Back, Lymphatics and Nerves Flashcards
What is A?
Lamina
What is B?
Transverse process
What is C?
Pedicle
What is D?
Body
What is E?
Vertebral column
What is F?
Superior facet
What is G?
Spinous process
What is A?
Vertebral notch
What is the most anterior and posterior structures?
Anterior is D (body)
Posterior is G (spinous process)
What is found inside the intervertebral foramen (vertebral canal, E)?
Spinal cord
What joint occurs between the adjacent bodies of vertebrae (D)?
Secondary cartilaginous
What joint is found between the articular facet of adjacent vertebrae?
Synovial plane
Where does a vertebrae articulate onto a rib?
Tubercle
Where do adjacent vertebrae articulate?
Body and facets
What are the different kinds of vertebrae of the spinal column?
Cervical
Thoracic
Lumbar
Sacral
Coccygael
How many of each vertebrae are there?
7 cervical
12 tharacic
5 lumbar
5 sacral
1 coccygael
What is the name of C1?
Atlas
What is the name of C2?
Axis
What is the name of C7?
Prominant vertebrae
What is the atlas and axis?
First and second vertebrae (C1 and C2)
What distinguishes cervical vertebrae from the rest?
Transverse foramen present
Smallest
What distunguishes thoracic vertebrae from the rest?
Long sharp, spinous process
Body is heart shaped
What distinguishes lumbar vertebrae from the rest?
Largest body
Big, blunt spinous process
What is A?
Intervertebral disk
What is B?
Articular facet
What joints do articulating vertebral disks form?
Secondary cartiliginous
What joints do superior and inferior facets form?
Synovial plane
What is the intervertebral disk composed of?
Analus fibrosis
Nucleus puposis
What is A?
Dura mater
What is B?
Analus fibrosis
What is C?
Nucleus puposis
What is D?
Spinal cord
What does this diagram show?
Intervertebral disk
What kind of cartilage is found inside the intervertebral disk?
Hyeline and fibrocartilage (secondary cartiliginous)
What is ‘slipped disk’?
Nucleus puplosis protrudes (herniate) through the annalus fibrosis
What does a herniates disk result in?
Compressed nerves
Which direction would the nucleus pulposis have to protrude to compress a spinal nerve?
Posterolateral
What are some of the ligaments present in the vertebral column?
Ligamentum flavum
Anterior longitudinal ligament
Posterior longitudinal ligament
Supraspinous ligament
Interspinous ligaments
What does the ligamentum flavin connect?
Lamina
What does the anterior longitudinal ligament connect?
Bodies
What does the posterior longitudinal ligament connect?
Bodies
What does the supraspinous ligament connect?
Spinous process
What does the interspinous ligament connect?
Adjacent spinous processes
What connects adjacent spinous processes?
Interspinous ligaments
What connects spinous processes?
Supraspinous ligaments
What connects bodies?
Anterior longitudinal ligament
Posterior longitudinal ligament
What connects lamina?
Ligamentum flavum
What is A?
Supraspinous ligament
What is B?
Transverse process
What is C?
Sectioned spinous process
What is D?
Ligamentum flavum
What is E?
Interspinous ligament
What is F?
Inferior articular process
What is G?
Sectioned body of vertebrae
What is H?
Nucleus pulposus
What is I?
Analus fibrosus
What is J?
Posterior longitudinal ligament
What is K?
Intervertebral foramen
What is L?
Anterior longitudinal ligament
What is M?
Intervertebral disk
How many curvatures of the spine are there?
4
Which of the curvatures of the spine are secondary?
1 and 3
What is the primary curvature of the spine?
The curves present from being a feotus (2 and 4)
What developmental changes occur in the neonate to produce the secondary spinal curvatures?
Cervical curvature from babies head looking up
Thoracic curvature for crawling
What is A?
Normal
What is B?
Lordosis
What is C?
Kyphosis
What is D?
Scoliosis
What is the type of movement at each vertebral column dependant of?
Orientation of the vertebral articular facets in that region of the column
In what plane is movement permitted in cervical vertebrae?
Transverse plane
In what plane is movement permitted in thoracic vertebrae?
Coronal
In what plane is movement permitted in lumbar vertebrae?
Sagittal
What is the main movement permitted in the cervical region?
Flexion/extension
Lateral flexion/rotation
What is the main movement permitted in the thoracic region?
Lateral flexion/rotation
What is the main movement permitted in the lumbar region?
Flexion/extension
What do the posterior vertebral muscles do to the spine?
Extend
What do the anterior vertebral muscles do to the spine?
Flex
What is bilaterally?
Muscles on both the left and right side contract together
What is unilaterally?
Muscles on one side contracts but not the other
What happens to the spine when muscles act unilaterally?
Rotation and lateral flexion
What is the posterior muscle that acts on the spine?
Erector spinae
What are the anterior muscles that act on the spine?
Obliques
Transverse abdominis
Rectus abdominis
What is A?
Obliques
What is B?
