Back Flashcards

1
Q

What line separates the sides of the back?

A

midaxillary line

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2
Q

Where is the suboccipital located?

A

inferior part of occipital bone on the back wall of the pharynx

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3
Q

What is the main component of the axial skeleton?

A

the back

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4
Q

List the back structures from superficial to deep:

A

skin, subcutaneous tissue, deep fascia, muscles, ligaments, vertebrae, ribs, spinal cord and meninges, spinal nerves, and blood vessels

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5
Q

What is the deep fascia of the back called?

A

thoracolumbar fascia (diamond shaped fascia)

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6
Q

Where the manubrium meets the sternum is called what?

A

angle of Louis (sternal angle)

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7
Q

The recess along the midline of the back is called what?

A

posterior median furrow (overlies vertebral spinous processes)

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8
Q

What spinous process is easily mistaken for C7?

A

T1

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9
Q

The vertebra prominent is visible in what region?

A

C7

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10
Q

T/F the thoracic spinous process always corresponds to the vertebral body level:

A

FALSE

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11
Q

What overlies the cervical spinous processes of C2-C6?

A

thick nuchal ligament

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12
Q

The superior angle of the scapula typically corresponds to what spinous process level?

A

T1/T2

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13
Q

The inferior angle of the scapula lies at what level?

A

T7/T8

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14
Q

What spinous process lies at the iliac crest?

A

L4

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15
Q

What is an important landmark for lumbar punctures?

A

the iliac crest @ L4

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16
Q

How many sacral spines can be palpated?

A

the first 3 fused segments

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17
Q

A small dimple can be visualized at the level of the S2 spinous process, what does this represent?

A

posterior superior iliac spine

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18
Q

Which region of vertebral column has ribs?

A

thoracic

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19
Q

What plane crosses the L4 spinous process?

A

supracristal plane

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20
Q

What two vertebral columns are fused?

A

sacral and coccygeal

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21
Q

How many vertebras do we have?

A

33

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22
Q

Name the vertebral columns of the spine and indicated how many vertebras they have in each column

A
  • 7 cervical
  • 12 thoracic
  • 5 lumbar
  • 3-5 coccygeal
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23
Q

What are vertebrae separated by?

A

fibrocartilaginous intervertebral discs

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24
Q

What is the function of the vertebral columns?

A

protect the spinal cord and spinal nerves and support body weight superior to the pelvis

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25
Q

Where does spinal motion occur?

A

superior to the sacral level

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26
Q

Spinal motion includes what?

A

extension, flexion, lateral side-bending, rotation, and circumduction

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27
Q

What is the vertebral arch formed by?

A

two pedicles that project posteriorly from the body and two laminae

(think of the vertebral arch as a house)

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28
Q

What cervical vertebras are short and bifid? What does bifid mean?

A

C3-C5
bifid = divided into two parts

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29
Q

Another name for C1 is what? What does it articulate with?

A

atlas - articulates w occipital condyles through two lateral masses & anterior facet that articulates with the dens of C2

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30
Q

What is another name for dens? (hint: relates to C2)

A

dens = odontoid process

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31
Q

Another name for C2 is what? What does it articulate with?

A

axis - projects superiorly to articulate with C1

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32
Q

C2 projects superiorly to articulate with C1, what type of synovial joint is this?

A

pivot joint

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33
Q

Which foramen transmit vertebral arteries traveling up to the head?

A

foramen transversarium

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34
Q

Which foramen accommodates the cervical enlargement of the spinal cord?

A

triangular vertebral foramen of the cervical region

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35
Q

The costal facets of the thoracic vertebrae articulate with what?

A

rib tubercles

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36
Q

Describe the structure of the lumbar vertebrae:

A

large, kidney-shaped bodies and large, triangular vertebral foramina

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37
Q

Where is the mammillary process located?

A

on the superior articular process

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38
Q

Why is motion in the thoracic region limited?

A

bc each thoracic vertebra has 12 joint structures

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39
Q

The facet orientation of the zygapophyseal (facet) joint in the thoracic region is in what plane?

A

frontal plane

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40
Q

The facet orientation of the zygapophyseal (facet) joint in the lumbar region is in what plane? What does this plane permit?

A

in the sagittal plane - permits flexion/extension and minimal rotation

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41
Q

The sacral vertebrae is a fused, wedge-shaped bone that is _____ anteriorly and ______ posteriorly

A

concave anteriorly & convex posteriorly

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42
Q

The Ala of the coccyx is latin for what word?

