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SPINAL CORD > BACK, SPINE AND SPINAL CORD > Flashcards

BACK, SPINE AND SPINAL CORD Flashcards

1
Q

anatomical relations of the back

A

superiorly - the neck
inferiorly - gluteal muscles
UL & LL

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2
Q

The back consists of:

A

mainly skeletal muscles and bones

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3
Q

functions of the back

A
  • maintenance of posture
  • movement of limbs and trunk
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4
Q

surface anatomy of the back - bony landmarks

A
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5
Q

surface anatomy of the back - muscles

A
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6
Q

Extrinsic back muscles

A
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7
Q

function of extrinsic back muscles

A
  • attach back to pectoral girdle
  • move UL
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8
Q

innervation of extrinsic muscles

A

Anterior rami of cervical SN except trapezius which is supplied by the spinal accessory nerve (CN XI)

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9
Q

intrinsic back muscles:

A

superficial group - erector spinae (spinals, longissimus, iliocostal)
deep group - transversospinalis

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10
Q

function of intrinsic back muscles

A

move the spine
maintain back posture

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11
Q

name the following muscles and which group of muscles do they belong to?

A

(L to R) iliocostalis, longissimus, spinalis
belongs to superficial intrinsic muscle group Erector spinae

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12
Q

location of transversospinalis and attachment points of its individual fibres:

A

location: within the grooves between spinous and transverse processes

attachment points
1. vertebrae to skull
2. vertebrae to a rib
3. vertebrae to another vertebrae
4. vertebrae to the sacrum

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13
Q

Innervation of intrinsic back muscles

A

segmental nerve supply from the posterior rami of the corresponding SN, i.e, if it is a cervical segment then it would be supplied by the posterior rami of the cervical SN and so on.

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14
Q

label

A
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15
Q

movements of the spine and the muscles responsible for them

A

flexion - Psoas major and rectus abdomens
extension - bilateral contraction of erector spinae
lateral flexion - unilateral contraction of erector spinae

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16
Q

number of vertebrae

A

33 total
7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccygeal (fused)

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17
Q

functions of the vertebral column

A

supports head and trunk when upright
protect the SC and the SN
allows movements of the head and neck and trunk

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18
Q

curvatures of the spine and specify whether they are primary or secondary

A

cervical lordosis (primary)
thoracic kyphosis (secondary)
lumbar lordosis (primary)
Sacral Kyohosis (secondary)

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19
Q

lumbar lordosis increases in certain conditions. name a few conditions and explain the reason.

A

pregnancy
obesity
certain postures
bc of increased weight bearing

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20
Q

abnormal conditions related to curvatures of the spine

A
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21
Q

important features of a typical vertebrae and their role

A

spinous process x 1 (for ligament and muscle attachment)
transverse process x 2 (ligament, muscle and rib articulation)
vertebral arch (pedicle x 2 + lamina x2) (protects te spinal cord)
superior articulate processes x 2 (articulation with adjacent vertebrae)
inferior articulate processes x 2 (articulation with adjacent vertebrae)
vertebral foramen x 1 (contains the spinal cord)
vertebral body x 1 (weight bearing region)

22
Q

label and give the role

A

Iv foramen - contains spinal nerves
facet joints - articulation between adjacent vertebrae, can be affected by arthritis
IV discs - articulation between adjacent vertebral bodies
has inner nucleus pulpous and outer annular fibrosus, can herniate

23
Q

IV discs: location, structure and function

A

location: between adjacent discs, except between C1 and C2 and the fused sacral and coccygeal segments

structure and function: inner soft nucleus pulpous (upto 90% water in Newborns, degenerates and gets gradually replaced by hard outer annulus fibrosus with age) - flexibility and protection
outer hard annulus fibrosus - provide string bond

each disc allows very small movements, but summation produces larger movement

24
Q

ligaments of the SC and their attachments/function

A

Ligamentum flavum: short, connects adjecent lamina

Posterior longitudinal ligament: narrow, weak, weaker support to the IV discs, prevent hyper flexion of the spine

