Week 1-2 Lumbar, cervical, thoracic spine Flashcards
functions of vertebrae column
- protect spinal cord and spinal nerves
- role in locomotion and posture
- supports weight of the body above the pelvis
- forces of gravity dissipated 消散 by the S shape
how many vertebrae in total
total 33
cervical - 7
thoracic - 12
lumbar - 5
sacrum - 5
coccyx - 4
shape of lumbar lordosis and sacral kyphosis
lumbar loadosis: concave posteriorly – secondary curvature
sacral kyphosis: concave anteriorly – primary cuvature
primary vs secondary curvatures
primary curvatures:
- develop during foetal period
- concave anteriorly
- occur in thoracic and scaral regions
secondary curvatures:
- appear during foetal period - become obvious in infancy
- differences in thickness between ant/ posterior parts of intervertebral discs
what is the function of pedicles
contributing to part of the vertebral arch
What part of a typical vertebrae that ossifies from a pressure epiphysis?
vertebral body
body and foreman of lumbar vertebra
kidney shaped and triangular
body and foreman of cervical vertebra
wide from side to side; rounded triangle and relatively large
body and foreman of thoracic vertebra
heart shaped; circular and smaller
lumbosacral spine features - intervertebral joints (between vertebral bodies) (classification and function)
secondary cartilaginous joint (symphyses)
function: limit ROM of spine, withstand pressure between vertebral bodies
intervertebral disc includes
annular fibrosis - resist movement in different direction
nucleus pulposus - resist axial compression forces
cartilages and plates (hyaline)
arrangement of blood supply of intervertebral joint
no nerve and blood supply
can change shape but not volume
function of intervertebral disc
shock absorption
zygapophysial/ facet joint classification and function
- between vertebral arches
- synovial plane joint
- gliding movement between articular processes
zygopophyseal joints of the cervical, thoracic and lumbar spine
cervical:
- aligned in the coronal plane (but oriented obliquely ~45 degrees plane inclined anteriorly)
thoracic:
- have an orientation that favours rotation
- aligned in the coronal plane
lumbar:
- typically aligned in a sagittal plane (~90 degrees to the sagittal plane)
deep layer of muscles
long group (erector spinae):
* iliocostalis
* longissimus
* spinalis
oblique group (transversospinalis):
* multifidus
* rotatores
* semispinalis
short group:
* intertransversales
* interspinales
* levatores costarum
innervation: dorsal primary rami
Describe the components of a typical spinal nerve:
anterior (ventral) root - efferent, motor fibers
posterior (dorsal) root - afferent, sensory fibers
dorsal root ganglion
vental primary rami
dorsal primary rami
which structure containing the cell bodies of sensory neurons
dorsal root ganglion
Describe in the lumbosacral spine, the gross structure of the spinal cord and its related structures:
- motor and sensory nerve roots
- dorsal root ganglia
- meninges: dura, arachnoid, pia mater
- space: epidural (extradural), dura-arachnoid interface (subdural), subarachnoid (contains CSF)
termination of cord (L1/2)conus medullaris- cauda equina (horse tail)
- dural sac of S2
- lumbosacral enlargement
- filum terminate —> continuation of pia mater
- extradural fat and venous plexuses
dermatome
an area of skin supplied by a single spinal segment
myotome
an area of muscle supplied by a single spinal segment
L2, 3, 4, 5 S1 - myotome
L2 - hip flexion
L3 - knee extension
L4 - ankle dorsiflexion
L5 - toe extension
S1- ankle plantarflexion and toe flexion
C1-2, 3, 4, 5, 6, 7, 8, T1, T7-12- myotome
C1 - neck flexion
C2 - neck extension
C3 - neck lateral flexion
C4 - scapula retraction & elevation
C5 - shoulder abduction
C6 - elbow flexion, wrist extension
C7 - elbow extension, wrist flexion
C8 - fingers flexion
T1 - fingers abduction
T7-12 - move, stabilise trunk
Sensory supply to the vertebral column and to the components of the vertebral canal in the lumbosacral spine:
