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Anatomy > Axial Exam > Flashcards

Axial Exam Flashcards

1
Q

Vertebral foramen v intervertebral foramen- walls

A

Vertebral foramen- spinal cord, bordered by body, pedicles, lamina
IV foramen- spinal nerve exits between 2 vertebrae

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2
Q

Special features of C3-C7 vertebrae (4)

A
  • small body
  • uncinate process on top, uncovertebral joints
  • C3-C6 bifid SP’s
  • Transverse foramen- vertebral artery (C1-C6)
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3
Q

Special features of Atlas (C1)

A

No body, hole for dens instead
Posterior tubercle instead of SP
Articulates w occipital condyles

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4
Q

Distinguishing features of T1-T12

A
  • Taller broader bodies
  • Long SP’s angled inferior
  • TP’s angled posterior
  • Costal facets (3 each, superior and inferior on body, on TP except T11/12)
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5
Q

Features of L1-L5 vertebrae

A
  • largest bodies

- thick SP’s point straight posterior

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6
Q

How many articulations on a typical vertebrae? Typical thoracic vertebrae

A
  • 6 (2 body, 2 sup & inf facets)

- 12 on T1-10 (6 normal, 3 costal facets each side)

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7
Q

Intervertebral Discs - type, make up how much of the spine?

A

FC joint (symphyses)
Absorb shock, no disc between C1-C2
20-33% total height
(Cervical discs 3 mm, lumbar 9 mm thick)

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8
Q

Parts of IV Disc (3)

A
  • Nucleus pulposus- 80-85% water, gelatinous
  • Annulus fibrosus outer layer - lamellae - concentric sheets, tensile strength, oriented 120º opposite from each other
  • AF Inner layer - attach to hyaline cartilage vertebral endplates
  • both type 1 collagen fibers
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9
Q

Zygoapophyseal joint type

A

AKA facet joints
4 per vertebra (2 superior, 2 inf articular processes and facets)
- synovial joint, capsule looser in c-spine

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10
Q

Cervical facet angle

A

45% angle, lower posteriorly

- allows flex/ext, rotation, and sidebend

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11
Q

Thoracic facet angle

A 
nearly vertical (80º), angled 20º inward
- allows rotation, sidebend, limits FL/Ext
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12
Q

Lumbar facet angle

A

90º vertical, angled 45º inward

- allows FL/Ext, limits sidebend and especially rotation

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13
Q

Anterior Longitudinal Ligament

A
  • Sacrum-C1, limits extension
  • Deep fibers- Discs- reinforce annulus fibrosus
  • superficial fibers attach to bodies not discs
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14
Q

Posterior Longitudinal Ligament

A
  • Sacrum-C2, limits flexion

- Attaches to bodies & discs

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15
Q

Ligamentum Flavum

A
  • Intersegmental between laminas
  • Sacrum-C1, limits flexion
  • Dense fibrous elastic CT
  • Constant tension, reinforce spinal cord
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16
Q

Transverse and spinous ligaments (3)

A
  • Interspinous (SPs)
  • Supraspinous (outside, post to SP’s, L5-T1)
  • Intertransverse (TP’s)
  • All limit flexion
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17
Q

Broadenings of anterior longitudinal ligament

A
  • anterior atlanto-occipital membrane

- anterior atlanto-axial membrane

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18
Q

Tectorial membrane

A

Posterior Longitudinal Ligament renamed from C2 to occiput

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19
Q

Continuation of ligamentum flavum

A
  • Not elastic fibers
  • posterior atlantoocipital membrane
  • posterior atlantoaxial membrane
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20
Q

Ligamentum nuchae

A
  • Broadening of supraspinous ligament, C7 to occiput

- Helps keep spine extended

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21
Q

Cruciform ligament (2 parts)

A
  • Transverse ligament- supports dens, atlas to atlas
  • longitudinal fascicles- superior to occiput, inferior to axis
  • Prevent ant mvt of C1 on C2
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22
Q

Alar ligaments

A
  • Skips from axis to occiput- from proximal lateral dens outward
  • Limits sidebend, frontal plane
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23
Q

Which vertebral ligaments restrict flexion? (5)

