B6-065 Back and Spine Anatomy Flashcards
(161 cards)
1
Q
how many cervical vertebrae are there?
A
7
2
Q
how many thoracic vertebrae are there?
A
12
3
Q
how many lumbar vertebrae are there?
A
5
4
Q
primary curvatures that develop in utero [2]
A
thoracic kyphosis
sacral kyphosis
5
Q
what secondary curvature forms when an infant starts to raise their head?
A
cervical lordosis
6
Q
what secondary curvature forms when a child begins to walk?
A
lumbar lordosis
7
Q
excessive curvature of the thoracic vertebrae
largely due to osteoporosis
A
kyphosis
8
Q
excessive curvature of the lumbar vertebrae
seen in pregnancy or obesity
A
lordosis
9
Q
curvature of the spinous processes on the forward bending test
A
scoliosis
10
Q
what forms the zygapophyseal facet joints?
A
the superior and inferior articular processes
11
Q
spinal nerves emerge from the
A
intervertebral foramen
12
Q
what keeps the dens in close approximation to C1?
A
transverse ligament of atlas
13
Q
where does the skull articulate with C1?
A
the superior articular surface
14
Q
what vascular structure passes through the foramen transversarium (formed by the transverse processes of C6-C1)?
A
vertebral artery
15
Q
the vertebral artery lies in the groove of […] before entering the foramen magnum
A
C1
16
Q
what neurologic structure lies in the vertebral foramen?
A
spinal cord
17
Q
helps C2 articulate with the axis
A
dens
18
Q
when someone does a chokehold and the person passes out, what structure is being compressed and where?
A
carotid artery at the carotid tubercle of C6
19
Q
what structure of the thoracic vertebrae allows the ribs to articulate with the spine?
A
costal facet
20
Q
which vertebrae have long spinous processes?
A
thoracic
21
Q
which vertebrae have long transverse processess?
A
lumbar
22
Q
what structure would have been the spinous processes of the bones of the sacrum before they fused?
A
median crest
23
Q
what structures of the sacrum are able to be palpated for insertion of a needed during epidural injection? [2]
A
sacral cornua
sacral hiatus
24
Q
ribs 2-9 articulate with […] vertebrae
A
2
the superior costal facet of one, and the inferior costal facet of another
25
the superior and inferior vertebral notch forms the
intervertebral foramen
**spinal nerves exit here
26
fracture of C1 caused by something landing on top of the head
Jefferson (burst) fracture
27
a dive into a shallow pool may cause a fracture of [...]
C1, Jefferson (burst) fracture
28
what structures are fractured in a Jefferson fracture?
anterior and posterior arches of C1
29
common fracture in younger patients as result of high speed, high energy injury
ex. car wreck, ATV
dens fracture C2
30
common cervical fracture in older patients as a result of falls, osteopenia, and osteoporosis
dens fracture of C2
31
what structures of C2 are affected by a Hangman's fracture?
**pars interarticularis** between the superior articular facet and the inferior articular process
32
fracture resulting from hyperextension of the head on the neck
Hangman's fracture (spondylolysis) of C2
33
degeneration of the joints, disk, and bones in the spine
spondylosis
34
stress fracture through the par interarticularis of the vertebrae
spondylolysis
**she's says this looks like a Scottie dog with a broken neck on Xray, not sure about that 😒
35
forward displacement of a vertebra on the one below it
spondylolisthesis
**often occurs with spondylolysis
36
usually the most prominent palpable vertebrae of the spine
C7
**T1 would be right below
37
T3 is in line with
spine of scapula
38
spinous process of T7/body of T8 is in line with the
inferior angle of the scapula
39
if you place your hands on the sides of the ribs and extend thumbs directly back, what vertebrae will this line up with?
L3 subcostal plane
40
if you place your hands at the top of the iliac crest and extend thumb back, what vertebrae will this line up with?
