Intro to musculoskeletal 2 Flashcards
functions of the vertebral column
support for the head
movement
protection - spinal cord
structure of vertebra
vertebral body
- weight transfer
- IVDs between
vertebral arch
- together with the body forms vertebral foramen
- surrounds and protects the spinal cord
pedicle - foot of arch
transverse process - muscle/ ligament attachment (+ ribs in thorax)
lamina - lateral and posterior part of arch
spinous process - muscle/ ligament attachment
superior/ inferior articular process - form joints
superior/ inferior vertebral notches - form intervertebral foramen (for spinal nerves)
cauda equina
spinal nerves descend to exit
where does the spinal cord end
L1/2
atlas (C1) and axis (C2)
C1 - no body
C2 - odontoid process (dens)
- protrudes through vertebral foramen to form joint
no IVD between C1-C2
atlanto-occipital (C1- base of skull)
- nodding head ‘yes’ joint
atlanto-axial
- synovial pivot joint
- shaking head ‘no’ joint
function of ligaments in MSK
connect bone-bone
provide support to joints
restrict movement at joints
ligaments of the spine
anterior longitudinal ligament
posterior longitudinal ligament
supraspinous + nuchal ligament
ligamentum flavum
interspinous/ intertransverse ligaments
supraspinous ligament
C7 - sacrum
connects tips of spinous processes
cord like
nuchal ligament
strong fibroelastic tissue
base of skull to C7
supports head on neck
provides attachment for muscle (e.g. trapezius)
2 types of vertebral joints
zygapophyseal (facet) joints
symphysis (IVDs)
zygapophyseal (facet) joints
synovial, plane
4x in vertebra
symphysis (IVDs)
secondary cartilaginous
2x IVD
functions of intervertebral discs
provide stability and flexibility
pressure regulation
water-cushion function - shock absorber
annulus fibrosus
outer layer of IVD
high tensile strength
fibrous sheath on the outer surface - collagen layers in rings
fibrocartilage inner zone
nucleus pulposus
inner layer of IVD
high resilience
gelatinous structure
80-85% water
short lasting burden in IVDs
incompressible, deformable water cushion
AF counter acts the pressure arising from the NP due to the burden on the spine
long lasting burden on IVDs
when pressure applied: slow release of water from the NP -> IVD becomes thinner
when relief: re-hydration of the NP
clinical relevance of burden on IVDs
slipped disc/ prolapse of IVD (hernia)
- tear in the AF - NP can protrude
- can impinge on spinal cord or nerves
- can cause numbness, tingling or pain (depends on location)
- rest/ painkillers
anterior longitudinal ligament attachments
base of skull to anterior surface of sacrum
attached to anterior surface of VBs and IVDs
anterior longitudinal ligament function
prevents hyperextension
posterior longitudinal ligament attachments
C2 to sacrum
attached to posterior surface of VBs and IVDs
posterior longitudinal ligament function
lines the anterior surface of the vertebral canal
weakly resists hyperflexion
ligamenta flava
pass between laminae
form part of vertebral canal
resist separation of vertebrae during flexion
interspinous ligament
between spinous processes
intertransverse ligament
between the transverse processes
intrinsic back muscles nerve origin
posterior rami of spinal nerves
intrinsic back muscles basic imfo
all directly act on the spine
embryonically develop in the back
maintain posture and control movement of vertebrae
superficial, intermediate and deep layers
thoracolumbar fascia
covers deep muscles of the back
critical to organisation and integrity of the region
latissimus dorsi and trapezius attached to it
splenius muscles (superficial layer)
shape
thick and flat (bandage - splenion)
splenius muscles (superficial layer)
origin
spinous processes (+ bottom of nuchal ligament)
splenius muscles (superficial layer) insertions
base of skull, mastoid process (capitis)/ transverse processes C1-C3 (cervicis)
splenius muscles (superficial layer) action
bilateral = extend neck
unilateral = rotate the head to one side (turn to face the same side as muscle)
supplied by dorsal rami of spinal nerves
erector spinae (intermediate layer)
primary extensions of vertebral column
3 columns of muscle - iliocostalis, longissimus, spinalis
common origin - broad tendon attached to sacrum, spinous processes of L and lower T vertebrae, iliac crest
primary muscles that extend the spine (leaning backwards)
each side independently = rotation
iliocostalis
lumborum, thoracis, cervicis
inserts angles of ribs and C transverse processes
longissimus
thoracic
cervicis
capitis
inserts T and C transverse processes and mastoid process
spinalis
thoracic
cervicis
capitis
inserts T spinous processes and skull
deep layer - transversopinalis
fill groove between transverse and spinous processes
semispinalis, multifidus, rotatores
cross multiple vertebrae
extend and rotate
deep layer - addition muscles
levatores costarum
interspinales and intertransversarii (postural muscles)
deep layer - smaller muscles have more muscles spindles
increase proprioception of muscle
‘fine-tuned’ muscles
clinical relevance - back pain
extremely common
can be non-specific - important to identify cause
muscle spasms, strained muscles, poor posture
sprain - ligament injury (incorrect lifting procedures)
nerve pain - prolapsed disc/ sciatica
synovial joints - arthritis (rheumatoid or osteo)
something else?