A
  • Post Longitudinal Lig (+ tectorial membrane)
  • Supraspinous lig (+ ligamentum nuchae)
  • Interspinous ligs
  • Ligamentum flavum
  • Intertransverse ligs, depending on orientation
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24
Q

What restricts spine extension? (2)

A
  • Ant longitudinal ligament (ant atlantoaxial, ant atlantooccipital
  • Spinous processes
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25
Q

Thorax cutaneous nerve innervation

A
  • Intercostal nerves from ventral rami- anterior and lateral cutaneous branches
  • posterior rami of spinal nerves innervate back
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26
Q

Extrinsic v Intrinsic back muscles

A
  • Extrinsic = attach outside vertebral column (superficial and deep layer)
  • Intrinsic = attach inside vertebral column (superficial, intermediate, and deep layers)
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27
Q

Extrinsic superficial back muscles (4)

A
  • Levator scap (C1-4 TP to sup angle scapula)
  • Trapezius
  • Latissimus dorsi
  • Rhomboids
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28
Q

Extrinsic deep back muscles (2)

A
  • Serratus posterior superior (SP lower cervical/upper thoracic TO upper ribs, elevate ribs)
  • s.p. inferior (SP lower thoracic/upper lumbar TO lower ribs, depress ribs)
  • intercostal N’s
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29
Q

Superficial intrinsic back muscles (2)

A
  • splenius capitis

- splenius cervicis

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30
Q

Muscles that do extension, ipsilateral rotation, and sidebend

A
  • splenius capitis
  • splenius cervicis
  • erector spinae (iliocostalis, longissimus, spinalis)
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31
Q

Intermediate intrinsic back muscles (3)

A

Erector spinae

  • Iliocostalis (L, T, C)
  • Longissimus (T, C, capitis)
  • Spinalis (T, C, capitus blends with semispinalis capitis)
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32
Q

Deep intrinsic back muscles (6)

A
  • Transversospinals (semispinalis, multifidus, rotatores)
  • interspinalis
  • intertransversarii
  • quadratus lumborum
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33
Q

Muscles that extend, contralaterally rotate, I/L sidebend

A
  • Transversospinals (semispinalis, multifidus, rotatores)
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34
Q

Suboccipital triangle borders

A
  • rectus capitis posterior major
  • obliquus capitis superior
  • obliquus capitis inferior
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35
Q

Suboccipital triangle - Important structures (3)

A
  • Vertebral artery runs transversely in triangle
  • Suboccipital nerve comes out of triangle, innervates muscles
  • greater occipital nerve comes out below triangle, separates semispinalis from spinalis capitis
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36
Q

Joints of sternum- type and number

A
  • manubriosternal (FC joint)
  • costochondral (1-10, hyaline synchondroses)
  • sternocostal (true ribs 1-7)
  • false ribs = 8-10, join to costal cartilage
  • floating ribs = 11-12
37
Q

Costovertebral Joints

A

synovial, 2 articulations. – Costovertebral- rib w its vertebrae, ribs 2-10 also articulate with superior vertebra

38
Q

Costovertebral Radiate ligament

A

Capsular, head of rib to 2 vertebrae & intervertebral disc

39
Q

Costotransverse Joints

A

20 (10 each side)

- Costal tubercle of rib to respective transverse costal facet

40
Q

Costotransverse Ligaments (3)

A
  • Superior - costal neck to superior TP
  • Proper- head and neck to tubercle
  • Lateral- posterior to tubercle
41
Q

Development of curves of spine

A

Newborn spine kyphotic

Transitional phase: cervical lordosis develops first, lumbar later on, becomes stable in puberty

42
Q

Muscles of respiration (3)

A 
Diaphragm
Internal Intercostal (run down and back)
External Intercostal (run down and forward)
43
Q

Diaphragm

A

O: lower margins ribs 7-12
I: Right and left crura, L1-L3 vertebral bodies, discs, ALL
- has holes for esophagus, aorta, vena cava

44
Q

Abdominals- orientation of each layer

A

Ext oblique, Int oblique, Transverse abs

happy on the outside, sad on the inside, stressed in the deepest layer

45
Q

Abdominal aponeuroses- orientation above and below arcuate line-

A
  • arcuate line- 5 cm below umbilicus
  • ABOVE: ext obl on top, int obl splits around rectus ab, transverse ab on bottom.
  • BELOW: all 3 aponeuroses run above rectus
46
Q

