Anatomy 2

Question 1

what is the ‘back’

Answer 1

posterior aspect of the trunk

Question 2

functions of the back

Answer 2

maintenance of posture

movement of limbs and trunk

Question 3

what is the first palpable spinus process in 70% of people

Answer 3

C7

Question 4

what is the first palpable sipnus process in 30% of people

Answer 4

T1

Question 5

Surface muscles of the back

Answer 5

Trapezius (3 parts, descending, transverse and ascending)

teres major

latissimus doors

Question 6

what are the extrinsic back muscles

Answer 6

back muscles which attach outwit the back - the pectoral girdle

trapezius
elevator scapulae
rhomboids
latissimus doors

Question 7

what nerve usually innervates extrinsic back muscles

Answer 7

anterior rami of cervical nerves

Question 8

what nerve innervates the trapezius

Answer 8

spinal accessory

Question 9

function of the intrinsic back muscles

Answer 9

maintain back posture

move spine

Question 10

what are the 2 groups of intrinsic back muscles

Answer 10

Erector spinal (superficial) 
Transversospinalis (deep)

Question 11

what is the erector spinaemuscle

Answer 11

group of 3 muscles that run laterally to the spine - attach to the sacrum and lower spinous processes

Question 12

attachment of erector spinae

Answer 12

either:
a rib
a transverse process of vertebrae
a spinous process of vertebrae

Question 13

what muscle commonly causes low back pain

Answer 13

erector spinae strain

Question 14

what is the transversospinalis muscle

Answer 14

back muscle located between transverse and spinous processes

Question 15

where do individual muscle fibres of the transversospinalis attach

Answer 15

a vertebra and the skull
a vertebra and a rib
on vertebrae and another
the sacrum and vertebra

Question 16

what nerves supply the intrinsic back muscles

Answer 16

segmental nerve supply as per the dermatome/myotome pattern

posterior rami branches of:

• cervical
• thoracic
• lumbar

Question 17

what is a less common cause of low back pain

Answer 17

referred visceral pain

• AAA
• Kidneys
• bowel
• pelvic disease

Question 18

which back muscles maintain posture

Answer 18

erector spinal and transversospinalis

Question 19

how is the spine extended

Answer 19

bilateral contraction of erector spinae

Question 20

what causes lateral flection of the spine

Answer 20

unilateral flexion of the erector spinae

Question 21

why do vertebrae get bigger as u go down the spinal column

Answer 21

because they’re holding more weight

they then get smaller when weight is transferred to lower limbs

Question 22

functions of the vertebral column

Answer 22

support head and trunk when upright

protect the spinal cord (and nerves)

allow movement of head on neck and trunk movements

Question 23

what are the curvatures of the vertebral column

Answer 23

Cervical lordosis (secondary curve formed) 
Thoracic kyphosis (primary- same as found in fetus)
Lumbar lordosis (secondary) 
Sacral kyphosis (primary)

Question 24

what are the features of a typical vertebrae

Answer 24

Vertebral body 
2 pedicles 
2 lamina 
vertebral arch 
2 transverse prowesses 
1 spinous process 
2 inferior articular processes 
2 superior arcticular processes (facet joints to other vertebrae)

Question 25

what forms the intervertebral foramen

Answer 25

form between adjacent vertebrae spinal nerves go through here

Question 26

what is a facet joint

Answer 26

where inferior articular process attaches to the superior articular process of another vertebrae

Question 27

what are the intervertebral discs

Answer 27

between bodies of adjacent vertebrae strong attachment can herniate

Question 28

where are the intervertebral discs

Answer 28

in between the vertebrae

Question 29

what makes up the intervertebral disc

Answer 29

annulus fibrosis - outer strong bond | nucleus pulposus - inner soft pulp

Question 30

what allows movement between vertebrae

Answer 30

intervertebral discs - each small disc moves a tiny bit but it is summative

Question 31

what are the spinal ligaments

Answer 31

``` Ligamentum flavum Posterior longitudinal ligament Anterior longitudinal ligament Supraspinous ligament Interspinous ligament ```

Question 32

describe the ligament flavum

Answer 32

short ligament | connects adjacent laminae posterior to spinal cord

Question 33

describe posterior longitudinal ligament

Answer 33

narrow, weak ligament less support for disc prevents over flexion of spine

Question 34

describe anterior longitudinal ligament

Answer 34

broad, strong strong support for discs prevents over extension

Question 35

describe supraspinus ligament

Answer 35

connects tips of spinous processes | strong, fibrous

Question 36

describe intersponus ligaments

Answer 36

connects superior and inferior surfaces of adjacent spinous processes weak, membranous

Question 37

What are typical features of cervical vertebrae

Answer 37

transverse foramen bifid spinous process triangular shaped vertebral foramen

Question 38

describe C1

Answer 38

Atlas no body of spinous process head posterior arch and anterior arch instead

Question 39

describe C2

Answer 39

Axis had ODONTOID process projects superiorly from body

Question 40

describe C7

Answer 40

vertebrae prominent | first palpable process in 70% of people

Question 41

what vertebrae have the most space around the spinal cord

Answer 41

cervical vertebrae

Question 42

what is the Atlanta-occipital joint

Answer 42

joint between the occipital condyles of the skull and the facet joints of the atlas

Question 43

what movements does the Atlanta-occipital joint do

Answer 43

flexion and extension of neck | little lateral flexion and rotation

Question 44

how many articulations does the Atlanta-axial joints have

Answer 44

3 - all synovial 2 between inferior articular facets of atlas and superior articular facets of axis 1 between anterior arch of atlas and odontoid process of axis

Question 45

why can the spinal cord sometimes escape in a slight cervical dislocation

Answer 45

because the intervertebral space is wider and there is more room for the cord

Question 46

what are the stages of cervical dislocation

Answer 46

1- flexion sprain 2- anterior subluxation - 25% translation 3- 50% translation 4- complete dislocation

Question 47

what is in the sacrum instead of vertebral foramen

Answer 47

sacral canal - flows into sacral hiatus

Question 48

where do spinal nerves exit the sacrum

Answer 48

anterior and posterior sacral foraminae

Question 49

where does the spinal cord start and end

Answer 49

start - foramen magnum ends - vertebral level L1/L2

Question 50

what is in the vertebral column after L1/L2

Answer 50

the cauda equine - all spinal nerve roots from L2-Co that have to descend through the column to get to where they need to go

Question 51

what surrounds the spinal cord

Answer 51

3 meninges dura arachnoid pia

Question 52

what is between the dura mater and the bone

Answer 52

epidural fat with venous plexus in it

Question 53

what happens in the venous plexus is disrupted in spinal anaesthetics

Answer 53

venous haematoma which can compress of spinal cord

Question 54

where should spinal and epidural anaesthetics be inserted

Answer 54

L3/L4 intervertebral space

Question 55

what does the needle go through in epidural

Answer 55

supraspinous ligament interspinous ligament ligamanetum flavum then into epidural space

Question 56

what does the needle go through in lumbar puncture

Answer 56

keep going past the epidural space into the dura and the arachnoid mater

Question 57

what is laminectomy

Answer 57

removal of the lamina of the vertebrae