Back Flashcards

1
Q

What is the first vertebra?

A

Atlas C1

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2
Q

What is the 2nd vertebra?

A

Axis C2

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3
Q

How many cervical vertebrae?

A

7

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4
Q

What kind of curvature does the cervical portion of the spine has?

A

Concave posteriorly - Cervical lordosis

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5
Q

What kind of curvature does the thoracic portion of the spine has?

A

Concave anteriorly - Cervical kyphosis

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6
Q

How many thoracic vertebrae?

A

12

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7
Q

What kind of curvature does the lumbar portion of the spine has?

A

Concave posteriorly - Cervical lordosis

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8
Q

How many lumbar vertebrae does the spine have?

A

5

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9
Q

How many sacral vertebrae does the spine have?

A

5 fused

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10
Q

How many vertebrae composes the coccygeal region?

A

variable 3-5

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11
Q

what is vertebral motion modified by

A

the ligaments and bones that connect them to each other

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12
Q

What passes through the intervertebral foramen?

A

Spinal nerve to enter the spinal cord

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13
Q

What is another name for vertebral facets?

A

Zygapophyseal joint

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14
Q

What kind of vertebrae often has a bifid spinous process?

A

Cervical vertebrae

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15
Q

What is the vertebral arch composed of?

A

pedicles + laminae

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16
Q

What kind of vertebrae has uncinate processes?

A

cervical

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17
Q

What kind of vertebrae have a transverse costal facet?

A

thoracic

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18
Q

What part of the spine do stabilizing muscles attach to?

A

Lumbar

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19
Q

What specific features can we find on lumbar vertebrae?

A
  1. Mammilary process
  2. Accesory processes
  3. Lumbar transverse process
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20
Q

What kind of vertebrae have a promontory, ala, and anterior and posterior sacral foramina?

A

Sacral

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21
Q

What kinds of sacral crest does sacral vertebrae have?

A

Median and lateral

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22
Q

Where can we find the auricular surface

A

Sacral vertebrae

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23
Q

What kind of vertebrae don’t have intravertebral discs?

A

C1-C2 and saccral

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24
Q

What are the two parts of an intervertebral disc and what are they made of?

A

Anulus fibrosus (sclerotome)- outer ring made of fibrous outer layers
and
nucleus pulposus (notochord)- inner oval made up of gelatinous core

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25
Q

During compression where does pressure go to in the intravertebral disc?

A

nucleus pulposus

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26
Q

What is another name for a slipped disc?

A

Herniated nucleus pulposus (HPN)

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27
Q

what happens when you have a slipped disc

A

pressure on the n.p exceeds a.f. integrity and the n.p herniates

deflected laterally by the posterior longitudinal ligament and can impact contents of the vertebral canal and/or intervertebral foramen

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28
Q

what happens to facets with flexion and extension of the back

A

flexion- the facets open and the np moves posteriorly

extension- the facets close and np shifts anteriorly

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29
Q

During examination, what are we looking for in the spinal curvatures?

A

Check for normal or abnormal spinal curvatures, and may indicate muscle spasms, damage, or fractures

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30
Q

what happens with lateral flexion

A

it deforms the IV disc into a wedge shape and pushes n.p. from from the “pinched” side

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31
Q

what happens during back flexion and extension

A

flexion pushes n.p. posteriorly (away from “pinched”) while extension pushes it anteriorly

it is restrained by the annulus fibrosis

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32
Q

What does atlas (C1) support?

A

The skull

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33
Q

What is the difference between a facet and a Demi-facet?

A

Facet: a single afraid head articulated with one vertebral body
Demi-facet: a rib head shared between two vertebral bodies

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34
Q

What kind of disc herniation is most common?

A

Posterior herniation

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35
Q

What causes excessive thoracic kyphosis?

A

Osteoporosis and compression fractures

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36
Q

What causes excessive lumbar lordosis?