Anterior longitudinal ligament : broad and strong, stronger support to IV discs, prevents hyper extension of spine

supraspinous ligaments: strong and fibrous, connects the tips of the spinous processes

interspinous ligaments: weak, membraneous, connects adjecent spinous processes

25
Q

typical features of cervical vertebrae

A

transverse foramen
bifid spinous process
triangular shaped vertebral foramen

26
Q

Atlas

A

C1
no body/spinous process
anterior and posterior arch present

27
Q

axis

A

C2
has an odontoid process
projects superiorly from body

28
Q

C7

A

vertebral prominens
1st palpable spinous process in 70% people

29
Q

Atlanto-occipital joint - articulation, type of joint and movements

A

articulation: occipital condyles superiorly
superior articular facets of atlas inferiorly
type of joint: synovial joint with loose capsule
movements: flexion and extension of the neck
a little lateral flexion and rotation pf the neck

30
Q

Atlanto - Axial joint: articulation, type of joint and movements

A

articulation: 3 articulations, 2 between superior articular processes of axis and inferior articular facets of atlas, 1 between anterior arch of atlas and the odontoid process of axis.
type of joint: all 3 articulations are synovial
movements: rotation

31
Q

Label

A
32
Q

What abnormality is shown by the white arrow?

A

Dislocation?

33
Q

which vertebrae(s) is/are involved

A

C6/C7

34
Q

Which other major structure may be damaged as a result of this injury?

A

SC/C7 SN?

35
Q

Can you think of a reason why the major structure may escape without being damaged in instances of slight dislocation?

A

IV foramen are larger around the cervical region?

36
Q

identify the different stages of cervical dislocation as shown in the picture and give descriptions for each

A

(A) Stage I - flexion sprain
(B) Stage II - anterior subluxation, 25% translation
(C) Stage III - 50% translation
(D) Stage IV - complete dislocation

37
Q

Label

A
38
Q

structure and course of the spinal cord

A

begins at foramen magna
continuous with MO
ends at upper border of L1/L2
as conus medullaris
then continue as film terminale
cauda equina

39
Q

Label

A
40
Q

meninges of the SC

A

pia
arachnoid
dura

41
Q

site of Spinal and epidural

A

between L3/L4/L5: spinal cord ends at L1/L2 but meninges continue until S2 –> SAS

42
Q

Epidural anaesthetic: needle passes through:

A

skin
superficial fascia
supraspinatous ligament
interspinatous ligament
ligamentum flavum
Epidural Space

43
Q

spinal anaesthesia: needle passes through

A

skin
superficial fascia
supraspinous ligament
interspinous ligament
ligamnetum flavum
Epidural fat
Dura
Arachnoid
SAS

44
Q

contraindication of Lumbar puncture

A

raised ICP

45
Q

epidural space contents

A

epidural fat and venous plexus

46
Q

clinical consequence of epidural venous plexus injury

A

epidural hematoma

47
Q

caudal anaesthesia

A

local anaesthetic
injected to sacral hiatus
anaesthetise the sacral spinal nerve root and caudal equine

48
Q

Laminectomy: purpose

A

to access spinal canal, posterior exposure of the SC and/or spinal roots
relieve pressure open SC/nerve roots

49
Q

conditions that cause increase pressure on SC/ nerve roots

A

tumour
herniated disc
bone hypertrophy

50
Q

Laminectomy: procedure

A

removal of one or more spinous processes and the adjacent lamina

51
Q

layers when performing laminectomy

A

skin
superficial fascia
aponeurotic origin of trapezius/thoracolumbar fascia of latissimus dorsi
intrinsic muscles: erector spinae and transversospinalis
supraspinatous, interspinatous ligs and L. flavum
Lamina
Spinous processes

SPINAL CORD (5 decks)

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