Back Flashcards
(180 cards)
1
Q
What is the first vertebra?
A
Atlas C1
2
Q
What is the 2nd vertebra?
A
Axis C2
3
Q
How many cervical vertebrae?
A
7
4
Q
What kind of curvature does the cervical portion of the spine has?
A
Concave posteriorly - Cervical lordosis
5
Q
What kind of curvature does the thoracic portion of the spine has?
A
Concave anteriorly - Cervical kyphosis
6
Q
How many thoracic vertebrae?
A
12
7
Q
What kind of curvature does the lumbar portion of the spine has?
A
Concave posteriorly - Cervical lordosis
8
Q
How many lumbar vertebrae does the spine have?
A
5
9
Q
How many sacral vertebrae does the spine have?
A
5 fused
10
Q
How many vertebrae composes the coccygeal region?
A
variable 3-5
11
Q
what is vertebral motion modified by
A
the ligaments and bones that connect them to each other
12
Q
What passes through the intervertebral foramen?
A
Spinal nerve to enter the spinal cord
13
Q
What is another name for vertebral facets?
A
Zygapophyseal joint
14
Q
What kind of vertebrae often has a bifid spinous process?
A
Cervical vertebrae
15
Q
What is the vertebral arch composed of?
A
pedicles + laminae
16
Q
What kind of vertebrae has uncinate processes?
A
cervical
17
Q
What kind of vertebrae have a transverse costal facet?
A
thoracic
18
Q
What part of the spine do stabilizing muscles attach to?
A
Lumbar
19
Q
What specific features can we find on lumbar vertebrae?
A
- Mammilary process
- Accesory processes
- Lumbar transverse process
20
Q
What kind of vertebrae have a promontory, ala, and anterior and posterior sacral foramina?
A
Sacral
21
Q
What kinds of sacral crest does sacral vertebrae have?
A
Median and lateral
22
Q
Where can we find the auricular surface
A
Sacral vertebrae
23
Q
What kind of vertebrae don’t have intravertebral discs?
A
C1-C2 and saccral
24
Q
What are the two parts of an intervertebral disc and what are they made of?
A
Anulus fibrosus (sclerotome)- outer ring made of fibrous outer layers
and
nucleus pulposus (notochord)- inner oval made up of gelatinous core
25
During compression where does pressure go to in the intravertebral disc?
nucleus pulposus
26
What is another name for a slipped disc?
Herniated nucleus pulposus (HPN)
27
what happens when you have a slipped disc
pressure on the n.p exceeds a.f. integrity and the n.p herniates
deflected laterally by the posterior longitudinal ligament and can impact contents of the vertebral canal and/or intervertebral foramen
28
what happens to facets with flexion and extension of the back
flexion- the facets open and the np moves posteriorly
extension- the facets close and np shifts anteriorly
29
During examination, what are we looking for in the spinal curvatures?
Check for normal or abnormal spinal curvatures, and may indicate muscle spasms, damage, or fractures
30
what happens with lateral flexion
it deforms the IV disc into a wedge shape and pushes n.p. from from the "pinched" side
31
what happens during back flexion and extension
flexion pushes n.p. posteriorly (away from "pinched") while extension pushes it anteriorly
it is restrained by the annulus fibrosis
32
What does atlas (C1) support?
The skull
33
What is the difference between a facet and a Demi-facet?
Facet: a single afraid head articulated with one vertebral body
Demi-facet: a rib head shared between two vertebral bodies
34
What kind of disc herniation is most common?
Posterior herniation
35
What causes excessive thoracic kyphosis?
Osteoporosis and compression fractures
36
What causes excessive lumbar lordosis?
Pregnancy, carrying excess belly fat lack of abdominal muscle tone
37
What kind of abnormal curvature does scoliosis exhibit?
Lateral
38
what does roto-scoliosis mean
scoliosis but the spine doesn't like to bend without rotating (body bends laterally when flexing due to curve in spine)
39
What kind of ligament is located anterior to vertebrae?
anterior longitudinal ligament
40
Name the ligaments found posterior to vertebrae
1. supraspinous ligament
2. interspinous ligament
3. Intertransverse ligament
41
where does supraspinous ligament go from
spinous process to spinous process
all the way through coccyx
42
What is the most posterior ligament of the spine?
supraspinous ligament
43
Name the two ligaments found inside the spine
1. Posterior longitudinal ligament
2. Ligamentum flavum
44
where is the posterior longitudinal ligament
on vertebral body (NOT most posterior)
45
what does ligamentum flavum mean and what is it composed up
means "yellow"
most elastic fibers in a ligament
46
where does nuchal ligament span from
fans out from skull, across the cervical and upper thoracic spinous processes
47
Where does the nuchal ligament arises from?
