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CNS CLERKSHIP > Anatomy of the back, spine and spinal cord > Flashcards

Anatomy of the back, spine and spinal cord Flashcards

1
Q

Functions of the back.

A
  • maintenance of posture.

- movement of limbs and trunk.

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2
Q

What do the skin “dimples” found on the surface anatomy indicate?

A

The positions of the posterior superior iliac spines.

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3
Q

Name the 3 parts of the trapezius muscle.

A
  • Descending (superior).
  • Transverse (middle).
  • Ascending (inferior).
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4
Q

Low back pain may be due to strain of which muscle(s)?

A

Erector spinae

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5
Q

Name the extrinsic muscles of the back.

A
  • Levator scapulae.
  • Rhomboid.
  • Trapezius.
  • Latissimus dorsi.
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6
Q

Where do the extrinsic back muscles attach?

A

The pectoral girdle.

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7
Q

What is the function of the extrinsic back muscles?

A

To move the upper limb.

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8
Q

Trapezius extends superiorly into the neck to attach to what?

A

The occipital bone.

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9
Q

Latissimus dorsi extends superiorly into the neck to attach to what?

A

Cervical vertebrae.

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10
Q

Function of the intrinsic back muscles?

A
  • Maintaining back posture.
  • Movement of spine.
  • Spine support.
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11
Q

Name the intrinsic muscles of the back.

A
  • Erector spinae (superficial).
  • Transverospinalis (deep).

NB both extend superiorly into neck.

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12
Q

Describe the positioning of the erector spinae muscles.

A

3 vertical muscle groups found laterally on either side of the spine.

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13
Q

Where do erector spinae muscles attach inferiorly?

A

Via a common tendon to the sacrum and iliac crest.

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14
Q

Where do erector spinae muscles attach superiorly?

A

Individual muscle fibres attach (via tendon) to:

  • a rib (between rib angles and tubercles) OR
  • a transverse process of a vertebra OR
  • a spinous process of a vertebra.
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15
Q

Where is transverospinalis located?

A

Within the grooves between the transverse and spinous processes of vertebrae.

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16
Q

Individual muscle fibres of Transversospinalis attach between?

A
  • A vertebra and the skull.
  • A vertebra and a rib.
  • One vertebra and another vertebra.
  • The sacrum and a vertebra.
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17
Q

Describe the anatomical relationship of Transversospinalis in relation to the laminae and articular processes?

A

Transversospinalis is found superficially.

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18
Q

How do intrinsic back muscles receive nerve supply?

A
  • Segmentally - dermatome/myotome pattern.

- Via POSTERIOR rami branches of the cervical, thoracic and lumbar regions.

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19
Q

Muscles of the anterolateral abdominal wall (superficial to deep)?

A
  • External oblique.
  • Internal oblique.
  • Transversus abdominis.
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20
Q

Muscles of the posterior abdominal wall?

A
  • Psoas major.

- Quadratus lumborum.

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21
Q

If erector spinae contracts bilaterally what happens to the spine?

A

Extension.

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22
Q

If erector spinae contracts unilaterally what happens to the spine?

A

Lateral flexion.

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23
Q

What muscles are involved in flexion of the spine?

A
  • Psoas major.

- Rectus abdominis.

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24
Q

How many vertebrae in the adult vertebral column?

A

33 vertebrae,

  • C7
  • T12
  • L5
  • S5
  • 4 coccygeal -> one coccyx.
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25
Q

What part of the vertebral column do spinal nerves pass through?

A

Intervertebral foraminae.

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26
Q

What part of the vertebral column does the spinal cord pass through?

A

Vertebral foraminae.

27
Q

Which curvatures of the adult spine are described as lordosis?

A

Cervical and lumbar.

Therefore thoracis and sacral will be kyphosis.

28
Q

What type of joint is found between the articular processes of adjacent vertebrae?

A

Facet joints.

- May be affected by arthritis.

29
Q

What is found between the bodies of adjacent vertebrae?

A

Intervertebral discs.

  • Can herniate.
30
Q

Pain signals from facet joints and discs of the spine are transmitted via what?

A

Posterior rami.

