Back: Vertebral Column Flashcards

1
Q

Vertebral Column

A
  • Vertebrae + disc
  • Semi-rigid
  • Provides stability, support, and permits motion
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2
Q

Vertebrae

A
  • 7 Cervical
  • 12 Thoracic
  • 5 Lumbar
  • 5 Sacral (fused)
  • 4 coccygeal (fused)
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3
Q

Vertebral Discs

A
  • All vertebrae have a disc except

- Occ/C1 and C1/2

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4
Q

Primary Curve

A
  • Develop during fetal life
  • Concave anteriorly
  • Thoracic and sacral curves
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5
Q

Secondary Curve

A
  • Develop in infancy and childhood
  • Concave posteriorly
  • Cervical and lumbar curves
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6
Q

Curves in Vertebral Column

A
  • Result of AP height differences of the bodies/disc

- Contribute to the flexibility and shock absorbing capacity

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7
Q

Vertebral Arch

A
  • Pedicle + lamina
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8
Q

Vertebral Body

A
  • Provides strength and supports weight
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9
Q

7 Processes that Arise from the Arch

A
  • 2 Superior articular processes
  • 2 Inferior articular processes
  • 1 Spinous process
  • 2 Transverse processes
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10
Q

Function of Processes

A
  • Serve as sites for muscle/ligament attachment and joint formation
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11
Q

Vertebral Foramen

A
  • Arch + Body
  • Anterior boundary: disc, body, PLL
  • Posterior: laminas
  • Lateral: pedicle
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12
Q

Intervertebral Notch

A
  • Forms intervertebral foramen

- Allows the passage of the spinal nerves, spinal arteries, intervertebral veins

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13
Q

Joints Between Vertebral Bodies

A
  • Intervertebral discs
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14
Q

Joints Between Vertebral Arches

A
  • Facet joints (zygapophyseal joints)
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15
Q

Craniovertebral

A
  • Upper cervical joints of the vertebral column
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16
Q

Cosotvertebral

A
  • Joints between ribs and thoracic vertebrae
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17
Q

Sacroiliac

A
  • Joints that connect axial to pelvic girdle
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18
Q

Vertebral Bodies + Disc

A
  • Symphysis joint (fibrocartilage)

- No disc between Occ/C1 and C1/C2

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19
Q

Vertebral Body Functionality

A
  • Cervical and lumbar have greatest relative thickness
  • Influences range of motion
  • Lowest functional disc is L5
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20
Q

Vertebral Column Ligaments

A
  • ALL: sacrum to occiput

- PLL: sacrum to body of C2

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21
Q

Intervertebral Discs

A
  • 25% length of vertebral column
  • Fibrocartilage
  • Permit movement, flexible
  • Absorbs shock
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22
Q

Two Parts of Intervertebral Discs

A
  • Annulus Fibrosis

- Nucleus Pulposus (gelatinous)

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23
Q

Annulus Fibrosis

A
  • Lamellae of collagen fibers
  • Successive layers runs at different angles
  • Outer portion has innervation and blood supply
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24
Q

Nucleus Pulposus

A
  • High water content (80%, declines with age)
  • Remnant of notochord
  • Avascular, aneural
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25
Q

Uncovertebral Joints (Joints of Luschka)

A
  • Cervical spine, C3-7
  • Between uncinate process and vertebral body above
  • Not considered a joint by some
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26
Q

Osteophytes (Bone Spurs)

A
  • Presence on the uncovertebral joints can compress spinal nerves
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27
Q

Facet (Zygapophyseal Joints)

A
  • Synovial, planar joints
  • Between hyaline cartilage covered articular facets
  • Allow gliding movements
  • Shape and orientation dictate movement
  • Limit extension
  • Innervated by dorsal primary rami of multiple levels
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28
Q

Cervical Motion of Facet Joints

A
  • All motions
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29
Q

Thoracic Motion of Facet Joints

A
  • Rotation, lateral flexion
30
Q

Lumbar Motion of Facet Joints

A
  • Flexion/extension
31
Q

Craniovertebral Joints

A
  • Designed to allow greater range of motion

- No discs

32
Q

Atlanto-Occipital Joints (Between Occiput and C1)

A
  • Synovial, condyloid joints

- Primarily allows flexion/extension (nodding your head yes)

33
Q

Atlanto-Axial Joints (Between C1 and C2)

A
  • Lateral atlanto-axial: synovial, planar joint
  • Median atlanto-axial: synovial, pivot
  • Head rotation, (shaking your head no)
34
Q

Ligaments of the Vertebral Column

A
  • Anterior longitudinal ligament
  • Posterior longitudinal ligament
  • Ligamentum flavum
  • Supraspinous ligament
  • Interspinous ligament
  • Intertransverse ligament
35
Q

