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M&M Test 4 > B6-065 Back and Spine Anatomy > Flashcards

B6-065 Back and Spine Anatomy Flashcards

1
Q

how many cervical vertebrae are there?

A

7

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2
Q

how many thoracic vertebrae are there?

A

12

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3
Q

how many lumbar vertebrae are there?

A

5

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4
Q

primary curvatures that develop in utero [2]

A

thoracic kyphosis
sacral kyphosis

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5
Q

what secondary curvature forms when an infant starts to raise their head?

A

cervical lordosis

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6
Q

what secondary curvature forms when a child begins to walk?

A

lumbar lordosis

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7
Q

excessive curvature of the thoracic vertebrae
largely due to osteoporosis

A

kyphosis

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8
Q

excessive curvature of the lumbar vertebrae
seen in pregnancy or obesity

A

lordosis

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9
Q

curvature of the spinous processes on the forward bending test

A

scoliosis

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10
Q

what forms the zygapophyseal facet joints?

A

the superior and inferior articular processes

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11
Q

spinal nerves emerge from the

A

intervertebral foramen

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12
Q

what keeps the dens in close approximation to C1?

A

transverse ligament of atlas

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13
Q

where does the skull articulate with C1?

A

the superior articular surface

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14
Q

what vascular structure passes through the foramen transversarium (formed by the transverse processes of C6-C1)?

A

vertebral artery

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15
Q

the vertebral artery lies in the groove of […] before entering the foramen magnum

A

C1

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16
Q

what neurologic structure lies in the vertebral foramen?

A

spinal cord

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17
Q

helps C2 articulate with the axis

A

dens

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18
Q

when someone does a chokehold and the person passes out, what structure is being compressed and where?

A

carotid artery at the carotid tubercle of C6

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19
Q

what structure of the thoracic vertebrae allows the ribs to articulate with the spine?

A

costal facet

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20
Q

which vertebrae have long spinous processes?

A

thoracic

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21
Q

which vertebrae have long transverse processess?

A

lumbar

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22
Q

what structure would have been the spinous processes of the bones of the sacrum before they fused?

A

median crest

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23
Q

what structures of the sacrum are able to be palpated for insertion of a needed during epidural injection? [2]

A

sacral cornua
sacral hiatus

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24
Q

ribs 2-9 articulate with […] vertebrae

A

2

the superior costal facet of one, and the inferior costal facet of another

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25
Q

the superior and inferior vertebral notch forms the

A

intervertebral foramen

**spinal nerves exit here

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26
Q

fracture of C1 caused by something landing on top of the head

A

Jefferson (burst) fracture

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27
Q

a dive into a shallow pool may cause a fracture of […]

A

C1, Jefferson (burst) fracture

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28
Q

what structures are fractured in a Jefferson fracture?

A

anterior and posterior arches of C1

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29
Q

common fracture in younger patients as result of high speed, high energy injury

ex. car wreck, ATV

A

dens fracture C2

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30
Q

common cervical fracture in older patients as a result of falls, osteopenia, and osteoporosis

A

dens fracture of C2

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31
Q

what structures of C2 are affected by a Hangman’s fracture?

A

pars interarticularis between the superior articular facet and the inferior articular process

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32
Q

fracture resulting from hyperextension of the head on the neck

A

Hangman’s fracture (spondylolysis) of C2

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33
Q

degeneration of the joints, disk, and bones in the spine

A

spondylosis

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34
Q

stress fracture through the par interarticularis of the vertebrae

A

spondylolysis

**she’s says this looks like a Scottie dog with a broken neck on Xray, not sure about that 😒

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35
Q

forward displacement of a vertebra on the one below it

A

spondylolisthesis

**often occurs with spondylolysis

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36
Q

usually the most prominent palpable vertebrae of the spine

A

C7

**T1 would be right below

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37
Q

T3 is in line with

A

spine of scapula

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38
Q

spinous process of T7/body of T8 is in line with the

A

inferior angle of the scapula

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39
Q

if you place your hands on the sides of the ribs and extend thumbs directly back, what vertebrae will this line up with?

A

L3 subcostal plane

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40
Q

if you place your hands at the top of the iliac crest and extend thumb back, what vertebrae will this line up with?