The supraspinous ligament
48
Why is the nuchal ligament so broad?
It's the site for multiple muscle attachment at the cervical area of the spine
49
what does the radiate ligament do
holds the head of the rib to the vertebral, facet and Demifacets
50
Where are the costotransverse ligaments found?
Thoracic region
51
what do the iliolumbar ligaments do
connects the transverse processes of L4 and L5 to the ilium
keep lumbar vertebra and hip in contact and doesn't allow excessive motion
52
Which muscles stretch between the C2 and C1 vertebrae?
Suboccipital muscles affecting primarily the atlanto-axial in atlanto-occipital joints
these help with most mobility of the head (along with some help from C3-C5)
53
What movement is produced by the atlanto-occipital joint?
Flexion and extension
= yes
54
what is the dens on C2 for?
pivot for C1
shaking head no
55
where does the posterior longitudinal ligament continue to
the skull, covering the dens
56
What movement is induced by the atlanto-axial joint?
Rotation
57
What composes the atlanto-occipital joint?
Superior articular facets of the atlas and occipital condyles
58
Where is CSF found within the spinal cord?
The subarachnoid space
59
What covers the spinal cord directly?
Pia mater
60
What is the outermost covering of the spinal cord?
Dura and arachnoid matter
61
What substance surrounds the vertebral venous plexus in the vertebral canal?
Fat
62
What kind of neurons are found in the anterior horn of a spinal nerve?
Lower motor neuron cell bodies
63
What is the gray matter composed off in the spinal cord?
Posterior and anterior Horns
64
What are the anterior roots made out of?
Lower motor axons
65
What kind of neurons are found in the posterior horn's?
Sensory neuron cell bodies
66
What are the posterior roots made out off?
Sensory axons
67
What can we find in the posterior root ganglion?
Sensory neuron cell bodies
(NOT axons)
68
What is a spinal nerve made out of?
Mixed motor and sensory axons
69
Where does the anterior rami send information to?
Motor and sensory axons to muscles and skin of anterior trunk and limbs
70
Where does the posterior rami send information to?
Motor and sensory axons to muscles and skin of the back
71
What is a dermatome?
Sensory region of the skin supplied by a single spinal nerve
72
Dermatome C4
Top of shoulder
73
Dermatome at C6
thumb
74
Dermatome at C8
Fifth digit of hand
75
Dermatome at T4
Nipple
76
Dermatome at T10
Umbilicus
77
Dermatome at L1
Inguinal region
78
Dermatome at L4
Medial heel and ankle
79
Dermatome at L5
Antero-lateral leg in dorsum of the foot
80
Dermatome at S1
Posterior lateral lower, limb
81
Dermatome at S2
Posterior medial lower limb
82
What is a myotome?
Muscle fibers supplied by a single spinal nerve
83
How many spinal nerves does the cervical region have?
Eight
84
How many thoracic spinal nerves
12
85
How many lumbar spinal nerves
5
86
How many sacral spinal nerves
5
87
Do spinal nerves, exit the vertebrae superiorly or inferiorly?
Superiorly by the cervical nerves and inferiorly by all the other nerves
88
What tethers the pia matter, and the spinal cord to the Dura matter?
Denticulate ligaments
89
When analyzing injury to the spinal cord between two vertebrae, which is spinal nerve is likely to be affected, the superior or inferior one?
Inferior
90
What is the adequate portion of the spine to perform a spinal tap?
Lumbar
91
Where does the spinal cord extends to in adults?
L2 vertebrae
92
What forms the cauda equina?
Interior and posterior roots of the spinal cord
93
What is the name of the tip of the spinal cord?
Conus medullaris
94
Where can anesthetic be injected in the spine?
Epidural space, or sacral hiatus
95
Where can we sample CSF?
Inserting a needle into the subarachnoid space
96
Where does every spinal nerve exits from the vertebrae?
