Basic Science Concepts and Applied Chiropractic Principles Flashcards
Cervical vertebra characteristics: C1 C2 axis epistropheus C7 vertebra prominens Facets
Transverse foramina, bifid spinous, rectangular body
no body, large lateral mass, A+P arches and tubercles
Dens
Long, non-bifid spinous, absent anterior tubercle
45o BUM, transverse, rotation
Thoracic vertebra characteristics:
Facets
Costal facets on body, heart-shaped body, sloping spinous process
60o BUL coronal for lateral bend
Lumbar vertebra characteristics:
Facets
Kidney-shaped body, mammillary and accessory processes
90o BM sagittal for flex/ext
Sacral characteristics:
Facet
5 fused vertebra in shape of triangle
90o B, coronal for lat bend
Alar/check ligament:
Posterior dens to medial occipital condyles; limits contralateral axis rotation around dens
Apical ligament:
Apex of dens to anterior edge of foramen magnum
ALL:
Sacrum to base of occiput, thick, strong, prevents hyperextension
Cruciate ligament:
Superior and inferior parts; C2 to occiput; btw coliculi atlantis to limit lateral translation and flexion of the neck
Interspinous ligament:
Btw adjacent spinouses prevent posterior translation
Intertransverse ligament:
Btw adjacent TVP to limit lateral bend
Ligamentum flavum:
Btw adjacent laminae, elastin to prevent buckling in extension
Ligamentum nuchae:
Continuation of supraspinous ligament from C7 to EOP
Posterior atlanto-occipital membrane:
Btw posterior arch of C1 and occiput may be calcified resulting in posterior ponticle
PLL:
C2 to sacrum thin and weak to prevent hyperflexion
Supraspinous:
Connects tips of spinous process from C7 to S5 limits flexion
Tectorial membrane:
Continue PLL beyond body of C2 to anterior foramen magnum
IVD features:
Fibrocartilage tissue btw endplates and attached to them with Sharpey fibers with an annulus fibrosis made of 15-20 concentric laminae made of Type 1 collagen fibers which are 65o to horizontal and alternating ad a nucleus pulposus with T2 collagen fibers and proteoglycans
Innervated by sinuvertebral N and gray sympathetic rami
Interverteral foramen boundaries:
Contents?
Superior: pedicle and inferior vertebral notch of vertebra above
Inferior: Pedicle and superior vertebral notch of vertebra below
Anterior: Postlat adjacent vertebral body, IVD, disc protrustion or large posterior osteophytes encroach
Posterior: Ant facet joint and capsule, hypertrophic ligament flavum and osteophytes from facet can encroach
Content: Spinal N, NR, DRG, spinal A/V, 2-4 sinuvertebral nerves, transforaminal ligaments and CT
Sinuvertebral N aka Recurrent meningeal N
Supplies PLL, posterior dura, posterior outer 1/3 of disc, perisoteum of nearby bone
Spinal canal:
Foramen magnum to bottom of sacrum
Posterior to vertebral bodies and anterior to neural arches
SC, N, meninges, CSF, BV and CT inside
Smallest in T spine, larges in C spine
Triangular in cervical and lumbar, oval in thoracic
Vertebral A Parts, termination, most vulnerable where?
Subclavian A to transverse foramen C6, then transverse foramina C6-C1, Behind lateral mass and up to foramen magnum
Then foramen magnum to basilar A
Most vulnerable in Part 3 with exreme rotation and hperextension
Circle of Willis:
Two vertebral A form Basilar to posterior cerebral A
Internal carotids to anterior cerebral connected by anterior communicating A
Posterior communicating A connect internal carotid to posterior cerebral arteries (occipital lobe and inferior temporal lob)
Middle cerebral MC affected in stroke (frontal, parietal, superior temporal lobes - Broca and internal capsule)
PICA is a branch of vertebral and supplies lower posterior cerebellum and lateral medulla
Hyperextension and rotation of upper cervicals can damage vertebral A –> Wallenberg’s syndrome (dysphage, dysarthria, ipsilateral Horner’s, ipsilateral loss of pain and temperature in face and contralateral loss of pain and temperature in rest of body)
Suboccipital triangle boundaries, roof, floor, contents:
All muscles spllied by?
Boundaries: rectus capitis posterior major (SP C2-occiput), obliquus capitis superior (TVP C1-Co), obliquus capitis inferior (SP C2 to TVP C1)
Roof: deep fascia covered by semispinalis capitis
Floor: posterior arch of C1
Contents: 3rd part of vertebral A, suboccipital N C and suboccipital V
Dorsal ramus C1 of suboccipital N
Nerve fiber, innervation, function A-alpha A beta A gamma A delta B C
Aa-motor (to skeletal muscle)
Ab-sensory (touch, vibration, 2pt touch discrimination)
Ag-motor (to muscle spindle)
Ad - sensory (Fast pain, temperature, crude touch)
B - autonomic preganglionic autonomic fibers
C - ANS and sensory - postganglionic slow pain
Sensory fiber, N fiber, ex, rate of adaptation Ia Ib II III IV
Aa muscle spindle afferent slow adapt
Aa GTO slow adapt
Ab Pacinian corpuscle; respond to vibration, rapid
Ag Receptor for touch, pressure, fast pain, rapid
C free nerve ending; pain, temperature slow
Mechanoreceptor location type sensitive to fast/slow Ruffini Pacinian GTO FNE Meissner Merkel Muscle spindle
Ruffini joint, I, stretch, slow
Pacinian joint and skin, II, vibration, rapid
GTO joint III, stretch, slow
FNE joint and skin IV, stretch and pain, rapid
Meissner skin – texture rapid
Merkel skin – pressure slow
Muscle spindle muscle – stretch slow
Dorsal column
Ascending Mechanoreceptors (vibration/fine touch) --> nuclei gracilis/cuneatus X in medulla --> VPL nucleus of thalamus
Spinothalamic anterolateral system
Nociceptors (thermoreceptors, crude touch, pressure) –> Lamina I and II in dorsal horn of grey matter X in SC –> VPL nuclus of thalamus
Dorsal spinocerebellar
Unconscious proprioception from lower limb –> Clarke’s nucleus (dorsal) found in Lamina VII in thoracic) –> stays ipsilateral to cerebellum via inferior peduncle