Spine/Thorax/Pelvis Flashcards
how many vertebrae are included in the vertebral column?
33 (can vary, 32-34)
7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 4 coccygeal
what are the bony landmarks of the vertebral column?
- body
- vertebral arch (2 laminae, 2 pedicles)
- foramen
- spinous process (1)
- transverse processes (2)
- articular processes (4)
- fibrocartilaginous intervertbral discs
the cervical anterior and lumbar anterior convexity are both? (curvature)
(secondary) lordotic
the thoracic and sacral anterior concavity are both? (curvature)
(primary) kyphotic
the primary curvatures of the vertebral column in the _____ and _____ regions develop during the fetal period and are caused by differences in height b/w the anterior and posterior aspects of the vertebrae.
thoracic ; sacral
the secondary curvature are mainly a result of anterior-posterior differences in IV disc thickness. The ____ curvature is acquired when an infant begins to lift his head and the _____ curvature when an infant begins to walk.
cervical ; lumbar
what are the movements of the cervical vertebrae?
- forward flexion
- lateral flexion/side bend
- extension
- rotation
the ____ cervical vertebrae is on the atlas.
C1
the _____ cervical vertebrae is on the axis.
C2
which cervical vertebrae has no body or spinous process, articulates w/ occipital condyles via paired lateral masses, and articulates w/ axis via inferior articular facets and dens of axis.
C1 (atlas)
our cervical spine ______ the best.
rotates
which cervical vertebrae are short bifid spinous processes?
C3 - C5
which vertebrae are long and nonbifid spinous processes?
C6 - C7
the thoracic vertebrae is relatively?
rigid
what is the main movement of the thoracic vertebrae?
mainly allow rotation of trunk
______ are part of the thoracic vertebrae and have some features of cervical vertebrae.
T1 -T4
_____ are part of the thoracic vertebrae and have some features similar lumbar vertebrae.
T9 - T12
Thoracic vertebrae have long transverse processes that extend?
posterolaterally
what are the movements of the lumbar vertebrae?
- forward flexion
- lateral flexion/ side bend
- extension
- little rotation
on the lumbar vertebrae, which segment has a massive body and transverse processes, thicker anteriorly
L5
which lumbar vertebrae contributes to lumbosacral angle (usually 130 degrees - 160 degrees) and carries weight of upper body.
L5
the sacrum is composed of ____ vertebrae that fuse at about 20 years of age, inferior portion is nonweightbearing.
5
the sacrum articulates with?
coal bones at sacroiliac joints
the sacrum is wider in?
females than males
the sacrum has a sacral canal with is a continuation of?
vertebral canal; that contains caudal equine
what are the features of the sacrum?
- sacral hiatus
- median crest
- paired medial crests
- paired lateral crest
- sacral cornua
the sacral hiatus is a termination of the?
sacral canal that contains film terminale
the median crest?
fused spinous processes
paired medial crest and paired lateral crest do what to the sacrum?
PMC - fused articular processes
PLC - fused tips of transverse processes.
what is attached to the coccyx?
- gluteus maximus
- coccyges muscles
- anococcygeal ligament
the coccyx is joined to sacrum by?
sacrococcygeal symphysis
the intervertebral discs act as?
“shock absorbers” and semifluid ball bearings to provide small movements b/w individual vertebrae
what kind of joint are involved in the vertebral column?
- zygapophyseal (of facet) joints; synovial joints b/w superior and inferior articular processes
- costovertebral joints (synovial; b/w vertebrae and ribs T1-T12)
- sacro-iliac (SI) joints (synovial)
what are the ligaments of the spine?
- anterior + posterior longitudinal
- intertransverse
- interspinous
- supraspinous
- ligamentum flavum
what ligaments limit flexion?
interspinous and supraspinous
which ligament limits extension but maintains stability of IV discs?
anterior longitudinal ligament
which ligament limits flexion and prevents IV herniation?
posterior longitudinal ligament
what ligament limits lateral bending?
intretransverse ligament
which ligament limits flexion, preserves curvature or column and prevents injury to IV discs?
ligamentum flavum
_______ fracture is when the vertebral body collapses, caused by osteoporosis, trauma, or tumor. This fracture usually occurs at C7 and T1, it is moderate to severe pain, limitation of movement, kyphosis.