A

Pregnancy, carrying excess belly fat lack of abdominal muscle tone

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37
Q

What kind of abnormal curvature does scoliosis exhibit?

A

Lateral

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38
Q

what does roto-scoliosis mean

A

scoliosis but the spine doesn’t like to bend without rotating (body bends laterally when flexing due to curve in spine)

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39
Q

What kind of ligament is located anterior to vertebrae?

A

anterior longitudinal ligament

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40
Q

Name the ligaments found posterior to vertebrae

A
  1. supraspinous ligament
  2. interspinous ligament
  3. Intertransverse ligament
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41
Q

where does supraspinous ligament go from

A

spinous process to spinous process

all the way through coccyx

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42
Q

What is the most posterior ligament of the spine?

A

supraspinous ligament

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43
Q

Name the two ligaments found inside the spine

A
  1. Posterior longitudinal ligament
  2. Ligamentum flavum
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44
Q

where is the posterior longitudinal ligament

A

on vertebral body (NOT most posterior)

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45
Q

what does ligamentum flavum mean and what is it composed up

A

means “yellow”
most elastic fibers in a ligament

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46
Q

where does nuchal ligament span from

A

fans out from skull, across the cervical and upper thoracic spinous processes

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47
Q

Where does the nuchal ligament arises from?

A

The supraspinous ligament

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48
Q

Why is the nuchal ligament so broad?

A

It’s the site for multiple muscle attachment at the cervical area of the spine

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49
Q

what does the radiate ligament do

A

holds the head of the rib to the vertebral, facet and Demifacets

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50
Q

Where are the costotransverse ligaments found?

A

Thoracic region

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51
Q

what do the iliolumbar ligaments do

A

connects the transverse processes of L4 and L5 to the ilium

keep lumbar vertebra and hip in contact and doesn’t allow excessive motion

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52
Q

Which muscles stretch between the C2 and C1 vertebrae?

A

Suboccipital muscles affecting primarily the atlanto-axial in atlanto-occipital joints

these help with most mobility of the head (along with some help from C3-C5)

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53
Q

What movement is produced by the atlanto-occipital joint?

A

Flexion and extension
= yes

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54
Q

what is the dens on C2 for?

A

pivot for C1

shaking head no

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55
Q

where does the posterior longitudinal ligament continue to

A

the skull, covering the dens

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56
Q

What movement is induced by the atlanto-axial joint?

A

Rotation

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57
Q

What composes the atlanto-occipital joint?

A

Superior articular facets of the atlas and occipital condyles

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58
Q

Where is CSF found within the spinal cord?

A

The subarachnoid space

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59
Q

What covers the spinal cord directly?

A

Pia mater

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60
Q

What is the outermost covering of the spinal cord?

A

Dura and arachnoid matter

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61
Q

What substance surrounds the vertebral venous plexus in the vertebral canal?

A

Fat

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62
Q

What kind of neurons are found in the anterior horn of a spinal nerve?

A

Lower motor neuron cell bodies

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63
Q

What is the gray matter composed off in the spinal cord?

A

Posterior and anterior Horns

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64
Q

What are the anterior roots made out of?

A

Lower motor axons

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65
Q

What kind of neurons are found in the posterior horn’s?

A

Sensory neuron cell bodies

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66
Q

What are the posterior roots made out off?

A

Sensory axons

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67
Q

What can we find in the posterior root ganglion?

A

Sensory neuron cell bodies

(NOT axons)

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68
Q

What is a spinal nerve made out of?

A

Mixed motor and sensory axons

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69
Q

Where does the anterior rami send information to?

A

Motor and sensory axons to muscles and skin of anterior trunk and limbs

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70
Q

Where does the posterior rami send information to?

A

Motor and sensory axons to muscles and skin of the back

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71
Q

What is a dermatome?

