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MSK-Derm by Minnie AH Version > SM MSK Anatomy - Back and Spine > Flashcards

SM MSK Anatomy - Back and Spine Flashcards

SM 221a, Lab 1

1
Q

What are the functions of the intrinsic back muscles?

A

Move the vertebral column

Extension, lateral bend, rotation

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2
Q

Which structure is labeled by #3?

A

Vertebral foramen

(Spinal cord runs through here)

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3
Q

The intrinsic muscles of the back attach to the ______

A

The intrinsic muscles of the back attach to the vertebral column

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4
Q

Identify the follwing on both the MRI and the bone

  • Vertebral body
  • Vertebral foramen
  • Spinous process
A

https://www.researchgate.net/publication/224950784_Unexpected_neuroimaging_abnormalities_in_patients_with_apparent_C8_radiculopathy_Broadening_the_clinical_spectrum/figures?lo=1

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5
Q

How many sacral vertebrae are there?

A

4-5

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6
Q

Which structure is indicated by #2?

A

Vertebral disc

(specifically the soft inside, Nucleus Pulposus)

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7
Q

True or false?

Back muscles attaching to the scapula will receive innervation from dorsal rami of the appropriate thoracic level

A

False

  • Back muscles attaching to the scapula are extrinsic muscles
  • They are innervated by ventral rami
    • Except trapezius, which is innervated by CN XI (the spinal accessory)
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8
Q

Where could this portion of spinal cord be taken from?

A

T1 through L1

Spinal nerves do not originate from cervical vertebrae
(cranial nerves exit cervical vertebrae)

The spinal cord ends at L1. The cauda equina takes spinal roots down to the lumbar and sacral vertebrae, where they exit as spinal nerves

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9
Q

What are the 3 groups of intrinsic muscles of the back?

(From superficial to deep)

A
  • Splenius
  • Erector spinae
  • Transversospinalis
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10
Q

What structure is labeled by #5?

A

Spinal nerve

Emerges from the vertebral column through the intervertebral foramen

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11
Q

True or False?

The erector spinae and the splenius are both extensors of the spine

A

True

  • Both are instrinsic back muscles
    • Extensors, lateral bend, rotators
  • Erector spinae extends the lumbar and thoracic regions
  • Splenius extends the head and neck
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12
Q

Which structure is labeled by #2?

A

Vertebral arch

(specifically the lamina)

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13
Q

Which structure attaches the pia mater to the coccyx?

A

Filum terminale

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14
Q

What is inside of the dural sac at the level of L3?

A

Cauda equina + arachnoid mater

The spinal cord ends at L1, giving rise to spinal roots that bundle together to form the cauda equina

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15
Q

Which structure is labeled by #4?

A

Spinous process

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16
Q

Which structure is labeled by #6?

A

Vertebral foramen

(This is where the spinal cord would be)

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17
Q

What are the most common sites for herniated discs?

A

Between L4-L5 in the lumbar region -> lower back/leg pain

May also occur in the cervical region -> neck/arm pain

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18
Q

Which structures hold the vertebrae together?

A

Ligaments and vertebral disks

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19
Q

What structure is labeled by #1?

A

Scapular spine

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20
Q

Which structure is labeled by #1?

A

The vertebral arch

(specifically the pedicle)

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21
Q

Which structures make up the vertebral arch?

A

Lamina + pedicle

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22
Q

While stopped at a light, a man’s car is rear-ended at high speed. He is brought to the emergency room with difficulty breathing and a severe hyperextension neck injury. His MRI shows a rupture of the anterior annulus of C4-5 intervertebral disc, inflammation of the disc, and a preverterbal hematoma (the cause of his breathing difficulty). Which of the following ligaments was likely disrupted?

  1. Anterior longitudinal
  2. Ligamentum flavum
  3. Interspinous
  4. Supraspinous
  5. Posterior longitudinal
A

a. Anterior longitudinal

Often injured in whiplash injuries

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23
Q

This is an axial T2 MRI of the lumbar spine

How is the muscle group outlined in red innervated?

A

Dorsal rami of the spinal nerves

These are intrinsic back muscles

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24
Q

Which structure is labeled by #4?

