PLL
- runs within canal on posterior of vertebral body firmly attached to the intervertebral discs (especially in T OR L region)
- superficial layer on C2 is continuation of tectorial membrane originating from foramen magnum
- deep layer continues from cruciate ligament and extends into sacral canal
- function: prevents hyperflexion of vertebral column and helps protect against posterior disc herniations
63
ligamentum flavum:
- continuous joint between vertebral arches
- contains elastic fibers and is yellow-ish
- function: brings flexed vertebral column back to its erect position
64
Interspinous lig:
short ligament between spinous processes
65
Supraspinous ligament:
long, continuous ligament on spinous process (C7-Sacrum)
66
Intertransverse ligament:
short, between transverse processes
67
Ligamentum nuchae:
ligament from occipital bone down to cervical spinous processes
- becomes continuous with supraspinous ligaments
68
Apical ligament:
head of dens to foramen magnum
69
Alar Ligament:
side of dens to lateral border of forament magnum
70
What are the 3 parts of the trapezius?
Descending: occipital to lateral third of clavicle
Transverse: C7-T3 + supraspinous lig to clavicle of scapula
Ascending: T3-12 + supraspinous lig to spine of scapula
71
Function and Innervation of Trapezius:
Function: elevation, rotation, rotation of scapula, helps in adduction and elevation of arms
Innervation: spinal root of accessory nerve: Cranial Nerve 11 (motor) and C3-C4 (pain)
72
If a patient can't shrug their shoulders, what could be wrong with him?
He could have problems with the cranial nerve 11
73
Function and Innervation of lattisimus dorsi
function: adduction and lowering of arms, raise body towards should, medial rotation, extension of arms, involved in coughing and forced expiration
Innervation: thoracodorsal nerve (C6, C7, C8), branch of posterior cord coming from brachial plexus.
74
Innervation and Function of Rhomboids:
Innervation: Dorsal scapular nerve (C4-C5)
Function: Presses scapulae to thoracic wall, medial rotation, retraction of scapula
75
Innervation and Function of levator scalpulae
Innervation: Dorsal scapular nerve (c4-c5)
Function: elevates the scapula, rotates inferior angle of scapula medially, rotates the glenoid of the scapula downward
76
Innervation and function of serratus posterior superior
innervation: intercostal nerves (t1-t4)
function: involved in respiration, proprioception
77
Innervation and function of serratus posterior inferior
innervation: intercostal nerves (t9-t12)
function: involved in respiration
78
Innervation, Function, and Parts of iliocostalis:
Innveration: dorsal rami of various spinal nerves
Function: keeping body posture erect
Parts: lumborum, thoracis and cervicis
79
Innervation, Function, and Parts of Longissimus
Innervation: primary dorsal rami of spinal nerves
Function: keeping body posture erect
Parts: thoracis, cervicis, capitis
80
Innervation, Function, and parts of Splenius
Innervation: primary spinal dorsal rami
Function: keeping body posture erect
Parts: cervicis, capitis
81
Innervation, Function, and parts of Spinalis
Innervation: primary dorsal rami
Function: keep body erect
Parts: thoracis, cervicis, and capitis
82
Innervation, Function of Multifidus
Innervation: primary dorsal rami
Function: stabilization of vertebrae with movement of column
83
Function of Rotator Brevis and longus
Function: stabilizing vertebrae, aid in rotation and extension of vertebrae
84
Interspinales, intertransversarii, and lavatores costarum:
smaller muscles found in deeper layers between vertebrae and adjacent ribs
Function: movements of column and assisting in respiration
85
What are the four muscles in the intrinsic muscle group in suboccipital region?
Rectus capitis posterior major, obliquus capitis superior, obliquus capitis inferior, rectus capitis posterior minor muscle
86
Function and Innervation of the intrinsic muscle group in the suboccipital region?
bilateral contractions turn head backwards, unilateral contractions turn the head to the sides
Innervation: greater occipital nerve (C2)
87
What are the contents of the suboccipital triangle?
- third part of the vertebral artery
- suboccipital nerve (dorsal rami of c1) innervating all four muscles
- suboccipital plexus of veins
88
What are the superficial extrinsic back muscles?
Trapezius, Lattisimus Dorsi, Levator Scapulae, and the Rhomboids
89
What are the intermediate extrinsic back muscles?
Serratus Posterior Superior and Inferior
90
What are the superficial Intrinsic back muscles? Function? Innervation?
Spenius Cervicis and Capitis
- Rotate and extend head and neck
- Contractions rotate the head to side of contraction
- Innervated by dorsal rami
91
What are the intermediate Intrinsic Back muscles?
Iliocostalis, Longissimus, and Spinalis (may be missing)
92
What are the deep intrinsic back muscles?
Semispinalis, Multifidus, Rotators, Interspinalis, Intertransversarii, levatores costarum
93
What is an epidural? how is it given?
- S1/S2 into epidural space
| - numbs lower limbs
