the back Flashcards
primary curvatures:
thoracic & scaral
anteriorly concave
like embryo
secondary curvature:
cervical & lumbar
concave posteriorly
what is thoracic hyperkyphosis?
excessive bending over
what is lumbar hyperlordosis?
excessive pushing out
center of gravity is a _______ line allowing body’s weight to be ________________________ in a way that expends minimal ____________________
vertical
balanced on vertebral column
muscle energy for bipedalism
what does the cervical back region consists of?
bifid spinous process (C3-C7)
transverse foramen
uncinate process
what attaches to the bifid spinous process?
ligamentum nuchae
what travels through the transverse foramen?
vertebral arteries
what is the uncinate process?
crests on superolateral part of body
the uncinate process articulates with body of vertebra above leading to the . . .
uncovertebral synovial joint
what does the uncovertebral synovial joint facilitate?
flexion and extension and limit lateral flexion in the cervical spine
what do C1 & C2 do?
allow movement of head
C1 (atlas) does NOT have what?
a body
C1 fuses with C2 during development leading to what?
dens
there is no ________ between C1 & C2
intervertebral disc (IVD)
lateral mass articulates above with what?
occipital condyle of skull
what does the atlanto-occipital joint allow?
head nod up and down
posterior side of anterior arch articulates with what?
dens of C2 (facets for dens)
atlanto-axial joint allow?
rotation of head
dens are held in position by what?
strong transverse ligament of atlas
dens projects _____________ from body
superiorly
strong ____________________ connects dens to ______________________.
alar ligaments
occipital condyle
what do dens do?
check excessive rotation of head
what does the thoracic (T1-T12) contains on each side of body?
superior and inferior costal demifacets
superior demifacet articulates with . . .
own rib (e.g. T2 and rib 2)
inferior demifacet articulates with . . .
rib below (e.g. T2 and rib 3)
transverse process has facet for articulation with . . .
tubercle of its own rib (e.g. T2 and rib 2)
lumbar (L1-L5) has a . . .
large body
where is the mammillary process?
superior articular process (multifidi muscle attachments)
lumbar has _______ and _______ transverse process except for ___ & ___
thin
long
L4 & L5
why are L4 & L5 larger transverse processes?
for attachment of iliolumbar ligaments to pelvic bone
what is the sacrum?
5 fused vertbrae
the sacrum has large facets for articulation with . . . which leads to . . .
ilium of pelvic bone
sacroiliac joint
the sacrum has 4 pairs of _________________ & 4 pairs of ____________________.
anterior sacral foramina
posterior sacral foramina
what is the coccyx?
3-4 fused coccygeal vertabra
the coccygeal cornu articulates with . . .
sacrum
where is the intervertbral foramina?
each side between adjacent vertabrae
what passes in and out of vertebral canal?
spinal nerves and blood vessels
intervertebral foramina is formed by:
inferior vertebral notch of pedicle above
superior vertebral notch of pedicle below
what borders the intervertebral foramina?
zygapophyisal joint posterior
intervertebral disc anteriorly
what is radiculopathy?
mechanical compression of a nerve root usually as they exit the intervertebral foramen
what are zygapophysial (facet) joints?
joint between superior and inferior articular processes
zygapophysial joints are _________ joints that are surrounded by a capsule of . . .
synovial
outer fibrous layer
inner synovial layer
what do zygapophysial joints allow?
sliding
what does the zygapophysial joint look like in cervical and what does it facilitate?
sloped
facilitates flexion and extension
what does the zygapophysial joint look like in thoracic and what does it facilitate?
vertical
limits flexion and extension
facilitates rotation
what does the zygapophysial joint look like in lumbar and what does it facilitate?
curved & interlocked (wrapped)
limit range of motion
in the lumbar region the zygapophysial joint is innervated by . . .
medial branch of posterior ramus
laminae and spinous processes ___________ along most of vertebral column
overlap
lumbar region =
large gaps between arches
posterior spaces between arches allow ?
flexion to widen further
easy access to vertebral canal for clinical procedures
what are the ligaments in the back?
longitudinal ligaments
ligamenta flava
supraspinous ligament
interspinous ligaments
what are the 2 longitudinal ligaments?
anterior longitudinal ligament
posterior longitudinal ligament
where is the anterior longitudinal ligament ? and what is it attached to?
base of skull to sacrum
attached to anterior part of bodies and intervertebral discs
where is the posterior longitudinal ligament ? and what is it attached to?
lines anterior surface of vertebral canal
attached to posterior part of bodies and intervertebral discs
upper part of the posterior longitudinal ligament connects ____ to ____________ and is called the . . .
