Exam 1 Flashcards
What are the parts of the axial skeleton?
skull, vertebral column, sternum, ribs, hyoid
Name the important roles of the vertebral column.
posture, support of body weight, locomotion, protection of spinal cord and roots
The vertebral column consists of ____ vertebrae arranged in ___ regions.
33; 5
Name the regions of the vertebral column and the number of vertebrae in each.
Cervical (7), Thoracic (12), Lumbar (5), Sacrum (5 fused), and Coccygeal (4 fused)
Name the primary curvatures of the vertebral column.
Thoracic and sacral
Normal curvatures occur due to….
the shape of the intervertebral discs
The primary curvatures are concave _____.
anteriorly
Where is a human’s center of gravity located?
anterior to the sacral promotory
What kind of curvature is present in the thoracic and sacral regions of the vertebral column?
kyphosis
Name the secondary curvatures of the vertebral column.
Cervical and lumbar
The secondary curvatures are concave _____.
posteriorly
When does the cervical secondary curvature develop?
when an infant develops head control.
When does the lumbar secondary curvature develop?
when a child begins to walk (typically 12-18 months)
Describe a kyphosis abnormal curvature.
hunchback, older women
Describe a lordosis abnormal curvature.
swayback
What cause a lumbar abnormal curvature?
compression of the posterior portion of lumbar discs. many activities such as diving, gymnastics
What is scoliosis?
Lateral or side to side curvature
Many times scoliosis is _____, meaning the cause is unknown
idiopathic
What are some typical signs of scoliosis?
uneven shoulder, uneven hips, curve in spine, rib hump
The body of a typical vertebrae is primarily composed of _____ bone (give both names).
cancellous, spongy
What is the function of the body of a vertebrae?
support weight
As you go down the vertebral column, the bodies of the vertebrae become progressively ______ in order to support greater weight.
larger
The cartilaginous interfaces between the discs and the vertebral body above and below are the
vertebral endplates
Vertebral endplates are made of (thick or thin?) _____ cartilage.
hyaline
The outer edge of the vertebral body is called _____ ____ (2 names) and is made up of _____ bone
ring apophysis, epiphyseal rim; compact
Name the anterior and poster parts of a typical vertebrae.
Anterior: Body
Posterior: Vertebral Arch
What does the vertebral canal protect?
spinal cord and nerve roots
What is a pedicle?
Joins the vertebral arch to the body of the vertebrae
What is the pars interarticularis?
region of the lamina located between the facet (zygopophyseal) joints
Spinous processes typical project in what direction?
posteroinferiorly
Transverse processes typically project what direction and from what point?
posterolaterally, the junction of the lamina and pedicle
What is a facet (zygapophyseal) joint?
the joint between the inferior articular processes of a superior vertebrae and the superior articular processes of an inferior vertebrae
What is the significance of the facets joints direction?
The direction of the facet joints determines the direction of movement
What is another name for the superior and inferior vertebral notches and what passes through these?
intervertebral foramen, dorsal root ganglia
What region of vertebrae allows for the most movement?
cervical
Which region of vertebrae have foramen of the transverse processes?
cervical, called foramen transversarium
Which vertebrae have bifid spinous processes?
C3-C6
Which vertebrae have characteristic large, triangular vertebral foramen?
cervical
Describe the transverse processes of the cervical vertebrae
end laterally in two projections forming the anterior and posterior tubercles
What is the name for the large anterior tubercles of the tranverse processes of the C6 vertebra
carotid tubercles
What is another name for zygapophyseal joints?
articular facet joint
What are the hornlike projections on the body of some cervical vertebrae called?
uncinate processes (or uncovertebral joints of Luschka)
Name the first two cervical vertebrae.
C1-Atlas
C2- Axis
What is the function of the atlas?
supports the skull by articulating with the occipital condyles
Describe the physical characteristics of the atlas.
no spinous process or body, ring-shaped with anterior and posterior arches, lateral masses
Which cervical vertebra is the strongest of the region?
C2-axis
What is the special physical characteristic of the axis (two names) and what holds it in place?
dens (odontoid process), transverse ligament of the atlas
Describe C7.
vertebra prominens, very long spinous process, easily papable.
What is the purpose of the costal facets on the thoracic vertebrae?
articulation with ribs
Describe how the ribs articulate with the vertebrae.
