Spine Flashcards
List the structural components of a typical vertebra and describe their function.
Spinous & Transverse processes: muscle attachment and movement
Articular processes: restriction of movement
Vertebral arch (pedicure & lamina): protection of spinal cord
Vertebral body: support BW
Discuss the changes in vertebrae with advancing age.
- Decrease in bone density at vertebral body
- Articular surfaces bow inward (as consequence of 1)
- Compression at periphery (consequence of 2)
- Osteocytes form (response to 3) - bony development
Summarize the development of spinal curvatures.
Primary Curvatures: thoracic and sacral
Secondary Curvatures: cervical (head support), lumbar (toddler - walking)
Define terminology for abnormal curvature of the spine.
Excessive Kyphosis: thoracic, rounded shoulders
Excessive Lordosis: lumbar, pregnant/gymnasts
Scoliosis: lateral deviation
Describe the components of the intervertebral disc.
Anulus fibrosus and nucleus pulposus (hyaline cc end plate)
*accounts for 20-25% of vertebral column length
Crossing fiber systems of the anulus fibrosus keeps the nucleus pulposus from spilling out
Describe posterolateral herniation of the intervertebral disc.
Anulus fibrosus breaks down allowing nucleus pulposus to spill out
- extrudes posterlateral direction - impacting spinal nerves (level below herniation)
- ligamentum flag a
List the six ligaments of the spine and describe the motions they limit.
- Anterior Longitudinal Ligament: either side of vertebral body
- stabilizes VC and prevents hyperextension - Posterior longitudinal ligament: blocks extrusion of nucleus
- pulposus in direct posterior direction (reason it is lateral)
- prevents hyperflexion - Supraspinous ligament: tip of spinous process,
- Interspinous ligament: between spinous process,
- Ligamentum flavum: connect lamina
- Intertransverse Ligament: connect transverse process
Discuss the structure of the ligamentum nuchae and its function.
External occipital protuberance to C7
Median fibroelastic septum
Separates R/L posterior neck
MM attachment for splenius capitis
List the six primary movements of the spine and discuss how the amount of motion differs between regions of the spine.
Flexion: greatest in cervical and lumbar
Extension: greater in cervical and lumbar
Lateral Flexion: most in cervical
Lateral Extension:
Rotation of Head & Neck: greatest in cervical
Rotation of Upper Trunk: slight in thorax
Zygapophysial Joint: orientation of articular process governs different amount of movement
Cervical (45 deg): highly mobile
Thoracic (60 deg): limited movement in thoracic spine
Lumbar (90 deg): facets face med/lat - good in flex/exten, very poor rotation, slight lateral flexion
Describe the organization, attachments, and innervation of the extrinsic and intrinsic muscles of the back.
Extrinsic
- Superficial: trapezius, latissimus dorsi, levator scapulae, rhomboids (CN XI, ventral rami of spinal nn.)
- Intermediate: serratus posterior superior, serratus posterior inferior (intercostal nn.)
Intrinsic
- Superficial: splenius capitis, splenius cervicis (dorsal rami of spinal nn.)
- Intermediate: Erector Spinae (spinalis, longissimus, iliocostalis - lateral br. Or dorsal rami of spinal nn.)
- Deep: transversospinales (semispinalis - capitis, thoracic, cervicis - multifidus, rotators - longus, brevis) — dorsal rami of spinal nn.
- Deep: interspinales, intertransversarii
Describe the meningeal covering of the spinal cord.
Dura mater:
Arachnoid mater: bonded to inner dura in vivo
Pia mater: denticulate ligament (attaches to dura forming lateral stabilization, minimize spinal cord movement)
Describe the structural changes and clinical findings of spinal stenosis.
Reduce space of vertebral canal that may cause compression of one or more spinal nerve roots (most common in lumbar level)
