Back Flashcards
(224 cards)
1
Q
Vertebral column movements are limited by:
A
IV discs, articular facets, back muscles, ligamenta flava, posterior longitudinal ligament, thoracic cage attachments
2
Q
vertebral column movements
A
flexion, extension, lateral flexion, rotation
3
Q
ventral roots:
A
efferent (motor)
4
Q
dorsal roots:
A
afferent (sensory)
5
Q
cutaneous innervation of the back
A
dorsal primary rami
6
Q
deep back muscles are innervated by:
A
dorsal primary rami
7
Q
superficial extrinsic back muscles are innervated by:
A
ventral primary rami of cervical nerves (because the superficial back muscles act on upper limbs) (exception: trapezius innervated by accessory nerve CN XI)
8
Q
skeletal muscles (other than deep back) are innervated by:
A
ventral primary rami
9
Q
location of cell body in efferent nerves
A
CNS
10
Q
location of cell body in afferent nerves
A
dorsal root ganglion
11
Q
nerve leaving intervertebral foramen is:
A
mixed spinal nerve
12
Q
white rami exist at what levels?
A
T1-L2/L3
13
Q
function of superficial extrinsic back muscles
A
movement of upper limb
14
Q
trapezius innervation
A
accessory nerve (CN XI)
15
Q
superficial extrinsic back muscles:
A
trapezius, latissimus dorsi, levator scapulae, rhomboid major, rhomboid minor
16
Q
intermediate extrinsic back muscles:
A
serratus posterior superior, serratus posterior inferior
17
Q
function of intermediate extrinsic back muscles
A
superficial respiratory, proprioceptive
18
Q
latissimus dorsi inntervation
A
Thoracodorsal N. (C6-C8)
19
Q
levator scapulae innervation
A
dorsal scapular (C5), cervical nerves (C3-C4)
20
Q
erector spinae origin
A
posterior sacrum, iliac crest, sacrospinous ligament, supraspinous ligament, spinous processes of lower lumbar and sacral vertebrae
21
Q
iliocostalis insertion
A
angles of lower ribs, cervical transverse processes
22
Q
longissiumus insertion
A
between tubercles and angles of ribs, transverse processes of thoracic and cervical vertebrae, mastoid process
23
Q
spinalis insertion
A
spinous processes of upper thoracic and midcervical vertebrae
24
Q
erector spinae innervation
A
dorsal rami of each region
25
erector spinae actions
extends and laterally bends vertebral column and head
26
cervical portions of erector spinae blood supply
occipital, deep cervical, and vertebral arteries
27
thoracic portions of erector spinae blood supply
dorsal branches of posterior intercostal, subcostal, and lumbar arteries
28
sacral portions of erector spinae blood supply
dorsal branches of lateral sacral arteries
29
interspinales origin
spinous processes
30
interspinales insertion
adjacent spinous process
31
interspinalis innervation
dorsal rami of spinal nerves
32
interspinales action
aids in extension of vertebral column
33
interspinales blood supply (cervical portions)
occipital, deep cervical, and vertebral arteries
34
interspinales blood supply (thoracic portions)
dorsal branches of posterior intercostal arteries
35
interspinales blood supply (lumbar portions)
dorsal branches of lumbar arteries
36
intertransversarii origin/insertion
extend between adjacent transverse processes of vertebrae
37
intertransversarii innervation
dorsal *and ventral* rami of spinal nerves
38
intertransversarii actions
assist in lateral flexion of vertebral column
39
intertransversarii blood supply (cervical portions)
occipital, deep cervical, and vertebral arteries
40
intertransversarii blood supply (thoracic portions)
dorsal branches of posterior intercostal, subcostal, and lumbar arteries
41
intertransversarii blood supply (lumbar portions)
dorsal branches of lateral lumbar arteries
42
latissimus dorsi origin
spinous processes T7-L5, thoracolumbar fascia, iliac crest, and last 3 ribs
43
latissimus dorsi insertion
humerus (intertubercular sulcus)
44
latissimus dorsi action
"swimmer's muscle" - extension, adduction, and medial rotation of humerus
45
latissimus dorsi blood supply
thoracodorsal artery
46
levator scapulae origin
posterior tubercles of transverse processes of C1-C4
47
levator scapulae insertion
medial border of scapular from superior angle to spine
48
levator scapulae innervation
ventral rami of C3-C4 and dorsal scapular nerve
49
levator scapulae action
elevate scapula medially, inferiorly rotates glenoid cavity
50
levator scapulae blood supply
dorsal scapular artery, transverse cervical artery, ascending cervical artery
51
multifidus origin
sacrum, ilium, transverse processes of T1-T12, and articular processes of C4-C7
52
multifidus insertion
spinous processes of vertebrae above, spanning 2-4 segments
53
multifidus innervation
dorsal rami of each region
54
multifidus action
stabilizes spine
55
