Back 2/3 Flashcards by Johannah Crumpton

Correctly identify:
-Vertebral artery and vein
-Vertebral Body
-Spinous process
-Spinal cord covered by pia mater

5
4
8
3

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Correctly Identify:
-Dura and arachnoid mater
-Subarchnoid space & CSF
-Spinal Nerve
-Vertebral venous plexus and fat in epidural space (vertebral canal)

1
2
6
7

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Correctly Identify:
Anterior Horn
Spinal Nerve
Posterior Root
Posterior Root Ganglion

2- Anterior Horn (Gray Matter)
5- Spinal Nerve
9- Posterior Root
8- Posterior Root Ganglion

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Correctly Identify:
- Posterior Horn
- Recurrent meningeal nerve
- Anterior Rami
- Posterior Rami
- Anterior Root

1- Posterior Horn
3-Recurrent meningeal nerve
6- Anterior Rami
7- Posterior Rami
4- Anterior Root

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Lower motor neuron cell bodies

Anterior horn

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Lower motor axons

Anterior Roots

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Sensory neuron cell bodies

Posterior horn

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Sensory axons

Posterior Roots

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Sensory neuron cell bodies

Posterior Root Ganglion

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Mixed motor and sensory axons

Spinal nerves

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Motor and sensory axons to muscles and skin of anterior trunk and limbs

Anterior Rami

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Motor and sensory axons to muscles and skin of the back

Posterior Rami

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C4 Dermatome

Top of shoulder

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C6 Dermatome

Thumb

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C8 Dermatome

5th digit of hand (pinky)

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T4 Dermatome

Nipple

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T10 Dermatome

Umbilicus

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L1 Dermatome

Inguinal Region

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L4 Dermatome

Medial heel and ankle

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L5 Dermatome

Antero-lateral leg and dorsum of foot

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S1 Dermatome

Posterior lateral lower limb

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S2 Dermatome

Posterior medial lower limb

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Muscle fiber supplied by a single spinal nerve

Myotome

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How many cervical spinal nerves? Where do they exit?

8, Exit superior the corresponding vertebra

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How many lumbar spinal nerves? Where do they exit?

5, exit inferior the corresponding vertebra

How many coccygeal spinal nerves?

1-2

Denticulate ligaments tether the _____ ______ and _____ ______ to the dura matter.

pia mater and spinal cord to the dura matter.

_______ _______ divide posterior and anterior roots within the dural sheath

Denticulate ligaments

Correctly Identify: Pia Mater Dura Mater Arachnoid Mater Subarachnoid Space (full of CSF) Denticulate ligament

3- Pia Mater 5- Dura Mater 4- Arachnoid Mater 1- Subarachnoid Space (full of CSF) 2- Denticulate ligament

Identify: Arachnoid Mater Dura Mater Denticulate Ligament Pia Mater

2- Arachnoid Mater 1- Dura Mater 4- Denticulate Ligament 3- Pia Mater

What level does the spinal cord terminate in normal adults?

around L2

Anterior and posterior roots that stretch below the end of the spinal cord are called _____

Cauda equina

The T12 vertebral body is more closely related to the cervical or lumbar region?

Lumbar

The L1 vertebral body is in close association with _____ spinal cord segments

Sacral

The tip of the spinal cord is called the ____ _______.

Conus medullaris

The conus medullaris is tethered to the coccyx by the _____ ______.

Filum terminale

What type of "material" is the filum terminale?

Pia mater

Identify: Filum Terminale Conus Medullaris

2- Filum Terminale 1- Conus medullaris

The dural sac extends to ____ level

~S2

What 2 places can anesthetic be injected along the spine?

Epidural space and sacral hiatus

What is another name for a lumbar puncture?

Spinal tap

What space do you insert into when doing a spinal tap?

Subarachnoid Space

What 2 places do you insert for anesthetic injection?

1 and 3

What place do you insert when doing a spinal tap?

Identify: Sacral Hiatus Cauda Equine Conus Medullaris

4- Sacral Hiatus 5- Cauda Equine 6- Conus Medullaris

What structures would you encounter on a midline tap?

Skin Subcutaneous fat Thoracolumbar fascia Supraspinous ligament Interspinous ligament (No ligamentum flavum on the exact midline) Dura mater Arachnoid mater Subarachnoid space

Identify: Intervertebral Foramina Superior Vertebral Notch Inferior Vertebral Notch

3- Intervertebral Foramina 1- Superior Vertebral Notch 2- Inferior Vertebral Notch

A herniated nucleus pulposus or narrowing of the intervertebral foramen may cause _____ and motor signs along a spinal segment

Sensory

______ is only in the back and/or gluteal area without radiation into the lower limbs

Non-Radicular pain

Name some causes of non-nerve injuries:

muscle/tendon strain, ligament sprain, discitis, arthritis or fractures

A herniated nucleus pulposus in the lumbar region generally affects the spinal nerve at the level ______.

