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Anatomy > Back and Vertebral Column > Flashcards

Back and Vertebral Column Flashcards

1
Q

How many vertebrae do we have

A

33 plus intervertebral discs

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2
Q

Functions of vertebral column

A
  • weight-bearing
  • protection
  • movement
  • site of muscle attachements
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3
Q

How does the vertebral column allow for weight bearing

A
  • Carries and transmits weight from upper body down to lower limbs
  • Vertebral bodies increase in size from superior to inferior
  • Cutvatures and intervertebral discs provide shock absorption
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4
Q

How is the spine curved as a fetus

A

1 big inwards curve

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5
Q

Spinal curves (names and positions/regions they occur in)

A

Cervical and lumbar lordoses (
Thoracic and sacral kyphoses )

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6
Q

scoliosis

A

spine curves sideways

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7
Q

Basic anatomy of typical vertebra

A

see sheet

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8
Q

Types of vertebrae and briefely outline their distinguishable characteristics)

3 main but 2 others too

A
  1. Cervical ( foramen transversarium, bifid spineous process)
  2. Thoracic (big fin thinngy)
  3. Lumbar - vertebral arch

Sacral
Coccygeal

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9
Q

function of intervertabral discs

A

shock absorption and movement

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10
Q

Components of intervetebral discs

A

nucleus pulposus - central core with high water content - shock absorbant
annulus fibrosus - tough cartilage which can resist high forces/compression

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11
Q

what is a “slipped disc”

A

herniated nucleus pulposus - compressing the nerve roots

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12
Q

What protects the spinal cord/spinal nerves

A

spinal cord protected by vertebral canal (vertebral foraman)
spinl nerves protected by intervertebral foramen

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13
Q

What are the meninges

A

3 layes/membranes that protect the spinal cord/brain

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14
Q

Name the 3 mininges and describe their relative locations

A

Dura mater - outermost
Arachnoic mater - middle
Pia mater - inner

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15
Q

Where is cerebrospinal fluid (CSF) found

A

in subarachnoid space (below arachnoic mater)

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16
Q

Flexion of spine

A

bend forwards

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17
Q

extension of spine

A

bend backwards

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18
Q

lateral flexion of spine

A

move outwards (sideways)

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19
Q

lateral extension of spine

A

move back inwards (sideways)

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20
Q

Rotaion of spine

A

circular rotational movement

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21
Q

5 joints of the vertebral column

A
  • Intervertabral discs (symphasis 2ndry cartilegenous joints)
  • Facet joints (synovail plane)
  • Joints with ribs (synovial plane)
  • Skull and atlas (synovial ellipsoid) - more mobile so can nod head
  • Atlas and axis (synovial plane) - rotation so can shake head
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22
Q

What is the orientation of facet joints like for cervical, thoracic and lumbar vertebrae

A

Cervical: slanty which allows fro largest range of movement
Thoracic - coronal plane
Lumbar - like fins ( \ / )

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23
Q

Name the 5 ligaments of the vertebral column

A
  • posterior longitudinal
  • anterior longitudinal
  • liganmentum flavum
  • interspinous
  • supraspinous
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24
Q

Give functions of 5 ligaments of vertebral column

A
  • posterior longitudinal - limits hyperflexion
  • anterior longitudinal - limits hyperextension
  • liganmentum flavum - holds vertebrea together and preserves posture
  • interspinous - links whole length of spine and limits flexion
  • supraspinous - only posterior tips of spines, keeps head up?
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25
Q

locate each ligament of the vertebral column

(lable it)

A

see sheet

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26
Q

What do extrinsci mucles of the back attach to

A
  • head
  • limbs
  • thorax
  • abdomen
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27
Q

Explain the erector spinae

location, function…

A

Intrinsci back muscle
Extension, lateral flexion and “controlling” flexion

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28
Q

generally what do the anterior spinal muscles do

A

flexion of spine

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29
Q

generally what do the posterior spinal muscles do

(erector spinae)

A

extension of spine

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30
Q

osteoarthritis

A

pain/stiffness of joints

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31
Q

osteoporosis

A

compression fractures altering the curvature of the spine - linked to Ca2+ absorption and capacity

