Sem 1 - P - Vertebral Column&Muscles - Structure/Function Vertebral Column, Vertebra, Joints/IV discs, Muscles (extrinsic&intrinsic) Flashcards
The vertebral column is a curved flexible pillar of segmented bones separated by intervertebral discs What are the functions of the vertebral column? Name 5 What type of joint are the IV joints?
Functions of the vertebral column * Muscle attachment * Mobility * Protection (protects the spinal cord) * Weight transfer * Haematopoeisis The IV joints are secondary cartilaginous joints
Name the regions of the vertebral column, the number of vertebrae and their curvatures?
Cervical (7 vertebrae) Thoracic (12 vertebrae) Lumbar (5 vertebra) Sacral (5 vertebrae - fused) Coccygeal (4 vertebrae - fused) Cervical and lumbar - secondary curvatures (lordosis) Thoracic and sacral - primary curvatures (kyphosis)
What is the difference between the primary and secondary curvatures?
Primary curvatures - anterior concavity - relate to the foetal position (thoracic and sacral)
Secondary curvatures - anterior convexity
- Cervical - develops around 2-3 months when the child develops head support
- Lumbar - develops around 6-8 months when the child sits upright unsupported
What is the difference between a postural and pathological curvature? WHat is he minimum degree of a lateral curvature to define scoliosis? What is this degree known as?
Postural curvatures are temporary and will rectify when standing up Pathoogical curvatures are permanent and can arise for a number of reasons Scoliosis is defined as a minimum of 10 degrees of lateral curvature - this is known as Cobb’s angle
Components of a typical vertebrae * Vertebral body * Vertebral arch * 7 processes * Vertebral notches What forms the vertebral arches? What are the 7 processes?
The vertebral arch is formed by the unison of the pedicles and lamina The 7 processes are - * Spinous process x1 * Transverse process x2 * 4 articular processes (superior and inferior articular processes with each having an articular facet)
Where are the vertebral notches? What do the notches align to create?
The vertebral notches are indentations above and below each pedicle (superior and inferior vertebral notch) These align with the vertbera above and below to form the intervertebral foramen
Which vertebra has no body or spinous process? What does it have instead? What does it articulate with superiorly?
C1 - atlas has no vertebral body or spinous process The atlas instead has an anterior and posterior vertebral arch each with its own tubercles The superior articular surfaces of the atlas articulate with the occipital condyles
On the anterior aspect of the anterior vertebral arch of the atlas there is an anterior tubercle On the posterior aspect of the posterior vertebral arch of the atlas there is a posterior tubercle * What is present on the posterior aspect of the anterior arch for the dens? * What is the name of the ligament in the atlas that will hold the dens in place?
On the posterior aspect of the anterior arch of the atlas there is the facet for the dens The ligament holding the dens in place is the transverse ligament of the atlas
The superior articular surfaces of the atlas join with the occipital condyles to form the atlantooccipital joint - this joint allows the nodding of the head Which articulation allows for the atlas to rotate? What sticks up form the vertebral body of the axis?
The atlas rotates on the superiro articular facets of the axis - at the atlantoaxial joint The dens (odonotid process) sticks up from the vertebral body of the axis
What are the two strong rounded cords that attach the skull to the axis? What is the purpose of these ligaments? There are grooves for the attachment of these ligaments in the odotnoid process of the axis
These two strong rounded cords are the alar ligaments - They limit axial rotation of the skull
What is the difference between the cervical vertebrae and other vertebrae spinous processes?
C1 vertebrae does not have a spinous process C2-C7 has a bifid spinous process The thoracic and lumbar verebtrae spinous processes do not split
On the edges of the cervical vertebrae are a sort of smooth edge known as the uncinate processes of the cervical vertebrae What shape are these uncinate processes that are on the edges of the cervical vertebrae? What cervical vertebra are they present in?
The uncinate processes are hook shaped They are present in C3-C7 cervical vertebrae
The uncinate processes articulate with the vertebrae above to from uncovertebral joints. What is the other name for this joint?
Uncovertebral joitns are also known as the joints of luschka
Cervical vertebrae C3-7 have a uncinate process on the vertebral body and bifid spinous processes (also C2 for bifid) What is special about their transverse processes?
The transverse process have foramen within in it for the passage of the vertebral vessels - known as the transverse foramen Also have anterior and posterior tubercle with a groove for the spinal nerve running between
What do the thoracic vertebrae possess for the articulation of the ribs? What is unique about their superior and inferior articular processes? What is unique about their spinous processes?
Thoracic vertebrae possess costal facets for the articulations of the ribs (superior and inferior costal facets as well as transverse costal facets) The superior and inferior articular processes are nearly vertical facing anteriorly and posteriorly The spinous processes are long and sloping
Describe the shape of a lumbar vertebral body?
