Flashcards in Chapter 2 Deck (133):
Posterior aspect of the trunk, between neck and buttocks. Contain the bones of the back, vertebral column, connected by intervertebral discs, joints and ligaments.
How many vertebrae in the human body? Now how many in each: And cervical? Thoracic? Lumbar? Sacral? Coccyx?
What are called false vertebrae?
Sacral and coccygeal
Between vertebrae, absorb shock, assure no friction between bones and facilitate movements of verbal column
Adult vertebral has how many curvatures?
What are the primary curvatures?
Thoracic & sacral. Are concave anteriorly (kyphoses). During fetal life
What are the secondary curvatures?
Cervical and lumbar curvature are convex anteriorly and develop later.(Lordoses).
Cervical curvature at what age?
3 months .
Lumbar curvature at what age?
Each vertebrae consists of a ______ that is situated anteriorly in the vertebral column. It is connect with two _______. The arches fuse together to form the _________, which contains the spinal cord, meninges, roots, vessels and other tissues. There is a backward extension from the point of fusion of the two arches called the ________. The arch itself consist of the ______ and _____.
Pedicle is ______situated while the lamina continues ______. At the junction between the pedicle and lamina on each side, there is a ______ projecting upward and the ______, projecting downward. These in turn have an articular surface called _____, which is covered by _______ and is the site of articulation between the vertebrae.
-superior articular process
-inferior articular process
Orientation of facets on articular processes change in vertebral column as we move _______
Vertebral Notch (superior or inferior)
Superior or inferior surfaces of pedicle, between articular process and vertebral body, bone has depression (indentation)
Where the vertebrae join each other in the vertebral column, vertebral notch form them....allows-transmits nerve roots and vessels of spinal cord and contains dorsal root ganglion
Bony extension from lateral side of vertebrae.
Foramen of transverse process, which transmits vertebral artery in each side.
Vertebral artery originate from ______
Subclavian arteries and provide major blood supply to spinal cord and the brain stem and partially to the brain.
Anterior and posterior ones that are by transverse process and sulcus between them, and are for spinal nerves to pass through
Major differences between cervical and other
Cervical vertebrae has relatively smaller vertebral body and larger vertebral foramen, they have transverse foramen and most have bifid spinous process
First cervical vertebrae (C1)
Difference between C1 and other cervical vertebrae
-No body in the atlas.
-two lateral masses connected together by small anterior arch and large posterior arch
Articular surfaces of C1
Join the occipital bone of the skull on too and axis at Atlanto-axial-articulation
Atlas has a large ______. And anterior part provides a space for ______.
Articular facet one inner aspect of anterior arch for articulation between C1 and C2, median-Atlanto-axial articulation.
Atlas has no _____. Instead posterior & anterior tubercle.
Second cervical vertebrae is called
Axis has a _____, an apex and two articular facets, one anterior for articulation with atlas and one posterior for connect with transverse ligament of the atlas. Relatively large _____. And has ______, transverse process, and transverse foramen.
-spinous process (bifid)
Anterior tubercle of C6 is more prominent
Project Upward from the superolateral borders of the body of these vertebrae, including C7. Processes are flat but start to elevate during childhood (5-10 yrs) and develop into uncovertebral joints.
Between cervical vertebrae. Develop by age and may become pathologic and permit disk herniation especially in C5 region. (C5-C6)...cause paralyzed
7th cervical vertebrae-long and palpable
Spinous process, anterior tubercle on its transverse process is missing
Different meningeal layers surrounding the spinal cord and the brain
Meninges consist of 3 membranes, dura mater (outer later), pia matter (innermost layer-attached to spinal cord), arachnoid mater (between them).
Extensions of pia mater from the surface of spinal for to arachnoid mater-support spinal cord in the vertebral canal.
3 spaces in relation to meninges: epidural space ( located between bone and the dura mater, contains fat, vertebral veins, nerve roots. Space is wider in lower parts of vertebral canal. & subdural space (lies between dura and arachnoid mater and subarachnoid space is between arachnoid and pia mater and contains CSF). Space is larger in specific areas in vertebral column referred to as cisterns (contain vessels and nerve roots)
Where's lumbar cistern and what's found there?
Below termination of spinal cord as medullary cone. Contains the cauda equina (nerve roots and filum terminate-cordlike extension if pia mater originating at medullary cone, which is floating in CSF).
Vertebral basilar syndrome
Basila artery is compressed, artery becomes compressed and one becomes light headed or dizzy, not enough blood to brain.
Contents of intervertebral foramen
Dorsal root ganglia are located at foramen and spinal roots and vessel pass through the foramen
Contains vertebral arteries and veins in C1-C6 vertebrae. C7 transverse foramen contains accessory vertebral vessels.
Vertebral artery originates from
-arch at posterolateral aspect
-pedicle is anterior part of the arch
-lamina is posterior part of the arch (toward the back)
-arches join and form circular vertebral foramen (smaller then cervical or lumbar foramen)
Spinous process of thoracic vertebrae are ______
Long and has posteroinferior slope. Spinous process of lowest 3-4 thoracic vertebrae resembles
Those of lumbar vertebrae.
