Deep Back

Question 1

Vertebral Level

Answer 1

Level associated with numbered vertebrae

Question 2

Spinal level

Answer 2

Level at spinal segements and roots are present

Question 3

Primary curvature of vertebral column

Answer 3

present in fetus, concave anterirorly. Remnant in adult at thoracic and sacral level

Question 4

Secondary curvatures of VC

Answer 4

Arise during development, function: load bearing. Concave posteriorly (thoracic and lumbar

Question 5

Kyphosis

Answer 5

excessive curvature of lower cervical and upper thoracic vertebrae

Question 6

Lordosis

Answer 6

excessive curvature of lumbar vertebrae

Question 7

Unique characteristics of typical cervical vertebrae

Answer 7

-thin bodies
-bifid spinous process
-large vertebral foramen(allows for cervical enlargement of spinal cord)
-articular facets nearly horizontal (allows for wide range of motion)
-transverse foramen

Question 7

Atypical vertebrae of cervical region

Answer 7

atlas (c1) and axis (C2), C7 spinous process

Question 8

Atlas (C1)

Answer 8

Anterior arch and posterior arch form atypical vertebral foramen, no real body
Lateral masses support superior articular facets that fit occipital condyles and are shaped to allow rocking motion of nodding yes
Articular facet for dens of C2

Question 9

Axis (C2)

Answer 9

Dens
Superior articular facets articulate with atlas
Posterior articular facet of dens articulates with C1 and interacts with the transverse ligament

Question 10

Hangman’s Fracture

Answer 10

bilateral fracture of pars interarticularis on C2 with assoc. traumatic subluxation of C2 on C3; can be caused by MVA, diving injuries

Question 11

Vertebral Arteries

Answer 11

arise in neck, passing superiorly through transverse foramen (except C7) to supply spinal cord, medulla, and cerebellum. They join to form the basilar artery in the cranium

Question 12

What is clinical significance of injury to the transverse foramen of a cervical vertebrae?

Answer 12

Injury to vertebral artery, potential for altered/impaired brain circulation

Question 13

Intervertebral foramen

Answer 13

conduits for spinal nerves

Question 14

transverse foramne

Answer 14

conduits for vertebral arteries

Question 15

Thoracic vertebrae characteristics

Answer 15

-thick body
-long spinous process (downward T1 to T10)
-costal facets for rib attachments
-superior and inferior articular facets oriented more vertically (more stable)
-T9 is same plane as xiphoid process

Question 16

Lumbar vertebrae characteristics

Answer 16

Short, thickest body for weight bearing
Mamillary processes for multifidus muscles

Question 17

Sacrum

Answer 17

5 fused vertebrae, articulates with L5 superiorly, coccyx inf, iliacs lat
transmits body weight to lower limbs
Sacral canal - cont. of vert. cancal, containing cauda equina
sacral hiatus (missing 5th spinous process)

Question 18

Coccyx

Answer 18

4 fused vertebrae functional for muscle attachemnts

Question 20

Zygapophysial joint

Answer 20

aka facet joint. Tiny synovial joints allowing for movement between articulating vertebrae. Made of joint capsule and ligaments

Question 21

What is the clinical significance of an injury near/to the zygapophysial joint?

Answer 21

/the zygapophysial joint is near the intervertebral foramen, which houses the spinal nerves. Injury to this joint could damage impair spinal nerves and function

Question 22

Intervertebral disks

Answer 22

cartilaginous joints between vertebral bodies made up of outer annuli fibrosis and inner nucleus pulposus, starting at C2/C3

Question 23

Annuli fibrosis

Answer 23

rings of fibrocartilage, attach to epiphysial rim of adjacent vertebra

Question 24

Nucleus pulposus

Answer 24

semifluid gel, withstands compressive forces. Remnant of notochord

Question 25

Herniation

Answer 25

loss of integrity of annuli fibrosis due to age or stress. Most often posterolateral (thinner annulus fibrosus and lack of coverage by posterior and anterior longitudinal ligaments)

Question 26

What symptoms can be associated with herniated discs?

