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621: Surface Anatomy & Exam Techniques > The Back and Vertebral Column > Flashcards

The Back and Vertebral Column Flashcards

1
Q

Where can you palpate the spinalis part of the erector spinae muscles?

A

They are the hills on back just lateral to the midline

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2
Q

At what spinal level does the scapular spine fall?

A

T3

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3
Q

At what spinal level does the inferior angle of the scapula fall?

A

T7 or T8

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4
Q

At what spinal level do the iliac crests fall?

A

L4

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5
Q

The ASIS should align with each other in the horizontal plane and with the ________ in the vertical plane

A

pubic symphysis

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6
Q

At what spinal level do the PSIS fall?

A

S2 (indicated by dimples)

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7
Q

What joint is located at S2?

A

sacroiliac joint

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8
Q

Which vertebral regions are the most flexible and why?

A

The cervical and lumbar regions are more mobile than the thoracic region because the cervical and lumbar vertebrae do not have ribs attached to them

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9
Q

The Atlantooccipital Joint allows for the movement of nodding ___ whereas the Atlantoaxial Joint allows for movement of nodding __.

A

Yes

No

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10
Q

In the cervical and upper thoracic spine, side bending is coupled with axial rotation in the ____ direction.

A

same

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11
Q

With left side bending the cervical and upper thoracic spinous processes move in what direction?

A

right

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12
Q

In the middle and lower thoracic spine, lateral bending is coupled with axial rotation in the _____ direction when lateral bending is the first movement

A

opposite

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13
Q

In the middle and lower thoracic spine, lateral bending is coupled with axial rotation in the _____ direction when rotation is the first movement

A

same

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14
Q

In the lumbar spine, side bending is coupled with axial rotation in the ____ direction.

A

opposite

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15
Q

With left side bending the lumbar spinous processes move in what direction?

A

left

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16
Q

What 3 things allow for a vertebral segment to move?

A

intervertebral disk joint and two posteriorly positioned facet joints (one right and one left)

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17
Q

In the Occipital-Atlanto-Axial Complex rotation and side bending of the head occurs in the ____ direction.

A

opposite

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18
Q

When the head rotates right, C1 side bends ___.

A

left

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19
Q

What fills the majority (1/3 to 1/2) of the intervertebral foramina?

A

cervical nerves

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20
Q

What does the vertebral artery test test for?

A

vertebral artery blood flow

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21
Q

A reduction in vertebral artery blood flow results in what?

A

transient ischemic attack (TIA)

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22
Q

What is a transient ischemic attack?

A

Occurs when blood flow to a part of the brain stops for a brief period of time which in turn will lead to a stroke

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23
Q

During coupled axial rotation and side bending is there more motion from the spine of C7 or T1?

A

C7

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24
Q

The first rib is attached to the clavicle via what ligament?

A

costoclavicular ligament

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25
Q

How many true ribs are there?

A

7 (ribs 1-7)

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26
Q

How many false ribs are there?

A

5 (ribs 8-12)

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27
Q

Of the false ribs, how many are floating?

A

2 (ribs 11 and 12)

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28
Q

What is the sternal angle?

A

The location where the manubrium and sternum meet

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29
Q

What rib articulates at the sternal angle?

A

rib #2

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30
Q

How many facet joints does each vertebrae have in total?

A

4

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31
Q

What is the function of a facet joint?

A

stabilize the spine, and prevent excessive bending and translation between adjacent vertebrae

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32
Q

What is the orientation of the articular surfaces of cervical facet joints?

A

midway between a frontal and horizontal plane (35-45 degrees)

33
Q

What 4 motions do the cervical facet joints allow for?

A

flexion, extension, rotation, and lateral flexion

34
Q

What is the orientation of the articular surfaces of thoracic facet joints?

A

mostly in the frontal plane (60 degrees)

35
Q

What is the primary motion allowed at the thoracic facet joints?

A

axial rotation

36
Q

What is the orientation of the articular surfaces of lumbar facet joints?

A

mostly in the sagittal plane (90 degrees)

37
Q

What 2 motions do the lumbar facet joints allow for?

A

flexion and extension

38
Q

What are the 2 types of nerve endings found in the nerves that innervate the facet joints?

A

mechanoreceptors and nociceptors.

39
Q

Mechanoreceptors react to what type of stimuli?

A

proprioceptive

40
Q

Nociceptors react to what type of stimuli?

A

pain sensations

41
Q

2 functions of intervertebral discs

A
  • Forms a fibrocartilaginous joint to allow slight movement of the vertebrae
  • Acts as a ligament to hold the vertebrae together
42
Q

How are the layers of the annulus fibrosus arranged?

