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JAFFY Anatomy > S2 - Back > Flashcards

S2 - Back Flashcards

1
Q

structure of vertebral column

A
  • 7 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 4 coccygeal
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2
Q

functions of vertebral column

A
  • protects spinal cord and spinal nerves
  • support body weight
  • provides a partly rigid and flexible axis for the body and a pivot for the head
  • posture and movement
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3
Q

what are A, B, C, D?

A
  • A = pedicle
  • B = vertebral foramen
  • C = articular processes
  • D = spinous process
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4
Q

what are E, F, G, H?

A
  • E = lamina
  • F = transverse process
  • G = vertebral arch
  • H = vertebral body
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5
Q

explain the articulations of vertebrae

A
  • 1) superior articular processes of one vertebra articulate w/ the inferior articular processes of the next (facet), allows for ROTATION
  • 2) vertebral body articulates w/ the next vertebral body via intervertebral disc
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6
Q

structure of cervical vertebrae

A
  • C1 - atlas
  • C2 - axis
  • C3-6 (typical)
  • C7 - vertebra prominens (long, slender spine)
  • generally have small body b/c only need to support the head
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7
Q

structure of C1 (atlas)
- vertebral body
- spinous process
- foramen
- vertebral arches
- superior articulation

A
  • atypical b/c lack of vertebral body and spinous process
  • largest vertebral foramen
  • contains TWO vertebral arches (A/P - each contains an A/P tubercle), other vertebrae have one
  • articulates superiorly w/ occipital condyle of cranium
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8
Q

structure of C2 (axis)

A
  • ANTERIOR tooth-like/odontoid process (dens) which projects superiorly and articulates w/ articular facets of atlas
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9
Q

what ligaments bind to the dens?

A
  • cruciform (vertical and transverse ligaments): provide stability and prevent posterior displacement
  • transverse ligament specifically binds the dens to the anterior arch of atlas
  • apical: no functional significance but points tip of dens anteriorly
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10
Q

4 reference lines in the spine

A
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11
Q

what does a frontal X-ray with the patient’s mouth open show?

A
  • the dens process of the axis (C2)
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12
Q

structure of C3-C7
- vertebral body
- vertebral foramen
- transverse processes
- articular processes
- spinous process

A
  • body: small, oval-shaped
  • foramen: large, triangular
  • transverse processes: contain transverse foramina
  • articular processes: oblique and horizontal orientation
  • spinous processes: short and bifid (except C7 - vertebra prominens)
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13
Q

structure of thoracic vertebra
- vertebral body
- vertebral foramen
- transverse processes
- articular processes
- spinous process

A
  • body: large, heart-shaped
  • foramen: small, circular
  • transverse processes: long and contain facets for ribs (T1-T8 have superior and inferior costal facets, T9-T12 have only one costal facet)
  • articular processes: almost coronal
  • spinous processes: long, point inferiorly
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14
Q

structure of lumbar vertebrae
- vertebral body
- vertebral foramen
- transverse processes
- articular processes
- spinous process

A
  • body: largest (since bear most weight), kidney-shaped
  • foramen: triangular, larger than thoracic but smaller than cervical
  • transverse processes: long, slender
  • articular processes: almost sagittal
  • spinous processes: short, sturdy
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15
Q

what type of vertebra is this?

A

cervical

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16
Q

what type of vertebra is this?

A

thoracic

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17
Q

what type of vertebra is this?

A

lumbar

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18
Q

structure of sacrum

A
  • 5 bones fused into one wedge-shaped, immobile bone
  • fusing finished by age 25-30
  • provides strength + stability to pelvis and transmits weight of body to pelvic girdle via sacroiliac joint
  • rough surface dorsally, smooth concave surface ventrally
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19
Q

what are A, B, C, D?

A
  • A = sacral hiatus
  • B = medial sacral crest
  • C = auricular surface
  • D = sacral canal
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20
Q

what are E, F, G?

A
  • E = superior articular process (articulates w/ inferior articular process of L5)
  • F = sacral foramina
  • G = base
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21
Q

what are H, I, J?

A
  • H = sacral ala (anterosuperior)
  • I = transverse ridges/lines
  • J = apex
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22
Q

structure of coccyx

A
  • vestigal tail w/ 3-5 fused segments (very variable)
  • has 2 horns which articulate w/ sacrum
  • apex points anteriorly in males and inferiorly in females
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23
Q

spina bifida + types

A
  • failure of vertebral lamina to unite during development, can be caused by folate deficiency
  • mildest: spina bifida occulta (vertebral arch of L5 and S1 do not form completely) - skin usually covers this but marked by tuft of hair or dimple, causes back pain and limb weakness
  • more severe forms: fluid filled sac - meningocele (no nerve damage but minor disability) or meningomyocele (spinal cord and nerves protrude thru > paralysis or weakness of limbs + bladder/bowel dysfunction)
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24
Q

curves of the vertebral column

A
  • primary: thoracic and sacral (C-shaped - form during foetal development) - KYPHOTIC
  • secondary: cervical and lumbar (backwards C-shaped - develop during childhood due to lifting head and upright sitting) - LORDOTIC
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25
Q

functions of curves of vertebral column

A
  • increase column strength
  • help maintain balance in upright position
  • absorb shock during walking and protect vertebrae from fracture
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26
Q