Transverse process of thoracic vertebrae are_____
Long and strong.
A prominent distinction of body of the thoracic vertebrae is two _____
Costal facets. These facets articulate with heads of ribs, forming the costovertebral joints. Also T1-T10 have a costal facet for articulation with tubercle of ribs, creating costotransverse joints.
Heart shaped body (vertebrae)
Vertebral foramen of lumbar is _____
Triangular and larger than thoracic but smaller than cervical vertebrae
Small vertebral joints between the articular processes. Also known as synovial joints
Vertebral arch of lumbar is _____
Short lamina and thick pedicle
Transverse (costal) process
Lumbar vertebrae is long, slender with accessory process in the back.
Superior and inferior articular processes have facets that _______[
That face each other either medially or laterally
Spinous process in lumbar is
Short, thick and flat, extends in sagittal direction
Kidney shaped body (vertebrae)
Lower extension if spinal cord in adults and newborns?
Spinal cord in adults ends at the lower level of L1 vertebra, newborns at L3 vertebra.
Dura mater continues down to ______, where Dural sac or cistern is formed for lumbar puncture
Procedure during which a needle is passed in between the spinous process and the interlaminar space between L3-L4 or L4-L5. Through skin into subarachnoid space by piercing throughout dura and Arachnoid maters. Line drawn between iliac crest is approximate of L4 spinous process
Lumbar puncture measures?
-pressure of CSF by using manometer (withdrawn CSF)
-anesthetics (spinal block) and other drugs, including contrast medium for myelography, can be given through lumbar puncture.
Lumbar puncture is newborns is better done at
Lumbar puncture is newborns is better done at L4-L5 (avoid possible spinal cord injury)
-wedge shaped bone formed in result of fusion of 5 sacral vertebrae together with their intervertebral discs.
-part of bony pelvis and is located between the two hips in posterior part of pelvis. It's base is on the top and faces L5 and joins coccyx.
Sacrum-prominent features of anterior surface
Top to base: sacral promontory, lateral parts which continue with ala, 4 pairs of anterior sacral foramine (spinal nerves leave)
Sacrum-prominent features of dorsal surface
-superior articulate processes, which articulate with the L5 vertebra,
- opening of the sacral canal
-the median, intermediate and lateral sacral crests
-4 pairs of posterior sacral foramine
-2 sacral horns
Spina bifida occurs?
Due to a failure of development and/or fusion of the vertebral arches of the L5 or S1 vertebrae.
Spina bifida cystica
Severe form of spina bifida results in one or more vertebral arches fail to develop. Associated with meningocele. Paralysis of limbs, neural tube defect. Caudal fail to close. Also have sensory, motor and autonomic syndromes.
Spina bifida occulta
Milder form in which some vertebrae do not close completely, malformation covered by skin.
What can pregnant woman take to prevent spina bifida?
Folic Acid supplement
Fusion of L5 vertebrae to the sacrum
When S1 separates from sacrum
S1 promontoid, use it to measure diameter in females for vagunal examination (13 cm)- should be anterior to pelvis, subtract 1.5-2 cm and get true distance of pelvic
No disc between?
C1-C2 and L5-S1
Intervertebral discs are compressible and contribute to about ____ of length of vertebral column
Discs consist of
-annulus fibrous (outer part)
-fibrocartilage tissues (collagen), arranged in concentric rings
-nucleus pulposus (inner part)
-jelly like structural remnant of embryonic notochord. Is vascular and receives nutrients by diffusion from surround blood vessels. Gelatinous part distributes pressure, and shrinks with age. Tension of annulus fibrosis decreases and makes discs prone to rupture.
Signal of development nervous become neural tube. Day 24-26 tube closes.
Neural chords superior , if not close head/brain not develop and have still born
Discs have thin plate of
Hyaline cartilage (derived from epiphysis of the bone)
Annulus of intervertebral discs is prone to taking and ______ of the nucleus pulposus.
Herniation of discs more common....
If between vertebrate C1-C2, then nerve that is affected is C2. Now if between L3-L4, the nerve that is affected is L3.
Lateral herniation of Lumbar disc
Press on nerve roots situated posterior to discs exiting lower intervertebral foramen
Lumbar disc herniation, pain is referred down the back and lateral side of leg and foot
Weakness in dorsiflexion or plantarflexion
Central disc herniation may compress
Whole cauda equina, causing paraplegia
Cervical disc herniation
Lateral protrusion compress spinal nerve, cause pain in the lower neck area and shoulders
Atlanto-occipital articulation function
Forward (flexion) and backward (extension)movement of the head
Atlanto-axial articulation function
Allows rotation (side to side) of the head
Anterior longitudinal ligament (ALL)
Strong band that prevents the hyper extension of the vertebral column. From atlas to sacrum. Anterior aspect of vertebral bodies
Posterior longitudinal ligament (PLL)
Narrow band consisting of superficial layer and deep layer. Prevents hyper flexion of vertebral column and helps protect against posterior disc (nucleus pulposus) herniation. Posterior aspect of vertebral bodies, within vertebral canal, attached to intervertebral discs, especially in thoracic and lumbar regions. Not as protected and vulnerable or injury
Located between vertebral arches (continuous joint). Contains elastic fibers and yellow appearance. Brings flexed vertebral column and allows back to its erect position.