Intervertebral Foramen
97
What is radicular pain radiates along?
Dermatome
98
Difference between radicular and not radicular pain
Radicular pain radiates causes, numbness, tingling and weakness, while non-radicular pain is localized
99
Which type of back muscle did not originate in the back?
Extrinsic back muscles
100
Where is the triangle of auscultation and the lumbar triangle found?
In the pack made out of extrinsic back muscles
101
What makes the triangle of auscultation?
Latissimus dorsi, scapula and trapezius
102
What triangle of the back can we use to look for herniations?
Lumbar triangle
103
What makes the lumbar triangle?
Latissimus dorsi, iliac crest, external abdominal oblique
104
List all the extrinsic back muscles
1. latissimus dorsi
2. Trapezius
3. Levator scapulae
4. Rhomboid, minor and major
5. Serratus posterior inferior
6. Thoracolumbar fascia
105
What is the thoracolumbar fascia?
Acts as aponeurosis for the latissimus dorsi and serratus posterior inferior muscles
106
What muscles origin from the thoracolumbar fascia?
Erector spinae muscles
107
What are the proximal attachment of the trapezius?
1. External occipital protuberance
2. Cervical to mid thoracic spinous processes
108
What are the distal attachment of the trapezius?
1. Clavicle
2. acromion
3. Spine of scapula
109
Major functions of the trapezius?
Upper fibers: elevate the scapula
Middle fibers: retract scapula
Lower fibers: depressed scapula
110
Proximal attachments of the latissimus dorsi?
1. Mid thoracic to sacral spinous processes
2. Iliac crest
111
Distal attachment of latissimus dorsi
Intertubercular sulcus (proximal humerus)
112
Major functions of the latissimus dorsi
1. Adduct arm from an abducted position
2. Extend arm from a flex position
113
What are the proximal attachment of the levator scapulae?
Transverse processes of upper cervical vertebrae
114
What are the distal attachments of the levator scapulae?
Superior angle of scapula
115
What is the major function of the levator scapulae?
Elevate scapula
116
What are the proximal attachment of the rhomboid major and minor?
Lower cervical to upper thoracic spinous processes
117
What is the distal attachment of the rhomboid major and minor?
Medial border of the scapula
118
What is the major function of the rhomboid major and minor?
Retract scapula
119
What are the two kinds of splenius muscles?
1. splenius capitis muscle
2. Splenius cervicis muscle
120
Where does splenius muscles originate?
From cervical and upper thoracic spinous processes
121
Where does the splenius cervicis muscle attach to?
To the transverse processes of the upper cervical vertebrae
122
Where does the splenius capitis muscle attaches to?
To the mastoid process in occipital bone
123
What muscles make the intermediate layer of intrinsic back muscles?
The erector spinae muscle group
1. Iliocostalis
2. Longissimus
3. Spinalis
124
Where does the Erector spinae muscle group originate from?
The iliac crest, sacrum and superior spinous and transverse processes
125
List the attachments of the erector spinae muscle group
1. Iliocostalis – attach lateral to costal angle
2. Longissimus – attach medial to costal angle
3. Spinalis - attach to more superior spinous process
126
What makes the deep intrinsic back muscle layer?
The transversospinalis muscle group
127
What makes the transversospinalis muscle group?
1. Rotatores
2. Multidifi
3. Semispinalis
128
Where do the transversospinalis muscle group attached to?
All attach from transverse process to more superior spinous processes
129
What muscles make the minor deep intrinsic muscles of the back?
1. suboccipital muscles
2. Interspinalis
3. Levatores costorum
4. Intertransversarii
130
What's a major role of minor deep, muscles of the back?
Involved more with Proprioception than movement
131
What is proprioception?
When a muscle is in charge of telling the brain about our position when moving – the smaller the muscle, the more proprioceptor
132
What makes the suboccipital triangle?
1. Rectus capitis posterior minor: C1-Skull
2. Obliquus capitis superior: C2-Skull
3. Rectus capitis posterior major
4. Obliquus capitis inferior
133
What is the Myodural bridge?
Sheet of connective tissue --> originate from --> rectus ca[itis posterior minos --> pierces the posterior atlanto-occipital membrane --> to the Dura matter
responsible for headaches
134
Which muscles assist in standing upright?