A

L4 supracristal plane

important to lumbar punture

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41
Q

ligament that limits extension of the spine

A

anterior longitudinal ligament

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42
Q

ligaments that limits flexion of the spine [4]

A

posterior longitudinal ligament
supraspinous ligament
interspinous ligament
ligamentum flavum

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43
Q

the nuchal ligament is an extension of

A

supraspinous ligament

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44
Q

ligament that joins the tips of the spinous processes

A

supraspinous ligament

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45
Q

the zygapophyseal facet joints of the cervical spine are sloped from anterior to posterior to help with

A

flexion/extension

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46
Q

the zygapophyseal facet joints of the thoracic spine are oriented vertically

A

limit flexion/extension
facilitate rotation

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47
Q

the zygapophyseal facet joints of the lumbar spine are oriented sagitally to

A

limit rotation and lateral bending
facilitate flexion/extension

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48
Q

usually the site of bone spur formation due to aging from C3-C7

A

uncovertebral joints/clefts of Luschka

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49
Q

joint at the articulation of the superior articular face of atlas (c1) and the occipital condyles

A

atlanto-occipital joint

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50
Q

joint of the neck that allows you to say “yes”

A

atlanto-occipital

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51
Q

joint that allows your head to say “no”

A

altanto-axial

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52
Q

trapezius is innervated by

A

CN 11 -spinal accessory

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53
Q

levator scapulae and the rhomboids are innervated by

A

dorsal scapular

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54
Q

the intrinsic (true) muscles of the back are all innervated by

A

posterior (dorsal) rami of spinal nerves

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55
Q

what muscles can act unilaterally to laterally flex the neck and bilaterally to extend the head and neck?

A

spenius capitis
splenius cervicis

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56
Q

erector spinae muscle that attaches distally to the lower ribs and transverse processes

A

iliocostalis

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57
Q

what intrinsic muscle of the back aids in rotational movements of the vertebral column?

A

rotatores (of the transversospinalis group)

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58
Q

muscles that act in extension of the back [3]

A

erector spinae
multifidis (TS)
semispinalis thoracis (TS)

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59
Q

muscles that act in lateral bending of the back [3 of importance to this lecture]

A

iliocostalis thoracis and lumborum (ES)
logissimus thoracis (ES)
multifidus (TS)

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60
Q

muscles that act in rotation of the back [4 of importance to this lecture]

A

rotatores (TS)
multifidus (TS)
iliocostalis (ES)
longissimus (ES)

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61
Q

posterior (dorsal) roots are purely […]

A

sensory

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62
Q

anterior (ventral) roots are purely […]

A

motor

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63
Q

what level does the spinal cord end?

A

L1/L2

rest is cauda equina

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64
Q

what areas of the spinal cord are enlarged? [2]

A

cervical
lumbrosacral

**thicker because more axons exiting to limbs

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65
Q

layers of meninges (including spaces) from most external to most internal

A

epidural space
dura mater
sub dural space (potential space)
arachnoid mater
subarachnoid space
pia mater

66
Q

the internal vertebral venous plexus lies in the

A

epidural space

67
Q

lateral extensions of pia mater that prevent side to side movement of the spinal cord

A

denticulate ligament

68
Q

separates the posterior roots from the anterior roots

A

denticulate ligament

69
Q

filum terminale internum is an extension of […]
filum terminale externum is an extension of […]

A

pia
pia and dura

**help to anchor the spinal cord in place

70
Q

comes from a variety of arteries to help supply the inferior regions of the spinal cord

A

great segmental medullary artery

71
Q

comes off a posterior intercostal or upper lumbar artery to reinforce the anterior longitudinal artery in supplying inferior 2/3 of the spinal cord

A

great anterior segmental artery (artery of Adeamkiewicz)

72
Q

what happens if the great anterior segmental artery (artery of Adeamkiewicz) becomes damaged?

A

cord below will die

**helps the anterior longitudinal artery in supplying inferior 2/3 of the cord

73
Q

arteries that supply the dorsal and ventral roots of the spinal nerves

A

radicular arteries

74
Q

if cancer metastasizes to the […] it can spread widely throughout the body

A

internal vertebral (epidural) plexus

(venous plexus)

75
Q

prime movement of the atlantoaxial joint

76
Q

prime movement of the atlanto-occipital joint

A

flexion and extension

77
Q

what space do the veins and arteries that supply the spinal cord lie in?