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32
Q

what does dehydration of intervertabral discs lead to

A

reduced shock absorption

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33
Q

what do weakened back muscles cause

A
  • imbalance loading of spine
  • back pain
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34
Q

What are the 6 muscle attachment sites for the back

just general

A
  • Head
  • Upper limb
  • Thorax
  • Abdomen
  • Hips
  • Lower limbs
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35
Q

function of extrinsic back muscles

2 functions

A

Upper limb movement and respiration

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36
Q

Functions of intrinsic back muscles

A
  • maintain posture
  • control movement of the vertebral column

(superficial, intermediate (erector spinae) and deep layers)

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37
Q

Flexion (bilateral)

where are the muscles - name them

A

Muscles anterior to the spine
* rectus abdominis
* psaos major

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38
Q

Extension (bilateral)

where are the muscles - name them

A

Muscles posterior to the spine
* erector spinae

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39
Q

what does bilateral mean in terms of muscle flexion and extension

A

muscles flex together either side of the column

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40
Q

Rotation (unilateral)

which muscles (name them)

A

Muscles with oblique fibre orientation
* external oblique
* internal oblique (opposite side)
* erector spinae

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41
Q

lateral flexion (inilateral)

muscles to do this movement…

A
  • erector spinae
  • exteranl and internal obliiques
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42
Q

Location and function of recturs abdominis

A
  • 3 large and flat muscles with different fibre orientation - anterior abdonimal wall muscles
  • Anterior flexion, lateral flexion and rotation of the trunk
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43
Q

posterior abdominal wall muscles

A

3 main ones:
* illiacus
* psosas major
* quadratus lumborum

Anterior flexion (psoas) and laterl flexion of spine

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44
Q

Intrinsic back musles: erector spinae functions

A
  • extension of vertebral column (bilaterally)
  • Lateral flexion of vertebral column (unilaterally)
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45
Q

older people: weakened back muscles/disability

A

loss of muscle mass, muscle strength and physical function

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46
Q

Where does the spinal cord begin and end

A

Begins at medulla oblongata (brain stem) and extends up to L1/L2 vertebral level

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47
Q

Cervical and lumbar enlargement

A

accomodate for nerve plexuses leaving at arms/legs

i think???

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48
Q

how many pairs of spinal nerves exit from the spinal cord

A

31 pairs

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49
Q

Number of verterae and nerves at each spinal segment

A

Cervical (7) - 8 spinal nerves
Thoracic (12) - 12 spinal nerves
Lumbar (5) - 5 spinal nerves
Sacral (5) - 5 spinal nerves
Coccygeal (4ish) - 1 spinal nerve

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50
Q

Explain the development of the spinal cord and why it does not exent the full length of the spine

A
  • spinal cord and vertebral canal length almost equal in fetus
  • vertebral canal grows and spinal cord ends at L1-L2 vertebral levels in adults
  • Remaing spinal nerves forms cauda equina seeking their intervertebral (IV) foramen to exit

vertebral colum grows, but spinal cord doesnt, so stops

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51
Q

conus medullarise

A

conical inferior end of the spinal cord - typically at L1

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52
Q

Cauda equina

A

bundle of spinal nerve roots - all spinal nerves looking for exit

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53
Q

filum terminale

what is it + function

A

continuation of pia mater (internum) - attach to coxyx so gives stability to cord

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54
Q

Dural cistern

A

dilated dural sac ends at S2 vertebral level - contains CSF

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55
Q

histology of spinal cord

A

sheet

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56
Q

grey matter

A

H shaped - cell bodies located here

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57
Q

White matter

A

axons (+schwann cells?)

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58
Q

Nissl bodies

A

rough ER in the neurone cell bodies

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59
Q

How do spinal nerves exit the vertebral canal

A

through intervertebral foramen

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60
Q

WHat do bentral rami of the spinal nerves from

A

Nerve plexuses that supplies the limbs:
* brachial plexus to upper limb C5-T1
* lumbosacral plexus to lower limb T12-L5