A

Vertebral foramen

(Spinal cord runs through here)

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25
When does lordosis of the cervical and lumbar regions develop?
When a child starts to walk Development continues for 1-2 years
26
Which group of the intrinsic back muscles is shown in this image (outlined in blue)? What is its function? Attachments? Innervation?
* Muscle: **Transversospinalis** * Found in the notch between the transverse process and spinous process * Function: **Extension, rotation, and lateral bending** * Attachments: **Spinous process, transverse process** * Innervation: **Dorsal rami of spinal nerves**
27
Which muscles are active when you shrug your shoulders?
Levator scapulae (main) Trapezius helps a bit
28
Which vertebrae are the smallest? 1. Cervical 2. Thoracic 3. Lumbar 4. Sacral
a. Cervical
29
What structure is labeled by #9?
Arachnoid mater Middle layer of the meninges covering the spinal cord
30
What structure is labeled by #2?
Inferior articular facet
31
Identify the following in the image * Spinal cord * CSF * Cauda equina * L1
The spinal cord ends at L1
32
Which structure is labeled by #6?
**Vertebral arch** | (specifically, the pedicle)
33
Which muscles elevate the scapula?
**Levator scapulae** Rhomboids Trapezius
34
Which ligament is labeled by #3?
Ligamentum flavum
35
Which ligament is labeled by #4?
Supra-spinous ligament
36
Which section of the spine is shown in this image? How do you know?
Lumbar Look for the "scotty dog" feature * Ear (D) = superior articular facet * Front leg (C) = inferior articular facet * Eye (B) = pedicle * (A) is the intervertebral disk
37
Which nerves innervate the extrinsic muscles of the back?
Ventral rami of the spinal nerve | (Anterior rami)
38
A hyperextension injury is most likely to injure which spinal ligament?
Anterior longitudinal ligament (a whiplash injury)
39
What structure is labeled by #3?
Acromion of the scapula
40
Which lines correspond with the following structures? * Line of the spinous process * Articular line * Anterior veterbral body line * Posterior vertebral body line
(In order from left to right) * Blue = Anterior vertebral body line * Red = Posterior vertebral body line * Orange = Articular line * Green = Line of the spinous process
41
Where is an epidural administered?
Outside of the dural sack - anesthetizes the nerve roots Usually accessed through lumbar vertebrae (L4-L5), sacral hiatus, or posterior sacral foramina (but can theoretically be done anywhere along the column - there is less risk of spinal cord injury because you are not puncturing the dural sac)
42
Which intrinsic back muscle has fibers that extend superio-laterally? \\ //
Splenius
43
An 81 yo woman complains of weakness and loss of sensation in her legs. Radiological studies show bony spurs (osteophytes) narrowing the intervertebral foramina at levels T12-L3. Which of the following structures is most likely to be impinged by the osteophytes? ## Footnote A. Spinal cord B. Spinal nerve C. Sympathetic trunk ganglion D. Anterior rootlets of spinal nerve E. Ventral ramus of spinal nerve
B. Spinal nerve Dorsal root ganglion may also be affected These structures must pass through the intervertebral foramina - if the opening is smaller, they may be impinged
44
What structure is labeled by #2?
Dura mater Outermost layer of meninges covering the spinal cord
45
Which muscle is outlined in yellow (labeled 2)? What is its function? Attachments? Innervation?
* Muscle: **Rhomboids** * Function: **Retract the scapula** * Attachments: **Scapula, spinous process** * Innervation: **Ventral rami of spinal nerves**
46
What structure is labeled by #1?
Superior articular facet
47
How many lumbar vertebrae are there?
Usually 5 May be 4-6
48
How many cervical vertebrae are there?
7
49
Which structure is labeled by #4?
Articular process
50
What is the deepest layer of the intrinsic back muscles?
Transversospinalis
51
Which muscles are found underneath the trapezius?
Levator scapulae Rhomboids
52
Describe the distinguishing features of the cervical vertebrae
* Smallest kind of vertebra * Small body relative to vertebral foramen * Has transverse foramen
53
Which muscle is indicated by #2? What is its function? Attachments? Innervation?
* Muscle: **Erector spinae** * Function: **Lateral bending, rotation,** extension **of the back** * Attachments: **Spinous process, transverse process, ribs** * Innervation: **Dorsal rami of spinal nerves**
54
Which muscle group is shown?
Erector Spinae (intrinsic back muscle) Innervated by dorsal rami Functions in extension, lateral flexion, rotation
55