Posterior Triangle boundaries

A
  • Ant: sternocleidomastoid
  • Post: trapezius
  • Inf: clavicle
47
Q

Posterior Triangle contents (9)

A
  • Scalenes (anterior, middle, posterior)
  • Levator scapulae
  • Splenius capitus
  • External jugular vein enters neck
  • CN XI accessory N- out jugular foramen to trap and SCM
  • Subclavian artery
  • Brachial plexus
48
Q

Muscles that flex, contralaterally rotate, ipsilaterally sidebend (3)

A
  • Sternocleidomastoid (flexes lower c-spine)
  • Anterior scalene (middle and post only do c/l rot and sidebend)
  • External oblique
49
Q

Interscalene triangle- borders and contents (2)

A
  • Between anterior and middle scalenes and first rib

- Contains: subclavian artery, brachial plexus nerve roots

50
Q

Thoracic outlet syndrome- possible causes

A

Brachial plexus compression, neurovascular symptoms

- Could be scalenes, clavicle, pec minor, subclavius

51
Q

Anterior triangle boundaries

A

Ant- midline neck
Post- sternocleidomastoid
Sup- lower border mandible

52
Q

Contents of anterior triangle (muscle/bone)

A
  • Hyoid bone

- Suprahyoid and infrahyoid muscles (sternohyoid, sternothyroid, thyrohyoid, omohyoid)

53
Q

Function of suprahyoid and infrahyoid muscles

A
  • Suprahyoid: form floor of mouth, secondary muscles of mastication
  • Infrahyoid- swallowing and moving larynx
54
Q

Ansa cervicalis

A

Cervical plexus- makes a loop, innervates supra and infra hyoid muscles
- C1-C3??

55
Q

Neurovascular contents of anterior triangle (8)

A
  • Sympathetic chain, hypoglossal N, glossopharyngeal N, phrenic N
    In carotid sheath:
  • Common carotid, splits to internal and external
  • Internal Jugular vein
  • Vagus nerve CN X
56
Q

Path of internal and external carotid arteries

A
  • Internal carotid: to brain without branching in neck, enters through twisty carotid canal
  • External carotid: supplies neck and face, many branches.
57
Q

Middle meningeal artery path

A
  • branch off external carotid, supplies interior calavera
  • Enters through foramen spinosum, runs between dura and skull
  • Epidural hematoma- TBI, bleeding presses on brain
58
Q

Internal jugular vein- path

A
  • Drains head face and neck

- From sinuses (spaces between dura in skull) through jugular foramen, IJV, to brachiocephalic vein

59
Q

Sympathetic chain

A

Carries sympathetic fibers up to head

60
Q

Phrenic nerve

A

C3-4-5 keeping you alive

- Innervates diaphragm, runs on top of anterior scalene

61
Q

Vagus Nerve - CN X

A
  • To larynx and parasympathetic innervation to thorax and gut
  • Out jugular foramen, runs in carotid sheath w common carotid A and int jugular V)
62
Q

Hypoglossal nerve (CN XII)

A

To muscles of tongue, exits through hypoglossal canal

63
Q

Glossopharyngeal N (CN IX)

A
  • taste and sensation to post 1/3 tongue
  • motor to pharynx (with CN X)
  • exits through jugular foramen
64
Q

Visceral structures of anterior triangle, 3 layers, 2 structures each

A

Anterior endocrine layer- thyroid and parathyroid
Middle respiratory layer- trachea and larynx
Posterior alimentary layer- pharynx and esophagus

65
Q

Parts of larynx (6 cartilages)

A
  • Thyroid- shields vocal apparatus
  • Cricoid- complete ring inferior to thyroid cartilage
  • Epiglottis- flap attached to post surface thyroid cartilage
  • 3 smaller cartilages- vocal folds and phonation
66
Q

Facial nerve CN VII path

A
  • enters skull through internal acoustic meatus (with CN VIII)
  • exits skull through stylomastoid foramen, runs under parotid gland
  • TO muscles of facial expression, taste anterior 2/3 of tongue, parasympathetic innervation
67
Q

Trigeminal nerve CN V- 3 divisions

A

Sensory to face

  • V1 Opthalmic- out superior orbital fissure, forehead to tip of nose
  • V2 Maxillary- out foramen rotundum, to top lip
  • V3 Mandibular- out foramen ovale, to chin
68
Q

