The Back

Question 1

What are primary curvatures

Answer 1

• Present in utero
• In thoracic and sacral regions
• Concave anteriorly (kyphosis)

Question 2

What are secondary curvatures

Answer 2

• Do not develop until infant lifts their head and stands to walk
• In cervical and lumbar regions
• Are concave posteriorly (lordosis)

Question 3

What are the zygapophyseal joints

Answer 3

Synovial joints between articular processes

Question 4

What is the symphysis joint

Answer 4

Secondary cartilaginous joint between endplates and the intervertebral discs

Question 5

What is the intervertebral foramen

Answer 5

Where the spinal nerve emerges

Question 6

How is the intervertebral foramen formed

Answer 6

By superior and inferior vertebral notches, with contribution from the disc

Question 7

What makes up the intervertebral disc

Answer 7

An outer anulus fibrosus, which surrounds a central nucleus pulposus

Question 8

What is the nucleus pulposus

Answer 8

Gelatinous, 70-90% water, relative collagen content increases with age. It absorbs compressive forces between vertebrae

Question 9

What is the annulus fibrosus

Answer 9

Very strong, concentric lamellae of fibrocartilage. It’s attached and kept in place by anterior and posterior longitudinal ligaments

Question 10

What supplies the periphery of the disc

Answer 10

Neighbouring capillaries

Question 11

What supplies the centre of the disc

Answer 11

Diffusion from the body of the vertebra

Question 12

Describe a herniated disc

Answer 12

The central position of the longitudinal ligament means that most disc herniations are posterolateral, towards the intervertebral foramen. The disc forms the anterior aspect of the foramen, but inferiorly, the spinal nerve probably emerges above the prolapsing disc and escapes injury

Question 13

What does the transverse ligament of atlas do

Answer 13

Keeps the dens close to the anterior arch

Question 14

What does the alar ligament do

Answer 14

Prevents excessive rotation

Question 15

What does the ligamentum flavum do

Answer 15

It extends between the vertebral
laminae and limit sudden
flexion

Question 16

What does the posterior longitudinal ligament do

Answer 16

On the posterior
surfaces of the bodies of
vertebrae between C2 to
sacrum, limiting hyper-flexion

Question 17

What does the anterior longitudinal ligament do

Answer 17

On the anterior
surfaces of the vertebral
bodies between Atlas to the
sacrum that limits extension

Question 18

What does the ligamentum nuchae do

Answer 18

Extends between occipital bone and spinous process of C7 to limit flexion and provide
muscle attachment

Question 19

What does the supraspinous ligament do

Answer 19

Tips of spines and run between sacrum to C7

Question 20

What does the interspinous ligament do

Answer 20

They may be damaged in whiplash injury

Question 21

Describe the vascular supply of the spine

Answer 21

Arteries form anastomotic rings that arise from the
vertebral arteries and posterior intercostal and
lumbar branches of aorta. Venous plexuses (internal and external) coalesce
and drain to the veins equivalent to the above
arteries

Question 22

What are extrinsic muscles

Answer 22

– Derivatives of hypoaxial myotome– superficial
– involved with movements of the upper limbs and thoracic wall
– innervated by anterior rami of spinal nerves

Question 23

What are intrinsic muscles

Answer 23

– Derivatives of epaxial myotome
– Located deep, between the spinous
processes and the angle of the ribs
– adapted to provide support and movement
in resistance to the effect of gravity
– move the vertebral column
– participate in moving the head
– innervated by the posterior rami of spinal
nerves

Question 24

What is the trapezius

Answer 24

– From skull, spinous processes to scapula and clavicle (laterally)
– Upper fibres elevate and rotate shoulders during abduction of arm– Supplied by spinal accessory nerve

Question 24

What is the latissimus dorsi

Answer 24

– Iliac crest, fascia, spines of T6 to T12, lower ribs; to humerus
– Shoulder extension and adduction
– Supplied by the Thoracodorsal nerve

Question 25

What are the layer 2 muscles of the back

Answer 25

• Levator scapulae– Scapular elevation* Rhomboid major andminor– Scapular retraction and elevation
• Serratus posterior superior– Inspiration
• Serratus posterior inferior– Expiration

Question 26

What are the layer 3 muscles of the back

Answer 26

• Intrinsic back muscles
• From skull, through cervical, thoracic and lumbar regions to pelvis* Keep the vertebral column upright and in extension against gravity* Arranged in 3 layers – Superficial, Intermediate, Deep

Question 27

What are the deep neck muscles

Answer 27

• Deep to semispinalis capitis
  – Obliquus capitis superior
  – Obliquus capitis inferior
  – Rectus capitis posterior major
  – Rectus capitis posterior minor
• The Sub-occipital Triangle
  – Transmits vertebral artery and vein as well as suboccipital nerve