Back And Spine Flashcards
1
Q
How many vertebrae do we have?
A
33
2
Q
Why is the back important for muscles?
A
It’s the attachments site for various muscles including head, thorax, limbs and hips
3
Q
Why are the 2 types of back muscles?
A
Intrinsic and extrinsic
4
Q
What are extrinsic muscles?
A
Upper limb movement and respiration (serratus muscles)
5
Q
What are intrinsic group of muscles?
A
Superficial intermediate and deep layers
Needed for posture (erect orspinae)
6
Q
What are bilateral muscles?
A
Muscles on both sides of our body based on the midline
7
Q
What muscle type do flexion or extension in the back?
A
Bilateral
8
Q
What do unilateral back muscles do?
A
Rotation
9
Q
What muscles are anterior to the spine?
A
- Rectus abdomens
- psoas Major
10
Q
What muscles are responsible for extension at the back?
A
Erector spinae
11
Q
What is responsible for rotation in the back muscles?
A
Muscles with oblique fibres
12
Q
What muscles are needed for lateral flexion?
A
Erector spinae
External and internal oblique
13
Q
Describe the structure of the erector spinae?
A
It is a long back muscle which split up into 3 muscles
It’s the chief extensor (bilaterally)
And it rotates (unilaterally)
14
Q
How does ageing affect the vertebral column?
A
-dehydration of nucleus purpulous as re absorption isn’t good enough
- the elastic fibres in the intervertebral discs decreased hence shock absorption is reduced
15
Q
Why do old people have difficulty bending?
A
The intervertebral discs are too close with each other due to lack of water
16
Q
How does the bone change with age?
A
Develops bony spurs around vertebrae
17
Q
What is osteoporosis?
A
The thickness of spongy bone in the vertebrae reduces mainly due to the decrease of calcium reabsorption.
Its common after menopause
18
Q
What is the lumbosacral angle?
A
Angle formed between the sacral vertebral region and the lumbar vertebral region
Can cause back pain if in abnormal regions
19
Q
Why is there only significant movement the superior 25 vertebrae?
A
Because the sacrum and coccyx is fused
20
Q
Why do sacral vertebrates have smaller bodies?
A
Because the weight is placed on the pelvic girdle
21
Q
What is lordosis?
A
-secondary
- cervical and lumbar
- concave
22
Q
What is kyphosis?
A
- Primary
-thoracic and sacral - convex
23
Q
Which curvature is more pronounced in women and why?
A
Lumbar curvature
24
Q
Which curvature is less prominent in women?
A
The sacral curvature is reduced so the coccyx protrudes less into the birth canal
25
What does a typical vertebrae have?
Vertebral body
Vertebral arch
7 processes
26
What makes the intervertebral foramen?
The superior and inferior vertebral notches
27
What is the shape of the thoracic vertebrae body ?
Heart shaped body
28
What are the 7 processes?
One spinous process
2 transverse processes
2 Inferior articular processes
2 superior articular processes
29
What do the articular processes do?
Allow for vertebral movement using facet joints
30
What do the other processes do?
Act as insertions and attachments for back muscles
31
Which vertebrae has what special spinous process?
The cervical one have a bifid spinous process
32
Describe the vertebral foramen of cervical vertebrae
Large and triangular
33
What is C7 called?
Vertebra prominens
34
Which cervical vertebrae have a bifid process?
C3 to C5
35
What extra foramen distinguishes cervical vertebrae from others?
Foramen transversarium
36
What are 3 distinct characteristics of atlas ?
Superior articular facets are concave to hold the skull
No spinous process
Overall ring shape
37
What is the distinct feature of the axis?
The dens at the anterior of the vertebrae
38
How do the body of cervical, vertebrae look?
Like a rectangle. Long not wide
39
How does the thoracic vertebrae differ?
It has a long spinous process
The articular process goes vertically sharply
Round vertebral foramen
40
What are distinguishable characteristics of the lumbar vertebrae?
Short, broad and sturdy spinous process
Long slender transverse process
41
Why is there hyaline around our vertebral body?
It’s from the remains of the cartilaginous model
42
What shape is vertebral foramen in the thoracic level?
Circular
43
How does the sacrum provide stability ?
Transmits the body weight onto the pelvic girdle
44
What is the sacral promontory?
The edge of the body of the sacrum (anterior)
45
What is median sacral crest
Fused spinous process
46
What are intermediate sacral crests ?
Fused articular processses
47
What are lateral sacral crests.
Fused transverse processes
48
Where is dislocation of the vertebrae uncommon?
Thoracic and lumbar
49
What is osteoporosis?
Net demineralisation of bones due to issue with calcium reabsorption and deposition.
50
Osteoporosis affects mainly spongy bone. True or False
True. It makes cortical bone look more apparent
51
Who most commonly has osteoporosis?
Post menopausal women
52
What and where are the important vertebrae levels we need to know?
C7 - lower neck
T3 - spine of scapula
T7 - inferior angle of scapula
L4 - iliac crest
53
What is C7?
Vertebra prominens
54
Where are the sacral dimples?
S2
55
Where does the supraspinous ligament run from across what vertebrae?
C7 to L3/4
56
What are the 2 joints between vertebrae
Symphyses between vertebral bodies
And synovial planar joint between facet joints
57
What do IV discs do?
Act as a shock absorber and allows movement between vertebrae
58
What are the parts of the in disc?
Annulus fibrosus
Nucleus pulposus
59
What is an annulus fibrosus?
Rings of concentric fibrocartilage around the nucleus pulposus
60
What is the nucleus pulposus?
Mostly water with elastin and proteoglycans
Get compressed during movements
61
What happens to the nucleus pulposus with age?
