The Back Flashcards
kyphosis
exaggerated overcurvature of thoracic area of vertebral column
lateral deviation of vertebral column
scoliosis
major feature of cervical vertebrae
transverse foramina
ligament that checks hyperextension of vertebral column
anterior longitudinal
ligament affected by whiplash injury
anterior longitudinal
ligament which limits skull rotation
alar
defective portion of vertebra with spondylolithesis in lumbar area
pars interarticularis,lamina
common direction of all superior articular facts
posterior
vertebra located at level of illiac crest
L4
ligament that connects internal surface of laminae of vertebrae
ligamentum flavum,
defective portion of vertebra with spondyloisthesis in cervical region
pedicle
structure in contact with posterior surface of dens
transverse ligament of atlas (part of cruciate)
most commonly herniated disk
l4-5
most common nerve compressed with herniated intervertebral disk
l5
spinal nerve affected by protrusion of the disc between c5 and c6
c6
thoracic intercostal space located deep to triangle of auscultation
6
vertebral level of lumbar puncture
l4
innervation of suboccipital muscles
suboccipital nerve
roof of suboccipital triangle
semispinalis capitis
floor of suboccipital triangle
posterior arch of atlas; posterior atlanto-occipital membrane
major vessel within suboccipital triangle
vertebral artery
synonym for dorsal ramus of c2
greater occipital nerve
inferior extent of spinal cord
lv2
inferior extent of dura-arachnoid sac
sv2
location of internal vertebral plexus
epidural space
what type of joint is the atlanto-occpipital articulation
synovial and condyloid
The atlanto axial articulation includes what joints
2 synovia andplane/gliding, and 1 synobial and pivot
the zygapophyseal articulation are what type of joints
synovial and plane/gliding
what type of cartilagenous joint is the intervertebral disc
secondary cartilagenous joint
Cervical dislocations
the slope of the zygapophyseal facets in the cervical region permit superior segments of the cervical column to slide anteriorly on inferior segments; large dislocations can damage the spinal cord
Jefferson Burst Fracture
results from trauma directed through the skull and occipital condyles onto the atlas bursting the arch typically the spinal cord is NOT injured
hangman fracture
tramautic, hyperextension injury that breaks the pars interarticularis of the axis bilaterally
osteoporosis
characterized by the loss of bone density, common in senior/geriatric patients, vertebral fractures are a common occurence
fracture of the dens
fractures may result in avascular necrosis of the dens, fragments of the dens may lacerate the spinal cord
rupture of the transverse ligament of the atlas
results in compression of the spinal cord by the dens
laxity of the transverse ligament of the atlas
this ligament is often absent in patients with down’s syndrome and may be lax in certain connective tissue disorders (marfan’s syndrome)
rupture of the alar ligaments
these are the check ligaments, increased range of motion on contralateral rotation
spinal stenosis
narrowing of the vertebral canal; can be caused by protruding intervertebral discs, meningioma, bony changes (aging), hypertrophy of ligaments, denegeration of zygapophyseal joints. symptoms include bilateral extremity pain numbness and weakness
excessive kyphosis
exaggerated curvature of thoracic vertebrae
excessive lordosis
exaggerated lumbar curve
scoliosis
abnormal lateral curvature of vertebral column
anklosing spondyltis
inflammation of the vertebral joints and ligaments, especially in the lumbar region; affected segments fuse resulting in pain and stiffness of the vertebral column
epidural anesthesia
injection of an anesthetic agent into the epidural space; can be injectected at the sacral hiatus or posterior sacral foramina
spinal anesthetsia
injection into the subarachnoid space, done via a lumbar puncture
uncovertebral joints (joints of luschka)
small plane, synovial joints that develop in early adolescence between the uncal processes of cv3-cv7 common sites of osteophyte formation resulting in stenosis of intervertebral foramen and may impinge spinal nerves or vertebral artery
what innervates the intervertebral disks
sinuvertebral nerves which arrise from recurrent branches of anterior ventral rami
innervation of zygopophyseal joints
posterior dorsal rami from level of joint and one above
