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Anatomy > Back (VC and SC) > Flashcards

Back (VC and SC) Flashcards

1
Q

How long is the adult vertebral column?

A

72-75 inches

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2
Q

What does the back consist of?

A

Posterior Trunk, SC, VC

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3
Q

True/False: The back is the region to which the neck, head, and limbs are attached.

A

True

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4
Q

What six things does the back include?

A
  1. skin and subcutaneous tissue 2. Muscles 3. VC (w/ associated structures) 4. Ribs 5. SC and meninges 6. Segmental nerves and vessels
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5
Q

What protects the SC and nerves?

A

Vertebral Column

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6
Q

What are the other three major functions of the VC?

A

Support weight, provide axis, and posture & locomotion

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7
Q

How many vertebrae are there in total?

A

33

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8
Q

How many cervical vertebrae are there?

A

7

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9
Q

How many thoracic vertebrae are there?

A

12

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10
Q

How many lumbar vertebrae are there?

A

5

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11
Q

How many sacral vertebrae are there?

A

5

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12
Q

How many coccygeal vertebrae are there?

A

4

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13
Q

What are the sacral vertebrae fused to form?

A

Sacrum

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14
Q

What are the coccygeal vertebrae fused to form?

A

Coccyx

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15
Q

At what age does fusing of the coccygeal vertebrae occur?

A

approx after age 30

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16
Q

What is it called when L5 abnormally fuses to the sacrum?

A

Sacralization

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17
Q

What is it called when S1 is not fused to the sacrum, but instead the Lumbar vertebrae?

A

Lumbarization

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18
Q

What type of joints primarily make up the VC?

A

Synovial Zygapophysial (facet) joints

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19
Q

What do the zygapophysial joints function to do?

A

Facilitate and control flexibility

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20
Q

What three components make up a typical vertebra?

A

Body, Arch, and 7 processes

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21
Q

Name three characteristics of the vertebral body.

A

More massive, cylindrical anterior part. Size increases as VC decends, and it is primarily made of spongy bone enclosed by a thing external layer of compact bone

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22
Q

What is most the vertebral body covered in?

A

Discs of Hyaline cartilage

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23
Q

What are the two parts of the vertebral arch?

A

Two pedicles and laminae

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24
Q

What is formed between the arch and the body?

A

Vertical Foramen

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25
Q

What structure is indicated by an indentation in lateral views above and below the pedicles?

A

Vertical Notch

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26
Q

What are the three types of processes found on a vertebrae?

A

Spinous, Tranverse, and Articular

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27
Q

How many spinous processes are on a given vertebrae?

A

one

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28
Q

How many transverse processes are on a given vertebrae?

A

Two, one on each side from junction pedicle and laminae

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29
Q

How many articular processes are on a given vertebrae?

A

four, two superior and two inferior

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30
Q

What structure does each articular process bear on?

A

Articular surface (facet)

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31
Q

What structure provides the attachment for epaxial muscles and serves as levers?

A

The Vertebral Arch

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32
Q

What type of vertebrae is formed of the skeleton of the neck?

A

Cervical

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33
Q

What structure is present in cervical vertebrae in the transverse processes?

A

Foramen Transversarium

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34
Q

What is the name of the C1 vertebrae?

A

Atlas

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35
Q

What is the name of the C2 vertebrae?

A

Axis

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36
Q

Vertebral arteries pass through all cervical vertebrae except for which one?

A

c7, only small accessory veins

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37
Q

Where on the cervical vertebrae do the anterior ramus of nerves course?

A

Grooves on the transverse processes between the tubercles

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38
Q

What paired structure is specific to the atlas to which the transverse processes arise from?

A

Lateral masses

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39
Q

What special structure does the axis have that allows promotes better articulation?

A

Dens of axis

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40
Q

T/F: The dens of axis is a tubercle.

A

False. it is a protuberance (projection)

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41
Q

What type of vertebrae provide the attachment for the ribs?

