Exam 1 Flashcards by S R

What are the 6 different types of synovial joints?

Pivot
Ball and socket
Saddle
Ellipsoid
Hinge
Gliding

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S2 tubercle is found approximately at the level of what other anatomical structure?

PSIS

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The apex of the heart is found approximately at what vertebral layer?

T10

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Vertebral notches are found as part of which vertebral structure?

Pedicle

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Supination and pronation movements occur in which plane?

Transverse

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List sympathetic responses

Pupils dilate, eyes widen
Mucous membranes of nose/mouth dry
Erector pili muscles contract, sweating
Blood supply to skin and GI tract constricted
Blood supply to heart, lungs, skel muscles dilated
Cardiac stroke volume increases, brachiodilation

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List parasympathetic responses:

Pupils constrict
Mucous membranes secrete
Peristalsis of GI tract
Blood supply increased to GI tract and skin
Blood supply decreased to skel muscle, heart, lungs
Bronchoconstriction and decreased cardiac output

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Medial and lateral movements occur in what plane?

Sagittal/Median

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Anterior and posterior movements occur in what plane?

Coronal/frontal

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Movement along an axis is what?

Translation

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Movement around an axis is what?

Rotation

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Theta movement moves in what direction?

Counterclockwise

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How many fused vertebrae make up the coccyx?

3-5

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Which 2 segments contain no discs between vertebrae?

C0-C1 and C1-C2

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The 7 processes from the posterior aspect are made of which processes?

1 SP, 2 TP, 4 APs

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The median furrow surface connects from ____ to ____.

EOP 
Gluteal cleft (S3)

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Inferior angle of scapula positioning while prone and while standing?

Prone- T6

Standing- T7

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T1 is the most prominent SP in what population percentage?

30-40%

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The mastoid process is felt by coming off the TP of which vertebra?

C1 (atlas)

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Which cervical vertebra has the smallest SP?

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The C3 SP is approximately the same level as what feature of the hyoid bone?

Greater cornua

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C4 disc sits level with ____.

Thyroid cartilage

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Lamina contact point or the articular pillars are approximately how far lateral from the cervical SPs?

1.5 cm

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Carotid tubercle (C6) is level with cricoid cartilage and which tracheal ring?

1st tracheal ring

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The root of the spine of the scapula is found off which SP?

T3 SP

The most convex point of thoracic kyphosis is which SP?

T12 is a 1/2 measurement point between ____ and ____.

IAS | Superior iliac crest

T5-9 are how many spinous interspaces superior to their SP?

Rib angles are approximately how far lateral to the midline at the level of their TP?

4 cm

Which SP is the last palpably movable through flex/extend?

80% of the time, L4 SP is at level of ____.

Iliac crests

What processes are found 2cm lateral on the superior articular processes?

Mammillary

Mammillary processes are level with which bony landmark?

PSIS

Which sacral tubercle is located at the upper end of the gluteal cleft?

Tip of coccyx is approximately how far posterior of the anus?

1cm

Spinal nerves exit at the same level as their vertebral body down the foramen magnum at what month of development?

3rd month

At birth, conus medullaris (spinal cord) extends to ____.

In adults, conus medullaris is located at which vertebral body?

L1 or L2

Cervical cord runs along foramen magnum

SP C6

Upper thoracic cord runs T1-T6 and approximates with ____.

SPs of C6-T4

Lower thoracic cord runs T7-T12 and approximates with ____.

SPs of T4-T9

Lumbosacral coccygeal cord approximates with ____.

SPs of T10-L1 conus medullaris

Cervical cord enlargement C4-T1 approximates with ____.

C4-C7 vertebral bodies

Lumbar cord enlargement L2-S3 approximates with ____.

T10-L1 vertebral bodies or T9-12 SPs

Aorta runs down which side of the vertebral bodies?

Left

Which portion of the aorta extends T12-L4?

Abdominal aorta

Abdominal aorta bifurcates as the ____ below L4.

Common iliac veins

Inferior vena cava forms at the joining of the common iliac veins at which level of the vertebral bodies?

Inferior vena cava travels up which side of the vertebral bodies?

Right

3 functions of the spine:

Support body Protect spinal cord/nerve roots Movement of trunk

The neural groove is made of the combinations of ____ and ____.

Neural tube | Neural crest

Somites are derived from what?

Paraxial mesoderm

Somites develop into what? (3)

Dermatomes Myotomes Sclerotomes

Dermatomes make up ____.

Dermis and subcutaneous tissue

Myotomes make up ____.

Axial muscles

Sclerotomes migrate centrally forming ____.

Vertebral column and associated ligaments

What are the 3 layers that the inferior portion of neural tube differentiates into?

Ependymal Mantle Marginal

Ependymal layer is located ____.

Around central canal

Mantle layer makes up ____.