The nucleus pulposus dehydrates
Loses elastin and proteoglycans
Gains collagen
62
What happens with the annulus fibrosus as we age?
It bears more weight and developes fissures and cavities
63
The nucleus pulposus is avascular. True or false
True
It gets its nutrients from peripheral vessels from the annulus fibrosus
64
Where is there no IV disc?
Between C1 and C2
65
Where are Iv discs most uniform?
Thoracic region
66
Where are the thickest IV discs?
Lumbar region for maximum movement
67
What are the anterior longitudinal ligament?
Covers the bodies of the vertebraes
68
What are the posterior longitudinal ligaments?
Weaker ligament which runs by the back of the bodies
69
What is the other name for facet joints?
Zygapophysial joints
70
What are ligamentum flavum?
Laminae of adjacent vertebrae are joined by ligaments
71
What are interspinous ligaments?
The ligaments connecting spinous process by the length
72
What are supraspinous ligaments?
They are ligaments which connect the vertebrae by the tips
73
What types of joints are in the Atlanta axial joint?
Pivot or planar
74
How are the facets orientated in the lumbar region?
Sagittally oreintated
75
What motion is permitted by the lumbar vertebrae?
Flexion and extension but not rotation
Lateral flexion
76
Where does lateral flexion happen the most?
Cervical and lumbar regions
77
What movement do thoracic vertebrae have?
Rotation and lateral flexion as they have thin IV discs
78
Cervical vertebrae have thin IV discs.
True or False
False
They have thick ones like the lumbar region
79
Why does the nucleus pulposus herniate postereolaterally ?
The presence of anterior and posterior longitudinal ligaments
The annulus fibrosus is relatively thin
80
Where are herniations most common?
Lumbar region
81
How can you tell there is a herniation in the lumbar region?
Increased ossification by osteophytes or herniated lumbar compressed on spinal root which causes lower back pain which radiates down to the thigh and leg
82
Why is a rupture in the transverse ligament of the atlas bad?
If it frees the dens is driven into the top of the spinal cord and the brain stem
83
How do the bodies of aged vertebrae look like?
Concave
84
What are osteophytes?
They are small smooth bumps on the vertebrae which affect the joint happens during arthritis
85
How can you tell what type of back pain it is?
Pain on the skin is problem with the nerves
Pain from within the back is a muscle joint or fibroskeletal problem
86
Where does the spinal cord end in children?
L2/3
87
Where does the spinal cord end for adults?
L1/2
88
What is the end of the spinal cord called?
Conus medullaris
89
What is the highest and lowest the conus medullaris can go?
T12 and L3
90
Where is the spinal cord enlarged?
Cervical enlargement
Lumbosacral enlargement
91
Where is the cervical enlargement?
C4 to T1
92
Why is there a cervical enlargement?
Brachial plexus
93
Where is the lumbosacral region?
Extends from L1 to S3
94
Why is there a lumbosacral enlargements ?
Lumbar and sacral plexus for legs
Forms the cauda equina
95
Where does the cauda equina start?
Inferior to the conus medullaris from the subarachnoid space
96
How many spinal nerves do we have ?
31 pairs
97
What is in the anterior horns of gray matter?
Cell bodies of somatic axons
98
What is filum terminale internum?
It is the part of the filum terminale that is inside the dural sac
99
What is the vertebral canal ?
It is in the vertebral column where the posterior and anterior roots become a spinal mixed nerve
100
What does the filum terminale do?
It anchors the spinal cord to the coccyx
101
Where does the filum terminale start?
End of conus medullaris
102
Where does the conus medullaris start?
L1
103
What are the layers of the meninges?
Pia
Arachnoid
Dura
104
What is the epidural space?
Space between the dura and vertebrae
105
Where does the dural sac end?
S2
106
What are dural root sheaths ?
Dura matter covering the spinal nerves by blending into the epineurium and the IV foramina.
107
What a particular structure do the arachnoid layer have?
They have arachnoid trabeculae which holds and suspends the layers in the spinal cord and holds the brain
108
What holds up the spinal cord?
Arachnoid trabeculae
Denticulate ligaments
109
Where are lumbar punctures taken from?
Subarachnoid
110
Why would someone inject the epidural space?
For anaesthesia to work quickly
111
Where are epidural usually given?
Sacral region
112
What are our external muscles types in the back?
Superficial and intermediate
113
What are the intrinsic back muscles?
The deep ones
114
How are the superficial back muscles innervated?
Anterior rami of cervical nerves because they act on the upper limbs
115
Give examples of superficial extrinsic back muscles
Trapezius
Latissimus Dorsi
Levator scapulae
Rhomboid
116
Give examples of intermediate extrinsic back muscles
Serratus posterior
117
How are intrinsic back muscles innervated?
Posterior rami
118
What do you intrinsic back muscles do?
Maintain posture and control movements of the vertebral column
119
Give examples of intrinsic back muscles
Erector spinae
120
How many sections are the erector spinae split into?
3
121
What are the origins of the erector spinae ?
They attach to the sacrum iliac crease or lower lumbar region
122
Where do the back muscles insert?
The ribs
123
What causes flexion of the head?
Sternocleidomastoid
124
What causes flexion?
Rectus abdominus
Psoas major
125
What causes extension?
Erector spinae
Gluteus maximus
126
What causes lateral flexion?
Serratus anterior
Rhomboid
Unilateral of erector spinae
Oblique muscles
Glutes
127
What prevents hyperextension?
Anterior longitudinal ligament
128
What prevents hyper flexion?
Posterior longitudinal ligaments
129
What does Serratus anterior do?
Elevates the scalpula
130
What does the Serratus posterior do?
Respiration
131
What is the muscle origin?
The fixed attachment of the muscle
More medial
132
How long is the sympathetic chain. (where does it start and end)
C1 to Co1