C2 to base of skull
tectorial membrane
ligamenta flava passes between . . .
laminae of adjacent vertebrae
ligamenta flava is made up of . . .
elastic tissue
where is ligamenta flava and what does it run between?
posterior surface of vertebral canal
runs between posterior surface of lamina below to anterior surface of lamina above
what does ligamenta flava resist? and what does it assist?
separation of laminae during flexion
assists extension back to anatomical position
what does the supraspinous ligament do?
connects tips of spinous processes from C7 to sacrum
ligamentum nuchae is the continuation of the . . . .
supraspinous ligament from C7 to skull
what does the ligamentum nuchae support? what does it resist? what does it facilitate?
head
flexion
extension back to anatomical position
ligamentum nuchae is site of muscle attachment for . . .
trapezius & splenius capitis
what do interspinous ligaments pass between? and what do they blend with?
pass between adjacent spinous processes
blend with supraspinous posteriorly and ligamentum flavum anteriorly
where is the spinal cord?
foramen magnum to disc between L1 and L2 in adults
distal end of the spinal cord is called . . .
conus medullaris
____________ continues inferiorly from conus medullaris
filum terminale
what is filum terminale?
fine filament of connective tissue
filum terminale is continuous with ___________ and surrounded by ____________
pia mater
dura mater & cauda equina
filum terminale gives longitudinal support to . . .
spinal cord
what is the filum terminale attached to?
coccyx
segmental arteries arises from where?
vertebral and deep cervical arteries in neck, posterior intercostal arteries in thorax, lumbar arteries in abdomen
what are the 2 spinal cord arteries?
segmental arteries
longitudinal arteries
where do segmental arteries enter through?
intervertebral foramina
segmental arteries give rise to . . .
anterior and posterior radicular arteries
segmental arteries supply . . .
anterior and posterior roots
segmental arteries also give off . . .
segmental medullary arteries
what is the largest segmental artery?
arteria radicularis magna
what are the 2 longitudinal arteries by the spinal cord?
anterior spinal artery
posterior spinal artery
where does the anterior spinal artery originate from?
vertebral artery in cranial cavity
where does the posterior spinal artery originate from?
vertebral arteries or posterior inferior cerebellar artery in cranial cavity
what do spinal cord veins form?
longitudinal channels
anterior spinal vein parallels what?
anterior median fissure
posterior spinal veins parallels what?
posterior median sulcus
spinal cord veins all drain into . . .
internal vertebral plexus that drain into major systemic veins
spinal cord meninges:
dura mater
arachnoid mater
denticulate ligaments
what is dura mater?
outermost, separated from vertebrae by extra dural space
dura mater is continuous with . . .
brain dura
dura mater narrows at _____ and forms an _____________ for the pial part of the ________________.
S2
investing sheath
filum terminale
what does the dura mater attach to?
posterior surface of the bodies of the coccyx
when spinal nerves are surrounded by sleaves of dura it leads them to . . .
merge with and become epineurium (outer covering of nerves)
what is arachnoid mater?
thin membrane that rests against but does not adhere to deep surface of dura
where does the arachnoid mater end?
