Unit 1_Vertebral Column & Back Flashcards
What is the study of the bones?
Osteology
Viewing the body from the back
Posterior/Dorsal
Viewing the body from the front
Anterior/Ventral
Viewing the body from the side
Lateral/Saggital
What is another name for the vertebral column?
Spinal Column
What is another name for the spinal column?
Vertebral Column
An intervertebral disc is included between all vertebrae but which ones?
C1 (Atlas) and C2 (Axis)
A straight up and down vertebral column from the anterior view is know as what kind of column?
Normal spinal column
How many vertebrae do humans have in the vertebral column?
33
What regions is the vertebral column broken down into?
Cervical Spine, Thoracic Spine, Lumbar Spine, Sacrum, Coccyx
How many vertebrae are included in the cervical spine?
7
How many vertebrae are included in the thoracic spine?
12
How many vertebrae are included in the lumbar spine?
5
How many vertebrae are included in the sacrum?
Typically 5, sometimes 4
How many vertebrae are included in the coccyx?
Typically 4
What area of the body is the cervical spine located?
The neck
What area of the body is the thoracic spine located?
The ribs
What area of the body is the lumbar spine located?
Lower back
What area of the body is the sacrum located?
Gluteal folds region
What are of the body is the coccyx located?
Tailbone
Describe the sacrum and coccyx.
Fused bones - two solid bones and joined by ligaments
What is another name for C1?
Atlas
What is another name for C2?
Axis
What bone does C1 articulate with?
The base of the skull - occiput (C0)
What does the occiput articulate with?
C0 (skull) on C1 (Atlas/cervical vertebrae) to allow for movement
As you descend down the vertebral column, how does the size change of the vertebrae?
They get larger as you descend down
What is another plane/reference for the lateral view of the body?
Sagittal view
The normal inward curve of the cervical vertebrae
Cervical Lorodosis
The normal posterior curve of the thoracic vertebrae
Thoracic Kyphosis
The normal inward curve of the lumbar vertebrae
Lumbar Lorodosis
The normal posterior curve of the sacrum
Sacral Kyphosis
What is the large bone included on the anterior portion of an individual vertebrae?
Vertebral Body
What is included between each vertebral body and allows for motion?
Intervertebral Discs
What is a hole that is created by two vertebrae and articulating in a certain way posteriorly?
Vertebral Foramen
What is housed in the vertebral foramen?
The spinal cord
How can people get arthritis in their back?
The vertebral foramen fills with extra bone causing it to become narrow and impacting the spinal nerves
Vertebrae include spinous processes on the posterior side, except for which vertebrae?
C1
What are the ridges in the middle of the sacrum made of?
Remnants of spinous processes
What’s another name for moving superiorly?
Cranially
What are the two handlebar like structures included on the right/left of a vertebrae?
Transverse processes
What function do lumbar vertebrae serve?
Weight bearing
What function do cervical vertebrae serve?
Motion
What kind of curve are we born with?
Primary curve
What kind of curve is a primary curve?
Kyphosis
What kind of curve is formed in a baby when muscles are pulling on the spine on the vertebral column (bone) as the baby tries to hold their head up?
Cervical Lorodosis
What kind of curve is formed in a baby when the baby is walking?
Lumbar Lorodosis
What are primary curves?
Thoracic and Sacral Kyphosis
What are secondary curves?
Cervical and Lumbar Lorodosis
What typical things does a vertebrae have?
A body, transverse processes, neural arch (everything behind the body), spinous process, ring of bone that encases the spinal cord
What vertebrae are typical?
C3-L5
What artery runs through some foramen in the cervical spine?
Vertebral artery
What is the unusual part of C2?
The Dens “tooth”
What are the “forked” spinous processes of the cervical spine called?
Bifid Spinous Processes
Why does the cervical spine have different/bifid spinous processes?
Lots of muscles are attaching here - muscle pulls down on bone creating new bone - mainly extend and rotate cervical spine
Where does the Dens (C2) sit?
Within the posterior facet of C1
What occurs at C1-C2?
C1 rotates around C2 (Dens)
What do the spinous processes in the thoracic vertebrae look like?
Longer, easy to palpate
What do the bodies in the thoracic vertebrae look like?
Getting larger, comparative to the cervical vertebrae
Where does motion occur in the thoracic vertebrae?
Superior Articular Facet Joint & Inferior Articular Facet Joint
What plane/gliding joint allows for the flexibility/at which motion occurs up and down the vertebral column?
Facet Joints
What kind of joint are facet joints?
Synovial Joints
What is a synovial joint?
A style of plane/gliding joint.