The lumbar vertebrae have a massive kidney shaped body
What are the additional processes present on the transverse process and superior articular facets of the lumbar vertebrae? What is their function?
Their is an accessory process on each of the transverse processes Their is a mammillary process on each superior articular process The accessory and mamillary processes serve as a site for muscle attachment of the deep back muscles
What direction do the articular facets of the lumbar vertebra face?
The superior articular facets face posteromedially and the inferior articular facets face anterolaterally
Weight transfer from vertebral coumn goes to sacrum before going to hipp bones Because of the fusion of the bones we have anterior and posterior sacral foramina What are the broad lateral aspects of the sacrum known as? How many bones fuse to form the sacrum? What is the anterior projection of bone from the sacrum known as?
The broad lateral aspects of the sacrum are known as the ala (wings) 5 bones fuse to form the sacrum The anterior projection of bone from the superior sacrum is known as the sacral promontory
The dorsal surface of the sacrum is coarse and rugged. This can be attributed to the fusion of the sacral vertebrae, which give rise to three bony ridges (or crests). We have the * Median crest * Intermediate crest * Lateral crest What forms each of these crests?
Median crest Formed by the fusion of the first three sacral vertebrae Intermediate crest Formed by the fusion of the sacral articular processes Lateral crest Formed by the fusion of the saral transverse processes
How many bones are in the coccyx? What shape is the coccyx?
There are 4 coccygeal bones that fuse to form the coccyx (3-5 due to variation) The coccyx is small and triangular shaped
What are the articulating processes of the coccyx and sacrum known as?
The inferior articulating process of S5 articulate with the superior articulating processes of the coccyx These are known as the sacral and coccygeal cornu (they are projections from each of the fused bones)
What type of joint and what is it formed between is the intervertebral disc? What type of joint and what is it formed between is the facet joint? What is its other name? What is the inervertebral foramen formed between?
- The IV disc is a secondary cartilaginous joint between two vertebral bodies
- Zygapophysial (facet) joint, is formed between by the articulations of the superior & inferior articular facet (synoival plane)
- Intervertebral foramen is between the superior and inferior notches (above and below the pedicle
What are the two parts of the IV disc?
The inner soft gelatinous core - the nucleus pulposus The outer tough fibrocartilaginous ring - the annulus fibrosus
The gelatinous nucleus pupossus allows the IV ring to be able change shape and facilitate the movmeemnts of the vertebral column – it can be compressed due to the weight of the vertebral bodies over a day This is why you appear smaller at night than in the morning What happens to the nucleus pulposus when flexing, extending or latrally flexing the spine?
When perofrming movements of the spine, the adjacent vertebra will come together on side decreasing the IV joint space and the nucleus pulposus will therefore move to the opposite side Small black arros in diagram show movement of the nucleus pulposus away form the narrowing of the joint
The muscles of the back can be divided into three groups – superficial, intermediate and deep: The deep muscles develop embryologically in the back, and are thus described as intrinsic muscles. The superficial and intermediate muscles do not develop in the back, and are classified as extrinsic muscles. * What are the main functions of the superficial and intermediate extrinsic muscles of the back? * What is the main function of the intrinsic muscles of the back?
The superficial extrinsic muscles of the back connect to the appendicular skeleton - movements of the shoulder (humerus, scapula, clavicle) The intermediate extrinsic muscles of the back are superficial respiratory muscles Intrinsic muscles of the back are associated with movements of the vertebral column and the maintenance of posture
Superficial extrinsic muscles of the back include: * Trapezius * Lattisimus dorsi * Rhomboid major * Rhomboid minor * Levator scapulae We will discuss each of these muscles What are the separate parts of the trapezius and what is the trapezius muscle nerve supply?
The trapezius muscles consists of three part The upper (descending) trapezius fibres The middle (transverse) trapezius fibres The lower (ascending) trapezius fibres The trapezius muscle is supplied by CN XI - the spinal accessory nerve (motor) and C3,4 spinal nerves (pain and proprioception)
What is the attachment sites of the trapezius muscle?
Trapezius muscle Originates - Medial 1/3rd of the superior nuchal line, nuchal ligament and spinous processes C7-T12 Inserts - Lateral clavicle, acromion and spine of scapula
Where does the nuchal ligament extend from? and what is it contiunous with?
Nuchal ligament - runs from external occipital protuberance and posterior border of the foramen magnum to the 7th spinous process and is conintous with the supraspinous ligament (connects tips of spinous process)
What is the function of the trapezius muscle?