A

Sensory region of the skin supplied by a single spinal nerve

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72
Q

Dermatome C4

A

Top of shoulder

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73
Q

Dermatome at C6

A

thumb

74
Q

Dermatome at C8

A

Fifth digit of hand

75
Q

Dermatome at T4

A

Nipple

76
Q

Dermatome at T10

A

Umbilicus

77
Q

Dermatome at L1

A

Inguinal region

78
Q

Dermatome at L4

A

Medial heel and ankle

79
Q

Dermatome at L5

A

Antero-lateral leg in dorsum of the foot

80
Q

Dermatome at S1

A

Posterior lateral lower, limb

81
Q

Dermatome at S2

A

Posterior medial lower limb

82
Q

What is a myotome?

A

Muscle fibers supplied by a single spinal nerve

83
Q

How many spinal nerves does the cervical region have?

A

Eight

84
Q

How many thoracic spinal nerves

A

12

85
Q

How many lumbar spinal nerves

A

5

86
Q

How many sacral spinal nerves

A

5

87
Q

Do spinal nerves, exit the vertebrae superiorly or inferiorly?

A

Superiorly by the cervical nerves and inferiorly by all the other nerves

88
Q

What tethers the pia matter, and the spinal cord to the Dura matter?

A

Denticulate ligaments

89
Q

When analyzing injury to the spinal cord between two vertebrae, which is spinal nerve is likely to be affected, the superior or inferior one?

A

Inferior

90
Q

What is the adequate portion of the spine to perform a spinal tap?

A

Lumbar

91
Q

Where does the spinal cord extends to in adults?

A

L2 vertebrae

92
Q

What forms the cauda equina?

A

Interior and posterior roots of the spinal cord

93
Q

What is the name of the tip of the spinal cord?

A

Conus medullaris

94
Q

Where can anesthetic be injected in the spine?

A

Epidural space, or sacral hiatus

95
Q

Where can we sample CSF?

A

Inserting a needle into the subarachnoid space

96
Q

Where does every spinal nerve exits from the vertebrae?

A

Intervertebral Foramen

97
Q

What is radicular pain radiates along?

A

Dermatome

98
Q

Difference between radicular and not radicular pain

A

Radicular pain radiates causes, numbness, tingling and weakness, while non-radicular pain is localized

99
Q

Which type of back muscle did not originate in the back?

A

Extrinsic back muscles

100
Q

Where is the triangle of auscultation and the lumbar triangle found?

A

In the pack made out of extrinsic back muscles

101
Q

What makes the triangle of auscultation?

A

Latissimus dorsi, scapula and trapezius

102
Q

What triangle of the back can we use to look for herniations?

A

Lumbar triangle

103
Q

What makes the lumbar triangle?

A

Latissimus dorsi, iliac crest, external abdominal oblique

104
Q

List all the extrinsic back muscles

A
  1. latissimus dorsi
  2. Trapezius
  3. Levator scapulae
  4. Rhomboid, minor and major
  5. Serratus posterior inferior
  6. Thoracolumbar fascia
105
Q

What is the thoracolumbar fascia?

A

Acts as aponeurosis for the latissimus dorsi and serratus posterior inferior muscles

106
Q

What muscles origin from the thoracolumbar fascia?

A

Erector spinae muscles

107
Q

What are the proximal attachment of the trapezius?

A
  1. External occipital protuberance
  2. Cervical to mid thoracic spinous processes
108
Q

What are the distal attachment of the trapezius?

A
  1. Clavicle
  2. acromion
  3. Spine of scapula
109
Q

Major functions of the trapezius?

A

Upper fibers: elevate the scapula
Middle fibers: retract scapula
Lower fibers: depressed scapula

110
Q

Proximal attachments of the latissimus dorsi?

A
  1. Mid thoracic to sacral spinous processes
  2. Iliac crest
111
Q

Distal attachment of latissimus dorsi

A

Intertubercular sulcus (proximal humerus)

112
Q

Major functions of the latissimus dorsi

A
  1. Adduct arm from an abducted position
  2. Extend arm from a flex position
113
Q

What are the proximal attachment of the levator scapulae?

