Flashcards in Back Deck (50):
How many bones in the adult/child
26 adult, 33 child; Sacrum bones and coccyx bones fuse
What are the most common herniation points
Lumbar - excessive weight of body
Cervical: excessive rotation
Cervical: when the baby holds up its head
Lumbar: when kid starts to walk
What 2 components make up the intervertebral disc?
Anulus fibrosis: outside
Nucleus pulpous: inside
What are intervertebral discs and what are their 2 functions
Pads of fibrocartilage
Absorb shock and permit movement between adjacent vertebrae
Holes between adjacent vertebra - nerves go through
The end part of a long bone: often grows separate from the shaft.
Pedicle of Spine
Attaches the transverse process of the spine to the bony arch - and all to the vertebral body:
Pedicle + Lamina = Vertebral Arch
Process vs Facet
Process: A bony prominance/protrusion
Facet: An indentation where another bone sits/connects. The actual point of contact.
Lamina of spine
Attaches the Spinous process to the transverse process:
Lamina + pedicle = vertebral arch
Draw and differentiate cervical/thoracic/lumbar vertebra.
Cervical: foramen in transverse processes for vasculature. Horizontal facets for ROM. Bifid spinous process.
Thoracic: 2 costal facets on each lateral side of vertebral body for articulation with ribs. 1 costal facet on distal transverse process. Facets on vertebral arch are vertical - little/no ROM
Lumbar:short, dull spinous process. Pointy transverse process. Nearly vertical articular facets directed medially and laterally.
Why are C1 and C2 special
C1: Atlas: Holds up head. doesn't have a body (foramen for dens)
C2: Axis: Has a Dens (odontoid process- tooth like) process, which fits inside C1. Also has a bifid spinal process
Majority of rotational capability of skull is taking place at the C1/C2 articulation
hunch forward of thoracic spine
lateral curvature of thoracic spine
Anterior curvature of lumbar spine.
List the ligaments and joints of the spin from anterior to posterior
Anterior longitudinal ligament, Either intervertebral disk or vertebral body; Posterior longitudinal ligament; intervertebral foramen (or pinnacle); Ligamentum flavum (strongest ligament); either interspinous ligament or transverse process; supraspinous ligament
How do herniations usually happen
Posteriolaterally, hitting the nerves in the intervertebral foramen.
2 Spinal joints
Intervertebral joint (Symphysis)
Zygapophyseal (Facet) Joint - stabilization and prevention of one vertebra sliding relative to another. between superior and inferior articular processes.
What type of joint is the intervertebral (symphysis) joint
secondary cartilaginous - designed for weight bearing and strength
Articulating surfaces of adjacent vertebrae are connected by
IV discs and ligaments
Describe the vasculature of the back
2 types of spinal arteries. Anterior spinal artery (1) feeds the anterior side of the spinal cord. Posterior spinal artery (2) feeds the posterior side of the spinal cord. The A/P spinal arteries arise from the VERTEBRAL arteries and supply the spinal cord.
Anterior part of the spinal cord
MOTOR- supplies anterior 2/3 of cord
Posterior part of spinal cord
SENSORY- supplies posterior 1/3 of cord
A/P spinal arteries provide blood flow to:
Only provide sufficient blood supply to the upper cervical spinal cord levels
The A/P spinal arteries are reinforced by radicular arteries - branches off the posterior intercostal arteries
The great radicular artery
The radicular artery at ~T12 - provide the entire arterial supply for the lumbosacral spinal cord
What is the epidural venous plexus
The anterior and posterior internal venous plexus which transmits venous blood inside the vertebra canal. Communicates with the external venous plexuses via intervertebral forming.
Draw out the superficial layer of muscles of the back
Trapezius, Latissimus dorsi (connects to the humerus, contraction causes adduction - also helps with medial rotation of the arm), Levator Scapulae, Rhomboid Minor, Rhomboid Major
Superficial Layer is related to upper extremity function: Manipulate the shoulder - and put the shoulder joint in a place where the UE can do its work.
Which nerve innervates the trapezius
Accessory nerve (CN)
Which nerve innervates the latissimus dorsi and what is its function
Which nerve innervates the Levator Scapulae
Dorsal scapular nerver
Which nerve innervates the Rhomboid major and minor
Dorsal Scapular nerve
Spine of the scapula can distinguish major from minor
Intermediat muscles of the back: name them and list their function
Serratus posterior superior
Serratus posterior inferior
These are accessory muscles of respiration
Spinal Dural Sac
Formed by the Dura Mater: long tubular sheath within the vertebral canal. Adheres to the margin of the foramen magnum of the cranium, where it is continuous with the radial dura mater, around the brain.
Filum Terminale Interna
The Pia mater extension within the dural sac
Filum Terminale Externa
As the film terminal internal reaches the end of the dural sac, it is joined by the dura to form the film terminal external. Anchors the spinal cord and meninges to the coccyx.
Name the abnormal increase in posterior curvature of the thoracic spine?
Kyphosis: Most common is postural kyphosis. May also be caused by resorption of the anterior part of the spine due to osteoporosis.
Name the abnormal increase in the anterior curvature of the spine caused by a weakening of the anterior abdominal wall musculature (may result in low back pain)
Name the abnormal lateral curvature of the spine
Scoliosis: May e caused by an absent half of a vertebra, or wedge-shaped vertebra, or asymmetric weakness in the back musculature.
What does the anterior longitudinal ligament do?
runs anterior to the vertebral bodies, connecting adjacent vertebra. Runs from the occipital bone to the sacrum. Helps secure intervertebral discs; prevents hyperextension of the vertebral column;
What ligament is typically injured in whiplash?
Whiplash causes cervical hyperextension of the anterior longitudinal ligament
What does the posterior longitudinal ligament do?
Runs from C2 to the sacrum but is continuous with the tectorial membrane (which attaches to the occipital lobe); Helps prevent hyper-flexion of the vertebral column. Also protects from posterior protrusion/herniation.
What does the ligament flavum do?
Yellow in color - connects the lamina of adjacent vertebrae
What does the supraspinous ligament do?
Attache the tips of adjacent vertebral spines. In the cervical region, supraspinous and interspinous ligaments are greatly thickened to form the ligament nuchae.
What vasculature innervates the vertebral column, nerve roots, and spinal cord?
Clinically, what happens if the blood supply is disrupted to the spinal cord?
Paresis or paralysis.
What (2) vasculature runs along the vertebral column and brings blood to the heart?
External vertebral venous plexus: lies external to the vertebral canal
Internal vertebral venous plexus: lies within the vertebral canal.
What is the foramen magnum?
The hole in the back of the scull through which vasculature runs down