L2.1 Back Flashcards

1
Q

What are the borderes of the back?

A
  • T1 → coccyx
  • Medial scapula border
  • Pos surfaces ribs
  • Iliac crest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different curvatures of the back?

A
  • 1o foetal C-shape
  • 2o lordortic curve (due to muscles strengthening)
    • Cervical (~6-8months) – to keep head up
    • Lumbar (~12-15months) – for walking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the vertebral abnormalities?

A
  • Lordosis
  • Kyphosis
  • Scoliosis
  • Cranial shift (features of vert shifted up – ribs on C7)
  • Caudal shift (features of vert shifted down)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the structure of a lumbar vertebrae?

A
  • (articular surface – sagittal)
  • Vertebral arch = pedicle (root) + laminar
  • Site of potential injury: pars interarticularis → bilateral fracture → slip disc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the structure of a thoracic vertebrae?

A
  • (articular surface – Coronal)
  • Essentially the same as lumbar
  • Key difference: articular (demi) facets for joint attachment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the structure of the sacrum & coccyx?

A
  • (articular surface – Coronal)
  • Fusion of vertebra (no discs in between)
    • Fuse from below up
  • Different articular orientation → stops L5 from slipping forward
  • Foraminae → for nerve roots & vessels (esp. sacral veins)
  • Canal hiatus → gap between sacrum & coccyx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What veins drain the vertebrae?

A
  • Basivertebral veins: drain vert bodies → internal vertebral venous plexus (outside dura) → external vertebral venous plexus (outside vertebral canal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are, and how many centres of ossifications do vertebrae have?

A
  • 3 primary centres
    • In body and each vertebral arch (aka neural arch)
  • 5 secondary centres
    • Tips of spinous and transverse process + upper & lower meninges of body (annular epiphysis)
    • Closes during adolescence when vertebral column growth is complete
      • There is a growth plate at the tips – may mistake for fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the vertebral growth anomalies?

A
  • Partial failure of formation – Wedge vertebrae
  • Complete failure of formation – Hemi vertebrae
  • Unilateral failure of segmentation – Congenital bar
  • Bilateral failure of segmentation – Block vertebrae
  • Spina Bifida (~L2-4)
    • Occulta (may have no significance)
    • Cystica → a sac
      • Meningocele (just meninges)
      • Meningomyelocele (contains neural tissues)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the function of the IV disc?

A
  • Nucleus pulposus: incompressible but deformable → keeps vertebrae apart
    • Made up of water (mucus texture in children)
  • Annulus fibrosus: Attaches below/above vertebral body → keeps vertebrae tgt
    • Laid down perpendicular to each other
    • Twisting while lifting dangerous → only 50% fibres can resist load
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 main ligaments of the vertebrae?

A
  • Posterior longitudinal: Back of vertebral body, within vertebral canal
    • Fans out at each IV disc → directs herniation pos-laterally over ligament
      • ∴ Herniation → impinges on nerve root below
        • E.g. herniation between L4 & 5 → impinge on L5 nerve root
  • Ligamentum flavum: has elastic connective tissues (allows flexion)
    • Becomes more fibrous (thickens) with age → encroaches into canal → impinge neural structures in canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the joints of the vertebrae innervated by?

And which structures are aneural/avascular?

A
  • Branches of the POS rami (also supplies overlying skin)
  • Synovial joint: capsule has blood & nerve supply
  • Hyaline cartilage avascular & aneural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the vertebral canal and what does it contain?

A
  • Terminates at L1-2 in adults (Cauda Equina)
  • Meninges around the spinal cord
  • Contains:
    • BV internal venous plexus
    • Vertebral column (longer than cord)
      • Cord finishes at L1 but dura mater finishes at S3 → leaves space called lumbar cistern → point where needle injected to extract CSF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the intervetebral foramen contain?

A
  • Dorsal root ganglion
  • Nerve root
    • Located in the upper part (inferior vertebral notch) of the foramen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the superficial muscles of the back?

A
  • (Innervated by ANT rami)
  • Attaches to and act on the UL
  • Trapezius (not innervated by ANT rami)
    • innverated by the 11th cranial (Sternocleidomastoid also)
  • Lat dorsi
  • Rhomboids
  • Levator Scapulae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the deep muscles of the back?

A
  • (Innervated by POS rami)
  • Erector Spinae (Med to Lat – across 5-7 vertebral segments)
    • Prime movers, returning flexed trunk to upright posture (extended)
      • *Contracts eccentrically doing toe touch*
    • Eccentrically ‘quiet’ during full flexion → Dangers of lifting flexed
    • Spinalis (closest to the spine)
      • Longissimus (longest)
      • Illiocostalis (From iliac crest)
  • Transversospinalis (Lat to Med - short segmental muscles)
    • Short segmental stabilisers (across 2 vertebra)
    • Pain → inhibits muscle contract
    • Lower back pain inhibits muscle contraction → deep muscles could go to wastage
      • Transversus abdomalis (resist tension from ab viscera) usually contracts to stabilises the back muscles
        • Due to connection between lumbar fascia
        • ∴ strengthen deep ab muscles → strengthens deep back muscles