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61
Q

dorsal root

A

sennsory

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62
Q

ventral root

A

motor

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63
Q

spinal nerve

motor/sensory

A

mixed

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64
Q

dorsal rami

motor/sensory

A

mixed

65
Q

ventral rami

motor/sensory

A

mixed

66
Q

where is CSF found

A

between arachnoid and pia mater

67
Q

Give the properties of the 3 coverings/membranes of the spinal cord

e.g. toughness/appearance

A
  • dura mater - tough/fibrous
  • arachnoid mater - clear/fibrous
  • pia mater - delicate/vascular/thin
68
Q

what is the dural sac + location

A

The membranous sheath of dura mater that surrounds the spinal cord and the cauda equina
terminates at S2 and attached to tip of coccyx by filum terminale externum

69
Q

where are sensory neuron cell bodies located

A

dorsal root ganglia

70
Q

where are motor neuron cell bodies located

A

grey matter in ventral horm

71
Q

outflow of sympathetic NS

A

Thoracolumbar: T1-L2

72
Q

Where are sympathetic neuron cell bodies located

A

At the lateral horn of the grey matter

73
Q

parasympathetic NS outlow

A

Craniosacral: brain and pelvic splanchnic nerve (S2-S4)

74
Q

Where are cell bodies of preganglionic parasympathetic fibres found

A

lateral horm

75
Q

Spinal Cord Ischemia

no idea what this is about??? - relevance?

A
  • Deficinecy of blood supply to spinal cord: muscle weakness and paralysis
  • venous drainage: internal vertebral venous plexuses. Drains to the cerebral dural venous sinuses
  • Infection and cancer can spread to vertebrae/spinal cord/brain/skull from other parts of the body
76
Q

Where could bleeding occur in the spinal cord (what spaces)

A
  • epidural space
  • subduroid space
  • subarachnoic space
77
Q

briefly summarise some common spinal cord injuries

more just general knowledge/understanding

A
  • blunt trauma and penetrating injuries —> paralysis
  • Cord compression from disc prolapse or bone metastasis from primary cancer/stenoisis of the vertebral canal -> chronic back pain
  • May lead to coplete/partial loss of motor function and sensation (including disruption to autonomic function)
78
Q

Where does lumbar puncture occur

A

L3-L4 of subarachnoic space (CSF collection)

Epiidural anesthesia: epidural space

79
Q

structural differences between somatic and autonomic NS

A

Somatic: 1 motor neurone
Autonomic: 2 motor neurons

80
Q

Where are ANS cell bodies located

A

lateral horn of spinal cord

81
Q

Somatic motor neuron

A

myelinated - white?

82
Q

autonomic pre- and post-ganglionic neurons

A

Pre: myelinated
Post: unmyelinated - grey?

83
Q

What neurotransmitters to sympathetic pathways use

A

Ach and norepinephrine

84
Q

What neurotransmitters to parasympathetic pathways use

A

Ach only

85
Q

What part of the spinal cord contains the cell bodies of sympathetic neurons

A

lateral horn

86
Q

Where is the lateral horn only present

A

In spinal cord betweeen T1-L2/3 vertebrae: therefore sympathetic outflow - thoracolumbar outflow

87
Q

How do we get nerves coming out of S2/3/4 if spincal cord ends at L1/2

A

Differential growth of vertebral column vs spinal cord.
Neurons named according to where they emerge from the vertebral column, not the spinal cord

88
Q

Where is parasympathetic outflow

A

nerves from lateral horn between S2-S4 spinal segments

  • synapse in a parasympathetic ganglion in pelvis - sacral outflow
89
Q

What does the lateral horn consist of

A

sympathetic nerve cell bodies from T1-L2/3 sdpinal segments but also parasympathetic nerve cell bodies from S2-S4 spinal segments

90
Q

If all 31 pairs of spinal nerves have sympathetic fibres in them, but they only emerge between T1-L2/3 how to other spinal nerves above/below this recieve their sympathetic fibre

A

Sympathetic fibres from T1-L2/3 are spread through bilateral sympathetic chains which run paravertebrally from C1-Cc1. Thus, mass distribution mechanism for sympathetic supply to all parts of the body

91
Q

Explain the colour/myelination of sympathetic neurons

A

White rami communicates: (myelinated, preganglionic) - from spinal nerve to SC
Synapses in SC
Grey rami communicates (unmyelinated, postganglionic) - from SC back to spinal nerve

92
Q

How do spinal nerves communicate with the sympathetic chain

A

through white and grey rami communicates

93
Q

If sympathetic fibres originate between T1-L2/3 how do parts of the body aboove/below this recieve sympathetic innervation

A

Some preganglionic fibres (from T1-L2/3) can travel up or down the sympathetic chain without synapsing there to synapse at a sympathetic ganglion lying at a level higher/lower than T1/L2/3 and only enter the spinal nerve at that level (e.g. at C4 or L4 etc.)