Transverse abdominis
What is C?
Rectus abdominis
What is A?
Erector spinae
What does trunk flexors and extendors contrasting simutaneously do?
Increase intra-abdominal pressure
What are 3 body functions that are facilitated by trunk flexors and extendors acting simutaneously, increasing intra-abdominal pressure?
Sneezing
Deficating
Vomiting
What are some surface anatomy of the back?
Vertebra prominens (at C7)
Spine of scapula (at T3)
Lateral margin of acromin
Greater tubercle of humerus
Inferior angle of scapula (at T7)
Summit of iliac crest (at L4)
What vertebrae is the vertebra prominens found at?
C7
What vertebrae is the spine of scapula found at?
T3
What vertebrae is the inferior angle of scapula found at?
T7
What vertebrae is the summit of iliac crest found at?
L4
What is L4 also known as?
Intercostal plane
What is A?
Spine of scapula
What is B?
Lateral margin of acromion
What is C?
Greater tubercle of humerus
What is D?
Inferior angle of scapula
What is E?
Summit of iliac crest
What is F?
Vertebra prominens
How does the orientation of the spinous process and interspinous distance differ between thoracic and lumbar spinal regions?
Lumbar has larger gaps sinces the processes are horizontal to each other whereas in thoracic they are angled downwards, so have a smaller gap
What is A?
Vertebrae
What is B?
Spinal cord
What is C?
Cerebrospinal fluid
What is D?
Skin
What is performed to obtain a sample of cerebrospinal fluid?
Lumbar puncture
Where is the needle for a lumbar puncture inserted in an adult?
Between L3 and L4
Where is the needle inserted for a lumbar puncture for a child?
Between L4 and L5
Why is a needle inserted between L3 and L4 to obtain a cerebrospinal fluid sample?
Won’t hit spinal cord
Large gaps between vertebrae
Why do patients flex their spine during a lumbar puncture?
Increases space between the spinous processes
In what region is this cross section?
Cervical
In what region is this cross section?
Thoracic
In what region is this cross section?
Lumbar
What is A?
Intervertebral disk
What is B?
Facet
What is C?
Spinous process
What region is this CT of and how do you know?
Cervical
Transverse foramen
What region is this CT of and how do you know?
Thoracic
Ribs are attached
What region is this CT of and how do you know?
Lumbar
Big vertebral body
What are MRIs useful for?
Soft tissues such as muscles and nerves
What are CTs useful for?
Bony structures
What is A?
Spinal cord
What is B?
Intervertebral disk
What is C?
Spinous process
What is D?
Herniated ‘slipped’ disk
Where does the spinal cord terminate in adults?
L1/L2
Where does the spinal cord terminate in children?
L3
What is the purpose of the lymphatic system?
Return lymph to circulation
What are some major groups of lymph nodes and their location?
Axillary (in axilla)
Superficial and deep inguinal (inguinal region)
Pectoral (around the pectoralis major muscle)
Tracheobronchial (at bifurcation of trachea)
Lumbar and pelvic (around root of arteries in abdomen and pelvis)
Superficial and deep cervical (neck)
What is A?
Incoming lymph vessel
What is B?
Paracortex
What is C?
Cortex
What is D?
Outgoing lymph vessel
What is E?
Artery
What is F?
Vein
What is G?
Medulla
What is H?
Follicle
What is I?
Germinal centre
What is A?
Capsule
What is B?
Cortex
What is C?
Deep cortex
What is D?
Medulla
What is LN?
Lymphatic node
What is T?
Trabecula
What is the main type of cell found in a lymph node?
Leukocyte (white blood cell)
What is the function of a lymph node?
Filter lymph and immune system
What process occurs inside a lymphatic nodule?
Differentiation of B cells into plasma cells
What is meant by the term sentinel node?
First few nodes into which a tumour drains
What is after the major lymph nodes?
Lymphatic ducts
What are the 2 lymphatic ducts?
Thoracic duct
Right lymphatic duct
What is A?
Azygos vein
What is B?
Thoracic aorta
What does area A drain into?
Right lymphatic duct
What does area B drain into?
Thoracic duct
What is A?
Cisterna chyli
What is B?
Thoracic duct
What is C?
Subclavian vein
Where does the thoracic duct commence?
L1 as the cisterna chyli
What does the thoracic duct commence at L1 as?
Cisterna chyli
Where does the thoracic duct lie?
On the posterior thoracic wall between the azygos vein and the descending aorta
What does the thoracic duct drain into?
Medial end of the left subclavian vein
Where does the thoracic duct cross the vertebral column to the left side?
T4
What does the spinal cord from at its distal end?
Conus medullaris
What does the spinal cord terminate as?
Filum terminale
What does the spinal cord show at its proximal and distal ends and why?
Enlargment due to the grey matter necessary to supply the limbs
What spinal nerves form the cauda equina?
L2-Cc1
From which spinal cord structure does the cauda equina emerge?
Conus medullaris
What is the function of the filum terminale?