31
Q

Where within the spine are intervertebral discs not found?

A
  • C1-C2.

- Fused sacrum/coccyx.

32
Q

What proportion of the spine’s length is made up of intervertebral discs?

A

20-25%.

33
Q

The outer fibrous ring of an intervertebral disc is known as?

A

Annulus fibrosus.

  • Made up of fibrocartilage.
34
Q

The inner soft pulp of an intervertebral disc is known as?

A

Nucleus pulposus.

NB in newborns, can be 90% water. Functions to provide flexibility and protection.

35
Q

This is a short ligament connecting adjacent laminae posterior to the spinal cord.

A

Ligamentum flavum.

36
Q

This is a narrow, weak ligament that prevents over-flexion of the spine. (Little disc support).

A

Posterior longitudinal ligament.

37
Q

This is a broad, strong ligament that prevents over-extension of the spine and provides strong support for the intervertebral disc.

A

Anterior longitudinal ligament.

38
Q

Anterior longitudinal ligament attaches to?

A

Anterior aspects of ALL vertebral bodies and intervertebral discs.

39
Q

Posterior longitudinal ligament attaches to?

A

Posterior aspects of ALL vertebral bodies and intervertebral discs.

40
Q

A strong, fibrous ligament connecting the tips of spinous processes.

A

Supraspinous ligament.

41
Q

A weak, membranous ligament connecting the superior and inferior surfaces of adjacent spinous processes.

A

Interspinous ligament.

42
Q

What does C1 (Atlas) have in place of a body and spinous process?

A

Posterior and anterior arch.

43
Q

Special feature of C2?

A

Odontoid process projecting superiorly.

44
Q

Where are the Atlanto-occipital joints found?

A

Between the occipital condyles and superior articular facets of the atlas.

45
Q

What type of joint are the Atlanto-occipital joints?

A

Synovial joints with a loose capsule.

46
Q

What movements occur at the Atlanto-occipital joints?

A
  • Flexion & extension of the neck.

- Some lateral flexion and rotation of the neck.

47
Q

Why might the spinal cord be unharmed in a dislocation of the cervical vertebra?

A

Due to the large vertebral canal in this area.

48
Q

What type of joints are the Atlanto-axial joints?

A

Synovial.

49
Q

How many articulations in the Atlanto-axial joints?

A

3.

  • 2 between inferior articular facets of atlas and superior articular facets of axis.
  • 1 between anterior arch of atlas and odontoid process of axis.
50
Q

What main movement occurs at the Atlanto-axial joints?

A

Rotation.

51
Q

What is found in place of intervertebral foraminae in the sacrum?

A

The anterior and posterior sacral foraminae.

52
Q

What is the inferior end of the sacral canal?

A

The sacral hiatus.

- A palpable structure.

53
Q

What is found within the sacral canal?

A

Cauda equina and meninges.

54
Q

In caudal anaesthesia, where is local anaesthetic injected?

A

Into the sacral hiatus.

55
Q

What is caudal anaesthesia attempting to anaesthetise?

A

The sacral spinal nerve roots of the cauda equina.

56
Q

Where does the spinal cord begin?

A

Foramen magnum.

57
Q

The spinal cord is continuous with which structure?

A

The medulla oblongata.

58
Q

Where does the spinal cord end?

A

Around L1/L2.

Can end from T12 - L3

59
Q

What name is given to the tapered end of the spinal cord?

A

Conus medullaris.

60
Q

Where does the spinal cord lie and what is it surrounded by?

A
  • In the spinal canal.

- 3 layers of meninges and epidural fat.

61
Q

Procedure used to access the spinal canal for the posterior exposure of the spinal cord and/or spinal roots.

A

Laminectomy.

62
Q

Why might a laminectomy be performed?

A

To relieve pressure on the spinal cord or nerve roots.

63
Q

What might cause pressure on the spinal cord or nerve roots?

A
  • Tumours.
  • Herniated disc.
  • Bone hypertrophy.
64
Q

Removal of one or more spinous processes and the adjacent lamina.

A

Laminectomy.

CNS CLERKSHIP (43 decks)

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