- The superior demifacet of a vertebral body articulates with the head of the rib at the same vertebral level.
- The inferior demifacet of a vertebral body articulates with the head of the rib inferior to it (below).
- The tubercle of of a typical rib articulates with the facet on the transverse process of the vertebra of the same level
The articular facets joints articulate with what?
each other
Which thoracic vertebrae have some features of cervical vertebrae?
T1-T4
Which thoracic vertebrae are considered to be typical and describe them?
T5-T8, heart-shaped bodies with circular vertebral foramina
Which thoracic vertebrae have tubercles similar to lumbar vertebrae?
T9-T12
Describe the characteristics of the lumbar vertebrae.
massive bodies, sturdy laminae, absence of costal facets because no ribs articulate, kidney shaped bodies, and oval or triangular vertebral foramina
Which regions of the vertebral column have articular, facet, zygapophyseal joints?
cervical, thoracic, lumbar
Which vertebrae is the largest of all moveable vertebrae and why?
L5, needs to transmit all weight of body to sacrum
What is another name for the transverse processes in the lumbar vertebrae?
costal processes
Name the two extra processes of the lumbar vertebrae and describe their location.
Accessory process- on the posterior surface if the base of each transverse process
Mammillary process- on the posterior surface of superior articular process
Which part of the sacrum is weight bearing and which part is non weight bearing?
superior portion- weight bearing
inferior portion- non weight bearing
The sacrum is ___ and ____ shaped.
triangular, wedge
What is the function of the sacrum?
provide strength an stability to the pelvis, transmits body weight through S_I joint
What is the sacral promontory?
projecting anterior edge of the body of the first sacral vertebrae (COG just anterior)
The sacrum is tilted at the articulation with L5 forming the ____ _____
lumbosacral angle
What is the median sacral crest?
represents fused spinous processes
What is the intermediate sacral crest?
represents fused articular processes
What is the lateral sacral crest?
tips of the transverse processes of fused vertebrae
The sacral canal is a continuation of the ____ _____
vertebral canal
The sacral foramina acts as….
anterior and posterior exits for sacral nerves
The top of the sacrum is called the ____ and the inferior end is called the _____.
base, apex
Describe the sacral hiatus, where it leads, and what it contains.
results from the absence of lamina and spinous process of S5, leads into sacral canal, and contains filum terminale, S5 and coccygeal nerve
What is the sacral cornua?
represents inferior articular processes of S5- bony prominences
Name the lateral part of the sacrum that is the site of the sacroiliac joint.
auricular (ear) surface
What is the name for the wing shaped portion of the sacrum on the superior, anterior, and lateral region.
ala
What is another name for the coccyx?
tailbone
What is the coccygeal cornua?
represents if the superior articular processes of Co1
True or False: The coccyx supports body weight.
False, it does not.
The intervertebral (IV) discs are _____ joints.
symphysis type joints
The IV discs are found in what vertebrae?
C2/C3-L5/S1
True or False: The IV discs are weight bearing.
True
Name the two components of the IV discs.
Annulus fibrosus and nucleus pulposes.
The annulus fibrosus is composed of what?
concentric lamellae of fibrocartilage
The lamellae of the annulus fibrosus run what direction?
obliquely from one vertebrae to another
Lamellae of the annulus fibrosus are (thicker/thinner?) and less numerous _______ than ______ or _______.
thinner, posteriorly, anteriorly, laterally
The nucleus pulposus is a _____ material that is highly _____
gelatinous, elastic
True or False: The nucleus pulposes has a high water content.
True
The annulus fibrosus has a direct blood supply only to its ____ parts.
outer
The nucleus pulposes is _____ and therefore receives its nourishment by way of ______.
avascular, diffusion
The nucleus pulposes is located more ______.
posteriorly
The IV discs vary is size and thickness in different regions of the vertebral column. They are thinnest in the _____ region and thickest in the _____ and _____ regions.
thoracic, cervical and lumbar
What is a possible problem with the uncovertebral joints of C3-C6?
possibility of formation of bony spurs
What innervates the the IV disc (sinovertebral)
recurrent branch of the spinal nerves
The anterior longitudinal ligament (ALL) runs from the ______ (anterior to the foramen magnum) to the ______
occiput, sacrum
The ALL functions to…
prevent hyperextension and connects the anterolateral space aspects of the vertebral bodies and the IV discs
The posterior longitudinal ligament (PLL) runs within the vertebral canal along the posterior aspect of the vertebral bodies from ____ to the ____
C2, sacrum
The PLL functions to…
prevent hyperflexion and posterior protrusion of the disc
True or False: The PLL is thicker than the ALL.
