Back Notes Flashcards
Vertebral body
Massive anterior part of bone
Vertebral arch
Posterior to vertebral bod and consists of two pedicles and laminae
Pedicles
Short processes projecting posteriorly from vertebral body
Laminae (Singular lamina)
Broad flat plates that connect to pedicles
Vertebral foramen (pleural foramina)
Formed by vertebral arch and posterior part of vertebral body
Vertebral canal
Formed by successive vertebral foramina
Vertebral notches
Indentations superior and inferior to each pedicle
Intervertebral foramina (singular foramen)
Formed by superior and inferior vertebral notches of adjacent vertebrae and their IV discs
Spinous Process (SP)
Posterior projection from vertebral arch at junction of laminae
Transverse process (TP)
Bilateral posterolateral projections from junctions of pedicles and laminae
Articular processes (superior and inferior)
Bilateral projections also arising from junctions of pedicles and lamina
Supraspinous Ligaments
Connects tips of SPs from C7 to sacrum
Merges Superiorly with Nuchal Ligament
Extrinsic
Divided into superficial and intermediate layers
Produce and control limb and respiratory movements respectively
Intrinsic
- Deep back muscles
- Divided into superficial, intermediate, deep and minor deep layers
- Specifically act on vertebral column
- Produces its movements and maintain posture
Thoracolumbar fascia
- fascia of thoracic and lumbar region
- forms a thin covering for intrinsic back mm. In thoracic regions
- forms a thick covering for mm. In lumbar region
Trapezius
Divided into 3 parts
Superior
Middle
Inferior
O- Origin: Medial 1/3 superior nuchal line, external occipital protuberance, nuchal l., SPs of C7-T12
Insertion: Lateral 1/3 clavicle, acromion and spine of scapula
Action:
Superior – elevation of scapula
Middle – retraction of scapula Inferior – depression of scapula
Superior and inferior fibers together – upward rotation of scapula
iNnervation: Motor - CN XI (spinal accessory n.); Sensory – C3, C4
Blood Supply: Transverse cervical a.
Excessive Lordosis & Causes
- “Sway Back”
- more common in lumbar region (increased extension)
Causes
- Weakened trunk muscles
- Obesity
- Muscles imbalances (lower cross syndrome)
Excessive Kyphosis & Causes
- “Hunchback”
- Most common in thoracic region
- Increased posterior curve
Causes
- Erosion (from osteoporosis- increases ant/post diameter of thorax)
- Posture
- Muscles imbalances (upper cross syndrome)
Scoliosis
- Abnormal lateral curvature & rotation of spine
- SP’s rotate toward curvature
- Ribs protrude on side of increased convexity
Types of scoliosis
1) Structural (idiopathic 80%)
2) Myopathic (asymmetrical muscle weakness- ex: Polio)
3) Functional (different limb length)
4) Habit (poor posture)
Triangle of Auscultation Borders
Lateral Border: Medial border of scap
Inferior Border: Latissimus dorsi
Medial Border: Trapezius
Floor: erector spinae & often rhomboid major
Good place to hear lungs; get patient to cross arms & lean forward which makes 6th & 7th ribs & 6th intercostal space subcutaneous
Lumbar Triangle & Borders
Lateral border: External Oblique
Medial border: Latissimus dorsi
Inferior border: iliac crest
Floor: Internal Oblique
Herniations occasionally occur here
Suboccipital Triangle & Borders
Superomedial Border: Rectus Capitis Posterior Major
Superolateral Border: Obliquus Capitis Superior
Inferolateral Border: Obliquus Capitis Inferior
Floor: Posterior Atlanto-occipital membrane & posterior arch of C1
Roof: Semispinalis Capitis
Contents
- Vertebral Artery
- Suboccipital Nerve
Dorsal Rami of Spinal Nerve
- Supplies the skin, intrinsic back muscles & the Z-joints
- From mixed spinal Nerve
- 2 unique dorsal rami = C1 & C2
What is unique about C1 when referring to dorsal rami?
- Larger dorsal Ramus
- Exits between occiput & C1 vertebrae
- Called Suboccipital n.
What is unique about C2 when referring to dorsal rami?
- Larger Dorsal Ramus
- Exits between C1 & C2 vertebrae
- Medial division of this Dorsla Ramus is called GREATER OCCIPITAL NERVE
Spinal Accessory Nerve
CN X1
- Supplies traps
- Travels with transverse cervical artery
Dorsal Scapular Nerve
- Branch of ventral Ramus of C5
- Supplies lavatory scapulae & rhomboids
- Travels with dorsal scapular artery