multifidus blood supply (cervical portion)
occipital, deep cervical, and vertebral arteries
56
multifidus blood supply (thoracic portion)
dorsal branches of posterior, intercostal, subcostal, and lumbar arteries
57
multifidus blood supply (sacral portion)
dorsal branches of lateral sacral arteries
58
obliquus capitis inferior origin
spine of axis
59
obliquus capitis inferior insertion
transverse process of atlas
60
obliquus capitis inferior innervation
suboccipital nerve
61
obliquus capitis inferior action
rotates atlas to turn face to same side
62
obliquus capitis inferior blood supply
vertebral artery, descending branch of occipital artery
63
obliquus capitis superior origin
transverse process of atlas
64
obliquus capitis superior insertion
occipital bone
65
obliquus capitis superior innervation
suboccipital nerve
66
obliquus capitis superior action
extends and bends head laterally
67
obliquus capitis superior blood supply
vertebral artery, descending branch of occipital artery
68
rectus capitis posterior major origin
spine of axis
69
rectus capitis posterior major insertion
inferior nuchal line
70
rectus capitis posterior major innervation
suboccipital nerve
71
rectus capitis posterior major action
extends and rotates head to same side
72
rectus capitis posterior major blood supply
vertebral artery, descending branch of occipital artery
73
rectus capitis posterior minor origin
tubercle of posterior arch of atlas
74
rectus capitis posterior minor insertion
median inferior nuchal line
75
rectus capitis posterior minor inervation
suboccipital nerve
76
rectus capitis posterior minor action
extends head
77
rectus capitis posterior minor blood supply
vertebral artery, descending branch of occipital artery
78
rhomboid major origin
spinous processes of T2-T5
79
rhomboid major insertion
medial border of scapula below base of spine of scapula
80
rhomboid major innervation
dorsal scapular nerve (C4, C5)
81
rhomboid major action
fixes scapula to thoracic wall and retracts and rotates it to depress glenoid cavity
82
rhomboid major blood supply
dorsal scapular artery
83
rhomboid minor origin
ligamentum nuchae, spines of C7 and T1
84
rhomboid minor insertion
medial border of scapula at spine of scapula
85
rhomboid minor innervation
dorsal scapular nerve (C4, C5)
86
rhomboid minor action
fixes scapula to thoracic wall and retracts and rotates it to depress glenoid cavity
87
rhomboid minor blood supply
dorsal scapular artery
88
rotatores origin
transverse processes of cervical, thoracic, and lumbar regions
89
rotatores insertion
lamina and transverse process of spine above, spanning 1-2 segments
90
rotatores innervation
dorsal rami of spinal nerves
91
rotatores action
stabilize, extend, rotate spine
92
rotatores blood supply
dorsal branches of segmental arteries
93
semispinalis origin
transverse processes of C4-T12
94
semispinalis insertion
spinous processes of cervical and thoracic regions
95
semispinalis innervation
dorsal rami of spinal nerves
96
semispinalis action
extend head, neck, and thorax and rotate them to the opposite side
97
semispinalis blood supply (cervical portions)
occipital, deep cervical, and vertebral arteries
98
semispinalis blood supply (thoracic portions)
dorsal branches of posterior intercostal arteries
99
serratus posterior inferior origin
spinous processes of T11-L2
100
serratus posterior inferior insertion
inferior aspect of ribs 9-12
101
serratus posterior inferior innervation
ventral rami of lower thoracic nerves
102
serratus posterior inferior action
depresses ribs
103
serratus posterior inferior blood supply
posterior intercostal arteries
104
serratus posterior superior origin
ligamentum nuchae, spinous processes of C7-T3
105
serratus posterior superior insertion
superior aspect of ribs 2-4
106
serratus posterior superior innervation
ventral rami of upper thoracic nerves
107
serratus posterior superior action
elevates ribs
108
serratus posterior superior blood supply
posterior intercostal arteries
109
splenius capitis origin
nuchal ligament, spinous processes of C7-T3
110
splenius capitis insertion
mastoid process of temporal bone, lateral third of superior nuchal line
111
splenius capitis innervation
dorsal rami of middle cervical nerves
112
splenius capitis action
bilaterally: extend head. unilaterally: laterally bends (flexes) and rotates neck toward same side
113
splenius capitis blood supply
descending branch of occipital artery, deep cervical artery
114
splenius cervicis origin
spinous process of T3-T6
115
splenius cervicis insertion
transverse processes C1-C3
116
splenius cervicis innervation
dorsal rami of lower cervical nerves
117
splenius cervicis action