3 types of vertebral column disorders

A
  • kyphosis
  • lordosis
  • scoliosis
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27
Q

kyphosis + causes

A
  • exaggerated thoracic curve (posterior)
  • causes: osteoporosis, neuromuscular disorders,
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28
Q

lordosis + causes

A
  • excessive anterior curve of lumbar region
  • causes: obesity, pregnancy, abdominal muscle weakness
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29
Q

scoliosis + causes

A
  • lateral curvature of column
  • causes: unilateral muscular paralysis
30
Q

how is the female lumbar spine different from males?

A
  • more flexible to cope w/ carrying baby while standing on 2 feet
  • centre of gravity shifts anteriorly during pregnancy which can cause disruption to posture and walking
31
Q

structure and function of intervertebral discs

A
  • fibrous hyaline cartilage between cervical, thoracic and lumbar vertebrae
  • nucleus pulposus: soft, gelatinous inner sphere made of water - shock absorption
  • anulus fibrosus: outer collar of ligaments and fibrocartilage - resist compressive stress
  • help absorb shock, increase flexibility, protect spinal nerves
32
Q

4 ligaments of the facet (zygapophyseal) joints

A
  • interspinous ligaments: connect spinous processes
  • ligamentum flavum: connects lamina
  • supraspinous ligaments: connects tips of spinous processes from C7 to sacrum
  • ligaments nuchae: supraspinous ligament that extends from C7 to base of skull
33
Q

2 types of joints in the vertebral column

A
  • vertebral body joints (where the discs are)
  • facet joints (plane - b/n facets of vertebrae) - (zygapophyseal, allow for rotation)
34
Q

name the ligaments of the spine from posterior to anterior

A
35
Q

2 ligaments of the vertebral body joints

A
  • anterior longitudinal ligament: thick, prevents hyperextension
  • posterior longitudinal ligament: thin, prevents hyperextension
36
Q

osteoporosis

A
  • decreased bone mass w/o changing shape
  • X-ray shows striations on vertebra due to decreased horizontal trabecular bone and increased vertical
  • causes: malnutrition, low physical activity, low oestrogen
37
Q

describe the changes in the vertebral column during ageing

A
  • articular surfaces curve inward = increased curvature = decreased height
  • osteoporosis
  • loss of fluid from intervertebral discs = become drier and thinner = compression = decreased height
38
Q

movements of vertebral column

A
  • flexion (bend forward)
  • extension (bend backwards)
  • lateral flexion (bend to one side, essentially adduction)
  • lateral extension (bend back to midline, essentially abduction)
  • rotation of head and neck
  • rotation of upper trunk
39
Q

facets orientation and movements throughout the vertebral column

A
  • Atlanto-occipital: convex (occipital) and concave (atlas) - flexion/extension
  • atlantoaxial: almost transverse = rotation
  • C2-C7: oblique = all
  • thoracic: almost coronal = limited rotation
  • lumbar: almost sagittal = all except rotation
40
Q

organisation of back muscles

A
  • intrinsic (axial - originate and insert on vertebral column): superficial, intermediate, deep
  • extrinsic (axio-appendicular - don’t originate or insert on vertebral column): superficial, intermediate
41
Q

superficial extrinsic back muscles

A
  • trapezius
  • latissimus dorsi
  • levator scapulae
  • rhomboids major and minor
42
Q

what is A?
- origin
- insertion
- innervation
- function

A
  • trapezius
  • origin: occipital bone and C7-T12 vertebrae
  • insertion: lateral clavicle, acromion and spine of scapula
  • innervation: spinal accessory nerve
  • function: elevate scapula (superior/descending part), retract scapula (middle part), depress scapula (inferior part)
43
Q

what is B?
- origin
- insertion
- innervation
- movements

A
  • levator scapulae
  • origin: transverse processes of C1-C4
  • insertion: medial border of scapula
  • innervation: dorsal scapular and cervical nerves
  • movement: elevation of scapula
44
Q

what is C and D?
- origin
- insertion
- innervation
- function

A
  • C = rhomboids major
  • D = rhomboids minor
  • origin: dorsal surface of cervical and thoracic vertebrae
  • insertion: medial border of scapula
  • innervation: dorsal scapular nerve
  • function: retract and rotate scapula
45
Q

