Examination Of The Back Flashcards
What are the curve of the spinal column ?
24 vertebra make up the spinal column. There are 3 curves :
- cervical spine : lordosis (inward)
- thoracic spine : kyphosis (outward)
- lumbar : lordosis (inward)
What are the characteristics of the lumbar vertebra ?
Taller and bulkier : because they have to wisthand pressure.
How does the spinal cord end ?
It goes from the brain to L2, where the end is called conus medullaris. There it split into a bundle of nerves (= caudal equina) to innervate the lower limps and pelvic organs. The filum terminale is a fibrous band connecting the conus medularis to the posterior body of the coccyx.
What does a spinal segment includes ?
- 2 vertebra
- 1 intervertebral disc
- 2 nerve root leaving through the neural foramen of this level (at the back of the vertebra)
- 2 facet joint linking the 2 vertebral body
What compose the intervertebral disc ?
Inner part : nucleus pulposus
- spongy and act as a shock absorber
Outer part : annulus fibrosus
- strong ligament rings connecting the 2 vertebra
What are the characteristics of the facets joint ?
At the back of spinal column, it’s a small bony knob sticking out of the vertebral back. It forms a synovial joint and move in sliding motion covered by articulate cartilage.
What are the types of lumbar muscles ?
They are covered by a fascia.
- middle muscle layer : runs over the lower ribs, chest and low back (up-down). They blend into the lumbar spine to form a thick tendon binding the bone of the pelvis, low back and sacrum.
- deep muscle layer : runs along the back surface of the spine. Hold the spine steady during activities
What are the functions of the cervical spine ?
Support the skull.
Allow us to move the head to support vision
Protect the spinal cord.
What is Atlas ?
It is C1 : connect to the bottom of the skull. The 2 thick bony structures form a large hole through the center of the atlas.
It is larger than the normal cervical vertebra because the spinal cord is larger at the exit of the brain.
What is the Axis ?
It is C2. It has a large bony dens on top pointing to the atlas that allow it to have a special connection and give the neck the ability to move left/right.
Of what is composed the ring of the vertebra ?
2 pedicles connecting to the back of the vertebral body
2 lamina joining the pedicles to complete the ring
1 spinous process where the lamina join
2 transverse processes at the pedicle-lamina connection
- in the cervical spine there are 2 transverse foramen passing through the process, giving passage to the arteries supplying the back of the brain
2 facet joint : connecting below and above the vertebra
2 neural foramen : on each side of the spinal cord where nerve root passes
What are the different ligaments of the spinal cord ?
Anterior and posterior longitudinal ligament
Ligamentum flavum : long elastic band connecting on the front surface of the laminar bone
Joint capsule around the facets
What do you inspect on the skin of the spine ?
Ventrally/Lateral : redness and swelling
Dorsal : asymmetrical hair growth, redness, swelling, spots, scars, fibromas
What do you inspect in the lower extremities for the spine?
Abnormal rotation of upper and lower leg resulting in lumbar lordosis.
Valgus/varus knee, elevated patella
Flat foot, splay foot or equinus.
Knee crease height discrepancy
Valgus calcaneus
What do you inspect in the trunk and upper extremities for the spine?
Atrophy
Malalignement and neck torticolis
Elevation of shoulder (scapula), winged scapula
Protraction
Pectus excavatum or carinatum
Asymmetry of the waist triangle between the trunk and arms.
Flattened or exaggerated lordosis (cervical and lumbar spine)
Flattened or exaggerated kyphosis (thoracic spine)
