Deep Back and Posterior Neck

Question 1

Classify the cervical curvature

Answer 1

Lordotic

Question 2

Classify the thoracic curvature

Answer 2

Kyphotic

Question 3

Classify the lumbar curvature

Answer 3

Lordotic

Question 4

Classify the sacral curvature

Answer 4

Kyphotic

Question 5

Name the two primary curvatures of the spine

Answer 5

Thoracic and Sacral

Question 6

Name the parts of the basic vertebrae

Answer 6

Vertebral body
Pedicle
Lamina
Inferior articular process
Superior articular process
Spinous process
Pars interarticularis 
Vertebral foramen 
Transverse process

Question 7

What two parts of the vertebrae make up the Vertebral arch?

Answer 7

Pedicle and Lamina

Question 8

What is different about cervical vertebrae?

Answer 8

Transverse foramen

Question 9

What is different about Thoracic vertebrae?

Answer 9

Rib facets (giraffe head)

Question 10

What vertebrae do vertebral arteries pass through?

Answer 10

C1-C6

Question 11

What vertebrae do vertebral veins pass through?

Answer 11

C1-C7

Question 12

What makes up the sacrum?

Answer 12

5 fused vertebrae

Question 13

Where do the spinal nerves pass?

Answer 13

Inter-vertebral foramen made from the inferior vertebral notch of one vertebrae and the superior vertebral notch of another

Question 14

Inferior articular process of one vertebrae + superior articular process of another = ?

Answer 14

Zygopophyseal joint

Question 15

Name the 2 joint types that join the vertebrae

Answer 15

Zygapophyseal joint = synovial joint

Intervertebral disks = symphysis joints

Question 16

Name the 3 parts to a Synovial Joint

Answer 16

1. Capsule with fibrous outer layer lined by a synovial membrane that makes synovial fluid
2. Cavities filled with capillary-thin layer of synovial fluid
3. Hyaline cartilage on articular surfaces

Question 17

Synovial fluid:

Answer 17

aqueous fluid similar to egg white for lubrication

Question 18

Name the 2 parts of the Intervertebral Disk

Answer 18

Nucleus Pulposus (gelatinous shock absorber as illustrated)
Annulus Fibrosis (Fibrocartilage)

Question 19

Spondylolisis

Answer 19

The neck of the Scottie dog is that part of the lamina located between the superior and inferior articular facets. When this part of the lamina is broken it destabilizes the connections between adjacent vertebra. The fracture of this region is known as spondylolisis

Question 20

Spondylolisthesis

Answer 20

Fractures of both pars intraarticularis regions can permit slippage of one vertebra one another, a condition known as spondylolisthesis.

Question 21

Name the ligaments of the Vertebral Column

Answer 21

Ligamentum Flavum
Supraspinous
Posterior Longitudinal 
Interspinous 
Anterior Longitudinal 
Intertransverse

Question 22

Nuchal Ligament

Answer 22

Muscle attachments
Limits Flexion
Separates left and right compartments

Question 23

Suboccipital Ligaments

Answer 23

Alar (“wing”) Ligaments - from dens to occiput

Longitudinal bands + Transverse band = Cruciform ligament

Question 24

Sacroiliac ligaments

Answer 24

Names are not important, but clinical significance is. These are incredibly strong ligaments that greatly limit movement of the sacroiliac joint

Question 25

Suboccipital Triangle components

Answer 25

``` Obliquus capitis superior Obliquus capitis inferior Rectus capitis posterior minor Rectus capitis posterior major Important in the ability to nod and tilt the head ```

Question 26

Rectus capitis posterior major (O, I, N, F)

Answer 26

``` O = Spinous process of C2 I = Lateral portion of occipital bone below inferior nuchal line N = Post. ramus of C1 F = Extension of head; rotation of face to same side as muscle ```

Question 27

Rectus Capitus Posterior Inferior (O, I , N, F)

Answer 27

``` O = Posterior tubercle of C1 I = Medial portion of occipital bone below inferior nuchal line N = Post. ramus of C1 F = Extension of head ```

Question 28

Obliquus capitis superior (O, I, N, F)

Answer 28

``` O = Transverse process of C1 I = Occipital bone between superior and inferior nuchal lines N = post. ramus of C1 F = Extension of head and bends to same side ```

Question 29

Obliquus capitis inferior (O, I, N, F)

