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MSK > Section 3, Exam Content > Flashcards

Section 3, Exam Content Flashcards

1
Q

sacroiliac joint

A
  • bumpy surface of ilium matches the bumpy auricular shaped side of the sacrum
  • absorbs a lot of force from our lower limbs
  • not a whole lot of movement here since the sacrum is a platform for the rest of the body
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2
Q

movements at the sacroiliac joint

A

nutation and counter-nutation

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3
Q

nutation

A

top part of sacrum tips forward

bottom part of sacrum tips backward

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4
Q

counter-nutation

A

top of sacrum moves backward and bottom of sacrum moves forward

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5
Q

ligaments of the sacroiliac joint

A
  • anterior, posterior and interosseus ligaments
  • sacrotuberous ligament
  • sacrospinous ligament
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6
Q

anterior, posterior and interosseus ligaments of the sacroiliac joint

A
  • anterior sits on inside surface of pelvis
  • posterior sits outside of pelvis
  • interosseus fills the surface between bones the make the joint more fibrous and stable
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7
Q

sacrotuberous ligament

A

runs from dorsal and lateral surfaces of sacrum and coccyx to the ischial tuberosity where it blends into tendons of the hamstrings

  • a strong ligament that integrates with a strong muscle group (hamstrings)
  • limits nutation of sacrum relative to the ilium
  • is bigger and more superficial than sacrospinous ligament
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8
Q

sacrospinous ligament

A

comes from inferior lateral margins of sacrum and coccyx to the ischial spine
- limits nutation of sacrum relative to the ilium

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9
Q

pelvis actions and equivalent spine actions

A
  • lateral tilt of pelvis causes contralateral side flexion of the spine to compensate
  • anterior tilt of pelvis = extension of lumbar spine
  • posterior tilt of pelvis = flexion of lumbar spine
  • L and R tilt of pelvis causes spine to rotate in the opposite direction (to keep us facing forward as we move)
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10
Q

body of vertebra

A

weight bearing anterior portion

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11
Q

transverse process of vertebra

A

aka costal processes

- angle will change depending on the area of the spine we are looking at

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12
Q

articular process of vertebrae

A

superior and inferior articular processes make a joint between adjacent vertebrae

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13
Q

pedicel of vertebrae

A

foot that comes off of the body of the vertebrae that helps to create the foramen

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14
Q

lamina of vertebrae

A

the narrow portion between spinous processes and articular processes

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15
Q

shape of lumbar spine

A

lordsis

  • a natural extension position of the spine
  • somewhat the result of how the spine sits on the pelvis such that L3 is the most neutral lumbar vertebrae
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16
Q

ZA joints

A

where superior and inferior articular processes meet
- small synovial joints that block rotation and translation of vertebrae
- there is a L and R for each vertebral level
SAP and IAP face opposite directions so that they match up with one another

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17
Q

directionality of the superior articular process of a vertebrae

A

faces back and medially

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18
Q

directionality of the inferior articular process of a vertebrae

A

faces forward and laterally

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19
Q

spinal tripod

A

3 joints formed b/w 2 vertebrae that help to give the spine stability

  • the body of the vertebrae make one joint
  • the SAP and IAP form the other 2 joints (ZA joints)
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20
Q

components of the intervertebral disc

A

annulus fibrosis

nucleus pulposus

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21
Q

annulus fibrosis

A

collagen rings that form on the tough outer layer (a series of 20-30 rings that wrap around a core
- each layer’s fibres run in opposite directions, alternating (annulus fibrosis is responsible for managing rotational stress)

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22
Q

nucleus pulposus

A

a gel like core with fluid like properties

  • responds by moving when we load the disc
  • if we squish the intervertebral disc, the nucleus pulposus will bulge out in the direction of less stress
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23
Q

ligaments of the spinal column (6)

A
  • anterior longitudinal ligament (ALL)
  • posterior longitudinal ligament (PLL)
  • interspinous ligament
  • supraspinous ligament
  • ligamentum flavum
  • iliolumbar ligament
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24
Q

anterior longitudinal ligament

A

runs along anterior aspect of vertebral bodies and intervertebral discs

  • tends to be broader than PLL by wrapping around the sides of vertebrae more
  • connects vertebral bodies
  • limits extension of the spine
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25
Q

posterior longitudinal ligament

A

runs along the posterior aspect of vertebral bodies and intervertebral discs within the spinal canal