False, the PLL is thinner than the ALL
The facet or zygapophyseal joints are ____ ____ joints.
plane, synovial
The facet/zygapophyseal joints allow what kind of movements?
gliding movements
The facet/zygapophyseal joints are innervated by nerves that arise from the _____ branches if the _____ primary rami
median, dorsal
Name the accessory ligaments of the vertebral arches.
ligamentum flava, interspinous ligaments, supraspinous ligaments, ligamentum nuchae, and intertransverse ligament (relatively thin, not very important).
What is the ligamentum flava?
joins lamina of adjacent vertebrae, made of yellow elastic tissue
The ligamentum flava functions to…
prevent separation of lamina, prevent abrupt flexion of the vertebral column and prevent injury to the dics
What do the interspinous ligaments do?
join adjacent spinous processes (weak)
What do the supraspinous ligaments do?
join adjacent spinous processes (strong)
The supraspinous ligament is found from ____ to ____
C7 to sacrum
What is the range of the nuchal ligament (ligamentum nuchae) ?
external occipital protuberance and the posterior border of the foramen magnum to the spinous processes of the cervical vertebrae–it is a median septum between the muscles on each side of the posterior aspect of the neck
True or False: Craniovertebral joints do not have intervertebral discs or facet joints.
True
The Atlanto-occipital joint lies between…
the superior articular surfaces of the atlas (C1) and the occipital condyles
The atlanto-occipital joint is a _____ joint of the ____ type
synovial, condyloid
The atlanto-occipital joint functions to…
permit nodding of the head (flexion and extension)
The anterior and posterior atlanto-occipital membranes extend from the anterior and posterior arches of ____ to the anterior and posterior margins of the ______ _____. This prevents excessive movement of the atlanto-occipital joints
C1, foramen magnum
The atlanto-axial joint is a _____ joint between ___ and ____ with ____ articulations.
synovial, C1 and C2, 3 (right and left lateral and median)
What is the tectorial membrane?
a continuation of the posterior longitudinal ligament that runs from the body of C2 to the internal surface of the occipital bone.
The tectorial membrane covers what two ligaments?
alar and transverse ligaments
Where and what is the purpose of the transverse ligament of the atlas?
extends between the tubercles on the lateral masses of C1; holds the dens of C2 against the anterior arch of C1
What forms the cruciform ligament?
transverse ligament of the atals and the longitudinal bands (fascicles)
What are vertically oriented superior and inferior bands that pass from the transverse ligament to the occipital bone superiorly and to the body of C2 inferiorly?
Longitudinal bands (type of craniovertebral joint)
The alar (check) ligaments extend from the sides of the ____ to the ____ ____ and check what movements of the head?
dens, foramen magnum; rotation and side to side movement of the head
The dens of C2 is held in a _____ formed by the anterior arch of the atlas and the transverse ligament.
collar
Normal range of movement of the vertebral column is limited by…(4 things)
- thickness and compressibility of the discs
- resistance if the muscles and ligaments if the back
- orientation of the zygapophyseal (facet) joints
- tension of the articular capsules of the zygapophyseal (facet) joints
Movements between adjacent vertebrae occur at the facet joints and the nucleus pulposes and include ___, ____, ____, and ____.
flexion, extension, lateral flexion, and rotation
Movements are freer in the ______ and _____ regions than in the _____ region
cervical and lumbar, thoracic
What is spodylolisthesis?
anterior displacement of a vertebra in relation to the vertebra below
What is spondylosis?
a fracture of the pars interarticularis
The ____ region allows for the most rotation
thoracic
What artery runs through the foramen of the transverse processes in the cervical vertebrae?