Includes a capsule (like shrink wrap), which can turn fibrous and cause issues, but otherwise allows for movement but creates an enclosure.
Has a capsule lined with synovium, a tissue, that secretes synovial fluid.
Ex. Facet Joints
Why is synovial fluid important?
To keep the motion/mobility happening at our joints
What happens when a synovial joint gets dried out/deteriorated?
Hypomobility - lack of motion
What is included in the vertebral/spinal canal?
Spinal Cord
Where does the spine begin?
Foramen Magnum - inferior aspect of the skull
What is everything posterior to the vertebral body?
Neural Arch
What does the neural arch do?
Ring of bone that houses/protects the spinal cord
What is included in a typical neural arch of the thoracic vertebrae?
Spinous process, lamina (right/left), transverse processes, pedicles
What is the concern if someone has a laminar fracture?
It would create an open window to the spinal cord.
Whatever level of spinal cord was impacted, individual would have distal symptoms to the region (impact on spinal nerves).
What are the differences between the spinous processes in the cervical, thoracic, lumbar vertebrae?
Cervical - small spinal processes
Thoracic - long spinal processes
Lumbar - chunky/stout spinal processes
When people crack their back, what is occurring?
Gas is being release from capsule
Where are the costal facet joints located?
Thoracic vertebrae
Costal “rib”
What costal facet joints are located in the thoracic vertebrae and connect to the ribs?
Superior Costal Facet, Inferior Costal Facet, Transverse Costal Facet
What are the ridges of the sacrum called?
Median sacral ridge
What is the median sacral ridge?
Located down the middle of the sacrum and remnants of spinous process
What is distributed through foramina?
Nerves
Where are the sacral nerves exiting through the foramina headed?
Towards the perineum/pelvic area
What are the “wings” included on the sacrum called?
Ala
What is the coccyx?
Fused bone, vestigial remnant of when we used to sit on our tailbones more
What is the coccyx important for?
Strong ligaments come off of the coccyx that help bind our pelvic floor musculature and control our bladder flow/bowel.
What is the outer fibrous layers of the intervertebral disc called?
Annulus Fibrosis
Stiff/guide motion/allow motion/keep space between two vertebrae/control our height
What is the inner layer of the intervetebral disc called?
Nucleus Polyposis
If the intervertebral disk gets smaller, what will also decrease?
Intervertebral foramen, impacting the spinal nerves
What joint sits at C0-C1?
Atlantooccipital joint
What joint sits at C1-C2?
Atlantoaxial joint
What ligament is located behind the Dens (C2)?
Transverse ligament
“Trampoline ligament”
Why is an upper cervical fracture (i.e., Dens) concerning?
Ring loses stability, impacting the spinal cord
What ligament comes off the Dens to the occiput to support the cervical spine?
Alar ligament
What ligaments support the cervical spine?
Alar ligament
Cruciform ligament (Superior Longitudinal Band, Transverse Ligament of Axis, Inferior Longitudinal Band)
What happens when you have a spinal cord lesion?
Nerves below will be impacted
What occurs when someone experiences a bulging disc?
The intervertebral disc is moving out a little bit/expanded
What occurs when someone experiences a herniated disc?
The annulus rings of the intervertebral disc have ruptured and the nucleus polyposis is extruding out. Material heads toward the spinal cord.
Why does the vertebral column require ligaments?
The vertebral column is very flexible, so strong ligaments are required.
Ligaments also restrain excessive motion.
Where do ligaments run?
Bone to bone
Where do tendons run?
Muscle to bone
What ligaments are included in the vertebral body?
Anterior longitudinal ligament and Posterior longitudinal ligament
Sandwiches the body, intervertebral discs, protection from extrusion, but don’t wraparound the side so there’s a weak spot
What is the anterior longitudinal ligament?
The anterior longitudinal ligament sits on the anterior aspect of the vertebral body and runs distal to proximal/inferior to superior
What is the posterior longitudinal ligament?
The posterior longitudinal ligament sits on the posterior aspect of the vertebral body and runs distal to proximal/inferior to superior
What happens to the anterior longitudinal ligament in the Lumbar spine vs the Cervical spine?
The anterior longitudinal ligament in the lumbar spine is wider and gets smaller in the cervical spine.
When a disc bulges anteriorly it tends to occur in the cervical spine because of this.
What happens to the posterior longitudinal ligament in the Lumbar spine vs the Cervical spine?
The posterior longitudinal ligament in the lumbar spine is very thin and gets bigger in the cervical spine.
The lumbar spine is prone to posterior lateral disc bulges/herniations because of the lack of coverage.
What ligaments support the neural arch?
