Clinical Anatomy of the Spine Flashcards
(107 cards)
1
Q
What 3 structures does the spine support
A
Head
Body
Limbs
2
Q
What are the 3 functions of the spine
A
To support other structures
To transmit and protect neurological structure (spinal column and nerve routes)
Allow movement and flexibility
3
Q
Where is the position of the spine
A
As near to the centre of the body as possible
4
Q
What part of the spine is it that we can palpate on examination and where are these anatomically
A
The spinous processes - most posterior spinal element
5
Q
What are the 5 regions of the spine and how many vertebra are in each region?
A
Cervical (7) Thoracic (12) Lumbar (5) Sacral (5) Coccygeal (4)
6
Q
What are the 2 names given to describe the natural curvature of the spine
A
Kyphotic and lordotic
7
Q
What do the natural curves in the spine provide
A
resisitance and elasticity in distributing body weigh and axial loads sustained during movement
They help the body support adjoining structures
8
Q
Where does the vervical region join cranially
A
Via the occiput
9
Q
What are the largest type of vertebrae in the body
A
Lumbar
10
Q
Why does each vertebra have a slightly different shape
A
Due to performing a slightly different funciton
11
Q
what connects the transverse process to the spinous process
A
Lamina
12
Q
Describe the shape of the spinous process in the thoracic region
A
They point downwards
13
Q
Describe the shape of the spinous process in the lumbar region
A
They are transverse
14
Q
What are the posterior elements of the vertebrae
A
Everything but the vertebral body
15
Q
Describe the appearance of the vertebrae in the thoracic region
A
Small pedicles and long spinous processes
More vertical facet joints
Limited ROM
16
Q
Describe the appearance of the vertebrae in the lumbar region
A
Longer, wider pedicles (stronger)
The spinous processes are horizontal
More horizontal facet joints
17
Q
What is the main purpose of the facet joints
A
To stabilise the spinal column whilst allowing movement
18
Q
What type of joints are facet joints
A
Synovial joints
19
Q
Why are facet joints important clinically
A
OA
Pain
Osteophytes can cause nerve root impingement
20
Q
Where does the facet capsule lie in relation to the facet joint
A
It overlies the facet joint
21
Q
What bones make up the upper cervical region of the spine
A
C1 and C2
22
Q
What bones make up the lower cervical region of the spine
A
C3-7
23
Q
What is the name given to C1
A
Atlas
24
Q
Describe the appearance of C1
A
It has no body
Articulates with the occiput of the skull
25
What is the name given to C2
Axis
26
What is the special feature belonging to C2
The dens process - blunt tooth like projection
| Also known as the ondontoid proess
27
What movement does the dens provide and what does this allow?
Pivot allowing the atlas and head to rotate around the dens
28
What is the purpose of the sacroiliac joints
Shock absorption whilst allowing movement
Stability
Weight bearing
29
Why are sacroiliac joints important clinically
OA
sacroilitis
SIJ dysfunciton
30
What movements does the atlanto - occupital joint allow
Flexion/ extension and lateral flexions
31
What movements does the atlanto-dens joint allow
rotations (with dens acting as pivot
32
What is the first palpable vertebra
C7
33
What is the most palpable vertebra
T1
34
What causes the thoracic segment to be relatively fixed
THe thoracic rib cage
35
In what 2 places is there the greatest risk of injury
Cervico-thoracic and thoraco-lumbar junciton
36
Describe the structure of the peripheral annulus fibrosus
Thin posteriorly
| Can rupture
37
Describe the structure of the central nucleus pulposus
Gelatinous, semi fluid
38
If your disc is going to rupture, in what direction will it most likely rupture
Posteriorly
39
How much of the spine are the intervertebral discs responsible for
1/4 of the length of the spine
| Secondary curvature of the spine
40
What is the purpose of having ligaments
Add to the stability of the spinal column
41
Name the 5 ligaments of the spine
```
Anterior longitudinal ligament
Posterior longitudinal ligament
Ligament flavum
Supraspinous ligament
Intraspinous ligaments
```
42
Where do the anterior and posterior longitudinal ligmanets run
The length of the vertebral column
43
describe the structure and function of the ligamentum flavum
Link vertebral laminae
| Tough, elastic
44
Describe the structure and function of the supraspinous ligament
Tough
| Runs along the tops of the vertebrae
45
Describe the 3 column theory of Denis
1 colum injury = stable
2 columns injured = maybe unstable
3 columns injured = unstable
46
What are the 3 columns in the theory of Denis
Anterior column, middle column and posterior column
47
What are the main functions of the intermediate muscles of the back
Respiation
48
Why are the superficial muscles of the spine clinically relevant
Tenderness due to spasm
| Wasting from disuse or denervation
49
What is the function of the superficial muscles of the spine
Movement of shoulder and upper limb
50
What are the 4 superficial muscles of the spine
Trapezius
Latissimus dorsi
Rhomboid minor and major
Levatus sacpularis
51
Where is the origin and insertion of the trapezius
Origin is the spinous processes and the insertion is the occiput and spine of scapula
52
What nerve innervates the trapezius
Accessory nerve CN XI
53
What is the function of the trapezius
Elevates and depresses scapula
| Retracts scapula
54
Where is the origin and insertion of the latissimus dorsi
Broadest and back
Origin is the spinous processes and pelvis
Insertion is the humerus
55
What nerves innervate the latissimus dorsi
