Spine Flashcards by Mathieson Russell

List the divisions of the spine and the number of vertebra in each.

Cervical - 7
Thoracic - 12
Lumbar - 5
Sacral - 5 (fused)
Coccygeal - 4 (fused)

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Describe vertebral development in relationship to the curvature.

2 fetal months, One curve
6 fetal months, Straightening of spine, sacral curve remains.
Newborn, Straight spine, slight lumbar curve, sacral curve.
4 year old, cervical curve, lumbar curve, less sacral curve.
13 year old, All curves present, less pronounced than adult.
Adult, All curves fully formed.

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Name the three types of abnormal curves of the spine and in what direction they occur.

Lordosis - Lumbar curve exaggerated anteriorly.
Kyphosis - Thoracic curve exaggerated anteriorly.
Scoliosis - Spinal curve laterally, left or right.

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What are the functions of the spine?

Support body weight.
Transmit forces through pelvis to lower limbs.
Carry and position head.
Brace an help manoeuvre upper limb.
Protect Spinal Cord.

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Describe a typical vertebra.

Body - Weight bearing.
Arch - Pedicles: Bony pillars attach to body. Laminae: Roof of arch, from pedicle to mid line.
Foramen - for spinal cord.
Spinal process - project posteriorly.
Transverse processes - project posterior/lateral.

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Describe the Cervical vertebrae.

Cervical = neck
7 cervical vertebrae.
small vertebral body.
Transverse foramen - for vertebral artery and vein.

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Name the joints between C1 and the skull and C2 and C1.

Atlanto-occipital joint (yes)

Atlanto-axial joint (no)

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Describe the Thoracic vertebrae.

Throacic = Upper chest
Body is larger, heart shape.
Vertebrocostal articulations
Small vertebral body.
Transverse process faces down, short, allow rotation.
spinous process faces down.

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Describe the lumbar vertebrae.

Lumbar = lower back
Body is large - bean shaped.
transverse processes long
Spinous processes face back
articular facets face medial and lateral.

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Describe the sacrum and coccyx.

5 fused sacral vertebrae
4 fused coccygeal vertebrae
Female shorter and wider.

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Describe the joints between vertebrae.

Typical vertebrae has 6 joints.
4 synovial joints, two above and below, between articular processes. facet or zygapophyseal.
2 symphases, one above an below, between vertebral bodies.

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Explain how the zygapopheseal joints guide movement.

Cervical zygapopheseal joints slope inferiorly to posteriorly allowing flexion/extension.
Thoracic zygapopheseal joints slope almost vertical, allows rotation.
Lumbar zygapopheseal joints curved to allow flexion/extension.

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Describe a typical intervertebral disk.

Fibrocartilaginous.
Outer layer - Annulus fibrous. (collagen and fibrocartilage)
Central - Nucleus pulposus (gelatinous)

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Describe intervertebral disk damage.

Distorted, Bulge, Herniated.

Little risk of issues unless compressing nerve.

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List the Ligaments of the spine.

Anterior longitudinal
Posterior longitudinal
Ligamentum flavum
Supraspinous
Interspinous ligaments
Ligamentum nuchae

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Desscribe the spinal cord.

About 45 cm long

Sensory(afferent) and
motor (efferent)
cord ends between L1 & L2
nerves from the lumbar and sacral levels ‘cauda equina’

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Describe the spinal cord in a cross section

Butterfly-shaped center of the cord = gray matter =
Nerve bodies
Ventral “wings” (horns) contain motor nerves
Dorsal horns contain sensory nerves
Surrounding white matter contains nerve fibers.

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Explain how the spinal nerves are named.

Cervical nerves
emerge above their vertebrae
C8 emerges below C7

Thoracic, lumbar and
sacral emerge below their vertebra.

Describe the inner spinal meninges.

Innermost = Pia mater Pia
Bound to the spinal cord
Blood vessels external to pia

Describe the middle and outermost spinal meninges.

Middle layer= Arachnoid mater; like spider web
Outermost layer= Dura mater
Epidural space between dura mater and bone
Subdural space- deep to dura

Describe the spinal motions.

Flexion/ Extension
Lateral flexion/ extension (left/right)
Rotation (left/right)

Describe the posterior ramus.

A motor and sensory branch

Travels anterior and another travels posterior from the spine.

List the layers of intrinsic spine muscles and the muscles within them.

