Exam 2 Flashcards
Functions of the vertebral column:
- Protect the spinal cord.
- Support the U.L., head, and ribs.
- Extensive muscle attachment.
- Provides locomotion.
Cervical vertebrae:
- There are 7 cervical vertebrae, but 8 cervical spinal nerves
- Have transverse formina.
- Has a cervical enlargement.
Why are there vertebral enlargements?
- There are two enlargements, lumbar and cervical.
- These areas of the spinal cord have more axons, so we can provide U.L. and L.L. with innervation.
- Provide structure support and strength where the limbs branch off.
Thoracic vertebra:
- Have articulations on the lateral sides. (Transverse processes)
- Articulate with the ribs in structures called costal fascets.
Lumbar vertebrae:
- Are very big.
- Have large transverse processes.
- Have a lumbar enlargement.
Sacral:
5 fused vertebrae.
What are the two common problem areas of the spine?
- The cervical region - Has a lot of movement.
- The lumbar region - Bares a lot of weight.
Flexion in TAP:
Head forward - TAP forward bend
Extension in TAP:
Head back - bending TAP backward.
Lateral flexion in TAP:
Bending TAP left or right. DO NOT USE AD OR AB DUCTION
Rotation in TAP:
Twisting spine.
How do vertebrae provide movement?
A single vertebrae cannot provide movement, but when many are stacked together they provide large movement due to articulations.
Inferior and superior articulating processes of the spine:
- Between adjacent vertebral bodies.
- Over 100 of them.
- Synovial joint.
- Has an intervertebral disc between them, that is made of cartilage and slightly movable.
Atlanto-occipital joint:
- between C1 and the skull.
- Allows for inferior and superior movement of the spine, sometimes called the yes joint.
- C1 has no vertebral body.
- Synovial planar gliding.
What is special about C1 vertebra?
C1 has no vertebral body.
Atlanto-axial joint:
- Between C2 and C1
- Is synovial rotation joint.
- Moves the skull medial and lateral - sometimes called the no joint.
- The C1 vertebrae rotates around the C2 Dens structure to give no movement.
- Dens goes thru the vertebral foramen of C1.
Sacroiliac joint:
- Between the scrum and the ilium
- Transfers weight from pelvic girdle to the femur.
Curves of the spine:
- Cervical curve.
- Thoracic curve.
- Lumbar curve.
- Sacral curve.
Why does the cervical curve form:
Makes the cervical portion stronger when an infant is learning to hold their head up.
Why does the lumbar curve form:
Makes lumbar portion stronger when infants learn to stand and walk.
Scoliosis:
A abnormal lateral curve of the spine.
Kyphosis:
- Exaggerates thoracic curve
- Mostly seen in older women and can be caused by osteoporosis.
Lordosis:
- Exaggerated lumbar curve.
- Pregnant women will develop temporary lordosis.
Anterior longitudinal ligament:
- Is on the anterior surface of the body of the vertebrae.
- Runs the whole spine - Is continuous.
- Limits extension of the spine.
Posterior longitudinal ligament:
- Is on the posterior surface of the body of the vertebrae.
- Runs the whole length of the spine - Is continuous.
- Limits flexion of the spine..
Ligamentum flavum:
- Connects adjacent lamina - runs in between them.
- Limits lateral flexion.
- Is discontinuous.
Interspinous ligament:
- Connects adjacent spinous processes.
- Discontinuous
- Limits flexion.
Supraspinous ligament:
- Limits flexion.
- Continuously runs over the top of spinous processes.
- In the cervical region it is called the nuchal ligament, and hold up the head.
Soft gel-like center of intervertebral disc, mostly made of H2O.
Nucleus pulposus
Why are we slightly shorter by the end of the day?
Compression of the nucleus pulposus when standing upright.
The tough outer ring of the intervertebral discs.
Annulas fibrous.
In what direction do intervertebral disc herniations occur, and why?
- Will happen posterior and lateral direction.
- This is because the posterior longitudinal ligament will not let it herniate in a posterior medial direction, so it has to move to sides.
An L4/L5 intervertebral disc hernia would impinge on what spinal nerve?
L5.
Hernias will always:
affect the next lowest spinal nerve when nucleus propusus is effected.
Extrinsic muscles of the back:
- Attach from back to U.L.
- Trapezius m. and latissimus Doris m.
- Inn = Ventral Rami of spinal nerves.
- attach from back to upper limb, not all attachments are in the axial skeleton.
____________ are the true back muscles.
Intrinsics muscles.
All intrinsic back muscles are innervated by -
Dorsal rami of spinal nerves.
Intrinsic muscle attachments will all be in the -
Axial skeleton.
Superficial intrinsic back muscles:
The splenius muscle -
1. A = spinous processes + nuchal ligament.
2. B = Transverse processes + skull.
3. Action = Bilateral contraction - the extension of the vertebral column/neck/back
4. Function = Unilateral flexion + rotation of the vertebral column
Intermediate muscles of the back intrinsics:
Erector spinae muscle group:
1. Iliocostalis, longussimus, spinous mm.
2. all run from scarum/ilium to the skull.
3. Action = Bilateral contraction - extension of back ??
4. Inn = dorsal rami of spinal nerves.
Deep muscles of the back intrinsics:
Transversospinous muscle group:
1. Attach transverse process to spinous process.
2. Inn = dorsal rami of spinal nerves.
3. Action = Bilateral contraction (Extends the back) and unilateral contraction (rotates back)
4. Function = Stabilize the vertebral column.
Spinalis muscle:
Attaches from spinous process to spinous process up the spine.