Which intrinsic back muscle has fibers that are straight up and down? || ||
Erector spinae
56
Which intrinsic back muscle has fibers that extend superio-medially? // \\
Transversospinalis Deepest layer of the intrinsic back muscles
57
Which layer of the meninges is labled by #1?
Arachnoid mater | (Middle layer)
58
Which muscles retract the scapula?
Rhomboid Trapezius
59
Which structure is labeled by #3?
Ligamentum flavum
60
Which structure is labeled by #2?
Posterior longitudinal ligament
61
What structure is labeled by #5?
Filum terminale Extension of the pia mater that attaches to the coccyx
62
What muscle is outlined in red (labeled #2)? What is its function? Attachments? Innervation?
* Muscle: **Latissimus Dorsi** * Function: **Extends and adducts the arm** * Attachments: **Humerus + Spinous processes + Illiac crest + Sacrum** * Innervation: **Ventral rami of the spinal cord** * Via brachial plexus
63
What kind of vertebra is this?
Thoracic * Long spinous process (points down) * Kidney bean-shaped body
64
Which movements are controlled by the intrinsic muscles of the back?
Extension Lateral bending Rotation
65
Which structures of the vertebrae, strung together, create a space for the passage of the spinal cord?
Vertebral foramen Together they form the spinal foramen (Note: the **inter**vertebral foramen is the exit pathway for the spinal nerves associated with each vertebra)
66
Which structure is indicated by #1?
**Intervertebral disc**
67
What structure is labeled by #6?
Pia matter
68
What structure is labeled by #4?
Ventral (anterior) ramus of the spinal nerve
69
Which structure is labeled by #3?
Transverse process
70
Which ligaments limit flexion of the spine?
* Supraspinous ligament * Ligamentum flavum * Posterior longitudinal ligament
71
Which parts of the spine exhibit natural lordosis?
Cervical and Lumbar regions
72
Which structure is labeled by #5?
Transverse process
73
Which layer of the meninges is labled by #3?
Pia mater (Innermost layer) The arrow is pointing specifically to the denticulate ligaments, which are made of pia mater
74
Most herniations occur posteriorly, to one side or the other of the midline, due to ligamentous reinforcement in the midline of the vertebral bodies. The ligament reinforcing in this manner is the…
Posterior longitudinal ligament
75
A woman reports difficulty extending her back. Which of these muscles would you examine first? ## Footnote a. latissimus dorsi b. rhomboid major c. pectoralis major d. erector spinae e. external oblique
d. erector spinae This is the only choice that is an intrinsic muscle. Intrinsic muscles of the back participate in extension, lateral bending, and rotation
76
Which back muscles depress the scapula?
Lattisimus dorsi
77
A whiplash injury is most commonly associated with injury to which spinal ligament?
Anterior longitudinal ligament
78
What structure is labeled by #1?
Spinal ganglion
79
What structure is labeled by #1?
Spinal cord
80
Which ligament is labeled by #1?
Anterior longitudinal ligament
81
Which parts of the spine have a natural kyphosis?
Cervical and lumbar
82
What structure is labeled by #4?
Cauda equina Spinal roots (dorsal and ventral) travel to their exits in the lumbar and sacral vertebrae, where they will join and become spinal nerves
83
Which layer of the meninges is labled by #2?
Dura mater | (outermost layer)
84
How many coccygeal vertebrae are there?
4
85
Which structure is labeled by #1?
Anterior longitudinal ligament
86
Through which structure do spinal nerves exit the spinal cord?
Intervertebral foramen | (#3)
87
The extrinsic muscles of the back attach to the \_\_\_\_\_\_
The extrinsic muscles of the back attach to the **_spinous process and limbs_**
88
What structure is labeled by #3? What is its purpose?
Intervertebral foramen The spinal nerves pass through here on their way to their final destinations
89
Which intrinsic back muscle is largest?
Erector spinae
90
What kind of vertebra is this? How do you know?
Lumbar vertebra * Broad spinous process * Spinous process points almost straight back * Articular processes * Superior faces inward * Inferior faces outward
91
Which ligaments limit the extension of the spine?
Anterior longitudinal ligament
92
What structure is labeled by #7?
Dura mater Most superficial layer of meninges covering the spinal cord
93
What structure is labeled by #3?
Dorsal (posterior) ramus of the spinal nerve
94
Describe the distinguishing features of the thoracic vertebrae
* Larger than cervical vertebrae, smaller than lumbar * Body is kidney-bean shaped * Articular facets for ribs * Large spnious process (lots of muscles attach to these vertebrae)
95
