Anatomy of Spinal Column Flashcards
Function of spinal column
protect spinal cord and nerves support weight of body rigid/flexible axis for body pivot for head posture and locomotion
What is the spinal column composed of
Cervical Thoracic Lumbar Sacral Coccygeal
How many cervical vertebrae
7
How many thoracic vertebrae
12
How many lumbar vertebrae
5
How many sacral vertebrae
5 (Fused)
How many coccygeal bones
4 (variable) fused
How many Vertebrae total in human
33
How do some anatomist describe the spinal column
26 separate bones (24 movable + sacrum +coccyx)
Why are spinal curves good
Better ability to withstand stress
What are the primary curvatures
- thoracic kyphosis
- sacral kyphosis
Convex posterioly
What are the secondary curvatures
- cervical lordosis
- lumbar lordosis
Convex anteriorly
When and why are secondary curves developed
Developed later in life due to our posture
Which come first, cervical or lumbar lordosis
Cervical
What are the features of a TYPICAL vertebrae
- body
- pedicles
- laminae
- vertebral/neural arch
- vertebral foramen (spinal canal)
- spinous process
- transverse process
- superior + inferior articular process
- superior + inferior vertebral notches
- intervertebral foramen (between 2 vertebrae)
What are the regional characteristics of a typical cervical vertebrae
- bifid spinous process
- presence of the transverse process foramina
- anterior + posterior tubercles on TP
- Large V. foramen
- uncinate process (uncus) (upper body)
Why do cervical vertebrae exhibit several different directions of movement?
articular processes and position of articular facets of cervical vertebra are closest to the transverse anatomical plane
What are the atypical cervical vetebrae
Atlas (C1)
Axix (C2)
vertebra prominens (C7)
What are the characteristics of C1
anterior arch
posterior arch
anterior and posterior tubercles on TP
lateral masses
superior articular surfaces (condyles) make joint with occipital bone
articular surface for dens on anterior arch
groove for vertebral artery
What are the characteristics of C2
Dens axis (odontoid process) two facets on dens axis: anterior- joint between dens and anterior arch of atlas posterior: transverse ligament of axis
What makes C7 different
longest spinous process which is easily palpated on the posterior surface of neck
What group of THORACIC vertebrae are the most typical
T5-T8
What are the characteristics of a typical THORACIC vertebrae
- large heart shaped Vertebral body
- long/point spinous process
- circular VF
- TP easily palpable
- facet joints are directed downward
- Costal facets- two half facets on body (ribs) ; one whole facet on TP (ribs)
What movement is generally seen in thoracic vertebrae
rotation
some extension/flexion
What at the ATYPICAL thoracic Vertebrae
T1, T10, T11, T12
What are the characteristics of T1
- body- one full facet for the 1st rib, two 1/2 facet for head of Rib2
- TP has full facet for Rib1
What are the characteristics of T10
- one 1/2 facet on superior margin of vertebral body
- TP may/maynot have the facet for Rib10
What are the characteristics of T11 & T12
- Each has full facet on body for ribs 11 + 12
- lack facets on TP
- Spinous process- short and rectangular ( more lumbar)
What are the characteristics of a Lumbar vertebrae
- largest vertebral bodies (kidney shaped)
- short
- regtangular and horizonatlly oriented spinous process
- two additional processes : mammillary and accessory
- facet joints are directed medially and vertically
- no costal facets
What are the position and orientation of facets on articular processes
approx the sagittal plane
What is the principle movement allowed by the sagittal plane?
flexion/extension
some lateral flexion
no rotation
Atypical LUMBAR verterbea
L5
What are the characteristics of L5
Wedge shaped body, which is thicker anteriorly than posteriorly
Why is the body of L5 wedge shaped
to accomodate the transition of lumbar spin to sacrum (which is nearly horizontal)
What are the characteristics of the PELVIC surface of sacrum
- transverse lines
- sacral pelvic foramina
- base of the sacrum
- apex
- ala
What are the characteristics of the DORSAL surface of the sacrum
- dorsal sacral foramina
- medial, intermediat and lateral sacral crests
- sacral canal as continuation of spinal canal
- sacral hiatus
- sacral conua
- auricular surface
- sacral tuberosity
What is in the sacral canal
spinal sacral nerves
What is the auricular surface of the sacrum for
sacro-iliac joint
what is the sacral tuberosity for?
attachment of ligaments that reingorce the sacro-iliac joint
What is the coccyx composed of?