what is E?
- origin
- insertion
- innervation
- function

A
  • latissimus dorsi
  • origin: spinous processes of thoracic and lumbar vertebrae
  • insertion: intertubercular sulcus of humerus
  • innervation: thoracodorsal nerve
  • function: extension, adduction, internal rotation of upper limbs
46
Q

what is in the extrinsic intermediate layer

A
  • serratus posterior
47
Q

what is F?
- function
- innervation

A
  • serratus posterior
  • function: elevation of ribs 2-5 (superior) and depression of ribs 9-12 (inferior)
  • innervation: 2-5th intercostal nerves and anterior rami to T9-T12 thoracis spinal nerves
48
Q

which muscles form the superficial INTRINSIC layer

A
  • splenius capitis
  • splenius cervicis
49
Q

what is A?
- origin
- insertion
- function

A
  • splenius capitis
  • origin: spinous processes of cervical and thoracic vertebrae
  • insertion: mastoid process of occipital bone
  • function: neck extension (when combined w/ splenius cervicis), lateral flexion, rotation
50
Q

what is B?
- origin
- insertion
- function

A
  • splenius cervicis
  • origin: spinous processes of T3-6
  • insertion: transverse processes of C1-C3/4
  • function: neck extension (when combined w/ splenius capitis), lateral flexion, rotation
51
Q

what muscles are in the intermediate intrinsic layer of the back

A
  • erector spinae (spinalis, iliocostalis, longissimus)
52
Q

what are A, B and C and what are their functions?

A
  • A = iliocostalis (lateral column)
  • B = longissimus (intermediate column)
  • C = spinalis (medial column)
  • erector spinae
  • when acting unilaterally, lateral flexion
  • when acting bilaterally, extension of spine + head
53
Q

which muscles form the deep intrinsic layer?

A
  • TRANSVERSOSPINALIS
  • semispinalis (capitis, cervicis, thoracis)
  • multifidi
  • rotatores
54
Q

what is A?
- what are its parts?
- function

A
  • semispinalis (most superficial)
  • 3 parts: capitis, cervicis, thoracis
  • function: extension (bilateral) and contralateral rotation of head and vertebral column (unilateral)
55
Q

what is B and C and what is their function?

A
  • B = multifidi
  • C = rotatores (deepest)
  • stabilise vertebral column
56
Q

which nerve innervates all intrinsic back muscles?

A
  • posterior rami of spinal nerves
57
Q

which muscles are involved in extension of the vertebral column?

A
  • splenius
  • erector spinae (spinalis, longissimus, iliocostalis): when they act bilaterally
  • semispinalis
58
Q

which muscles are involved in rotation of the vertebral column?

A
  • multifidus
  • rotatores
  • internal and external obliques
  • rectus abdominis
59
Q

which muscles are involved in lateral flexion of the vertebral column?

A
  • latissimus dorsi
  • splenius
  • erector spinae (spinalis, longissimus, iliocostalis) - when they act unilaterally
60
Q

describe the arterial supply of the back

A
  • vertebral arteries arise from the subclavian artery
  • they travel thru the transverse cervical foramina
  • anterior and posterior (x2) spinal arteries branch out from vertebral arteries, supplying spinal cord
61
Q

describe the venous supply of the back

A
  • vertebral column drained by internal and external vertebral plexus
  • these drain into the spinal veins (3 anterior and 3 posterior)
  • veins are valveless > blood can flow in both directions
62
Q

describe the meninges

A
  • dura mater: tough, thick, separated from inner walls of vertebral canal by epidural space
  • arachnoid mater: avascular, CSF found in subarachnoid space
  • pia mater: thin, transparent, vascular, covers spinal cord + neurovasculature
63
Q

which muscles are responsible for flexing the back from an extended position?

A
  • rectus abdominis
  • psoas major
64
Q

which muscles are responsible for extending the back from a flexed position?

A
  • glutes maximus
    (think RDL)
65
Q

lumbar puncture

A
  • used to draw CSF from subarachnoid space
  • L4/L5 level
66
Q

epidural

A
  • injection of local anaesthetic into epidural space e.g. pregnancy
67
Q

in a herniated disk, how to know which nerve root will be affected?

A
  • cervical discs would impact the LOWER nerve
  • thoracic and lumbar discs would impact the HIGHER nerve
68
Q

spondylosis

A
  • pain from degenerative spine conditions
69
Q

ankylosing spondylitis

A
  • autoimmune arthritis of vertebral joints
70
Q

spondylolysis

A
  • stress fracture through pars interarticularis
  • similar to spondylolisthesis except not dislocated
71
Q

spondylolisthesis

A
  • anteriorly slipped vertebrae
  • usually L5 slips over S1
  • ‘scottie dog’ fracture
72
Q

at which level does the spinal cord become conus medullaris?

A
  • L2 (spinal cord tapers off to become conus medullaris)
  • then spinal nerves form cauda equine

JAFFY Anatomy (14 decks)

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