A

wing

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43
Q

Why is the articular surface of the coccyx sometimes called the auricular surface?

A

because it resembles an ear

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44
Q

The intervertebral discs are arranged between all presacral vertebra except for between what structures?

A

occiput, atlas, & axis

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45
Q

In adults, the intervertebral discs constitute for how much of the total length of the spine?

A

~25%

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46
Q

Each intervertebral disc consists of an outer and inner what?

A

outer annulus fibrosis & inner nucelus pulposus

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47
Q

The strong outer annulus of the intervertebral discs are made up of how many fibrocartilaginous rings (lamellae)?

A

6-10

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48
Q

The inner nucleus pulpous of the intervertebral discs is a gel-like connective tissue structure that contains what content?

A

water (has high water content)

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49
Q

Collectively, the outer annulus and the inner nucleus pulpous of the intervertebral discs do what?

A

permit spinal movement & transmit loads across each vertebral segment (also bind vertebral bodies together)

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50
Q

Regionally, intervertebral discs range in thickness for what purpose? What regions are discs thicker?

A

thickness = to permit different ranges of motion
thicker in cervical and lumbar regions

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51
Q

Tears in the annulus fibrosis allow for herniation of what?

A

nucleus pulpous out into the spinal canal

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52
Q

Gel-like nucleus pulpous contains what percentage of water at the time of birth and what percentage by the time an individual turns 60 y/o?

A

birth = 80% water
60+ = <70% water

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53
Q

List the four distinct spinal curvatures:

A

primary, secondary, cervical, & lumbar

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54
Q

The primary spinal curvatures are found in what region(s)? When are they developed and what is their shape?

A

thoracic & sacral (concave anteriorly)
develop during fetal period
C SHAPE

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55
Q

The secondary spinal curvatures are found in what region(s)? When are they developed and what is their shape?

A

cervical & lumbar (concave posteriorly)
develop as infant begins to hold head and walk
INDENTED C

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56
Q

Name the 4 spinal curvatures of the spinal regions:

A

cervical (lordosis)
thoracic (kyphosis)
lumbar (lordosis)
sacral (kyphosis)

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57
Q

The back musculature can be divided into what two muscle groups?

A

intrinsic and extrinsic

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58
Q

Extrinsic muscles are found in what groups?

A

found in superficial & intermediate groups

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59
Q

Intrinsic muscles make up what group?

A

make up the deep group

60
Q

What muscle is an exception to the intrinsic and extrinsic muscle of the back?

A

trapezius

61
Q

The trapezius is innervated by what cranial nerve?

A

accessory nerve (XI)

62
Q

Superficial back muscles originate from the spine and insert onto the upper back limb, this group comprises what two layers?

A

1st layer - latissimus dorsi & trapezius muscle
2nd layer - rhomboid major/minor & elevator scapulae muscles

63
Q

Intermediate back muscles function to assist respiration and proprioception and to receive ____ _____ & ______?

A

segmental innervation (anterior rami) & vascularization

64
Q

What are the three back muscle groups?

A

superficial (2 layers)
intermediate
deep (3 layers)

65
Q

What does it mean that deep back muscles are “native” to the back?

A

meaning during development, they originated posteriorly & remains in position

66
Q

What are the deep back muscles innervated by?

A

segmental posterior rami

67
Q

What are the layers of the deep back muscles?

A

superficial, intermediate, & deep layers

(same as back muscle groups but deep back muscles have these subgroups as well)

68
Q

The intermediate layer of the deep muscle group of the back contains what collection of muscles?

A

erector spinal muscles

69
Q

The intermediate layer of the deep muscle group of the back contains a collection of three muscles. Name the 3 muscles:

A

spinalis, longissimus, iliocostalis

70
Q

The deep layer of the deep muscle group of the back contains what muscle group?

A

transversospinales muscle group

71
Q

What is the function of the transversospinales muscle group of the deep layer of the deep muscle group of the back?

A

acts as spinal stabilizers

72
Q

Name the muscles that make up the transversospinales muscles (deep layer of deep muscle group of back):

A

semispinalis (capitis), multifidus, rotatores

73
Q

Testing trapezius function is a quick way to assess the integrity of which cranial nerve?

A

accessory nerve (XI) - ask pt to shrug shoulders & test muscle strength

74
Q

What space allows for respiratory sounds to be heard clearly because of thinning of back musculature?

