Back Flashcards
BACK: Curves
birth, when cervical/lumbar lordosis, purpose (2)
kyphosis - plane, gibbus vs. dowager
scoliosis - where common, severity, SP, tight, VB, ribs apart, rib hump
neural arch - other name, form, content (3), wider in FLEX/EXT, BW
vertebral body - purpose (2), cover, BW
lamina - face
pedicle - face, size, purpose
pars - contains (2), where/between, medical
VF - compare size + why
- kyphotic at birth
- cervical lordosis when head raise, lumbar when sit up
- kyphosis: at sagittal plane; gibbus (1 vertebra)
scoliosis
- common in thoracic
- mild (0-20), mod (20-40)
- concave = SP, tight muscles
- convex = vertebral body, ribs apart, pos rib hump
neural/vertebral arch
- form vertebral foramen (forms sacral canal)
- content: lamina, pedicle, process
- wider in FLEX; 1/3 of BW
vertebral body
- transmit weight, compression forces
- cortical + cancellous cover; 2/3 BW
others
- lamina: face posmed
- pedicle: face poslat; C>T>L; for bending forces
- pars: contains L&P; between articulating facets; weak so many fx
- vertebral foramen: C>L>T since plexuses
BACK: Parts
cervical - body (shape), AP/ML, foramen (size shape), SAF (faces + projection), SP (size shape + size per level), arteries/veins x foramen
thoracic - body (shape height), T1 body, AP/ML, foramen (size shape), SAF (faces), TP (attach), SP (size shape + levelling)
lumbar - body (shape height), L5 body (shape), foramen (size shape), AP/ML, SAF (faces + concavity), SP (size shape + levelling)
sacrococcygeal - shape, concave where, ant vs. pos + why, SAP (attach), ala (shape + has)
CERVICAL
- body (oval large), AP<ML, foramen (large triangle)
- SAF: supmedpos, has uncinate process which has uncovertebral joint/joint of luschka (cartilaginous)
- SP: short bifid, C2>C3<C7
- artery go up C6 to C1, vein go down C1 to C8
THORACIC
- body (heart/wedge; thicker pos), T1 body (cervical),
- AP=ML, foramen (small circular)
- SAF: suplatpos
- TP: has costal facets for rib attachment (T1 T10 T11)
- SP: long, directed inferiorly so levelled with vertebral body below
LUMBAR
- body (kidney; thicker ant), L5 body (wedge since sacrum)
- AP=transverse, foramen (large triangle)
- SAF: supmedpos, concave
- SP: longer nonbifid, directed inferiorly
SACROCOCCYGEAL
- wedge; concave sacrum & triangle coccyx; smoother ant since pos has medlat sacral crests
- SAP: with IAP of L5
- ala: winglike, has pelvic foramen
BACK: Cervical
VBI why
where most ROT, FLEX/EXT
IV disc - thicker AF ant/pos, layering
kinetics - coupling in upper vs. lower, if rotate to left then what happens to upper vs. lower vertebra, when inc compression, no (?) at C1-C2 & therefore, weight in C3-C7 is carried by (2G)
- VBI: d/t sudden change in direction of artery as it heads to brain
- C1-C2 = most ROT (atlantoaxial), C5-C6 = most FLEX/EXT
- IV disc: AF thicker ant, not alternating
KINETICS
- coupling in upper cervical = contralateral
- if rotate to left then upper will move to right & lower to left
- inc compression during FLEX/EXT
- no IV disc at C1-C2 = more weight goes down
- C3-C7 weight goes to anterior (IV disc & body) & posterior (facet joint)
BACK: Cervical - Ligaments
ALL - strength vs. PLL, strength by level, from to/level, attach (3)
PLL - strength by level, strength by level, from to/level, attach (3)
tectorial membrane - continuation of, from to/level, against
nuchae - shape, where, against, from to
transverse atlantal - name, if torn, divides
alar & apical - against
ALL
- stronger than PLL; stronger in lower
- C2 to sacrum; attaches to body, IV disc, ant AF
PLL
- stronger in upper
- C2 to sacrum; attaches to body, IV disc, pos AF
- TECTORIAL MEMBRANE: continuation of PLL; C2 to occiput; against FLEX
other shit
- LIGAMENTUM NUCHAE: triangle, C7 to occiput, against FLEX
- ALAR: against ipsilateral ROT
- APICAL: against contralateral LF
TRANSVERSE ATLANTAL LIGAMENT/CRUCIFORM
- if torn = odontoid go down to spine
- divides atlas to spine & dens
BACK: Cervical - Ligaments
flavum - from to, structure, for, with (20, strength by level
intertransverse - against, strength by level
supraspinous - cont, from to, strength by level, med, against
infraspinous - from to, against, med, collagen
anterior atlantoaxial, pos AA, pos AO - from to
LIGAMENTUM FLAVUM
- C2 to sacrum, pos lamina of lower to ant lamina of upper
- to prevent lamina separation
- with posterior atlantoaxial & atlantooccipital
- stronger below
INTERTRANSVERSE
- against LF; stronger below
SUPRASPINOUS
- cont of nuchal, C7 to L3/L4, stronger up, against FLEX
- first damaged
INFRASPINOUS
- throughout, against FLEX, first damaged, type I
other shit
- ant atlantoaxial: C2 to occiput
- pos atlantoaxial: C2 to C1
- pos atlantooccipital C1 to occiput
BACK: Thoracic
costovertebral vs. costotransverse joint
IV disc - shape, thicker ant/opos
