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MSK SM > Clinical Anatomy of the Spine > Flashcards

Clinical Anatomy of the Spine Flashcards

1
Q

What 3 structures does the spine support

A

Head
Body
Limbs

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2
Q

What are the 3 functions of the spine

A

To support other structures
To transmit and protect neurological structure (spinal column and nerve routes)
Allow movement and flexibility

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3
Q

Where is the position of the spine

A

As near to the centre of the body as possible

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4
Q

What part of the spine is it that we can palpate on examination and where are these anatomically

A

The spinous processes - most posterior spinal element

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5
Q

What are the 5 regions of the spine and how many vertebra are in each region?

A 
Cervical (7)
Thoracic (12)
Lumbar (5)
Sacral (5)
Coccygeal (4)
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6
Q

What are the 2 names given to describe the natural curvature of the spine

A

Kyphotic and lordotic

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7
Q

What do the natural curves in the spine provide

A

resisitance and elasticity in distributing body weigh and axial loads sustained during movement
They help the body support adjoining structures

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8
Q

Where does the vervical region join cranially

A

Via the occiput

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9
Q

What are the largest type of vertebrae in the body

A

Lumbar

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10
Q

Why does each vertebra have a slightly different shape

A

Due to performing a slightly different funciton

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11
Q

what connects the transverse process to the spinous process

A

Lamina

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12
Q

Describe the shape of the spinous process in the thoracic region

A

They point downwards

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13
Q

Describe the shape of the spinous process in the lumbar region

A

They are transverse

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14
Q

What are the posterior elements of the vertebrae

A

Everything but the vertebral body

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15
Q

Describe the appearance of the vertebrae in the thoracic region

A

Small pedicles and long spinous processes
More vertical facet joints
Limited ROM

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16
Q

Describe the appearance of the vertebrae in the lumbar region

A

Longer, wider pedicles (stronger)
The spinous processes are horizontal
More horizontal facet joints

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17
Q

What is the main purpose of the facet joints

A

To stabilise the spinal column whilst allowing movement

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18
Q

What type of joints are facet joints

A

Synovial joints

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19
Q

Why are facet joints important clinically

A

OA
Pain
Osteophytes can cause nerve root impingement

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20
Q

Where does the facet capsule lie in relation to the facet joint

A

It overlies the facet joint

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21
Q

What bones make up the upper cervical region of the spine

A

C1 and C2

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22
Q

What bones make up the lower cervical region of the spine

A

C3-7

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23
Q

What is the name given to C1

A

Atlas

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24
Q

Describe the appearance of C1

A

It has no body

Articulates with the occiput of the skull

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25
Q

What is the name given to C2

A

Axis

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26
Q

What is the special feature belonging to C2

A

The dens process - blunt tooth like projection

Also known as the ondontoid proess

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27
Q

What movement does the dens provide and what does this allow?

A

Pivot allowing the atlas and head to rotate around the dens

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28
Q

What is the purpose of the sacroiliac joints

A

Shock absorption whilst allowing movement
Stability
Weight bearing

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29
Q

Why are sacroiliac joints important clinically

A

OA
sacroilitis
SIJ dysfunciton

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30
Q

What movements does the atlanto - occupital joint allow

A

Flexion/ extension and lateral flexions

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31
Q

What movements does the atlanto-dens joint allow

A

rotations (with dens acting as pivot

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32
Q

What is the first palpable vertebra

A

C7

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33
Q

What is the most palpable vertebra

A

T1

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34
Q

What causes the thoracic segment to be relatively fixed

A

THe thoracic rib cage

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35
Q

In what 2 places is there the greatest risk of injury

A

Cervico-thoracic and thoraco-lumbar junciton

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36
Q

Describe the structure of the peripheral annulus fibrosus

A

Thin posteriorly

Can rupture

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37
Q

Describe the structure of the central nucleus pulposus

A

Gelatinous, semi fluid

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38
Q

If your disc is going to rupture, in what direction will it most likely rupture

A

Posteriorly

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39
Q

How much of the spine are the intervertebral discs responsible for

A

1/4 of the length of the spine

Secondary curvature of the spine

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40
Q

What is the purpose of having ligaments

A

Add to the stability of the spinal column

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41
Q

Name the 5 ligaments of the spine

A 
Anterior longitudinal ligament 
Posterior longitudinal ligament 
Ligament flavum
Supraspinous ligament 
Intraspinous ligaments
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42
Q