4 coccygeal segments
coccygeal cornua
What are the two types of ossification centers?
primary and secondary
How many osssification centers are on the vertebrae
8
Where are the ossification centers located
Primary: on the body, on the pedicles
secondary: Transverse process, spinous process, and the superior and inferior surface of the body
How would one write out LUMBARIZATION
7C + 12T + 5L + 1S + S(4) + Co
How would one write out SACRALIZATION
7C + 12T + 4L + L5 on S + S + Co
What is LUMBARIZATION
when an extra sacral bone is fused to lumbar instead of sacrum
How many intervertebral discs are there
23
What is an anterior intervertebral joint
joints between bodies of adjoining vertebrae
What is an intervertebral disc made of
nucleus pulposus
annylus fibrosus
What is a nucleus pulposus
gelatinous central core of disc, attracts water
highly elastic
What is a annulus fibrosus
an external ring of fibrous tissue
What sections of the spine dont have an intervertebral disc?
occipital bone-axis
atlas-axis
What are the functions of the intervertebral disc
resistance to compression
connection between vertebral bodies
What are the steps in an intervertebral disc herniation
protrusion
prolaps
extrusion (sequestration of extruded discs)
Describe the anterior longitudinal ligament
wider than posterior long. ligament
attached to anterior surface of Vertebral body
resists extensions of spinal column
maintain joint stability
describe the posterior longitudina ligament
narrow, band-like within the spinal column
attached to posterior surface of vertebral bodies
prevent posterior protrusion of nucleus pulposis of disc
resists flexion of spinal column
What are posterior intervertebral joints
joints between superior and inferior articular processes between adjoining vertebrae
What type of movement is allowed in the cervical spine
flexion/extension
lateral flexion (side bending)
rotation
What type of movement is allowed in the Thoracic spine
rotation
limited flexion/extension
What type of movement is allowed in the lumbar spine
flexion /extension
lateral flexion
What are the four ligaments of the posterior intervertebral joints
Ligamentum flavum
Interspinous ligament
Intertransversarii ligaments
Supraspinous ligaments
What happens to the supraspinous and interspinous ligaments superior to C7?
Merge fibers, then follow nuchal ligament to occipital bone
What are the important characteristics of the occipital bone
basilar portion (squama) foramen magnum codyles of the occipital bone external occipital protuberance superior and inferior nuchal lines
Where is the atlanto-occipital joint? And what movement does it allow
between the occipital bone and atlas
permits flexion/extension
Where is the atlanto axial joint? and what movement does it allow
between the atlas and axis
allows rotation
What is the tectorial membrane
upward continuation of posterior longitudinal ligament, superior to C2
What is the Cruciate ligament
composed of two individual bands; Transverse ligament, attached to atlas,
superior/inferior band attach to the margin of Foramen Magnum and to posterior surface of C2
what is the alar ligament
dens to lateral margin of foramen magnum
what is the apical ligaments
dens axis to foramen magnum
What are the tree groups if intrinsic muscle of the spinal cord
- spinotransverse
- sacrospinalis
- transversospinalis
Where is the spinotransverse located
superficially
where is the sacrospinalis located
middle
where is the transversospinalis located
deep
Where do the fibers in the spinotransverse group run
fibers run from spinous process to the transverse process
What muscle(s) are in the spinotransverse group
Splenius capitis
Splenius cervicis
What is the O and I of Splenius capitis
O: Spinous process of C7-T4 and ligamentm nuchae
I: lateral third of the superior nuchal line and mastoid process
What is the O and I of the Splenius cervicis
O: spinous process of T3 to T6 vertebrae
I: posterior tuberles of TVPs of vertebrae C1-C4
What is the nerve contolling the splenius carvicis
dorsal rami of cervical cerves
what is the action of the splenius cervicis