Answer 29

``` O = Spinous process of C2 I = Transverse process of atlas N = post. ramus of C1 F = Rotation of face to same side ```

Question 30

Deepest Intrinsic Back Muscles

Answer 30

Segmental Muscles: Levatores Costarum Interspinales Intertransversarii

Question 31

Levatores Costarum (O, I, F)

Answer 31

``` O = Short paired muscles arising from transverse processes of C7 to T11 I = The rib below vertebra or origin near tubercle F = Contraction elevates ribs ```

Question 32

Interspinales (O, F)

Answer 32

``` O = Short paired muscles attached to the spinous processes of contiguous vertebrae, one on each side of the interspinous ligament F = postural muscles that stabilize adjoining vertebrae during movement of vertebral column ```

Question 33

Intertransversarii (O, F)

Answer 33

``` O = Small muscles between the transverse processes of contiguous vertebrae F = Postural muscles that stabilize adjoining vertebrae during movements of vertebral column ```

Question 34

Deep Intrinsic Back Muscles

Answer 34

Transversospinalis: attach from transverse process to spinous processes Rotatores Multifidus Semispinalis

Question 35

Rotatores (O, I) - Brevis and Longus; skip 0-1 vertebrae

Answer 35

Lumborum, thoracis, cervicis O = Transverse processes (or articular in cervical) I = Spinous process

Question 36

Multifidus (O, I); skip 2-4

Answer 36

``` O = sacrum, origin of erector spinae, posterior superior iliac spine, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae, and articular processes of lower four cervical vertebrae I = Base of spinous processes of all vertebrae from L5 to C2 ```

Question 37

Semispinalis (O, I); skip >4

Answer 37

``` O = transverse processes of T5 to T10 (thoracis), transverse processes of upper 5 or 6 thoracic vertebrae (cervicis), transverse processes of T1 to T6 and C7 and articular processes of C4 to C6 (capitis) I = spinous processes of upper four thoracic and lower two cervical vertebrae (thoracis), spinous processes of C2 to C5 (cervicis), Medial area between superior and inferior nuchal lines of occipital bone ```

Question 38

Intermediate Intrinsic Back Muscles

Answer 38

``` Erector Spinae Muscles Iliocostalis Longissimus Spinalis Enclosed in thoracolumbar fascia ```

Question 39

Iliocostalis (O, I)

Answer 39

``` O = sacrum, spinous processes of lumbar and lower two thoracic vertebrae and their supraspinous ligaments, and the iliac crest (lumborum); Angles of the lower six ribs (thoracis); Angles of ribs 3 to 6 (cervicis) I = Angles of the lower 6 or 7 ribs (lumborum); Angles of the upper 6 ribs and the transverse process of C7 (thoracis); Transverse processes of C4 to C6 (cervicis) ```

Question 40

Longissimus (O, I)

Answer 40

``` O = Blends with iliocostalis in lumbar region and is attached to transverse processes of lumbar vertebrae (thoracis); Transverse processes of upper four or five thoracic vertebrae (Cervicis); transverse processes of upper four or five throacic vertebrae and articular processes of lower three or four cervical vertebrae (capitis) I = transverse processes of all thoracic vertebrae and just lateral to the tubercles of the lower nine or ten ribs (thoracis); transverse processes of C2 to C6 (cervicis); Posterior margin of the mastoid process (Capitis) ```

Question 41

Spinalis (O, I)

Answer 41

``` O = Spinous processes of T10 to T11 or L2 (thoracis); lower part of ligamentum nuchae and spinous process of C7 (cervicis); Usually blends with semispinalis capitis (capitis) I = Spinous processes of T1 to T8 (thoracis); spinous process of C2 (cervicis); with semispinalis capitis (capitis) ```

Question 42

Superficial Intrinsic Back Muscles

Answer 42

Splenius Capitis | Splenius Cervicis

Question 43

Splenius Capitis (O, I, N, F)

Answer 43

``` O = lower half of ligamentum nuchae, spinous processes of C8 to T4 I = Mastoid process, skull below lateral on the third of superior nuchal line N = post rami of middle cervical nerves F = together - draw head backward, extending neck; individually - draw and rotate head to one side ```

Question 44

Splenius Cervicis (O, I, N, F)

Answer 44

``` O = Spinous processes of T3 to T6 I = Transverse processes of C1 to C3 N = Posterior rami of lower cervical nerves F = same as capitis ```

Question 45

Where is the most common site for bony metastases and why?

Answer 45

Vertebral column because the venous drainage and lymphatics provide a pathway for the spread of infection or metastatis