Back Flashcards
What arteries supply the spinal cord?
Descending Aorta –> Posterior intercostal –> Dorsal branch (spinal and musculocutaenous)
Abdominal Aorta –> Lumbar –> Dorsal Branch (spinal and musculocutaneous
What is number 5?
Posterior intercostal artery of spine
Where is the posterior intercostal artery?
5
What is number 4?
Dorsal branch of the posterior intercostal artery
Where is the dorsal branch of the posterior intercostal artery?
Number 4
What are numbers 1 and 2?
Anterior and posterior spinal branches?
What are the attachments to the vertebral body?
Anterior and posterioer longitudal ligaments
psoas muscle
Where are the costal facets located?
laterally on the verebral body
what is the function of the costal facet?
articulate with the head of the rib
what is the function of the vertebral foramen and canal?
houses spinal cord
Where is the vertebral notch?
Number 7
Inferior vertebral notch
What is function of the the intervertebral foramen?
Where is it?
Between the superir and inferior vertebral notches
transmists spinal and radicular nerves
What composes the nuearal arch?
Pedicile, Lamina, Spinous Process
Where is the transverse process?
4
What attaches to the transverse process?
erector spinae, psoas (lumbar), transversospinalis, leveator scapulae muscle
What facet is located on the trasverse process? What is its function?
Costotubular facet
articulates with rib
What is number 10?
What is number 8?
what is the function?
superior costal facet
Inferior costal facet
articualtes with adjacent vertebral surface to form zyphophyseal joint
What is the attachments on the lamina?
ligamentutum flava on internal vertebral canal
What attaches to spinous process?
trapezius, rhomboids, lattissimus dorsi, spinalis, erector spinae, transversospinalis (m)
interspinous, nuchal, and supraspinous ligaments
What are the caracteristics of cervical vertabre?
Transverse foramina which allow transmision of artery up to the skull
what is caracteristic of the thoracic vertebrae?
costal facets, place of articulation for head and tubercle of rib
Head - superior costal facet
tubercle - transverse costal fact
What is characteristic of the lumbar vertebrate?
Mammillary Processes
Allow attachment of multifitus muscles
What happens with advancing age of the spinal column?
Decreased bone density of tribecular done
arcitular surfaces bow inward
compression at periphery
osteophytes form (growths) to limit range of moton
Who many vertebrae are there?
7 Cervical
12 Thoracic
5 lumbar
5 sacral *fused
4 coccygeal *fuse
Kyphosis
Anerior curve. opens to front
Throacic and sacral regions
(primary curvature_
Lordosis
posterior curve (opens towards back)
secondary curvature
cervical and lumbar
Excessive kyphosis
thoracic spine has change in bone density to curve more anteriorly.
Seen in geriatric population
Dowagers hump or humpback
Excessive lordosis
exessive posterior curvature in the lumbar region.
Found in gymnasts and American American women
Called Sway back
What the function of the sacrum?
forms posterior aspect of pelvis
provides stability and strength to pevic architecture
What is represened by the area ecompassing 1 and 4?
What is the function?
Sacral Base
Articulates with 5th lumbar vertebrae
What is number 5?
What is the attachments?
Promotory
anterior longitudinal ligmant
Where is the promotory?
5
What is 2?
Ala (wing)
where is the pelvic surface?
What are the attachments?
ventral surface of the sacrum
piriformis m
Where are the pelvic sacral faramina?
Function?
6
transmit ventral rami of sacral nerves and lateral sacral arteries
Where is the dorsal surface?
Attachments
Ventral side of sacrum
erector spinae, gluteus maxiumus m.
sacrotuberous and sacrospinous ligaments
What are number 11?
Function?
Dorsal sacral foramina
transmit dorsal rami of sacral nerves
What is it called when the sacrum and coccyx articulate?
Apex
Where is the sacral canal?
What is the function?
just below dorsal surface
houses sacral spinal roots
What are 4?
what is 1?
superior articular process (articualates with inferior articular process of lumbar vertebrae)
lumbosacral articular process (articulates with intervertebral disc)
What is number 3?
attachments
Coccyx
coccygeus muscle of trunk
what articulates with costal facet of vertebral body?
head of rib
what attaches to shaft of rib?
pectoralis minor (3-5)
serratus anterior m.
what attaches to angle of rib?
erector spinae (iliocostalis)
what articulates with the traverse process of the vertebrae?
articular facet on rib tubercle
where does the articular facet of rib articulate?
transverse process of thoracic vertebrae
What is the fascia on the back?
thoracolumbar fascia
what does the posterior theracolumbar fascia attach to?
what does it pass posterior to?
spinous process
erector spinae to fuse with middle layer
What does the middle thoracolumar fascia attach?
what does it pass posterior to?
transverse process
quadratus lumborum m.
what does the anterior throacolumbar fascia attach to?
What is it anterior to?
transverse process
quadratus lumborum to fuse with middle layer to form aponeurotic origin of transversus abdominis muscle
What are the two major joints in the spine?
Zygapophysial facets
intervertebral symphysis
What is the intervertebral joint?
Joint between adjacent vertebral bodies that are separated by an intervertebral disc. on either side of disc is the hyaline cartilage plate
Classification: symphysis
movements: flexion and extension, lateral flexion, rotation
What is the intervertebral disc?
composed of two elements:
anulus fibrosus, exterior of very dense cartilage.
nucleus pulposus: interior, soft mucoid gel that becomes more fibrocartilaginous with age.