Below

A cervical HNP will primarily affect the nerve exiting at the _____ level

same

Describe the Spurling's test:

Extend, rotate and side bend w/compression (cervical spine)

Describe the compression test

Push down on the head to compress the intervertebral foramen

Describe the distraction test

Pull up the chin and occiput to see if pain decreases

Pathway of a facet joint injection:

Skin Subcutaneous fat Extrinsic back muscles Erector spinae muscles Transversospinalis muscles Joint capsule

Where do the anterior and posterior spinal arteries arise from?

the vertebral arteries

Define extrinsic muscles:

originating elsewhere

Define Intrinsic back muscles

develop in the back

In the back, extrinsic muscles are ______ to intrinsic muscles

superficial

Identify: -Non-back muscles -Extrinsic back muscles -Deep Layer of intrinsic back muscles -Superficial and intermediate layers of intrinsic back muscles

1-Non-back muscles 2-Extrinsic back muscles 4-Deep Layer of intrinsic back muscles 3-Superficial and intermediate layers of intrinsic back muscles

Non- back muscles are innervated by:

Anterior Rami

Extrinsic back muscles are innervated by:

Cranial nerves (Not innervated by posterior rami)

Superficial and Intermediate Layers of Intrinsic muscles are innervated by:

Posterior Rami

Deep Layer of Intrinsic back muscles are innervated by:

Posterior Rami

Identify: -Non-back muscles -Superficial and Intermediate Layers of Intrinsic Back Muscles - Extrinsic Back Muscle - Deep Layer of Intrinsic Back Muscles

4-Non-back muscles 2-Superficial and Intermediate Layers of Intrinsic Back Muscles 3- Extrinsic Back Muscle 1- Deep Layer of Intrinsic Back Muscles

3 components of the triangle of auscultation

Latissimus dorsi, scapula, trapezius

3 components of the lumbar triangle

Latissimus dorsi, iliac crest, external abdominal oblique

Identify: -Trapezius - Levator Scapulae - Rhomboid Minor and Major - Serratus posterior inferior

2-Trapezius 8- Levator Scapulae 7- Rhomboid Minor and Major 6- Serratus posterior inferior

Identify: -Latissimus dorsi -Triangle of auscultation -Lumbar Triangle -Thoracolumbar fascia

3-Latissimus dorsi 1-Triangle of auscultation 4-Lumbar Triangle 5-Thoracolumbar fascia

______ is the origin of the erector spinae muscles

thoracolumbar fascia

Define aponeurosis

a thin sheath of connective tissue that helps connect your muscles to your bones

The thoracolumbar fascia acts as aponeurosis for the ______ and ________.

latissimus dorsi and serratus posterior inferior muscles

proximal attachments for Trapezius

External occipital protuberance (back of skull), cervical to mid-thoracic spinous processes

Distal attachments of Trapezius

Distal attachment: Clavicle, acromion, spine of scapula

Function of the Trapezius

Elevate, retract and depress the scapula

Proximal attachments of Latissimus Dorsi

Mid-thoracic to sacral spinous processes (through the thoracolumbar fascia) and iliac crest

Distal attachments of Latissimus Dorsi

Intertubercular sulcus (proximal humerus)

Major functions of the Latissimus Dorsi

Adduct arm from an abducted position; extend arm from a flexed position

Identify: - Levator Scapulae -Rhomboid Major -Rhomboid Minor

1- Levator Scapulae 3-Rhomboid Major 2-Rhomboid Minor

Proximal attachment of the Levator Scapulae

Transverse processes of upper cervical vertebrae

Distal attachment of the Levator Scapulae

Superior angle of scapula

Proximal attachment of Rhomboid Major and Minor

Lower cervical to upper thoracic spinous processes

Distal attachment of Rhomboid Major and Minor

Medial border of scapula

Function of the Rhomboid Major and Minor

Retract scapula

Superficial Layer of Intrinsic Back Muscles are the ______.

Splenius muscles

Identify: -Splenius Capitis Muscle -Splenius Cervicis Muscle

1-Splenius Capitis Muscle 2-Splenius Cervicis Muscle

Splenius muscles proximal attachment

cervical and upper thoracic spinous processes

Splenius cervicis distal attachment

transverse processes of the upper cervical vertebrae

Slenius capitis attaches to the.....

mastoid process and occipital bone

Erector spinae originate from the.....

iliac crest, sacrum as well as more superior spinous and transverse processes.