A

Thoracic

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42
Q

What special type of facets do thoracic vertebrae have?

A

Costal facets

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43
Q

What is unique about the shape of the spinous processes on thoracic vertebrae?

A

Extra long and thick spiky

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44
Q

What type(s) of movements do the thoracic vertebrae allow?

A

Rotation and some Lateral Flexion

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45
Q

What type of movement do the cervical vertebrae allow?

A

Flexion, Extension, LFlexion, Rotation

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46
Q

True/False: T7-12 are missing the costal facets restricting movement to only flexion and extension.

A

True

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47
Q

Describe the rule of “threes” for spinous processes of thoracic vertebrae.

A

T1-T3 are at the same level. T4-6 are half a level below. T7-10 are one whole level below. T11 is a half level below. T12 is at the same level.

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48
Q

Which vertebrae have massive bodies for weight bearing?

A

Lumbar vertebrae

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49
Q

What type of process is special to lumbar vertebrae?

A

Mamillary processes

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50
Q

What do the the transverse processes allow attachment of?

A

Intertransversarii muscles

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51
Q

What do the mamillary processes allow attachment of?

A

Multifidus and intertransversarii muscles

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52
Q

What is special about the sacral vertebrae?

A

They are fused

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53
Q

What are the two “functions” of the sacrum?

A

Provides strength and stability to pelvis AND transmits the body weight to pelvic girdle

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54
Q

Where does the vertebral canal end?

A

Approximately L1

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55
Q

What is formed beyond L1 containing a bundle of spinal nerve roots?

A

Cauda Equina

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56
Q

What structure special to the posterior sacral vertebrae surfaces provide the exit of rami of spinal nerves.

A

Sacral Foramina

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57
Q

How many pairs of sacral foramina are there?

A

4

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58
Q

Where is the base and apex relative to the sacral/coccygeal vertebrae?

A

Base - top. Apex - bottom.

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59
Q

At what age does fusion of the sacrum begin?

A

~20

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60
Q

In which gender is the sacrum typically wider in/?

A

Females

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61
Q

What structure forms from the absense of laminae and process of L5?

A

Sacral hiatus

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62
Q

What structure represents the inferior articular processes of S5? (projects on each side of sacrum)

A

Sacral Cornea

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63
Q

What forms in the middle of the sacrum starting at the base?

A

Sacral canal

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64
Q

What structures does the coccyx provide attachment for?

A

Gluteus maximus, coccygeus muscles, anococcygeal ligament

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65
Q

When does ossification begin?

A

Embryonic period

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66
Q

From what does ossification begin?

A

Mesenchymal condensations around notochords

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67
Q

What forms next from the mesenchymal bone models?

A

Cartilaginous Vertebrae

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68
Q

When does ossification typically begin?

A

End of embryonic period (8th week)

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69
Q

What are the three primary ossification centers?

A

Endochondral Centrum and two pericondral centers

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70
Q

Which ossification centers constitutes the majority of the VC body?

A

Endochondral

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71
Q

Where are the perichondral centers?

A

One in each half of the neural arch

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72
Q

Typically, at birth what does the VC consist of?

A

3 bony parts united by hyaline cartilage

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73
Q

At what age does fusing of neural arches typically begin and finish?

A

3,6

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74
Q

Where are the five secondary ossification centers that develop during puberty?

A
  1. tip of spinous process 2. tip of each transverse process 3. two annular epiphyses
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75
Q

When does secondary ossification usually unite by?

A

25

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76
Q

What can developmental errors result in?

A

One less or one extra vertebrae

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77
Q

What is it called when vertebral foramen narrows?

A

Lumbar Spinal Stenosis

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78
Q

What abnormality can form from C7 transverse process enlarging?

A

Cervical Rib

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79
Q

What is hemisacralization?

A

L5 fused with sacrum

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80
Q

What is it called when epiphyses fail to fuse?

A

Spina bifida

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81
Q

What type of joints are at the vertebral bodies?