94
Q

what does the sympathetic chain allow for

like general overview

A

all parts of the body to recieve sympathetic supply, every spinal nerve (C1 to Cc1) contains sensory, motor and sympathetic fibres

95
Q

3 options of sympathetic fibres leaving lateral horn of spinal cord

A
  1. synapse in chain at the same level
  2. can run up or down the chain and synapse at a higher or lower level
  3. can pass right through the sympathetic chain without synapsing and synpase in an autonomic ganglion in the abdomen lying outside the SC. Known as splanchnic nerves and supply only abdominal organs - are preganglionic
96
Q

splanchnic

A

supply organs

97
Q

how does the face/head recieve sympathetic supply

A

after synapsing at 1 of 4 cervical ganglia, sympathetic fibres utilise blood vessels going to the head/face by “climbing up” them

98
Q

Horner’s syndrome

not sure if need to know???

A

sympathetic fibres damaged along course to head/face:
- partial ptosis (drooping of upper eyelid)
- Miosis C(constriction of pupil)
- Anhydrosis (dec sweating)

99
Q

does the autonomic NS have sensory supply

A

Yes, although primarily motor system

100
Q

Autonomic sensory supply

A

Pain (nociceptive) and sensory impulses from organs run back to spinal cord mainly in sympathetic afferent fibres (parasympathetic afferent fibres in pelvis) via the dorsal root

101
Q

Parasympathetic nerves - craniosacral outflow

summarise key points/anatomy of outflow

A
  • Parasympathetic nerve fibres arise from the CNS with the S2, S3, and S4 spinal nerves and also cranial nerves - craniosacral outflow
  • the S2, S3, and S4 spinal nerves carrying parasympathetic fibres to pelvic organs are commonly referred to as the pelvic splanchnic nerves - pelvic splanchnic nerve cell bodies reside in the lateral horn of the spinal cord in the L2-3 spinal segments, but emerge from the vertebral column between S2-S4
  • These axons are preganglionic and synapse in a parasympathetic ganglion close to or within the pelvic target organ. Postganglionic fibres then supply the organ
102
Q

where would a C4 emerge

A

between C3 and C4 vertebbrae - like nerve number=number of lower vertebr

103
Q

Name C1 vertebrae

A

atlas

104
Q

name C2 vertrbrae

A

Axis

105
Q

facet joint

A

joints located on the top and bottom of each vertebra that connect the vertebrae to each other and permit back motion

106
Q

name parts of cervical vertebrae

A

see sheet

107
Q

name parts of thoracic vertebrae

A

see sheet

108
Q

name parts of lumbar vertebrae

A

see sheet

109
Q

what motions occur at atlas and axis joints

A

Lateral rotation/flexion/pivots occur here

110
Q

what lies within the vertebral foramen

A

spinal canal

111
Q

what lies within the intervertebral foramen

A

(ventral) roots of spinal nerves

112
Q

what joint occurs between the bodies of adjacent vertebrae

A

Intervertebral joint: symphysis (secondary cartilaginous joint)

113
Q

what type of oint occurs between articular facets of adjacent vertebrea

A

synovial joints

114
Q

C7 - vertebrae name

A

vertebra prominens

115
Q

distinguishing features of cervical vertebrae

A

Bifid spinous process, Transverse process (foramina)

116
Q

distinguishing features of thoracic vertebrae

A

Demi facets for ribs, spinous processes of thoracic vertebrae oriented obliquely inferiorly and posteriorly, vertebral foramen of thoracic vertebrae is circular

117
Q

distinguishing features of lumbar vertebrae

A

Large with kidney shaped vertebral bodies, no costal facets/bifid spinous processes

118
Q

costal facet

A

site of connection between rib and vertebral body

119
Q

type of cartilage found in intervertebral disc

A

fibrocartilage cartilage

120
Q

In what direction with an intervertebral disc herneate and why

A

Posterolateral: herniates in this direction as softest part/easiest/weakest gap to outside intervertebral disc - spinal cord is directly lateral and is “harder”