stable d/t, where most & least FLEX/EXT + why
coupling, LOG falls & therefore
ribs - true vs. false (name + why + which), bucket pump caliper piston (by + diameter)
- costovertebral joint: at vertebral body
- costotransverse joint: at tubercle & transverse process
- IV disc: wedge, thicker pos
- stable d/t attachment to ribs
- most FLEX/EXT at T9-12 since facets face sagittal unlike T1-T6 which is corornal
- coupling: upper = ipsilateral
- LOG falls anterior = flexion = must EXT
ribs
- true/vertebrosternal/ribs 1-7
- false/vertebrocostal/ribs 8-10
- floating: ribs 11-12
- pump handle: by sternum, up down
- bucket handle: by ribs, up sideways, inc medlat
- caliper: by floating ribs, outwards
- piston: by diaphragm, up, supinf diameter
BACK: Lumbar
lumbosacral angle - normal, if inc then (2), y vs. x force, if inc/dec then what pathology & where stress
IV disc - layering, against, shape
iliolumbar ligament - cont/level, against
TL/lumbodorsal fascia - name, where, origin insertion
where most ROT & LF
rhythm - how (3), purpose
muscles - flexion relaxation phenomenon, semispinalis has what nerve, which contra ROT ipsi LF (2)
lumbosacral angle
- N:30, inc = lordosis & inc ant shear
- y force (BW), x force (ant shear)
- if inc = lordotic = stress on anterior = L5 slip
- if dec = flat back = stress on SIJ
- IV disc: alternating, against FLEX, ring
- iliolumbar lig: cont of intertransverse at L5, against slippage
- TL/lumbodorsal fascia/stabilizing corset: surrounds lumbar; lat dorsi to glutmax
- most LF & ROT at L2-L3
- lumbopelvic rhythm: bend = back > pelvis > hip to dec erector spinae moment arm
muscles
- flexion relaxation phenomenon: too much flex = erector go silent
- semispinalis has greater occipital nerve
- contralateral ROT ipsi LF = SCM, scalenes
BACK:
sacrococcygeal - microscopic corrugations stabilizes (2), sacral sit = ? ligament = ? SIJ & vertebra, nutation vs. counter
trabeculation system - what, against (2), why develop, ant vs. pos vertebra + d/t
supplies - artery (5.1.2.2), veins (2), nodes (3) + where drain, IV disc artery & nerve
SACROCOCCYGEAL
- microscopic corrugation: fingerlike projections stabilizing sacrum & pelvis
- sacral sit = lax ligament = unstable vertebra & SIJ
- nutation = promontory (ANT INF), apex (POS SUP)
TRABECULATION SYSTEM
- inner portion of bone; develop d/t stress; against compression & torsion
- ant = vertical since BW
- pos = horizontal since most muscles & ligaments are here and have poslat force
SUPPLIES
- cervical artery: occipital, deep cervical, ascending cervical, vertebral
- thoracic artery: pos intercostal
- lumbar artery: subcostal, lumbar
- sacral: iliolumbar, lat sacral
- veins: external & internal vertebral venous plexus
- nodes: cervical, axillary (til iliac crest), superficial inguinal
- IV disc: by diffusion has metaphyseal artery; no central nerve
BACK:
spinal x vertebral level, root exit (2G)
interbody vs. facet joint - type, purpose
joint capsule - lax/level, continue after, against (2), which joint
facet more medial = ?
LOG x vertebra, C/T/L
head weight vs. forward head
- cervical (+1), T1-T6 (+2), T7-T9 (+3), T10 (L1-L2)
- til C6: below (C4-C5 = C5)
- C7 below: above (C7-T1 = C8) (T1-T2 = T1)
- interbody: cartilaginous, against slide/compression/distraction
- facet/z/apophyseal: synovial, prevent bone to bone
- joint capsule: lax at C>L>T, continue after failed supra & infrapsinous ligament, against FLEX ROT, in facet
- if facet faces more medial = less ROT
- LOG through vertebra, pos to C, ant to T/L
- head weight (12lb), forward head (43lb)
BACK: IV Disc
% of length, purpose (2), made of, strength d/t, thickness & ratio per level
NP - made mostly of (?) + day/night height, made of fancy shit (4) + purpose, abundant type, if FLEX/EXT
AF - made of (1), type, made of fancy shit (3), shape, ant/pos compression x ant/pos bulge, sharpey (attach to 2)
end plate - made of (2) + where, strength, covers (2), made of fancy shit (3)
proteoglycan, water - AF vs. NP vs. VEP
- 20-33% of length
- transmit weight between vertebra, separate vertebral bodies
- made of fibrocartilage, last to fail d/t creep
- cervical: 3-5mm, 2/5
- thoracic: 5-7mm, 1/4
- lumbar: 9-10mm, 1/3
nucleus pulposus
- made of water: more in morning = taller
- made of proteoglycan/glycosaminoglycan = attract water
- chondrocytes elastin, protein (nutrition), proteolytic enzyme (metabolism)
- type 2 > type 1
- FLEX = move POS
annulus fibrosus
- made of water, proteoglycan, chondrocyte elastin, fibroblast
- type 1 > type 2
- ring; ant compression = ant bulge
- sharpey fibers: attach to end plate & periosteum = inc attachment to bone
vertebrlal endplates
- made of hyaline (body), fibrocartilage (NP), first to fail
- covers entire NP not entire AF
- proteogylcan: NP > AF & VEP
- water: NP < AF & VEP
