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MD1 Revision > Back Anatomy > Flashcards

Back Anatomy Flashcards

1
Q

Where is thick and thin skin found?

A

Skin thicker and tougher on back than on front

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2
Q

Is hairy skin thick or thin?

A

Thin

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3
Q

Where is thick skin found?

A

Palms

Bottom of feet

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4
Q

Describe the structure of the vertebral column and its development

A

Foetal C-shaped curvature > secondary lordotic curves develop in cervical and lumbar regions

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5
Q

What does cervical lordosis allow?

A

Support of head

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6
Q

What does lumbar lordosis do?

A

Shift line of gravity forward to help with balance and posture

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7
Q

What are the types of abnormal curves of the vertebral column?

A

Thoracic exaggerated curvature = kyphosis
Lumbar exaggerated lordosis
Lateral deviation = scoliosis

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8
Q

What is cranial shift?

A

T1 becomes C8

Gives cervical rib

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9
Q

What is caudal shift?

A

Extra lumbar vertebra/lumbar vertebra becomes fused with sacrum

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10
Q

What is an extrinsic muscle of the back?

A

One of attachments on to back

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11
Q

What is an intrinsic muscle of the back?

A

Both origin and insertion is to back

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12
Q

What is the spatial relationship between extrinsic and intrinsic muscles of the back?

A

Extrinsic muscles tend to be closer to surface than intrinsic muscles

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13
Q

At what level does the spinal cord end?

A

L1-2

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14
Q

What is the structure of a typical lumbar vertebra?

A

Highly vascularised
Articular process projects upwards
L1 > L5 - vertebrae increase in size to support greater load
Contain smooth surface on medial side

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15
Q

What is the significance of the pars interarticularis?

A

Site of weakness

Common location for fracture

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16
Q

What is the pars interarticularis?

A

Between inferior and superior facets of articular joints

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17
Q

What do the anterior and posterior sacral foraminae contain?

A

Nerve roots and vessels

Especially sacral veins

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18
Q

What are sacral veins important for?

A

Communication between pelvic veins and veins of back for drainage

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19
Q

What is the arterial supply to the lumbar vertebrae?

A

Posterior intercostal arteries
Lumbar arteries
Lateral sacral arteries

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20
Q

What is the venous drainage of the lumbar vertebrae?

A

Body drained by basivertebral vein > internal vertebral venous plexus > external vertebral venous plexus

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21
Q

What is the relationship between the internal vertebral venous plexus, and the meninges and vertebral canal?

A

Extradural but still within vertebral canal

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22
Q

Where are the primary centres of ossification of the vertebrae?

A

In body and each neural arch = vertebral arch = posterior part of vertebra

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23
Q

When do the primary centres of ossification of the vertebrae appear?

A

Before birth at 6-8 weeks

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24
Q

Where are the secondary ossification centres of the vertebrae?

A

5 secondary centres at

  • Tips of spinous and transverse processes
  • Upper and lower margins of body
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25
Q

When do the secondary ossification centres of the vertebrae close?

A

Late adolescence

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26
Q

What are the two components of the intervertebral disc?

A

Annulus fibrosus

Nucleus pulposus

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27
Q

What type of cartilage is the annulus fibrosus?

A

Fibrocartilage

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28
Q

What is the nucleus pulposus?

A

Remnant of notochord

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29
Q

What is the main role of the lumbar joints and ligaments?

A

Limiting range of movement of vertebrae

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30
Q

What are the six types of lumbar joints and ligaments?

A 
Interspinous ligaments
Posterior longitudinal ligament
Facet joints
Intertransverse ligaments
Supraspinous ligmant
Anterior longitudinal ligmanent
31
Q

What is the shape of the posterior longitudinal ligament?

A

Ribbon-like
Then fans out to side when it gets to intervertebral disc
- Provides protection
Goes back to midline

32
Q

What are the functions of the intervertebral discs?

A

Absorb weight bearing forces

Allow for stretching and distortion

33
Q

Why is the ligamentum flavum made of elastic tissue?

A

For stretching = flexion of back, then recoiling to original shape

34
Q

Whys is twisting whilst lifting hazardous to the intervertebral disc?

A

Only 50% of annular fibres positioned to resist load - can’t handle extra movement
Risk of disc prolapse

35
Q

In which plane is thoracic movement in?