What happens with a bulging disc?
nucleus pulposus migrates posterior laterally to pus anulus fibrousis outside vertebral column and imoinge on the spinal cord
what happens with a herniated disc?
nucleus polpolsus escapes from the confines of the anulus fibrosis
What direction does a herniated or buldging disc occur in?
posterolateral
due to the posterior longitudinal ligamet
What is the zygapophyseal joint?
joint between the superior and inferior articular processes of vertebral column
classification - synovial plane
movements: flexion, extension, lateral flexion, rotation
What is number 1?
Attachements:
Function:
anterior longitudinal ligament
to anterior surface of vertebral bodies and intervertebral discs
stablizes vertebral column and prevents hyperextension
What is number 3?
attachments:
function:
Posterior longitudinal ligament
posterior surface of vertebral bodies and intervertebral discs
frevents hyperflexion
What is 8?
attachments
Ligamentum flavum
interconnect adjacent laminae
what is number 6?
attachments
supraspinous
apices of spinous process c7 to sacrum
What is number 7?
attachments:
interspinous
interconnect adjacent spinous processes
what is ligamentum nuchae?
ligament attaching from c7 spinous process to external occipital protuberance
What ligament extends above c7?
ligamentum flavum
What is the function of the ventral root?
carries axons from Lower motor neurons to skeletal muscle innervation
preganglionic sympathetic neurons (ventral roots T1-L2)
preganglionic parasympathetic motor neurons S2-4
What is the function of the dorsal root?
carries axons from primary sensory nuerons innervating skin, fascia, joints, muscles, bones, blood vessels, and viscera
Dorsal root ganglion
houses cell bodies of pimary sensory nuerons
ventral ramus
carries axons from primary sensory nuerons, LMN, and PostG sympathetic nuerons innervating anterior neck, thoracic wall, abdominal wall, pelvic wall, and extremities
dorsal ramus
carries axons from PSN, LMN, PostG sympathetic to innervate posterior neck and back (skin, fascia, muscles, ligaments, joints, bones, vessels)
What are the surface features of the spinal cord?
cervical enlargement
lumbar enlargement
conus medullaris
Where does the spinal cord start and end?
foramen magnum to L2 at conus medullaris
What is the cauda equina?
roots of the dorsal and ventral spinal nerves below L2-coccygeal nerve
site of lumbar puncture
How many nerves are there?
How are they named?
C8, T12,L5, S5, Coccygeal 1
Cervical: number correspons to inferor number of vertebra name.
C6: exits through C5-6 foramen
The rest are named according to the superior vertebra name
T11 nerve exits thorugh T11-12
What makes up the meninges?
Dura mater
Arachnoid mater
Pia mater
Dura mater
though ribrous, connective tissue covering outtermost layer of spinal cord
anchored to coccyx by filum terminale
can spread disease longitudinally
Arachnoid mater
delicate, avascular membrane of fiberous and elastic tissues that lines spinal cord, roots, and spinal ganglioin.
separated from pia by subarachnoid space containg CSF
pia mater
innermost covering membrane
thin, transparent, follows spinal cord, roots of spinal nerves, blood vessles.
Contains dentricate ligaments
dentricate ligaments
suspend spinal cord ind ural sac. Sheats of fibrous pia that extend between anterior and posterioer nerve roots
what is lumbar spinal stenosis?
narrowing of vertebral canal, most common in lumbar region, to compress spinal nerve roots
symptoms occurs often on one side (sensory or motor)
numbness, cramping, pain in back, butt, thighs, or claves.
weakness in lower extremity
what is done to help with spinal stenosis?
laminectomy - excision of spinous process to relieve pressure on cord and nerve roots
Cervical zygapophysical joint
slope ineriogly from ant to post at 45°
good at flexion and extension, axial rotation, okay at lateral flexion
Throacic Zygapophysical joints
slope vertically from ant to post at 60°
limit flexion and extenion, faciliate rotation
lumbar zygapophysial joints
curved in medial lateral positon
flexion and extsion high, limit all other movement
what areas are best for felxion and extension of back?
Cervical > Lumbar > thoracic
What area is best for rotation?
Cervical > Thoracic > lumbar
Wjhat area is best for lateral flexion?
Cervical > Lumar ~= Thoracic
What are the dep muscles of the back?
Erector Spinae
Transversospinalis
What are the three subtypes of the erector spinae?
Spinalis
Logissimus
iliocostalis
Erector spinae attachments
from scarum, lumbar and thorascic supraspinous ligament, sacrotuberous ligament, to”
costal angles (iliocostalis)
ribs and transver processes (longissimus)
Spinous processes (spinalis)
Erector spinae
Action
Innervation
Blood supply
Action: extension and lateral flexion
Innervation: drosal rami of spinal nerve
BS: dorsal branches of interconstal, subcostal, lumbar, and lateral sacral arteries
What are the subsets of transersospinalis?
Semispinalis
Multifudus
Rotatores
Semispinalis Attachments
from transver process to DISTANT superior spinous process
Semispinalis
Action
IN:
BS:
ACtion: extnesion, contralateral rotation
IN: dorsal vami of spinal nerves
BS: Dorsal braches of intercostal and lumbar
Multifidus and Rotatores Attachments
From transverse process to superior spinous process
Multifidus is longer than rotatores
Multifidus and rotatores
ACT
IN
BS
ACT: stabalizes vertebrae, assist in extnsion and rotation
IN: Dorsal rami of spinal nerve
BS: dorsal branches of intercosal and lumbar
Arrange the subtypes of the erector spinae muscles.
Medial: Spinalis
Int: Longissimus
Lat: iliocostalis
What is 1/2?
What is 5/4?
What is 7/6?
1/2: Rotatores
5/4: maltifidus
7/6: semispinalis
What type of muscle does the rotatores, multifidus, and semispinalis make up?
transversospinalis
What is the venous system like in the back?
a valvelss azygos system