A

Symphyses

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82
Q

What two things connect the articulating surfaces of adjacent vertebrae?

A

IV discs and ligaments

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83
Q

How much of the length of VC do IV discs account for?

A

20-25%

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84
Q

What secondary function do IV disks provide?

A

Shock absorbers

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85
Q

Between which two vertebrae is no IV disc present?

A

c1 and c2

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86
Q

What is the gelatinous middle of an IV disk?

A

Nucleus pulposus

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87
Q

What surrounds the nucleus pulposus?

A

Annulus fibrosus

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88
Q

What develops between the unci of the bodies of C3/C4 and C6/C7?

A

Clefts (unconvertebral joints)

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89
Q

Where are these clefts located?

A

Lateral and posterolateral margins of IV discs

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90
Q

What abnormality can develop at these clefts?

A

Bone spurs

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91
Q

What ligament connects and covers the anterolateral aspects of vertebral bodies and IV discs?

A

Anterior Longitudinal Ligament

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92
Q

What motion is prevented because of this ligament?

A

Hyperextension

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93
Q

What movement is limited by all other ligaments?

A

Flexion

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94
Q

What ligament runs within the VC along the posterior vertebral bodies?

A

Posterior Longitudinal Ligament

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95
Q

What benefit does the PLL have for the nucleus pulposis?

A

Redirects herniation

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96
Q

What type of nerve endings innervate the PLL?

A

Nociceptive (pain)

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97
Q

What type of joint are at the vertebral arches between the superior and inferior processes?

A

Zygapophysial (facet) joints

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98
Q

What type of joint are these facet joints?

A

Plane synovial

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99
Q

What movement do these joints permit?

A

Gliding

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100
Q

What rami innervates the facet joints? how many nerves supply each articular branch?

A

Posterior, 2

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101
Q

What ligament joins adjacent laminae?

A

Ligamenta flava

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102
Q

What do ligamenta flava function to provide?

A

Resist separation of laminae, limit abrupt flexion of VC, preserve the normal curvatures and promote separating

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103
Q

What ligaments connect adjoining spinous processes?

A

Interspinous Ligaments

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104
Q

What ligaments connect the tips of spinous processes from C7 to the sacrum?

A

Supraspinous ligaments

105
Q

What ligament does the supraspinous ligaments merge with?

A

Nuchal Ligament

106
Q

What is the nuchal ligament?

A

Thickened fibroelastic tissue extends from exterior occipital protuberance and posterior border of foramen magnum to the spinous processes.

107
Q

What ligament connects adjacent transverse processes?

A

Intertransverse ligament

108
Q

What are the two craniovertebral joints?

A

Atlanto-occiptal and atlanto-axial

109
Q

What is the Atlanto-Occipital Joint?

A

Atlas and occipital bone (condyles)

110
Q

What type of joint is the Atlanto-Occipital Joint?

A

Synovial condyloid

111
Q

What movements are permitted by the Atlanto-Occipital joint?

A

Nodding (Flexion/Ext) and Sideways tilting (Lat Flexion)

112
Q

What three articulations are formed by the Atlanto-Axial Joint?

A

Two lateral gliding synovial and one median pivot joint

113
Q

What movement does the Atlanto-Axial Joint permit?

A

Rotation (Shaking head no)

114
Q

What ligament is a transverse ligament of the atlas plus the longitudinal bands?

A

Cruciate Ligament of the atlas

115
Q

What ligament extends from the sides dens of the axis to the lateral margins of the foramen magnum?

A

Alar ligaments

116
Q

What is a strong continuation of the post-longitudinal ligament that passes posteriorly over the median AA joint and its ligaments?

A

Tectorial Membrane

117
Q

What six things limit range of movement?

A
  1. thickness, elasticity, and compressibility of IV discs 2. shape and orientation of zygapophysial joints 3. tension of joint capsules of zygapophysial joints 4. Resistance of the back muscles and ligaments 5. attachment to the rib cage 6. bulk of surrounding tissue
118
Q

What are the four curvatures that occur in the spine?

