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PHTH 511: Anatomy > Spine Lecture Questions > Flashcards

Spine Lecture Questions Flashcards

1
Q

What are the functions of the spine?

A

-Support the body’s weight
-Transmit forces
-Carry & positioning of the head
-Brace & help maneuver the upper limbs

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2
Q

What are the primary curvatures of the spine? What kind of curvature is it? When do they develop?

A

-Thoracic curvature: kyphosis
-Sacral/coccygeal curvature: kyphosis
-Present at birth

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3
Q

What are the secondary curvatures of the spine? What kind of curvature is it? When do they develop?

A

-Cervical curvature: lordosis
-Lumbar curvature: lordosis
-Cervical develops when babies start lifting their head
-Lumbar develops upon walking and sitting up

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4
Q

Why do we need secondary curvatures?

A

-After birth, we need secondary curvatures to counteract the primary ones so that we are able to stand up straight
-They bring the center of gravity into a vertical line so we can be bipedal

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5
Q

What do extrinsic back muscles do?

A

Move the upper limbs & ribs

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6
Q

What do intrinsic back muscles do?

A

Maintain posture & move vertebral column (flexion, extension, lateral flexion, rotation)

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7
Q

What does the spine protect?

A

-The CNS (brain and spinal cord)
-The PNS (cranial and spinal nerves)

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8
Q

How many cervical vertebrae are there?

A

7

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9
Q

How many thoracic vertebrae are there?

A

12

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10
Q

How many lumbar vertebrae are there?

A

5

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11
Q

How many sacral vertebrae are there?

A

5, but they are fused

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12
Q

How many coccygeal vertebrae are there?

A

3-4, but they are fused

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13
Q

What is the function of the body of the vertebrae?

A

Receives weight & provides mobility

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14
Q

What does the vertebral arch form? What does it do?

A

-It forms the vertebral canal
-It restricts some movement

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15
Q

What are the facet joints? What do they do?

A

-The articulation between two vertebrae
-They restrict and guide movement

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16
Q

What is a symphysis?

A

-A major joint between vertebrae
-Each symphysis includes an intervertebral disc

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17
Q

What makes up an intervertebral disc?

A

-Annulus fibrous, which is a ligament like structure that surrounds the nucleus pulposus and holds it together
-Nucleus polposus, which is a gellatenous like structure that helps the spine resist compression

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18
Q

What happens when the annulus fibrous degenerates?

A

Discs can be very easily herniated w/ degeneration of the annulus fibrous, because it can no longer properly hold the nucleus polposus in place

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19
Q

What are the extrinsic back muscles innervated by?

A

Anterior rami of spinal nerves

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20
Q

What are the intrinsic back muscles innervated by?

A

Posterior rami of spinal nerves

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21
Q

Where is the cerebrospinal fluid (CSF) located?

A

In the subarachnoid space

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22
Q

How many pairs of spinal nerves are there?

A

31 total
-8 cervical
-12 thoracic
-5 lumbar
-5 sacral
-1 coccygeal

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23
Q

What is the difference between rami and roots?

A

-Rami have both motor & sensory components, while roots do NOT

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24
Q

Why is the cervical vertebral foramen larger than the thoracic & lumbar?

A

Because the cervical vertebrae houses the cervical & brachial plexuses

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25
Q

What level does the spinal cord stop at? Why does it not go all the way down?

A

-The spinal cord stops at L1, but could be as high as T12, or as low as L2
-This occurs because the spinal cord grows a lot slower than the vertebrae

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26
Q

What is the cauda equina?

A

Formed by lumbar and sacral nerve roots

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27
Q

Where do the spinal nerves exit the vertebral column?

A

Through the intervertebral foramen that is formed by adjacent vertebral arches

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28
Q

How much movement can occur in the cervical vertebrae?

A

-60 degrees of flexion
-75 degrees of extension
-45 degrees of lateral flexion
-80 degrees of rotation

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29
Q

What is the incidence of cervical pain?

A

-25-70% of people will experience neck pain
-30% will develop chronic pain

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30
Q

What are the general characteristics of the cervical spine?

A

-Small size
-Spinal process is short and bifid (except C1 and C7)
-Presence of foramen in each transverse process (foramen transversarium)

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31
Q

Why is there a foramen in the transverse processes of the cervical vertebrae?

A

Because they house the vertebral artery

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32
Q

What level does the vertebral artery enter the vertebral column? How much blood does the vertebral artery supply to the brain?

A

-Enters at C6 and exits at C1 to go into the skull
-Supplies 15% of blood to the brain

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33
Q

What happens if someone’s vertebral artery enters the vertebral column at C7?