lateral flexion of the head and neck and heat rotation (unilateral contraction)
extension of the head and neck (bilateral contraction)
What three muscles are in the Erector spinae group
- iliocostalis muscle
- longissimus muscle
- spinalis muscle
What are the common origins for the erector spinae group
iliac crest,
posterior surface of sacrum
thoracolumbar fascia
spinous processes of lumbar and lower thoracic vertebrae
What three muscles are part of the iliocostalis group
iliocostalis lumborum
iliocostalis thoracis
iliocostalis cervicis
What three muscles are part of the longissimus group
longissimus thoracis
longissimus cervicis
longissimus capitis
What three muscles are part of the spinalis group
spinalis thoracis
spinalis cervicis
spinalis capitis
All three columns of the erector spinare are innervated by what?
Posterior rami of spinal nerves
What does unilateral contraction of the erector spinae group lead to
lateral flexion of the spine
what does bilateral contraction of the erector spinae lead to
extension of the spinal column
What three muscles are in the Transversospinalis group?
- semispinalis
- multidifi
- Rotatores (short and long)
What are the three muscles in the semispinalis group
semispinalis thoracis
semispinalis cervicis
semispinalis capitis
Where does the semispinalis capitis insert?
On the occipital bone between the superior and inferior nuchal lines
How many vertebrae to semispinalis muscles generally pass over
5
What does bilateral contraction of the semispinalis muscles do
extrends the spinal column
what does unilateral contraction of the semispinalis group do
contralateral rotation
Where do multidifi muscles arise from
vetebral (neural) arches and go to spinous processes of vertebrae 2-3 levels up
What direction do the multidifi travel
same as semispinalis
What does bilateral contraction of the multidifi result in
extension of the spinal column
what does unilateral contraction of the multidifi result in
contralateral rotation
Where do long rotatores arise from
the transverse processes or vertebral arches
Where do the long rotatores insert
on the spinous processes of vetebrae 2 levels above
Where do short rotatores arise from
transverse processes of vertebral arches
Where do short rotatores insert
on the spinous processes of the next vertebra above
What is the action of rotatores
stabilization of the spinal colum
contralateral rotation
What are two types of segmental muscles
interspinous
intertransverse
Where is an interspinous segemental muscle
between spinous processes of asjoining vertebear
Where is an intertransverse segmental muscle
between transverse processes of adjoining vertebrae
Where are intertransverse muscles important
on the cervical spinal comumn
What does unilateral contraction of the intertransverse muscle result in
lateral flexion
what does bilateral contraction of the intertransverse muscle help with
extension of the spine
How many levator costarum muscles are there
12
What is the attachment of the levator costarum muscle
upper- transverse process of C7
lowest- transverse process of T11
Where does the levator costarum insert
on the ribs between ribls angle and tubercle
What is the action of the levator costarum
elevate ribs
What are the four subooccipital muscles
rectus capitis posterior major
rectus capitis posterior minor
obliquus capitis superior
obliquus capitis inferior
Rectus capitis posterior muscles are mainly what?
postural muscles
Where may the contraction of the rectus capitis posterior muscle extend
to the head at the atlantooccipital joint or ipsilateral rotation of the head
Is ipsilateral rotation bilataral or unilateral
unilateral contraction
What kind of joint contraction is the atlanto ooccipital joint
bilateral contraction
Innervation for the suboccipital muscles is through where?
the dorsal ramus of C1 nerve
Which three muscles make the suboccipital triangle
rectus capitis posterior major
obliquus capitis superior
obliquus capitis inferior
What is the floor of the suboccipital triangle formed of
posterior occipito-atlantal membrane, and the posterior arch of the atlas.
