Back Layers, vertebral, spinal Flashcards
how long does it take for nerves to fully myelinate so we can walk?
12-18 months
what are the planes of the body?
coronal (front) transverse (top bottom) sagittal (left right)
_______ is a natural state when ligaments are not stretched, and therefore a natural position.
flexion
skull bones
22 skull bones
lower limbs bones
62 lower limbs
vertebrae
33 spine bones; 26 if sacrum/coccyx is one each
upper limb bones
24 upper limb bones
ribs total
26 ribs
bones in axial skeleton
80 bones in axial skeleton
bones in appendicular skeleton
126 bones in appendicular skeleton
how many bones do we have that do not articulate with other bones and name?
1, hyoid bone does not articulate with any other bones
define viscera
viscera are organs within a body cavity
periosteum provides blood and __________ to bones
stem cells
list bones with no periosteum and significance
patella have no periosteum and why they do not heal quickly due to no stem cells.
what constricts blood vessels, increases MAP heart rate increasing blood to brain for quicker decisions; increased blood to muscles for action; sweats
sympathetic nervous system
why do we get dry mouth when we panic or are frightened?
parasympathetic nervous system is suppressed during fight or flight, which controls all glands except sweat glands
how can stress negatively affect hormone production?
stress affects hypothalamus, which controls glands, due to proximity to limbic center in brain
of spinal nerves total and by region of spine
31 total spinal nerves, 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccyx
of nerve roots that make up sciatic nerve and name
5 nerve roots that make up sciatic nerve L4 L5 S1 S2 S3
split spinous process of cervical spine allow for ______
hyperextension
vertebra prominens on what bone
vertebra prominens on C7
vertebral artery goes through transvers foramen of ____ and supplies what?
C6 - C1 artery supplies occipital lobe (vision), cerebellum (balance), and brain stem (keeps us alive)
when atherosclerosis of one vertebral artery occurs, turning to the opposite side causes _______, but not looking forward or turning to same side.
diplopia (double vision)
why does injury to spinal cord superior to C3 result in suffocation?
phrenic nerve is from C3-4-5 and supplies diaphragm, so injury above = suffocation
this fracture is caused by blow to top of head yielding compression down from cranium. name and bone
Jefferson fracture of atlas C1
what patient positioning is required for an x-ray of C1 & C2
open mouth
what is the significance of checking to see if pupils react to light?
negative response means brain stem death
in reference to C1 and C2, which is yes and no?
C1 “yes” movement, C2 “no” movement
these bones have “heart shaped” bodies, look like giraffes laterally and have long downward spinous processes that prevent what?.
thoracic vertebrae, hyperextension
the head of every rib articulates with how many bones where?
2 bones, the superior costal facet of corresponding vertebra, and inferior costal facet of vertebra above
movement of ribs up down is referred to as this kind of movement.
bucket handle movement.
these bones have kidney shaped bodies with what unique structure? what attached to said structure?
lumbar vertebrae, mammillary process, multifidus muscle
on what day of embryonic development does the heart beat?
heart beats day 21
folic acid deficiency causes this failure of closure of the caudal neural fold at week 4 of embryonic development?
spina bifida
in this type of spina bifida, the dural sac is exposed
menigocele
in this type of spina bifida, the dural sac is exposed and CNS tissue resides superficially in the sac
menigomyelocele
in this type of spina bifida, the spinal cord is exposed
rachischisis
in this type of spina bifida, the bones are unfused with no neurological symptoms
occult
intervertebral discs are made of ______ and these structures prevents herniation of discs posteriomedial, hence they usually herniate posteriolateral
fibrous cartilage, posterior longitudinal ligament
a herniated disc patient presents with?
later postural tilted to the normal side
what are the most commonly compressed nerves in disc herniation?