A

Cervical and lumbar lordosis AND Thoracic and sacral kyphoses

119
Q

What innervates the VC?

A

Meningeal branches of spinal nerves

120
Q

What other structures are supplied by the meningeal branches?

A

Periosteum, annuli fibrosi, and ALL

121
Q

What type of sensation is innervated by these meningeal branches?

A

Pain receptor/ proprioception

122
Q

What effect does aging have on VC?

A

Nucleus pulposis dries up and annulus fibrosis assumes the share of the lead and leads to stress/strain, IV discs increase in size and become convex

123
Q

What are the five sources of back pain?

A

Fibroskeletal Structures, Meninges, Synovial Joints, Muscles, Nervous Tissue

124
Q

What is a herniation of an IV disc?

A

annulus fibrosi ruptures and nucleus pulposis flows out

125
Q

What is it called when two vertebraes are joined by surgery?

A

Spinal Fusion

126
Q

What is a secondary term for spinal fusion?

A

Spondylodesis, spondylosyndesis

127
Q

What is osteoarthritis of VC?

A

breakdown of cartilage of the joints and IV discs

128
Q

True/False: You can’t rupture a back ligament.

A

False, you can.

129
Q

Can you fracture or dislocate vertebrae?

A

Yes you can

130
Q

What is the name given to excessive thoracic kyphosis?

A

Humpback/Hunchback

131
Q

What is the name given to excessive lumbar lordosis?

A

Sway back

132
Q

What is scoliosis?

A

sideways curvature of the spine

133
Q

What are known as extrinsic muscles?

A

Superficial and immediate muscles

134
Q

What are the functions of extrinsic muscles?

A

Control limbs and respiratory movements

135
Q

What are the four superficial back muscles?

A

Trapezius, Latissimus Dorsi, Levator Scapulae, Rhomboids

136
Q

What do the extrinsic muscles connect?

A

Axial skeleton w/ appendicular skeleton

137
Q

What is the primary intermediate extrinsic muscle?

A

Serratus

138
Q

What is the OIAN of the trapezius?

A

O: external occiptal protuberance, ligamentum nuchae, and spinous process of C7 to T12. I: Posterior border of lateral third of clavicle, acromion process, and spine of scapula. A: Elevation of upper fibers, retraction from the middle fibers, depression from the lower fibers. N: Spinal root of the accessory nerve (CN XI)

139
Q

What is the OIAN of the Latissimus Dorsi?

A

O: Spinous process of T7-L5, thoracolumbar fascia, illiac crest, inferior ribs 3 and 4 and inferior angle of scapula. I: Medial lip of intertuburcular groove of the humerus. A: Extension, Adduction, Medial Rotation of humerus, elevate the body when climbing. N: Thoracodorsal nerve.

140
Q

What is the OIAN of the Levator Scapulae?

A

O: Posterior tubercles of transverse process of C1 to C4. I: Superior part of medial border of the scapula. A: Elevates scapula, rotates head to the same side. N: Dorsal Scapular nerve (C4-5)

141
Q

What is the OIAN of the Rhomboid major?

A

O: Spinous process of T2-5. I: Medial border of scapula. A: retracts and downwardly rotates the scapula. N: Dorsal scapular nerve (C4-5)

142
Q

What is the OIAN of the Rhomboid Minor?

A

O: Spinous process of C7, T1 and the ligamentum nuchae. I: Medial border of scapula. A: Retracts and downwardly rotates the scapula. N: Dorsal scapular nerve (C4-5)

143
Q

What is the OIAN of the serratus posterior superior?

A

O: Ligamentum nuchae, spinous process of C7-T3. I: 2-5 Ribs. A: Elevates the 4 superior ribs (to increase the size of thorax). N: Ventral Primary Rami of first 3-4 thoracic nerves

144
Q

What is the OIAN of the serratus posterior inferior?

