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Anatomy - Thorax, Back > Back > Flashcards

Back Flashcards

1
Q

Referred pain of upper GI structures

A

Mid-back

Liver, gallbladder also to shoulder

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2
Q

Referred pain of lower GI structures

A

Low back

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3
Q

Referred pain of GU structures

A

Low back, flank to groin, sacral region

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4
Q

Upper quadrant landmarks

A 
C7
Medial scapula border
Spine of scapula
Inferior angle of scapula
Upper trap
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5
Q

Lower quadrant landmarks

A 
CVA
T12
Lower trap
Lumbar paraspinal muscles
Iliac crest
L4
PSIS (dimples)
Sacrum
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6
Q

Function of spine curves

A

Absorb shock

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7
Q

Kyphotic curves

A

Primary
Thoracic and sacral
From birth

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8
Q

Lordotic curves

A

Secondary
Cervical and lumbar
Develop with weight bearing

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9
Q

Movements of the spine

A

Flexion
Extension
Lateral flexion
Rotation

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10
Q

Which vertebrae are “typical”

A

C3 - L5

Everything but C1, C2

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11
Q

Vertebral body

A

Main part of vertebra

T4 and below gradually increase in size to support increasing body weight

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12
Q

Vertebral (neural) arch

A

Pedicles and lamina

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13
Q

Spinous process

A

Project posteriorly from junction of lamina

Attachment and lever for spinal muscles

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14
Q

Transverse process

A

Project laterally from junction of pedicles and lamina

Attachment and lever for spinal muscles

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15
Q

Articular process

A

Superior and inferior processes

Project from junction of pedicle and lamina

Adjacent articular processes form facet joints b/w vertebrae

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16
Q

Vertebral notches

A

Superior and inferior

Forms IVF between 2 vertebrae

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17
Q

Intervertebral foramen

A

Formed “between vertebrae” via vertebral notches of 2 adjacent segments

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18
Q

Vertebral foramen

A

Formed by body and vertebral arch

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19
Q

Vertebral canal

A

Vertebral foramina collectively form the canal

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20
Q

C1 landmarks

A

Anterior, posterior arches
Lateral mass (superior and inferior facets)
TP

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21
Q

Lateral mass

A

Superior facets of C1 articulate with occiput for extension/flexion movement

Inferior facets of C1 articulate with C2 for rotation movement

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22
Q

Dens (odontoid process)

A

C2
Forms “pivot” or axis for rotation between C1-C2

Forms a small synovial joint with anterior arch of C1

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23
Q

Typical C3-C7 features

A
  • Small rectangular body
  • Large triangular VF
  • Transverse foramen (vertebral artery)
  • Spinous process (bifid C3-5, C7 most prominent)
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24
Q

Thoracic vertebrae features

A
  • Heart shaped body
  • Small circular VF
  • Long TPs
  • Long SPs
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25
Q

Lumbar vertebrae features

A
  • Kidney shaped body
  • Triangular VF (smaller than C, larger than T)
  • SP (sturdy, hatchet shape)
  • Accessory process (base of TP)
  • Mammillary process (on superior articular pillar)
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26
Q

Apex of sacrum

A

Inferior end (same as heart, opposite of lungs)

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27
Q

Base of sacrum

A

Superior portion

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28
Q

Promontory

A

Prominent anterior edge of S1

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29
Q

Ala

A

“Wings” of sacrum

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30
Q

Median sacral crest

A

Midline, formed by fused SPs

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31
Q

Sacral hiatus

A

Formed by failure of lamina of S5 to fuse

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32
Q

Sacral cornu

A

Horns

Formed by pedicles of S5

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33
Q

Sacral canal

A

Contain nerve roots of cauda equina

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34
Q

Coccyx

A

Wedge shaped bone of 4 fused coccygeal vertebrae

Provide attachment for pelvic muscles

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35
Q

Lordosis description and causes

A

Excessive anterior curve in lumbar region

Caused by: orthopedic anomalies, postural habits, pregnancy, etc.

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36
Q

Kyphosis description and causes

A

Excessive posterior curve in thoracic spine

“Hump back”

Caused by: compression fracture, postural habits, pathology, etc.

