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Anatomy - Thorax, Back > Back > Flashcards

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1
Q

Referred pain of upper GI structures

A

Mid-back

Liver, gallbladder also to shoulder

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2
Q

Referred pain of lower GI structures

A

Low back

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3
Q

Referred pain of GU structures

A

Low back, flank to groin, sacral region

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4
Q

Upper quadrant landmarks

A 
C7
Medial scapula border
Spine of scapula
Inferior angle of scapula
Upper trap
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5
Q

Lower quadrant landmarks

A 
CVA
T12
Lower trap
Lumbar paraspinal muscles
Iliac crest
L4
PSIS (dimples)
Sacrum
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6
Q

Function of spine curves

A

Absorb shock

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7
Q

Kyphotic curves

A

Primary
Thoracic and sacral
From birth

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8
Q

Lordotic curves

A

Secondary
Cervical and lumbar
Develop with weight bearing

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9
Q

Movements of the spine

A

Flexion
Extension
Lateral flexion
Rotation

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10
Q

Which vertebrae are “typical”

A

C3 - L5

Everything but C1, C2

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11
Q

Vertebral body

A

Main part of vertebra

T4 and below gradually increase in size to support increasing body weight

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12
Q

Vertebral (neural) arch

A

Pedicles and lamina

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13
Q

Spinous process

A

Project posteriorly from junction of lamina

Attachment and lever for spinal muscles

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14
Q

Transverse process

A

Project laterally from junction of pedicles and lamina

Attachment and lever for spinal muscles

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15
Q

Articular process

A

Superior and inferior processes

Project from junction of pedicle and lamina

Adjacent articular processes form facet joints b/w vertebrae

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16
Q

Vertebral notches

A

Superior and inferior

Forms IVF between 2 vertebrae

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17
Q

Intervertebral foramen

A

Formed “between vertebrae” via vertebral notches of 2 adjacent segments

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18
Q

Vertebral foramen

A

Formed by body and vertebral arch

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19
Q

Vertebral canal

A

Vertebral foramina collectively form the canal

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20
Q

C1 landmarks

A

Anterior, posterior arches
Lateral mass (superior and inferior facets)
TP

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21
Q

Lateral mass

A

Superior facets of C1 articulate with occiput for extension/flexion movement

Inferior facets of C1 articulate with C2 for rotation movement

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22
Q

Dens (odontoid process)

A

C2
Forms “pivot” or axis for rotation between C1-C2

Forms a small synovial joint with anterior arch of C1

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23
Q

Typical C3-C7 features

A
  • Small rectangular body
  • Large triangular VF
  • Transverse foramen (vertebral artery)
  • Spinous process (bifid C3-5, C7 most prominent)
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24
Q