A

subarachnoid

78
Q

the subarachnoid space contains [2]

A

CSF
veins/arteries that supply spinal cord

79
Q

the epidural space contains [2]

A

fat
internal vertebral venous plexus

80
Q

space between the vertebral arch and the dura

A

epidural space

81
Q

space between the dura and the arachnoid mater is the

A

subdural space

82
Q

abnormally increased thoracic curvature, usually resulting from osteoporosis

83
Q

abnormal accentuation of the lumbar curvature usually due to pregnancy or obesity

84
Q

abnormal lateral and rotational curvature of the spine that may present with uneven hips, shoulders, and rib cage

85
Q

exit through the intervertebral foramen

A

spinal nerves

86
Q

located in the vertebral foramen

A

spinal cord

87
Q

located in the transverse foramen of C1-C6

A

vertebral artery

88
Q

anatomical landmark to find L4

A

supracristal plane

89
Q

anatomical landmark used to find L3

A

subcostal plane

90
Q

anatomical landmark used to find C7

A

vertebra prominens

91
Q

anatomical landmark used to find T3

A

spine of scapula

92
Q

anatomical landmark used to find T7/T8

A

inferior angle of scapula

93
Q

caudal anesthesia is administered into which opening?

A

sacral hiatus

94
Q

prime extensors of the back

A

erector spinae

95
Q

extends, adducts, and medially rotates the humerus

A

latissimus dorsi

96
Q

extend the neck and head bilaterally
flexes neck and rotates head to ipsilateral side unilaterally

97
Q

transversospinalis […] the back

98
Q

rotatores […] the back

99
Q

elevate, depress, and retract scapula
elevate shoulders
extend head

100
Q

as a needle moves into the spine during a lumbar puncture, what ligaments does it come into contact with [3]

(superficial to deep)

A

supraspinous
interspinous
ligamentum flavum

101
Q

ligament located anterior to the bodies of the vertebrae

A

anterior longitudinal

102
Q

ligament located between the spinal cord and vertebral body

A

posterior longitudinal ligament

103
Q

anastomoses with the anterior and posterior spinal arteries to supply the inferior 2/3 of the spinal cord

A

great anterior segmental artery (artery of Adeamkiewicz)

104
Q

the radicular arteries supply the

A

dorsal and ventral roots of the spinal cord

105
Q

herniated disk and spinal stenosis are examples of […] back pain

A

mechanical

106
Q

ankylosing or psoriatic spondylitis are examples of […] back pain

A

nonmechanical

107
Q

pancreatitis and cholecystitis are examples of […] causing back pain

A

visceral disease

108
Q

what anatomical landmarks are used during a lumbar puncture

A

supracristal plane (L4)

109
Q

between what vertebral levels is the needle inserted during a lumbar puncture?

A

L4/5

spinal cord ends about L2, so this is safest

110
Q

where does the spinal cord end in an infant?

A

L3ish

cord begins same length as spine and shortens with development. Is at L3 by birth

111
Q

space between the ligamentum flavum and dura mater

A

epidural space

112
Q

why is a lumbar puncture contraindicated when there is potential for increased ICP?

A

sudden shift in pressure can cause brain herniation

113
Q

if you hit […] during a lumbar puncture, you’ve gone too far

A

posterior longitudinal ligament

114
Q

a herniated disk will always compress the […] root

A

lower

**herniation between C5 and C6 compresses C6 nerve root

115
Q

what ligament is likely to be damaged in hyperextension of the spine?

A

anterior longitudinal ligament

116
Q

what ligaments are likely to be damaged by hyperflexion of the spine? [4]

A

nucchal ligament
supraspinous
interspinous
posterior longitudinal ligament

117
Q

how will damage to the C6 nerve root affect
motor:
reflex:
sensory:

A

motor: biceps weakness
reflex: loss/weak biceps reflex
sensory: thumb

118
Q

how will damage to the C7 nerve root affect
motor:
reflex:
sensory:

A

motor: triceps weakness
reflex: weak/absent triceps reflex
sensory: index and middle finger

119
Q

how will damage to the C8 nerve root affect
motor:
reflex:
sensory:

A

motor: weakness of interossei
reflex:
sensory: ring finger and pinky

120
Q

what is herniating out in disk herniation?