  • connects vertebral bodies
  • limits flexion of the spine
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26
Q

interspinous ligament

A

runs between spinous processes of adjacent vertebrae

- limits flexion of the spine

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27
Q

supraspinous ligament

A

connects the tips of the spinous processes of adjacent vertebrae
- limits flexion of the spine

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28
Q

ligamentum flavum

A

runs in the spinal canal, connects laminae of adjacent vertebrae

  • has more stretch to it
  • limits flexion of the spine
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29
Q

iliolumbar ligament

A

runs from L5 transverse process to iliac crest (posterio-medial aspect)
- prevents anterior translation of L5 vertebrae relative to the sacrum/ilium (which is what gravity wants)

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30
Q

dorsal root of spinal nerve

A

is called afferent

- carries sensory info

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31
Q

ventral root of spinal nerve

A

is called efferent

- carries motor signals

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32
Q

dermatomes

A

area of skin innervated by the sensory axons within each spinal nerve

33
Q

myotomes

A

collection of muscle fibres innervated by the motor axions within each spinal nerve
- the joint actions that we produce that are heavily influenced by a spinal level

34
Q

meninges (layers)

A

3 levels protect the brain and SC:

  • duramater: tough outer layer
  • arachnoid mater: weblike middle layer
  • pia mater: most delicate, closest to brain
35
Q

cauda equina

A

at about level L1, the spinal cord tapers to a point and strands (spinal nerves) extend

36
Q

intervertebral foramen

A

hole b/w 2 vetebrae (where pedicels are) that serve as an exit point for spinal nerves

37
Q

naming spinal nerves

A

they are named the the level at which they exit the SC

  • cervical spinal nerves are named for the vertebrae below them
    • C1 nerve exits b/w skull and C1
  • C8 sits above T1 and below C7
  • spinal nerves below T1 are named for the vertebrae above them
38
Q

sacrum (vertebrae and spinal nerves)

A

the sacrum is composed of a bunch of vertebrae fused together into one bone
- sacral spinal nerves exit through dorsal and ventral foramina (spinal nerves S1 to S5)

39
Q

thoracic spine

A

has 12 vertebrae

  • kyphosis: somewhat flexed position to balance extension of lumbar spine
  • orientation of spinous processes change as we move along
40
Q

ligaments associated with the ribs and vertebrae

A
  • costotransverse ligaments

- radiate ligaments

41
Q

costotransverse ligaments

A

3 ligaments that act like a big smear of ligaments which run from neck and costal tubercle of the rib to the TP of the matching vertebra

42
Q

radiate ligament

A

attach around the circumference of the head of the rib to the body of the matching vertebra and the vertebra above it

43
Q

sternal angle

A

junction where manubrium meets body of sternum

- helps us landmark our 2nd rib since it articulates with the sternum at the sternal angle

44
Q

xiphoid process

A

the most inferior bony process sticking off of the bottom of the sternum

45
Q

true ribs

A

ribs 1-7

  • each have their own costal cartilage
  • open in anterior/posterior direction when we breathe (less movement as a result of having short costal cartilages)
46
Q

false ribs

A

ribs 8, 9, 10

  • do not have their own individual costal cartilages, but share them instead so their costal cartilages are longer
  • ribs face more laterally than anteriorly
  • ribs move/open more laterally/medially where they hinge on the thoracic spine, opening up side to side dimensions
47
Q

floating ribs

A

ribs 11 and 12

- have no costal cartilages attaching them to sternum

48
Q

the difference b/w upper and lower thoracic vertebrae SP

A
  • lower thoracic vertebrae look more like lumbar vertebrae with short, broad SPs
  • upper thoracic vertebrae have longer, more narrow SPs that point downward, articulate with one another and limit extension
49
Q

the difference b/w upper and lower thoracic vertebrae TP

A
  • upper have TP pointing more anteriorly so is associated more with true ribs that move anteriorly/posteriorly
  • lower. have TP that point to face more laterally and better articulates with false ribs, causing them to move more medial/laterally
50
Q

thoracolumbar fascia (TCF)

A

3 layers: posterior, middle, anterior

  • layers wrap around and compartmentalize muscles
  • erector spinae are surrounded by posterior and middle layers
  • quadratus lumborum is surrounded by anterior and middle layers
  • TCF is the insertion for transverse abdominis and internal oblique muscles
  • also connects upper and lower extremities (lat dorsi and glut max)
51
Q

do abdominals connect directly to the spine?