A

Coronal

36
Q

In which plane is lumbar movement in?

A

Sagittal

37
Q

What are the anterior and posterior rami?

A

Branches/divisions of spinal nerves, supplying different parts of body

38
Q

Where the the cell bodies of sensory neurons located?

A

Dorsal root ganglia

39
Q

Where are the dorsal root ganglia located?

A

Intervertebral foramen

40
Q

What do arteries and veins accompany?

A

Nerves

41
Q

Where do nerve roots sit in relation to the bony foramen?

A

Top

42
Q

What is the danger of a fracture at thee pars interarticularis of L5?

A

L5 may slip into pelvis

43
Q

What are the three types of disc prolapse?

A

Bulge
Herniation
Extrusion

44
Q

What is a bulge disc prolapse?

A

Bulges at a fissure

45
Q

How can a bulge disc prolapse cause pain?

A

If it hits outer third, may be pain from recurrent meningeal nerve

46
Q

What is a herniation disc prolapse?

A

Herniates out posterior longitudinal ligament

47
Q

In which direction does a herniation disc prolapse tend to be, and why?

A

Posterolateral, because of posterior longitudinal ligament being directly posterior

48
Q

Why is a herniation disc prolapse a common cause of back pain?

A

Prolapse directs nuclear material towards dorsal root of spinal nerve

49
Q

What may an extrusion disc prolapse impinge on?

A

Nerve roots and dorsal root ganglia

50
Q

How does height change during the day, and why?

A

Become shorter during day because postures tend to increase loads on lumbar intervertebral discs

51
Q

Where do all extrinsic muscles of the back act?

A

All attach to and act on upper limb

52
Q

What are the extrinsic muscles of the back?

A

Trapezius
Latissimus dorsi
Rhomboids
Levator scapulae

53
Q

What is the nerve supply of the extrinsic muscles of the back?

A

Except for trapezius, innervated by anterior rami of spinal nerves

54
Q

Do the posterior rami of spinal nerves supply the extrinsic muscles of the back?

A

No - penetrate them, but don’t supply them, and pass to skin

55
Q

What is the nerve supply to trapezius?

A

CN XI = spinal accessory nerve

56
Q

What are the intermediate muscles of the back?

A

Serratus

  • Posterior
  • Superior
  • Inferior
57
Q

What is the function of the intermediate muscles of the back?

A

Act on ribs - accessory muscles of respiration

58
Q

What is the nerve supply of the intermediate muscles of the back?

A

Anterior rami

59
Q

What are the two groups of deep muscles of the back?

A

Erector spinae

Transversospinalis

60
Q

What are the three divisions of erector spinae?

A

Spinalis
Longissimus
Iliocostalis

61
Q

What is the function of erector spinae?

A

Long muscles - prime movers of back = flexion and extension of trunk

62
Q

What type of contraction occurs in erector spinae?

A 
Concentric = returning flexed trunk to upright position
Eccentric = extension of trunk
63
Q

Where is transversospinalis?

A

Short muscles - run from lateral to medial across few vertebral segments

64
Q

What is the function of transversospinalis?

A

Stabiliser and fixator - limit movement

65
Q

What is the blood supply of the back?

A

Superficial veins pass anteriorly

Arteries pass through muscles with dorsal rami to skin

66
Q

Where does lymph from the skin of the back drain?

A

Skin above umbilicus drains into axillary nodes

Skin below umbilicus drains into inguinal nodes

67
Q

What do the posterior rami innervate in the back?

A

Facet joints
Deep muscles
Overlying skin

68
Q

What is the reflex muscle spasm?

A

Protective muscle spasm to prevent facet joint injury

Overlying skin sensitised from irritation of posterior ramus so deep muscles can’t contract

69
Q

What are the two types of back pain?

A

Mechanical

Compressive/neurogenic

70
Q

What is compressive back pain?

A

When nerve roots that leave spine irritated/pinched

71
Q

Which nerve root will an L4/5 disc prolapse affect?

A

One directly below prolapsed disc because nerve root pertaining to above vertebra already exited
= L5

72
Q

What is spondylosis?

A

Age-related loss of water in bone > deceased density and increased rigidity of bone

73
Q

How may spondylosis cause pain?

A

May cause overgrowth of bone producing osteophytes

Can extend into vertebral foramina and compress exiting nerve roots

MD1 Revision (9 decks)

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