What are in the in the deep groove on the upper surface of the posterior arch of the atlas
vertebral artery and the first cervical or suboccipital nerve.
What are the contents of the suboccipital triangle
1) Third part of vertebral artery
2) Dorsal ramus of nerve C1-suboccipital nerve
3) Suboccipital venous plexus
What do the vertebral arteries branch from
subclavian arteries
What do the subclavian arteries (that the vertebral arteries branch from) merge to form
basilar artery
Abdominal wall muscles will be used to flex what part of the spinal column
lumbar portion
How is flexion caused tin the cervial spine
sternocleidomastiod muscle
The group of muscles that flexes the head and neck are innervated by what
anterior rami of cervical nerves
What is the ORIGIN of the sternocleidomastoid muscle
(superior) mastoid process of temporal bone and lateral portion of the superior nuchal line of the occipital bone
What is the INSERTION of the sternocleidomastoid bone
(inferior) sternal head to the upper portion of the sternal manubrium
clavicular head to the medial third of the clavicle
What is the ACTION of the sternocleidomastiod muscle
Bilateral contraction- flexes the neck
Unilateral contraction- bring mastoid process forward and closer to the sternoclavicular joint
How is the sternocleidomastoid muscle INNERVATED
through the cranial nerve 11 (CN XI- accessory nerve) but through its spinal roots
What are the four prevertebral muscles
- longus colli muscle
- longus capitis muscle
- rectus capitis anterior
- rectus capitis lateralis
Where are the rectus capitis anterior and lateralis located
between the skull and spinal cord
Describe the rectus capitis anterior and lateralis
small, postural muscles
minimal flexion of head
scribe the weight distribution on the spinal canal
80%- anterior intervertebral joints
20% posterior (articular processes ) intervertebral joints
What are the two types of joints
FUNCTIONAL AND STRUCTURAL
What are the functional joints
synarthroses
amphiarthoses
diarthroses
What are the structural joints
fibrous
cartilaginous
synovial (fluid)
Describe spina bifida occulta
Mostly harmless
Neural tube does not fuse properly leaving a hole
outside on skin hair is usually surrounding area
Describe spina bifida cystica
CSF bubble is outside hole where the neural tube failed to fuse
two types
1- no nervous system displacement, just a herinated meningocoela, nervs remain inside neural tube.
2- paralyzation- meningomyelocoela, nerves are outside the neural tube
How do nerves pass to the exterior of the spinal column
intervertebral foramina
The movable vertebrae are connected by what 3 things
intervertebral disc
facet joints
longitudinal ligaments
What do intervertebral discs do
joints between adjacent vertebral bodies
act as fibrous shock absorbers
What do facet joints do
joints between adjacent vertebral arches
prevent displacement and allow movement
What do longitudinal ligaments do
prevent hyper-flexion or extension
What is Occipitalization of C1
C1 becomes fused with the base of the skull
What is Sacralization of L5
L5 is incorporated into sacrum
What is Lumbarization of S1
S1 is separated from sacrum, but is fused with L5
as a result, the first normal articulation bears the body weight
What is kyphosis
excessive posterior curvature
What is lordosis
excess anterior curvature
What is Scoliosis
lateral curvature (usually in thoracic region)
Describe the body of the vertebrae
- cylindrical for support of weight
- bodies become progressively larger to support more weight
What are the two main parts of the vertebral arch and their purpose
pedicle and laminae to protec the neural tissue
What id the function of Articular Processes
•
prevent displacement
What id the purpose of Spinous and Transverse Processes
movement
The sacrum consists of how many fused vertebrae
5
what is the product of the fusion of the spinous processes in the sacrum
median sacral crest
What is the lateral sacral crest
fused transverse processes
How many vertebral foramina are there on the sacrum
4
What is the sacral promontory and where is it located
an important obstetrical landmark
to measure A-P width of pelvic inlet
fetal head must pass through
located on the anterior edge of S1
What is the sacral hiatus
can be palpated at superior part of natal cleft
filled with fatty connective tissue
leads into the sacral canal (inferior end of vertebral canal)
a landmark for epidural anesthesia
Where does the aorta divide
L4
Where do the common iliac arteries divide
sacro iliac joints
Where can the top of the coccyx be palpated
natal cleft
Where can the anterior surface of coccyx be palpated?
