Back 2/3 Flashcards
Correctly identify:
-Vertebral artery and vein
-Vertebral Body
-Spinous process
-Spinal cord covered by pia mater
5
4
8
3
Correctly Identify:
-Dura and arachnoid mater
-Subarchnoid space & CSF
-Spinal Nerve
-Vertebral venous plexus and fat in epidural space (vertebral canal)
1
2
6
7
Correctly Identify:
Anterior Horn
Spinal Nerve
Posterior Root
Posterior Root Ganglion
2- Anterior Horn (Gray Matter)
5- Spinal Nerve
9- Posterior Root
8- Posterior Root Ganglion
Correctly Identify:
- Posterior Horn
- Recurrent meningeal nerve
- Anterior Rami
- Posterior Rami
- Anterior Root
1- Posterior Horn
3-Recurrent meningeal nerve
6- Anterior Rami
7- Posterior Rami
4- Anterior Root
Lower motor neuron cell bodies
Anterior horn
Lower motor axons
Anterior Roots
Sensory neuron cell bodies
Posterior horn
Sensory axons
Posterior Roots
Sensory neuron cell bodies
Posterior Root Ganglion
Mixed motor and sensory axons
Spinal nerves
Motor and sensory axons to muscles and skin of anterior trunk and limbs
Anterior Rami
Motor and sensory axons to muscles and skin of the back
Posterior Rami
C4 Dermatome
Top of shoulder
C6 Dermatome
Thumb
C8 Dermatome
5th digit of hand (pinky)
T4 Dermatome
Nipple
T10 Dermatome
Umbilicus
L1 Dermatome
Inguinal Region
L4 Dermatome
Medial heel and ankle
L5 Dermatome
Antero-lateral leg and dorsum of foot
S1 Dermatome
Posterior lateral lower limb
S2 Dermatome
Posterior medial lower limb
Muscle fiber supplied by a single spinal nerve
Myotome
How many cervical spinal nerves? Where do they exit?
8, Exit superior the corresponding vertebra
How many lumbar spinal nerves? Where do they exit?
5, exit inferior the corresponding vertebra
How many coccygeal spinal nerves?
1-2
Denticulate ligaments tether the _____ ______ and _____ ______ to the dura matter.
pia mater and spinal cord to the dura matter.
_______ _______ divide posterior and anterior roots within the dural sheath
Denticulate ligaments
Correctly Identify:
Pia Mater
Dura Mater
Arachnoid Mater
Subarachnoid Space (full of CSF)
Denticulate ligament
3- Pia Mater
5- Dura Mater
4- Arachnoid Mater
1- Subarachnoid Space (full of CSF)
2- Denticulate ligament
Identify:
Arachnoid Mater
Dura Mater
Denticulate Ligament
Pia Mater
2- Arachnoid Mater
1- Dura Mater
4- Denticulate Ligament
3- Pia Mater
What level does the spinal cord terminate in normal adults?
around L2
Anterior and posterior roots that stretch below the end of the spinal cord are called _____
Cauda equina
The T12 vertebral body is more closely related to the cervical or lumbar region?
Lumbar
The L1 vertebral body is in close association with _____ spinal cord segments
Sacral
The tip of the spinal cord is called the ____ _______.
Conus medullaris
The conus medullaris is tethered to the coccyx by the _____ ______.
Filum terminale
What type of “material” is the filum terminale?
Pia mater
Identify:
Filum Terminale
Conus Medullaris
2- Filum Terminale
1- Conus medullaris
The dural sac extends to ____ level
~S2
What 2 places can anesthetic be injected along the spine?
Epidural space and sacral hiatus
What is another name for a lumbar puncture?
Spinal tap
What space do you insert into when doing a spinal tap?
Subarachnoid Space
What 2 places do you insert for anesthetic injection?
1 and 3
What place do you insert when doing a spinal tap?
2
Identify:
Sacral Hiatus
Cauda Equine
Conus Medullaris
4- Sacral Hiatus
5- Cauda Equine
6- Conus Medullaris
What structures would you encounter on a midline tap?
Skin
Subcutaneous fat
Thoracolumbar fascia
Supraspinous ligament
Interspinous ligament
(No ligamentum flavum on the exact midline)
Dura mater
Arachnoid mater
Subarachnoid space
Identify:
Intervertebral Foramina
Superior Vertebral Notch
Inferior Vertebral Notch
3- Intervertebral Foramina
1- Superior Vertebral Notch
2- Inferior Vertebral Notch
A herniated nucleus pulposus or narrowing of the intervertebral foramen may cause _____ and motor signs along a spinal segment
Sensory
______ is only in the back and/or gluteal area without radiation into the lower limbs
Non-Radicular pain
Name some causes of non-nerve injuries:
muscle/tendon strain, ligament sprain, discitis, arthritis or fractures
A herniated nucleus pulposus in the lumbar region generally affects the spinal nerve at the level ______.
