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MSS > MSS22 Anatomy Of The Spine > Flashcards

MSS22 Anatomy Of The Spine Flashcards

1
Q

Vertebral column general features

A
  • 24 individual vertebrae
  • fused sacrum (S1-5) and coccyx (Co1-4)
  • 33 total
  • each articulate with one superior and one inferior
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2
Q

Vertebral column functions

A
  1. Provide vertical support for body and head
  2. Houses and Protects spinal cord
  3. Maintain upright body posture
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3
Q

Vertebral column regions

A

5 regions:

  1. Cervical
  2. Thoracic
  3. Lumbar
  4. Sacral
  5. Coccyx
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4
Q

Spinal curvatures

A

4 spinal curvatures (連續兩個S):

  1. Cervical (內)
  2. Thoracic (外)
  3. Lumbar (內)
  4. Sacral (外)

Functions:

  • Give column flexibility
  • Biomechanical support of body weight > straight spine
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5
Q

Primary curvatures

A
  • Thoracic + Sacral
  • Concave anteriorly (外)
  • Newborn: only primary curvatures
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6
Q

Secondary curvatures

A
  • Cervical + Lumbar
  • cervical: appear when child raises head (3-4 months)
  • lumbar: appear when child stand (by 1st year)
  • appear after birth
  • Concave posteriorly (內)
  • help shift trunk weight over the legs
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7
Q

Spinal curvature abnormalities

A
  1. Kyphosis
    - exaggerated Thoracic curvature
    - results from osteoporosis / poor posture
    - “hunchback” look
  2. Lordosis
    - exaggerated Lumbar curvature
    - results from added abdominal weight (obesity)
    - “Donald duck walk”
  3. Scoliosis
    - abnormal lateral curvature (usually at Thoracic spine)
    - may require back brace / surgery
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8
Q

Vertebrae

A

2 parts:

  • Body (thick anterior weight-bearing structure)
  • Vertebral arch (posterior to body)

Both parts enclose:

  1. Vertebral foramen
  2. Vertebral canal (spinal canal)
    - formed by stacked vertebral foramina
    - contains spinal cord
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9
Q

Vertebral arch

A

Composed of:

  • 2 Pedicles from posterolateral margins of body
  • 2 Laminae extending posteromedially from edge of pedicle

7 processes:
- 1 Spinous process (project posteriorly from ***laminae junction)

  • 2 Transverse processes (lateral projections on both sides of vertebral arch)
  • 2 Superior + 2 Inferior articular processes
  • -> originate at ***pedicle-lamina junction
  • -> each with smooth surface (articular facet)
  • -> inferior facet articulate with superior facet of next vertebrae below (facet joint: ***synovial joint)
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10
Q

Intervertebral foramina (=/ vertebral foramen) (nerve root canal)

A
  • Lateral opening between adjacent vertebrae (between 2 pedicles)
  • Passageway for spinal nerves + blood vessels (左右出)
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11
Q

Intervertebral discs

A
  • **Fibrocartilage pads lies between 2 vertebral bodies, consists of 2 parts:
  • Anulus fibrosus (outer ring)
  • Nucleus pulposus (inner gelatinous region)

Functions:

  1. Shock absorbers between vertebral bodies
  2. Allow vertebral column to bend
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12
Q

Joints of vertebral column

A

2 different joints:

  1. Between vertebral ARCHES
    - Articulation of superior-inferior articular processes (facet joint)
    - ***Synovial joint
  2. Between vertebral BODIES
    - joined by intervertebral discs
    - made of fibrocartilage –> type of ***Cartilaginous joint (aka Symphysis)
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13
Q

Ligaments of vertebral column

A

6 major ligaments:

  1. Anterior / Posterior longitudinal ligaments
    - long ligaments running length of vertebral column
    - cover vertebral bodies and intervertebral discs
  2. Ligamentum flavum
    - connect laminae of adjacent vertebrae
  3. Intertransverse ligament
    - connect transverse processes of adjacent vertebrae
  4. Interspinous ligament
    - connect spinous processes of adjacent vertebrae (塊狀)
  5. Supraspinous ligament
    - connect tips of spinous processes from C1-C7 adjacent vertebrae –> down to sacrum (條狀)
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14
Q

Vertebral trends

A
  • Smallest near skull –> Larger as weight-bearing ↑

- NO anatomic discrete “cutoffs” between regions: similarities between adjacent vertebrae

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15
Q

Cervical vertebra

A
  • C1-C7
  • 3 distinguishable features:
    1. Triangular vertebral foramen
    2. **Bifid spinous process
    3. **    Transverse foramen
  • -> holes in transverse processes
  • -> give passage way to Vertebral artery + vein, sympathetic nerves

Direction of articular facets:
Superior: Posterosuperior
Inferior: Anteroinferior

C1, C2:

  • highly specialized and form unique set of articulations
  • -> provide great mobility to skull

C1 (Atlas):

  • NO body / spinous processes
  • 2 ***Lateral masses connected by Anterior + Posterior arches
  • -> serve as ring for skull to rest upon
  • joint between C1 and skull provide 50% of flexion/extension in neck (***nodding)
  • articulates in pivot joint with Dens / Odontoid process of C2