Vertebral arteries, (not through C7 though)
What area of the back does the trapezius muscle cover?
the posterior aspect of the neck and superior half of the trunk
What do the superficial extrinsic muscles of the back function to do?
connect upper limbs to the trunk and is concerned with movement of the upper extremity
The trapezius muscle attaches the pectoral girdle to the ____ and _____ and also assists in ______ the pectoral girdle.
skull, vertebral column; suspending
The superior and inferior fibers of the trapezius rotate the scapula to allow full abduction —> _____ ______.
scapulohumeral rhythm
What artery supplies the trapezius and what trunk does it arise from?
transverse cervical artery-branch of the thyrocervical trunk
How far does the nuchal ligament span of the back of the neck?
skull to the spinous processes of C7
What superficial muscle covers the inferior portion of the back?
Latissimus dorsi
Along with the pec major, the lat dorsi forms a sling from the trunk to the arm, which functions to….
raise the trunk (chin up)
The levator scapulae is ____ to the sternocleidomastoid and trap muscles
deep
What forms the triangle of auscultation?
latissimus dorsi, part of the rhomboid major, and the trapezius muscle
The intermediate muscles are also know as the _____ muscles of the back
respiratory
The intrinsic or deep muscles of the back are concerned with…
maintenance of posture and movements of the vertebral column and head
Where does the intermediate layer of the intrinsic back muscles lie?
within the middle and posterior layers of the thoracolumbar fascia
Name the erector spinae muscles from lateral to medial.
Iliocostalis, Longissimus, and Spinalis
What is the common origin of the erector spinae muscles?
through a broad tendon which is attached inferiorly to the posterior part of the iliac crest, posterior sacrum, supraspinous ligaments, sacrotuberous and sacroiliac ligaments
What is the additional action of the longissimus capitis?
rotation of the head to the same side
What are the actions of the erector spinae muscles?
chief extensors of the vertebral column, maintains erect posture, acting unilaterally-laterally flex the head or vertebral column to the same side
The deep layer of the intrinsic back muscles describe the short muscles in the groove between the _____ and ______ of the vertebrae
transverse and spinous processes
What is another name for the deep layer of the intrinsic back muscles?
transversospinal muscles
The semispinalis arises from about _____ the vertebral column from ____ to ____
half; C4-T12
Name how many segments each of the muscles of the deep layer of the intrinsic back muscles spans and their general origin and insertion.
Semispinalis: 4-6 segments, TP–>SP (C4-T12)
Multifidus: 2-4 segments, TP –> SP (C2-L5)
Rotatores: 1-2 segments, TP –> SP (whole spinal column)
The multifidus is best develop in what region?
lumbar
Name the deep layer of the intrinsic back muscles in order from most superficial to deep
semispinalis, multifidus, rotatores
True or False: The multifidus is divided into several bundles.
True
The rotatores has both a ____ and ____ portion.
brevis and longus
The interspinales and intertransversarii are better developed in what region more than the other two?
cervical
The intertransversarii and interspinales (small muscles of the deep back) have been proposed to be more important as what…rather than movement of the vertebral column?
organs of proprioception
Describe fascia.
connection tissue composed of irregularly arranged collagen fibers.
The arrangement of collagen fibers of fascia allows it to fulfill a role as ____ _____ which resists…..
packing tissue; resist tensional forces in multiple directions
True or False: There is both superficial and deep fascia.
True
The deep fascia covers ____ and blends with the ____ of bone.
muscles; periosteum
The superficial fascia covers ____ _____.
cutaneous structures
What are the layers of the thoracolumbar fascia?
Posterior, Middle, and Anterior
The anterior layer of the thoracolumbar fascia passes anterior to the _____ muscle.
quadratus lumborum
The middle layer of the thoracolumbar fascia goes between the erector spinae muscles and the ____ _____
quadratus lumborum
Which layer of the thoracolumbar fascia is the primary link between the tension generated in the abdominal muscles and the lumbar spine?
Middle layer
The middle layer of the thoracolumbar fascia blends with the aponeurosis of what?
transversus abdominis
What muscles are responsible for cervical rotation to the same side?
levator scapulae, splenius cervicis, longissimus captitis, rectus capitis posterior major and minor, inferior oblique
How many pairs is the levator costarum?
