The Back Flashcards
Primary Curvatures
Thoracic and Sacral
Concave Anteriorly
Arise during the fetal period due to differences in the thickness of the vertebral bodies anteriorly and posteriorly
Secondary Curvatures
Cervical and Lumbar
Convex Anteriorly
Develop during infancy due to differences in the thickness of the IV discs. Cervical arises as the infant begins to keep his head up, lumbar arises as the infant beings to sit up
Typical Cervical Vertebrae
Vertebrae Bodies Spinous Processes Transverse Processes Articular Processes/Motion Vertebral Foramen
Vertebrae: CV3 - CV7
Bodies:
Bodies are small and wide
Bodies have ridges on them called uncinate processes
Spinous processes:
CV3 - CV5 are short and bifid
CV6 - CV7 are long (CV7 longest = vertebral prominence)
Transverse Processes
TRANSVERSE FORAMEN***
Vertebral artery travels here on its way to the skull
Articular processes:
Superior - face a superior posterior direction
Inferior - face an inferior anterior direction
Most motion is available at the atlantoaxial joints
Motions in this region include flexion/extension, lateral flexion, and rotation (most rotation occurs between C1 and C2)
Vertebral Foramen:
Triangular and large
Houses the cervical enlargement of the spinal cord
Atypical Cervical Vertebrae: CV1
Aka “Atlas”
No body or spinous process
Divided into Anterior and posterior arches (each of which has a tubercle)
Has 2 lateral masses located between the arches
The articular surfaces on the superior aspects of the lateral masses articulate with the occipital condyles of the occipital bone
The inside of the anterior arch has an articular facet for the dens
Atypical Cervical Vertebrae: CV2
Aka “Axis”
Has a DENS which projects superiorly, and articulates with the articular facet on the anterior arch of the atlas, where it is held in place by the transverse ligament of the atlas; it is the pivot around which CV1 rotates
Has superior articulating facets for articulation with CV1 and inferior articular facets for articulation with CV3
Typical Thoracic Vertebrae
Vertebrae Bodies Spinous Processes Transverse Processes Articular Processes/Motion Vertebral Foramen
Vertebrae:
TV5 - TV8
Bodies:
Heart shaped
Have superior costal facets or articulation with the rib of the same number, and inferior costal facets for articulation with the rib below
Spinous Processes are long and overlap on another more in this region than in other regions
Transverse Processes are long and have costal facets for articulation with the ribs of the same number
Articular Processes:
Superior Facets face posterior
Inferior Facets face anterior
Movement is most restricted in the thoracic region because of the ribs; despite restriction due to ribs, there is some movement in all 3 planes
Vertebral Foramen are Circular and small
**COSTAL FACETS
Typical Lumbar Vertebrae
Bodies Spinous Processes Transverse Processes Articular Processes/Motion Vertebral Foramen
Bodies:
MASSIVE, Kidney bean shaped bodies; large because they must support the body weight
Spinous Processes:
Short and Sturdy
Transverse processes:
Long and slender
Articular Processes:
Superior ones face medially and slightly posteriorly and have an additional process called the mamillary process for muscle attachments
Inferior ones face laterally and slightly anteriorly
Primary movement is flexion/extension but there is some lateral flexion and rotation
Vertebral foramen:
Triangular
Intermediate in size between thoracic and cervical
Joints of the Vertebral Column: Intervertebral Joints
Articulation
Ligaments (List)
Articulation:
Symphysis type joint between adjacent vertebral bodies which are connected by intervertebral discs
Ligaments:
Anterior Longitudinal Ligament
Posterior Longitudinal Ligament
Intervertebral Discs
Outer part: Annulus Fibrosis
Made up of many concentric lamellae aka layers of fibrocartilage; holds the nucleus pulposus in place
Inner Part: Nucleus Pulposus
Central semifluid region positioned slightly posteriorly within the disc. hydration reduces with age
Uncovertebral joints
Synovial joints between the outer lips of the vertebral bodies of adjacent cervical vertebrae
**whether they exist is still debated
Intervertebral Joints: Ligaments
Anterior Longitudinal Ligament
Extends from the sacrum to the occiput.
Broad ligament covering the anterior and lateral sides of the vertebral bodies and IV discs
Prevents hyperextension of the vertebral column
**Only ligament anterior to the vertebral column
Intervertebral Joints: Ligaments
Posterior Longitudinal Ligament
Extends from the sacrum to the occiput along the posterior surface of the vertebral bodies (anterior to the spinal cord)
Attaches to the occipital bone via the tectorial membrane
Smaller and narrower than the anterior longitudinal ligament
Helps prevent hyper flexion of the vertebral column and posterior protrusion of the IV discs
Zygapophyseal Joints
Articulation
Ligaments (List)
Plane Type Synovial Joints
Articulation between the articular facets of adjacent vertebrae.
