Deep Back and Vertebral Column Flashcards
What layer invests the erector spinae?
The posterior and middle layers of the thoracolumbar Fascia
3 parts of erector Spinae
Spinalis
Longissimus
Ileocostalis
Describe the origins and insertions of erector spinae muscles
has several origins because of arches formed spanning only 3-4 vertebrae
Describe location of ileocostalis
most lateral of erector spinae
associated with ribs
Describe the location of longissimus
middle erector spinae muscle
Describe the location of Spinalis
Erector spinae muscle in closest association with the spine
How many dorsal rami are there?
31 (8 cervical, 5 lumbar, 5 sacral, and 1 coccygeal)
What are the two primary curvatures of the back (concave anterior)
Thoracic and sacral
What are the first two curvatures to develop?
Thoracic and sacral
What are the second two curvatures to develop?
Cervical and Lumbar curvatures
Kyphosis
abnormal increase in the primary curvature in the thoracic region
common name for kyphosis
dowager’s hump
Scoliosis
lateral curvature of the spine
Lordosis
increase in secondary curvature in lumbar spine
Dorsal Rami
Sensory and Motor
Interact with deep back muscles and skin within 3in of vertebra column
Characteristics of Cervical Vertebrae
spinous process points directly posterior and is bifid
Also have a hole separating the little rib and transverse process
Thoracic Vertebrae Characteristics
sharply descending spinous process
Costal articular Facets on body and transverse processes
Lumbar Vertebrae Characteristics
large vertebral bodies
have rectangular spinous processes that extent directly posterior
Zygopophysial Joints
Synovial Joints that Exist at R and L superior and inferior articular facets from C2 to L5
Purpose of Transverse Foramena
Exist in cervical vertebrae to supply blood to the brain
What prevents rotation around vertical axis in lumbar region
The vertical angle of the superior and inferior transverse processes
Location of Supraspinous ligament
On top of spinous processes
Location of intraspinous ligament
between spinous processes
Ligamentum nuchae
supraspinous/intraspinous ligament that exists in the cervical region
Posterior Longitudinal ligament
within the vertebral canal and has cruciform shape extending horizontally onto interventricular discs
Anterior longitudinal ligament
runs up and down anterior side of spine
Which ligament between anterior and posterior longitudinal ligaments resists hyperflexion?
Posterior ligament
Interal Vertebral Venous Plexus
no predetermined direction of blood flow
May work with brown fat to regulate spinal temperature
Why can blood travel along spine toward head when standing on head?
Internal vertebral venous plexus has no valves
What creates the “pop” sound when performing an intrathecal injection?
The pop comes from the ligamentum flava between each lamina
Two structures created from extensions of pia mater.
Dentriculate ligaments (attach S.C. to dura and hold in place) and the filum terminale (attaches to sacrum and holds S.C. in place).
Two enlargements in spinal cord?
cervical enlargement and lumbosacral enlargment
Endpoint of spinal cord
conus medularis at L2
Where does Dura terminate
S2
Where does arachnoid/ fluid filled space stop?
S2
Cauda Equina
Nerves extending down from S.C.
Nucleus Pulposus
gel area on inside of intervertebral discs
Anulus Fibrosus
Fibrous area surrounding nucleus pulposus on intervertebral discs
Why does a disc herniation at T12 not cause symptoms in spinal nerve T12?
Superior vertebral notch is larger in intervertebral foramen, so spinal nerve T12 exits above disc 12.
A patient experiences lack of sensation in the L1 dermatome. Where might spinal herniation exist?
Herniation in T12 disc.
What ligament acts to reinforces the inferior part of the annulus fibrosis?
The cruciform parts of the posterior longitudinal ligament
Disc C7 is located between what two vertebrae?
C7 and T1
Nerve numbering
C1-C8 the nerve is named for the vertebrae below. The rest are carry the same number as the vertebrae above.
GSA
General Sensations in skeletal muscle, fascia, ligaments, tendons, joint capsules, periosteum, skin (except glands, follicles, and vessels)
General Sensations (skeletal)
pain, temperature, touch, pressure, proprioception
GSE
Motor innervation of skeletal muscles of trunk, neck, and limbs
GVA
General sensations from smooth and cardiac muscle, mucous and serous membranes
General Sensations (visceral)
mostly pain and pressure
GVE
Motor innervation of cardiac and smooth muscle
Where do sensory fibers emerge?
Dorsal root
Motor fibers emerge from?
Ventral root
If a patient experiences no sensation in the shoulder and middle forearm what nerve is affected and disc may herniated?
C4 disc may be herniated because this describes the C5 dermatome
What spinal nerve innervates the nipple region?
T4
What innervates the naval region?
T10
Do dorsal rami form nerve plexuses?
NOOOOOO
The posterior/dorsal rami innervate…
Sensory - from skin on scalp down dorsum of back and neck
Somatic innervation to DEEP back muscles
Autonomic Innervation of glands and follicles in back
Ventral Rami innervate…
innervate much of the anterior part of the body
Where can the cervical enlargement be found?
C5-T1
What separates the Dura mater from the spinal canal?
Epidural Space
Where is spinal fluid contained?
subarachnoid cpace
Dentriculate ligaments
Extentions of the pia that attach to the Dura to hold spinal cord in place
How many fibers are typically innervated by a single axon?
Very few. (e.g. parts of trapezius can contract indepedently)
Is the cell body for the dorsal root ganglion inside or outside of the CNS?
Outside
Is the cell body for the ventral root inside or outside of CNS?
Inside
Sensory information enters where in the spinal cord?
Dorsal gray horn
Motor commands exit from where in spinal cord?
Anterior gray horn
The internal vertebral venous plexus resides where?
in the epidural space/epidural fat
