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MD2001 > The Back: Bones, Joints, Ligaments & Muscles > Flashcards

The Back: Bones, Joints, Ligaments & Muscles Flashcards

1
Q

What are the different vertebral regions of the spine, and how many vertebrae does each consist of?

A 
(C) Cervical (7)
(T) Thoracic (12)
(L) Lumbar (5)
(S) Sacral (5 fused to 1)
(Co) Coccygeal ( variable 3/4 fused to 1/2
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2
Q

What are the functions of the spinal cord?

A

+ Locomotion
+ Supports body weight
+ Protects and transmits spinal cord and nerves

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3
Q

What is primary curvature?

A

+ Kyphosis
+ Concave anteriorly
+ Bases on spinal curvature in utero
+ Remains in thoracic and sacral regions

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4
Q

What is secondary curvature?

A

+ Lordosis
+ Concave posteriorly
+ Cervical and lumbar regions

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5
Q

What are the different movements allowed throughout the vertebral column, to varying degrees?

A

+ Extension
+ Flexion
+ Lateral flexion
+ Rotation

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6
Q

What are the features of a typical vertebra?

A 
\+ Body
\+ Vertebral foramen (canal)
\+ Pedicle
\+ Transverse process
\+ Superior articular facet
\+ Inferior articular facet
\+ Lamina
\+ Spinous process (spine)
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7
Q

What are features of typical cervical vertebrae?

A

Body: smaller, short AP diameter, longer lateral diameter

Uncinate Processes at lateral edges, synovial articulation with vertebra above

Superior articular facets: flat, facing superiorly and posteriorly

Bifid spine (C7 is not bifid, but prominent)

Vertebral foramen: large, triangular

Foramen transversarium

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8
Q

What movements are assocciated with the cervical region?

A
  1. Flexion is greatest movement

2. Some lateral flexion

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9
Q

What are features of typical thoracic vertebrae?

A

Body: heart shapes, longer AP diameter, shorter later diameter

Costal demi-facts: upper (articulation with head of own rib) lower (articulation with head below)

Transverse process: long with a facet for articulation with the tubercel of its own rib

Superior articular facets: flat and facing postero-laterally, on the arc of a circle

Spinous process/spine: long and pointing inferiorly, overlapping 2 vertebrae

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10
Q

What movements are associated with the thoracic region?

A
  1. Rotation is the greatest movement
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11
Q

What are features of typical lumbar vertebrae

A

Body: large for weight bearing, short AP, diameter, longer lateral diameter

Vertebral foramen: small, triangular

Transverse process: length and size variable, 3rd is longest

Superior articular facets: concave, facing postero-medially (interlocking with inferior facets)

Spinous process/spine: sturdy, stumpy, quadrangular

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12
Q

What movements are associated with the lumbar region?

A
  1. Extension is greatest movement
  2. Then flexion
  3. Some lateral flextion
  4. No rotation
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13
Q

What are the faetures of the sacrum and coccyx from an anteroinferior view?

A 
\+ Sacral promontory
\+ Ala
\+ S1
\+ Anterior foramen
\+ Coccyx
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14
Q

What are the features of the sacrum and coccyx from a posterosuperior
view?

A 
\+ Median crest
\+ Intermediate crest
\+ Lateral crest
\+ Posterior foramen
\+ Sacral hiatus
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15
Q

What are the two atypical vertebrae?

A

Atlas and Axis

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16
Q

What are the features of the atlas?

A

Anterior (short) and posterior (long) arches between two lateral masses but no body

Transverse process with foramen

Superior articular facets: concave oval to reciprocate with the occipital condyles

Inferior facets: flat, circular to articulate with the axis

Groove for vertebreal artery

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17
Q

What movements are associated with the atlas?

A

Flexion and extension at the atlanto-occipital joint

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18
Q

What are the features of the axis?

A

Body: with odontoid process or Dens for articulation with the anterior arch of the atlas

Transverse process with foramen

Vertebral foramen: large, triangular

Spinous process/spine is bifid

Superior articular facets: flat and circular to reciprocate with the inferior facets of the atlas

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19
Q

What movements are associated with the axis?

A

Rotation of the head and neck at the atlanto-axial joint, around the odontoid process

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20
Q

What are features of the joints of the vertebral colum?

A
  1. Zygopophyseal facet joints: synovial with fibrous capsule and supportive ligaments
  2. Intervertebral (IV) discs of fibrocartilage (symphysis or 2y cartilaginous joint)
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21
Q

Where in the vertebral column doe the spinal nerves emerge?

A

The intervertebral foramen

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22
Q

What are the boundaries of the intervertebral foramen?

A
  1. Pedicle
  2. Vertebral body
  3. IV disc inferiorly
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23
Q

What are features of the IV discs?

A

+ They bind the ventral bodies together
+ Contribute to the shape of the spinal curvatures
+ Form 20-25% of the length of the column
+ Consist of the anulus fibrosus and the nucleus pulposus

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24
Q

What are features of the anulus fibrosus?

A

+ Very strong

+ Concentric lamellae of fibrocartilage

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25
Q

What are features of the nucleus pulposis?

A

+ Draws in water
+ Semi-fluid
+ Tense and resilient
+ Flexible

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26
Q

What are the functions of IV discs?

A

+ Strong, resilient shock-absorbers

+ Deform to allow movement between the vertebral bodies

27
Q

IV discs have the ability to deform - what effect does this have on the discs?