rectally
What is produced when an injury to the coccyx
coccydinia
Are joints between vertebral bodies cartilagenous or synovial
cartilaginous
What are the articulating surfaces of the vertebral body covered by
hyaline cartilage
Are joints between arches cartilagenous or synovial
synovial
What is the ligamentum flavum
discontinuous ligament joining anterior surfaces of adjacent laminae
within vertebral canal
What is the interspinous ligament
joins adjacent spinous processes
What is the supraspinous ligament
from tip to tip of spinous processes
Describe Facet Joints
between inf. and sup. articular processes of adjacent vertebrae
synovial
articular facets covered by hyaline cartilage
joint surrounded by fibrous capsule
cervical region are the most mobile
What is the function of a facet joint
permit gliding movements between vertebrae (flexion & extension)
limit rotation between adjacent vertebrae
limit displacement between adjacent vertebrae
What is the orientation of a cervical facet
horizontal
What is the orientation of a thoracic facet
downward and posterior
what is the orientation of a lumbar facet
vertical and sagittal
When does Spondylolisthesis occur
“obstructive” function of articular processes is lost
defect is in pedicles of lumbar vertebrae
whole vertebral column is carried anteriorly
What happens in Nerve Root Irritation
facet joints are related posteriorly to intervertebral foramina
joint injury or disease can affect spinal nerves
What are some mechanisms of nerve root irritation
overgrowth of bone
facet dislocation
joint inflammation
What factors contribute to intervertebral disc injury
age
forces (twisting, rapid deceleration, loads)
Where do the majority of disc injurys occur
lumbar-sacral levels
mobile part of spine meets a relatively immobile part
Posterolaterally.
Cause of symptoms in disc herniation
local tissue trauma & inflammation
pressure on spinal nerve
pressure on cervical/thoracic cord or cauda equina
Typical symptoms of disc herination
lumbago sciata muscle spasm and rigidity listing (favoring away from injury) motor or sensory loss
What are the effects of Compression of the L5 Nerve Root
impaired dorsiflexion of foot
impaired extension of toes or big toe
loss of or impaired sensation on dorsum of foot
no change in strength of ankle jerk reflex
What are the effects of Compression of the S1 Nerve Root
impaired plantarflexion of foot
impaired eversion of foot
loss of or impaired sensation on lateral side of foot
loss or weakness of ankle jerk reflex
Why does movement vary from person to person
thickness and compressibility of intervertebral discs
muscle resistance
tension of capsule around facet joint
strength of associated ligaments
what are some injurys due to injuries due to excessive movement
dislocation
disk herniation
fracture-dislocation
Describe Pure Dislocations
commonly in cervical region
typically between C5/C6 or C6/C7
unilateral or bilateral
C5/C6 dislocation
diminished elbow flexion
diminished wrist extension
diminished brachioradialis reflex
sensory loss on distal lateral arm and hand
C6/C7 dislocation
diminished elbow extension diminished wrist flexion diminished finger extension diminished triceps tendon reflex sensory loss on middle finger and hand
Fractures of vertebral column commonly occur because
sudden forceful flex
falling from height onto top of head
What happens in Fracture Dislocations
caused by excessive flexion-compression injury
-causes tearing of ligaments