Lecture 13 Flashcards

1
Q

Three joint complex of C1 and C2

A
  • median: dens articulates with anterior arch (pivot joint)
  • 2 lateral Z joints

Primary movement is cervical rotation (50% of all cervical rotation)

Median is a pivot synovial joint

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2
Q

Features of the C3- C7 cervical vertebrae

A
  • small, kidney-shaped body
  • bifurcated spinous process (bifurcation increased SA for ligament and muscle attachment)
  • transverse foramina for vertebral artery
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3
Q

Features of the thoracic vertebrae

A

-• Heart-shaped body
• Long spinous process, directed inferiorly
• Long, thick transverse process (for attatchment of ligaments and muscles)
• Costal facets for rib attachment

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4
Q

How do the thoracic vertebrae articulate with ribs

A
  • articualtes with two demifacets
  • synovial joints - surrounded by a joint capsule
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5
Q

Features of lumbar vertebrae

A

• Large kidney-shaped body forVload bearing (transmit force
from upper body)
• Spinous process horizontal
- bigger thicker transverse processes
• Distal end of the spinal cord ends at L1/L2
• Only cauda equina below this level; important site for lumbar puncture

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6
Q

Lumbar puncture

A
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7
Q

How many fused vertebrae in the sacrum

A

5

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8
Q

Shape of the sacrum

A

Inverted triangle, curved

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9
Q

Features of the sacrum

A
  • forms the sacroiliac joint with the hip bones
  • sacral canal (superior) + sacral hiatus (inferior) = a continuation of vertebral canal
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10
Q

What forms a continuation of the vertebral canal?

A

Sacral canal and sacral hiatus

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11
Q

What passes through the anterior and posterior foramina

A
  • lower limb nerves and vessels
  • nerve roots
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12
Q

Number of vertebrae in coccyx

A

Varies - usually 4

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13
Q

What is the vestigial tail in humans?

A

Coccyx

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14
Q

What articulates with sacrum

A

Coccygeal Cornu

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15
Q

Two main joints of the vertebral column

A
  • interbody joint
  • zygapophysial/facet joint
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16
Q

What kind of joint is the interbody joint

A
  • cartilaginous joint
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17
Q

Location of the interbody joint

A
  • between bodies of adjacent vertebrae
  • Includes intervertebral disc
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18
Q

What kind of joint is the zygaphphysial/facet joint

A

– Synovial, plane joint

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19
Q

Where is the Zygapophysial/facet joint

A

– Between superior and inferior articular processes of adjacent vertebrae

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20
Q

Two parts of the invertebral disc

A

– Annulus fibrosus (outer, binds to bone)
– Nucleus pulposus (inner, “pulp”)

Lambar region has a much larger fibrosus region compared to the cervical

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21
Q

Function of the interbody joint

A

• Separates vertebral bodies
• Binds vertebrae
• Resists compression
• Absorbs shock
• Resists motion in any direction

= Stability and mobility

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22
Q

Features of zygapophysial (Z) joints

A

• Orientation of facets differ between regions (allows different movement at different levels of the spine)
• Guide and direct movement
• At every level (except C0-C1)

• Cervical – 45 degree angle (faciliatate lateral flexion and rotation)
• Thoracic – coronal plane, almost vertical (roatate or lateral flex) - limited flexion and extention due to the ribs
• Lumbar – sagittal plane (flexion and extention)

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23
Q

What are the implications of Z-joint orientation on the available movement?

A

• Cervical – 45 degree angle (faciliatate lateral flexion and rotation)
• Thoracic – coronal plane, almost vertical (roatate or lateral flex) - limited flexion and extention due to the ribs
• Lumbar – sagittal plane (flexion and extention)

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24
Q

What is osteoporosis

A

When bone resorption > bone formation
Osteoplasts are working faster then osteoblasts

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25
Q

Features of osteoporosis

A

− Reduction in bone mass
−Microstructural changes
−Bones become brittle and loses elasticity
−When bone density drops below a specific level, osteoporosis is diagnosed

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26
Q

What is osteoporosis associated with

A

ageing and some medical conditions

27
Q

What does osteoporosis increase risk of

A

fracture (hip, vertebrae, proximal humerus, wrist)

28
Q

Osteoporosis of the spine - Vertebral compression fractures

A

• Prevalence increases with age
• 25% of postmenopausal women, 40% of women > 80 years
• Often occur during trivial events

• Symptoms
– Sudden onset low back pain
– Limited spinal mobility
– Kyphotic deformity
– Height loss
• Diagnosed with x-ray, initial management non-surgical

29
Q

Two main ligaments of the vertebral column

A

• Anterior longitudinal ligament
• Posterior longitudinal ligament

Ligamenta flava

Ligamentum nuchae

Supraspinous ligament

Interspinous ligament

30
Q

Where are the Anterior longitudinal ligament and Posterior longitudinal ligament and what do they attach to

A

Length of spine, attaching to vertebral bodies and discs

31
Q

Function of Anterior longitudinal ligament • Posterior longitudinal ligament

A
  • restrict movement between vertebrae in extension and flexion
32
Q

Where are Ligamenta flava and what do they connect

A

one on each side, connects laminae

High elastin content

33
Q

Where is the Ligamentum nuchae and what does it do

A

from external occipital protuberance to C7, supports head, site of muscle attachment

34
Q

Where is the supraspinous ligament ?