Superficial: Splenius Capitus and Cervicis
Intermediate: Erector Spinae
Deep:Semispinales, Multifidus, Rotatores.
Suboccipital.
Interspinales, intertransversii, levetores costarum.
Quatratus Lumborum.

Describe Spenius Capitus.

Origin:Nuchal Ligaments and spinous processes.
Insertion: Mastoid Process, occipital Bone
Action:Extend (bilateral) Rotate (unilateral)

Descirbe Spenius Cervicis.

Origin: Nuchal Ligaments and spinous processes Insertion: Transverse processes C1 - 4 Action: Extend (bilateral) Rotate (unilateral)

Describe the thoracolumbar facia.

Membrane covers deep muscles of back. 3 Layers, Anterior, middle, posterior. Between the anterior and middle later lies quadratus lumborum. Erector spinae muscle is between middle and posterior layers.

Describe erector spinae. (Generally)

Each of the three columns are further named after its location. Static role, Concentric role, Eccentric role.

Describe erector spinae.

Origin:Posterior iliac crest, posterior sacrum, lumbar spinous processes. Insertion: Iliocostalis - Lower ribs, cervical transverse process. Longissumus - Ribs, transverse processess, mastoid proccess. Spinales - Adjacent spinous processes. Action: Spinal extensors (bilateral) Allow lateral flexion (unilateral)

Describe the Transversospinales muscles.

Run upward and medially from transverse - spinous processes. 3 Main groups are: Semispinales, Rotatores, Mutifidus. Extend (bilaterally) Rotate (Unilaterally)

Describe Semispinales.

Origin:Transverse Process C4 - T12 Insertion: Occipital Bone, cervical and thoracic transverse processes. Action: Extension (bilateral) Rotation (unilateral)

Describe mutifidus.

Most developed in the lumbar spine travel 1 - 3 segments Origin: Posterior sacrum, deep surface erector spinae, PSIS, lumbar, thoracic, cervical. Insertion: Spinous processes L5 - C2 Action: Extends (bilaterally), Assists upright sitting.

Describe the Rotatores.

Most developed in thorax Origin: Transverse processes. Insertion: Spinous processes Action: Extension (bilateral) rotation (unilateral)

Describe the levatores Costarum.

Origin: Transverse process C7 - T11 Insertion: Posterior, angle of rib below. Action: Elevate Rib

Describe the Intertransversarii.

Origin: Transverse processes Insertion: Transverse Process above Action: Stabilise

Describe Interpinales.

Origin: Spinous processes Insertion: Spinous process above Action: Stabilise

Describe Quadratus Lumborum.

Origin: Iliac crest, Iliolumbar ligament. Insertion: 12th rib, lumbar transverse processes. Action: Depress ribs (bilateral) Lateral flexion (unilateral)

Describe Suboccipital.

Extend the head cervical vertebrae to occipital bone.

List the hypaxial muscles of the neck. (You do not need to know these muscles, Understanding only)

``` Longus capitis Longus Colli Rectus Capitis lateralis Rectus Capitis anterior Scalenus Anterior Scalenus Medius Scalenus Posterior ```

List the Hypaxial muscles (anterior)

Diaphragm (Central tendon, Anterior longitudinal ligament) Quatratus Limborum Iliopsoas

List the Abdominals. (more superficial)

External Oblique Rectus abdominis Internal Oblique

Describe Transversus Abdominus.

Origin: Iliac Crest, Inguinal Ligament, Lumbar fascia, and cartilages of inferior six ribs. Fibres run TRANSVERSELY. Insertion: Xiphiod process, linea alba, pubis Action: Compresses abdomen. Nerve Supply: Thoracic Spinal nerves T8 - T12.

Describe the Internal Oblique.

Origin: Lateral inguinal ligament, anterior iliac crest. Insertion: Ribs 8 - 12, linea alba Action: Compresses abdomen, flexes trunk (bilateral) rotates trunk (unilateral) Nerve Supply: Lower intercostal nerves.

Describe the External Oblique.

Origin: Lower 8 ribs. Insertion: Linea alba, abdominal neurosis, anterior iliac crest. Fibres run OBLIQUELY Action: Compresses abdomen, flexes trunk (bilateral) rotates trunk (unilateral) Nerve Supply: Lower Intercostal nerves

Describe Rectus Abdominus.

Superficial Origin: Pubis Insertion: Costal Cartilage ribs 5 - 7, xiphoid. Tendinous Inscriptions Action: Trunk flexion Nerve Supply: thoracic spinal nerves T7 - T12