L4 supracristal plane
**important to lumbar punture**
41
ligament that limits extension of the spine
anterior longitudinal ligament
42
ligaments that limits flexion of the spine [4]
posterior longitudinal ligament
supraspinous ligament
interspinous ligament
ligamentum flavum
43
the nuchal ligament is an extension of
supraspinous ligament
44
ligament that joins the tips of the spinous processes
supraspinous ligament
45
the zygapophyseal facet joints of the cervical spine are sloped from anterior to posterior to help with
flexion/extension
46
the zygapophyseal facet joints of the thoracic spine are oriented vertically
limit flexion/extension
facilitate rotation
47
the zygapophyseal facet joints of the lumbar spine are oriented sagitally to
limit rotation and lateral bending
facilitate flexion/extension
48
usually the site of bone spur formation due to aging from C3-C7
uncovertebral joints/clefts of Luschka
49
joint at the articulation of the superior articular face of atlas (c1) and the occipital condyles
atlanto-occipital joint
50
joint of the neck that allows you to say "yes"
atlanto-occipital
51
joint that allows your head to say "no"
altanto-axial
52
trapezius is innervated by
CN 11 -spinal accessory
53
levator scapulae and the rhomboids are innervated by
dorsal scapular
54
the intrinsic (true) muscles of the back are all innervated by
posterior (dorsal) rami of spinal nerves
55
what muscles can act unilaterally to laterally flex the neck and bilaterally to extend the head and neck?
spenius capitis
splenius cervicis
56
erector spinae muscle that attaches distally to the lower ribs and transverse processes
iliocostalis
57
what intrinsic muscle of the back aids in rotational movements of the vertebral column?
rotatores (of the transversospinalis group)
58
muscles that act in extension of the back [3]
erector spinae
multifidis (TS)
semispinalis thoracis (TS)
59
muscles that act in lateral bending of the back [3 of importance to this lecture]
iliocostalis thoracis and lumborum (ES)
logissimus thoracis (ES)
multifidus (TS)
60
muscles that act in rotation of the back [4 of importance to this lecture]
**rotatores** (TS)
multifidus (TS)
iliocostalis (ES)
longissimus (ES)
61
posterior (dorsal) roots are purely [...]
sensory
62
anterior (ventral) roots are purely [...]
motor
63
what level does the spinal cord end?
L1/L2
rest is cauda equina
64
what areas of the spinal cord are enlarged? [2]
cervical
lumbrosacral
**thicker because more axons exiting to limbs
65
layers of meninges (including spaces) from most external to most internal
epidural space
dura mater
sub dural space (potential space)
arachnoid mater
subarachnoid space
pia mater
66
the internal vertebral venous plexus lies in the
epidural space
67
lateral extensions of pia mater that prevent side to side movement of the spinal cord
denticulate ligament
68
separates the posterior roots from the anterior roots
denticulate ligament
69
filum terminale internum is an extension of [...]
filum terminale externum is an extension of [...]
pia
pia and dura
**help to anchor the spinal cord in place
70
comes from a variety of arteries to help supply the inferior regions of the spinal cord
great segmental medullary artery
71
comes off a posterior intercostal or upper lumbar artery to reinforce the anterior longitudinal artery in supplying inferior 2/3 of the spinal cord
great anterior segmental artery (artery of Adeamkiewicz)
72
what happens if the great anterior segmental artery (artery of Adeamkiewicz) becomes damaged?
cord below will die
**helps the anterior longitudinal artery in supplying inferior 2/3 of the cord
73
arteries that supply the dorsal and ventral roots of the spinal nerves
radicular arteries
74
if cancer metastasizes to the [...] it can spread widely throughout the body
internal vertebral (epidural) plexus
(venous plexus)
75
prime movement of the atlantoaxial joint
rotation
76
prime movement of the atlanto-occipital joint
flexion and extension
77
what space do the veins and arteries that supply the spinal cord lie in?