Identify: - Erector spinae muscle group -Iliocostalis - Spinalis - Longissimus

4- Erector spinae muscle group 3-Iliocostalis 1- Spinalis 2- Longissimus

_____ attach lateral to costal angle

Iliocostalis

_____ attach medial to costal angle

Longissimus

______ originates from spinous processes and attach to more superior spinous processes

Spinalis

All ______ attach from transverse process to more superior spinous processes

transversospinalis muscles

Rotatores: span ____ levels Multifidi: span ___levels Semispinalis: span ____ levels

1-2 3-4 5-6

Identify: - Multifidus lumborum - Rotatores thoracis -Semispinalis cervicis - Semispinalis capitis

2- Multifidus lumborum 1- Rotatores thoracis 3-Semispinalis cervicis 4- Semispinalis capitis

The minor deep muscles of the back (along with the rotatores) are _____ and are more involved with _______ than movement

Small, proprioception

What small muscles are extremely painful when torn

Minor Deep Intrinsic Muscles: Suboccipital muscles Interspinalis Levatores costorum Intertransversarii

Identify: - Intertransversarii - Levatores costorum - Interspinalis - Suboccipital Muscles

4- Intertransversarii 3- Levatores costorum 2- Interspinalis 1- Suboccipital Muscles

The four suboccipital muscles are ____ of the head and upper cervical region.

extensors

The four suboccipital muscles also carry _________ from the region

proprioceptive input

Identify: -Rectus capitis posterior major - Rectus capitis posterior minor - Obliquus capitis superior - Obliquus capitis inferior

3-Rectus capitis posterior major 1- Rectus capitis posterior minor 2- Obliquus capitis superior 4- Obliquus capitis inferior

A sheet of connective tissue that originates from the rectus capitis posterior minor pierces the posterior atlanto-occipital membrane to fuse with the dura mater

Myodural Bridge

Mydodural bridge is a direct connection between ______ and the _______ makes it a consideration when treating headache

pain-sensitive dura and the posterior neck muscles

Identify: - Atlas - Axis - Rectus Capitis Posterior Major

7- Atlas 2- Axis 4- Rectus Capitis Posterior Major

Identify: - Rectus Capitis posterior minor - Rectus Capitis posterior minor - Rectus Capitis Posterior Major - Obliquus Capitis Inferior

5- Rectus Capitis posterior minor 6- Rectus Capitis posterior minor 1- Rectus Capitis Posterior Major 3- Obliquus Capitis Inferior

When standing upright, the 5 large postural muscles are active include:

1. Erector spinae 2. Multifidus lumborum 3. Semispinalis muscles 4. Abdominal muscles 5. Psoas major

Besides the 5 large postural muscles, what else assists in supporting the weight of the body?

The normal curvatures of the spine

Mid-thoracic region, what 2 ligaments blend together?

Supraspinous and nuchal ligament blend

Identify: - Posterior Median Furrow -Medial Border of Scapulae - Rhomboid - Erector spinae - Nuchal groove

5- Posterior Median Furrow 3-Medial Border of Scapulae 4- Rhomboid 7- Erector spinae 1- Nuchal groove

Identify: - Vertebra prominens (C7) - Dimples indicating posterior superior iliac spines - Intergluteal cleft - Posterior site of Sacrum -Latissimus Dorsi

2- Vertebra prominens (C7) 8- Dimples indicating posterior superior iliac spines 10- Intergluteal cleft 9- Posterior site of Sacrum 6-Latissimus Dorsi

Identify: - Iliac Crest - Sacral Hiatus - S2 spinous process - Tip of Coccyx

8- Iliac Crest 4- Sacral Hiatus 2- S2 spinous process 6- Tip of Coccyx

Identify: - Sacral Triangle - Iliac Tubercle - Median Sacral Crest - Lumbar Spinous processes

11- Sacral Triangle 9- Iliac Tubercle 3- Median Sacral Crest 1- Lumbar Spinous processes

Identify: -L4/L5 IV Disc - Posterior Superior Iliac Spine - Coccyx - Intergluteal cleft

7-L4/L5 IV Disc 10- Posterior Superior Iliac Spine 5- Coccyx 12- Intergluteal cleft

The supracristal plane includes what 3 things?

1. High points of the iliac crest 2. L4 Spinous Process 3. L4/L5 IV Disc