Longitudinal support to spinal cord
What region of the spinal cord is most often injured?
Thoracic due to the canal being small
What makes up the grey matter of the spinal cord?
Cell body
What makes up the white matter of the spinal cord?
Axon (myelinated)
What is A?
Posterior (dorsal) horn
What is B?
Lateral horn
What is C?
Anterior (ventral) horn
What is D?
Anterior (ventral) columns
What is E?
Central canal
What is F?
Lateral columns
What is G?
Posterior (dorsal columns)
Where is the white matter and the grey matter?
Grey matter on the inside and white on the outside
What nerve impulses are associated with the anterior horn cells?
Motor
What nerve impulses are associated with the posterior horn cells?
Sensory
What nerve impulses are associated with the lateral horn cells?
Autonomic
What are the 3 layers of the meninges?
Dura mater
Arachnoid mater
Pia mater
What is the function of the meninges?
Protect the CNS
What is A?
Spinal cord
What is B?
Dorsal root
What is C?
Denticulate ligament
What is D?
Pia mater
What is E?
Dura mater
What is F?
Arachnoid
Where does the dura mater descent to?
S3
Where does the arachnoid mater descend?
S3
Where is the subarachnoid space located?
Between the pia mater and arachnoid mater
What is in the subanarachnoid space?
Cerebrospinal fluid
Where is the spinal epidural space found?
Between the dura mater and the periosteum covering the vertebral bodies
Where is the subdural space found?
Between the dura mater and the arachnoid mater
What supplies the spinal cord with blood?
Aorta and its branches
What drains the blood from the spinal cord?
Vertebral venous plexus
Where is the vertebral venous plexus found?
Epidural space (in the fatty tissue between the dura mater and the vertebrae)
What do the veins of the vertebral venous plexus not have?
Valves
How many pairs of spinal nerves are there?
31
What do the autonomic fibres of the spinal nerve supply?
Organs, involuntary movement and glands
What do the somatic fibres of the spinal nerve supply?
Voluntary muscles and skeletal structures
Where are the lateral horns located between?
T1-L2
What is A?
Dorsal root ganglion
What is B?
Dorsal ramus
What is C?
Ventral ramus
What is D?
Anterior root
What is E?
Anterior horn
What is F?
Lateral horn
What is G?
Posterior horn
What is H?
Posterior root
Where do the somatic nerves originate in the spinal cord?
Anterior/posterior horns
Where do the autonomic nerves originiate in the spinal cord?
Lateral horns
Which of somatic and autonomic nerves stop at a ganglia before the target?
Autonomic
From what spinal levels do somatic nerves arise from?
C1 - Cc1
From what spinal levels do sympathetic nerves arise from?
T1 - L2/3
What is A?
Dorsal root
What is B?
Dorsal root ganglion
What is C?
Sympathetic chain
What is D?
Spinal nerve
What is E?
Grey ramus
What is F?
White ramus
What is G?
To effector
What is H?
Ventral root
Does the grey or white ramus come first?
White ramus (F)
What nerves supplies abdominal organs?
Splanchnic nerves
What is A (supplying abdominal organs)?
Splanchnic nerve
What are the sympathetic chains also refered to as?
Prevertebral ganglia
How do sympathic nerves get to structures outwidth where they emerge from (T1-L2)?
Use the sympathetic chain
Where does the sympathetic chain extend from and to?
C1 - between S5 and Cc1
What do white ramus carry?
Sympathetic fibres from the spinal nerve to the sympathetic ganglia
What do grey ramus carry?
Sympathetic fibres from the sympathetic ganglion back to the ventral ramus of the spinal nerve
Which of white and grey ramus is more myelinated?
White ramus
Where do the 3 thoracic splanchnic nerves range from?
T6 - T12
What are the 3 thoracic splanchnic nerves?
Coeliac
Superior
Inferior mesenteric
Where are the thoracic splanchnic nerves visible?
Emerge from thoracic sympathetic chain, going to the diaphragm and entering the abdomen
Where are parasympathetic nerves found?
Cranial III, VII, IX and X
S2 - S4
Where do parasympathetic nerves arise and emerge?
Arise in the conus medullaris, descending in the cauda equina and emerging between S2 and S4
What are autonomic nerve plexuses and how are they named?
Extends along major arteries, being named for its underlying artery
What are the large autonomic nerve plexuses?
Cardiac
Pulmonary
Coeliac
Superior hypgastric
Inferior hypogastric (pelvic)
What are the pelvic splanchnic nerves and where do they originate?
Parasympathetic
Originate in S2 - S4
What do pelvic parasympathetic splanchnic nerves run through?
Pelvic plexus and travel to their target organs
What is the pelvic plexus an example of?
Mixed autonomic plexus (both sympathetic and parasympathetic fibres)
How many cervical vertebrae and nerves are there?
7 vertebrae
8 nerves
Why is there 8 cervical nerves but 7 vertebrae?
First 7 spinal nerves emerge above vertebrae they are named after, the rest emerge below