Neurons and glia

Marginal layer is associated with ____.

Axons of the tract cells (white matter)

Neural crest makes up sensory neurons of the ____ and postganglionic neurons of the ____.

PNS | ANS

Which type of cells form 3 pairs of chondrifaction centers forming a cartilage model?

Sclerotomal cells

Of the 3 primary centers of ossification, 1 forms the ____ of the vertebral body and 2 form the ____.

Future anterior portion | Future posterior portion

Fusion of either side of the vertebral body with the neural arch is called what?

Neurocentral synchdrosis

Secondary ossification centers develop between what ages?

10-13

Where are the 5 secondary ossification centers located?

Superior endplate-1 Inferior endplate aka annular or ring epiphyses- 1 TP- 1 each SP- 1

Growth ends between what age range?

14 and 25 years

Thoracic kyphosis apex is at what vertebra?

In thoracic kyphosis, the vertebral bodies are ____ posteriorly than anteriorly.

Taller

In pelvic kyphosis, lumbosacral junction to coccyx faces ____ and ____.

Anterior | Inferior

Cervical lordosis occurs around what age?

3-4 months, reinforced around 9 months

At what age does lumbar lordosis occur?

10-18 months

In lumbar lordosis, disc and vertebral bodies are ____ anteriorly than posteriorly.

Taller

What are the cervical segments where compression fractures from superior force occur?

C4-C6

What are the cervical segments where compression fractures from inferior force occurs?

T9-L2

Hyperflexion of trunk injury most commonly affects which segments?

T5-T6

Trabeculae are orientated in which direction relative to lines of greatest stress (such as axial compression)?

Parallel

Smooth region around the edge of the superior and inferior surfaces of vertebral body is formed by what?

Annular apophysis

Most vertebral bodies concave posteriorly towards the ____.

Vertebral foramen

Pedicles attach to the posterior ____ aspect of vertebral body.

Lateral

Pedicles are ____ to the midpoint of the vertebral body.

Superior

Laminae are continuous with what structures?

Pedicles

Laminae thickness ____.

Varies regionally

Spinous processes may normally deviate in which directions?

Left and right

Borders of vertebral foramen are composed of what structures?

Vertebral body, R/L pedicles, R/L lamina, spinous process

Which ligaments are found within the the vertebral canal?

PLL, ligamentum flava

Transverse processes project laterally from the junction of which structures?

Lamina and pedicle

Cervical transverse processes project ____.

Obliquely anterior between sagittal and coronal plane | Located anterior to articular process and lateral to pedicles

Thoracic transverse processes project ____.

Obliquely posterior | Located posterior to articular processes, pedicles

Lumbar transverse processes project ____.

Anterior to articular processes, posterior to pedicles

Cervical costal element:

Anterior tubercle of transverse foramen

Thoracic costal element:

Ribs

Lumbar costal element:

Anterior aspect of TP

Sacral costal element:

Sacral ala

Superior articular process projects ____.

Superiorly from lamina pedicle junction

Superior articular process forms ____.

Zygapophyseal joints (facets)

Cervical and lumbar articular surfaces face ____.

Posteromedial

Thoracic articular surfaces face ____.

Posterolateral

Inferior articular processes articular surface faces ____.

Which functional components of a typical vertebra determine spinal movement?

Superior/inferior articular processes

Which functional component of a typical vertebra acts to transfer weight?

Posterior arches

What are the 3 AKAs for zygapophyseal joints?

Z joint, facet joint, interlaminar joint

Z joints are what kind of synovial joint?

Planar

What is the function of the z joint?

Determine direction/limitation of movement between vertebrae, help carry load during extension/rotation

Anterior and medial portions of z joint are covered by the ____.

Ligamentum flavum

Which layer of z joint has sensory and autonomic innervation?

Synovial

Ligamentum flavum and z joint capsule have ____ receptors.

Nociceptive

Z joints are innervated by the medial branch of the ____ primary rami.

Dorsal

Broad pain referral pattern within z joints comes from innervation of what nerve?

Medial branch of dorsal primary rami

What are the 3 types of sensory receptors which innervate the z joints?

Nociceptors, free nerve endings Complex unencapsulated nerve endings Proprioceptors, encapsulated nerve endings

Z joint pathology for back pain?

Facet syndrome

What are the facet angles in the cervical spine?

45 degrees, loose joint capsule

What are the facet angles in the thoracic spine?

60 degrees | Allows rotation, limits flex/extend and lateral flex

What are the facet angles in the lumbar spine?

90 degrees | Allows flex/extend, limits rotation and lateral flexion

Movement is limited/determined by what 4 main structures?

IVD shape/orientation of articular facets ligaments muscles

Spinal ligaments are most effective when carrying loads when ____.

The stress parallels the direction that ligament fibers run

Ligamentum nuchae runs what length of the spinal column?