Answer 26

Pain radiating down leg and muscle weakness due to compromised mixed spinal nerves due to posteriolateral herniation

Question 27

Lumbar herniation

Answer 27

hernation at lumbar region can impact cauda equina. EX: protruded L5-S1 disk compresses S1 root

Question 28

Ligamentum flavum

Answer 28

Elastic cartilage ligament binding lamina of adj. vertebra and stabilizing joints of the arches

Question 29

Interspinous ligament

Answer 29

connects spinous process

Question 30

Supraspinous ligaments

Answer 30

connect spinous process

Question 31

Intertransversarii ligament

Answer 31

connects transverse process

Question 32

Anterior longitudinal ligament

Answer 32

Runs anterior to body of vertebrae, limiting extension

Question 33

Posterior longitudinal ligament

Answer 33

Runs Posterior to body , anterior to spinal cord, limits flexion

Question 34

Atlanto-occiptal joint

Answer 34

articulation with occiput, permits flexion/extension (rocking/nodding yes)

Question 35

Atlanto-Axial joint

Answer 35

3 articulations with C1, permiting rotation of the head

Question 36

Cruciform ligament components

Answer 36

Transverse ligament of the atlas, superior longitudinal band, inferior longitudinal band

Question 37

Tectorial membrane

Answer 37

cervical continuation of posterior longitudinal ligament

Question 38

anterior antlanto-occiptal membrane

Answer 38

cervical continuation of anterior longitudinal ligament

Question 39

anterior antlanto-axial ligament

Answer 39

cervical continuation of anterior longitudinal ligament

Question 40

Posterior atlanto-occipital and atlanto-axial ligaments

Answer 40

cervical continuations of ligamentum flavum

Question 41

Arteries of the vertebrae

Answer 41

arise from branches of regional arteries that divide into anterior/posterior branches. It is the posterior branches that give off the spinal branches that vascularize the vertebrae

Question 42

Veins of the vertebrae

Answer 42

-Anterior/posterior internal vertebral plexus -External vertebral plexus of veins -Azygous and hemiazygous veins

Question 43

Clinical significance of vertebral veins

Answer 43

Vertebral veins are valve-less and are responsible for venous drainage and communication with other plexuses. They are an easy route for metastasizing cancer cells leading the vertebral column to be the most common site for bony mets

Question 44

List the meningeal coverings and 'spaces' from superficial to deep

Answer 44

- epidural space -dura mater -subdural space (pathological) -arachnoid mater -subarachnoid space (CSF) -Pia mater

Question 45

epidural space

Answer 45

between the periosteum lining of bony wall of vertebral canal and spinal dura, filled with fat, intervertebral venous plexus

Question 46

subarachnoid space

Answer 46

naturally occurring space between arachnoid and pia mater, containing CSF

Question 47

blood supply of the spinal cord

Answer 47

posterior aspects of segmental vasculature give rise to spinal branches which give off radicular arteries

Question 48

Intrinsic back muscles

Answer 48

aka deep muscles; posture and spine movement. innervated by dorsal primary rami blood supply posterior intercostal and segmental lumbar arteries -erector spinae -splenius -transversospinalis

Question 49

thoracolumbar fascia

Answer 49

deep fascia of the back, invests intrinsic back muscles

Question 50

suboccipital muscles

Answer 50

rectus capitis posterior major and minor obliquus capitis superior and inferior all innervated by suboccipital nerve (C1 dorsal primary rami) extension and rotation of the head Span from C1 or C2 to occiput (except obliquus cap inf)

Question 51

suboccipital triangle

Answer 51

Formed by superior and inferior obliquus capits and rectus capitis major

Question 52

Suboccipital vasculature

Answer 52

vertebral artery, branches of occipital artery