C6,7,8
56
What are the functions of the latissimus dorsi
Extends
| internally rotates the humerus
57
What are the functions of the rhomboid major and minor
To keep the scapula against the thoracic wall
| Retract scapula
58
What nerves innervate the thomboid major and minor
Dorsal scapula nerve (C3,4)
59
Where is the origin and insertion of the rhomboid minor
Spinous processes C7/T1
| Insertion: Scapula
60
Where is the origin and insertion of the rhomboid major
Spinous processes T2-T5
| Insertion: Scapula
61
What is the function of Levatus scapularis
Elevates the scapula
62
What is the origin and insertion of the levatus scapularis
Transverse processes C1
| Insertion: Superior angle of scapula
63
What nerve innervates the levatus scapularis
Branches C4/C5
64
Why are the deep muscles of the spine clinically relevant
Pain due to spasm in trauma
Weakness will cause spinal instability
Largest group of muscles in the back
65
What are the functions of the deep muscles of the spine
Movement of vertebral column and psture
66
What are the names of the deep muscles of the spine
Iliocostalis
Longisimus thoracis
Spinalis thoracis
67
What is the origin for the deep muscles of the spine
Occiput of the skull
68
What is the insertion for the deep muscles of the spine
Pelvis
69
What nerves innervate the deep muscles of the spine
Posterior rami of the spinal nerves
70
What can weakness of the deep muscles of the spine cause
Spinal instability leading to slips often due to poor musculature of the spine and abdo muscles
71
The spinal cord is a continuation of what and where does it exit the skull
Medulla oblongata
| Exits via the foramen magnum
72
Where does the spinal cord terminate
In the cauda equina L2
73
What does the spinal cord give off at each vertebral levle
A pair of nerve roots (Left and right)
74
Where do nerves in the cervical spine branch out to
Your arms
75
Where do nerves in the thoracic spine branch out to
Middle of the body
76
Where do nerves in the lumbar spine branch out to
Legs
77
Where do nerves in the sacral spine branch out to
Posterior aspect of legs and organ functions of the pelvis
78
Where is the origin of myotomes and dermatomes
The spinal cord
79
What is a myotome
Muscles controlled by the motor element of the nerve root from a specific level
80
What is a dermatome
Skin sensation supplied by the sensory element of the nerve root from a specific level
81
Grey matter is found in the centre of the nerve roots. True or False
True
82
The anterior and posterior horns are part of the white matter in the nerve roots. True or false
False - they are part of the grey matter
83
What lives in the white matter
Ascending sensory tracts and descending motor tracts
84
What is another name for the descending motor tract
Crossed pyramidal or lateral cerebrospinal tract
85
Where does the descending motor tracts cross
At the medullary level
86
Descending motor tracts descend the spine on what side of the cord
The contralateral side
87
What do the lateral and anterior spinothelamic tracts do?
Carry information relating to pain and temperature
88
What side of the spine do the ascending sensory tracts ascend
The ipsilateral side of the cord
89
What do the Posterior and Anterior Spinocerebellar tracts do
Information relating to proprioception
90
What side of the spine do the lateral and anterior spinothemalic tracts ascend on
The ispsilateral side of the cord then cross and ascend the spine of the opposite side before enterning the thalamus
91
What are the 2 posterior ascending sensory tracs called
Fasciculus gracilis of Goll
| Fasciculus cunateatus of Burdach
92
What side of the spine do the posterior columns of the ascending sensory tract travel
Ipsilaterlaal side of the cord
93
What information do the posterior columns of the ascending sensory tracts carry
Information relating to fine touch and proprioception
94
What happens in the grey matter
The descending motor tracts enter the anterior horn of the grey matter and are transmitted via the ventral root to the nerve root then the muscle of action
Sensation is transmitted via the spinal nerve root to the dorsal root and into the posterior horn of the grey matter and via the ascending sensory tracts enter the brain
95
The ventral and dorsal roots joint to become what
Nerve root
96
The nerve roots divide to form what
The posterior and anterior rami
97
What do the posteiror rami do
Serve the intrinsic muscles of the back and the trip of skin sensation in the center of the back
98
What do the anterior rami do
Form the nerve supply to the rest of the body/ limbs as we know it
99
Where do the spinal nerves on each side exit the spinal column
The intervertebral foramina
100
What is the nerve root at risk from
Prolapsed disc
Facet joint
Osteophytes
Foraminal stenosis
101
What is the cauda equina
A bundle of spinal nerves and nerve roots: L2-L5
102
What do the nerves that compose the cauda equina innervate
The pelvic orans and lower limbs
103
What are the motor functions of the cauda equina
Hips, knees, ankles, feet, internal anal sphincter and external anal sphincter
104
What are the sensory functions of the Cauda equina
Hips, knees, ankles, feet, perineum and partially parasympathetic innervation of the bladder
105
Where do the anterior and posterior spinal arteries descend from
The pia
106
The cerebrospinal venous system consists of what
Interconnected venous systems of the brain and the spine
107
What is the Batson's venous plexus
A network of valveless veins
| They connect the deep pelvic veins and thoracic veins to the internal vertebral venous plexus
