Clinically relevant anatomy of the back, spine and spinal cord

Question 1

What is the first palpable spinous process?

Answer 1

C7

Question 2

What is the function of the extrinsic back muscles?

Answer 2

Move upper limb

Question 3

What are the extrinsic back muscles?

Answer 3

Levator scapulae
Rhomboids
Trapezius
Latissimus dorsi

Question 4

What are the 2 groups of intrinsic back muscles?

Answer 4

Erector spinae

Transversospinalis

Question 5

What are the 3 muscles groups under erector spinae?

Answer 5

Inferiorly - common tendon attaches to sacrum and iliac crest
Superiorly - rib, transverse process and spinous process

Question 6

Where can the transversospinalis muscle be found?

Answer 6

Located within the grooves between the transverse and spinous process

Question 7

What is the main function of the transversospinalis?

Answer 7

Stability
Rotation of vertebrae
Elevation of ribs

Question 8

Muscles of posterior abdominal wall

Answer 8

Psoas major

Quadratus lumborum

Question 9

Which muscles control extension and lateral flexion of the spine?

Answer 9

Erector spinae

Question 10

What occurs if the erector spinae contracts bilaterally?

Answer 10

Extension of spine

Question 11

What occurs if the erector spinae contracts unilaterally?

Answer 11

Lateral flexion

Question 12

Which muscles control flexion of the spine?

Answer 12

Psoas major and rectus abdominus

Question 13

Describe the curvatures of the vertebral column

Answer 13

Cervical lordosis
Thoracic kyphosis
Lumbar lordosis
Sacram kyphosis

Question 14

Where are spinal nerves found?

Answer 14

Intervertebral foramen

Question 15

Where can facet joints be found in the spine?

Answer 15

Between articular processes of adjacent vertebrae

Question 16

What ligaments are present in the spine?

Answer 16

Ligamentum flavum
Posterior longitudinal ligament
Anterior longitudinal ligament

Question 17

What movements will the anterior longitudinal ligament prevent?

Answer 17

Overextension

Question 18

What is the clinical relevance of the fact that the posterior longitudinal ligament is weaker than the anterior?

Answer 18

IV discs will herniate posterioly

Question 19

What movement will the posterior longitudinal ligament help to prevent?

Answer 19

Overflexion of the spine

Question 20

Where can the supraspinous ligament be found?

Answer 20

Tips of spinous processes

Question 21

Where can the interspinous ligaments be found?

Answer 21

Connects superior and inferior surfaces of adjacent spinous processes

Question 22

Which vertebrae is the atlas?

Answer 22

C1

Question 23

Which vertebrae has an odontoid process?

Answer 23

C2 - axis

Question 24

What are common typical features of cervical vertebrae?

Answer 24

Transverse foramen
Bifid spinous process
Triangular shaped vertebral foramen

Question 25

Does C1 have a vertebral body?

Answer 25

NO - posterior and anterior arch

Question 26

What runs in the transverse foramen?

Answer 26

Vertebral arteries

Question 27

Where are the atlanto-occipital joints?

Answer 27

Between the occipital condyles and the superior articular facets of the atlas

Question 28

What type of joint is the atlanto-occipital joint?

Answer 28

Synovial

Question 29

Which movements does the atlanto-occipital joint facilitate?

Answer 29

Flexion and extension of neck | Lateral flexion and rotation of neck

Question 30

What are the articulations of the atlanto-axial joints?

Answer 30

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

Question 31

What is the main movement of the atlantoaxial joint?

Answer 31

Rotation

Question 32

Where does the cauda equina with it meninges run in the sacrum?

Answer 32

Within the sacral canal

Question 33

Where does the spinal cord begin?

Answer 33

At the foramen magnum, continuous with the medulla oblongata

Question 34

Where does the spinal cord end?

Answer 34

Around L1/2

Question 35

What is the end of the spinal cord called?

Answer 35

Conus medullaris which becomes cauda equina

Question 36

Where is a common space for an LP and an episural?

Answer 36

L3/4

Question 37

Where does the meninges end on the spinal cord?

Answer 37

S2

Question 38

Should you perform an LP in raised ICP?

Answer 38

NO

Question 39

What structures will the needle pass through to give an epidural anaesthesia?

Answer 39

Supraspinous ligament Interspinous ligament Ligamentum flavus Epidural space

Question 40

What structures will the needle pass through to perform an LP?

Answer 40

``` Supraspinous ligament Interspinous ligament Ligamentum flavus Epidural space Dura mater Arachnoid mater Subarachnoid space ```

Question 41

What is a laminectomy?

Answer 41

Used to assess spinal canal, posterior exposure of spinal cord

Question 42

When is a laminectomy utilised?

Answer 42

Relive pressure on spinal cord or nerve roots in case of a tumour, herniated disc or bone hypertrophy