Where do the anterior and posterior longitudinal ligmanets run

A

The length of the vertebral column

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43
Q

describe the structure and function of the ligamentum flavum

A

Link vertebral laminae

Tough, elastic

44
Q

Describe the structure and function of the supraspinous ligament

A

Tough

Runs along the tops of the vertebrae

45
Q

Describe the 3 column theory of Denis

A

1 colum injury = stable
2 columns injured = maybe unstable
3 columns injured = unstable

46
Q

What are the 3 columns in the theory of Denis

A

Anterior column, middle column and posterior column

47
Q

What are the main functions of the intermediate muscles of the back

A

Respiation

48
Q

Why are the superficial muscles of the spine clinically relevant

A

Tenderness due to spasm

Wasting from disuse or denervation

49
Q

What is the function of the superficial muscles of the spine

A

Movement of shoulder and upper limb

50
Q

What are the 4 superficial muscles of the spine

A

Trapezius
Latissimus dorsi
Rhomboid minor and major
Levatus sacpularis

51
Q

Where is the origin and insertion of the trapezius

A

Origin is the spinous processes and the insertion is the occiput and spine of scapula

52
Q

What nerve innervates the trapezius

A

Accessory nerve CN XI

53
Q

What is the function of the trapezius

A

Elevates and depresses scapula

Retracts scapula

54
Q

Where is the origin and insertion of the latissimus dorsi

A

Broadest and back
Origin is the spinous processes and pelvis
Insertion is the humerus

55
Q

What nerves innervate the latissimus dorsi

A

C6,7,8

56
Q

What are the functions of the latissimus dorsi

A

Extends

internally rotates the humerus

57
Q

What are the functions of the rhomboid major and minor

A

To keep the scapula against the thoracic wall

Retract scapula

58
Q

What nerves innervate the thomboid major and minor

A

Dorsal scapula nerve (C3,4)

59
Q

Where is the origin and insertion of the rhomboid minor

A

Spinous processes C7/T1

Insertion: Scapula

60
Q

Where is the origin and insertion of the rhomboid major

A

Spinous processes T2-T5

Insertion: Scapula

61
Q

What is the function of Levatus scapularis

A

Elevates the scapula

62
Q

What is the origin and insertion of the levatus scapularis

A

Transverse processes C1

Insertion: Superior angle of scapula

63
Q

What nerve innervates the levatus scapularis

A

Branches C4/C5

64
Q

Why are the deep muscles of the spine clinically relevant

A

Pain due to spasm in trauma
Weakness will cause spinal instability
Largest group of muscles in the back

65
Q

What are the functions of the deep muscles of the spine

A

Movement of vertebral column and psture

66
Q

What are the names of the deep muscles of the spine

A

Iliocostalis
Longisimus thoracis
Spinalis thoracis

67
Q

What is the origin for the deep muscles of the spine

A

Occiput of the skull

68
Q

What is the insertion for the deep muscles of the spine

A

Pelvis

69
Q

What nerves innervate the deep muscles of the spine

A

Posterior rami of the spinal nerves

70
Q

What can weakness of the deep muscles of the spine cause

A

Spinal instability leading to slips often due to poor musculature of the spine and abdo muscles

71
Q

The spinal cord is a continuation of what and where does it exit the skull

A

Medulla oblongata

Exits via the foramen magnum

72
Q

Where does the spinal cord terminate

A

In the cauda equina L2

73
Q

What does the spinal cord give off at each vertebral levle

A

A pair of nerve roots (Left and right)