A

-It is more taught/tight, so it can cause headaches, dizziness, ataxic gait

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34
Q

What portions of the brain does the vertebral artery supply?

A

-Upper spinal cord
-Cerebellum
-Posterior part of brain

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35
Q

Where does the vertebral artery branch off of?

A

Subclavian artery

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36
Q

What are the 2 parts of the cervical vertebrae?

A

-Upper cervical/cranio-vertebral region (occipital condyles, C1 & C2)
-Lower cervical region (C3-C7)

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37
Q

Where does 50% of rotation occur?

A

Upper cervical region (C1 & C2)

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38
Q

What joint allows us to nod our heads?

A

OA joint (occipital-atlanto joint)

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39
Q

What are unique characteristics of C1 (Atlas)?

A

-Shaped like a ring
-Has no vertebral body or spinous process
-Has 2 large lateral masses that have a vertical alignment under each occipital condyle

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40
Q

What are the lateral masses in C1 connected by?

A

The lateral masses are connected by an anterior & posterior arch that form the ring structure and creates large transverse processes for muscle attachments

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41
Q

What is the function of C1?

A

-Transfers weight of head to segments below
-Knodding bone (“yes” bone)

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42
Q

Why is there slack in the vertebral artery where it exits at C1?

A

To allow for rotation

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43
Q

What is the primary function of C2

A

-Provides motion for axial rotation (“no” bone)
-Transmits the combined load of head & atlas

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44
Q

What are the unique characteristics of C2 (Axis)?

A

-The anterior portion of the body extends inferiorly & a vertical projection (dens) arises from the superior surface of the body
-Has the dens

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45
Q

What is the dens?

A

-Odontoid process of C2
-Has an anterior facet for articulation with the anterior arch of the atlas & a posterior groove for articulation w/ transverse ligament

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46
Q

What is the posterior groove of the dens for?

A

For attachment of the transverse ligament

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47
Q

What is the alar ligament? What motion does it limit?

A

-It attaches the axis, from the superior region of the dens, to the border of the foramen magnum
-It limits head rotation

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48
Q

What happens to head rotation if the alar ligament is injured?

A

Head rotation will increase by 30% if the alar ligament is injured

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49
Q

What is the transverse ligament? What movement does it prevent?

A

-Ligament that attaches to the both sides of the inside of C1
-Keeps dens from sliding forward into the spinal cord/vertebral canal

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50
Q

What types of surfaces are found at the atlanto-occipital joint? What movement does it allow?

A

-Atlas has superior concave facets
-Occipital condyles are convex
-The shape of these two surfaces allows for nodding of the head

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51
Q

What are the craniovertebral ligaments?

A

-Posterior antlanto-occipital membrane
-Posterior atlantoaxial ligament
-Nuchal ligament
-Alar ligament
-Transverse ligament (cruciate)
-Superior longitudinal band (cruciate)
-Inferior logintudinal band (cruciate)

52
Q

What ligaments keep the transverse ligament in place?

A

-Superior longitudinal band
-Inferior longitudinal band

53
Q

What are the attachments of the superior longitudinal band?

A

-Transverse ligament
-Occipital bone

54
Q

What are the attachments of the inferior longitudinal band?

A

-Transverse ligament
-Body of C2

55
Q

What is the tectorial membrane? Where does it attach?

A

-Continuation of the posterior longitudinal ligament
-Covers the dens & cruciate ligament
-Inserts at the anterior rim of the foramen magnum

56
Q

What percentage of axis fractures are dens fractures? Why does fracture of the dens occur more often than a tear of the transverse ligament?

A

-40% of axis fractures are fractures of the dens
-The dens is fractures more often then the transverse ligament is torn because it is stronger than the dens

57
Q

Why does a fracture higher up on the dens cause necrosis while a fracture lower on the dens, closer to the body, not?

A

-A fracture higher on the dens will be covered by the transverse ligament which would cut off the blood supply
-A fracture lower down would heal since the blood supply could get to it

58
Q

Is a fracture of the dens or rupture of the transverse ligament more dangerous?

A

-Rupture of the transverse ligament is more dangerous because it keeps the dens from moving forward into the spinal cord
-If the dens is fractured, it is still held in place by the transverse ligament

59
Q

What happens to the transverse ligament in some people with Down Syndrome?

A

20% of people with down syndrome have laxity in their transverse ligament

60
Q

What is atlantoaxial instability (AAI) in individuals with Down Syndrome?

A

-Affects 10-20%
-Condition is mostly asymptomatic
-Lower cervical lordosis
-Causes by laxity in transverse ligament

61
Q

What are normal anterior atlanto-odontoid distances?