A

triangle of auscultation (ask pt to fold arms across chest and flex forward for better reveal)

75
Q

What can be the root cause of lumbar lordosis?

A

psoas muscle tightness

76
Q

Which lumbar group is important for posture?

A

erector spinae group

77
Q

Which lumbar group provides increased stabilization to the spinal column?

A

transversospinalis group

78
Q

Joints of the vertebral column include what type of articulations?

A

synovial & symphysis

79
Q

Anteriorly in the vertebral column, adjacent vertebral bodies are joined by ____ _____ ___.

A

interposed intervertebral discs (symphysis type)

80
Q

T/F symphysis type allows for weight bearing and contributing to the strength of the spine:

A

TRUE

81
Q

Posteriorly in the vertebral column, _____ ____ occur between the articular process bilaterally.

A

zygapophyseal joints (synovial type)

82
Q

T/F in synovial type, orientation of the articular facets dictate regional type and range of motion:

A

TRUE

83
Q

Craniovertebral joints join in what two places?

A

the base of skull and cervical spine

84
Q

Synovial plane joints are supported by what, which allows for what?

A

an articular capsule (allows for gliding in different places)

85
Q

Cervical spine synovial joints are between what two planes allowing for a wide range of motion?

A

horizontal (transverse) & frontal (coronal) planes

86
Q

The lumbar facet joints are oriented in what plane allowing for spinal flexion and extension?

A

sagittal plane

87
Q

Posteriorly, zygapophyseal joints occur between what two articular processes on either side of the vertebral arch?

A

superior and inferior articular processes

88
Q

The craniovertebral joints include what two joints?

A

atlanto-occipital joint & atlantoaxial joint

89
Q

The atlanto-occipital joint is between what two structures?

A

the occipital condyles and C1 (atlas)

90
Q

The atlantoaxial joint is between what two structures?

A

C1 and C2 (axis)

91
Q

The atlantoaxial joint permits what movement?

A

head rotation (“no” movement)

92
Q

The atlanto-occipital joint permits what movement?

A

head nodding (“yes” movement)

93
Q

Where does rotation at the atlantoaxial joint occur?

A

around the axis of the dens of C2

94
Q

T/F the vertebral column is supported by a series of ligaments that limit excessive spinal motion:

A

TRUE

95
Q

The anterior longitudinal ligament spans from where to where?

A

from the occipital tubercle to the sacral over the anterior and lateral surfaces of the vertebral bodies and discs

96
Q

What ligament is wide and strong and prevents hyperextension of the spine?

A

anterior longitudinal ligament

97
Q

The posterior longitudinal ligament runs from where to where?

A

along the posterior surface of the vertebral bodies and discs from the axis to the scare and coccyx

98
Q

What ligament is thin and provides little resistance to disc herniation, especially in the lumbar region? (hint: prevents hyperextension)

A

posterior longitudinal ligament

99
Q

The location on the vertebra that connects adjacent laminae is called what?

A

location of ligament flavum

100
Q

In an adult, the spinal cord spans from what to what?

A

the foramen magnum to approx. L2

101
Q

The spinal cord in the CNS serves as what and conducts what?

A

serves as a reflex center and conducts motor + sensory signals between brain & body

102
Q

The spinal cord has what shape?

A

cylindrical

103
Q

Distally, the spinal cord tapers and ends where?

A

at L2 as the conus medullaris

104
Q

Multiple spinal nerve rootlets emerge from the distal spinal cord and _____ _____ to exit the vertebral column:

A

conus medullaris

105
Q

The nerve rootlets that emerge from the distal spinal cord and conus medullaris to exit the vertebral column is collectively called what?

A

cauda equina (latin for horse tail)

106
Q

The spinal nerves exit above corresponding vertebrae in the cervical region and begin in the ____, ____, and ____ regions:

A

thoracic, lumbar, and sacral regions

107
Q

In a cross section, the spinal cord has an “H”-shape core made up of cell bodies. What is this called?

A

gray matter (continuous)

108
Q

What is peripheral white matter (saltatory) made up of?

A

nerve fibers (axons)

109
Q

Gray matter is organized into ____ and ____ horns, which contain motor and sensory body cells:

A

anterior & posterior

110
Q

The thoracolumbar region is at what vertebral levels?

A

T1-L2/L3

111
Q

The thoracolumbar region features a what?

A

lateral horn

112
Q

The lateral horn in the thoracolumbar region features a lateral horn that contains preganglionic sympathetic cell bodies organized into what?