74
Q

Where do nerves in the cervical spine branch out to

A

Your arms

75
Q

Where do nerves in the thoracic spine branch out to

A

Middle of the body

76
Q

Where do nerves in the lumbar spine branch out to

A

Legs

77
Q

Where do nerves in the sacral spine branch out to

A

Posterior aspect of legs and organ functions of the pelvis

78
Q

Where is the origin of myotomes and dermatomes

A

The spinal cord

79
Q

What is a myotome

A

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

80
Q

What is a dermatome

A

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

81
Q

Grey matter is found in the centre of the nerve roots. True or False

A

True

82
Q

The anterior and posterior horns are part of the white matter in the nerve roots. True or false

A

False - they are part of the grey matter

83
Q

What lives in the white matter

A

Ascending sensory tracts and descending motor tracts

84
Q

What is another name for the descending motor tract

A

Crossed pyramidal or lateral cerebrospinal tract

85
Q

Where does the descending motor tracts cross

A

At the medullary level

86
Q

Descending motor tracts descend the spine on what side of the cord

A

The contralateral side

87
Q

What do the lateral and anterior spinothelamic tracts do?

A

Carry information relating to pain and temperature

88
Q

What side of the spine do the ascending sensory tracts ascend

A

The ipsilateral side of the cord

89
Q

What do the Posterior and Anterior Spinocerebellar tracts do

A

Information relating to proprioception

90
Q

What side of the spine do the lateral and anterior spinothemalic tracts ascend on

A

The ispsilateral side of the cord then cross and ascend the spine of the opposite side before enterning the thalamus

91
Q

What are the 2 posterior ascending sensory tracs called

A

Fasciculus gracilis of Goll

Fasciculus cunateatus of Burdach

92
Q

What side of the spine do the posterior columns of the ascending sensory tract travel

A

Ipsilaterlaal side of the cord

93
Q

What information do the posterior columns of the ascending sensory tracts carry

A

Information relating to fine touch and proprioception

94
Q

What happens in the grey matter

A

The descending motor tracts enter the anterior horn of the grey matter and are transmitted via the ventral root to the nerve root then the muscle of action

Sensation is transmitted via the spinal nerve root to the dorsal root and into the posterior horn of the grey matter and via the ascending sensory tracts enter the brain

95
Q

The ventral and dorsal roots joint to become what

A

Nerve root

96
Q

The nerve roots divide to form what

A

The posterior and anterior rami

97
Q

What do the posteiror rami do

A

Serve the intrinsic muscles of the back and the trip of skin sensation in the center of the back

98
Q

What do the anterior rami do

A

Form the nerve supply to the rest of the body/ limbs as we know it

99
Q

Where do the spinal nerves on each side exit the spinal column

A

The intervertebral foramina

100
Q

What is the nerve root at risk from

A

Prolapsed disc
Facet joint
Osteophytes
Foraminal stenosis

101
Q

What is the cauda equina

A

A bundle of spinal nerves and nerve roots: L2-L5

102
Q

What do the nerves that compose the cauda equina innervate

A

The pelvic orans and lower limbs

103
Q

What are the motor functions of the cauda equina

A

Hips, knees, ankles, feet, internal anal sphincter and external anal sphincter

104
Q

What are the sensory functions of the Cauda equina

A

Hips, knees, ankles, feet, perineum and partially parasympathetic innervation of the bladder

105
Q

Where do the anterior and posterior spinal arteries descend from

A

The pia

106
Q

The cerebrospinal venous system consists of what

A

Interconnected venous systems of the brain and the spine

107
Q

What is the Batson’s venous plexus

A

A network of valveless veins

They connect the deep pelvic veins and thoracic veins to the internal vertebral venous plexus

MSK SM (42 decks)

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