A

Transverse processes of upper cervical vertebrae

114
Q

What are the distal attachments of the levator scapulae?

A

Superior angle of scapula

115
Q

What is the major function of the levator scapulae?

A

Elevate scapula

116
Q

What are the proximal attachment of the rhomboid major and minor?

A

Lower cervical to upper thoracic spinous processes

117
Q

What is the distal attachment of the rhomboid major and minor?

A

Medial border of the scapula

118
Q

What is the major function of the rhomboid major and minor?

A

Retract scapula

119
Q

What are the two kinds of splenius muscles?

A
  1. splenius capitis muscle
  2. Splenius cervicis muscle
120
Q

Where does splenius muscles originate?

A

From cervical and upper thoracic spinous processes

121
Q

Where does the splenius cervicis muscle attach to?

A

To the transverse processes of the upper cervical vertebrae

122
Q

Where does the splenius capitis muscle attaches to?

A

To the mastoid process in occipital bone

123
Q

What muscles make the intermediate layer of intrinsic back muscles?

A

The erector spinae muscle group
1. Iliocostalis
2. Longissimus
3. Spinalis

124
Q

Where does the Erector spinae muscle group originate from?

A

The iliac crest, sacrum and superior spinous and transverse processes

125
Q

List the attachments of the erector spinae muscle group

A
  1. Iliocostalis – attach lateral to costal angle
  2. Longissimus – attach medial to costal angle
  3. Spinalis - attach to more superior spinous process
126
Q

What makes the deep intrinsic back muscle layer?

A

The transversospinalis muscle group

127
Q

What makes the transversospinalis muscle group?

A
  1. Rotatores
  2. Multidifi
  3. Semispinalis
128
Q

Where do the transversospinalis muscle group attached to?

A

All attach from transverse process to more superior spinous processes

129
Q

What muscles make the minor deep intrinsic muscles of the back?

A
  1. suboccipital muscles
  2. Interspinalis
  3. Levatores costorum
  4. Intertransversarii
130
Q

What’s a major role of minor deep, muscles of the back?

A

Involved more with Proprioception than movement

131
Q

What is proprioception?

A

When a muscle is in charge of telling the brain about our position when moving – the smaller the muscle, the more proprioceptor

132
Q

What makes the suboccipital triangle?

A
  1. Rectus capitis posterior minor: C1-Skull
  2. Obliquus capitis superior: C2-Skull
  3. Rectus capitis posterior major
  4. Obliquus capitis inferior
133
Q

What is the Myodural bridge?

A

Sheet of connective tissue –> originate from –> rectus ca[itis posterior minos –> pierces the posterior atlanto-occipital membrane –> to the Dura matter

responsible for headaches

134
Q

Which muscles assist in standing upright?

A
  1. Erector spinae
  2. Multifidus lumborum
  3. Semispinalis muscles
  4. Abdominal muscles
  5. Psoas major
135
Q

What mature structure originate from ectoderm?

A

Central nervous system and epidermis

136
Q

What mature structure originates from endoderm?

A

Lining of Gut, respiratory and urogenital tracts

137
Q

White mature structure originates from the mesoderm?

A

Muscles, bones, connected tissue, fat

138
Q

What structure in the mesoderm signals the ectoderm to fold to form the neural groove? - neurulation

A

Notochord

139
Q

List what makes the trilaminar embryo

A
  1. Primitive groove in ectoderm
  2. Extraembryonic mesoderm
  3. Embryonic endoderm
140
Q

What structure is formed by the folding of the neural groove?

A

Neural tube

141
Q

What does the neural tube give rise to?

A

Central nervous system (CNS= the brain, brainstem, and spinal cord)

142
Q

What does the neural crest cells give rise to?

A

posterior root ganglia

143
Q

What gives rise to somites?