Below
A cervical HNP will primarily affect the nerve exiting at the _____ level
same
Describe the Spurling’s test:
Extend, rotate and side bend w/compression (cervical spine)
Describe the compression test
Push down on the head to compress the intervertebral foramen
Describe the distraction test
Pull up the chin and occiput to see if pain decreases
Pathway of a facet joint injection:
Skin
Subcutaneous fat
Extrinsic back muscles
Erector spinae muscles
Transversospinalis muscles
Joint capsule
Where do the anterior and posterior spinal arteries arise from?
the vertebral arteries
Define extrinsic muscles:
originating elsewhere
Define Intrinsic back muscles
develop in the back
In the back, extrinsic muscles are ______ to intrinsic muscles
superficial
Identify:
-Non-back muscles
-Extrinsic back muscles
-Deep Layer of intrinsic back muscles
-Superficial and intermediate layers of intrinsic back muscles
1-Non-back muscles
2-Extrinsic back muscles
4-Deep Layer of intrinsic back muscles
3-Superficial and intermediate layers of intrinsic back muscles
Non- back muscles are innervated by:
Anterior Rami
Extrinsic back muscles are innervated by:
Cranial nerves (Not innervated by posterior rami)
Superficial and Intermediate Layers of Intrinsic muscles are innervated by:
Posterior Rami
Deep Layer of Intrinsic back muscles are innervated by:
Posterior Rami
Identify:
-Non-back muscles
-Superficial and Intermediate Layers of Intrinsic Back Muscles
- Extrinsic Back Muscle
- Deep Layer of Intrinsic Back Muscles
4-Non-back muscles
2-Superficial and Intermediate Layers of Intrinsic Back Muscles
3- Extrinsic Back Muscle
1- Deep Layer of Intrinsic Back Muscles
3 components of the triangle of auscultation
Latissimus dorsi, scapula, trapezius
3 components of the lumbar triangle
Latissimus dorsi, iliac crest, external abdominal oblique
Identify:
-Trapezius
- Levator Scapulae
- Rhomboid Minor and Major
- Serratus posterior inferior
2-Trapezius
8- Levator Scapulae
7- Rhomboid Minor and Major
6- Serratus posterior inferior
Identify:
-Latissimus dorsi
-Triangle of auscultation
-Lumbar Triangle
-Thoracolumbar fascia
3-Latissimus dorsi
1-Triangle of auscultation
4-Lumbar Triangle
5-Thoracolumbar fascia
______ is the origin of the erector spinae muscles
thoracolumbar fascia
Define aponeurosis
a thin sheath of connective tissue that helps connect your muscles to your bones
The thoracolumbar fascia acts as aponeurosis for the ______ and ________.
latissimus dorsi and serratus posterior inferior muscles
proximal attachments for Trapezius
External occipital protuberance (back of skull), cervical to mid-thoracic spinous processes
Distal attachments of Trapezius
Distal attachment: Clavicle, acromion, spine of scapula
Function of the Trapezius
Elevate, retract and depress the scapula
Proximal attachments of Latissimus Dorsi
Mid-thoracic to sacral spinous processes (through the thoracolumbar fascia) and iliac crest
Distal attachments of Latissimus Dorsi
Intertubercular sulcus (proximal humerus)
Major functions of the Latissimus Dorsi
Adduct arm from an abducted position; extend arm from a flexed position
Identify:
- Levator Scapulae
-Rhomboid Major
-Rhomboid Minor
1- Levator Scapulae
3-Rhomboid Major
2-Rhomboid Minor
Proximal attachment of the Levator Scapulae
Transverse processes of upper cervical vertebrae
Distal attachment of the Levator Scapulae
Superior angle of scapula
Proximal attachment of Rhomboid Major and Minor
Lower cervical to upper thoracic spinous processes
Distal attachment of Rhomboid Major and Minor
Medial border of scapula
Function of the Rhomboid Major and Minor
Retract scapula
Superficial Layer of Intrinsic Back Muscles are the ______.
Splenius muscles
Identify:
-Splenius Capitis Muscle
-Splenius Cervicis Muscle
1-Splenius Capitis Muscle
2-Splenius Cervicis Muscle
Splenius muscles proximal attachment
cervical and upper thoracic spinous processes
Splenius cervicis distal attachment
transverse processes of the upper cervical vertebrae
Slenius capitis attaches to the…..
mastoid process and occipital bone
Erector spinae originate from the…..
iliac crest, sacrum as well as more superior spinous and transverse processes.