subarachnoid
78
the subarachnoid space contains [2]
CSF
veins/arteries that supply spinal cord
79
the epidural space contains [2]
fat
internal vertebral venous plexus
80
space between the vertebral arch and the dura
epidural space
81
space between the dura and the arachnoid mater is the
subdural space
82
abnormally increased thoracic curvature, usually resulting from osteoporosis
kyphosis
83
abnormal accentuation of the lumbar curvature usually due to pregnancy or obesity
lordosis
84
abnormal lateral and rotational curvature of the spine that may present with uneven hips, shoulders, and rib cage
scoliosis
85
exit through the intervertebral foramen
spinal nerves
86
located in the vertebral foramen
spinal cord
87
located in the transverse foramen of C1-C6
vertebral artery
88
anatomical landmark to find L4
supracristal plane
89
anatomical landmark used to find L3
subcostal plane
90
anatomical landmark used to find C7
vertebra prominens
91
anatomical landmark used to find T3
spine of scapula
92
anatomical landmark used to find T7/T8
inferior angle of scapula
93
caudal anesthesia is administered into which opening?
sacral hiatus
94
prime extensors of the back
erector spinae
95
extends, adducts, and medially rotates the humerus
latissimus dorsi
96
extend the neck and head bilaterally
flexes neck and rotates head to ipsilateral side unilaterally
splenius
97
transversospinalis [...] the back
extends
98
rotatores [...] the back
rotates
99
elevate, depress, and retract scapula
elevate shoulders
extend head
trapezius
100
as a needle moves into the spine during a lumbar puncture, what ligaments does it come into contact with [3]
(superficial to deep)
supraspinous
interspinous
ligamentum flavum
101
ligament located anterior to the bodies of the vertebrae
anterior longitudinal
102
ligament located between the spinal cord and vertebral body
posterior longitudinal ligament
103
anastomoses with the anterior and posterior spinal arteries to supply the inferior 2/3 of the spinal cord
great anterior segmental artery (artery of Adeamkiewicz)
104
the radicular arteries supply the
dorsal and ventral roots of the spinal cord
105
herniated disk and spinal stenosis are examples of [...] back pain
mechanical
106
ankylosing or psoriatic spondylitis are examples of [...] back pain
nonmechanical
107
pancreatitis and cholecystitis are examples of [...] causing back pain
visceral disease
108
what anatomical landmarks are used during a lumbar puncture
supracristal plane (L4)
109
between what vertebral levels is the needle inserted during a lumbar puncture?
L4/5
spinal cord ends about L2, so this is safest
110
where does the spinal cord end in an infant?
L3ish
cord begins same length as spine and shortens with development. Is at L3 by birth
111
space between the ligamentum flavum and dura mater
epidural space
112
why is a lumbar puncture contraindicated when there is potential for increased ICP?
sudden shift in pressure can cause brain herniation
113
if you hit [...] during a lumbar puncture, you've gone too far
posterior longitudinal ligament
114
a herniated disk will always compress the [...] root
lower
**herniation between C5 and C6 compresses C6 nerve root
115
what ligament is likely to be damaged in hyperextension of the spine?
anterior longitudinal ligament
116
what ligaments are likely to be damaged by hyperflexion of the spine? [4]
nucchal ligament
supraspinous
interspinous
posterior longitudinal ligament
117
how will damage to the C6 nerve root affect
motor:
reflex:
sensory:
motor: biceps weakness
reflex: loss/weak biceps reflex
sensory: thumb
118
how will damage to the C7 nerve root affect
motor:
reflex:
sensory:
motor: triceps weakness
reflex: weak/absent triceps reflex
sensory: index and middle finger
119
how will damage to the C8 nerve root affect
motor:
reflex:
sensory:
motor: weakness of interossei
reflex:
sensory: ring finger and pinky
120
what is herniating out in disk herniation?
