The back region Flashcards
What does the term back include?
Whole posterior aspect of the trunk and neck
What makes up the back?(7)
Spine
Discs
Nerves
Muscles
Tendons
Ligaments
Fasciae
Where are the organs located compared to the spine?
Anterior
What is the position when we stand up kept by?
Active energy consumption
How many muscles are in the posterior part of the neck?
7
Which movement is flexion of the trunk?
Forward
Which movement is extension of the trunk?
Backward
Which are the primary movements of the back?
Flexion/extension
Lateral bending
Rotation of the trunk
What is fascia?
Layer of connective tissue that makes envelopes to the different muscles and groups of muscles
Allows muscles to act independently of eachother
2 parts of the abdomio-pelvic cavity
Abdominal cavity
Pelvic cavity
2 main parts of the ventral cavity
Thoracic cavity
Abdomino-pelvic cavity
2 parts of the dorsal cavity
Spinal cavity
Cranial cavity
What is the middle region og the back called?
Main part: vertebral region
Lower back: Sacral region
Bottom part: anal region
What kind of border is between the skull and the spine?
A conventional operation, there is no real separation as they are continuous
How does the occipital bone articulate with the spine?
The condyles at the bottom by the foramen magnum
Different name for C1?
Atlas
What kind of movement does plane joints allow for?
Sliding
Uniaxial
What kind of joints are in the spine?
Plane joints
What allows for the complex movements of the spine?
Plane joints in series alternating directions allowing for movement in all directions
Example of ball and socket joint
Shoulder
Hips
Which joints allow the widest movement in our body?
Ball and socket (shoulder)
What do you loose when increasing movability of a joint?
Stability
The less moveable the stable it is
What are the condyles on the occipital bone convex or concave?
Convex
What are the condyles on the atlas bone convex or concave?
Concave
What allows for turning of the head?
Median atlantoaxial joint (joint between atlas and axis (C1 and C2) where the atlas rotates, pivots around the dens
What allows for the flexing and extension of the neck?
The condyles of the occipital bone and atlas bone
What are the 7 first vertebrae’s grouped as?
Cervial
What are the 12 middle vertebrae’s grouped as?
Thoracic/ dorsal
What are the 5 last vertebrae’s grouped as?
Lumbar
What does the sacrum derive from?
5 vertebres fused together
What is the spine used for by all doctors?
As a point of reference benchmark, a landmark
What is the sacrum part of?
Spine and pelvis
What connects the spine to the pelvis?
The sacrum
From what view is the spine perfectly vertical?
Anterior and posterior
From what view is the spine not vertical, curvy?
Lateral
What is the cervical tract called?
Cervical lordosis
What is the Thoracic tract called?
Thoracic kyphosis
What is the lumbar tract called?
Lumbar lordosis
What is a lordosis?
Curvature of the spine where the convex part is anterior
What is a kyphosis?
Curvature of the spine where the convex part is posterior
What is the whole spine like in a newborn?
Kyophases
What is excessive lordosis?
Excessive curvature of the spine posteriorly (backwards bent)
What is excessive kyphosis?
Excessive curvature of the spine anteriorly (forward bent)
What is the canal formed by the vertebrae called?
Vertebral canal
What does the vertebral arch consist of?
Pedicle
Lamina
What is the boney part we can feel on our back of the spine called?
Spinous process
Names of the two parts of the articular process
Superior articular process
Inferior articular process
Which is the only vertebra that has no body?
Atlas
What is the upwards process on the C2 (axis) called?
Dens
Why does atlas not have a body?
Because it articulates with Axis through the process called Dens which goes where the body would have
What keeps the dens in place when rotating?
Transverse ligament of atlas
What kind of trauma typically breaks the dense?
Compression trauma
Like from diving in too low water
Where does the vertebral artery pass through?
Foramen only found in the cervical vertebrae (foramen transversarium)
What does the rib articulate with?