where is the posterior longitudinal ligament deficient
4 disk
where does a postero-lateral herniation occur most commonly
cervical and lumbar regions
which roots are affected in a c5-c6 postero lateral herniation
c6 nerve roots or spinal nerve
what roots are affected in the l4 l5 postero lateral herniation
l5 nerve roots or spinal nerve
a lateral herniation at c5-c6 will likely affect
c6 nerve
a lateral herniation at l4-l6 will most likely affect
l4 nerve
how do you test the c5 nerve root
strength in deltoid, biceps brachii,
MSR- biceps brachii
sensory-lateral shoulder and lateral arm
how do you test the c6 nerve root
strength- biceps brachi, wrist extension
MSR-brachioradialis
sensory-lateral forarm, lateral palm including first digit and possibly second digit
how do you test a c7 nerve root
strength-tricepts brachii, wrist flextion
MSR-triceps brachii
sensory-middle finger
how do you test a c8 nerve root
strength-finger flexion
MSR-none
Sensory-5th digit and medial forearm, possibly 4th digit also
how do you test the T1 nerve root
strength:finger adduction/abduction
MSR-none
sensory-medial arm
how do you test the L4 nerve root
strength-tibialis anterior, quadriceps
MSr-patellar tendon
Sensory-medial leg, medail aspect of foot including medial malleolus
how you test the l5 nerve root
strength-extensor hallucis longus, extensor digitorum longus, walk on heels
MSR- tibialis posterior
sensory-dorsum of the foot
How do you test S1 nerve root
strength-fiularis longus, walk on toes
MSR-calcaneal (achilles)
sensory- lateral aspect of foot
radiculopathy
involves injury/compression of a spinal nerve root. signs and symptoms are restricted to dermatomes and or myotomes
polyradiculopathy
refers to involvement of more than 1 nerve root
innervation of the suboccipital muscles
posterior ramus of C1 (the suboccipital nerve)
greater occipital nerve
sensory nerve which passes through the semispinalis capitis muscle (dysfunction results in paresthesias in the cutaneous territory of this nere
intrinsic deep back muscles are innervated by
posterior rami
where does the spinal cord terminate
lv2
nerves roots below lv2 are called
cauda equina
where does the dural sac end
s2
spondyloysis
fracture or compromise of the pars interarticularis on the lamina in lumbar vertebrae and pedicles of cervical vertebrae
spondylolitehsis
dislocation or slippage between adjacent vertebrae
What is the scoring for muscle stretch reflexes
0-absent 1-trace 2-normal 3-hyperactive with clonus 4-hyperactive with clonus (injury to CNS)
What is the scoring for muscle strength
0-no contraction/joint movement
1-muscle flicker, no joint movement
2-complete range of motion with your support
3-complete range of motion against gravity
4-complete range of motion against gravity with some resistance
5-complete range of motion against gravity and full resistance
what are the extrinsic back muscles
movement the upper limbs and thoracic wall
what are the intrinsic back muscles
movement of the back, innervated by posterior rami of spinal nerves
what are the 7 cervical vertebra characterized by
small size and presence of a transverse foramen in each transverse process
what are the characteristics of the 12 thoracic vertabra
have articular processes for their rib elements
atlantooccpital joint
allows the head to nod up and down
transverse ligament of the atlas
holds the dens in place
atlanto axial joint
allows to shake head side to side saying (no!)
alar ligaments
check excessive rotation of the head and atlas relative to the axis
illiolumbar ligament
connect to the transverse process to
the pelvic bones
sympheses
type of joints between the vertebral bodies
synovial joints
between the articular processes
zygopophyseal joints
synovial joint between superior and inferior articular processes on adjacent vertebrae
uncovertebral joints
lateral margins of the upper surfaces of typical cervica vertebrae are elebated into crests or lips
tectorial membrane
part of the posterior longitudinal ligmant that connects cII to the base of the skull
ligamentum flava
pass between the laminae of adjacent vertebrae and assists in extension of back to anatomical position
ligamentum nuchae
traigular sheet like structure in median sagittal plane; supports the head and resists and facilitates returning head to anatomical position
interspinous ligaments
pass between adjacent vertebral spinous processes