nucleus pulposis
121
which direction does a herniated disk protrude?
posterolateral
**posterior longitudinal ligament is in midline
122
paresthesia over SI joint, hip, lateral thigh front of calf and big toe
weak dorsiflexion
difficulty walking on heels
lesion in [...] nerve root
L5
123
paresthesia over SI, hip, posterolateral thigh, back of calf, and lateral heel to toe
weak plantar flexion
difficulty walking on toes
diminished ankle jerk reflex
indicates lesion in [...] nerve root
S1
124
sensory loss in perianal region
urinary/fecal incontinence
sexual dysfunction
indicates lesion in [...] nerve roots
S2/S3
125
caused by intraspinal lesion caudal to the conus
cauda equina syndrome
126
saddle sensory defect of perineal regions, buttocks, and posterior thigh
cauda equina syndrome
127
bladder dysfunction
bowel dysfunction
saddle sensory defect
bilateral sciatica
cauda equina syndrome
128
what arteries supply the spinal cord?
anterior spinal artery
2 posterior spinal arteries
129
reinforces blood flow to the lumbar and sacral regions of the cord ensuring adequate blood flow
great anterior segment medullary artery
**injury do this causes necrosis of the cord below, leading to bladder/bowel/sexual dysfunction
130
history of intraspinal surgery
abnormal post-void residual
bilateral sensory deficits in clear dermatomal distribution
cauda equina syndrome
131
a back sprain is defined as an injury to a [....] of the back
ligament
132
a back strain is defined as an injury to a [...] of the back
muscle
133
central mucoid substance of a disk
nucleus pulposis
134
surrounding fibrous tissue and fibrocartilage of the disk
annulus fibrosis
135
in a herniated disk, the [...] herniates through the [...]
nucleus pulposis herniate through the annulus fibrosis
136
defect in pars interarticularis
spondylolysis
137
stiffening of the spine due to any lesion of the spine of a degenerative nature
spondylosis
138
decreased sensation of the posterior leg and lateral foot
diminished ankle jerk reflex
weak plantar flexion, toe flexion, and eversion
S1 radiculopathy
139
weakness of dorsiflexion
L5 radiculopathy
140
structures that can cause spinal stenosis [3]
hypertrophy of ligamentum flavum
facet osteophytes
disc herniation
141
bilaterally decreased sensation and back pain/leg pain that improves with rest may indicate
spinal stenosis
142
mechanical back pain does not cause [...] deficits
neurological
143
the lumbar curvature forms when
a child begins to walk
144
the cervical curvature forms when
a child begins to hold their head up
145
what space is CSF found in?
subarachnoid
146
space between the arachnoid layer and the pia mater
subarachnoid space
147
the internal vertebral venous plexus and epidural fat is located in the [...] space
epidural
148
space between the dura and bone of the vertebral foramen
epidural space
149
space between the arachnoid and the dura
subdural space
150
during proper administration of an epidural anesthetic, the needle will pass though: (ligaments only)
supraspinous ligament
interspinous ligament
ligamentum flavum
151
ligament overlying the spinous processes of the lumbar vertebrae
supraspinous
152
ligament connecting the spinous processes of adjacent vertebrae
interspinous
153
ligament that stretches between the laminae of adjacent vertebrae
ligamentum flavum
154
ligament that attaches along the anterior sides of the vertebral bodies
anterior longitudinal
155
ligament that runs vertically along the posterior aspect of the spinal column
posterior longitudinal
156
lateral extension of the pia mater
denticulate ligament
157
inferior extension of the pia mater from the tip of the conus medullaris
filum terminale internum
158
extends from the tip of the dural sac to the coccyx
filum terminale exturnum (coccygeal ligament)
159
prevents hyperflexion of the vertebral column
ligamentum flavum
160
responsible for rotation of the spinal column
rotatores (transversospinalis)
161
a disk herniation always affects which nerve root?
the lower
