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Flashcards in Chapter 2 Deck (133):
1

Back location

Posterior aspect of the trunk, between neck and buttocks. Contain the bones of the back, vertebral column, connected by intervertebral discs, joints and ligaments.

2

How many vertebrae in the human body? Now how many in each: And cervical? Thoracic? Lumbar? Sacral? Coccyx?

33-34.
-7 cervical
-12 thoracic
-5 lumbar
-5 sacral
-4-5 coccyx

3

What are called false vertebrae?

Sacral and coccygeal

4

Intervertebral discs

Between vertebrae, absorb shock, assure no friction between bones and facilitate movements of verbal column

5

Adult vertebral has how many curvatures?

4

6

What are the primary curvatures?

Thoracic & sacral. Are concave anteriorly (kyphoses). During fetal life

7

What are the secondary curvatures?

Cervical and lumbar curvature are convex anteriorly and develop later.(Lordoses).

8

Cervical curvature at what age?

3 months .

9

Lumbar curvature at what age?

9-10 months

10

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 _____.

-body
-vertebral arches
-vertebral foramen
-spinous process
-pedicle
-lamina

11

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.

-anteriorly
-posteriorly
-superior articular process
-inferior articular process
-facet
-hyaline cartilage

12

Orientation of facets on articular processes change in vertebral column as we move _______

Caudally

13

Vertebral Notch (superior or inferior)

Superior or inferior surfaces of pedicle, between articular process and vertebral body, bone has depression (indentation)

14

Intervertebral foramen

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

15

Transverse process

Bony extension from lateral side of vertebrae.

16

Transverse foramen

Foramen of transverse process, which transmits vertebral artery in each side.

17

Vertebral artery originate from ______

Subclavian arteries and provide major blood supply to spinal cord and the brain stem and partially to the brain.

18

Tubercle

Anterior and posterior ones that are by transverse process and sulcus between them, and are for spinal nerves to pass through

19

Major differences between cervical and other
Vertebrae

Cervical vertebrae has relatively smaller vertebral body and larger vertebral foramen, they have transverse foramen and most have bifid spinous process

20

Atlas

First cervical vertebrae (C1)

21

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

22

Articular surfaces of C1

Join the occipital bone of the skull on too and axis at Atlanto-axial-articulation

23

Atlas has a large ______. And anterior part provides a space for ______.

-Vertebral foramen.
-Dens

24

Fovea dentis

Articular facet one inner aspect of anterior arch for articulation between C1 and C2, median-Atlanto-axial articulation.

25

Atlas has no _____. Instead posterior & anterior tubercle.

Spinous process

26

Second cervical vertebrae is called

Axis

27

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.

-dens
-vertebral foramen
-spinous process (bifid)

28

Carotid tubercle

Anterior tubercle of C6 is more prominent

29

Uncinate process

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.

30

Uncovertebral joints

Between cervical vertebrae. Develop by age and may become pathologic and permit disk herniation especially in C5 region. (C5-C6)...cause paralyzed

31

Vertebrae prominence

7th cervical vertebrae-long and palpable
Spinous process, anterior tubercle on its transverse process is missing

32

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).

33

Denticulate ligaments

Extensions of pia mater from the surface of spinal for to arachnoid mater-support spinal cord in the vertebral canal.

34

Intermeningeal spaces

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)

35

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).

36

Vertebral basilar syndrome

Basila artery is compressed, artery becomes compressed and one becomes light headed or dizzy, not enough blood to brain.

37

Contents of intervertebral foramen

Dorsal root ganglia are located at foramen and spinal roots and vessel pass through the foramen

38

Transverse foramen

Contains vertebral arteries and veins in C1-C6 vertebrae. C7 transverse foramen contains accessory vertebral vessels.

39

Vertebral artery originates from

Subclavian artery

40

Thoracic vertebrae

-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)

41

Spinous process of thoracic vertebrae are ______

Long and has posteroinferior slope. Spinous process of lowest 3-4 thoracic vertebrae resembles
Those of lumbar vertebrae.

42

Transverse process of thoracic vertebrae are_____

Long and strong.