12, short or long
What muscles are responsible for cervical rotation to the opposite side?
upper trapezius, semispinalis cervicis and capitis,
What muscles are responsible for lateral bending of the cervical spine to the same side?
levator scapulae, splenius capitis and cervicis, erector spinae, semispinalis cervicis and capitis, superior and inferior oblique
What muscles are responsible for cervical extension?
upper trap, levator scapulae, splenius, semispinalis cervicis and capitis, rectus capitis posterior major and minor, superior oblique
What are the overlying muscles of the suboccipital triangle?
Trapezius, splenius (bandage) and semispinalis capitis
Name the boundaries of the suboccipital triangle.
superior and medial boundary: rectus capitis posterior major
superior and lateral boundary: obliques capitis superior
inferior and lateraly boundary: obliques capitis inferior
floor: posterior atlanto-occipital membrane and posterior arch of C1
roof: semispinalis capitis
What are the contents of the suboccipital triangle?
vertebral artery and suboccipital nerve (dorsal ramus of C1)
Name the four suboccipital muscles.
Rectus capitis posterior major and minor, superior and inferior oblique
The rectus capitis posterior major arises from…
the spinous process of C2
The rectus capitis posterior minor arises from…
the posterior tubercle on the posterior arch of C1
Both the rectus capitis posterior major and minor insert side by side where?
on occiput inferior to the inferior nuchal line
What is the function of the rectus capitis posterior major and minor?
postural muscles, also help rotate the head to the same side; acting bilaterally they help extend the head
The multifidis spans from where to where?
C2-L5
How far does the rotatores span and where is it most easily seen?
The entire length of the spinal column, thoracic region
In general, the spinalis runs from ___ process to ___ process from the ______ thoracic region to the ______.
spinous, spinous; lower, occiput
The CNS consists of….
brain and spinal cord
The spinal cord begins as a continuation of the _____ _____ and extends from the ____ ____ to the level of the ___ vertebra in an adult.
medulla oblongata, foramen magnum, L2
At birth, the spinal cord is at the level of ____.
L3
What are the two enlargements of the spinal cord, where are they located, and what is their purpose?
Cervical, C4-T1 (brachial plexus) and Lumbar,T11-S1 (lumbosacral plexus)
True or False: Spinal cord segments correspond with vertebral levels.
False, they do not. This is because during development the vertebral column grows more rapidly than the spinal cord
What is a spinal cord segment?
the portion of the spinal cord that gives rise to the roots/rootlets that form one bilateral pair of spinal nerves
How many pairs of spinal nerves are there?
31 pairs formed by the union of the dorsal and ventral roots
Separate the number of spinal nerve pairs per region.
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
Ventral roots contain _____ (_____) fibers with cell bodies locates in the ventral _____ horn.
efferent (motor); gray
Dorsal roots contain _____ (_____) fibers with cell bodies locates in the dorsal _____ ____.
afferent (sensory), root ganglia
Each spinal nerve divides into a ____ and ____ primary ramus.
ventral and dorsal
The ventral primary ramus supplies the… and the dorsal primary ramus supplies the…
limbs and trunk;
back
What is a bundle of nerve rootlets in the subarachnoid space distal to the termination of the spinal cord.
cauda equina (horse’s tail)
What is the conus medullaris?
inferior end of the spinal
The spinal arteries supply superior (/) of the spinal cord.
1/3
What artery is formed by the union of branches from the vertebral arteries and supplies the anterior 2/3 of the spinal cord?
anterior spinal artery
What arteries are branches of either the vertebral or posterior inferior cerebellar arteries and supplies the posterior 1/3 of the spinal cord?
2 posterior spinal arteries
What arteries are located at the cervical and lumbosacral enlargements where the need for good blood supply is greatest?
segmental medullary arteries
The segmental medullary arteries arise from a number of different arteries and enter the vertebral canal through the….
intervertebral foramen
What artery usually arises from the inferior intercostal or upper lumbar artery?
great anterior segmental medullary artery (medullary artery of Adamkiewicz)
The great anterior segmental medullary artery supplies… and provides the main blood supply to the inferior (/) of the spinal cord.
the inferior thoracic, superior lumbar and lumbosacral enlargement; 2/3
What artery makes a major contribution to the anterior spinal artery?
great anterior segmental medullary artery
Radicular arteries supply…
dorsal and ventral roots
There are usually ___ anterior and ____ posterior spinal veins, They communicate freely and are drained by ____ and ____ veins
3,3;
medullary, radicular
….are found in the epidural space and communicate with venous sinuses of the dura mater
internal vertebral plexuses
Name the three layers of spinal meninges.