C7 SP to EOP | Lamellar and funicular portions

Supraspinous ligament and ligamentum nuchae limit which range of motion?

Flexion

Interspinous ligaments run what length of spinal column?

Inferior aspect of 1 SP to the superior aspect of 1 SP below Limits flexion

Intertransverse ligaments run what length of the spinal column?

Connect inferior aspect of 1 TP to superior aspect of 1 TP below Limits contralateral lateral flexion

Ligamentum flava connects ____ to ____.

Lamina to lamina

Ligamentum flava lies directly ____ to the spinal cord.

Posterior

PLL runs down which aspect of the vertebral canal?

Anterior | Posterior to vertebral bodies

PLL begins at which vertebral body?

PLL functions to limit which movements?

Flexion | Posterior disc protrusion

Tectorial membrane runs what length of the vertebral column?

Posterior body of C2 up to anterior rim of foramen magnum

Tectorial membrane functions to limit what movement?

Flexion and extension of atlas and occiput

What are the 4 specialized upper cervical ligaments?

Accessory atlanto-axial Cruciate ligament of atlas Alar ligaments Apical

Cruciate ligament of atlas functions to ____.

Keep the transverse ligament of C1 centered on the dens with superior/inferior bands

Alar ligaments function to limit what movement?

Contralateral axial rotation

Alar ligaments run what length of the vertebral column?

Posterior lateral dens to occipital condyle

Apical ligament runs what length of the spinal column?

Posterior superior dens to anterior rim of foramen magnum

ALL runs what length of the spinal column?

Runs occiput and anterior tubercle of atlas to each vertebral body limiting extension

Anterior atlanto-occipital membrane runs what length of the spinal column?

Anterior margin of foramen magnum to superior aspect of anterior arch of atlas Limits extension of occiput on C1

Anterior atlanto-occipital membrane is located ____ to ALL.

Posterior

Spinal flexion is limited by which ligaments?

``` Posterior IVD PLL Ligamentum flava Interspinous ligaments Supraspinous ligaments Ligamentum nuchae Articular capsules Articular facets Muscles (extensors) ```

Spinal extension is limited by which structures?

``` Anterior IVD ALL Approximation of SPs Articular processes Laminae ```

Spinal lateral flexion is limited by which structures?

Lateral IVD Intertransverse ligaments Approximation of articular processes Muscles (antagonists)

Spinal rotation is limited by which structures?

Annulus fibrosus of IVD | Orientation of articular processes/facets

Coupled motion is a combined movement of ____.

Rotation with lateral flexion

Which regions of the spine have slight vertebral body rotation due to orientation of superior and inferior articular facets when laterally flexed?

Cervical and lumbar

Nucleus pulposus comes from the ____ and annulus fibrosus comes from the ____.

Notochord | Mesechyme/sclerotome

A 12-20 layered annulus fibrosus is found in which region of the spine?

Lumbar

A crescent shaped annulus fibrosus is found in which region of the spine?

Cervical

The IVD is connected to the vertebral body by ____ cartilaginous endplates.

Superior and inferior

Joint formed by IVD connecting 2 vertebral bodies is called the ____ or ____.

Anterior interbody joint | Intervertebral symphysis

The anterior interbody joint or intervertebral symphysis is classified as what kind of joint?

Cartilaginous, symphysis joint

At what age has the IVD started to become nearly avascular?

Sacral IVD remnants ossify into what structures?

Transverse lines

IVD are thickest in which region of the spine?

Lumbar

IVD are thinnest in what region of the spine?

Upper thoracic

Cervical and lumbar IVDs are thicker ____ than ____ contributing to regional lordosis.

Anteriorly | Posteriorly

Cervical IVDs are approximately ____ height of the vertebral bodies.

2/5

Thoracic IVDs are approximately ____ the height of the vertebral bodies.

1/5

Lumbar IVDs are approximately ____ the height of the vertebral bodies.

1/3

IVDs are connected firmly to the ____ and loosely to the ____.

PLL | ALL

IVD composition includes:

Water, chondrocytes, fibroblasts, proteoglycans aggregates, type I and II collagen fibers

The process by which IVD uptakes fluid is called ____.

Imbibition

What are the 3 regions of the IVD?

Annulus fibrosus Nucleus pulposus Vertebral (cartilaginous) endplates

Annulus fibrosus is composed of what kind of tissue?

Type I collagen

Nucleus pulposus is composed of what type of tissue?

Type II collagen

Lumbar and thoracic annulus fibrosus are convex ____.

Anteriorly

Collagen fibers of annulus fibrosus run parallel at ____ degrees from vertical.

Most superficial lamella attach to the IVD of the ring apophysis via ____.

Sharpey fibers

Cervical annulus fibrosus are composed of how many rings of crescent shaped fibrocartilage?

What part of of the annulus fibrosis limits flexion?