L5 S1
what are the venous plexuses of the vertebral column? what is their significance?
anterior and posterior internal plexuses and anterior and posterior external plexuses (4 plexuses), Most internal organs connect to these plexuses; Cancer can travel through bidirectionally (no values) and can travel anywhere.
the term metamedicine applies to what part of the body?
intercostal spaces since they contain all tissues types
our liver can grow back portions and is the largest gland in the body (t or f)
True, liver is the largest gland and can grow donated portions partially back
where does the spinal cord end?
L1/L2
99.9% of neurons are ______
99.9% of neurons are multipolar
dorsal horn of the spinal cord controls what
sensory function
ventral horn of the spinal cord controls what
motor function
what sections of the spinal cord are larger in diameter and why? which region of the cord is enlarged?
cervical and lumbar. upper and lower extremities, respectively, require greater degrees of fine motor control; therefore the ventral region is enlarged as it controls motor fuction
what are the 3 layers of meninges
dura mater, aracnoid mater, and pia maters
define motor unit
number of muscle fibers controlled by one neuron
what space contains contains CSF and arteries of brain/spinal cord
subarachnoid space
what meninges is pain sensitive?
dura mater
what are pachy and lepto meninges?
pachy is dura mater, and lepto is a collective term for aracnoid and pia maters
what is the end of the spinal cord called?
conus medullaris is the tapering end of spinal cord
what is created by the pia mater that starts at conus medullaris, pierces the dural sac terminating at coccyx. name it’s sections’ locations
filum terminale; interna extends from conus medullaris to dural sac, and externa extends from dural sac to coccyx
dural sac terminates where, inferiorly?
S2
what function dies the filum terminale serve?
filum terminale anchors the spinal cord vertically
this modifications of pia mater and prevent side to side movement of spinal cord and is at what levels?
denticulate ligaments, T1-L2
what is tethered cord syndrome
filum terminale is too short, resulting in pain and/or neurological damage during flexion of the vertebral column
these are any collection of nerve cell bodies outside the CNS and are either sensory or autonomic.
ganglia
why are the ventral rami of spinal nerves larger than the dorsal rami?
ventral rami are larger due to all their innervation of all muscles, except muscles of layer 4-6 of the back, which are the only muscles supplied by the dorsal rami
the sympathetic chain ganglion run from where to where
T1 to L2
what is the condition caused by damage to the sympathetic chain ganglion?
Horner’s syndrom (redness in face due to vasodilation, pupil dilation and lack of sweat)
of the types of bones, what is a vertebra?
irregular
what are functions of osteoblasts and osteoclasts?
osteoblast build bone tissue (b for build), osteoclast break down bone tissue
the proximal epiphysis is composed of?
spongy bone
the diaphysis of a bone is composed of?
compact bone
what is the phrase to remember the direction of blood nutrients to bones?
to the elbow I go, from the knew I flee
what are the 4 stages of healing a bone fracture?
hematoma formation, fribrocartilage callus formation, bony callus formation, bone remodeling
what are the primary curves of the spine what what kind of curve are they?
thoracic and sacral kyphosis
what spinal curves form as a result of gravity and movement?
cervical and lumbar lordosis
what is the condition presented by lateral curvature and rotation of the vertebrae?
scoliosis – lateral curvature + rotation of the vertebrae
the 2 main structures of a vertebra are?
the body and the vertebral arch
what is formed by the inferior vertebral notch of a vertebra and the superior vertebral notch of the vertebra below it?
intervertebral foramen
uncus aka unicinate process does what?
uncus prevents dislocation of cervical vertebrae during flexion/extension
what is the strongest cervical vertebra?
axis C2
what prevents odontoid process from injuring the spinal cord during cervical movement?
transverse ligament of atlas
what is a bilateral fracture of the pedicles or lamina of the 2nd cervical vertebra
hangman fracture
dislocation of cervical vertebrae occurs at ?
the facet joints.
the head of each rib articulates with how many bones?
