Back, Spine and Spinal Cord

Question 1

What are the two main functions of the back?

Answer 1

Maintenance of posture and movement of the trunk and limbs

Question 2

Lower back pain may be due to strain of which muscle?

Answer 2

Erector spinae

Question 3

What are the names of the three parts of the trapezius muscle and where do they lie?

Answer 3

Descending (superior), transverse (middle), ascending (inferior)

Question 4

What are the 4 extrinsic back muscles?

Answer 4

Levator scapulae, rhomboids, trapezius and latissimus dorsi

Question 5

Extrinsic back muscles attach the back to where?

Answer 5

Pectoral girdle

Question 6

The extrinsic back muscles allow movement of where?

Answer 6

The upper limb

Question 7

Are the extrinsic back muscles involved in the maintenance of posture?

Answer 7

No

Question 8

The trapezius muscle extends superiorly into the neck to attach to where?

Answer 8

Occipital bone

Question 9

The latissimus dorsi extends superiorly into the neck to attach to where?

Answer 9

Cervical vertebrae

Question 10

What are the two groups of intrinsic back muscles?

Answer 10

Erector spinae and transversospinalis

Question 11

Which group of intrinsic back muscles is more superficial?

Answer 11

Erector spinae

Question 12

Which group of intrinsic back muscles is more deep?

Answer 12

Transversospinalis

Question 13

Both groups of intrinsic back muscles extend superiorly into where?

Answer 13

The neck

Question 14

What are the functions of the intrinsic back muscles?

Answer 14

Maintenance of posture and movement of the spine

Question 15

The erector spinae is made up of how many muscle groups?

Answer 15

Three

Question 16

Where is the erector spinae muscle group located in relation to the spine?

Answer 16

Lateral

Question 17

Where does the erector spinae attach inferiorly?

Answer 17

A common tendon attaches to the sacrum and iliac crest

Question 18

Where does the erector spinae attach superiorly?

Answer 18

Individual muscle fibres attach via a tendon to either a rib, a transverse process of a vertebra or a spinous process of a vertebra

Question 19

Where is the transversospinalis muscle group located?

Answer 19

Within the grooves between transverse and spinous processes

Question 20

Individual muscle fibres of the transversospinalis muscle can attach between a vertebrae and what other structures?

Answer 20

The skull, a rib, another vertebrae, the sacrum

Question 21

Describe the nerve supply of intrinsic back muscles?

Answer 21

This is segmental - i.e. as per the dermatome/myotome pattern

Question 22

Are the intrinsic back muscles supplied by anterior or posterior rami?

Answer 22

Posterior rami

Question 23

What is the nerve supply to the levator scapulae?

Answer 23

Dorsal scapular nerve

Question 24

What is the nerve supply to the rhomboids?

Answer 24

Dorsal scapular nerve

Question 25

What is the nerve supply to the trapezius?

Answer 25

Spinal accessory nerve

Question 26

What is the nerve supply to the latissimus dorsi?

Answer 26

Thoracodorsal (long scapular) nerve

Question 27

What muscles are responsible for extension of the spine?

Answer 27

Erector spinae and transversospinalis

Question 28

Bilateral contraction of the erector spinae muscle results in what movement?

Answer 28

Extension

Question 29

Unilateral contraction of the erector spinae muscle results in what movement?

Answer 29

Lateral flexion

Question 30

What muscles are responsible for flexion of the spine?

Answer 30

Psoas major and rectus abdominus

Question 31

How many vertebrae are there? How is this divided?

Answer 31

33: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 4 coccygeal

Question 32

Describe the variations in size of the vertebrae?

Answer 32

They get bigger as you descend as they bear more weight, and then get smaller again once weight has been transferred to the hips

Question 33

The vertebral foraminae combine to form what two structures?

Answer 33

Vertebral canal and intervertebral foramina

Question 34

What structure passes through the vertebral canal?

Answer 34

Spinal cord

Question 35

What structures pass through the intervertebral foramina?

Answer 35

Spinal nerves

Question 36

What are the names of the two lordosis' in the spine?

Answer 36

Cervical and lumbar

Question 37

What are the names of the two kyphosis' in the spine?

Answer 37

Thoracic and sacral

Question 38

What structures attach to the spinous processes of vertebrae?

Answer 38

Muscles and ligaments

Question 39

What structures attach to the transverse processes of vertebrae?

Answer 39

Muscles, ligaments and ribs

Question 40

What is the role of the articular processes of a vertebrae?