A

-Males is ≤ 3mm
-Females is ≤ 2.5mm

62
Q

How do ruptures of the alar ligament occur? What will be an objective sign of alar ligament rupture?

A

-Combined flexion and rotation of the head may tear one of the alar ligaments
-A rupture of the alar ligament will increase ROM by 30%

63
Q

What population are alar ligament ruptures the most common in?

A

American football players

64
Q

What is a unique joint of cervical vertebrae? What is the function?

A

-They have uncinate processes
-The uncinate processes help provide stability and guide movement
-Prevents segments from sliding anteriorly or laterally
-Limits sidebending

65
Q

What are some other unique characteristics of the cervical vertebrae?

A

-Foramen transversarium (foramen in the transverse processes for vertebral artery)
-Anterior & posterior tubercles on the transverse process

66
Q

What is the anterior tubercle on C6 called?

A

Carotid tubercle

67
Q

What is C7 also called and why?

A

Also know as the “vertebral prominens” because it has the most prominent spinous process of the cervical vertebrae

68
Q

How common is an extra rib? Where does it attach to?

A

-6% of people have an extra pair of ribs
-It is attached to C7

69
Q

What are the main function of the sub-occipital muscles?

A

Extend and rotate the head at the atlantoaxial joint

70
Q

What nerve is the posterior ramus of C1 nerve root?

A

Suboccipital nerve

71
Q

What is the vascular supply of the suboccipital muscles?

A

Branches of vertebral and occipital arteries

72
Q

What makes up the sub-occipital triangle?

A

-Medial border: rectus capitis posterior major
-Lateral border: obliquus capitis superior
-Inferior border: obliquus capitis inferior

73
Q

What muscle of the suboccipital muscles is not part of the suboccipital triangle?

A

Rectus capitis posterior minor

74
Q

What structures pass through the suboccipital triangle?

A

-Vertebral artery
-Suboccipital nerve

75
Q

What muscle is attached to the dura mater? What happens if this muscle is tight?

A

-Rectus capitis posterior minor
-If it is tight, it can cause a disruption to the normal CSF fluctuations
-CSF will always be flowing into the brain, which can cause extra pressure in the brain causing headaches

76
Q

What are the main functions of the thoracic region?

A

-Provides a stable basis for muscles to control the craniocervical region
-Protection of intrathoracic organs
-Mechanical allows for breathing, helps create pressure differences

77
Q

What is unique about the thoracic vertebrae?

A

It has costal facets for the ribs to attach

78
Q

How many joints are there in the spine?

A

364 joints

79
Q

How many articular facets do thoracic vertebrae have?

A

10 each

80
Q

Where does the ribs also attach to on the thoracic vertebrae?

A

As they curve posteriorly, they attach to the transverse process

81
Q

What are the atypical thoracic vertebrae? Why are they atypical?

A

-T1, T11, and T12
-They are atypical because only articulate with 1 rib instead of 2

82
Q

What is different about T10?

A

It only have a superior articular facet for a rib and no inferior

83
Q

What connects the ribs to the sternum?

A

Costal cartilage

84
Q

Does T1 articulate with rib 2?

A

-Yes, but barely
-It has a partial costal facet for rib 2

85
Q

How prominent is the T1 spinous process?

A

Just as prominent as C7

86
Q

What is unique about ribs 11 and 12?

A

They do not form articulations with the transverse processes

87
Q

Which of the thoracic vertebrae are very similar to the lumbar spine?

A

T11 and T12

88
Q

What are the joints in the thoracic cage?

A

-Costovertebral joints
-Costotransverse joints

89
Q

What do the costovertebral joints allow the ribs to do?

A

-Rotate around their longitudinal axis
-Elevate and depress relative to the vertebral column

90
Q

Why are the lower ribs able to elevate and depress more than the upper ribs?

A

Because there is more costal cartilage, which allows the ribs more space to move

91
Q

What is the intraarticular ligament?

A

The ligament that connects the head of the rib to the intervertebral disc & separates into two different synovial compartments

92
Q

How are the costotransverse joints stabilized?

A

-Costotransverse ligaments (medial)
-Lateral costotransverse ligament (lateral)

93
Q

What does the costotransverse ligament do?

A

It connects the transverse processes to the rib below

94
Q

What muscles are in the superficial group of back muscles?

A

-Trapezius
-Latissimus dorsi
-Rhomboids
-Levator scapulae

95
Q

What muscles are in the intermediate group of back muscles?

A

-Serratus posterior superior
-Serratus posterior inferior

96
Q

What is the blood supply to the serratus posterior superior/inferior?

A

Intercostal arteries

97
Q

What muscles are involved in forced respiration during high intensity exercise?