2; the superior costal facet of corresponding vertebra, and inferior costal facet of vertebra above
what bone could this be? superior 1⁄2 is thoracic in character and inferior 1⁄2 is lumbar in character
T12
presence of a cervical rib may result in?
thoracic outlet syndrome: costal element of C7 becomes abnormally enlarged yielding compression the brachial plexus and compression of blood vessels
mammilary process resides below and between what 2 structures?
transverse and spinous processes of lumbar vertebrae
what is narrowing of the vertebral foramen with spinal cord and/or spinal nerve roots compression in lumbar vertebrae?
spinal stenosis
what is a kyphoplasty procedure?
a process injecting an “internal cast” into vertebral bodies in osteoporosis patients with compression fractures
what is the inferior aperture of the sacral canal?
sacral hiatus
in what region is the gross movement of rotation greatest?
thoracic
forward movement of the body of one of the lower lumbar vertebrae on the vertebra below it, or upon the sacrum.
SPONDYLOLISTHESIS
unilateral or bilateral defect in the lamina of L.V. 5 between the superior and inferior articular processes, with no slippage between vertebrae.
SPONDYLOLYSIS
layer 1 of the back consist of what muscles?
trapezius, latissimus dorsi
layer 2 of the back consist of what muscles?
romboidius major, romboidius minor, levator scapulae
layer 3 of the back consist of what muscles?
serratus posterior superior, serratus posterior inferior
layer 4 of the back consist of what muscles?
splenius capitis, splenius cervicis
layer 5 of the back consist of what muscles?
erector spinae group: iliocostalis, longissimus, spinalis
layer 6 of the back consist of what muscles?
transverospinalis group: semispinalis, multifidus, rotatores
name the muscle regions of the erector spinae group
iliocostalis: lumborum, thoracis, cervicis; longissimus: thoracis cervicis capitus; spinalis: thoracis cervicis capitus
name the muscle regions of the transverospinalis group
semispinalis: thoracis, cervicis, capitis; multifidus: lumborum, thoracis, cervicis; rotatores: lumborum, thoracis, cervicis
name the suboccipital muscles
rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior, obliquus capitis superior
suboccipital triangle boundaries:
medially – rectus capitis posterior major and minor
superolaterally – obliquus capitis superior
inferolaterally – obliquus capitis inferior
suboccipital triangle contains? clinical use?
dorsal ramus of C1, vertebral artery, suboccipital venous plexus. clinically cisternal puncture
Trapezius action
upper- unilaterally flex neck bilaterally elevates scapula; middle- retracts scapula; lower depresses scapula
Trapezius O&I
O: occipital protuberance, medial 1/3 superior nuchal line, nuchal ligament, spinous processes C7-T12
I: spine of scapula, acromion, lateral 1/3 clavicle
Trapezius nerve
motor= spinal accessory cranial nerve (no root due to cranial nerve) (also SCM); proprioception=C3/C4
Latissimus Dorsi action
extension, adduction, medial rotation of humerus, raises body to arm climbing, forced expiration/deep inspiration
Latissimus Dorsi O&I
O: spinous processes T7-T12, thoracolumbar fascia, lumbar spinous processes, posterior medial 1/3 iliac crest, inferior 3 or 4 ribs
I: floor of bicepital (intertubercular sulcus) of humerus
Latissimus Dorsi nerve
thoracodorsal nerve (root C6 C7 C8)
Romboidius Major action
retracts scapula
Romboidius Major O&I
O: spinous processes T2-T5
I: medial border of scapula inferior to spine of scapula to the inferior angle of scapula
Romboidius Major nerve
dorsal scapular nerve aka nerve to romboids (root C5)
this is formed formed by “intersection” of trapezius, latissimus dorsi, and romboidius major= stethoscope for breath sounds.
