Back and Posterior neck Flashcards
What are the functions of the vertebral columm?
Protection of spinal cord
Support and attachment
Mobility with rigidity
Posture and locomotion
superiorly to inferiorly, the the size of vertebrae…. due to….
increase due to weight of the body
What are the two fused parts of the VC?
Sacrum - 5 fused
Coccyx = 3-4 fused
Describe the distsinctive features of cervical vertebrae.
Transverse foramen, bifid spinous process
Large triangular vertebral foramen for the cervical enlargement
Articular processes in traverse plane
Vertebral body contains concave superior surface and convex interior surface
What is C1 articulating with in the atlanto-occiptal joint and what movement does it allow for?
b) Articulates occipital condyles of occipital bone = flexion and tension
what is C2 articulating with in the atlanto-axial joint?
what movements does this joint allow?
facet of C1 (posterior surface of the anterior arch of atlas)
rotation (synovial pivot joint)
What are the unique structural features of C1, C2 and C7.
C1: is an atlas bone, lacks a body and spinous process
C2: axis bone, odontoid process = superiorly projecting process
C7: vertebra prominences = smaller transverse foramen than other cervical vertebrae, long spinous process.
Name the distinctive features of thoracic vertebrae.
Distinctive features
Costal facets on transverse processes and vertebral bodies
Long spinous process angled inferiorly (giraffe)
Articular process in coronal plane
Distinctive features of lumbar verebrae.
Large vertebral body
Short spinous process
Articular process in sagittal plane
What is the function of the cervical, thoracic, lumbar and coccygeal vertebrae respectively?
C= support and movement, T= stability, support thoracic cavity and suspend ribs, L= mobility between thorax and pelvis and stability. Coccygeal = support pelvic floor
What is the purpose of the spinal curvatures?
enhance flexibility and weight bearing
What are the 2 primary curves? when do they develop? What way do they curve?
- thoracic and sacral curves (posterior curves)
- fetal development - primary
curvature is retained from the original fetal curve
3- posteriorly
What are the 2 secondary curves? when do they develop?
- cervical and lumbar curves (anterior curves)
- develop throughout life as the pressure changes one’s posture
cervical- first few months when baby develops muscles to hold up head
lumbar - when baby starts walking due to weight redistribution - first year
3 joints of the VC.
Intervertebral body joints
Zygapophyseal joints
intervertebral joints (costovertebral and costotransverse)
What is the intervertebral body joint and what is its structural joint type, features and functions?
joints between vertebral bodies
Structural joint type: cartilaginous symphyseal
features: fibrocartliaginious disc and hyaline cartilage
function: weight bearing
What is the zygaphphyseal joint and what is its functional joint type and structral features and function
Joints between vertebral arches
Functional
Synovial plane
Structural features
Planes:
Cervical = transverse
Thoracic= coronal
Lumbar = sagittal
(inf and sup articular processes)
function
keep vertebrae properly aligned
allow movement orientation differs throughout vertebral collum to allow for different movements.
What is the costovertebral joints and what is its functional joint type?
Between ribs and lateral thoracic vertebrae
Synovial plane
What is the costotranverse joint and what is its functional joint tpe?
between tubercle of rib and transverse process of T1-10
synovial
What does the inner nucleus and outer annulus fibrosus of fibrocartliaginious disc in interverebral bodies allow for?
Function
inner nucleus
= shock absorption
-outer annulus fibrosus
= resists tension in any direction
Name the ligaments that support the VC.
anterior longitudinal
posterior longitudional
ligmentum flavum
supraspinious
interspinious
nuchal ligament
Where is the anterior longitudinal ligament of back and what does it limit?
- lines the anterior aspect of the vertebral body
- limits extension
Where is the Posterior longitudinal ligament of back and what does it do?
- lines the posterior aspect of vertebral body (anterior aspect of the spinal canal)
- limits flexion and prevents herniation of IV discs
ligmentum flavum ligament of back
- forms the posterior wall of the vertebral canal
- elastic (returns vertebrae back to normal after flexion)
- maintain curvatures (good for posture)
supraspinous ligament of back
between the apices of the spinous processes
maintains upright position of head
interspinous ligament of back
between spinous processes
Limits flexion via restricting separation of spinous processes of VC
nuchal ligament of back
strong, thick ligament
runs along back of neck and extends to posterior aspect of skull
limits flexion of neck
Compare the atlanto-occipital and atlanto-axial joint.