Dura (forms long dural sac), arachnoid, and pia mater
What innervates the spinal meninges.
recurrent menigeal nerves
What is found in the epidural space? What is found in the subdural space?
epidural space- adipose tissue and venous plexus
subdural space- potential space
What is found in the subarachnoid space?
cerebralspinal fluid and blood vessels
What are two structures made up of pia mater?
filum terminale and denticulate ligament
What does the denticulate ligament do?
divides the posterior (dorsal) and anterior (ventral) roots (rootlets)
The PNS consists of ____ pairs of cranial nerves and 31 pairs of spinal nerves.
12
What does the Somatic Nervous System do?
carries conscious sensations and innervates voluntary muscles
General Somatic Afferents (GSA) fibers of the somatic nervous system transmit what kind of sensation from the body to the CNS?
pain, temperature, touch, and proprioception
General Somatic Efferent (GSE) fibers of the somatic nervous system carry ___ ____ from the CNS to skeletal muscles
motor impulses
The visceral nervous system is located in the _____ horn.
lateral
What does the visceral nervous system do?
carries sensation from viscera (internal organs) and innervates smooth muscle, cardiac muscle, and glands
General Visceral Afferent (GVA) fibers of the visceral nervous system transmits sensory impulses from the ____ to the ____
viscera, CNS
General Visceral Efferent (GVE) fibers transmits motor impulse from _____ to….
CNS;
smooth muscle, cardiac muscles, and glandular tissues
The autonomic nervous system is a…. system only.
motor efferent
All smooth muscle, cardiac muscle and glands are innervated by the autonomic (_____) nervous system.
involuntary
What are the divisions (both names) of the ANS and what is the main function of each?
Sympathetic Nervous System (thoracolumbar)-fight or flight
Parasympathetic Nervous System (craniosacral)- homeostasis
What is the primary function of the sympathetic nervous system?
regulate blood vessels
The cell bodies of the sympathetic nervous system are located in the ______ cell column in the ____ horn–only in the thoracic and lumbar regions.
intermediolateral, lateral
The ganglia of the _____ nervous system are located at a distance from their target organ while the ganglia of the ____ nervous system are located close to their target organ.
sympathetic, parasympathetic
What nerves are located in the parasympathetic nervous system?
CN III, VII, IX, X, and S2-S4
The autonomic nervous system is a two neuron system with both ______ and _____ fibers
preganglionic and postganglionic
For preganglionic fibers, the ____ neuron begins in the CNS and travels to a ganglion where a synapse occurs with the ____ neuron.
1st, 2nd
For postganglionic fibers, after the synapse with the ____ neuron, the fibers travel to…
2nd, target organ
What connects the spinal nerves to the sympathetic chain ganglion?
rami communicantes
White rami are found between T1-L2 and conveys sympathetic _____ fibers to the ______ ____ and also visceral _____ fibers that pass through the sympathetic chain to the spinal nerve.
preganglionic, sympathetic ganglion, afferent
True or False: Gray rami are found at every spinal level.
True
Gray rami conveys sympathetic ______ fibers from the sympathetic chain to the spinal nerve.
postganglionic
Typical spinal nerves are formed from what?
dorsal (sensory) and ventral (motor) roots
A dorsal root ganglion which is a collection of cells in located within the…
intervertebral foramen
Each spinal nerve divides into a ____ which courses to the back and a ____ which followed the body wall to the anterior surface of the body
dorsal ramus, ventral ramus
Which ventral rami are called intercostal nerves?
T1-T11
True or False: Typical spinal nerves are mixed nerves.
True, contain both sensory and motor fibers
GSE motor fibers have cell bodies located in the ____ ___ horn of the spinal cord and GVE fibers have cell bodies located in the ___ horn of the spinal cord (segments T1-L2 only)
ventral gray; lateral
A spinal nerve contains sensory fibers located whose cell bodies are located in….
the dorsal root ganglion (GSA, GVA)
A strip of skin supplied by the dorsal root (sensory) of a specific spinal nerve.
Dermatome
A group of muscles supplied by a single nerve root.
Myotome
Pain that is perceived as coming from an area remote from its actual origin.
Referred pain