triangle of auscultation
Romboidus Minor action
retracts scapula
Romboidus Minor O&I
O: lower nuchal ligament, spinous processes C7 T1
I: medial scapula at spine of scapula
Romboidus Minor nerve
dorsal scapular nerve (root C5)
Levator Scapulae action
elevate scapula, unilaterally rotation of head
Levator Scapulae O&I
O: transverse processes C1-C4
I: medial boarder of scapula superior to spine of scapula and inferior to superior angle of scapula
Levator Scapulae nerve
dorsal scapular nerve (C5), ventral primary rami of C3 and C4
Serratus Posterior Superior action
inspiration proprioception
Serratus Posterior Superior O&I
O: nuchal ligament, spinous processes C7-T3
I: ribs 2-4/5
Serratus Posterior Superior nerve
2nd-5th intercostal (root T2 – T5)
Serratus Posterior Inferior action
expiration proprioception
Serratus Posterior Inferior O&I
O: spinous processes T11-L2
I: ribs 9-12
Serratus Posterior Inferior nerve
anterior rami to T9 to T12 thoracic spinal nerves
Splenius Capitis action
unilateral lateral flexion and rotation to same side, bilaterally extension of neck
Splenius Capitis nerve
dorsal rami of spinal nerves C2-6
Splenius Cervicis action
unilateral lateral flexion and rotation to same side, bilaterally extension of neck
Splenius Cervicis nerve
dorsal rami of spinal nerves C5-C7
Iliocostalus action
bilaterally extend vertebral column and head; unilaterally flex vertebral column
Iliocostalus nerve
posterior rami of spinal nerves at that level
Longissimus action
bilaterally extend vertebral column and head; unilaterally flex vertebral column
Longissimus nerve
posterior rami of spinal nerves at that level
Spinalis action
bilaterally extend vertebral column and head; unilaterally flex vertebral column
Spinalis nerve
posterior rami of spinal nerves at that level
Semispinalis action
unilateral rotation, bilateral extension
Semispinalis nerve
posterior rami of spinal nerves at that level
Multifidus action
unilateral rotation, bilateral extension
Multifidus nerve
posterior rami of spinal nerves at that level
Rotatores action
unilateral rotation, bilateral extension
Rotatores nerve
posterior rami of spinal nerves at that level
Levator Costae Longus and Brevis action
Elevate ribs, may help laterally flex and rotate trunk to same side
Levator Costae Longus and Brevis nerve
posterior rami of spinal nerves at that level
Intertransversalis action
Lateral flexion of vertebra
Intertransversalis nerve
posterior rami of spinal nerves at that level
Interspinalis action
Extend spine (approximate spinous processes)
Interspinalis nerve
posterior rami of spinal nerves at that level
Rectus capitis posterior major action
Bilaterally: extend head Unilaterally: rotate face toward same side
Rectus capitis posterior major nerve
Suboccipital (dorsal ramus of C1)
Rectus capitis posterior minor action
Extend neck
Rectus capitis posterior minor nerve
Suboccipital (dorsal ramus of C1)
Obliquus capitis inferior action
Rotate face toward same side
Obliquus capitis inferior nerve
Suboccipital (dorsal ramus of C1)
Obliquus capitis superior action
Bilaterally: extend head Unilaterally: lateral flex head to same side
Obliquus capitis superior nerve
Suboccipital (dorsal ramus of C1)
why do the subocippitals become stiff in meningitis?
the meningies of posterior cranial fossa are innervated by C1, which innervates the suboccippitals
Rectus capitis posterior major O&I
O: Spinous process of C2
I: Lateral portion of inferior nuchal line
Rectus capitis posterior minor O&I
O: Posterior tubercle of C1
I: Medial portion of inferior nuchal line
Obliquus capitis inferior O&I
O: Spinous process of C2
I: Transverse process of C1
Obliquus capitis superior O&I
O: Transverse process of C1
I: Occiput between lateral portions of superior and inferior nuchal lines
of the suboccipital, there’s rectus and obliquus pairs. one does yes, the other does no movements. which?
rectus small yes movement, obliquus small no movement
Roof of the Suboccipital Triangle
Skin
Superficial and deep fascia
Trapezius
Splenius capitis Semispinalis capitis
floor of the Suboccipital Triangle
Posterior arch of atlas Atlanto occipital membrane
Vertebral artery supplies?
occipital cortex (visual), brain stem, and cerebellum (motor coordination/muscle memory).