S2 (more inferior than spinal cord)
arachnoid mater is separated from pia by what ?
subarachnoid space
subarachnoid space surrounds the . . .
cauda equina
what are denticulate ligaments?
lateral projections of pia mater
what do denticulate ligaments form and what do they do?
form triangular-shaped ligaments that anchor the spinal cord along its length to the dura mater on each side
extrinsic back muscles are innervated by . . .
anterior rami of spinal nerves (brachial plexus)
superficial group moves what?
upper limb
intermediate group moves what?
ribs (respiration)
intrinsic (true) back muscles are innervated by . . .
posterior rami of spinal nerves
intrinsic back muscles move what?
vertebral column and head
superficial back muscles:
trapezius
latissimus dorsi
levator scapulae
rhomboid major
rhomboid minor
trapezius:
- origin
- insertion
- innervation
- function
origin: superior nuchal line, external occipital protuberance, ligamentum nuchae, spinous processes of C7 to T12
insertion: lateral one third of clavicle, acromion, spine of scapula
innervation: motor – accessory nerve, proprioception – C3 & C4
function: upper fibers elevate, middle fibers abduct, and lower fibers depress scapula
latissimus dorsi:
- origin
- insertion
- innervation
- function
origin: spinous process of T7 to L5 and scarum, iliac crest, ribs 10 to 12 via thoracolumbar fascia
insertion: floor of intertubercular sulcus of humerus
innervation: thoracodorsal nerve (C6 to C8)
function: extends, adducts, and medially rotates humerus
levator scapulae:
- origin
- insertion
- innervation
- function
origin: transverse processes of C1 to C4
insertion: upper portion medial border of scapula
innervation: C3 to C4 and dorsal scapular nerve (C4,C5)
function: elevates scapula
rhomboid major:
- origin
- insertion
- innervation
- function
origin: spinous processes of T2 to T5
insertion: medial border of scapula between spine and inferior angle
innervation: dorsal scapular nerve (C4,C5)
function: retracts (adducts) and elevates scapula
rhomboid minor:
- origin
- insertion
- innervation
- function
origin: lower portion of ligamentum nuchae
insertion: medial border of scapula to spine of scapula
innervation: dorsal scapular nerve (C4, C5)
function: retracts (adducts) and elevates scapula
superficial back muscle are immediately deep to
superficial fascia
superficial back muscles attach to . . .
upper appendicular skeleton
what are the intermediate (respiratory) back muscles ?
2 thin muscular serrated sheets in superior and inferior back
the intermediate back muscles pass what?
obliquely from vertebral column to attach to ribs
intermediate (respiratory) back muscles:
serratus posterior superior
serratus posterior inferior
serratus posterior superior:
- origin
- insertion
- innervation
- function
origin: lower portion of ligamentum nuchae, spinous processes of C7 to T3, and supraspinous ligaments
insertion: upper border of ribs 2 to 5 just lateral to their angles
innervation: anterior rami of upper thoracic nerves (T2 to T5)
function: elevates ribs 2 to 5
serratus posterior inferior:
- origin
- insertion
- innervation
- function
origin: spinous processes of T11 to L3 and supraspinous ligaments
insertion: lower border of ribs 9 to 12 just lateral to their angles
innervation: anterior rami of lower thoracic nerves (T9 to T12)
function: depress ribs 9 to 12 and may prevent lower ribs from being elevated when the diaphragm contracts
how many layers is thoracolumbar fascia?
3 layers
thoracolumbar fascia is continuous with what?
nuchal fascia
thoracolumbar is a critical part of what?
myofascial girdle that surrounds torso
what does the thoracolumbar fascia cover?
deep muscles of back and trunk
where does the thoracolumbar fascia attach?
medial attachments of latissimus dorsi and serratus posterior inferior blend into thoracolumbar fascia
spinotransversales back muscles run from ____________________ to ______________________
spinous processes
ligamentum nuchae
spinotransversales back muscles
— bilateral contraction = ?
extend neck
spinotransversales back muscles
— unilateral contraction = ?
rotate head to ipsilateral side
spinotransversales back muscles insert onto . . .?
transverse processes of C1-3 and mastoid process of occipital bone
what are the spinotransversales back muscle?
splenius capitis
splenius cervicis
splenius capitis:
- origin
- insertion
- innervation
- function
origin: lower half of ligamentum nuchae, spinous processes of C7 to T4
insertion: mastoid process, skull below lateral one third of superior nuchal line
innervation: posterior rami
function: together– draw head backward, extending neck; individually – draw and rotate head to one side
splenius cervicis:
- origin
- insertion
- innervation
- function
origin: spinous processes of T3 to T6
insertion: transverse processes of C1 to C3
innervation: posterior rami
function: together – extend neck; individually – draw and rotate head to one side