compression fracture
This fracture is a four part fracture of ring of C1, caused by a fall on vertex. Patients have upper neck pain but can be neurologically intact. (fall on the head fracture)
Jefferson fracture
_____ fracture caused by hyperextension of head on neck. Bipedicle fracture of C2, anterior displacement of C2 and C3, and results in quadriplegia or death.
hangman fracture
most common in young adults and elderly, resulting in cord compression, usually as a result of whiplash from car accidents, results in soft tissue injury, fractures, dislocations, ligamentous tears, and disc disruption
cervical hyperextension
_____ is an increased thoracic curvature, commonly seen in the elderly (“dowager hump”). It is usually caused by osteoporosis, resulting in anterior vertebral erosion or a compression fracture.
kyphosis
an excessive lumbar curvature is termed a ____ and is seen in association w/ weak trunk muscles, pregnancy, and obesity.
lordosis
_____ is an abnormal lateral curvature of the spine, accompanied by rotation of the vertebrae.
scoliosis
as the line of body weight passes anterior to the SI joints, anterior displacement of L5 over S1 may occur, applying pressure to the spinal nerves of the caudal equina is known as?
spondylolisthesis
what is sacralization?
the L5 vertebra is partially or totally fused w/ the sacrum; because the L5/S1 level is now very strong, the L4/5 level is likely to degenerate in these cases.
the muscles of the spine are divided into?
extrinsic and intrinsic (deep or true) muscles
what are the superficial extrinsic muscles of the spine?
- trapezius
- latissimus dorsi
- levator scapulae
- rhomboid minor + major
what are the intermediate extrinsic muscles of the spine?
- serratus posterior superior
- serratus posterior inferior
what are the superficial intrinsic muscles of the spine?
splenius (capitals/cervicis)
what are the intermediate intrinsic muscles of the spine?
erector spinae - sacrospinalis group
- iliocostalis
- longissimus
- spinalis
capitus refers to muscles attaching at the?
head
cervicis refers to muscles attaching at the?
cervic
what are the deep intrinsic muscles of the spine?
transversospinalis group:
- semispinalis
- multifidus
- rotatores
what are the minor deep intrinsic muscles of the spine?
- interspinales
- intertransversarii
- levatores costarum (brevis + longus)
where is the fascia located medially on the spine?
to nuchal ligament, tips of spinous processes, supraspinous ligament, and median line of sacrum
where is the fascia located laterally on the spine?
to cervical and lumbar transverse processes
the fascia is thickened as thoracolumbar fasciae toward lumbar region and extends b/w _____ and _____
12th rib ; iliac crest
how many muscles does the suboccipital region have?
4
what are the movements of the head muscles? (suboccipital region)
laterally flex, extend, and rotate
what muscles are in the suboccipital region?
- rectus capitis posterior minor and major
- obliques capitis superior and inferior
what are the muscles of the lateral and anterior neck?
- scalenes (anterior, middle, posterior)
- sternocleidomastoid [SCM] (sternal head + clavicular head)
- prevertebrals (behind the throat but in front of the vertebrae) [longus capitus + coli]
_____: very common, usually self-lifting complaint, often affecting the lumbar region.
back pain
_____: stretching and microscopic tearing of muscle fibers or ligaments. the muscles go into spasm as a protective response, causing pain and interfering w/ function.
back strain (common cause of low back pain)
_____: cervical muscle and/or ligament strain because of forceful hyperextension of the neck. may cause herniation of the IV disc and subsequent radiculopathy.
whiplash
what are the important vertebral landmarks?
- spine of scapula: T2
- level of the heart: T5 - T8
second intercostal space at the midclavicular line: insertions of tube for an?
apical pneumothorax
4th to 6th intercostal space at the midaxillary line: insertion of chest drains for a?
hemothorax
left 5th intercostal space: apex beat of the heart and this is shifted in?
heart enlargement
cervical ribs articulate w/ the C7 vertebra but do not attach to the?
sternum
what are the functions of the abdominal wall muscles?
- protect viscera, help maintain posture
what muscles make up the anterolateral abdominal wall?
- external oblique
- internal oblique
- rectus abdominis
- transverse abdominis
what are the muscles of the posterior abdominal wall?
- psoas major
- iliacus
- quadratus lumborum
- respiratory diaphragm
what are the joints of the pelvis?
lumbosacral joints, sacroiliac joints, pubic symphysis, and sacrococcygeal joints