Thoracic vertebrae features

A
  • Heart shaped body
  • Small circular VF
  • Long TPs
  • Long SPs
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25
Lumbar vertebrae features
- Kidney shaped body - Triangular VF (smaller than C, larger than T) - SP (sturdy, hatchet shape) - Accessory process (base of TP) - Mammillary process (on superior articular pillar)
26
Apex of sacrum
Inferior end (same as heart, opposite of lungs)
27
Base of sacrum
Superior portion
28
Promontory
Prominent anterior edge of S1
29
Ala
"Wings" of sacrum
30
Median sacral crest
Midline, formed by fused SPs
31
Sacral hiatus
Formed by failure of lamina of S5 to fuse
32
Sacral cornu
Horns | Formed by pedicles of S5
33
Sacral canal
Contain nerve roots of cauda equina
34
Coccyx
Wedge shaped bone of 4 fused coccygeal vertebrae Provide attachment for pelvic muscles
35
Lordosis description and causes
Excessive anterior curve in lumbar region Caused by: orthopedic anomalies, postural habits, pregnancy, etc.
36
Kyphosis description and causes
Excessive posterior curve in thoracic spine "Hump back" Caused by: compression fracture, postural habits, pathology, etc.
37
Scoliosis description
Lateral deviation with rotary component (convexity)
38
Facet joint
- Synovial joint - B/w superior and inferior facets of articular process - Some weight bearing function in C and L regions - Prone to degenerative changes (limited movement & pain) - Excessive bone spurs can cause stenosis of IVF
39
Intervertebral disc function, composition
Acts as a shock absorber, influences motion Composition = water, collagen fibers, proteoglycans Two parts: annulus fibrosis, nucleus pulposus NOTE: no disc between occiput & C1 OR C1-C2
40
Annulus fibrosis composition, function
Concentric layers of collagen fibers "Crosswoven" effect - direction of fibers alternates each layer Anchor disc to bone or cartilaginous end plate Outside layers will blend with ALL, PLL and do have innervation (pain possible)
41
Nucleus pulposus composition, function
Inner layer of disc Proteoglycans attract water Finer collagen fibers, loose, random network Aging causes decrease in proteoglycan content (so less H2O) = decreased disc height
42
Clinical problems a/w intervertebral discs
- Fissures (discogenic pain) - Herniation (potential to compress nerve roots) - Degenerative changes (loss of disc height)
43
Joints of Luschka
- Uncovertebral - Formed by uncinate processes of C3-C7 - "Pseudo" joint looks similar to synovial
44
Clinical problems a/w joints of Luschka
Prone to degenerative changes (bone spur formation)
45
Atlanto-axial joint
Comprised of: facet joints C1-C2, dens and anterior arch Provides rotation of head/neck
46
Atlanto-occipital joint
Synovial joints between C1 facet and occipital condyles Provides flexion/extension of head and neck
47
Anterior longitudinal ligament
Anterior portion of vertebral column C2-sacrum
48
Posterior longitudinal ligament
Posterior vertebral column within vertebral canal C2-sacrum
49
Ligamentum flavum
Connects lamina between each vertebra Forms part of posterior wall of vertebral canal High elastin content Restore neutral position after flexion of spine
50
Interspinous ligaments
- Connect adjacent SPs | - Attach along inferior and superior portion of SP
51
Supraspinous ligaments
Connect adjacent SPs (C7-sacrum)
52
Anterior atlanto-occipital membrane
- Continuation of ALL | - Connect arches of C1-occiput (edges of foramen magnum)
53
Tectorial membrane
- Continuation of PLL | - C2-foramen magnum
54
Posterior atlanto-occipital membrane
- Continuation of ligamentum flavum | - Connect arches of C1 to occiput (edges of foramen magnum)
55
Nuchal ligament
- Continuation of supraspinous ligament - EOP to C7 - Acts as septum separating muscles of R/L posterior neck
56
Cruciate ligament
Stabilizes dens against anterior arch of C1 3 sections - transverse, superior (occiput to dens), inferior (C2 body to dens)
57
Alar ligament
Sides of dens to lateral margin of foramen magnum LIMITS excessive rotation
58
Apical ligament
Apex of dens to foramen magnum
59
Superficial layer of back muscles
Trap Lat dorsi Rhomboid Levator scapula
60
Trapezius attachments, innervation, actions
Attachments: EOP/SP C7-T12, clavicle/scapula Innervation: CN 11 Actions: elevation + upward rotation of scapula (upper), scap retraction (middle), depression + upward rotation (lower)
61
Lat dorsi attachments, innervation, actions
Attachments: SP of T7-L5/inferior angle of scapula, humerus Innervation: Thoracodorsal Actions: "Handcuffs" - extends arm back, internal rotation, adduction
62
Rhomboid attachments, innervation, actions
Attachments: nuchal ligament/SP of C7-T5, medial border of scapula Innervation: Dorsal scapular Actions: retraction (squeezing shoulders together), some shrug action
63
Levator scapula attachments, innervation, actions
Attachments: TP C1-C4, medial border of scapula Innervation: Dorsal scapular Actions: Elevates scapula, ipsilateral lateral movement of neck
64
Intermediate layer of back muscles
Serratus posterior superior and inferior
65
Serratus posterior superior actions
Elevates the ribs which aids in inspiration
66
Serratus posterior inferior actions
Depresses the lower ribs, aiding in expiration
67
Deep layer of back muscles
Superficial, intermediate, deep layers
68
Deep layer (superficial) of back muscles
Splenius capitis/cervicis
69
Splenius capitis attachments and actions
Attachments: SP C7-T3, mastoid process Actions: Unilateral contraction - ipsilateral bending and rotation
70
Splenius cervicis attachments and actions
Attachments: SP T3-T6, TP C1-C3 Actions: Unilateral and bilateral contraction (extend, flex, rotate head and neck to same side)
71
Deep layer (intermediate) back muscles and actions
Erector spinae (paraspinal muscles) - iliocostalis (most lateral), longissimus, spinalis (most medial) Actions: bilateral - extension also assists with flexion (eccentric contraction)
72
Deep layer (deep) back muscles and actions
Semispinalis (attachments go up 4-6 levels) Multifidi Rotators (attachments up 2-3 levels) Actions: Unilateral - contralateral rotation of spine (opposite of splenius capitis)
73
Sub-occipital triangle borders
Rectus capitis posterior major Obliquus capitis inferior Obliquus capitis superior NOTE: Rectus capitis posterior minor is NOT included
74
Sub-occipital triangle contents
Vertebral artery and CN1 (sub-occipital nerve)
75
Cervical enlargement of spinal cord
C4-T1 segments Most anterior rami arising from here form brachial plexus
76
Lumbosacral enlargement of spinal cord
T11-S1 segments Anterior rami from here make up lumbar and sacral plexuses
77
Conus medullaris
Tapered, lower end of spinal cord May terminate as high as T12 or as low as L3
78
Cauda equina
Bundle of spinal nerves beginning from conus medullaris (end of spinal cord) through sacrum "Horse tail"
79
Denticulate ligaments
Ligaments on each side of spinal cord connecting pia mater to arachnoid and dura mater
80
Filum terminale
Suspends the spinal cord in the dural sac ("mechanical anchor")
81
Lumbar cistern
Enlargement of subarachnoid space between conus medullaris of spinal cord Occupied by cauda equina, filum terminale, CSF Site for lumbar puncture and spinal anesthesia
82
Pia filament
Portion of filum terminale within the dural sac Goes all the way to coccyx
83
Spina bifida occulta
Failure of vertebral arch to fuse, bony defect
84
Meningocele
Type of spina bifida (uncommon) Meninges protrude through bony defect of vertebral arch
85
Myelomeningocele
Type of spina bifida (most severe) Meninges AND spinal cord protrude through defect of vertebral arch
86
These three longitudinal arteries supply the spinal cord
1 anterior spinal artery | 2 posterior spinal arteries
87
Anterior and posterior segmental medullary arteries
Support the A & P spinal arteries Occur mainly in association with cervical and lumbosacral enlargements (where good blood supply is needed)
88
Anterior and posterior radicular arteries
Run along nerve roots Most are small and supply only nerve roots
89
Spondylolisthesis
Pars defect Forward displacement of a vertebra - esp L5 MC occurring after break/fracture X-ray finding = scotty dog
90
Scotty dog sign on x-ray
Spondylolisthesis

Anatomy - Thorax, Back (2 decks)

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