Upper part (descending) - elevates the scapula and rotates glenoid cavity
Middle part (transverse) - retracts the scapula
Lower part (ascending) - depresses the scapula
State the nerve supply to the trapezius muscle State the attachment sites and its function
- Nerve supply to trapezius- spinal accessory nerve (CN XI) (Motor) and C3,4 spinal nerves (pain and proprioception)
- Attachment - Origin - Medial 1/3rd superior nuchal line, ligamentum nuchae, spinous process C7-12 Insertion - Lateral 1/3rd clavicle, acromion & spine of scapula
- Function -
- * Upper - Elevates the scapula & rotates glenoid cavity
- * Middle - retracts the scapula
- * Lower - depresses the scapula
The two most superficial, superficial extrinsic back muscles are the trapezius and lattismus dorsi State the attachment of the lattismus dorsi and its nerve supply?
Lattismus dorsi
- Originates - Spinous process T7-12, thoracolumbar fascia, iliac crest & the lower 3/4 ribs
- Inserts - Into the floor of the bicipital groove of the humerus
- Supplied by a branch of the posterior cord of the brachial plexus the thoracodorsal nerve (C6-8)
What are the attachments of the lattismus dorsi? What is its nerve supply? What is its function?
Lattismus dorsi Originates at the spinous processes T7-12, thoracolumbar fascia, iliac crests, and the lower 3/4 ribs and inserts at the floor of the bicipital groove of the humerus Function - It extends, adducts and medially rotates the humerus Nerve supply - thoracodorsal nerve (C6,7,8) branch of the posterior cord of the brachial plexus
Superficial extrinsic muscles of the back include: * Trapezius * Lattisimus dorsi * Rhomboid major * Rhomboid minor * Levator scapulae We have discussed the trapezius muscles and the lattismus dorsi Now we discuss the rhomboids and levator scapulae What is the attachments of the levator scapula?
Levator sacpula originates from the posterior tubercles of transverse processes of C1-C4 vertebrae and attaches to the medial border of the scapula above the spine
What is the nerve supply and the function of the levator scapulae muscle?
Function - elevate the sccapula Nerve suppl y -Cervical nerves C3 and 4 and C5 form the dorsal scapula nerve So C3,4 cervical nerves and the dorsal scapular nerve
State the attachments, function and nerve supply of the levator scapulae
Attachments Posterior tubercles of transverse processes of C1-C4 vertebrae to the medial border of the scapula above the spine Function is to elevate the scapula Nerve supply - C3 and 4 cervical nerves and dorsal scapular nerve
There are two rhomboid muscles – major and minor. The rhomboid minor is situated superiorly to the major. What are the attachment points of the rhomboid muscles?
Rhomboid minor - attaches from the nuchal ligament, spinous process of C7 and T1 to the medial end of the scapular spine Rhomboid major - attaches from spinous processes T2 - T5 to the medial border of the scapula (from spine to inferior angle)
State again the attachments of the rhomboid minor and major as well as their function and nerve supply
Rhomboids Function - Retract and rotate the scapula Nerve supply - dorsal scapular nerve (C4,5) Rhomboid minor Ligamentum nuchae, C7 and T1 spinous processes to the medial border of the scapular spine Rhomboid major Spinous processes T2 to T5, to the medial border of the scapula (from spine to inferior angle)
The intermediate extrinsic back muscles have a respiratory function The two muscles are the: Serratus posterior superior (lies deep to the rhomboids) Serratus posterior inferior What are the attachments of both of these muscles?
Serratus posterior superior Nuchal ligament and spinous processes C7-T3 to the superior borders of ribs 2-4 Serratus posterior inferior Spinous processes of T11-L2 to the inferior borders of ribs 8-12 near the costal angle
What are the different nerve supplies to the serratus posterior muscles?
Serratus posterior superior - 2nd - 5th intercostal nerves Serratus posterior inferior - anterior rami of T9-12
State the attachments, nerve supply and functions of serratus posterior superior and inferior
Serratus posterior superior
- Nuchal ligament & spinous processes C7 to T3 to the superior borders of ribs 2-4
- Function - elevate ribs 2-4
- Intercostal nerves 2-5
Serratus posterior inferior
- Spinous processes T11-L2 to the inferior borders of ribs 8-12 near costal angle
- Function - depress ribs 8-12
- Anterior rami of T9-T12
The deep muscles develop embryologically in the back, and are thus described as intrinsic muscles. The superficial and intermediate muscles do not develop in the back, and are classified as extrinsic muscles. What are the three intrinsic muscles of the back groupings?
Intrinsic muscles of the back
- * Superficial intrinsic muscles - Spinotransversales muscles - (2 Splenius muscles)
- * Intermediate intrinsic muscles - Erector Spinae muscle group (3 muscles)
- * Deep intrinsic muscles - Transversospinalis muscle group (3 major and 3 minor muscles)
Intrinsic muscles of the back are all supplied by posterior rami of spinal nerves
What are the two superficial intrinsic back muscles known as?
These are the Spleniu Capitis and Splenius Cervicis
What are the attachments of the splenius capitis and cervicis?
