Spine

Question 1

What is the surface landmark to locate the 3rd thoracic vertebra?

Answer 1

Spine of the scapula.

Question 2

What is the principle role of the erector spinae muscles?

Answer 2

Control/limit flexion of the back.

Question 3

What muscles fails to hold the scapula flat against the back when its inner action is lost, hence the term “winged scapula”?

Answer 3

Serratus anterior muscle.

Question 4

What sort of curvature should be considered “normal” in a healthy persons lumbar vertebral column?

Answer 4

Lordosis

Question 5

Why is the spine curved?

Answer 5

It increases mobility and ability to bear the axial load.

Question 6

What is a scoliosis?

Answer 6

An abnormal lateral curvature of the spine.

It can be congenital, idiopathic or neuromuscular.

Question 7

What is the surface landmark for T7?

Answer 7

At the level of the inferior angle of the scapula.

Question 8

What is the surface landmark of L4/5?

Answer 8

At the level of a line drawn between the iliac crests.

Question 9

At what level does the spinal cord terminate?

Answer 9

L1/L2. Cauda equina is below.

Question 10

What is muscle tone?

Answer 10

Muscles resistance to passive stretch.

Question 11

What is muscle power?

Answer 11

Tension generated by voluntary contraction.

Question 12

Neurotome

Answer 12

Area of skin innervated by one peripheral nerve.

Question 13

Dermatome

Answer 13

Area of skin innervated by one spinal nerve. Important in evaluating extent of a spinal injury.

Question 14

Myotome

Answer 14

Group of muscles innervated by one spinal nerve. Important in evaluating extent of a spinal injury.

Question 15

Explain posterior convexity

Answer 15

Thoracic and sacral kyphosis are backward curving primary curves.

Question 16

Explain anterior convexity

Answer 16

Cervical and lumbar lordosis are forward curving secondary curves.

Question 17

When and why do the secondary curves come from?

Answer 17

Initially spine is C shaped at birth. Cervical lordosis develops at about 6 months to improve lifting of the head and head control. Lumbar lordosis develops at 10-14 months to allow standing and walking.

Question 18

What is C1 also known as?

Answer 18

‘Atlas’. Greek Titan who had to hold up the sky.

Question 19

Why do most fractures occur at the junction between cervical and thoracic and thoracic and lumbar?

Answer 19

Stress difference. Thoracic is relatively immobile- biomechanical increase in stress between a stiff and moveable segment.

Question 20

What is a tendon reflex?

Answer 20

An involuntary muscle contraction response to the sudden stretch of its tendon. It tests the integrity of a 2 neurone reflex arc innervated by a single segment of the spinal cord.

Question 21

What examination findings would there be if the afferent pathway of a reflex was damaged?

Answer 21

Reflex is absent with associated sensory loss.

Question 22

What examination findings would there be if the efferent pathway of a reflex was damaged?

Answer 22

Reflex is absent with with associated muscle paralysis.

Question 23

What is the cause of hyper-reflexia (tonic, brisk reflexes)?

Answer 23

A cortico-spinal pathway above the segment which modulates muscle activity is damaged.

Question 24

What is muscle tone?

Answer 24

Muscle resistance to passive strength.

Question 25

What is muscle power?

Answer 25

Tension generated by voluntary contraction.

Question 26

What is a lower motor neurone lesion?

Answer 26

Injury to the nerve fibres travelling from the anterior horn of the spinal cord to the muscles eg. spinal cord injury, traumatic division of a peripheral nerve.

Question 27

What is an upper motor neurone lesion?

Answer 27

Injury to the neural pathway above the motor neurones in the anterior horn of the spinal cord eg. stroke, traumatic brain injury, cerebral palsy.

Question 28

What is the tone, power and reflexes on examination of a lower motor neurone lesion?

Answer 28

Tone-reduced. Power-reduced. Reflexes- hypo-reflexia.

Question 29

What is the tone, power and reflexes on examination of a upper motor neurone lesion?

Answer 29

Tone-increased. Power-spasticity. Reflexes- hyper-reflexia.

Question 30

How many vertebrae are there in each spinal segment?

Answer 30

Cervical (8). Thoracic (12). Lumbar (5). Sacral (5). Coccygeal (1). Total of 31. Each segment gives rise to a pair of spinal nerves.