43

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.

44

Heart shaped body (vertebrae)

Thoracic

45

Vertebral foramen of lumbar is _____

Triangular and larger than thoracic but smaller than cervical vertebrae

46

Zygapophysial joints

Small vertebral joints between the articular processes. Also known as synovial joints

47

Vertebral arch of lumbar is _____

Short lamina and thick pedicle

48

Transverse (costal) process

Lumbar vertebrae is long, slender with accessory process in the back.

49

Superior and inferior articular processes have facets that _______[

That face each other either medially or laterally

50

Spinous process in lumbar is

Short, thick and flat, extends in sagittal direction

51

Kidney shaped body (vertebrae)

Lumbar

52

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.

53

Dura mater continues down to ______, where Dural sac or cistern is formed for lumbar puncture

S2

54

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

55

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.

56

Lumbar puncture is newborns is better done at

Lumbar puncture is newborns is better done at L4-L5 (avoid possible spinal cord injury)

57

Sacrum

-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.

58

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)

59

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
-sacral hiatus
-2 sacral horns

60

Spina bifida occurs?

Due to a failure of development and/or fusion of the vertebral arches of the L5 or S1 vertebrae.

61

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.

62

Spina bifida occulta

Milder form in which some vertebrae do not close completely, malformation covered by skin.

63

What can pregnant woman take to prevent spina bifida?

Folic Acid supplement

64

Sacralization

Fusion of L5 vertebrae to the sacrum

65

Lumbarization

When S1 separates from sacrum

66

Diagonal conjugate

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

67

No disc between?

C1-C2 and L5-S1

68

Intervertebral discs are compressible and contribute to about ____ of length of vertebral column

20-25%

69

Discs consist of

-annulus fibrous (outer part)
-fibrocartilage tissues (collagen), arranged in concentric rings
-nucleus pulposus (inner part)

70

Nucleus pulposus

-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.

71

Notochord

Signal of development nervous become neural tube. Day 24-26 tube closes.

72

Anacephally

Neural chords superior , if not close head/brain not develop and have still born

73

Discs have thin plate of

Hyaline cartilage (derived from epiphysis of the bone)

74

Annulus of intervertebral discs is prone to taking and ______ of the nucleus pulposus.

Herniation

75

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.

76

Lateral herniation of Lumbar disc

Press on nerve roots situated posterior to discs exiting lower intervertebral foramen

77

Sciatica

Lumbar disc herniation, pain is referred down the back and lateral side of leg and foot

78

Motor deficits

Weakness in dorsiflexion or plantarflexion

79

Central disc herniation may compress

Whole cauda equina, causing paraplegia

80

Cervical disc herniation

Lateral protrusion compress spinal nerve, cause pain in the lower neck area and shoulders

81

Atlanto-occipital articulation function

Forward (flexion) and backward (extension)movement of the head

82

Atlanto-axial articulation function

Allows rotation (side to side) of the head

83

Anterior longitudinal ligament (ALL)

Strong band that prevents the hyper extension of the vertebral column. From atlas to sacrum. Anterior aspect of vertebral bodies

84

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

85

Ligamentum ligaments

Located between vertebral arches (continuous joint). Contains elastic fibers and yellow appearance. Brings flexed vertebral column and allows back to its erect position.

86

Interspinous ligaments

Short ligament located between spinous processes of the vertebrae

87

Supra spinous

Spinous process provide a continuous connection from C7 to sacrum

88

Intertransverse ligaments

Short ligaments located between transverse processes of the vertebrate

89

Ligamentum nuchae

Originates from occipital bone and extends to spinous processes of cervical vertebrae, becomes continuous with supra spinous ligament. Also attaches to some back muscles.

90

Cruciate ligament

Formed by superior and inferior longitudinal
Bands, as well as transverse ligament of atlas

91

Apical ligament

Dens extends from head of Odontoid of process to anterior border of foramen magnum

92

Alar ligament

Originates from both sides of dens to lateral borders of foramen Magnum

93

Falling on buttocks injury

Coccydyna (pain in coccyx)

94

Most superficial muscle in posterior region of the neck

Trapezius

95

Trapezius consist of 3 parts

Upper fibers, middle fibers, and lower fibers

96

Trapezius function

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.

