Spine and Deep Back Flashcards
Describe the function of the vertebral arch
Protection of spinal cord
Identify and describe the function of the orange structure.
Spinous process
Muscle attachment and movement
Identify the green structure.
Pedicles
Identify and describe the function of the red structure.
Transverse process
Muscle attachment and movement
Identify the purple structure.
Lamina
Identify and describe the function of the yellow structure.
Superior articular process
Restriction of movement
Identify and describe the function of the blue structure.
Vertebral body
Supports bodyweight
Identify and describe the function of the shaded structure.
Vertebral foramina
Spinal cord runs through
Describe the changes in vertebrae with advancing age
Decreases in bone density
Articular surfaces bow inward
Periphery begins to compress
Osteophytes form in response
Describe the development of spinal curvatures
Primary curvatures in spine at infancy are kyphotic
-Thoracic & Sacral
Secondary curvatures in spine develop with supporting head & body weight
- Cervical & Lumbar
What are abnormal curvatures of the spine?
Excessive Kyphosis
Excessive Lordosis
Scoliosis
What abnormal spinal curvature is this?
Excessive Kyphosis
What abnormal spinal curvature is this?
Excessive Lordosis
What abnormal spinal curvature is this?
Scoliosis
Identify the labeled parts of this intervertebral disc
1: nucleus pulposus
2: annulus fibrosus
3: cartilaginous end plate
4: anterior longitudinal ligament
5: posterior longitudinal ligament
Describe a posterolateral disc herniation.
Posterolateral disc herniations are most common
The nucleus pulposus protrudes out of the annulus fibrosus where it is thinnest and lacks structural support from the ant & post longitudinal ligaments
The herniation in this direction is more likely to compress the nerve root and cause sypmtoms
What are the six ligaments of the spine?
- anterior longitudinal
- posterior longitudinal
- supraspinous
- interspinous
- ligamentum flavum
- intertransverse
What motion does the anterior longitudinal ligament limit?
hyperextension
What motion does the posterior longitudinal ligament limit?
hyperflexion
*can help prevent disc herniation
What motion does the supraspinous ligament limit?
hyperflexion and separation of spinous processes during flexion
What motion does the interspinous ligament limit?
flexion
What motion does the intertransverse ligament limit?
lateral flexion
What motion does the ligamentum flavum limit?
separation of the laminae during flexion
Describe the structure of ligamentum nuchae and it’s function.
Spans the external occipital protuberance to the spinous process of C7
Thick and triangular ligament
Resists flexion of the cervical spine
What are the six primary movements of the spine?
Flexion /Extension
Lateral Flexion/ Lateral Extension
Rotation of head/neck
Rotation of trunk
Describe spine movement at the cervical spine
*all movements
Flex/Ext
Lateral Flex/Ext
Axial rotation (C1&C2)
Describe spine movement at the thoracic spine
Does best in rotation
Flexion/extension and lateral flexion limited by rib connections
Describe spinal movement at the lumbar spine
Primarily flexion and extension, some lateral flexion/ext
Limited rotation
How does facet joint orientation affect spinal movements?
The facets of the articular processes are regions of joint contact.
The angle of orientation allows for/limits spinal movement.
What is the angle of orientation of the facets at the cervical spine?
45 degrees
in frontal plane allows for all movements
What is the angle of orientation of the facets at the thoracic spine?
60 degrees
more oblique orientation allows more rotation and less flex/ext
What is the angle of orientation of the facets at the lumbar spine?
90 degrees
more vertical allows for flex/ext but less rotation
Describe the meningeal coverings of the spinal cord
Dura mater
Arachnoid mater
Pia mater (dura narrows to denticulate ligaments/lateral expansions that anchor the spinal cord to the dura)
Describe spinal stenosis at the lumbar level
Spinal stenosis is narrowing of the vertebral canal that can cause compression of one or more spinal roots that occupy the canal
Patients may present with lower extremity motor & sensory symptoms
What muscles make up the superficial layer of the extrinsic back muscles?
Trapezius
Latissimus dorsi
Levator scapulae
rhomboids
What muscles make up the intermediate layer of the extrinsic back muscles?
Serratus Posterior Superior
Serratus Posterior Inferior
What muscles make up the supericial layer of the Intrinsic muscles of the back?
Splenius capitus
Splenius cervicis
What muscles make up the intermediate layer of the Intrinsic muscles of the back?
Erector Spinae Group:
Iliocostalis
Longissimus
Spinalis
I Love Spaghetti!
What muscles make up the deep layer of the Intrinsic back muscles?
Transversospinalis Group:
Multifidus
Rotatores Longus
Rotatores Brevis
Semispinales
and
Interspinales Intertransversarii
What is the innervation of the Extrinsic mm. superficial layer?
ventral rami of spinal nn.
*Except Trapezius - CN XI
What is the innervation of the Extrinsic mm, intermediate layer?
Intercostal nn.
What is the innervation of the intrinsic muscles of the back?
Dorsal rami of spinal nn.
What is the segmental innveration of Serratus posterior superior?
T1-4
Segmental innervation of serratus posterior inferior
T9-12
P, D, A, I Serratus posterior superior
P: spinous processes of C7-T3
D: Inferior borders of ribs 2-5
A: proprioception of thoracic wall
I: intercostal nn. (T1-4)
P, D, A, I Serratus posterior inferior
P: spinous processes of T11-L2
D: inferior borders of ribs 9-12
A: proprioception of thoracic wall
I: intercostal nn. (T9-12)
Iliocostalis attachments
Thoracolumbar fascia to costal angles
Longissimus attachments
ribs & transverse processes
Spinalis attachments
spinous processes
Semispinalis (transversospinales) Attachments
P: transverse processes
D: distant superior spinous processes
Multifidis (transversospinales) Attachments
P: sacrum, posterior SI lig, posterior iliac spine, transverse processes
D: superior spinous processes
Rotatores longus and brevis (transversospinales) Attachments
P: Transverse processes
D: Spinous process of vertebra above
Interspinales Attachments
between spinous processes of adjacent vertebrae
Intertransversarii Attachments
between transverse processes of adjacent veretebrae