A

Serratus posterior superior/inferior

98
Q

What muscles are in the deep group of back muscles?

A

-Multifidi
-Rotatores
-Intrinsic muscles

99
Q

What is one of the most distinct characteristics of the lumbar spine?

A

They have large vertebral bodies

100
Q

In largest to smallest, what are the sizes of the vertebral foramens of the cervical, thoracic, and lumbar spine?

A

-Cervical
-Lumbar
-Thoracic

101
Q

What direction are the facet joints in the lumbar spine?

A

-Vertical
-Inferior facets directed anterolaterally

102
Q

What is the pars interarticularis?

A

-A region of the lamina located between the facet joints

103
Q

Which lumbar vertebrae are typical?

A

L1-L4

104
Q

What is unique about the lumbar vertebrae?

A

-They have accessory processes that come off the transverse process
-Mamillary processes

105
Q

What is the function of the accessory processes on the lumbar vertebrae?

A

Provide attachments for the intertransversarii laterales muscles

106
Q

What is the function of the mammillary processes on the lumbar vertebrae?

A

Provide attachment for the multifidi & intertransversarii mediales muscles

107
Q

Why is L5 vertebrae atypical?

A

-It has a taller body anteriorly
-The taller body is responsible for the lumbosacral angle (LSA) between the axis of the lumbar vertebrae and the sacrum

108
Q

What are the major nerves in the lumbar plexus?

A

-Iliohypogastric
-Ilioinguinal
-Genitofemoral
-Femoral
-Obturator
-Inferior gluteal
-Superior gluteal

109
Q

What is the anterior longitudinal ligament? What is its function?

A

-Ligament that is anterior to the vertebral bodies
-Limits extension

110
Q

What is the posterior longitudinal ligament? What is its function?

A

-Ligament that is posterior to the vertebral bodies
-Limits flexion

111
Q

What is the ligamentum flava? What is its function?

A

-Ligament that is on each side of the inside surface of the lamina
-Guides the joints
-Suspends the column to help maintain upright w/ minimal energy needded

112
Q

What is the most elastic ligament in the body?

A

Ligamentum flava

113
Q

What is the supraspinous ligament? What is its function?

A

-Ligament on the spinous processes from C7-coccyx (continuation of ligamentum nuchae)
-Limits flexion

114
Q

What is the intertransverse ligament? What is its function?

A

-Connects the transverse processes from C1-S1
-Limits side bending

115
Q

What are the iliolumbar and lumbosacral ligaments? What is their function?

A

-2 bands that extend from the tip & border of the L5 transverse process to connect the lumbar spine to the sacrum & ilium
-Function is to stabilize L5 (resist flexion, extension, rotation, and side bending)

116
Q

What is spondylolisthesis? Where does it often occur? How is it classified?

A

-It is when there is a stress fracture at the pars interarticularis and forward sliding of the vertebrae
-Often occurs in the lumbar spine since it takes heavier loads than other regions of the spine
-Grade I: 25% slippage
-Grade II: 25-50% slippage
-Grade III: 50-75% slippage
-Grade IV: 75-100% slippage

117
Q

What are the causes/risk factors of spondylolisthesis?

A

-Usually occurs in adults over 50
-Abnormal wear and tear of the cartilage (arthritis)
-Common in L4/L5 and L5/S1
-Fractures in the parts interarticularis (can happen in weightlifting, gymnastics, and football)

118
Q

What are common causes of abnormal spinal curvatures?

A

-Developmental anomalies
-Pathological processes such as osteoporosis

119
Q

What are common abnormal spinal curvatures?

A

-Excessive thoracic kyphosis
-Excessive lumbar lordosis
-Scoliosis

120
Q

What is excessive thoracic kyphosis typically associated with? What is the average degrees of normal kyphosis?

A

-Osteoporosis
-42 degrees

121
Q

What can excessive thoracic kyphosis cause?

A

Significant reduction in pulmonary capacity

122
Q

What is excessive lumbar lordosis typically associated with?

A

-Weakened anterolateral abdominal muscles
-Obesity

123
Q

What are common causes of scoliosis? What population is it more common in?

A

-80% of structural scoliosis is idiopathic, and occurs without any other health conditions
-More common in females aged 10-15

124
Q

What is a laminectomy? What is the objective of it?

A

-Surgical excision of one or more spinous processes
-Objective is to gain access to the vertebral canal and posterior spinal cord

125
Q

What are common clinical indications of laminectomy?

A

-To relieve pressure on the spinal cord and nerve roots
-Pressure could be caused by tumor, herniated disc, or bony hypertrophy

PHTH 511: Anatomy (9 decks)

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