Identify:
- Erector spinae muscle group
-Iliocostalis
- Spinalis
- Longissimus
4- Erector spinae muscle group
3-Iliocostalis
1- Spinalis
2- Longissimus
_____ attach lateral to costal angle
Iliocostalis
_____ attach medial to costal angle
Longissimus
______ originates from spinous processes and attach to more superior spinous processes
Spinalis
All ______ attach from transverse process to more superior spinous processes
transversospinalis muscles
Rotatores: span ____ levels
Multifidi: span ___levels
Semispinalis: span ____ levels
1-2
3-4
5-6
Identify:
- Multifidus lumborum
- Rotatores thoracis
-Semispinalis cervicis
- Semispinalis capitis
2- Multifidus lumborum
1- Rotatores thoracis
3-Semispinalis cervicis
4- Semispinalis capitis
The minor deep muscles of the back (along with the rotatores) are _____ and are more involved with _______ than movement
Small, proprioception
What small muscles are extremely painful when torn
Minor Deep Intrinsic Muscles:
Suboccipital muscles
Interspinalis
Levatores costorum
Intertransversarii
Identify:
- Intertransversarii
- Levatores costorum
- Interspinalis
- Suboccipital Muscles
4- Intertransversarii
3- Levatores costorum
2- Interspinalis
1- Suboccipital Muscles
The four suboccipital muscles are ____ of the head and upper cervical region.
extensors
The four suboccipital muscles also carry _________ from the region
proprioceptive input
Identify:
-Rectus capitis posterior major
- Rectus capitis posterior minor
- Obliquus capitis superior
- Obliquus capitis inferior
3-Rectus capitis posterior major
1- Rectus capitis posterior minor
2- Obliquus capitis superior
4- Obliquus capitis inferior
A sheet of connective tissue that originates from the rectus capitis posterior minor pierces the posterior atlanto-occipital membrane to fuse with the dura mater
Myodural Bridge
Mydodural bridge is a direct connection between ______ and the _______ makes it a consideration when treating headache
pain-sensitive dura and the posterior neck muscles
Identify:
- Atlas
- Axis
- Rectus Capitis Posterior Major
7- Atlas
2- Axis
4- Rectus Capitis Posterior Major
Identify:
- Rectus Capitis posterior minor
- Rectus Capitis posterior minor
- Rectus Capitis Posterior Major
- Obliquus Capitis Inferior
5- Rectus Capitis posterior minor
6- Rectus Capitis posterior minor
1- Rectus Capitis Posterior Major
3- Obliquus Capitis Inferior
When standing upright, the 5 large postural muscles are active include:
- Erector spinae
- Multifidus lumborum
- Semispinalis muscles
- Abdominal muscles
- Psoas major
Besides the 5 large postural muscles, what else assists in supporting the weight of the body?
The normal curvatures of the spine
Mid-thoracic region, what 2 ligaments blend together?
Supraspinous and nuchal ligament blend
Identify:
- Posterior Median Furrow
-Medial Border of Scapulae
- Rhomboid
- Erector spinae
- Nuchal groove
5- Posterior Median Furrow
3-Medial Border of Scapulae
4- Rhomboid
7- Erector spinae
1- Nuchal groove
Identify:
- Vertebra prominens (C7)
- Dimples indicating posterior superior iliac spines
- Intergluteal cleft
- Posterior site of Sacrum
-Latissimus Dorsi
2- Vertebra prominens (C7)
8- Dimples indicating posterior superior iliac spines
10- Intergluteal cleft
9- Posterior site of Sacrum
6-Latissimus Dorsi
Identify:
- Iliac Crest
- Sacral Hiatus
- S2 spinous process
- Tip of Coccyx
8- Iliac Crest
4- Sacral Hiatus
2- S2 spinous process
6- Tip of Coccyx
Identify:
- Sacral Triangle
- Iliac Tubercle
- Median Sacral Crest
- Lumbar Spinous processes
11- Sacral Triangle
9- Iliac Tubercle
3- Median Sacral Crest
1- Lumbar Spinous processes
Identify:
-L4/L5 IV Disc
- Posterior Superior Iliac Spine
- Coccyx
- Intergluteal cleft
7-L4/L5 IV Disc
10- Posterior Superior Iliac Spine
5- Coccyx
12- Intergluteal cleft
The supracristal plane includes what 3 things?
- High points of the iliac crest
- L4 Spinous Process
- L4/L5 IV Disc