A

O: Spinous processes of T11-L2. I: Inferior ribs 3 or 4. A: Depress the inferior 3-4 ribs (to prevent superior pull by the diaphragm). N: Ventral primary rami of last 4 thoracic nerves

145
Q

What are the functions of the intrinsic muscles?

A

Specifically act on vertebral column, producing its movements, and maintaining posture

146
Q

What are the intrinsic muscles composed of?

A

Deep fascia that attaches medially to nuchal ligament, tips of vertebrae, supraspinous ligament, and median crest of sacrum

147
Q

What are the intrinsic muscles of the back?

A

Splenius muscles, Errector Spinae muscles, transversospinalis muscles

148
Q

What are the two splenius muscles?

A

Splenius capitis, Splenius cervicis

149
Q

What is the OIAN of the Splenius capitis?

A

O: Nuchal Ligament and spinous processes of c7-T3. I: Mastoid process, occipital bone. A: Rotate the head and neck to the same side, neck/head extension. N: Dorsal primary rami.

150
Q

What is the OIAN of the Splenius cervicis?

A

O: Spinous processes of T3-6. I: Transverse process of C1-4. A: Rotate the head and neck to the same side, extend head and neck. N: Dorsal primary rami.

151
Q

What are the three errector spinae muscles?

A

Spinalis, Longissimus, Iliocostalis

152
Q

What is the common innervation of the errector spinae muscles?

A

Dorsal primary rami.

153
Q

What are the actions of the errector spinae muscles?

A

Extension, Lateral Flexion, Eccentric contraction as back is flexed

154
Q

What is the origin and insertion of the Iliocostalis Lumborum?

A

Iliac crest to the angles of the inferior six ribs

155
Q

What is the origin and insertion of the Iliocostalis Thoracis?

A

6 lower ribs to the six upper ribs

156
Q

What is the origin and insertion of the Iliocostalis Cervicis?

A

Six upper ribs to the transverse processes of lower cervical vertebrae 4-6

157
Q

What is the origin and insertion of the Longissimus thoracis?

A

Lower Lumbar spinous processes and sacrum to the lower nine ribs and assoc. transverse processes

158
Q

What is the origin and insertion of the Longissimus cervicis?

A

Transverse processes of T1-4 or 6 to the transverse processes of C2-6

159
Q

What is the origin and insertion of the Longissimus capitis?

A

Lower 4 cervical vertebrae to the mastoid process of the temporal bone

160
Q

What is the origin and insertion of the Spinalis?

A

Spinous processes of T11-L2 to the spinous processes of the upper 4-8 thoracic vertebrae

161
Q

What are the deep intrinsic muscles?

A

Semispinalis, multifidus, rotatores, interespinales, intertransversarii, levatores lostarum

162
Q

What is the OIAN of the semispinalis?

A

O: Transverse processes of C4-T12. I: occipital bone and spinous processes in thoracic and cervical regions. A: Head Extension, Head rotation N: Dorsal rami of cervical spinal nerves

163
Q

What is the OIAN of the Multifidus?

A

O: C2-S4, most prominent in lumbar region, vertebral arches I: spinous processes A: Lateral Flexion, Rotation, trunk extension

164
Q

What is the OIAN of the Rotatores?

A

O: transverse processes of vertebrae. *most prominent in T region. I: base of the spinous process of superior vertebrae of attachment. A: rotation, proprioceptive role. N: Dorsal rami of spinal nerves

165
Q

What is the OIAN of the Interspinales?

A

O: Superior surfaces of spinous processes of cervical and lumbar vertebrae. I: Inferior surfaces of spinous processes of vertebra superior to origin/ A: Aid in extension and rotation N: Posterior rami of spinal nerves

166
Q

What is the OIAN of the Intertransversarii?

A

O: Transverse processes of cervical and lumbar vertebrae. I: Transverse processes of adj vertebrae. A: Aid in Lateral Flexion, stabilization. N: Posterior and anterior rami of spinal nerves.

167
Q

What is the OIAN of the Levatores costarum?