SPONDYLOLYSIS fracture “scotty dog neck” is what part of lumbar vertebrae?
pars interarticularis
on what day does the embryonic heart beat?
day 21
what ligament inhibits “over extension” of the vertebral column? What venous plexus of the vertebral column resides anterior to this ligament?
anterior longitudinal ligament; anterior external venous plexus
what ligaments inhibits “over flexion” of the vertebral column and in the the vicinity of the posterior external venous plexus? (lumbar & thoracic, and what additional ligaments only in the thoracic)
ligamentum flavum, intraspinous ligament, intertransverse ligament; additional thoracic are radiant ligament of head of rib, interarticular ligament of head of rib, superior costotransverse ligament and lateral costotransverse ligament
what ligament(s) is (are) in the vicinity of the anterior internal venous plexus of the cervical vertebral column?
posterior longitudinal ligament and tectorial membrane
I’m unsure of the alar and transverse ligaments of atlas, as appears tectorial is between them and the plexus
what ligament resides in the area of the posterior internal venus plexus?
anterior aspect of ligamentum flavum (also posterior external venous plexus on posterior aspect)
what venous plexus(es) reside in the epidural space?
posterior AND anterior internal venus plexuses
the sympathetic chain runs what levels of the vertebral column, and is it on the posterior or anterior side?
T1 to L2, anterior
what artery joins the descending anterior spinal artery and makes it bigger?
Great anterior radicular artery of Adamkiewicz
how many spinal cord arteries and veins are there? do the veins connect to any vertebral venous plexuses?
3 spinal arteries (1 anterior/ 2 posterior) and 6 viens (3 anterior/ 3 posterior veins); no connection to venous plexuses
Interturbercular or Supracristal plane of the posterior iliac crest is the level of what vertebra?
L4
tracts of the spinal cord that end in “spinal” are?
descending and is motor
tracts of the spinal cord that are ascending and sensory begin or end with what? (begin or end is part of answer)
begin with “spino”
when injury affects upper motor, what spinal cord tract is usually affected?
corticospinal
lateral spinothalamic spinal cord tracts carry?
carries pain and temperature from opposite side
anterior spinothalmic spinal cord tracts carry?
carries touch and pressure from the opposite side
Stereognosis (what is this?) is carried by this spinal cord tract that crosses in the medulla?
fasciculus cuneatus; stereognosis is ability to discern/identify shapes/objects via touch
when a part of the brain is injured and another part takes over is called?
Neuronal placidity
Brown sequard syndrome is damage to what?
either the entire left or entire right side of the spinal cord
ALS affects what region of the spinal cord (grossly)?
cervical
Polio virus destroys what? causes what?
destroys motorneurons in ventral horn in lower spinal cord (so not usually fatal due to lower); causes lower paralysis and muscle atrophy.
what becomes the posterior longitudinal ligament at C2?
Techtorial membrane
in what anatomical part of the body are all symphysis joints found? what bones have these?
the midline; vertebrae, mandible, pubis
what is the precursor for vertebral column in development and became the nucleus pulposus?
Notochord
ZYGAPOPHYSEAL is another name for these joints?
facet joints
a poseriolateral disc prolapse affects nerve the above or below?
below
what ligament is punctured in a lumbar puncture?
ligamentum flavum
what connects spinous process to each other?
interspinous ligament
the nuchal ligament becomes what inferior to C7?
Supura spinous ligament
what ligament is responsible for protection of the spinal cord during a disc prolapse?
posterior longitudinal ligament
what ligaments prevent dislocation of ribs?
Superior AND lateral costrotransverse ligaments
intervertebral discs are named how? why?
named after the vertebra below the disc since there is no disc between C1/C2
the measurement between these 2 points determines if the birth canal is big enough?