C2 (Axis):

  • ***Dens / Odontoid process
  • -> projects up from the body
  • -> pivot for ***lateral rotation between C1 and skull
  • ***Atlantoaxial joint between C1 and C2
  • -> provided 50% of side-to-side turning in the neck (***shaking)
  • -> NO IV disc

C7 (Vertebra Prominens):

  • ***NON-bifided spinous process longer than other cervical vertebrae
  • easily palpated between scapula
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16
Q

Thoracic vertebrae

A
  • T1-T12
  • 3 distinguishable features:
    1. Heart-shaped vertebral body
    2. Articulate facets on sides of **vertebral body and **transverse processes –> articulate with ribs
    3. Spinous processes: long + slant inferiorly

Direction of articular facets:
Superior: Posterolateral
Inferior: Anteromedial

17
Q

Ribs

A

12 corresponding ribs:

  • each articulates with 2 vertebrae (superior + inferior articulate facets)
  • 1, 11, 12 articular with single vertebra only
  • 1-7: true ribs
  • 8-12: false ribs
  • 11, 12: floating ribs
18
Q

Lumbar vertebrae

A
  • L1-L5
  • 5 distinguishable features:
    1. Large and Kidney-shaped vertebral body
    2. Triangular vertebral foramen
    3. Articular processes have nearly **vertical facets (垂直的板)
    4. Transverse process: long + slender
    5. **    Spinous process: short + broad (for attachment of muscles and ligaments –> stabilize lower back)

Direction of articular facets:
Superior: Medial
Inferior: Lateral

19
Q

Sacral vertebra

A
  • S1-S5 fused vertebra
  • **Features:
  • Triangular shape
  • Concave anterior and posterior surface
  • Forms posterior wall of pelvic cavity

Female: wider, shorter, more concave
Male: longer, less wide

Sacral canal

  • continuation of vertebral canal
  • terminates in inferior opening: Sacral hiatus (Epidural anaesthesia given through it to block ***Pelvic nerves)
  • Sacral cornua: bony projections on either side
20
Q

Coccyx

A
  • Co1-Co4
  • Smallest, most inferior bone in spine
  • 4 coccygeal vertebrae fused together
  • anchor several muscles and ligaments in pelvic region
  • acts as one of the bones that bears body weight while sitting
21
Q

Movement of vertebral column

A

Range of movement:

  1. Flexion / Extension
  2. Left / Right side bending
  3. Left / Right rotation

Depend on 2 factors:

  • Facet joints / Articulation plane: determine range and type of movement
  • Muscles: determine control and strength of movement
22
Q

***Regional difference in articulation plane

A

Cervical:
AP in ***Coronal plane –> allow Flexion + Extension

Thoracic:
AP in ***Arc of circle –> allow Rotation

Lumbar:
AP in ***Sagittal plane –> allow Flexion, Extension, Lateral bending (little rotation)

23
Q

Muscles of back

A

Deep / True / Intrinsic muscles:

  • support and move vertebral column (including head)
  • 2 groups:
  1. Extensors (3 layers)
    - Superficial (Splenius muscle)
    - Intermediate (Erector spinae muscles)
    - Deep (Transversospinal muscles)
  2. Flexors (located in neck / lower back / abdomen)
24
Q

Intrinsic extensor back muscles

A

Actions:

  1. Bilaterally (兩邊一齊contract): extends head / spine
  2. Unilaterally (其中一邊contract): rotates / lateral flexes head / spine

Superficial group (Spinotransverse) (run from skull to early thoracic area)

  1. Splenius capitis
  2. Splenius cervicis

Intermediate group (Erector spinae muscles / Sacrospinalis) (run the length of the spine) (***SLI)

  1. Spinalis (medial)
  2. Longissimus (middle)
  3. Iliocostalis (lateral)

Deep group (***TransRMS,Inter,Inter)

  1. Transversospinalis
    - Rotatores (1 vertebra)
    - Multifidus (2-4 vertebrae)
    - Semispinalis (>5 vertebrae)
  2. Interspinalis
  3. Intertransversarii
25
Q

Deep flexor muscles

A

Confined anterior of spine at Cervical + Lumbar regions

Actions:

  1. Bilaterally: flexes head / spine
  2. Unilaterally: rotates / lateral flexes head / spine
    - -> Work against gravity e.g. sit-ups

Flexors of Cervical spine:

  1. Longus colli
  2. Scalenes (anterior, middle, posterior)
  3. Sternocleidomastoid (SCM)

Flexors at the Hip:

  1. Quadratus lumborum
  2. Psoas major

Flexors of Lumbar spine:

  1. Rectus abdominis
  2. Obliques
26
Q

Radiology of spine

A

Look at irregularities at 4 lines:

  1. Anterior vertebral
  2. Posterior vertebral
  3. Spinal Laminar
  4. Spinous process
27
Q

Herniated / Prolapsed IV discs

A

Nucleus pulposus protruding through Anulus fibrosus

  • -> Bulging of disc contents into vertebral canal
  • -> presses spinal cord / spinal nerves
  • -> neurological symptoms: pain, sensory deficit, paralysis
  • -> Cervical / Lumbar discs most commonly injured

MSS (32 decks)

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