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37
Q

Scoliosis description

A

Lateral deviation with rotary component (convexity)

38
Q

Facet joint

A
  • Synovial joint
  • B/w superior and inferior facets of articular process
  • Some weight bearing function in C and L regions
  • Prone to degenerative changes (limited movement & pain)
  • Excessive bone spurs can cause stenosis of IVF
39
Q

Intervertebral disc function, composition

A

Acts as a shock absorber, influences motion

Composition = water, collagen fibers, proteoglycans

Two parts: annulus fibrosis, nucleus pulposus

NOTE: no disc between occiput & C1 OR C1-C2

40
Q

Annulus fibrosis composition, function

A

Concentric layers of collagen fibers

“Crosswoven” effect - direction of fibers alternates each layer

Anchor disc to bone or cartilaginous end plate

Outside layers will blend with ALL, PLL and do have innervation (pain possible)

41
Q

Nucleus pulposus composition, function

A

Inner layer of disc

Proteoglycans attract water

Finer collagen fibers, loose, random network

Aging causes decrease in proteoglycan content (so less H2O) = decreased disc height

42
Q

Clinical problems a/w intervertebral discs

A
  • Fissures (discogenic pain)
  • Herniation (potential to compress nerve roots)
  • Degenerative changes (loss of disc height)
43
Q

Joints of Luschka

A
  • Uncovertebral
  • Formed by uncinate processes of C3-C7
  • “Pseudo” joint looks similar to synovial
44
Q

Clinical problems a/w joints of Luschka

A

Prone to degenerative changes (bone spur formation)

45
Q

Atlanto-axial joint

A

Comprised of: facet joints C1-C2, dens and anterior arch

Provides rotation of head/neck

46
Q

Atlanto-occipital joint

A

Synovial joints between C1 facet and occipital condyles

Provides flexion/extension of head and neck

47
Q

Anterior longitudinal ligament

A

Anterior portion of vertebral column

C2-sacrum

48
Q

Posterior longitudinal ligament

A

Posterior vertebral column within vertebral canal

C2-sacrum

49
Q

Ligamentum flavum

A

Connects lamina between each vertebra

Forms part of posterior wall of vertebral canal

High elastin content

Restore neutral position after flexion of spine

50
Q

Interspinous ligaments

A
  • Connect adjacent SPs

- Attach along inferior and superior portion of SP

51
Q

Supraspinous ligaments

A

Connect adjacent SPs (C7-sacrum)

52
Q

Anterior atlanto-occipital membrane

A
  • Continuation of ALL

- Connect arches of C1-occiput (edges of foramen magnum)

53
Q

Tectorial membrane

A
  • Continuation of PLL

- C2-foramen magnum

54
Q

Posterior atlanto-occipital membrane

A
  • Continuation of ligamentum flavum

- Connect arches of C1 to occiput (edges of foramen magnum)

55
Q

Nuchal ligament

A
  • Continuation of supraspinous ligament
  • EOP to C7
  • Acts as septum separating muscles of R/L posterior neck
56
Q

Cruciate ligament

A

Stabilizes dens against anterior arch of C1

3 sections - transverse, superior (occiput to dens), inferior (C2 body to dens)

57
Q

Alar ligament

A

Sides of dens to lateral margin of foramen magnum

LIMITS excessive rotation

58
Q

Apical ligament

A

Apex of dens to foramen magnum

59
Q

Superficial layer of back muscles

A

Trap
Lat dorsi
Rhomboid
Levator scapula

60
Q

Trapezius attachments, innervation, actions

A

Attachments: EOP/SP C7-T12, clavicle/scapula

Innervation: CN 11

Actions: elevation + upward rotation of scapula (upper), scap retraction (middle), depression + upward rotation (lower)