Posterior annulus

What part of the annulus fibrosus limits extension?

Anterior annulus

What part of the annulus fibrosus limits lateral flexion?

Contralateral side of annulus

What part of the annulus fibrosus limits axial rotation?

45 degrees off the plane of the disc, tensile force

During lateral flexion, what direction does the IVD bulge towards?

Side of the concavity

Which region of the IVD is the weakest?

Postero-lateral

Which fibers innervate the annulus fibrosus?

GSA and GVA Posterior aspect, recurrent meningeal nerve Anterior/lateral aspect, branches of ventral rami and sympathetic chain

What are the 2 different types of IVD tears?

Circumferential and radial tears

Nucleus pulposus notochordal cells are completely replaced by what type of tissue around 11 years of age?

Fibrocartilage

Nucleus pulposus is made up ____ percent of water?

70-90

At what age does water begin to degenerate from within the nucleus pulposus?

How does the nucleus pulposus receive nutrients?

Imbibition, sodium and potassium remain inside IVD as compressive forces force out water

Vertebral (cartilaginous) end plate lines everywhere but where?

The most peripheral rim, superiorly and inferiorly

The vertebral (cartilaginous) end plate attaches disc to ____ vertebral body.

Adjacent

During compressive loading of the vertebral column, when does the vertebral (cartilaginous) end plate fail?

First

Cervical (C1-C7) spinal nerves exit through ____ above their respective vertebra.

IVFs

Which spinal nerve would a C4 disc protrusion affect?

C5 nerve

C8 spinal nerves and below enter through IVFs ____ their respective vertebra.

Below

Lumbar spinal nerves exit below its respective vertebra but the nerve ____ preventing a disc protrusion below.

Hugs the pedicle

Narrowing of he vertebral canal is called what?

Spinal canal stenosis

Epidural space is how deep?

4-6 mm deep

Internal vertebral venous plexus is also known as?

Batson’s plexus of veins

What divides the spinal cord into spinal segments?

Rootlets

Medial branches of the dorsal ramus supply what structures?

Z joints and transversospinalis muscles

Lateral branches of the dorsal ramus supply what?

Erector spinae muscles

IVF anterior border is located along what structures?

Vertebral bodies and IVDs

IVF superior border is located along what structure?

Inferior vertebral notch of pedicle above

IVF inferior border is located along what structure?

Superior pedicle notch of pedicle below

IVF posterior border is located along what structure?

Z joints

Function of spinal muscles:

Move spine, maintain posture, absorb shock, protect spine/viscera

Which part of the nervous system controls muscle coordination?

CNS

The 1st of the 6 layers of back muscles connects what portions of the body?

Upper limb to vertebral column

Which muscles make up the 1st layer of the back muscles?

Trapezius and latissimus dorsi

Trapezius is innervated by what structure?

Spinal accessory N (CN XI) and proprioceptive from C3 and C4 ventral rami

Latissimus dorsi is innervated by what structure?

Thoracodorsal nerve (C6-C8 ventral rami off of posterior cord of brachial plexus)

Thoracolumbar (thoracodorsal) fascia is made up of how many layers?

2nd layer of the 6 layers of back muscles all attach on what structure?

Medial border of scapula

Muscles of the 2nd layer of 6 layers of the back include:

Rhomboid major and minor | Levator scapular

Rhomboid major and minor muscles are innervated by what structure?

Dorsal scapular nerve (C5 from ventral rami of brachial plexus)

Levator scapula muscle is innervated by what structure?

Dorsal scapular nerve (C5) and ventral rami of C3 and C4 spinal nerves

3rd layer of the 6 layers of back muscles contains the following muscles:

Serratus posterior superior and inferior

Serratus posterior superior is innervated by what structure?

Ventral rami of T2-T5 (via intercostal nerves)

Serratus posterior inferior is innervated by what structure?

Ventral rami of T9-T11 via intercostal nerves and subcostal nerve (ventral rami of T12)

4th layer of 6 layers of back muscles has the following muscles:

Splenius capitis | Splenius cervicis

All deep back muscles (4th-6th layers) are all innervated by what structure?

Dorsal (posterior) rami

5th layer of the 6 layers of back muscles contain the following muscles:

Iliocostalis group Longissimus group Spinalis group

5th layer of the 6 layers of the back are innervated by what portion of the dorsal primary rami?

Lateral portions

6th layer of the 6 layers of back muscles contains the following muscles:

Semispinalis group Multifidus group Rotatores group

6th group of 6 layers of back muscles are innervated by what portion of the dorsal rami?

Medial branches

Suboccipital muscles are innervated by what structure?

Dorsal rami of C1 (suboccipital nerve)

Diaphragm is innervated by what structure?

Phrenic nerve (ventral rami C3-C5 off cervical plexus)

Exam 1 Flashcards

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