Atlanto-occipital joint
- Allows flexion and extension and little flexion and rotation
- Nodding
Atlanto-axial joint
- Dens of axis acts as a pivot to allow rotation of atlas
- Moving head to say no
Name the superficial and intermediate extrinsic muscles of the back.
Superficial
-Trapezius
-Latissimus dorsi
-Levator scapulae
-Rhomboids
intermediate
- Serratus posterior superior
- Serratus posterior inferior
Name all the muscles (extrinsic and intrinsic,) from most superficial –> deep for the back
- extrinsic
a. superficial group
- trapezius
- latissimus dorsi
- levator scapulae
- rhomboids
b. intermediate group
- serratus posterior superior/ inferior- intrinsic
a. spinotransversales
- splenius capitis
- splenius cervicis
b. erector spinae
- iliocostalis
- longissimus
- spinalis
- intrinsic
- transversospinales
- semispinalis
- multifidus
- rotatores
How does the back complete flexion?
Bilateral contraction of:
Internal and external obliques
and
rectus abdominus
How does the muscles back display extension?
Bilateral contraction of:
Erector spinae
Transversospinales
Quadratus lumborum
what gives motor innervation to the back muscles?
anterior rami (extrinsic)
posterior rami (intrinsic)
thoracolumbar fascia
CT enclosing intrinsic back muscles
What are the muscles of the posterior neck?
Semispinalis captis
longissimis captis
splenius captis
spleniius cervicis
movements of the neck
Flexion
Bilateral contraction of SCM
Extension
Bilateral contraction of:
-splenius capitis
-splenius cervicis
-longissimus capitis
-semispinalis capitis
Lateral flexion
Unilateral contraction of SCM and scalenes ‘
Rotation
Unilateral contraction of
-splenius capitis and splenius cervicis (ipsilateral)
- SCM and scalenes (contralateral)
What is the most commonly fractured vertebrae? Why?
T12
subject to increased transitional stress
- what landmarks do you use to perform a lumbar puncture?
- Have the patient lie with their back flexed (fetal position)
- draw a horizontal line joining the iliac crest with the tip of the L4 spinous process
- this corresponds to the level of the L4/L5 IV disc
Scoliosis
lateral bending of vertebral collumn (usually thoracic)
Kyphosis
abnormally accentuated posterior curvature of thoracic spine
commonly caused by osteoporosis
lordosis
abnormally accentuated curvature pf lumbar spine
commonly caused by pregnancy
What is the purpose of curves in the vertebral column?
provides flexible support with shock absorbing resilience
the primary curvatures of the back are concave…
anteriorly
the secondary curvatures of the back are concave…
posteriorly
what is the lamina of a typical vertebra?
area between spinous process (posterior) and transverse process (lateral)
what are the two atypical cervical vertebrae?
c1 Atlas
C2 Axis
c1 Atlas
ring-shaped bone with posterior AND anterior arch, NO body
transverse processes extend further laterally than other cervical vertebrae = levers for muscle action
c2 Axis
contains an odontoid process on the superior part
= pivot to allow atlas to rotate on an axis
two large flat weight weight-bearing surfaces
is the axis of rotation for the skull to allow for pivoting
What is the movement allowed by the atlanto-occipital joint?
flkexion and extension
what is the major movement allowed by the atlanto-axial joint?
rotation
Where is the zygapophysial joint in the cervical vertebrae and what movement does it permit?
inferiorly from anterior to posterior
movement in all directions
Where is the zygapophysial joint in the thoracic vertebrae and what movement does it permit?
coronal place
rotation and lateral bending- but limits flexion and extension
Where is the zygapophysial joint in the lumbar vertebrae and what movement does it permit?
saggital plane
flexion and extension, limits rotation
What joints are in the thoracic region only?
Costovertebral joints:
-Joint with head of rib
-Costrotransverse joints
Describe the joints with head of rib
between head of ribs and posterolateral aspect of bodies
synovial plane joints
synovial compartments separated by intra-articular ligament
Describe costotransverse joints
between transverse tubercle of ribs and transverse process of vertebrae
strenegthened by the costotransverse and lateral costotransverse ligaments
What are the three columns of the Erector spine. State their name and their features.
Iliocostalis – most lateral, inserts in ribs and transverse processes of C
Longissimus – LARGEST, inserts into transverse processes
Spinalis – mode MEDIAL and smallest, inserts into spinous processes, usually absent in cervical region
