Clinical Anatomy

Question 1

What are the characteristics of vertebrae in the thoracic region?

Answer 1

Increase in size T1-12. Small pedicles, long spinous processes. More vertical facet joints (60’). ROM limited; ribs/vertebrae connections and long spinous processes

Question 2

What are the characteristics of vertebrae in the lumbar region?

Answer 2

Increases in size L1-5. Longer, wider pedicles. Spinous processes are horizontal. More horizontal facet joints (90’)

Question 3

Describe the purpose and structure of facet joints

Answer 3

Stabilise spinal column whilst allowing movement. Superior & inferior facet articulations, synovial joints, hyaline cartilage

Question 4

Describe the purpose and structure of SIJ

Answer 4

Shock absorption whilst allowing movement. Designed for stability. Weight bearing synovial plane joint with irregular elevations and depressions that produce interlocking

Question 5

What vertebrae make up the cervical region?

Answer 5

C1+2

Question 6

What vertebrae make up the lower cervical region?

Answer 6

C3-7

Question 7

What does C1 articulate with superiorly?

Answer 7

Occiput of the skull

Question 8

What is the other name of the odontoid process on C2?

Answer 8

Dens process

Question 9

Describe the purpose and structure of vertebrae in the lower cervical region

Answer 9

Large foramen to admit wide spinal cord. Transervse foramen: vertebral artery, vein, nerve fibre. Small body with wide lamina, much shorter transverse processes

Question 10

What is the vertebra prominens?

Answer 10

C7- First palpable

Question 11

What is the most palpable vertebrae?

Answer 11

T1

Question 12

Where in the spine has the greatest risk of injury?

Answer 12

Cervico-thoracic and thoraco-lumbar junctions-at junctions of fixed and mobile segments

Question 13

What is the peripheral structure of intervertebral discs?

Answer 13

Annulus fibrosis

Question 14

What is the central structure of intervertebral discs?

Answer 14

Nucleus pulposus

Question 15

What are the characteristics of annulus fibrosis?

Answer 15

Thin posteriorly, can rupture

Question 16

What are the characteristics of nucleus pulposus?

Answer 16

Gelatinous, semi-fluid

Question 17

What is the purpose of ligaments of the spine?

Answer 17

Add to stability of spinal column- as important as bony structures

Question 18

What are the spinal ligaments?

Answer 18

Anterior longitudinal ligament, posterior longitudinal ligament (runs length of column), ligamentum flavum (link vertebral laminae) , supraspinous ligament, intraspinous

Question 19

Describe the strength of ligamentum flavum, supraspinous and intraspinous ligaments

Answer 19

Tough and elastic, tough, relatively weak

Question 20

What are the intermediate spinal muscles, origin, insertion and purpose

Answer 20

Serratus posterior, superior and interior. Origin-spinous processes, insertion-ribs. Concerned with respiratory function

Question 21

What are the superficial spinal muscles?

Answer 21

Trapexius, latissimus dorsi, rhomboid minor & major, levatus scapularis

Question 22

What is the function of the superficial spinal muscle?

Answer 22

Movement of shoulder & upper limb

Question 23

Describe trapezius

Answer 23

Trapezium shaped. Origin-spinous processes (>T12). Insertions: occiput, spine of scapula. Innvervation: Accessory nerve (CN XI). Function- elevates, depresses and retracts scapula

Question 24

Describe latissimus dorsi

Answer 24

Broadest and back. Origin-spinous processes and pelvis. Insertions-humerus. Innervation: C6-8). Functions- adducts, extends, internally rotates the humerus

Question 25

Describe rhomboid major & minor

Answer 25

Origin Minor: Spinous processes C7/T1, Major T2-5. Insertions-scapula. Innervation-dorsal scapula nerve (C3/4). Function-keeps scapula against thoracic wall, retracts scapula

Question 26

Describe levatus scapuaris

Answer 26

Origin-transverse processes C1. Insertions: superior angle of scapula. Innervation: branches C4/5. Elevates scapula

Question 27

What are the deep spinal muscles and function?

Answer 27

Erector spinae muscles (others but not clinically relevant)- movement of vertebral column and posture

Question 28

Describe the erector spinae muscles

Answer 28

Laterally-iliocostalis. Intermediate- longisimus thoracis. Medially- spinalis thoracis. Origin-occiput of skull. Insertion-pelvis (multiple attachments along wall). Innervation- posterior rami of spinal nerves

Question 29

Where does the spinal cord terminate?

Answer 29

Cauda equina at L2

Question 30

What are myotomes?

Answer 30

Muscles controlled by the motor element of the nerve root from a specific level

Question 31

What are dermatomes?

Answer 31

Skin sensation areas supplied by the sensory element of the nerve root from a specific level

Question 32

What is contained in the white matter of the spinal cord?

Answer 32

Ascending sensory tracts and descending motor tracks

Question 33

What are the descending motor tracts?

Answer 33

Crossed pyramidal or lateral cerebrospinal tract

Question 34

What are the intervertebral foramina formed from?

Answer 34

The notch above and below the pedicle

Question 35

How are nerve roots named?

Answer 35

Named for vertebrae below them, so nerve root is above- nerve root above C1, is called C1. Changes at vertebrae C7, below this is C8 nerve root. Then nerve root is named for vertebrae above this i.e. T1 nerve root is below T1 vertebrae

Question 36

What spinal nerves and roots are contained in the cauda equina?

Answer 36

L2-5, S1-5, Coccygeal nerve

Question 37

What motor function is provided by the cauda equina?

Answer 37

Movement of hips, knees, ankles, feet, internal anal sphincter and external anal sphincter

Question 38

What sensory function is provided by cauda equina?

Answer 38

Sensory function in hips, knees, ankles, feet, perineum and partially parasympathetic innervation of bladder