Sacral promontory and pubic symphasis
why is nerve damage unlikely during a lumbar puncture?
cauda equina spreads when the dura mater is pierced due to pressure release.
the spinal cord extends from what to what?
From foramen magnum in skull to L1/L2
Cervical enlargement (C4 – T1) of the spinal cord gives rise to?
brachial plexus which supplies the upper limb
Lumbosacral enlargement (L2 – S3) of the spinal cord gives rise to?
lumbar & sacral plexuses which supplies the lower limb
what are the 2 primary functions of the spinal cord?
Major reflex center & pathway between body & brain
the spinal cord ends as what? where?
conus medullaris at L1/L2
what is a filamentous continuation of the piamater of the spinal cord?
Filum terminale- is about 20cm in length and begins from the tip of the conus meduallaris to coccyx
what structure is present within the dural sheath and extends to S2
Filum terminale interna
Filum terminale externa is located where?
S2 to coccyx
the spinal nerves (lumbar, sacral and coccygeal) extend downward as a bundle in the subarachnoid space known as?
Cauda equina
gray matter of the spinal cord contains?
neural cell bodies
white matter of the spinal cord contains?
axons
number of spinal cord segments & number of pairs of spinal nerves?
31 spinal cord segments & 31 pairs of spinal nerves
how many spinal cord segments & pairs of spinal nerves reside in the cervical spine?
8 segments and 8 pairs of spinal nerves
spinal nerves C1-C8 are broken into these plexuses?
cervical AND brachial plexuses
cauda equana nerves are broken into these plexuses?l
lumbar AND sacral plexuses
what resides in the subarachnoid space?
CSF and spinal cord arteries and veins
outermost covering for the spinal cord & brain is?
duramater
the space between the periosteum of the
vertebral canal and duramater is?
Epidural space
Internal venous plexus is embedded in what?
epidural fat
of the 3 coverings of the spinal cord & brain, which is sensitive to pain?
duramater
what is adherent to the spinal cord
surface?
piamater
what anchor the lateral surfaces of piamater to the dural sac?
Denticulate ligaments (21 pairs, T12 – L1)
in a lumbar puncture, a needle is inserted into the subarachnoid space between arches of? why is there no risk of spinal cord injury?
L3 & L4; spinal cord ends at L1/L2
the size of what area of the spinal cord depends on the area innervated?
ventral horn
what are the possible directions of the sympathetic chain?
Go up the chain
Go down the chain
Go through the chain to different ganglia
Go through to organ
semispinalis capitis has what nerve going through it, responsible for severe tension headaches?
Great occipital nerve
Atlanto-Occipital Joint is what type of joint?
SYNOVIAL, CONDYLOID
ligamentum flavum extends from lamina to lamina of vertebrae except C1/C2. what is the comparable ligament from C1 to skull and C2 to C1? what artery goes through this structure at what level?
posterior atlantooccipital membrane; vertebral artery between C1 and skll
what ligaments connect C2 to the skull? (on what aspect of what structure of C2)
apical ligament of dens connects the superior aspect of dens to skull, alar ligament connects lateral aspects of dens to skull
what ligament prevents the odontoid process from moving posteriorly into the spinal cord? what is the name of this joint?
transverse ligament of atlas; atlantoaxial joint
what structure is contiguous with the transverse ligament of atlas and connects that ligament to C2 body?
inferior longitudinal band of cruciate ligament of atlas
what is the space called where spinal nerves exit the vertebral column created by what?
intervertebral foramen; the inferior vertebral notch of the superior vertebra, and the superior notch of the inferior vertebra
what is the space between the transverse process and body of a vertebra?
pedicle
what is the depression between the spinous process and the transverse process of a vertebra?
lamina
what are the regions of an intervertebral disc?
anulus figrosus, nucleus pulposus
what is the characteristic posture of an person with a lumbar disc contralateral prolapse?
lateral flexion to the unaffected side