dorsal (posterior) rami of spinal nerves
radicular nerves (recurrent meningeal)
Arterial supply (and their sources) to the vertebral column and to the spinal cord in the lumbosacral spine:
anterior (1) and posterior (2) spinal arteries
abdominal aorta (lumbar arteries)
Venous drainage of the vertebral column and the vertebral canal in the lumbosacral spine:
spinal veins (3 anterior/ 3 posterior)
external/ internal vertebral venous plexus
anterior wall of vertebral canal in the lumbosacral region
PLL
intervertebral disc
vertebral bodies
posterior wall of vertebral canal in the lumbosacral region
laminae
ligamentum flava
base of spinous process
lateral wall of vertebral canal in the lumbosacral region
pedicle
intervertebral foramine
contents of vertebral canal in the lumbosacral region
dural sac
epidural space
intervertebral foreman in the lumbosacral region formed by
- inferior
vertebral notchof upper Lx vertebra - superior vertebral notch of lower Lx vertebra
contents of intervertebral foramen in the lumbosacral region
anterior/ posterior spinal nerve roots
mixed spinal nerves
dorsal root ganglion
arteries, veins, lymphatics
extradural fat
typical cervical vertebra - superior articular processes and facets
directed superoposteriorly
typical cervical vertebra - inferior articular processes and facets
directed inferoanteriorly
C1 (atlas)
- no body or spinous process
- allow ‘yes’ motion of the head
C2 (axis)
- have dens
- allow ‘no’ motion of the head
- bifid spinous process
which vertebral is known as the vertebra prominens 椎骨突出
C7
spinous process of typical thoracic vertebra
long and slope posteroinferiorly
atypical T1 vertebrae
- complete costal facet superiorly
- demi facets inferiorly
- spinous process is long and almost horizontal
atypical T12 vertebrae
- transitional vertebrae
- largest body of all thoracic spine
- transverse process have no costal facets
- superior facet in the same plane (coronal) as thoracic spine
- inferior facet in the same plane (sagittal) as lumbar spine
AO atlanto occipital joint
2 synovial condyloid (ellipsoid) joint
no intervertebral disc
AA atlanto axial joint
3 synovial joints:
2 plane joint (laterally), 1 pivot joint (centrally)
no intervertebral disc
joints of cervical spine
- AO joint
- AA joint
- intervertebral joint
- facet joint
costovertebral joint vs costotransverse joint
costovertebral joint:
between head of rib and vertebral body
costotransverse joint:
between neck of rib and transverse process
cervicothoracic spine features
- anterior longitudinal ligament
- posterior longitudinal ligament
- alar ligament (prevent excessive head rotation)
- lgamentum flavum
- nuchal ligament
- cruciate ligament (transverse ligament of atlas, superior and inferior longitudinal bands)
- supraspinous, interspinous and intertransverse ligaments (resist seperation of the spinous processes during flexion)
muscles of the region of the back—serving the upper limb and rib cage:
- superficial (extrinsic) layer:
1st layer:
* trapezius
* latissimus dorsi
2nd layer:
* levator scapulae
* rhomboid major
* rhomboid minor
- intermediate (extrinsic) layer:
serratus posterior superior
& secondary curvatures
serratus posterior inferior
Gross structure of the spinal cord and its related structures in the cervicothoracic spine:
- motor and sensory nerve roots
- dorsal (posterior) root ganglia
- meninges and related spaces
- extradural fat
- cervical enlargement
Sensory supply to the vertebral column and to the components of the vertebral canal in the cervicothoracic spine:
dorsal rami of spinal nerves
radicular nerves
Arterial supply to the vertebral column and to the components of the vertebral canal in the cervicothoracic spine:
anterior (1) and posterior (2) spinal arteries
posterior intercostals (thoracic aorta)
Venous drainage to the vertebral column and to the components of the vertebral canal in the cervicothoracic spine:
spinal veins (3 anterior/ 3 posterior)
external/ internal vertebrae venous plexus
