The Spine Flashcards
significant motion only occur at which portion of the spine?
upper 25 vertebrae
how many vertebra does a human have? how many are in each region?
32-34
7 cervical 12 thoracic 5 lumbar 5 sacral 4 coccygeal
T/F the size of the vertebral body increases as the column descends
T
anterior part which gives strength to the vertebral column
vertebral body
what consists the vertebral arch?
pedicles(pillars) and lamina(roof)
most important stabilizing structure of posterior elements of the vertebra
pars interarticularis
hole where nerve roots pass
neuroforamina
vertebral arch+posterior surface of vertebral body
vertebral foramen
foramen formed by the superior and inferior vertebral notches of the adjacent vertebrae
intervertebral foramen
spinal nerves passes through which foramen?
intervertebral foramen
what passes through the transverse foramen?
vertebral arteries
ligament demarcating anterior and posterior elements
posterior longitudinal ligament
distribution of weight bore by the anterior and posterior elements
anterior: 80% posterior: 20%
what gives the spine its flexibility?
IV discs
what determines the degree of motion of the spine
angle/direction of facets
most movable portion of the spine
cervical
angle of facet joints of cervical, lumbar and thoracic segments
cervical: 45deg
thoracic: 60deg
lumbar: 90deg
[spine segment] small body, largest canal, short bifurcated spinous process, thin lamina
cervical
[spine segment] medium sized body, smallest canal, long caudad spinous process, short transverse process, medium thickness laminae
thoracic vertebrae
[spine segment] large canal, short, broad spinous processes, broad transverse process, broad strong laminae
lumbar
which spine segment has a thin intervertebral disc compared to others?
cervical
which atypical vertebra?
with ring, no body, no spinous process, short transverse process, with lateral masses
C1/atlas
which atypical vertebra?
only vertebra with specialized process(dens/odontoid process), with thick lamina, has superior articulating facets
C2/axis
which atypical vertebra
has vertebra prominens, only cervical vertebra with a spinous process that is not bifid
C7
[significance] lateral masses of the atlas
bear weight of the skull
[significance] superior articular facets of axis
where atlas rotates
which atypical vertebra?
with a long spinous process, almost as prominent as C7
T1
thoracic vertebrae that has mammillary processes
T9-T12
what muscles attaches to the mammillary processes of the thoracic vertebrae?
intertransversarii and multifidus
T/F the lumbar vertebrae facilitates flexion and extension but not rotation
T
what is the largest movable vertebra?
L5
provides strength and stability to the pelvis and transmits weight of the body to the pelvic girdle
sacral vertebrae
how many sacral foramina are there?
4
important obstetrical landmark
sacral promontory
which coccygeal vertebra is the largest?
Co1
muscles that attach to the coccyx
gluteus maximus, coccygeus, pubococcygeus
what is the first secondary curvature and when is it developed?
cervical lordosis; after birth
where is the center of gravity in a baby?
between its forelegs
where is the center of gravity in an adult?
2 inches in front of S2
what is the 2nd secondary curvature ans when does it develop?
lumbar lordosis; baby
at 5-6 y.o, the spinal cord stops growing. at what vertebral level would the spinal cord end?
conus medullaris (tip of spinal cord) would be at L1
motions that the cervical vertebrae are capable of
flex, extend, rotate, laterally bend
what structures prevent the thoracic vertebrae from extension?
spinous processes
motions that the thoracic vertebrae are capable of
flex, rotate, laterally bend
a true joint with capsule, hyaline cartilage and synovial membrane in the articulating surface
diarthrodial joint
example of a diarthrodial joint in the vertebral column
joint over the facets
movement allowed by diarthrodial joint
gliding (e.g. between vertebrae)
articulation where bony surfaces are connected by interosseous ligament
syndesmosis
examples of syndesmosis in the vertebral column and the corresponding ligaments
between laminae: ligamentum flavum, between spinous processes: interspinous ligament
most important joint in the spine
amphiarthrodial joint between the IV discs
the IV discs are made of
fibrocartilage
what type of joint so you use when you nod, and what forms it?
condyloid joint formed by the skull and the atlas
what type of joint do you use when you shake your head as if saying no? what forms this joint?
trochoid; atlas and axis
on what bone do we sit on?
ischial tuberosity
arrange the following in ascending order of which the spine is strongest in:
compression, torsion, bending, shear
shear<compression
give the breakdown of torsional load on the spine
50% disc
20% ligaments
30% facets
strongest ligament in the vertebral column
anterior logitudinal ligament
extent of anterior longitudinal ligament
sacrum-c1
functions of anterior longitudinal ligament
maintains stability of IV discs; prevents hyperextension of vertebral column
T/F the anterior longitudinal ligament helps when you straighten up by recoil
T
ligament with the most number of nociceptors
posterior longitudinal ligament
cord-like ligament connecting the apices of spinous processes from c7 to sacrum
supraspinous ligament
which ligament has a lot of proprioceptors?