Anterior Longitudinal Ligament

A
  • Extends from base of skull to sacrum along anterior aspect of vertebral bodies
  • Resists extension
36
Q

Posterior Longitudinal Ligament

A
  • Extends from sacrum to C2 along posterior aspect of vertebral bodies
  • Resists flexion located within the vertebral canal
37
Q

Ligamentum Flavum

A
  • Between lamina
  • Resists flexion
  • Large amounts of elastic fibers, assist with straightening the spine located within the vertebral canal
38
Q

Mechanoreceptors

A
  • All ligaments in the vertebral column contain these
39
Q

Supraspinous Ligament

A
  • Tips of spinous processes from C7 to sacrum
40
Q

Interspinous Ligament

A
  • Between spinous process, C2 to L5
41
Q

Intertransverse Ligament

A
  • Between transverse process
42
Q

Ligamentum Nuchae (Nuchal Ligament)

A
  • Extends from EOP to C7, attaches to all SPs

- Site of muscle attachment

43
Q

Tectorial Membrane

A
  • From C2 to occiput (anterior rim of foramen magnum

- Continuous with PLL

44
Q

Cruciform Ligament of Atlas

A
  • Superior and inferior longitudinal bands
  • Transverse ligament of atlas
  • Disruption can cause cord compression
45
Q

Apical Ligament of the Dens

A
  • Dens to anterior foramen magnum
46
Q

Alar Ligaments

A
  • Dens to medial aspect of occipital condyle
47
Q

Costovertebral Joints

A
  • Between rib head and costal facets on vertebral bodies

- All are synovial

48
Q

Costotransverse Joints

A
  • Between rib tubercle and costal facets on the transverse processes of thoracic vertebrae except T11 and T12
  • All are synovial
49
Q

Thoracic Spine/Rib Joints

A
  • Costovertebral joints

- Costotransverse joints

50
Q

Cervical Ligaments

A
  • Ligamentum nuchae (nuchal ligament)
  • Cruciform ligament of atlas
  • Apical ligament of the dens
  • Alar ligaments
51
Q

Movement of Vertebral Column

A
  • Multisegmental
  • Summation of segmental movement between vertebrae
  • Produced by back, abdominal muscles, gravity
52
Q

Determines Direction and Degree of Movement in Vertebral Column

A
  • IVD : Vertebral body ratio (cervical and lumbar)
  • Zygapophyseal joint orientation
  • Joint capsule tension
  • Surrounding soft tissue (ligaments, etc.)
  • Rib cage
53
Q

Vertebral Column Movement

A
  • More free in cervical
  • Rotation is limited in the lumbar
  • Flexion/extension and lateral flexion are limited in thoracic
54
Q

Excessive Thoracic Kyphosis

A
  • Osteoporosis
  • Leads to loss of vertebral body height
  • Compression fractures
  • Postural
55
Q

Lumbar Kyphosis

A
  • Reversal of lumbar curve
56
Q

Excessive Lumbar Lordosis (Swayback)

A
  • Anterior tilting of pelvis

- Weakened abdominal muscles, obesity, pregnancy

57
Q

Primary Curves

A
  • Normally kyphotic
58
Q

Secondary Curves

A
  • Normally lorditic
59
Q

Scoliosis

A
  • Any side to side curve in the back
  • Can have lateral and rotational components
  • Can be C-shaped or S-shaped
60
Q

Structural Scoliosis

A
  • Due to a structural abnormality

- Fixed: does not correct with motion

61
Q

Functional Scoliosis

A
  • Not due structural abnormality
  • Leg length inequality, muscle dominance/spasm
  • Typically corrects with motion (not fixed but flexible)
62
Q

C7 (Vertebral Prominens)

A
  • Longest cervical spinous process

- Visible

63
Q

T3 Vertebra

A
  • Corresponds with base of the scapular spine
64
Q

T7 Vertebra

A
  • Corresponds with the inferior angle of the scapula
65
Q

L4 Vertebra

A
  • Corresponds with the supracristal plane

- Passes through L4 SP and L4/5 disc

66
Q

L5 Vertebra

A
  • Corresponds with the tubercle of the iliac crest
67
Q

S2 Vertebra

A
  • Corresponds with posterior superior iliac spines
68
Q

C2 Vertebra

A
  • Palpable because it has a large, bifid spinous process
69
Q

C6 Vertebra

A
  • Can be palpable
70
Q

Thoracic and Lumbar Spinous Processes

A
  • Palpable depending on body composition
71
Q

Sacral Spinous Processes

A
  • Also palpable (Median * Crest)