A

O: Tips of transverse processes of C7 and T1-11 vertebrae. I: Rib between tubercle and angle. A: Elevate ribs, assist with respiration, assist with lateral flexion. N: posteriopr rami of C8-T11 spinal nerves

168
Q

Review: What are the muscles that assist with flexion?

A

Longus coli, scalene, SCM, rectus abdominus, psoas major

169
Q

Review: What are the muscles that assist with extension?

A

Semispinalis cervicis, Iliocostalis cervicis, Splenius cervicis, levator scapulae, splenius capitis, multifidus, longissimus capitis, Semispinalis capitis, trapezius, erector spinae, semispinalis thoracis

170
Q

Review: What are the muscles that assist with lateral flexion?

A

Iliocostalis cervicis/thoracis/lumborum, Longissimus capitis/lumborum/cervicis, Splenius capitis and cervicis, Intertransversarii, scalenes, multfidus, external and internal obliques, quadratus lumborum, rhomboids, serratus anterior

171
Q

Review: What are the muscles that assist with rotation?

A

Rotatores, semispinalis capitis and cervicis, multifidus, splenius cervicis/thoracis, Iliocostalis, Longissimus

172
Q

What are the suboccipital muscles?

A

Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior.

173
Q

What are the suboccipital muscles innervated by?

A

Posterior rami of C1, suboccipital nerve

174
Q

What is the origin and insertion of the rectus capitis posterior major?

A

Spinous process of c2 to lateral part of inferior nuchal line of occipital bone

175
Q

What is the origin and insertion of the rectus capitis posterior minor?

A

Posterior tubercle of posterior arch of C1 to medial part of inferior nuchal line of occipital bone

176
Q

What is the origin and insertion of the obliquus capitis superior?

A

Posterior tubercle of posterior arch of C2 to transverse process of C1

177
Q

What is the origin and inseretion of the obliques capitis inferior?

A

Transverse process of C1 to occipital bone between superior and inferior nuchal lines.

178
Q

What are the muscles that allow flexion of the atlanto-occipital joints?

A

Longus capitis, Rectus capitis anterior, Anterior fibers of SCM, Suprahyoid and infrahyoid muscles

179
Q

What are the muscles that allow extension of the atlanto-occipital joints?

A

Rectus capitis posterior major and minor, obliquus capitis superior, splenius capitis, longissimus capitis, trapezius

180
Q

What are the muscles that allow Lateral flexion of the atlanto-occipital joints?

A

SCM, Obliquus Capitis superior, rectus capitis lateralis, longissimus capitis, splenius capitis

181
Q

What are the six aspects of the suboccipital triangle?

A

Superomedial boundary, superolateral boundary, inferolateral boundary, floor, roof, and contents.

182
Q

What is the structure of the superomedial boundary?

A

Rectus capitis posterior major

183
Q

What is the structure of the superolateral boundary?

A

Obliquus capitis superior

184
Q

What is the structure of the inferolateral boundary?

A

Obliquus capitis inferior

185
Q

What is the structure of the floor of the suboccipital triangle?

A

Posterior atlanto-occipital membrane and posterior arch of C1

186
Q

What is the structure of the roof of the suboccipital triangle?

A

Semispinalis capitis

187
Q

What is the structure of the contents of the suboccipital triangle?

A

Vertebral artery and suboccipital nerve

188
Q

What are the muscles of the atlanto-axial joints rotate the head to the left?

A

Obliquus capitis inferior, rectus capitis posterior major and minor, longissimus capitis, and splenius capitis (ipsilateral)

189
Q

What are the muscles of the atlanto-axial joints rotates the head to the right?

A

SCM and semispinalis capitis

190
Q

Where do the suboccipital nerves originate, travel, and distribute?

A

Posterior ramus of C1 -> Cranium and C1 -> muscles of suboccipital triangle

191
Q

Where do the greater occipital nerves originate, travel, and distribute?