A

intermediolateral cell column

113
Q

Peripheral white matter is organized into specific tracts, what are they and are they sensory or motor?

A

ascending (sensory) & descending (motor) tracts

114
Q

If a word has ‘spino’ at the beginning, does this indicate its afferent or efferent?

A

afferent (sensory)

115
Q

If a word has ‘spino’ at the end, does this indicate its afferent or efferent?

A

efferent (motor)

116
Q

White matter is ______ (saltatory) while gray matter is _____ (continuous).

A

white = myelinated (saltatory), gray = unmyelinated (continuous)

117
Q

T/F the majority of nerves decussate:

A

TRUE

118
Q

How many paired spinal nerves exit the vertebral column through the intervertebral foramina or sacral foramina at each vertebral level?

A

31

119
Q

Anterior and posterior rootlets of the spinal nerves arise from the spinal cord laterally, representing what fibers?

A

motor (anterior) and sensory (posterior) fibers

120
Q

The spinal nerve rootlets converge to form nerve roots, which contain autonomic and somatic motor or sensory components. What are these roots called, respectively?

A
  • anterior root = autonomic & somatic motor
  • posterior root = sensory
121
Q

Pseudounipolar sensory neurons are housed where?

A

the spinal ganglion (posterior root ganglion)

122
Q

Multipolar motor neuron cell bodies are found where? Their axons form what room?

A
  • found in the anterior horn of the spinal cord
  • axons form the anterior root
123
Q

Once the spinal nerve has exited the vertebral column, it splits into what?

A

an anterior & posterior ramus

124
Q

Is the general sensory afferent (GSA) system somatic or visceral? Where does it distribute to?

A
  • somatic
  • discriminative touch, proprioception, pain and temp from the skin, joints, and muscles
125
Q

Where does the general visceral afferent (GSA) system convey?

A

sensation from the viscera

126
Q

The general somatic efferent (GSE) system carries motor impulses to where?

A

skeletal muscles

127
Q

The general visceral efferent (GVE) projects motor neurons to what?

A

viscera

128
Q

What houses cell bodies for somatic and autonomic sensory neurons?

A

spinal ganglion

129
Q

What anchors spinal cord inferiorly to the coccyx?

A

film terminale (pia)

130
Q

What do the spinal meninges include?

A

dura mater, arachnoid mater, pia mater

131
Q

Deep to the dura mater is the _____ _____, a delicate, web-like layers creates a subarachnoid space filled with CSF.

A

arachnoid mater

132
Q

T/F is the subdural space considered a true space?

A

no, it shouldn’t be visible unless bleeding occurs

133
Q

Where does the lumbar cistern lie and what does it contain?

A

within the dural sac and contains CSF & caudal equina

134
Q

What meningeal layer is closely adhered to the spinal cord?

A

pia mater

135
Q

_____ ______ are extensions of pia that project laterally at each vertebral foramen level and anchor into the inner surface of the dura matter, separating anterior and posterior rootlets.

A

denticulate ligaments

136
Q

What is an extension of pia from the tip of the conus medullaris that extends inferiorly to attach on the coccyx, acting as a caudal anchor for the spinal cord?

A

filum terminale

137
Q

What artery serves the lower 2/3 of the spinal cord and is the largest of the medullary arteries?

A

great anterior segmental medullary artery (artery of Adamkiewicz)

138
Q

T/F the radicular arteries anastomose with spinal arteries:

A

FALSE - they do not anatomies w spinal arteries

139
Q

The radicular arteries supply what?

A

meningeal coverings and spinal nerve roots

140
Q

The periostea and equatorial branches supply arterial blood to the _____ column:

A

vertebral

141
Q

Where does the venous drainage of the vertebral column arise from?

A

spinal veins

142
Q

There are 20-22 pairs of denticulate ligaments that line the spinal canal and help to do what?

A

anchor the spinal cord laterally

143
Q

The conus medullaris terminates at what interspace?

A

L1-L2

144
Q

The caudal equina consists of the posterior and anterior root from ____ to _____ vertebral levels, and descend below the level the conus medullaris:

A

L3 to coccygeal

145
Q

What anchors the spinal cord inferiorly to the coccyx?

A

filum terminale

146
Q

When performing a lumbar puncture, the needle should be inserted below the level at which the spinal cord ends. What area is this called?

A

conus medullaris

147
Q

What joint has a dual innervation?

A

synovial