97

Trapezius innervation

Spinal roots of accessory nerve (cranial nerve 11) is involved in motor innervation. C3-C4 nerves involved in sensory innervation (proprioception and pain)

98

Patient can't shrug shoulder

Cranial nerve 11 affected

99

Acrominon process

Spine of scapula

100

Latissimus Dorsi

Wide, flat muscle in superficial layer extended from back to humerus. Partially beneath trapezius

101

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.

102

What muscle involved in coughing and forced expiration

Latissimus Dorsi

103

Latissimus Dorsi innervation

Thoracodorsal nerve. Branch of posterior cord coming from brachial plexus

104

Rhomboid minor and major function

Press scapulae to the thoracic wall, involved in medial rotation and retraction of the scapula

105

Rhomboid minor and major innervation

Dorsal scapular nerve to both rhomboid muscles

106

Levator scapulae function

Elevates scapula, rotates inferior angle of scapula medially, rotates glenoid of scapula downward

107

Levator scapulae innervation

Dorsal scapular nerve

108

Serratus posterior superior innervation

Intercostal nerves

109

Serratus posterior inferior function

Rib elevation

110

Serratus posterior inferior innervation

Intercostal nerves

111

Remove latt. Dorsi and rhomboid

Have serratus posterior superior and inferior

112

Both may function as accessory muscles of respiration (COPD), chronic bronchitis

Serratus posterior inferior and superior

113

Illiocostalis

Have lumbar, thoracic and cervical areas and innervated by dorsal rami of various spinal nerves

114

Longissimus

Muscles distributed to thoracic, cervical and head areas. Innervated by primary Dorsi rami of spinal nerves

115

Splenius cervicis and capitis

Cervical vertebrae and mastoid process and innervated by primary dorsal rami

116

Illicostalis and longissimus muscles functions

Hold muscles in erect posture of body

117

Splenius muscles functions

Rotate or extend the head and neck when both contract. Contraction of each splenius rotates head to the side of contraction

118

Semispinalis thoracic (cervicis) and capitis function and innervation

Involved in extension of head and vertebral column, rotation. Innervated by primary Dorsi rami

119

Multifidus function and innervation

Involved in stabilization of vertebrae with movement of the vertebral column. Innervated by primary Dorsi rami

120

Rotator brevis and longus function

Involved in stabilizing vertebrae and aid in rotation and extension of vertebrae.

121

Interspinales, intertransversarii, levatores costarum function

Movement of vertebral column and assisting in respiration

122

4 muscles in intrinsic muscle group in suboccipital region, but 3 mentioned

-rectus capitis posterior major
-obliquus capitis superior
-obliquus capitis inferior

123

Contents of suboccipital triangle

-third part of vertebral artery
-suboccipital nerve innervation 4 muscles
-suboccipital plexus of veins

124

Suboccipital region muscles functions and innervation

Bilateral contractions turn the head backward, and unilateral contraction turns head to sides. Innervated greater occipital nerve

125

Vertebrobasilar syndrome

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.

126

Extrinsic muscles of back

-trapezius, lattisimus Dorsi. Levator scapulae, rhomboid minor
And major.

127

Extrinsic intermediate muscles

Serratus posterior inferior and superior

128

Superficial intrinsic back muscles

Splenius cervicis and capitis

129

Intermediate intrinsic muscles

Iliocostales, longissimus, cervicis, capitis and medial groups

130

Deep intrinsic back muscles

Semispinalis thoracic, cervicis and capitis. Multifidus, rotators, interspinales, intertransversarii , levatores costarum.

131

Spinalis capitis is often ______

Absent

132

Dorsal scapula nerve damaged (winged scapula)-scapula bulge out

-either rhomboid or serratus anterior muscle damaged

133

Ask patient to elevate arm, if ok then problem with ______, if not ok and can't elevate arm 90 degrees ______

-rhomboid
-serratus anterior muscle