Temporomandibular joint movements

A
  • FIrst 15º, Head of mandible rotates in mandibular fossa of temporal bone
  • > 15º, glides forward onto Anterior tubercle- convex surface ant. to mandibular fossa
  • Articular disc- FC, attaches to lateral pterygoid tendon anteriorly, protrudes head of mandible
69
Q

Lateral temporomandibular ligament

A

Supports TMJ (along with capsule, FC disc, and bony configuration)

70
Q

Olfactory CN I

A
  • sense of smell

- sits on ethmoid bone above nasal cavity

71
Q

Optic CN II

A
  • sense of vision

- through optic canal

72
Q 
CN III (oculomotor)
CN IV (trochlear)
CN VI (abducent)
A

to extraocular muscles

through superior orbital fissure (CN 3,4,6 together)

73
Q

Vestibulocochlear CN VIII

A
  • through internal acoustic meatus to inner ear

- balance and hearing

74
Q

Accessory CN XI

A

out jugular foramen

to SCM and trapezius

75
Q

Sympathetic v Parasympathetic Chains- difference between neurons

A

Sympathetic: 1st neuron short, 2nd neuron long

- Parasympathetic: 1st neuron long, 2nd neuron short

76
Q

Sympathetic chain- path of neurons

A
  • 1st neuron- down spinal cord, exits with spinal nerve, synapses on sympatic chain ganglion next to T/L spine
  • 2nd neuron- straight to organ
77
Q

Parasympathetic chain- path of neurons

A
  • 1st neuron: cell body in brainstem, vagus N to synapse in target organ
  • 2nd neuron: acts on target organ
78
Q

3 layers of pelvic floor muscles (deep to superficial)

A
  • Pelvic diaphragm (levator ani)
  • External urethral sphincter
  • Urogenital diaphragm- perineum muscles
79
Q

3 parts of the levator ani

A
  • Puborectalis (loop from pubic symphysis)
  • Pubococcygeus
  • Iliococcygeus
    (obturator internis runs on top of the tendinous arch of levator ani))
80
Q

Inferior aperture (borders of pelvic floor)

A
  • inf pubic symphysis
  • inf pubic rami
  • ischial tuberosities
  • sacrotuberous and sacrospinous ligaments
  • Sacrum and coccyx
81
Q

2 differences in function in male pelvic floor muscles

A
  • bulbospongiosus surrounds urethra- assists w erection, ejaculation, pushes out residual urine
  • Ischiocavernosus- guidewires for penis rigidity, ejaculation
82
Q

Type of fiber distribution in pelvic floor muscles

A
  • 70% slow twitch, 30% fast twitch
  • always active in standing, need endurance
  • need power to hold in pee
83
Q

Innervation of pelvic floor muscles

A
  • Pudendal nerve (S2-3-4 keeps pee and poop off the floor!)

- Contracting inhibits parasympathetic urge to pee

84
Q

Alcock’s Canal

A
  • path of Pudendal N, potential entrapment

- between sacrospinous and sacrotuberous ligaments, runs on top of piriformis, coccygeus, and obturator internis,

85
Q

Autonomic nerve input the bladder

A
  • Sympathetic promotes storage - T11-L2. detrusor relaxes, internal sphincter contracts
  • Parasympathetic promotes bladder emptying - S2-S4, detrusor contracts, internal sphincter relaxes
86
Q

Causes of pelvic floor dysfunction

A
  • Childbirth, chronic UTI’s, age related soft tissue changes
  • Pelvic/abdominal surgery cuts stabilizing muscles
  • Pain inhibition- LBP, pelvic pain
87
Q

Neurological causes of pelvic floor dysfunction

A
  • denervation due to: spinal cord injury or severe herniated disc
  • diabetes, autonomic neuropathy
  • CNS reduced cognitive awareness- CVA, MS, Parkinson’s
88
Q

Insertions on mastoid process (3)

A

splenius capitis, SCM (+ sup nuchal line)

longissimus capitis

89
Q

Insertions on superior and inferior nuchal lines (2 each)

A

Superior: splenius capitis, sternocleidomastoid
Inferior: rectus capitis posterior major and minor

Anatomy (7 decks)

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