bilaterally: extend neck. unilateally: laterally bends (flexes) and rotates neck toward same side
118
splenius cervicis blood supply
descending branch of occipital artery, deep cervical artery
119
trapezius origin
superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes of C7-T12
120
trapezius insertion
lateral third of clavicle, acromion, spine of scapula
121
trapezius action
elevates, retracts, and rotates scapula; lower fibers depress scapula
122
trapezius blood supply
transverse cervical artery, dorsal perforating branches of posterior intercostal arteries
123
C5 dermatome
clavicles
124
C5, C6 dermatomes
lateral sides of upper limbs
125
C8, T1 dermatomes
medial sides of upper limbs
126
C6 dermatome
digit I (thumb)
127
C6, C7, C8 dermatomes
hand
128
C8 dermatome
digits IV and V (ring and little fingers)
129
T4 dermatome
level of nipples
130
T10 dermatome
level of umbilicus
131
L1 dermatome
inguinal region
132
L1, L2, L3, L4 dermatomes
anterior and inner surfaces of lower limbs
133
L4, L5, S1 dermatomes
foot
134
L4 dermatome
medial side digit I (great toe)
135
L5, S1, S2 dermatomes
lateral and posterior surfaces of lower limbs
136
S1 dermatome
lateral margin of foot and digit V (little toe)
137
S2, S3, S4 dermatomes
perineum
138
deep back muscles action
maintain posture, control movement of vertebral column
139
cervical movements
flexion, extension, rotation, lateral flexion
140
chief extensors of vertebral column
erector spinae muscles (iliocostalis, longissimus, spinals)
141
transversospinalis muscles:
semispinalis (capitis, cervicis, thoracis), multifidus, rotatores
142
levatores costarum origin
tips of transverse processes of C7-T11
143
levatores costarum insertion
inferolaterally to rib between tubercle and angle
144
levatores costarum innervation
posterior rami of C8-T11 spinal nerves
145
levatores costarum action
elevate ribs, assist respiration, aid lateral flexion of vertebral column
146
intrinsic deep muscles:
interspinalis, intertransversarii, levatores costarum
147
annulus fibrosis
outer layer of intervertebral disc
148
nucleus pulposus
hydrophilic, jelly-like inner layer of intervertebral disc
149
primary curvatures of spine
thoracic and sacral kyphoses
150
secondary curvatures of spine
cervical and lumbar lordoses
151
facet joints innervation
articular branches from medial branches of posterior rami spinal nerves
152
facet joints function
limit movement of vertebral column
153
ligaments that limit spinal extension
anterior longitudinal ligament
154
ligaments that limit spinal flexion
posterior longitudinal ligament, ligamentum flavum, supraspinous and interspinous ligaments
155
ligaments that limit lateral bending
intertransverse ligaments
156
median atlantoaxial joint function
"no" movement
157
lateral atlanto-occiptal joints
"yes" movement
158
most common cause of back pain
strain of erector spinae muscles
159
suboccipital triangle borders
rectus capitis posterior major (superomedially), obliquus capitis superior (superolaterally), obliquus capitis inferior (inferolaterally), posterior atlanto-occipital membrane and posterior arch of C1 (floor), semispinalis capitis (roof)
160
suboccipital triangle contents
suboccipital nerve (C1), vertebral artery
161
suboccipital triangle muscles
rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior
162
ganglion
collection of nerve cell bodies
163
demyelinating diseases
multiple sclerosis in CNS, guillain-barre syndrome in PNS
164
gray matter is composed of:
nerve cell bodies
165
white matter is composed of:
axons
166
meninges:
dura mater (outer layer), subarachnoid mater, pia mater (inner layer)
167
functional organization of peripheral nervous system
somatic (voluntary) and autonomic (involuntary/visceral)
168
somatic sensory
connective tissue; sensations (pain, temperature, pressure), muscle spindles (proprioception), golgi tendon organs, pleura, peritoneum, skin, joints
169
visceral sensory
sensations (poorly localized; pain may seem like hunger or nausea)
170
somatic motor
exclusive to skeletal muscle
171
visceral motor
heart, smooth muscles, glands
172
visceral motor neuron
2 neurons between CNS and motor tissue; preganglionic neuron cell body in CNS, postganglionic neuron cell body in autonomic ganglion
173
somatic motor neuron
1 neuron between CNS and motor tissue; cell body in CNS
174
dorsal root ganglion
contains cell body of sensory neuron
175
ventral horn
contains cell bodies of motor neurons
176
sympathetic division
thoracolumbar (T1-L2/3); catabolic (fight or flight) effects on autonomic nervous system
177
parasympathetic division