Short ligament located between spinous processes of the vertebrae
Spinous process provide a continuous connection from C7 to sacrum
Short ligaments located between transverse processes of the vertebrate
Originates from occipital bone and extends to spinous processes of cervical vertebrae, becomes continuous with supra spinous ligament. Also attaches to some back muscles.
Formed by superior and inferior longitudinal
Bands, as well as transverse ligament of atlas
Dens extends from head of Odontoid of process to anterior border of foramen magnum
Originates from both sides of dens to lateral borders of foramen Magnum
Falling on buttocks injury
Coccydyna (pain in coccyx)
Most superficial muscle in posterior region of the neck
Trapezius consist of 3 parts
Upper fibers, middle fibers, and lower fibers
Supporting scapula and shoulder, elevation of scapula (shrugging shoulders) using upper fibers, produces slight elevation of the arm in conjunction with serrated anterior muscle. Part of working together to pull scapula toward vertebrae, retraction of scapula. Fibers pull clavicle and rotate scapula and adduct arm.
Spinal roots of accessory nerve (cranial nerve 11) is involved in motor innervation. C3-C4 nerves involved in sensory innervation (proprioception and pain)
Patient can't shrug shoulder
Cranial nerve 11 affected
Spine of scapula
Wide, flat muscle in superficial layer extended from back to humerus. Partially beneath trapezius
Latissimus Dorsi function
Adduction and lowering of the arm. Also able to raise the body toward the shoulder. Medial rotation and extension of the arm acting on humerus.
What muscle involved in coughing and forced expiration
Latissimus Dorsi innervation
Thoracodorsal nerve. Branch of posterior cord coming from brachial plexus
Rhomboid minor and major function
Press scapulae to the thoracic wall, involved in medial rotation and retraction of the scapula
Rhomboid minor and major innervation
Dorsal scapular nerve to both rhomboid muscles
Levator scapulae function
Elevates scapula, rotates inferior angle of scapula medially, rotates glenoid of scapula downward
Levator scapulae innervation
Dorsal scapular nerve
Serratus posterior superior innervation
Serratus posterior inferior function
Serratus posterior inferior innervation
Remove latt. Dorsi and rhomboid
Have serratus posterior superior and inferior
Both may function as accessory muscles of respiration (COPD), chronic bronchitis
Serratus posterior inferior and superior
Have lumbar, thoracic and cervical areas and innervated by dorsal rami of various spinal nerves
Muscles distributed to thoracic, cervical and head areas. Innervated by primary Dorsi rami of spinal nerves
Splenius cervicis and capitis
Cervical vertebrae and mastoid process and innervated by primary dorsal rami
Illicostalis and longissimus muscles functions
Hold muscles in erect posture of body
Splenius muscles functions
Rotate or extend the head and neck when both contract. Contraction of each splenius rotates head to the side of contraction
Semispinalis thoracic (cervicis) and capitis function and innervation
Involved in extension of head and vertebral column, rotation. Innervated by primary Dorsi rami
Multifidus function and innervation
Involved in stabilization of vertebrae with movement of the vertebral column. Innervated by primary Dorsi rami
Rotator brevis and longus function
Involved in stabilizing vertebrae and aid in rotation and extension of vertebrae.
Interspinales, intertransversarii, levatores costarum function
Movement of vertebral column and assisting in respiration
4 muscles in intrinsic muscle group in suboccipital region, but 3 mentioned
-rectus capitis posterior major
-obliquus capitis superior
-obliquus capitis inferior
Contents of suboccipital triangle
-third part of vertebral artery
-suboccipital nerve innervation 4 muscles
-suboccipital plexus of veins
Suboccipital region muscles functions and innervation
Bilateral contractions turn the head backward, and unilateral contraction turns head to sides. Innervated greater occipital nerve
Caused by atherosclerosis of the vertebral arteries in and around suboccipital triangle, syndrome is due to insufficient blood supply to hindbrain. Blood supply can be lessened by turning head back up for period of time, leading to dizziness and light-headed ness.
Extrinsic muscles of back
-trapezius, lattisimus Dorsi. Levator scapulae, rhomboid minor
Extrinsic intermediate muscles
Serratus posterior inferior and superior
Superficial intrinsic back muscles
Splenius cervicis and capitis
Intermediate intrinsic muscles
Iliocostales, longissimus, cervicis, capitis and medial groups
Deep intrinsic back muscles
Semispinalis thoracic, cervicis and capitis. Multifidus, rotators, interspinales, intertransversarii , levatores costarum.
Spinalis capitis is often ______
Dorsal scapula nerve damaged (winged scapula)-scapula bulge out
-either rhomboid or serratus anterior muscle damaged