supraspinous ligament
ligament connecting adjacent transverse processes
intertransverse ligaments
which ligament limits lateral bending?
intertransverse ligament
which ligament limits flexion?
interspinous ligament
which ligament prevents hyperflexion and posterior protrusion of IV discs?
posterior longitudinal ligament
why is the ligamentum flavum yellow?
because it is abundant in elastin
which ligament assists in straightening spine after flexing?
ligamentum flavum
secures dens process to occupit, connects dens to tubercles on medial side of occipital condyle, and limits flexion and rotation in the CV complex
alar ligament
most important ligament over C1 and C2; securely fastens dens between C1 and C2
transverse atlantal ligament
ligament between ribs and transverse process
costotransverse ligament
secures dens to occiput
occipitodental ligament
prevent easy breakage of connection to the head
atlanto-occipital ligament
[function] IV discs
shock absorption/ energy dissipation/ cushioning
protrusion of the nucleus pulposus into the annulus fibrosus
herniation/ slipped disc
T/F central herniation is more common than posterolateral herniation
F
4 types of herniation
protrusion - bulging of nucleus pulposus without thinning of annulus fibrosus
prolapse - bulging of nucleus pulposus but with thinning annulus fibrosus
extrusion - ruptures annulus fibrosus but with no detachments escaping into the spinal canal
sequestration - parts of nucleus pulposus escapes into spinal canal; diagnosed with MRI and needs surgery
What is the gross mover of the spine?
erector spinae
what muscles make up the erector spinae?
iliocostalis, logissimus, spinalis
main action of transversocostal group
bilateral action: extends vertebral column and head, back is flexed,
unilateral action: laterally flex vertebral column
what comprises the transversocostal group?
splenius capitis, splenius cervicis, erector spinae
what happens to a patient if the multifidus is injured suring surgery?
back pain to muscle weakness through the years
major posterior stabilizer of the spine
multifidus
fine steering movement of the spine is due to
rotatores + multifidus
the artery of adamkiewicz is found at which vertebral levels?
T10-L2
how many anterior spinal artery are there? posterior?
1;2
what type of lever is the spine along the sagittal plane, coronal plabe and top view?
1st class lever
arrange the following in ascebding order of strength
vertebral body, pedicle, facets, spinous process
spinous process<vertebral body
arrange the following in order of ascending strength:
ALL(anterior longitudinal ligament), LF (ligamentum flavum), PLL(posterior longitudinal ligament), ISL(interspinous ligament), FC(facet capsule)
ISL
how much force/ weight will it take to break the vertebral body?
6000 N/ 612kg
T/F at 816kg (8000 N), the IV disc will still
be intact
T
at what force/ weight will the ligaments get damaged, and disc herniated?
900 kg (9000N)
what composes the functional unit of the vertebral column?
2 vertebrae and the disc in between
most thoracolumbar fractures happen at what region?
L1-T12
inflammation of the spine
spondylitis
defect in pars interarticularis; gives the dog collar
spondylolysis
instability of the degenerating spine
spondylosis
disengagement of the superior vertebra from the inferior
spondylolisthesis
T/F all spondylolysis eventually lead to spondylolisthesis
F
T/F all spondylolisthesis has an aspect of spondylolysis
T
damage to the back of the spinal cord causing loss in proprioception and difficulty in coordinating limb movements
posterior cord syndrome
damage on one side of the spinal cord causing loss of motor function on the ipsilateral side; pain and temp sensation may still be preserved
Brown-Sequard syndrome
[define] anterior cord syndrome
damage towards the front of the spinal cord; loss of motor function and pain, temp, touch sensation
among the incomplete spinal cord injuries, which has the worst prognosis? the best?
anterior spine injury; Brown-Dequard Syndrome
bone grafts to replace IV discs are obtained from
the iliac crest
what is the hallmark of osteoporosis?
vertebral compression fracture
vitamin lacking in those who get osteoporosis
vit D
at what angles should a scoliotic spine be for it to require surgical intervention?
> 40; if <=40, surgery is unnecessary
how do you test for scoliosis?
clasp hands as if praying then bend over; ribs will protrude out
the transversocostal group is innervated by
posterior rami of spinal nerves
[action] splenius capitis and cervicis
acting alone: laterally flex neck and rotate head to side of active muscles
acting together: extend head and neck
[action] semispinalis
extends head and thoracic and cervical regions of vertebral column, and rotates them contralaterally
[action] rotatores
stabilizes vertebra and assist with local extension and rotatory movements