craniosacral (CN III, CN VII, CN IX, CN X, S2, S3, S4); anabolic (rest and digest) effects on autonomic nervous system
178
dorsal scapular nerve
C5
179
suboccipital nerve
C1
180
greater occipital nerve
C2
181
thoracodorsal nerve
C6-C8
182
neurotransmitter used in sympathetic division
norepinephrine (except in sweat glands - acetylcholine)
183
neurotransmitter used in parasympathetic division
acetylcholine
184
location of presynaptic neurons of sympathetic division
intermediolateral (IML) cell columns
185
interomediolateral cell columns (IMLs)
lateral horns; part of gray matter from T1-L2/3; location of presynaptic neurons of sympathetic division
186
paravertebral ganglia
form right and left sympathetic trunks on sides of vertebral column
187
prevertebral ganglia
located in the plexuses that surround the origins of main branches of abdominal aorta
188
cervical enlargement
C4-T1; forms brachial plexus, innervates upper limbs
189
lumbosacral (lumbar) enlargement
L1-S3; forms lumbar and sacral plexuses, innervates lower limbs
190
pairs of spinal nerves
31 (8C, 12T, 5L, 5S, 1Co)
191
posterior rami supply:
zygapophysial joints, deep muscles of back, and overlying skin
192
anterior rami supply:
muscles, joints, and skin of limbs, and remainder of trunk
193
filum terminale internum consists mainly of
pia mater
194
filum terminale externum consists of
dura mater
195
filum terminale externum passes through _________ to ultimately attach to coccyx posteriorly
sacral hiatus
196
characteristics of typical thoracic vertebrae
round vertebral foramen, demifacets/costal facets, heart-shaped v. body
197
characteristics of typical cervical vertebrae
transverse foramen, bifid spinous process, large v. foramen, uncinate process
198
characteristics of typical lumbar vertebrae
large v. body, kidney-shaped body, transverse processes protrude more laterally, spinous process is hatchet-shaped
199
characteristics of atlas (C1)
no spinous process, no body, anterior and posterior arches, posterior tubercle, lateral masses, no IV disc
200
characteristics of axis (C2)
strongest cervical v., has dens
201
functions of ligamentum flavum
resist separation of lamina, limit abrupt flexion (prevents injury to IV disc), assist with straightening column after flexing
202
uncovertebral joints (clefts of Luschka)
located between uncinate processes of C3-C6. synovial joint-like. frequent site of bone spur formation
203
scotty dog fracture
fracture at pars interarticularis (part of lamina)
204
hangman's fracture
fracture of both pedicles or pars interarticularis of the axis
205
spondylolysis
a defect or fracture of the pars interarticularis of the vertebral arch; most common cause of spondylolisthesis
206
spondylolisthesis
the forward displacement of a vertebra (typically L5), most commonly occurring after a fracture
207
Jefferson or Burst fracture
C1 fx; vertical forces to head lead to fx of anterior and/or posterior arch; not necessarily resulting in spinal cord inj. If transverse lig. ruptures, spinal cord inj. more likely
208
rupture of transverse ligament of atlas
leads to atlanto-axial subluxation (dens is free)
209
lumbar cistern
L2-S2; contains CSF and cauda equina
210
arteries supplying spinal cord are branches of:
vertebral a., ascending cervical a., deep cervical a., intercostal a., lumbar and lateral sacral a.
211
arterial supply of neck region
vertebral and ascending cervical a.
212
arterial supply of thorax region
posterior intercostal a.
213
arterial supply of abdominal region
subcostal and lumbar a.
214
arterial supply of pelvic region
iliolumbar and lateral and medial sacral a.
215
internal vertebral venous plexus (IVVP)
AKA epidural plexus. inside vertebral canal. drains into segmental vein via intervertebral vein
216
external vertebral venous plexus
outside vertebral canal: communicates with internal vertebral venous plexus via intervertenral vein and basivertebral vein
217
spina bifida occulta
laminae of L5 and/or S1 fail to develop normally and fuse
218
degenerative disc disease (DDD)
structure and chemistry of IV disc changes over time; loss of water content and proteoglycan; making disc less resilient to stress and strain
219
osteophytes (bone spurs)
bony overgrowths caused by hypertrophy of v. bodies adjacent to a degenerating disc.
220
central spinal stenosis
narrowing of the central part of the spinal canal
221
foraminal spinal stenosis
narrowing of the foramen, resulting in pressure on the exiting nerve root
222
far lateral recess spinal stenosis
narrowing of the lateral part of the spinal canal
223
myelopathy
spinal cord compression
224
cauda equina syndrome
caused by central disc herniation. damage to the cauda equina causes loss of function