Which structure is labeled by #3?
Spinous process
96
What are the functions of the spinous and transverse processes?
Attachment sites for muscles
97
Which structure is labeled by #5?
Body of the vertebra
98
True or false? In a typical spinal nerve the dorsal root contains motor fibers which will innervate the deep (intrinsic back musculature)
False * The dorsal **root** contains sensory fibers. * The ventral **root** contains motor fibers. * When the roots merge to form the spinal nerve... * Dorsal **ramus** innervates the intrinsic muscles of the back * Ventral **ramus** innervates the extrinsic muscles of the back
99
When you hunch over your computer, you are introducing unnatural [kyphosis/lordosis] into your spine
Kyphosis | (In the cervical spine)
100
What are the functions of the extrinsic back muscles?
Move the limbs (arms) by moving the scapula and the humerus
101
This is an axial T2 MRI of the lumbar spine What structure is outlined in blue? What traverses it?
Structure = **intervertebral foramen** The **spinal nerves** traverse the intervertebral foramen
102
What muscle is outlined in green (labeled #1)? What is its function? Attachments? Innervation?
* Muscle: **Trapezius** * Function: **Scapular motion** * Rotates the scapula * Moves it vertically * Pulls it back * Attachments: **Scapula + Spinous processes + Head** * Innervation: **Cranial Nerve XI** * One of the few extrinsic back muscles not supplied by the ventral ramus
103
How many thoracic vertebrae are there?
12
104
Which muscle is responsible for extending and adducting the arm?
Latissimus dorsi
105
Which muscle is indicated by #1? What is its function? Attachments? Innervation?
* Muscle: **Splenius** * Only seen in the neck and head region * Most superficial intrinsic back muscle * Function: **Head e****xtension, head rotation, and lateral bend of the neck** * Attachments: **Spinous process, head** * Innervation: **Dorsal rami of spinal nerves**
106
Where is spinal anethesia administered?
In the subarachnoid space (in between the arachnoid and the pia mater) Administer between L3-L4 (the spinal cord ends at L1) - this decreases the chance of a spinal cord injury.
107
What structure is labeled by #2?
Coracoid process of the scapula
108
Which part of the vertebral arch articulates with the superior and inferior vertebrae?
Articular processes
109
What kind of vertebra is this? How do you know?
Cervical * Vertebral foramen is large comapared to the body * Spinous process is short * Contains transverse foramen
110
What bone is this?
Right scapula
111
Which structure is labeled by #7?
Body of the vertebra
112
What structure is labeled by #10?
Pia mater Deepest layer of the meninges covering the spinal cord Firmly attached to the spinal cord
113
Describe the distinguishing features of the lumbar vertebrae
* Larger than thoracic or cervical vertebrae * Body is large compared to vertebral foramen
114
Which ligament is labeled by #2?
Posterior longitudinal ligament
115
Which muscle is responsible for rotating and retracting the scapula?
Trapezius
116
Which muscle is outlined in red (labeled 1)? What is its function? Attachments? Innervation?
* Muscle: **Levator scapulae** * Function: **Elevates the scapula** * Attachments: **Scapula, transverse processes C1-C4** * Innervation: **Ventral rami of spinal nerves**
117
Which nerves innervate the intrinsic muscles of the back?
Dorsal rami of the spinal nerve | (Posterior rami)
118
This vertebra comes from which region?
Thoracic Articulates with the ribs
119
What structure is labeled by #2? | (between the two layers)
Subarachnoid space Usually filled with cerebrospinal fluid
120
Which extrinsic back muscle is NOT innervated by ventral rami of the spinal cord?
**Trapezius** Innervated by cranial nerve XI (spinal accessory)
121
Identify labeled parts in this Xray of a section of thoracic vertebrae
1. Rib 2. Vertebral arch 3. Spinous process 4. Transverse process
122
What structure is labeled by #3?
Arachnoid mater Middle layer of meninges covering the spinal cord (The pia mater ends with the spinal cord at L1)
123
Which structure is labeled by #5?
Vertebral Arch | (Lamina + Pedicle)
124
Which structure is labeled by #6?
Transverse foramen Sympathetic nerve plexus + vertebral artery + vertebral vein pass through this
125
Which muscle lies on top of the levator scapulae and rhomboid muscles?
Trapezius
126
What are the major extrinsic muscles of the back?
* Most superficial layer * **Trapezius** * **Latissimus dorsi** * Middle layer * **Levator scapula** * **Rhomboids**

MSK-Derm by Minnie AH Version (47 decks)

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