A

mesoderm

144
Q

What do somites give rise to?

A

Muscles, bones, and dermis

145
Q

How many occipital somites?

A

4

146
Q

How many cervical somites?

A

8

147
Q

How many thoracic somites?

A

12

148
Q

How many lumbar somites?

A

5

149
Q

How many sacral somites?

A

5

150
Q

How many coccygeal somites?

A

2-3

151
Q

Name the parts of a somite

A
  1. Sclerotome
  2. Myotome
  3. Dermatome
152
Q

What does the sclerotome of a somite give rise to?

A

vertebrae and axial bones

153
Q

What does the myotome of a somite give rise to?

A

muscle of body wall and limbs

154
Q

What does the dermatome of a somite give rise to?

A

deep dermis of body

155
Q

What does the neural tube differentiates to?

A

It thickens and differentiates into anterior and posterior horns

156
Q

How do sensory neurons reach dermatomes?

A

By following motor axons that have reached the corresponding myotomes

157
Q

Which sign reaches the brain first when a nerve is pinched and why?

A

Sensory - because sensory axons are on the outside of the nerve

158
Q

Describe the process of origin of a spinal nerve

A

anterior horn axon –>myotome
posterior root ganglion axons –> dermatome –> posterior horn

Sclerotomes split in half –> so axons can pass

159
Q

How do vertebrae develop from sclerotomes?

A

when sclerotomes divide, the remnants fuse to form vertebrae

160
Q

Describe intervertebral discs development

A

These form at the sites of fissures from sclerotomes splitting
- Annulus fibrosus = sclerotome
- Nucleus pulposus = mature remnant of notochord

161
Q

Where and when chondrification takes place?

A

In week 6th at the sclerotome and start replacing with cartilage

162
Q

When are ossification centers developed and what do they replace?

A

On week 7 and cartilage is replaced by bone at the vertebral body, pedicles and lamina

163
Q

What part of vertebrae is the last to ossify?

A

Spinous processes

164
Q

What happens with ossification in spina bifida?

A

Ossification fails or the spinous process does not form at all

165
Q

What can you test in utero to determine if baby has spina bifida?

A

test for alpha-fetoprotein in maternal blood

166
Q

Spina bifida oculta

A

neural arch - spinous process fail to ossify

defect is not large

167
Q

Meningocele

A

Type of spina bifida when meninges and CSF herniate through hole left by failed neural arch

168
Q

Meningomyelocele

A

Type of spina bifida when meninges, CSF, spinal cord and roots herniate

169
Q

Rachischisis

A

Type of spina bifida where neural tube fails to fold properly = neural arch cannot form

170
Q

Why does the spinal cord end at L2?

A

Because the growth after the embryonic stage increases to the point the spinal cord cannot keep up

171
Q

Which myotomes and dermatomes migrate to upper limb bud?

A

From C4-T2 region

172
Q

Which myotomes and dermatomes migrate to Lower limb bud?

A

From L4-S3 region

173
Q

Do limb bones come from somites?

A

No, they come from lateral mesoderm

174
Q

Define the cause of syndactyly

A

Caused by the failure of apoptosis of the interdigital areas that carve out the digits

175
Q

Define the cause of sirenomelia

A

Failed formation of rescind of tail segment resulting in fusion of the rear limb buds

176
Q

Define the cause of muscle agenesis

A

Failure of anterior rami to form complex plexi before reaching target muscles.

The muscles resulting from this process fail to form

177
Q

Define the cause of Amelia and phocomelia

A

When the FGF8 gene in not produced or expressed = limbs dont form (amelia) or are disrrupted (phocomelia)

178
Q

Define de cause of polydactyly

A

Mutation in the Shh gene interferes with signals in the medio-lateral patterning that defines number or pattern of digits

179
Q

What makes a superficial layer of intrinsic back muscles?

A

Splenius muscles

180
Q
A