A

Posterior ramus of c2 -> Obliquus capitis inferior and ascends to posterior scalp -> skin over neck and suboccipital bone

192
Q

Where do the lesser occipital nerves originate, travel, and distribute?

A

Anterior rami of c2-3 -> passes directly to skin -> Skin of superior posterior/lateral neck and scalp posterior to external ear

193
Q

Where do the posterior rami nerves of c3-7 originate, travel, and distribute?

A

Posterior: same -> Pass segmentally to skin and muscles -> intrinsic muscles of back and overlying skin

194
Q

What is a back strain?

A

Injury to a ligament

195
Q

What is a back sprain?

A

Stretching/tearing of muscle fibers

196
Q

What is a back spasm?

A

Response to inflammation sudden involuntary contraction attended by cramps, pain, and interference

197
Q

What is arteriosclerosis of the back?

A

Reduced blood supply = lightheaded, dizziness, and inference to blood supply to brainstem

198
Q

How does the spinal cord begin?

A

As a continuation of the medulla oblongata

199
Q

Where does the spinal cord terminate?

A

Conus medullaris ~ L1/L2

200
Q

Approximately what portion of the spinal cord makes up the vertebral column?

A

2/3

201
Q

In adults, how long is the spinal cord?

A

42-45 cm

202
Q

What is the spinal cord considered to be?

A

The major reflex pathway between the body and brain

203
Q

What are the two enlargements of the spinal cord?

A

Cervical enlargement, lumbosacral enlargement

204
Q

Describe the cervical enlargement.

A

Extends from c4-T1, most of the anterior rami form brachial plexus of nerves that innervate the upper limbs

205
Q

Describe the lumbosacral enlargement.

A

Extends from T11-S1, the anterior rami of spinal nerves make up the lumbosacral plexuses of nerves that innervate the lower limbs

206
Q

Describe the beginning of spinal cord development in the embryonic period.

A

SC occupies the entire vertebral canal

207
Q

During what developmental period does the vertebral column grow faster than spinal cord, leading to the ascension of it?

A

Fetal period

208
Q

At birth, at what level is the conus medullaris?

A

L4-5

209
Q

What structure forms to extend beyond the SC to reach the remaining lumbar, sacral, and coccygeal foramina?

A

Cauda equina

210
Q

What is the cauda equina?

A

A bundle of nerve roots that courses within the lumbar cistern of CSF caudal to the termination of the SC.

211
Q

What structure arises from the tip of the conus medullaris and decends among the spinal nerve roots in the cauda equina?

A

Filum terminale

212
Q

What is the hard, outermost meninge?

A

Dura mater

213
Q

What makes up the dura mater?

A

Tough fibrous tissue with some elastic fibers

214
Q

What separates the dura from the periosteum-covered bone and ligaments formed by the walls of the vertebral canal?

A

The epidural space

215
Q

What is the length of the epidural space?

A

runs the lengeth of the vertebral canal terminating superior to the foramina magnum and laterally to the IV foramina, and inferiorly to the sacral hiatus.

216
Q

What type of nerves supply the dura mater?

A

afferent pain receptors by Meningeal nerves

217
Q

What is the inflammation of meninges?

A

Meningitis

218
Q

What is the subarachnoid mater?

A

The middle layer composed of fibrous and elastic tissue that lines the spinal dura sac and its root sheaths.

219
Q

What hold the subarachnoid mater to the dura?

A

CSF pressure

220
Q

What is the arachnoid trabeculae?

A

Connective tissue that spans the subarachnoid space, connecting the spinal arachnoid and pia.

221
Q

What is bleeding in the [sub]arachnoid space?

A

Subdural hematoma

222
Q

What is the pia mater?

A

thin, transparent Innermost covering

223
Q

What does the pia mater directly cover?

A

Roots of spinal nerves and spinal blood vessels

224
Q

What is the fibrous sheet of pia that extends between posterior and anterior nerve roots?

A

Dentriculate ligaments

225
Q

What are the three longitudinal arteries that supply the spinal cord?

