Back and Neck: osteology, joints and ligaments Flashcards
name the 33 vertebrae
7 cervical 12 thoracic 5 lumbar 5 sacral (fused) 4 coccygeal (fused)
functions of vertebrae
suport
shock absorption - intervertebral discs
Protection - of spinal cord and nerve roots
haematopoiesis - vertebrae contain red bone marrow
curvatures of spinal column
primary curvature
secondary curvatures
primary curvatures
flexion i.e the fetal position
secondary curvatures
develop after birth
cervical lordosis - develops with upright posture
convex curves of spinal column
thoracic and sacral
concave curves of spinal column
cervical and lumbar
abnormalities of spinal column
excess lordosis/kyphosis - excess compression of thoracic bones from osteoporosis - hump
scoliosis
processes of vertebrae
spinous and transverse processes
articular processes of vertebrae
superior and inferior
vertebral arch/foramen
pedicles/laminae
canal
typical cervical vertebra from C3 -C6
small kidney shaped body
triangular
small transverse process
small spinous process - bifid
atypical cervical vertevra
C1, C2, C7
Atypical cervical vertebrae C1
Atlas No body • Anterior arch & tubercle • Posterior arch & tubercle 2 lateral masses • Articular facets • Superior & inferior • Transverse foramen • Groove for vertebral artery
Atypical cervical vertebrae C2
Axis
• Odontoid process (dens)
• Articular facets
• Spinous process - bifid
joints of cervical spine atlanto-occipital joint
- Between C1 & occipital condyles
- Synovial condyloid joint
- Movement - nodding
joints of cervical spine
atlanto-occipital joint
atlanto-axial joint
plane synovial joint
what type of joint is in the atlanto-axial joint how do they connect with cervical vertebrae
synovial pivot joint
dens of C2vertebrae and anterior of C2 arch are connected by joints - cruciate ligament (transverse and vertical), alar ligament
typical thoracic vertebrae from T2 - T9
Body • Heart-shaped – with costal facets • Vertebral canal • Round • Transverse process • Facet for tubercles of ribs • Spinous process • Slopes inferiorly
costal facets of thoracic vertebrae T2-T9
Identify costal facets • 2 demifacets on body for head of ribs • Facet on transverse process for tubercle of rib
Atypical thoracic vertebrae T1
T1
• Has 1½ facets on the body for articulation with head of ribs
• Full superior facet & inferior demifacet
Atypical thoracic vertebrae T10 T12
Single facet on side of vertebral body of T10 – T12
• These ribs only articulate with their own vertebrae
• No facet on transverse process of T11 & T12
typical lumbar vertebrae L1-L4
Body – Large & kidney-shaped • Vertebral canal – Small in comparison – Cord ends L1 / L2 • Spinous process – Horizontal & bulky
Atpyical lumbar vertebrae
L5
wedge-shaped BODY
• Transverse process is anterior to side of body to iliolumbar ligament
• May be fused to sacrum
typical sacrum S1-S5
– 5 sacral vertebrae – Transverse ridges present between fused bodies – “Ala” (wing) • (Transverse processes) – Anterior sacral foramina
facet joints
– Between adjacent vertebrae
• Between the superior & inferior articular
facets
– Small synovial plane joints
symphyses
Secondary cartilaginous joints
– Hyaline & fibrocartilage
where does the fibrocartilaginous disc lie between
outer annulus fibrous
inner nucleus pulposus
annulus fibrosus
“coiled spring”
• Holds vertebrae together
nucleus pulposus
“ball bearing” which the vertebra “roll over”
during movement
motion segment
Functional unit of the spine
– 2 vertebrae & associated soft tissues
movement of spine
flexion and extension
lateral flexion
spinal rotation
forces parallel to discs
where does flexion and extensions of spine
– Occurs throughout spine
– Occurs in atlanto-occipital joint
• (C1 & skull)
lateral flexion of spine
– Maximal in lumbar region
– Restricted in neck & thorax (ribs)
– Atlanto-occipital joint (C1 & skull)
spinal rotation of spine
– Mainly present in thoracic region
– Sheer stresses
– “Twist” disc fibres at periphery
forces of parallel to discs
– Also sheer stresses on discs
– Slip in the direction of the force
two types of longitudinal ligaments
– Anterior
• Anterior vertebral bodies
– Posterior
• Posterior vertebral bodies
ligamentum flavum
– Between laminae
– Yellow due to elastin
Ligaments of spine
Interspinous ligaments
• Supraspinous ligament
• Ligamentum nuchae in neck
herniated discs
The intervertebral disc may rupture, or herniate
• This compresses the spinal nerve
– i.e. sciatica or lumbar back pain
symptoms of herniated dics of L4/5
leg pain weak movement
treatment for herniated disc of L4/5
sciatic stretch
symptoms of herniated discs of L5/S1
pain, weakness, absent tendon reflex
treatment of herniated discs of L5/S1
sciatic stretch
symptoms of herniated discs of L3/4
– Anterior thigh pain, weak quad,
absent tendon reflex,
treatment of herniated disc of L3/4
femoral stretch
sciatic stretch tests
– Supine
– Leg raise
– Ankle dorsiflexion
femoral stretch test
- Prone
– Flex knee
– Extend hip
kyphosis
abnormal flexion
scoliosis
abnormal lateral curvature
congenital pathologies of the spine
Accessory hemivertebra
– Fusion of adjacent vertebral bodies
spina bifida
– Embryological defect
– Range of severity
• Mild – only vertebra affected
• Severe – vertebra & spinal cord affected