Splenius capitis Nuchal ligament and spinous process from C7 to T3/4 Capitis fibres then ascend to the mastoid process and lateral 1/3rd of the superior nuchal line Splenius cervicis Spinous processes of T3-T6 to the posterior tubercles of transverse processes of C1-3/4
State the function of the splenius muscles? Already known all the deep back muscles are supplied by the posterior rami of spinal nerves
Rotation of the head to the same side for both and extension of the head and neck if bilateral contraction
State again the attachments and function of the splenius captitis and cervicis
Splenius capitis Attachment - nuchal ligament and spinous processes C7 to T3/4. Capitis fibres then ascend to mastoid process and lateral 1/3rd of superior nuchal line Splenius cervicis Attachment - spinous processes T3 to T6 to the posterior tubercles of transverse processes of C1 to C3/4 vertebrae Both cause rotation of the head to the same side and extension of the head and neck if bilateral contraction
The erector spinae muscles are arrnaged in 3 columns from lateral to medial What are the three groups?
Iliocostalis Longissmus Spinalis
The erector spinae is situated posterolaterally to spinal column, between the vertebral spinous processes and the costal angle of the ribs. What is the common tendinous attachment of all three erector spinae muscle groups?
Posterior iliac crest Posterior sacrum and sacroliliac ligaments Spinous processes of sacrum and lower lumbar vertebrae Supraspinous ligament
The common proximal attachment as stated is * Posterior iliac crest * Posterior sacrum and sacroiliac ligaments * Spinous processes of sacrum and lower lumbar vertebrae * Supraspinous ligament What is the function of the erector spinae muscles?
The muscles act unilaterally to laterally flex the vertebral column and act bilaterally to extend the vertebral column and head
All three muscles can be subdivided by their superior attachments (into lumborum, thoracic, cervicis and capitis). What are the three parts of each of the erector spinae groups?
Iliocostalis lumborum, thoracic and cervicis parts Longissimus thoracis, cervicis and capitis parts Spinalis thoracis, cervicis and capitis parts
All three erector spinae groups arise from the common tendinous attachments What is the common tendinous attachment? What is the insertion of the iliocsotalis?
Iliocostalis - Posterior iliac crest Posterior sacrum and sacroliliac ligaments Spinous processes sacrum & lower lumbar vertebrae Supraspinous ligament Iliocostalis inserts to the angles of lower ribs and (thoracis) cervical transverse processes (cervicis)
What is the insertion of the longissimus?
Fromm the common tendinous attachment to the Longissmus insertion Ribs between angles and tubercle (thoracis part) Thoracic and cervical transverse processes (thoracis and cervicis part) Mastoid process (capitis part)
What is the insertion of the spinalis muscle?
From the common tendinous attachment to the
- Spinalis Insertion
- Upper thoracic and cervical spinous processes (thoacis and cervicis part)
- Cranium (occipital bone) (capitis part)
State the insertion of the iliocostalis, the longissimus and the spinalis Which is often poorly developed?
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The deep intrinsic muscles are located underneath the erector spinae, and are known collectively as the transversospinales. They are a group of short muscles, associated with the transverse and spinous processes of the vertebral column. What are the three major and three minor transversospinalis muscles?
Major * Semispinalis * Multifidus * Rotatores Minor * Levator Costarum * Interspinale * Intertransversari
The semispinalis is the most superficial of the deep intrinsic muscles. Much like the intermediate muscles, it can be divided by its superior attachments into thoracic, cervicis and capitis. What are the semispinalis attachments?
Semispinalis Attaches from the transverse processes of C4-T12 To thoracic and cervical spinous process and to the occipital bone
Multifidus Where is the multifidus most thick? In what direction do its fibres pass and to how many vertebra above?
Multifidus is thickest in the lumbar region Its fibres pass superomedially to spinous processes 2-4 vertebra above
Rotatores Where is it most developed? What direction do its fibres pass to and how to how many vertebra above?
Rotatores is most developed in the thoracic region Its fibres pass superomedially to the junction between lamina and transverse process of 1 to 2 vertebra above
What are the three minor deep intrinsic muscles of the back?
The levator costarum, interpsinales and intertransversari
What regions are the minor deep intrinsic back muscles well developed? What is their attachment and what is their function?
- Levator costarum - well developed in the thoracic region - from transverse processes of vertebra to the upper surface of ribs below (elevates ribs)
- Interspinale - between spinous processes
- Intertransversari - between transverse processes - Both well developed in cervical & lumbar region & stabilise vertebral column
State again the function of the intrinsic muscles of the back? What fascia are the intrinsic muscles of the back located between (intermediate and deep layers)?
Function is to maintain posture and control movements of the vertebral column Intrinsic muscles of the back are located between the middle and posterior layers of the thoracolumbar fascia (anterior layer is covering quadratus lumborum)