A
  1. Anterior spinal artery. 2. two posterior spinal arteries
226
Q

What derives from these ascending arteries?

A

Anterior and posterior segmental arteries

227
Q

What artery reinforces circulation of 2/3s of the spinal cord?

A

Great anterior segmental medullary artery

228
Q

Where does the great anterior segmental medullary artery arise and enter?

A

Inferior intercostal or upper lumbar artery enters VC through IV foramen and the lower thoracic or upper lumbar level

229
Q

What supply the posterior and anterior roots of spinal nerves and their coverings?

A

Radicular arteries running along the nerve roots

230
Q

How many anterior and posterior veins of the spinal cord are there?

A

Three anterior and three posterior

231
Q

What direction are the veins arranged?

A

Longitudinally

232
Q

What drains the anterior and posterior veins?

A

Anterior and posterior medullary and radicular veins

233
Q

Describe the formation of spinal nerves/

A

Fusion of ventral and dorsal roots arising from the spinal cord: dorsal roots carry afferent information (contain the cell bodies in the ganglion), ventral roots carry efferent information (cell bodies are located in the gray matter), roots come together to form nerves as the exit the IV foramen, then immediately split into ventral and dorsal primary rami.

234
Q

What increases the chance that nerve roots will be conpressed?

A

Narrow foramina if osteophytes or herniation of IV discs occur

235
Q

What is myelography?

A

Radiopaque contrast procedure that allows for visualization of the SC and nerve roots (CSF is withdrawn and replaced w/ contrast material.)

236
Q

What is the withdrawal of CSF from the lumbar cistern?

A

Lumbar spinal puncture (LP, Spinal tap)

237
Q

How is a patient oriented when performing a spinal tap?

A

Lays on side with back and hips flexed (fetal position)

238
Q

Where is the needle inserted for a spinal tap?

A

midline between spinous processes of L3-4.

239
Q

How many cm in does the needle “po” the liagemtnum flavum, puncturing the dura and arachnoid space to enter the lumbar cistern?

A

4-6

240
Q

What is the approximate rate of CSF escape?

A

One drop per second

241
Q

Where is spinal anesthesia injected into?

A

Subarachnoid space

242
Q

Tue/False: Epidural Anesthesia is also called a block.

A

true.

243
Q

True/False: Ischemia (decreased blood supply) can lead to muscle weakness and paralysis.

A

True.

244
Q

What can the protrusion of cervical IV discs after a neck injury cause?

A

Spinal cord shock

245
Q

What does Transection to C1-C3 result in?

A

No function below head, ventilator required for respiration

246
Q

What does Transection to C4-C5 result in?

A

quadriplegia (no function of limbs but can respirate)

247
Q

What does Transection to C6-C8 result in?

A

Loss of lower limb function

248
Q

What does Transection to T1- T9 result in?

A

Paraplegia (lower limb paralysis)

249
Q

What does Transection to T10-L1 result in?

A

Some thigh muscle function (may be able to walk with braces)

250
Q

What does Transection to C2-C3 result in?

A

Retention of most leg muscle function, short leg braces may be required.

251
Q

What are the two branches of the major cervical and segmental arteries that supply the VC?

A

Periosteal and Equatorial

252
Q

Where do spinal artery branches enter and divide?

A

IV foramina

253
Q

What are the two smaller vertebral canal branches?

A

Anterior and posterior

254
Q

What do the smaller anterior vertebral canal branches innervate?

A

ventral bodies, supplying most of the red marrow

255
Q

What do the larger branches of artery spinal branches continue as?

A

Radicular or segmental medullary arteries

256
Q

What do spinal veins form along the VC?

A

venous plexuses, internal and external

257
Q

What veins form within the vertebral bodies?

A

Basivertebral veins

258
Q

What veins receive veins from the SC and venous plexuses as they accompany nerves through the IV foramina and drain into vertebral veins?

A

Intervertebral veins

Anatomy (19 decks)

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