Longissimus muscle:
Connects transverse process to transverse process up the spine.
Iliocostalis muscle:
Connects ilium to rib to rib to rib up the spine.
Spinal cord starts where?
At the foramen magnum - The large whole in the posterior skull.
Spinal cord functions:
- Sensory processor - goes to the brain stem, cerebellum, cerebrum, different regions of the spinal cord, etc, for communication.
- Motor outflow - Done by lower motor neurons (LMN) cell bodies in the ventral horn, know as the common final pathway. This is influenced by the upper motor neurons (UMN).
What part of the brain allows for reflexes to be independent from consciousness?
The cerebrum.
External anatomy of the spinal cord:
- Give rise to two bilateral spinal nerves.
- Have enlargements - The lumbar and cervical.
- the conus medularis
Conus medularis:
- Is the end of the spinal cord.
- Happens are boney level of L2 vertebra.
- Is nerve tissue.
- Happens cause our spine grows longer, but our spinal cord does not, as we aged.
Lumbar cistern:
The space below the L2 boney level, where CSF is found.
Cauda equina:
Collection of spinal nerves inferior to the conus medularis. Horse tail.
Internal anatomy of the spinal cord:
- Dorsal horn, ventral horn, and lateral horn.
- Spinal cord does not align with boney levels - rule of 1s
- White matter.
Dorsal horn of the spinal cord:
- Contains interneuron cell bodies.
Ventral horn of the spinal cord:
- Contains cell bodies for motor neurons.
- Lower motor neurons.
- This is wwhere the final common pathway is - if this is damaged everything is ruined, resulting in flaccid paralysis (no tone).
Lateral horn of the spinal cord:
- Is for the sympathetic autonomic nervous system.
- IS only found in T1-L2.
What is the function of the white matter?
To protect the cell bodies - made of myelin fat.
Miniges:
- are connective tissue coverings.
- Support the CNS.
- Protect the CNS.
- Suspend CNS in cerebrospinal fluid protecting it from banging around in it’s enclosure.
If there is a spinal cord injury at T10, how would this present above the level of the injury?
We will have normal reflexes and full feeling.
If there is a spinal cord injury at T10, how would this present at the level of the injury?
The would be no feeling, no reflexes (areflexia), complete lack of voluntary movement. This is called flacid paralysis.
If there is a spinal cord injury at T10, how would this present below the level of the injury?
- There would be no voluntary movement.
- There would be hypereflexia - where there are still local reflexes. This is called spastic paralysis.
Dura mater, Pia mater, and arrachnoid matter are all _______.
miniges.
Which minige is directly against the spinal cord, supplying a vascular layer, and makes up the filum terminale.
The Pia Mater.
The arachnoid mater has a _____________ space between itself and pia mater, which is filled with _______________ _______ to suspend and protect the CNS.
- Sub-arachnoid space.
- Cerebrospinal fluid.
Which minige is the outermost layer, that attaches the spinal cord to the spinal bone?
Dura mater.
__________ space is a real space that contains fat and vasculature, where we often will inject numbing drugs.
epidural space.
True or false: The sub-dural space is a real space between the dura mater and pia mater, that holds CSF.
False -
1. The sub-dural space is the space between the dura mater and arachnoid and is a potential space that only exists during disease conditions.
- There is no space between the dura mater and pia mater, because the arachnoid runs between them.
- The space that holds CSF is the sub-arachnoid space, between the arachnoid mater and pia mater. This is a real space, not potential.
The posterior longitudinal ligament runs along what surface, and has what function?
- Runs continuously along the posterior surface of the body of the vertebrae.
- The function of the post. longitudinal ligament prevents flexion (bending forward) of the spine.
The anterior longitudinal ligament runs along what surface, and has what function?
- Runs along the anterior surface of the body of the vertebrae.
- The function of the ant. longitudinal ligament is to prevent extension of the spine (Bending back).
Boundaries of the thoracic wall:
- Anterior = Sternum/Costal cartilage.
- Posterior = Ribs/thoracic vertebrae.
- Lateral = Ribs.
- Inferior = Respiratory diaphragm.
Innervation of the thoracic wall:
Somatic innervation.
Innervation of thoracic viscera (organs):
Autonomic innervation.
Protection of the thoracic/abdominal viscera (organs, supporting the U.L, and respiration are all functions of the _______________.
Thoracic cage (wall).
Which vessels will go in-between the ribs, and branch directly off of the aorta?
The posterior intercostal arteries.
Which vessels go in between the ribs near the sternum, and branch off of the internal thoracic arteries?
The anterior intercostal arteries.
True or false: The internal thoracic arteries branch off of the subclavian arteries.
True!
The posterior intercostal veins will drain blood from the _________, and dump it into the ________ vein.
- Intercostals.
- azygous.
Where does the azygos vein drain into?
The superior vena cava.
What are intercostal nerves?
Thoracic spinal nerve’s ventral rami, all of which run in the costal groove.
Superior opening of the thoracic cage is called the -
Thoracic outlet - connecting the chest and neck.
Explain the primary differences between the left and right lungs.
Right lung has three lobes and is larger. The left lung has two lobes and is smaller. this is because the apex of the heart points to the left side, giving less space for the left lung.
Define segmented lungs:
The lobes of the lungs are segmented, meaning that their blood supply/return/nerves are separate between each lobe.