A

no - they connect to the pelvis, rib cage and thoracolumbar fascia

52
Q

linea alba

A

“white line” that runs through the centre of the anterior abdominal wall from xiphoid process to symphysis pubis

53
Q

upper cervical spine

A

includes C1, C2 and occiput

  • joints are designed to facilitate movement of the head relative to the neck
  • there is A LOT more rotation here than the rest of the spine which allows us to turn our head 70-90 degrees
54
Q

atlas

A

C1

55
Q

axis

A

C2

56
Q

AO joint

and joint actions

A

atlas meets with occiput (head)

  • head rolls back and forth
  • flexion of upper cervical spine = chin tuck where head rolls on axis
  • extension would be the opposite
57
Q

AA joint

and actions

A

atlantoaxial joint

- C1 rotates around C2 axis

58
Q

lower cervical spine

A

includes C3-C7

- functions just like the rest of the spine

59
Q

foramen transversarian

A

a hole in the TP of cervical vertebrae that the vertebral artery runs through to deliver blood to the circle of willis in the brain

60
Q

TPs in the cervical spine

A
  • TPs are longer

- TPs are bifid

61
Q

superior nuchal line

A

spreads laterally from external occipital protuberance of skull
- note that inferior nuchal line is smaller and located just below the external occipital protuberance

62
Q

nuchal ligament

A

runs from external occipital protuberance of skull to the spinous processes of all cervical vertebrae
- a broad ligament that limits flexion of the upper and lower cervical spine

63
Q

features of the C2 (axis)

A
  • dens
  • shorter spinous process
  • lots of ligaments holding the head onto the neck
64
Q

ligaments associated with the C2 axis

A
  • apical ligament

- alar ligaments

65
Q

dens

A

upward projection on the C2 that has an articular surface on its anterior aspect that articulates with the C1 atlas

66
Q

apical ligament

A

runs from apex (top) of dens to anterior margins the foramen magnum

67
Q

alar ligaments

A

“wings”

a pair of ligaments that run from the lateral surfaces of the C2 dens to the margins of the foramen magnum, medial to the occipital condyles

68
Q

features of the C1 atlas

A
  • no body - dens sits where the body would be
  • lateral masses
  • no SP
  • we have a posterior tubercle (larger) and an anterior tubercle (smaller)
69
Q

lateral masses of C1 atlas

A

act like the body of the vertebrae but are much smaller

70
Q

transverse ligament of C1 atlas

A

connects lateral masses of C1 to one another, crossing over the back of the C2 dens
- presses the dens against C1

71
Q

3 membranes associated with vertebrae

A
  1. PAOM - posterior atlanto-occipital attaches to foramen magnum
  2. tectorial - in the middle, prevents dens from compressing SC
  3. AAOM - anterior atlanto-occipital limits atlanto-occipital joint translation
72
Q

suboccipital muscles (4)

A
  • obliquus capitis superior and inferior
    cause side to side head tilt
  • rectus capitis major and minor
    extend upper cervical spine
73
Q

anterior upper cervical muscles

A

rectus capitis anterior - flexion of

rectus capitis lateralis - lateral flexion of

74
Q

sterno-cleido-mastoid

A

attaches to clavicle, sternum and mastoid process

  • lower portion flexes lower cervical spine
  • upper portion flexes upper cervical spine
  • whole muscle causes contralateral rotation of cervical spine
75
Q

scalenes and brachial plexus

A

brachial plexus runs through the space between the middle and anterior scalenes

76
Q

diaphragm

A

runs from xiphoid process to the inside surfaces of bottom 6 ribs and their costal cartilages

  • connect to L1-L3 vertebrae via R and L crus
  • 2 arcuate ligaments
  • blends with deepest fibres of the transverse abdominis
77
Q

arcuate ligaments and the diaphragm

A
  • 1st arcuate ligament is over psoas

- 2nd arcuate ligament is over quadratus lumborum

78
Q

central endon

A

surrounds the hole where the esophagus, aorta, and other major vessels pass through the diaphragm

MSK (4 decks)

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