Thoracic vertebrae
Why is back pain typically in the lower part of the spine (lumbar)?
Because of forces of compression and gravity all goes there
Why are the vertebrae thicker towards the bottom of the spine (in the lumbar)?
Because the load on them is heavier
How many foramen in the sacrum?
4 (on each side)
Are joints always moving?
No, its a boundary through two bones
What do the foramen in the sacrum allow for?
Passage of nerves
Do all vertebrae have intervertebral discs?
Yes
What are the two components of intervertebral discs?
Central and peripheral
What is the peripheral part of the intervertebral disc made of?
Anulus fibrosus
What is the central part of the intervertebral disc made of?
Nucleus pulposus
What keeps the shape of the intervertebral disc?
Anulus fibrosus
Are there ligaments between the lamina of the vertabae?
Yes
Why are the ligaments between the lamina (ligamentum flavum) yellow?
Because they are rich in elastic fibers
What are the ligaments between C1-C2 and cranium called?
Cranio-spinal ligaments
What is the cruciform ligament made up of?
Alar ligament and transverse ligament of the atlas
What is flexion of lower cervical vertebrae limited by?
Limited by the laminae
What is extension of lower cervical vertebrae limited by?
Limited by the spinous processes
Which part of the spine is most moveable?
Lumbar and cervical
Degree of flexion of cervical
40
Degree of flexion of thoracic
40
Degree of flexion of lumbar
60
Degree of extension of cervical
45
Degree of extension of thoracic
15
Degree of extension of lumbar
30
Degree of lateral inclination of cervical
40
Degree of lateral inclination of thoracic
35
Degree of lateral inclination of lumbar
15
Where does the spinal chord stop?
Disc between L2 and L3
How many layers of muscle is there in the back?
3
Which is the biggest muscle in our body?
Latissimus dorsi
Which layer of muscle in the back has the most function?
Superficial
What is the envelope of the muscle?
Fascia
Where in the back is the fascia very thick?
Posterior:
Thoracolumbar fascia
Two categories of back muscles
Extrinsic
Intrinsic
What muscles are antigravital and have both hands of the muscle in the back?
Intrinsic
What muscles have origin in the back but insertion somewhere else?
Extrinsic
Which kind of muscle make movement?
Agonist
Which type of muscle make the opposite movement?
Antagonist
Which muscles are under voluntary control?
Skeletal
Which is the most medial of the muscles of the intermediate layer of the back?
Spinalis
Which muscles form the intermediate layer of the back?
Spinalis
Longissimus
Iliocostalis
Which muscle form the deep layer of the back?
Semispinalis
Multifidus
Rotatores
How many muscles on each sub-occipital triangle?
4
Are the muscle of the sub-occipital triangle coupled?
Yes
Which group of muscles in comparison to the axis are flexors?
Anterior
Which group of muscles in comparison to the axis are extendors?
Posterior
What is the total inclination of the spine?
80 degree
How does the thickness of the intervertebral disc affect the degree of displacement?
The bigger the disc the larger the angle
The smaller the disc the smaller the angle
How is flexion, extension, rotation and lateral inclination in the thoracic segment?
Flexion and extension is poor
Lateral inclination is good
Rotation is moderate
How is flexion, extension, rotation and lateral inclination in the cervical segment?
Flexion and extension is good
Lateral inclination is good
Rotation is good
How is flexion, extension, rotation and lateral inclination in the lumbar segment?
Flexion and extension is good
Lateral inclination is moderate
Rotation is poor
Why does mobility vary in the various segments of the vertebral column?
Size/thickness of intervertebral discs
Length and spacing between spinous processes
What is the plane of movement for the spine during flexion and extension?
Sagittal
What is the axis of rotation of the spine during flexion and extension?
Transvere
Degree of total flexion of the vertebral column
140
Degree of total extension of the vertebral column
90
What is the axis of rotation of the spine during lateral inclination ?