121
Q

what does a herniated disc generely compress on

A

Nerve roots - cause pain/numbness

122
Q

ligaments of spine

A

see sheet

123
Q

ligamentum flavum

A

connects lamina of adjacent vertebrae

124
Q

anterior longitudinal ligament

A

connects the anterior surface of vertebral bodies

125
Q

posterior longitudinal ligament

A

connects the posterior surface of vertebral arches

126
Q

supraspinous ligament

A

connect the spinous tips of adjacent vertebrae

127
Q

interspinous ligaments

A

connects the spinous processes of adjecent vertebrae

128
Q

primary curvature of spine

A

like as foetus - kyphosis

129
Q

secondary curvature of spine

A

happens in adults in cervical and lumbar regions of spine

130
Q

scoliosis

A

abnormal twisting and curvature of the spine

131
Q

what is key to remember about facet joints of different types of vertebral bodies

A

they are all in different places/angles in comparison with each other - allows for different range/types of movement

132
Q

What movements are permitted at cervical, thoracic and lumbar vertebrae

A

flexion, extension, lateral flexion and rotation

However, range dec as we go down spine

133
Q

where is the vertebral prominence found

A

spinous process of C7

134
Q

spine of scapula location

A

spine of T3

135
Q

Summit of iliac crest

A

spine of L4

136
Q

inferior angle of scapula

A

spine of T7/8/9?

137
Q

lumbar puncture location

A

between L3 and L4

138
Q

Where does a lumbar puncture occur in children and why is this different to as in adults

A

between L4 and L5 - spinal cord stops growing in kids whereas spine continues to lengthen as age. Means spinal cord protrudes lower down spine in children

139
Q

what are transverse foramen

A

an opening that is occupied by the vertebral artery and vein in the first six vertebrae and only the vertebral vein in the seventh

140
Q

conus medullaris

A

terminal end of the spinal cord

L1 (ish)

141
Q

cauda equina

A

bundle of nerve roots located at the lower end of the spinal cord - once spinal cord has “ended”

142
Q

filum terminale

location/function

A

fibrous band that extends from the conus medullaris to the periosteum of the coccyx, and its functions are to fixate, stabilize, and buffer the distal spinal cord from normal and abnormal cephalic and caudal traction.

143
Q

Why does the spinal cord show an enlargement in the cervical and lumbar regions

A

Due to enlargement for grey matter necessary to supply the limbs

144
Q

vertebral level spinal cord terminates in adults and kids

A
  • adults = L1-L2
  • Kids = L3
145
Q

What type of nerve impulses are associated with the anterior horn cells

A

motor

146
Q

What type of nerve impulses are associated with the posterior horn cells

A

sensory

147
Q

What type of nerve impulses are associated with the lateral horn cells

A

Autonomic (sympathetic)

148
Q

dural sac

/thecal sac

A

the membranous sheath of dura mater that surrounds the spinal cord and the cauda equina

149
Q

where does the dural sac terminate caudally

A

S2

150
Q

where is the epidural space found

A

between the dura mater and the vertebral bones

151
Q

Where is CSF found

A

subarachnoid space

152
Q

what is meant by “sentinel node”

A

The first lymph node to which cancer cells are most likely to spread from a primary tumour

153
Q

how does the sympathetic nervous system connect to the sympathetic chain

A

via white and grey rami communicates

154
Q

how is lymph returned to the venous system

A

Lymphatic vessels empty the lymph into the right lymphatic duct and left lymphatic duct (also called the thoracic duct). These ducts connect to the subclavian vein, which returns lymph to your bloodstream.

155
Q

main movement of thoratic vertebrae

A

rotation (and lateral flexion but to lesser extent)

156
Q

main movement of lumbar verterbrae

A

flexion and extension (but with some lateral flexion and some rotation)

157
Q

main movement of cerviacal vertebrea

A

All (flexion, extension, lateral flexion, rotation)

158
Q

2 broad ways to divide a vertebrae

like 2 sections of a vertebrae

A

vertebral body and vertebral arch

159
Q

what are extrinsic back muscles innervated by

A

mostly ventral rami

Anatomy (9 decks)

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