Answer 40

To allow mobility by forming synovial facet joints with adjacent vertebrae

Question 41

What is the role of the vertebral foramen?

Answer 41

Convey and protect the spinal cord

Question 42

What is the role of the vertebral arch? What is it formed of?

Answer 42

Protects the spinal cord, formed of 2 lamina and 2 pedicles

Question 43

What joints of the back are affected by arthritis?

Answer 43

Facet joints

Question 44

Pain signals from the back will be transmitted through where?

Answer 44

Posterior rami

Question 45

Where in the vertebral column are intervertebral discs not found?

Answer 45

Between C1 and C2, and in the fused sacrum/coccyx

Question 46

Describe the movement provided by intervertebral discs?

Answer 46

Each disc allows a small amount of movement which has a summative effect providing a large amount of movement

Question 47

What is the role of the ligamentum flavum?

Answer 47

This is a short ligament, responsible for connecting adjacent laminae posterior to the spinal cord

Question 48

What does the posterior longitudinal ligament attach to?

Answer 48

The posterior aspect of all vertebral bodies and intervertebral discs

Question 49

Which is stronger, the anterior or posterior longitudinal ligament?

Answer 49

Anterior (broad and strong whereas the posterior is narrow and weak)

Question 50

What is the role of the posterior longitudinal ligament?

Answer 50

Prevents over flexion of the spine

Question 51

What does the anterior longitudinal ligament attach to?

Answer 51

The anterior aspect of all vertebral bodies and intervertebral discs

Question 52

What is the role of the anterior longitudinal ligament?

Answer 52

Prevents over extension of the spine

Question 53

Describe the strength/material of a supraspinous and interspinous ligament?

Answer 53

Supraspinous = strong, fibrous / interspinous = weak, membranous

Question 54

What is the role of the supraspinous ligament?

Answer 54

To connect the tips of spinous processes

Question 55

What is the role of the interspinous ligament?

Answer 55

To connect the superior and inferior surfaces of adjacent spinous processes

Question 56

What structure do cervical vertebrae possess that other vertebrae do not?

Answer 56

Transverse foraminae

Question 57

What structures pass through the transverse foraminae in cervical vertebrae?

Answer 57

Vertebral arteries

Question 58

What is unique about C1 atlas?

Answer 58

Does not have a vertebral body or spinous process

Question 59

What structure does C2 axis possess that other vertebrae do not?

Answer 59

An odontoid process projecting superiorly

Question 60

What is C7 vertebrae known as and why?

Answer 60

Vertebrae prominens as it is the first palpable spinous process

Question 61

Where do the atlanto-occipital joints connect between?

Answer 61

The occipital condyles and superior articular facets of atlas

Question 62

What type of joints are the atlanto-occipital joints?

Answer 62

Synovial joints with a loose capsule

Question 63

What movements do the atlanto-occipital joints allow?

Answer 63

Flexion and extension of the neck and a little lateral flexion and rotation

Question 64

Why may spinal cord damage not always occur in a dislocation of a cervical vertebrae?

Answer 64

Because the vertebral canal in this area is larger

Question 65

How many articulations form the atlanto-axial joint? What type of joint is this?

Answer 65

3 - it is a synovial joint

Question 66

Where are the 3 articulations which form the atlanto-axial joint?

Answer 66

2x between the inferior articular facets of atlas and superior articular facets of axis, and 1x between the anterior arch of atlas and odontoid process of axis

Question 67

What is the main movement that the atlanto-axial joint is responsible for?

Answer 67

Rotation

Question 68

What are found in the sacrum instead of intervertebral foraminae?

Answer 68

Anterior and posterior sacral foraminae

Question 69

What structures are found in the sacral canal?

Answer 69

Cauda equina and meninges

Question 70

Where is anaesthetic injected in caudal anaesthesia? What nerves are anaesthetised?

Answer 70

Sacral hiatus / the sacral spinal nerve roots of the cauda equina

Question 71

Where does the spinal cord begin? It is continuous with what other structure?

Answer 71

Foramen magnum / medulla oblongata

Question 72

Where does the spinal cord end? What is this known as? What does it become after this?

Answer 72

L1/L2 / conus medullaris / cauda equina

Question 73

What is the spinal cord surrounded by?

Answer 73

3 layers of meninges and epidural fat

Question 74

What is a laminectomy?

Answer 74

Removal of one or more spinous processes and the adjacent lamina

Question 75

What layers do you have to pass through to perform a laminectomy?

Answer 75

Skin, superficial fascia, deep fascia, intrinsic muscles, ligaments (flavum, supraspinous, interspinous)