Ligaments: Ligamentum flava Interspinous Ligaments Supraspinous Ligaments Intertransverse Ligaments Nuchal Ligament Iliolumbar LIgament
Zygapophyseal Joint: Ligaments
Ligamentum Flava
Run vertically between lamina of adjacent lamina on their anterior surfaces (within the vertebral canal)
Made up of Yellow Elastic Tissue
Prevent abrupt hyper flexion of the vertebral column and provide the most support of the vertebral column ligaments; prevent separation of the lamina
Zygapophyseal Joint: Ligaments
Interspinous Ligaments
Run vertically between spinous processes
Prevent hyperflexion
Zygapophyseal Joint: Ligaments
Supraspinous Ligaments
Run vertically along the tips of the spinous processes
Prevent hyperflexion
Zygapophyseal Joint: Ligaments
Intertransverse Ligaments
Run vertically between the transverse processes of adjacent vertebrae
Zygapophyseal Joint: Ligaments
Nuchal Ligament
Runs form the occiput to the spinous process of CV7
About 1 inch wide
Made of fibroelastic tissue
Extra anchor at the top of the vertebral column
Zygapophyseal Joint: Ligaments
Iliolumbar ligament
Runs form the transverse processes of LV4 and LV5 to the ilium and blends with the anterior sacroiliac joint
Anchors the Spine to the hip bone
Craniovertebral Joints
The joints and their articulations
List of associated ligaments
Atlantooccipital joint: between the superior articular surfaces of the lateral masses of the atlas and the condyles of the occiput; “yes” joint
Atlantoaxial joints: one between the dens of CV2 and the articular facet on the anterior arch of CV1 and 2 between the superior articular facets of CV2 and the 2 inferior articular facets of CV1 “no” joint
Ligaments:
Atlanto occipital membranes (anterior and posterior)
Transverse ligament of the axis (cruciate ligament)
Alar Ligament
Tectorial membrane
Craniovertebral Joints: Ligaments
Anterior and Posterior atlantooccipital membranes
Located along the edges of the foramen magnum, run inferiorly to attach to the anterior and posterior arches of CV1
Craniovertebral Joints: Ligaments
Transverse ligament of the axis
Runs horizontally between the tubercles on the lateral masses of CV1
Holds the Dens in place
Has superior and inferior longitudinal bands projecting superiorly and inferiorly. Together these 3 components make up the cruciate ligament
Craniovertebral Joints: Ligaments
Alar Ligaments
Project from the dens to the lateral margins of the foramen magnum of the occiput
Craniovertebral Joints: Ligaments
Tectorial Membrane
Continuation of the posterior longitudinal ligament
Extends from the posterior arch of CV1 to the posterior margin of the foramen magnum
Spinal Cord
Overview
Regions
Vasculature
Overview:
Cylindrical
Slightly flattened
Runs from foramen magnum to LV2
Regions:
Cervical enlargement - gives rise tot he nerves that innervate the upper limb; extends from C4 to T2
Lumbar Enlargement - gives rise to the nerves that innervate the lower limb
Medullary Cone - End of the spinal cord; ends at the level of LV2
Cauda Equina - distal to the medullary cone, it is complsed of the dorsal and ventral roots arising from the lumbosacral enlargement and medullary cone
Vasculature:
3 longitudinal arteries - one anterior and 2 posterior
Spinal Nerves
Overview
Roots
Rami
Overview:
31 pairs of spinal nerves named for the intervertebral foramina they emerge from.
Occupy the space within the intervertebral foramina
Roots:
Dorsal - AFFERENT fibers; carry sensory information inward; cell bodies are in the dorsal root ganglion
Ventral - EFFERENT fibers; carry motor information outward; cell bodies are in the ventral horns of the spinal cord
Rami:
Dorsal - supply the deep back muscles, joints of the vertebral column, and skin over those areas
Ventral - form plexes and provide motor and peripheral sensory supply
Meninges: Dura Mater
Outermost covering
Made up of dense, irregular CT
Very thick
Creates a dural sac, which is a sheath within the vertebral canal that encases the spinal cord
Anchored at the top to the foramen magnum
Anchored at the bottom to the coccyx
Epidural space - between the vertebrae and the duramater (outside the dural sac)
Subdural space - between the dura mater and the arachnoid mater
Meninges: Arachnoid Mater
Looks like spiderwebs
Inside dura mater (within dural sac)
Composed of fibrous and elastic connective tissue
CSF is in the subarachnoid space so this is where lumbar punctures go
Subarachnoid space is largest caudals to the medullary cone where the cauda equina is
Arachnoid trabeculae anchor the arachnoid mater to the pia mater
Meninges: pia mater
Inner most layer
Made up of loose CT
Adhered to the neural tissue of the spinal cord
DENTICULATE LIGAMENTS extend from the lateral surfaces of the pia mater and anchor the spinal cord to the dural sac
Terminal Filum is a continuation of the pia mater from the medullary cone to the coccyx