A

+ Puts pressure on the nucleus pulposus

+ Anulus fibrosis may degenerate and weaken

28
Q

What can happen to the nucleus pulposus when pressure is applied?

A

The nucleus may herniate or prolapse to compress:

  • spinal cord (which stops at L1/2)
  • cauda equina
  • emerging spinal nerve
29
Q

Where are disc herniations most likely to occur?

A

+ Most disc herniations are postero-lateral, towards the intervertebral foramen

+ This is due to the central position of the posterior longitudinal ligament

30
Q

How does a prolapsed L5 disc manage to escape injury?

A

The disc forms the anterior aspect of the foramen, but inferiorly, so the spinal nerve probably emerges above the prolapsing disc and escapes injury

Consequently, a prolapsed L4 disc is likely to compress the L5 (and lower) nerves

31
Q

Where are the anterior and posterior longitudinal ligaments in relation to the vertebral column?

A

+ Anterior and posterior longitudinal ligament are ant. and post. to vertebral bodies

+ Posterior ligament is anterior to spinal cord

32
Q

What are features of the posterior longitudinal ligament?

A

+ Resists hyper-flexion
+ Narrow band
+ Attached mainly to discs
+ From C2 to sacrum

33
Q

What are features of the anterior longitudinal ligament?

A

+ Limits extension
+ Thick, broad band
+ Attached to vertebral bodies and discs
+ Passes from occipital bone and atlas all the way to the sacrum

34
Q

What are features of the ligamenta flava?

A

+ Limits sudden flexion
+ Supports the curvatures
+ Strong, elastic bands of varying thickness
+ Between the vertebral laminae
+ Left and right may meet and fuse in the midline

35
Q

Where can the intertransverse ligaments be found?

A

Between all the transverse processes

36
Q

What are features of the supraspinous ligaments?

A

+ Thick cords between tips of spines

+ From sacrum to C7 where it continues with the Ligamentum Nuchae

37
Q

What are features of the interspinous ligaments?

A

+ Thin membrane

+ Found between all spines

38
Q

What are features of the ligamentum nuchae (nuchal ligament)

A 
\+ In cervical region
\+ Limits flexion
\+ Provides muscle attachment
\+ Broad, fibro-elastic band
\+ From external occipital protuberance and posterior edge of foramen magnum down to C7
39
Q

What structures does the ant. longitudinal ligament continue as?

A

+ Anterior atlanto-axial membrane

+ Atlanto-occipital membrane

40
Q

What structure is the tectorial membrane a continuation of?

A

The posterior longitudinal ligament

41
Q

What does the ligamentum flavum continue as?

A

+ Posterior atlanto-axial membrane

+ Atlanto-occipital membrane

42
Q

Where do the alar ligaments attach?

A

From sides of dens to sides of foramen magnum

43
Q

What is the function of the alar ligaments?

A

To stop excess rotation

44
Q

What is the role of the inf. longitudinal bands of the cruciate ligament?

A

+ Bind together

+ Prevent excess movement between the acis, atlas and occiput (back of head)

45
Q

Where is the transverse part of the crucial ligament located?

A

+ Spans the lateral masses of the atlas

+ Holds its anterior arch close to the dens

46
Q

The aorta branches off to form arteries - how does the blood supply come about and where?

A

Arteries form anastomotic rings that arise segmentally from:

  • vertebral arteries
  • posterior intercostal and lumbar branches of aorta
47
Q

What is facilitated by the venous plexuses?

A

The spread of tumours

48
Q

Where do the basivertebral veins emerge?

A

Between the vertebral body and posterior longitudinal ligament

49
Q

What are the muscles that form the superficial layer?

A

+ Trapezius
+ Latissimus dorsi
+ Levator scapulae
+ Rhomboid minor and major

50
Q

What is another term for the deeper layer muscles?

A

Intrinsic (proper) muscles

51
Q

What is the role of the intrinsic muscles?

A

Keep the vertebral column upright and in extension against gravity

52
Q

Where do the intrinsic muscles range from?

A

Skull, through C, T, L regions to pelvis

53
Q

How are the intrinsic muscles supplied?

A

Supplied segmentally by the dorsal rami of spinal nerves (also passing to the overlying skin)

54
Q

What are the 3 layers that form the intrinsic muscles?

A

+ Superficial
+ Intermediate
+ Deep

55
Q

What are the superficial intrinsic muscles of the back?

A

+ Splenius capitus

+ Splenius cervicis

56
Q

Where do the superficial intrinsic muscles attach to?

A

+ Ligamentum nuchae
+ C & T spines
+ Trans processes and skull (laterally)

57
Q

What is the intermediate intrinsic muscles of the back?

A

Erector spinae

58
Q

What are features of the erector spinae?

A

+ Has 3 columns from lateral to medial, each subdivived 3 times depending on position

59
Q

Where does the erector spinae cover?

A

From spines and supraspinous ligaments to ribs, trans processes and skull

60
Q

What are the three colums of the erector spinae?

A

+ Iliocostalis
+ Longissimus
+ Spinalis

61
Q

What is the deep intrinsic muscle of the back?

A

Transversospinalis

62
Q

Where does the transversospinalis span from?

A

Trans processes upwards to spines

63
Q

What are features of transversospinalis?

A

Consist of multiple small muscles:

  • in between the spines
  • in between the trans processes
  • from trans processes to ribs
64
Q

What is the role of the venous plexuses?

A

Venous plexuses, internal and external, coalesce and drain to the veins equivalent to the above arteries

MD2001 (52 decks)

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