Sagittal
What is the plane of movement for the spine during lateral inclination?
Frontal
Does the lateral inclination of the vertebral column show the same amplitude in both sides?
Yes however scoliosis may limit it in one or both sides
How many vertebrae?
33 or 34
What kind of bone marrow does vertebrae contain?
Red bone marrow
Is the vertebral column a site of hematopoieis?
Yes because it consists of red bone marrow
What is the 7th cervical vertebrae known as?
Vertebra prominens
Why are the 2 kyphosis also referred to as primary curvatures?
Because they curve in the same way as fetus’ which only have kyphoses present
What are the lordosis also called?
Secondary/compensatory curvatures
When do lordosis develop?
After birth
Cervical lordosis: 3-4th months
Lumbar: 6-9th months
What does the promontory of the base of the sacrum correspond to?
The center of gravity
Which parts of the vertebral column are fused together?
The sacrum
The coccyx
What kind of bones are vetebra?
Short bone
What forms the vertebral canal?
The vertebral foramen
In which direction does the size of the vertebral disc increase?
Craniocaudal (going downwards)
Which vertebra are the smallest?
The cervical
Why is the 7th cervical vertebra also known as vertebra prominens?
Because its spinous process (which is not bifid) is long and protrudes posteriorly ending in a tubercle
Do all thoracic vertebra articulate with the ribs?
Yes
Which kind of vertebra have the smallest vertebral foramen?
Thoracic
What 3 processes replace the transverse process in lumbar vertebrae?
Costal
Mammillary
Accessory
Which vertebral notch of the pedicle is deeper in the lumbar vertebrae?
The inferior vertebral notch
What is the last segment of the vertebral column?
The coccyx
Where does the vertebral canal extend from and to?
The foramen magnum to the sacral hiatus
What is the functional spinal unit?
Smallest segment of movement, consists of 2 contiguous vertebrae
What does FSU stand for?
Functional spinal unit
What can the FSU be divided into?
The anterior crus
The posterior crus
What does the anterior crus of the FSU contain?
The vertebral bodies and disk
What does the posterior crus of the FSU contain?
Joints of the vertebral arch
Which part of the FSU has the static function and what is it?
The anterior part, absorb compression
Which part of the FSU has the dynamic function and what is it?
The posterior crus, directing movement
Which vertebral segments develops the latest? (embryology)
The sacrum
What are the joints between the vertebrae called?
Intrinsic joints
What are the joints between the vertebrae and the hips, cranium and ribs called?
Extrinsic joints
Is the nucleus pulpous hard or soft?
Soft and gelatinous
Is the annulus fibrosus hard or soft?
Hard
What are the joints between the articular processes of the vertebrae called?
Zygapophysial joints
What kind of joints are Zygapophysial joints?
Plane joints
The 4 remote ligaments of the spine
Ligamenta flava
Interspinous ligaments
Supraspinous ligament
Intertransverse ligaments
What kind of joints is the Atlanto-occipital joint?
2 synovial joints
What is the Atlanto-occipital joint primarily involved with?
The flexion and extension movements of the head
What is the joint between the fifth lumbar vertebra and the sacrum called?
Lumbosacral joint
What is the joint between the apex of the sacrum and the superior intervertebral surface of the first coccygeal vertebra called?
Sacrococcygeal joint
Which are the muscles of the back proper?
The ones that originate and insert on the vertebral column
Which are the 3 erector spinae?
Iliocostalis
Longissimus
Spinalis
Which is the most medial erector spinae?
Spinalis
What does the spinals attach to?
The spinous process
Which is the thickest and longest erector spinae?
Longissimus
What does the Illiocostalis connect?
The ilium to the rib
3 muscles of the transversospinalis
Semispinalis
Multifidus
Rotatores
What does semispinalis connect to?
Transverse processes
Spinous processes
(except for one which inserts of the skull)
Where are the interspinalis?
Between the spinous process of the spine in cervical and lumbar spine
