Anatomy of Back, Vertebral Column and Spinal Cord

Question 1

What are the functions of the back?

Answer 1

Maintenance of posture

Movement of limbs and trunk

Question 2

What are the 3 parts of the trapezius?

Answer 2

Descending (superior)
Transverse (middle)
Ascending (inferior)

Question 3

What are the muscles of the back from superior to inferior?

Answer 3

Trapezius
Teres major (rotator cuff muscle)
Latissimus dorsi
Erector spinae

Question 4

What are the extrinsic back muscles?

Answer 4

Levator scapulae
Rhomboids
Trapezius
Latissimus dorsi

Question 5

What are the 2 groups of intrinsic back muscles?

Answer 5

Erector spinae (superficial)
Transversospinalis (deep)

Question 6

Describe the erector spinae muscles?

Answer 6

3 vertical muscle groups located lateral to the spin

Question 7

Where do the erector spinae muscles attach?

Answer 7

Superiorly- individual muscle fibres attach to rib, transverse process or spinous process
Inferiorly- sacrum & iliac crest

Question 8

Where are the transversospinalis muscles located?

Answer 8

Within grooves between transverse and spinous processes

Question 9

Where do the individual muscle fibres of transversospinalis muscles attach?

Answer 9

Between:
vertebra and skull
vertebra and rib
vertebra and another vertebra
sacrum and vertebra

Question 10

What innervates the intrinsic back muscles?

Answer 10

Segmental nerves as per dermatome and myotome pattern

Posterior rami branches

Question 11

What are the muscles of the anterolateral abdominal wall from deep to superficial?

Answer 11

Transversus abdominis
Internal oblique
External oblique

Question 12

Which muscles extend the spine?

Answer 12

Erector spinae contracts bilaterally

N.B Unilateral contraction gives rise to lateral flexion

Question 13

Which muscles flex the spine?

Answer 13

Psoas major and rectus abdominis

Question 14

What does the vertebral arch consist of?

Answer 14

2 pedicles

2 lamina

Question 15

What is the role of the intervertebral foramen?

Answer 15

Form between adjacent vertebrae

Spinal nerves are found here

Question 16

What is the role of facet joints?

Answer 16

Form between articular processes of adjacent vertebrae

Can be affected by arthritis

Question 17

Describe intervertebral discs?

Answer 17

Found between the bodies of adjacent vertebrae

Form strong attachments and so can herniate

Question 18

Where are there no intervertebral discs?

Answer 18

None between C1-C2

Sacrum/coccyx is fused

Question 19

What is the name and function of the outer fibrous ring of the intervertebral disc?

Answer 19

Annulus fibrosis

Provides strong bond

Question 20

What is the name and function of the inner soft pulp of the intervertebral disc?

Answer 20

Nucleus pulposus

Flexibility and protection

Question 21

What are the ligaments of the spine and their functions?

Answer 21

Ligamentum flavum- short, connects adjacent laminae to spinal cord
Posterior longitudinal ligament- prevents over-flexion of spine
Anterior longitudinal ligament- prevents over-extension of spine
Supraspinous ligament- connects tips of spinous processes- strong + fibrous
Interspinous ligament- connects superior and inferior surfaces of adjacent spinous processes- weak + membranous

Question 22

How do the anterior and posterior longitudinal ligaments differ?

Answer 22

Anterior- attaches to anterior of vertebra and is broad and strong

Posterior- attaches to posterior of vertebra and is narrow and weak

Question 23

What are the common features of the cervical vertebrae?

Answer 23

Transverse foramen
Bifid spinous process
Triangular shaped vertebral foramen

Question 24

What are the features of C1- atlas?

Answer 24

No body or spinous process

Posterior and anterior arch instead

Question 25

What are the features of C2-axis?

Answer 25

Odontoid process

Projects superiorly from body

Question 26

What are the features of C7?

Answer 26

Vertebrae prominens

First palpable spinous process

Question 27

What movements does the Atlanta-occipital joint facilitate?

Answer 27

Flexion + extension of the neck

Little lateral flexion and rotation

Question 28

How many synovial articulations does the atlanto-axial joint have?

Answer 28

Three
2 between inferior articular facets of atlas and superior articular facets of axis
1 between anterior arch of atlas and odontoid process of the axis

Question 29

What is the main movement of the atlanto-axial joint?

Answer 29

Rotation

Saying “no”

Question 30

Where is the sacral hiatus found?

Answer 30

Inferior end of sacral canal

Question 31

Where is local anaesthesia injected in caudal anaesthesia?

Answer 31

Into the sacral hiatus to anaesthetise sacral spinal nerve roots of caudal equina

Question 32

Where does the spinal cord begin?

Answer 32

Foramen magnum continuous with medulla oblongata

Question 33

Where does the spinal cord end?

Answer 33

Vertebral level L1/L2

Question 34

What is the end of the spinal cord called?

Answer 34

Conus medullaris

Question 35

Where does the caudal equina supply?

Answer 35

All spinal nerve roots from L2 to Co

Question 36

What are the 3 layers of meninges that surround the spinal cord?

Answer 36

Pia mater
Arachnoid mater
Dura mater

Question 37

What surrounds the meninges?

Answer 37

Epidural fat

Question 38

What is a laminectomy?

Answer 38

Removal of one or more spinous processes and the adjacent lamina

Question 39

What is a laminectomy used for?

Answer 39

Used to access spinal canal at posterior of spinal cord to relieve pressure on spinal cord/nerve roots

Question 40

What clinical conditions would indicate a laminectomy?

Answer 40

Tumour, herniated disc, bone hypertrophy