A

the fibrocartilage fibers of each layer are distributed in different directions (like layers of plywood)

43
Q

How many IVDs are there?

A

23 discs in the human spine:
6 in the cervical region
12 in the thoracic region
5 in the lumbar region

44
Q

Is there a direct blood supply to the IVDs?

A

NO

45
Q

Before the age of 40 approximately __% of people show evidence of DJD

A

25

46
Q

After the age of 40 approximately __% of people show evidence of DJD

A

60

47
Q

What changes occur in the nucleus pulposus of IVDs during aging?

A

The nucleus pulposus begins to dehydrate and the concentration of proteoglycans in the matrix decreases, thus limiting the ability of the disc to absorb shock

48
Q

What changes occur in the annulus fibrosis of IVDs during aging?

A

It becomes weaker and has an increased risk of tearing

49
Q

What branch of spinal nerves innervate the meninges, vertebrae, and spinal ligaments?

A

Meningeal branch (aka sinuvertebral nerves)

50
Q

What do the dorsal primary rami supply?

A

motor and sensory innervation of the skin and muscles of the back as well as the facet joints

51
Q

What do the ventral primary rami supply?

A

the ventral and lateral skin and muscles of the trunk

52
Q

The ventral primary rami in the upper and lower thoracic regions form what kinds of nerves?

A

Upper form intercostal nerves

Lower form thoracoabdominal nerves

53
Q

What do the remainder of the primary ventral rami form?

A

the nerve plexuses (cervical, brachial, lumbar, sacral, and coccygeal plexuses)

54
Q

The posterior aspects of the lumbar intervertebral discs are supplied by what nerves?

A

the sinuvertebral nerves (meningeal branches of the spinal nerves)

55
Q

What supplies the posteriolateral aspects of the lumbar intervertebral discs?

A

The branches of the adjacent ventral primary rami and the grey rami communicantes near their junction with the ventral primary rami

56
Q

What innervates the lateral aspects of the lumbar intervertebral discs?

A

branches from the rami communicantes

57
Q

What innervates the anterior aspects of the lumbar intervertebral discs?

A

recurrent branches of rami communicantes

58
Q

The cervical intervertebral discs are supplied by what nerves?

A

sinuvertebral nerves

59
Q

What are the 4 types of nerve endings found in joints?

A
  • Free nerve endings
  • Golgi type endings
  • Ruffini endings
  • Paciniform endings
60
Q

Where are free nerve endings found?

A

in the joint capsule and connective tissue surrounding a synovial joint

61
Q

What activates free nerve endings?

A

extreme mechanical or chemical irritation

62
Q

Where are Golgi type nerve endings found?

A

in the ligaments of the joint

63
Q

What activates Golgi type nerve endings?

A

ligament stretch

64
Q

Where are Ruffini nerve endings found?

A

in the joint capsule

65
Q

What activates Ruffini nerve endings?

A

stretching and tactile stimulation

66
Q

Where are Paciniform nerve endings found?

A

in the periosteum near the articular attachments

67
Q

What activates Paciniform nerve endings?

A

active at onset and termination of movement, they signal movement velocity and acceleration

68
Q

Describe the basic idea behind the gate control theory

A

Non-painful input closes the gates to painful input by activating inhibitory interneurons which prevent the pain sensation from traveling to the CNS

69
Q

The gate theory was the rationale behind the production and use of what modality?

A

transcutaneous electrical nerve stimulation (TENS)

70
Q

Proprioception involves both ____ sense and _____ sense.

A

position

motion

71
Q

Where are nociceptors located in a joint?

A

Throughout it. In the capsule, ligaments, menisci, periosteum and subchondral bone.

72
Q

Pain afferents are ____ diameter neurons, whereas mechanoreceptors are _____ diameter neurons.

A

small

large

73
Q

The perception of pain is dependent upon what?

A

The balance of activity in large [mechanoreceptor] and small [nociceptive] afferents

74
Q

What supplies the sensation for the facet joints (zygapophyseal joints)?

A

The medial branch of the dorsal primary ramus above and below the level it is on

75
Q

What 4 things does the xiphisternal plane mark?

A

1) Anterior and inferior limit of the thoracic cavity
2) Superior surface of the liver
3) Diaphragm
4) Inferior border of the heart

76
Q

At what vertebral level does the xiphisternal plane fall?

A

T9

77
Q

What is the supracristal plane and what does it mark?

A

It is the highest point on the iliac crest (L4) and marks the bifurcation of the aorta

78
Q

How many joints does each vertebrae have?

A

12

2 IVDs
4 facet joints
2 for costal transverse processes
4 for the ribs

621: Surface Anatomy & Exam Techniques (13 decks)

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