1. Erector spinae
2. Multifidus lumborum
3. Semispinalis muscles
4. Abdominal muscles
5. Psoas major
135
What mature structure originate from ectoderm?
Central nervous system and epidermis
136
What mature structure originates from endoderm?
Lining of Gut, respiratory and urogenital tracts
137
White mature structure originates from the mesoderm?
Muscles, bones, connected tissue, fat
138
What structure in the mesoderm signals the ectoderm to fold to form the neural groove? - neurulation
Notochord
139
List what makes the trilaminar embryo
1. Primitive groove in ectoderm
2. Extraembryonic mesoderm
3. Embryonic endoderm
140
What structure is formed by the folding of the neural groove?
Neural tube
141
What does the neural tube give rise to?
Central nervous system (CNS= the brain, brainstem, and spinal cord)
142
What does the neural crest cells give rise to?
posterior root ganglia
143
What gives rise to somites?
mesoderm
144
What do somites give rise to?
Muscles, bones, and dermis
145
How many occipital somites?
4
146
How many cervical somites?
8
147
How many thoracic somites?
12
148
How many lumbar somites?
5
149
How many sacral somites?
5
150
How many coccygeal somites?
2-3
151
Name the parts of a somite
1. Sclerotome
2. Myotome
3. Dermatome
152
What does the sclerotome of a somite give rise to?
vertebrae and axial bones
153
What does the myotome of a somite give rise to?
muscle of body wall and limbs
154
What does the dermatome of a somite give rise to?
deep dermis of body
155
What does the neural tube differentiates to?
It thickens and differentiates into anterior and posterior horns
156
How do sensory neurons reach dermatomes?
By following motor axons that have reached the corresponding myotomes
157
Which sign reaches the brain first when a nerve is pinched and why?
Sensory - because sensory axons are on the outside of the nerve
158
Describe the process of origin of a spinal nerve
anterior horn axon -->myotome
posterior root ganglion axons --> dermatome --> posterior horn
Sclerotomes split in half --> so axons can pass
159
How do vertebrae develop from sclerotomes?
when sclerotomes divide, the remnants fuse to form vertebrae
160
Describe intervertebral discs development
These form at the sites of fissures from sclerotomes splitting
- Annulus fibrosus = sclerotome
- Nucleus pulposus = mature remnant of notochord
161
Where and when chondrification takes place?
In week 6th at the sclerotome and start replacing with cartilage
162
When are ossification centers developed and what do they replace?
On week 7 and cartilage is replaced by bone at the vertebral body, pedicles and lamina
163
What part of vertebrae is the last to ossify?
Spinous processes
164
What happens with ossification in spina bifida?
Ossification fails or the spinous process does not form at all
165
What can you test in utero to determine if baby has spina bifida?
test for alpha-fetoprotein in maternal blood
166
Spina bifida oculta
neural arch - spinous process fail to ossify
defect is not large
167
Meningocele
Type of spina bifida when meninges and CSF herniate through hole left by failed neural arch
168
Meningomyelocele
Type of spina bifida when meninges, CSF, spinal cord and roots herniate
169
Rachischisis
Type of spina bifida where neural tube fails to fold properly = neural arch cannot form
170
Why does the spinal cord end at L2?
Because the growth after the embryonic stage increases to the point the spinal cord cannot keep up
171
Which myotomes and dermatomes migrate to upper limb bud?
From C4-T2 region
172
Which myotomes and dermatomes migrate to Lower limb bud?
From L4-S3 region
173
Do limb bones come from somites?
No, they come from lateral mesoderm
174
Define the cause of syndactyly
Caused by the failure of apoptosis of the interdigital areas that carve out the digits
175
Define the cause of sirenomelia
Failed formation of rescind of tail segment resulting in fusion of the rear limb buds
176
Define the cause of muscle agenesis
Failure of anterior rami to form complex plexi before reaching target muscles.
The muscles resulting from this process fail to form
177
Define the cause of Amelia and phocomelia
When the FGF8 gene in not produced or expressed = limbs dont form (amelia) or are disrrupted (phocomelia)
178
Define de cause of polydactyly
Mutation in the Shh gene interferes with signals in the medio-lateral patterning that defines number or pattern of digits
179
What makes a superficial layer of intrinsic back muscles?
Splenius muscles
180