Supraspinous process (starts at C7, tips of spinous process)
Ligamentum flavum (yellow coloring - runs between the lamina, holds lamina together; may enfold into neural arch - spinal cord)
Interspinous ligament (between the spinous process, restrains hyperflexion)
What is the continuation of the supraspinous ligament into the cervical spine (C7-C1) called?
Ligamentum nuche
Nuchal ligament
What is the ligamentum nuchae?
Located in the cervical spine; expansive sheet where a lot of muscles are going to attach.
What muscles does the ligamentum nuchae attach to?
Splenius Capitis
Levator Scapulae
Rhomboideus Minor
Rhomboideus Major
Trapezius
What ligaments does an epidural injection touch?
Supraspinous ligament, interspinous ligament, ligamentum flavum
What is Scheuerman’s Disease?
A disorder of the thoracic spine, developmental disease, stiffening of the spine, interior is wedged, excessive kyphosis, won’t be able to change spine, but can do strengthening exercises
What is Scoliosis?
3Dimensional vertebral column pathology that occurs in certain regions of the thoracic spine, congenital/hormonal links, females > males.
Flexion, lateral bend, rotation to vertebral column in certain segments.
A surgery for correction/stop progression is Herrington’s (Herrington’s Rod).
Once you’re skeletally mature, progression should stop.
What is insertion?
Muscle inserting onto the movable part
What is the origin?
Muscle inserting onto the fixed part
What is the insertion and origin of the deltoid?
Insertion: Humerus
Origin: Axial skeleton
Insertion is pulled towards the origin
Deltoid creates abduction of the arm
What does the trapezius attach to?
Occiput
Cervical spine
Thoracic spine
Scapula
Insertion and origin can change depending on what motion it’s doing.
How does the trapezius function as a scapular retractor?
When the trapezius contracts, it will pull on the scapula towards the origin/fixed spine.
What is the insertion of the latissimus dorsi?
The humerus
humeral adduction
What is the thoracolumbar fascia?
A binding tissue down to the sacrum for the muscles to attach to the vertebral column.
What is the function of the levator scapulae?
Scapula elevation
Attaches to the superior aspect of the scapula, and heads up to the cervical spine
Can assist with elevation of the shoulder too
Where do the rhomboids minor/major take their origin/insertion?
Origin: vertebral column of the spine
Insertion: medial border of the scapula (C7-T1, rhomboid minor to T5)
What is the major function of the rhomboids minor/major?
Scapular retraction
Squeezing the shoulder blades together
What are the major muscles of the superficial back?
Trapezius, Deltoid, Latissiumus dorsi, Thoracolumbar fascia, Levator scapulae
What are the deep muscles of the back?
Rhomboid minor/major
Serratus posterior superior
Serratus posterior inferior
What is a tiny slip of muscle that attaches in the upper thoracic spine and reaches down to grab onto the ribs? It also serves as an accessory muscle for inhalation.
Serratus posterior superior
Origin: Axial skeleton
Insertion: Rib cage
What is a tiny sliver of muscle that is deep to latissimus dorsi that includes a fascial layer? It attaches to the thoracolumbar ligament, lumbar region along the spinous processes and grabs onto ribs. It also serves as an accessory muscle for exhalation.
Serratus posterior inferior
What muscle group is covered by white filmy layer of fascia, deep to the Serratus posterior inferior muscle and spans from the head down to the iliac crest?
Erector spinae group
What muscles make up the erector spinae group and serve as muscles that erect the spine, maintain posture upright, attach to the cervical vertebrae, thoracic vertebrae, spinous processes, ribs, and transverse processes?
Ilicostalis
Longissimus
Spinalis
“I Love Spinach”
What are two muscles in the neck that attach at the skull?
Semispinalis Capitis
Splenius Capitis
What are two muscles in the neck that attach to the cervical spine?
Semispinalis Colli
Splenius Colli
What is the innervation of the Trapezius?
Spinal accessory nerve (Cranial Nerve XI)
Comes off high of the cervical spine and dives in deep to innervate the Trapezius
What is the innervation of Latissimus dorsi?
Thoracodorsal nerve
Comes off the brachial plexus under the axila
What is the innervation of the Levator Scapulae?
Dorsal Scapular Nerve
Brachial Plexus nerves head between intervertebral foramen to rhomboids affecting the shrugging
What is the innervation of the Rhomboids?
Dorsal Scapular Nerve
Brachial Plexus nerves head between intervertebral foramen to rhomboids affecting scapular retraction
What is the innervation of the Erector Spinae Group?
Dorsal Primary Rami
Head to the back and provide motor and sensory information in deep back muscles