A

nucleus pulposis

121
Q

which direction does a herniated disk protrude?

A

posterolateral

**posterior longitudinal ligament is in midline

122
Q

paresthesia over SI joint, hip, lateral thigh front of calf and big toe
weak dorsiflexion
difficulty walking on heels

lesion in […] nerve root

123
Q

paresthesia over SI, hip, posterolateral thigh, back of calf, and lateral heel to toe
weak plantar flexion
difficulty walking on toes
diminished ankle jerk reflex

indicates lesion in […] nerve root

124
Q

sensory loss in perianal region
urinary/fecal incontinence
sexual dysfunction

indicates lesion in […] nerve roots

125
Q

caused by intraspinal lesion caudal to the conus

A

cauda equina syndrome

126
Q

saddle sensory defect of perineal regions, buttocks, and posterior thigh

A

cauda equina syndrome

127
Q

bladder dysfunction
bowel dysfunction
saddle sensory defect
bilateral sciatica

A

cauda equina syndrome

128
Q

what arteries supply the spinal cord?

A

anterior spinal artery
2 posterior spinal arteries

129
Q

reinforces blood flow to the lumbar and sacral regions of the cord ensuring adequate blood flow

A

great anterior segment medullary artery

**injury do this causes necrosis of the cord below, leading to bladder/bowel/sexual dysfunction

130
Q

history of intraspinal surgery
abnormal post-void residual
bilateral sensory deficits in clear dermatomal distribution

A

cauda equina syndrome

131
Q

a back sprain is defined as an injury to a [….] of the back

132
Q

a back strain is defined as an injury to a […] of the back

133
Q

central mucoid substance of a disk

A

nucleus pulposis

134
Q

surrounding fibrous tissue and fibrocartilage of the disk

A

annulus fibrosis

135
Q

in a herniated disk, the […] herniates through the […]

A

nucleus pulposis herniate through the annulus fibrosis

136
Q

defect in pars interarticularis

A

spondylolysis

137
Q

stiffening of the spine due to any lesion of the spine of a degenerative nature

A

spondylosis

138
Q

decreased sensation of the posterior leg and lateral foot
diminished ankle jerk reflex
weak plantar flexion, toe flexion, and eversion

A

S1 radiculopathy

139
Q

weakness of dorsiflexion

A

L5 radiculopathy

140
Q

structures that can cause spinal stenosis [3]

A

hypertrophy of ligamentum flavum
facet osteophytes
disc herniation

141
Q

bilaterally decreased sensation and back pain/leg pain that improves with rest may indicate

A

spinal stenosis

142
Q

mechanical back pain does not cause […] deficits

A

neurological

143
Q

the lumbar curvature forms when

A

a child begins to walk

144
Q

the cervical curvature forms when

A

a child begins to hold their head up

145
Q

what space is CSF found in?

A

subarachnoid

146
Q

space between the arachnoid layer and the pia mater

A

subarachnoid space

147
Q

the internal vertebral venous plexus and epidural fat is located in the […] space

148
Q

space between the dura and bone of the vertebral foramen

A

epidural space

149
Q

space between the arachnoid and the dura

A

subdural space

150
Q

during proper administration of an epidural anesthetic, the needle will pass though: (ligaments only)

A

supraspinous ligament
interspinous ligament
ligamentum flavum

151
Q

ligament overlying the spinous processes of the lumbar vertebrae

A

supraspinous

152
Q

ligament connecting the spinous processes of adjacent vertebrae

A

interspinous

153
Q

ligament that stretches between the laminae of adjacent vertebrae

A

ligamentum flavum

154
Q

ligament that attaches along the anterior sides of the vertebral bodies

A

anterior longitudinal

155
Q

ligament that runs vertically along the posterior aspect of the spinal column

A

posterior longitudinal

156
Q

lateral extension of the pia mater

A

denticulate ligament

157
Q

inferior extension of the pia mater from the tip of the conus medullaris

A

filum terminale internum

158
Q

extends from the tip of the dural sac to the coccyx

A

filum terminale exturnum (coccygeal ligament)

159
Q

prevents hyperflexion of the vertebral column

A

ligamentum flavum

160
Q

responsible for rotation of the spinal column

A

rotatores (transversospinalis)

161
Q

a disk herniation always affects which nerve root?

M&M Test 4 (14 decks)

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