Back2

Question 1

movements of the vertebral column is limited by:

Answer 1

• Thickness, elasticity and compressibility of the IV disc
• Shape and orientation of the facet joints and looseness of their capsule
• Resistance of back muscles and ligaments
• Attachment to the thoracic cage and bulkiness of the surrounding tissue

Question 2

Movements are free at the cervical region because:

Answer 2

• Thick IV discs relative to the thickness of vertebral bodies
• Almost horizontally oriented articular surfaces of facet joints
• Loose nature of the capsules of facet joints
• Slenderness of the neck compared to the trunk

Question 3

Slenderness of the neck compared to the trunk

Answer 3

The narrower the part of the body the more movable it is. the neck (narrow) is
a lot more movable that the thorax

Question 4

Primary curvatures

Answer 4

Kyphotic
Concave;thoracic, sacral
During fetal development

Question 5

Born with them Primary curvatures- because of

Answer 5

less height of the vertebral body anteriorly than posteriorly

Question 6

Secondary curvatures

Answer 6

Lordotic
After delivery
Convex; cervical, lumbar

Question 7

Secondary curvatures- because of

Answer 7

more height of the IV disc anteriorly than that in posteriorly

Question 8

The curvatures provide additional——- to the vertebral column in addition to that provided by the IV discs

Answer 8

flexibility

Question 9

Causes of abnormal curvatures:

Answer 9

Developmental or disease

Question 10

Excessive thoracic kyphosis:

Answer 10

Humpback/hunchback- increase in thoracic curvature

Question 11

Excessive lumbar lordosis

Answer 11

Hollow back- anterior rotation of pelvis

Question 12

Scoliosis

Answer 12

Crooked or curved back- Lateral curvature

Question 13

Protrusion of nucleus pulposus

Due to?

Answer 13

weak thin annulus fibrosus (AF) on the posterolateral side

Question 14

Usually herniation occurs on the——-

Why?

Answer 14

postero-lateral side

no ligaments there!)

Question 15

Protrusion of nucleus pulposus

Causes

Answer 15

Compress the spinal nerve roots

Question 16

95% herniations occur in——— between either ——or——- back pain (sciatica)

Answer 16

IVD

L4-L5

L5-S1

Question 17

As we age, the——- becomes weak,
the nucleus pulposus (NP) loses ——- and ——-and gains more———-
(dehydration of NP)

Answer 17

IVD

elastin and proteoglycan

collagen

Question 18

dehydration of NP,
The AF starts taking more load and stress which
causes the formation of

Answer 18

cavities and fissures

Question 19

if there is a prolapse

What seen in X-ray

Answer 19

decrease in height of IVD (intervertebral space)

Question 20

The annulus fibrosus (AF) is ——- posteriorly than anteriorly

Answer 20

Thinner

Question 21

Acute localized back pain is due to

Answer 21

pressure on ligaments and AF, and

inflammation

Question 22

Chronic pain is due to——–usually a referred pain

Answer 22

nerve compression

Question 23

Sciatica
Define?
but the symptoms (referred pain) depend upon?

Answer 23

compression of L5/S1 nerve,

the nerve compressed

Question 24

In lumbar region, the intervertebral foramina are———-, and the diameter of the spinal nerve is———

Answer 24

smaller

larger

Question 25

When an IVD prolapses, the spinal nerve numbered one——— to it is compressed For example L4-L5 disc prolapses, then—- nerve is compressed

Answer 25

inferior L5

Question 26

The arteries that supply the vertebral | canal are the

Answer 26

branches of regional arteries (vertebral, intercostal, aortic, etc.)

Question 27

branches of regional | arteries ?

Answer 27

vertebral, intercostal, aortic, | etc.)

Question 28

The arteries give———- branches

Answer 28

periosteal, equatorial, | spinal and nutrient

Question 29

The veins of the vertebral canal | profusely anastomose and form

Answer 29

external and internal vertebral venous | plexuses

Question 30

the vertebral column is innervated by

Answer 30

``` recurrent meningeal branches (of Luschka)of spinal nerve ```

Question 31

Muscles of back

Answer 31

Extrinsic muscles Intrinsic muscles-

Question 32

Extrinsic muscles

Answer 32

Superficial extrinsic muscles | Intermediate extrinsic muscles

Question 33

Superficial extrinsic muscles

Answer 33

Trapezius - Latissimus dorsi - Levator scapulae - Rhomboids

Question 34

Intermediate extrinsic muscles

Answer 34

- Serratus posterior superior | - Serratus posterior inferior

Question 35

Extrinsic muscles | Innervation

Answer 35

Innervated by anterior rami of spinal nerves except trapezius

Question 36

Intrinsic muscles-deep back muscles innervated by

Answer 36

posterior primary rami

Question 37

Intrinsic muscles | Superficial layer

Answer 37

-Splenius muscles in the neck

Question 38

Intrinsic muscles | Intermediate layer

Answer 38

-Erector spinae muscles

Question 39

Intrinsic muscles- | Deep layer

Answer 39

-Transversospinales (Semispinalis, multifidus and rotatores)

Question 40

Intrinsic muscles- | Minor deep layer

Answer 40

Interspinales - Intertransversarii - Levatores costarum

Question 41

Superficial Intrinsic back muscles Splenius muscles function Acting alone: Acting together:

Answer 41

Acting alone: lateral flexion of neck Acting together: Extension of head and neck

Question 42

Intermediate layer of intrinsic back muscles: Erectror spinae Functions: Acting bilaterally:- Acting unilaterally:-

Answer 42

Acting bilaterally:- Extend vertebral column and head; control movements Acting unilaterally:-Laterally flex vertebral column

Question 43

The joint planes of facet joints in the lumbar region are———, that is why flexion and extension are possible

Answer 43

sagittal

Question 44

————prevent rotation

Answer 44

Articular processes

Question 45

Back sprain-

Answer 45

injury to ligaments due to strong stretching of the ligaments

Question 46

Back strain-

Answer 46

-Due to strong muscular contraction which results in stretching or microscopic tearing of muscle fibers (tendon) (of erector spinae)

Question 47

Muscle spasm-

Answer 47

sudden involuntary contraction of muscles in response to inflammation

Question 48

Microscopic tears in this muscle causes back pain?

Answer 48

Erector spinae

Question 49

A medical student realized that a patient can perform flexion and extension of his back more than rotation. What is the anatomical significance of the lumbar vertebrae?

Answer 49

Sagittally arranged articular process

Question 50

1.What component of the spinal nerve innervates the intrinsic muscles of the vertebral column?

Answer 50

Posterior rami

Question 51

- A pt with lumbar and thoracic compression fractures and kyphosis, what would have a high radiodensity in the x-ray

Answer 51

cortical rim

Question 52

Surgical incision to relieve pressure on the spinal cord

Answer 52

Lamina

Question 53

horizontal on cervical vertebra

Answer 53

Transverse process

Question 54

Radiograph showed injury of facet joint btw L3-L4, which part of L4 spinal nerve will be compressed?

Answer 54

Trunk

Question 55

A rugby player had hyperextension neck injury and there was rupture of the intervertebral disc, he felt pain on the radial side of the forearm and the thumb, what IV disc is most likely to be affected?

Answer 55

C5/C6