61
Q

Lat dorsi attachments, innervation, actions

A

Attachments: SP of T7-L5/inferior angle of scapula, humerus

Innervation: Thoracodorsal

Actions: “Handcuffs” - extends arm back, internal rotation, adduction

62
Q

Rhomboid attachments, innervation, actions

A

Attachments: nuchal ligament/SP of C7-T5, medial border of scapula

Innervation: Dorsal scapular

Actions: retraction (squeezing shoulders together), some shrug action

63
Q

Levator scapula attachments, innervation, actions

A

Attachments: TP C1-C4, medial border of scapula

Innervation: Dorsal scapular

Actions: Elevates scapula, ipsilateral lateral movement of neck

64
Q

Intermediate layer of back muscles

A

Serratus posterior superior and inferior

65
Q

Serratus posterior superior actions

A

Elevates the ribs which aids in inspiration

66
Q

Serratus posterior inferior actions

A

Depresses the lower ribs, aiding in expiration

67
Q

Deep layer of back muscles

A

Superficial, intermediate, deep layers

68
Q

Deep layer (superficial) of back muscles

A

Splenius capitis/cervicis

69
Q

Splenius capitis attachments and actions

A

Attachments: SP C7-T3, mastoid process

Actions: Unilateral contraction - ipsilateral bending and rotation

70
Q

Splenius cervicis attachments and actions

A

Attachments: SP T3-T6, TP C1-C3

Actions: Unilateral and bilateral contraction (extend, flex, rotate head and neck to same side)

71
Q

Deep layer (intermediate) back muscles and actions

A

Erector spinae (paraspinal muscles) - iliocostalis (most lateral), longissimus, spinalis (most medial)

Actions: bilateral - extension also assists with flexion (eccentric contraction)

72
Q

Deep layer (deep) back muscles and actions

A

Semispinalis (attachments go up 4-6 levels)
Multifidi
Rotators (attachments up 2-3 levels)

Actions: Unilateral - contralateral rotation of spine (opposite of splenius capitis)

73
Q

Sub-occipital triangle borders

A

Rectus capitis posterior major
Obliquus capitis inferior
Obliquus capitis superior

NOTE: Rectus capitis posterior minor is NOT included

74
Q

Sub-occipital triangle contents

A

Vertebral artery and CN1 (sub-occipital nerve)

75
Q

Cervical enlargement of spinal cord

A

C4-T1 segments

Most anterior rami arising from here form brachial plexus

76
Q

Lumbosacral enlargement of spinal cord

A

T11-S1 segments

Anterior rami from here make up lumbar and sacral plexuses

77
Q

Conus medullaris

A

Tapered, lower end of spinal cord

May terminate as high as T12 or as low as L3

78
Q

Cauda equina

A

Bundle of spinal nerves beginning from conus medullaris (end of spinal cord) through sacrum

“Horse tail”

79
Q

Denticulate ligaments

A

Ligaments on each side of spinal cord connecting pia mater to arachnoid and dura mater

80
Q

Filum terminale

A

Suspends the spinal cord in the dural sac (“mechanical anchor”)

81
Q

Lumbar cistern

A

Enlargement of subarachnoid space between conus medullaris of spinal cord

Occupied by cauda equina, filum terminale, CSF

Site for lumbar puncture and spinal anesthesia

82
Q

Pia filament

A

Portion of filum terminale within the dural sac

Goes all the way to coccyx

83
Q

Spina bifida occulta

A

Failure of vertebral arch to fuse, bony defect

84
Q

Meningocele

A

Type of spina bifida (uncommon)

Meninges protrude through bony defect of vertebral arch

85
Q

Myelomeningocele

A

Type of spina bifida (most severe)

Meninges AND spinal cord protrude through defect of vertebral arch

86
Q

These three longitudinal arteries supply the spinal cord

A

1 anterior spinal artery

2 posterior spinal arteries

87
Q

Anterior and posterior segmental medullary arteries

A

Support the A & P spinal arteries

Occur mainly in association with cervical and lumbosacral enlargements (where good blood supply is needed)

88
Q

Anterior and posterior radicular arteries

A

Run along nerve roots

Most are small and supply only nerve roots

89
Q

Spondylolisthesis

A

Pars defect

Forward displacement of a vertebra - esp L5

MC occurring after break/fracture

X-ray finding = scotty dog

90
Q

Scotty dog sign on x-ray

A

Spondylolisthesis

Anatomy - Thorax, Back (2 decks)

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