Vertebral Column & Back

Question 1

What are the curvatures of the vertebral columns and where are they?

Answer 1

primary (present in fetus) is kyphotic (convex), thoracic & sacral

secondary (develops when upright) is lordotic (concave), cervical & lumbar

Question 2

What is kyphosis? Causes?

Answer 2

increase in convex thoracic curvature
collapsing osteoporotic bodies (geriatric)

Question 3

What is lordosis? Causes?

Answer 3

increase in concave lumbar curvature
poor posture/ imbalance of hip muscles, pregnancy/obesity, genetic

Question 4

What is scoliosis? Cause?

Answer 4

abnormal coronal plane curvature
difference in limb length/rapid growth/vertebral rotation
DOES NOT CAUSE BACK PAIN

Question 5

What are the components of a typical vertebrae?

Answer 5

processes - spinous/transverse, bony projection for muscle attachments
facet - superior/inferior, bone to bone articulation on either side of midline, restriction of movement
body - support of body weight separated by intervertebral discs
arch - pedical & lamina, spinal cord protection

Question 6

What are the notable features of C1? Movement?

Answer 6

Altas - no body, no spinous process, wide transverse processes, facet for C2 dens, holds skull
slight nod “yes”

Question 7

What are the notable features of C2? Movement?

Answer 7

Axis - dens (odontoid process), small spinous process
slight side to side “no”

Question 8

Notable features of C3-C7

Answer 8

oval shaped vertebral body
45 degree facet angulation
bifid spinous processes
transverse foramen

Question 9

Thoracic notable differences

Answer 9

heart shaped vertebral bodies
frontal plane facets
costal demi-facets
angulated spinous processes
smaller vertebral canal

Question 10

Lumbar notable differences

Answer 10

largest & thickest vertebral bodies
crescent shaped body
sagittal plane facets

Question 11

Describe the articulation of vertebrae with adjacent vertebrae in each region

Answer 11

cervical: 45 degree frontal-transverse
thoracic: frontal plane
lumbar: sagittal plane

Question 12

Describe ROM in each vertebral region

Answer 12

cervical: largest & significant ant/post flex/exten and rotation/lateral flex/exten
thoracic: limited ROM (ant/post flex/exten and rotation/lateral flex/exten)
lumbar: significant ant/post flex/exten, limited rotation/lateral flex/exten

Question 13

Describe the components of intervertebral discs

Answer 13

nucleus pulposus (semisolid hydrogel) inside
anulus fibrosis (fibrocartilage concentric layers) outer ring

present from C2/C3 to L5/S1
anterior/posterior thickness varies to accommodate spinal curves

Question 14

What are the classifications of disc herniation from mild to severe?

Answer 14

protrusion, prolapse, extrusion, sequestration

Question 15

What are the five spinal ligaments and where are they?

Answer 15

anterior longitudinal ligament: anterior to vertebral body
posterior longitudinal ligament: posterior to vertebral body, anterior to vertebral canal
ligamentum flavum: lamina to lamina, posterior to vertebral canal
interspinous ligament: spinous process to spinous process
supraspinous ligament: tip of spinous process to tip of spinous process

Question 16

What is the innervation & function of the trapezius?

Answer 16

CN XI, spinal accessory
elevation, depression, & retraction of scapula; superior rotation of glenoid

Question 17

What is the innervation & function of the rhomboids?

Answer 17

dorsal scapular nerve
retraction of scapula

Question 18

What is the innervation & function of the levator scapulae?

Answer 18

dorsal scapular nerve, C3/C4 nerves
elevation of scapula, inferior glenoid rotation

Question 19

What is the innervation & function of the latissimus dorsi?

Answer 19

thoracodorsal nerve
extension & adduction of humerus

Question 20

What is the common cause of back pain

Answer 20

non-specific (no identifiable pathology on imaging)