Anatomy of Back, Spine, Spinal Cord

Question 1

intrinsic back muscles, what are the 2 groups?

Answer 1

• erector spinae (superficial)
• transversospinalis (deep)

Question 2

“low back pain” - which muscle might be strained?

Answer 2

erector spinae

Question 3

erector spinae attachments

Answer 3

inferiorly - common tendon attaches to sacrum and iliac crest

superiorly - individual muscle fibres attach via tendon to either a rib, a transverse process of a vertebra, or a spinous process of vertebra

Question 4

name the muscles of anterolateral abdominal wall from superficial to deep

Answer 4

• external oblique
• internal oblique
• transversus abdominus

Question 5

name the features of a typical vertebra

Answer 5

• vertebral body
• vertebral foramen
• vertebral arch (consists of 2 pedicles and 2 lamina)
• transverse processes x2
• superior articular processes x2
• inferior articular processes x2
• spinous process

Question 6

where do spinal nerves emerge from spinal column

Answer 6

through intervertebral foramen

Question 7

intervertebral disc structure

Answer 7

outer fibrous ring - annulus fibrosus

inner soft pulp - nucleus pulposus (up to 90% water in newborns)

Question 8

name the ligaments of the spine

Answer 8

• ligamentum flavum
• posterior longitudinal ligament
• anterior longitudinal ligament
• supraspinous ligament
• interspinous ligament

Question 9

which is stronger, the anterior or posterior longitudinal ligament?

Answer 9

anterior

Question 10

C1 - atlas

Answer 10

no body or spinous process

Question 11

C2 - axis

Answer 11

has an odontoid process

Question 12

atlanto-occipital joints movements

Answer 12

flexion/extension of neck
a little lateral flexion and rotation

Question 13

what type of joint is atlanto-occipital

Answer 13

synovial

Question 14

where does the spinal cord start and end

Answer 14

begins at foramen magnum

ends around L1/L2

Question 15

spinal cord lies within the ________ ________

Answer 15

vertebral canal

Question 16

at what level should spinal and epidural anaesthetic be administered?

Answer 16

L3/4 interspace

Question 17

what level does the subarachnoid space end at?

Answer 17

S2

Question 18

when should you NOT perform lumbar puncture?

Answer 18

in cases of raised ICP

Question 19

spinal anaesthetic - what layers will the needle pass through?

Answer 19

• supraspinous ligament
• interspinous ligament
• ligamentum flavum
• epidural space (fat and veins)
• dura mater
• arachnoid mater
• reaches subarachnoid space (contains CSF)

Question 20

where is local anaesthetic injected into in caudal anaesthesia?

Answer 20

sacral hiatus

Question 21

name the extrinsic back muscles

Answer 21

Trapezius
latissimus dorsi
rhomboid major and minor
levator scapulae
serratus posterior - superior and inferior

Question 22

is there an intervertebral disc between C1 and C2?

Answer 22

no

Question 23

What is the first palpable/prominent spinous process in most people?

Answer 23

C7

Question 24

atlanto-occipital joints are between the ________ _________ and the _________ __________ ________ of the _______

Answer 24

occipital condyles
superior articular facets of the atlas

Question 25

cervical vertebrae dislocation - stage 1

Answer 25

flexion sprain

Question 26

cervical vertebrae dislocation - stage II

Answer 26

anterior subluxation, 25% translation

Question 27

cervical vertebrae dislocation - stage III

Answer 27

50% translation

Question 28

cervical vertebrae dislocation - stage IV

Answer 28

complete dislocation