A

C7 to sacrum

Attatch to tip of spinous processes

35
Q

Intersoinous ligament

A
36
Q

What function is common to all of these ligaments?

Ligamenta flava

Ligamentum nuchae

Supraspinous ligament

A
  • they all restrict flexion
37
Q

What is the cause of whiplash injury

A
  • hyperextention of the neck
  • e.g from rear-end collision
  • anterior longitudinal ligament is stretched or torn
  • anterior intervertebral disc (annulus) and vertebrae also affected
38
Q

Location of the anterior muscles of the vertebral column

A
  • cervical and lumbar
39
Q

Location of the lateral muscles of the vertebral column

A
  • cervical and lumbar
40
Q

Location of the posterior muscles of the vertebral column

A
  • cervical, thoracic and lumbar
41
Q

What controls movemnt and stabilises spine

A

80% muscles, 20% osseoligamentous)

42
Q

• Muscles attaching to skull = capitis
• Muscles of spine often named according to the region they are located (cervicis, thoracis, lumborum)

A
43
Q

• Multifidus
• Trapezius
• Splenius
• Erector spinae
• Semispinalis

Order them from superficial to deep

A

• Trapezius • Splenius • Semispinalis • Erector spinae • Multifidus

44
Q

Posterior muscles

A

• Trapezius • Splenius • Semispinalis • Erector spinae • Multifidus

45
Q

What function is common to all these muscles :? • Trapezius • Splenius • Semispinalis • Erector spinae • Multifidus

A
  • they are all located posteriorly
  • restrict extention
46
Q

Where does the trapezius muscle attach

A
  • attaches external occipital protuberance and connects down to clavicle / scapula
  • ligament nuchae and spinous processes
47
Q

How many parts of the trapezius

A

3

48
Q

What does the trapezius do

A

Extends the neck

  • both trapezius muscles contracting together causes extention
  • lateral flexion - one side
  • rotation (oblique fibres)
49
Q

Selenius capitis and cervicis muscle

A
  • attaches on the midline to the spinous processes
  • fans outwards and then attaches to the transverse processes (cervicis) or skull, including mastoid process (capitis)
50
Q

Fibre orientation of splenius capitis and cervicis muscle

A

Oblique

51
Q

Function of splenius capitis and cervicis muscle

A
  • extends
  • rotator (diagonal arrangement) - if muscle on left shortens head will rotate to the left
52
Q

Semispinalis capitis and cervicis

A
  • starts the transverse processed and fibres go inwards to the spinous process (cervicis) or skull (capitis)
53
Q

Fibre orientation of Semispinalis capitis and cervicis

A

Oblique

54
Q

Semispinalis capitis and cervicis function

A
  • rotation - contraction of left muscle turns head to the right
55
Q

How many parts of the erector spinae?

A

3

56
Q

Three parts of erector spine

A

• Spinalis (medial), underdeveloped
• Longissimus (intermediate)
• Iliocostalis (lateral)

57
Q

Erector spinae fibre orientations and functions

A
  • straight up and down fibres
  • dont allow rotation
  • lateral flex - side bend
58
Q

Multifidus

A

• Spans the entire length of the spine
• Extends across 2–4 vertebrae
• Largest in lumbar spine

Contributes to extention
Rotation

59
Q

Erector spinae and multifidus
Real life prosecution

A
60
Q

Abdominal muscles

A

Layered arrangment
1. Rectus abdominis (anterior)
2. External oblique
3. Internal oblique
4. Transverse abdominis

61
Q

Where do the abdominal muscles attach to

A

• Ribs and costal cartilages, fascia
• Iliac crest and/or pubic symphysis

62
Q

Abdominal muscle rotation

A

Rectus abdominis - orientation: straight up and down: ANTERIOR - FLEXION

External oblique (hands in pocket orientation) - Internal oblique (hands in pocket) - Transverse abdominis: ROTATION

If they all contract together they contribute to spine flexion and if u contract one side it contributes to rotation - external oblique on right will rotate to right and internal oblique on left will rotate right

63
Q
A
64
Q

What do the abdominal muscles maintain

A

Interabdomal pressure
- cough
- vomit