Intro to musculoskeletal 2

Question 1

functions of the vertebral column

Answer 1

support for the head
movement
protection - spinal cord

Question 2

structure of vertebra

Answer 2

vertebral body
- weight transfer
- IVDs between
vertebral arch
- together with the body forms vertebral foramen
- surrounds and protects the spinal cord
pedicle - foot of arch
transverse process - muscle/ ligament attachment (+ ribs in thorax)
lamina - lateral and posterior part of arch
spinous process - muscle/ ligament attachment
superior/ inferior articular process - form joints
superior/ inferior vertebral notches - form intervertebral foramen (for spinal nerves)

Question 3

cauda equina

Answer 3

spinal nerves descend to exit

Question 4

where does the spinal cord end

Answer 4

L1/2

Question 5

atlas (C1) and axis (C2)

Answer 5

C1 - no body
C2 - odontoid process (dens)
- protrudes through vertebral foramen to form joint
no IVD between C1-C2
atlanto-occipital (C1- base of skull)
- nodding head ‘yes’ joint
atlanto-axial
- synovial pivot joint
- shaking head ‘no’ joint

Question 6

function of ligaments in MSK

Answer 6

connect bone-bone
provide support to joints
restrict movement at joints

Question 7

ligaments of the spine

Answer 7

anterior longitudinal ligament
posterior longitudinal ligament
supraspinous + nuchal ligament
ligamentum flavum
interspinous/ intertransverse ligaments

Question 8

supraspinous ligament

Answer 8

C7 - sacrum
connects tips of spinous processes
cord like

Question 9

nuchal ligament

Answer 9

strong fibroelastic tissue
base of skull to C7
supports head on neck
provides attachment for muscle (e.g. trapezius)

Question 10

2 types of vertebral joints

Answer 10

zygapophyseal (facet) joints
symphysis (IVDs)

Question 11

zygapophyseal (facet) joints

Answer 11

synovial, plane
4x in vertebra

Question 12

symphysis (IVDs)

Answer 12

secondary cartilaginous
2x IVD

Question 13

functions of intervertebral discs

Answer 13

provide stability and flexibility
pressure regulation
water-cushion function - shock absorber

Question 14

annulus fibrosus

Answer 14

outer layer of IVD
high tensile strength
fibrous sheath on the outer surface - collagen layers in rings
fibrocartilage inner zone

Question 15

nucleus pulposus

Answer 15

inner layer of IVD
high resilience
gelatinous structure
80-85% water

Question 16

short lasting burden in IVDs

Answer 16

incompressible, deformable water cushion
AF counter acts the pressure arising from the NP due to the burden on the spine

Question 17

long lasting burden on IVDs

Answer 17

when pressure applied: slow release of water from the NP -> IVD becomes thinner
when relief: re-hydration of the NP

Question 18

clinical relevance of burden on IVDs

Answer 18

slipped disc/ prolapse of IVD (hernia)
- tear in the AF - NP can protrude
- can impinge on spinal cord or nerves
- can cause numbness, tingling or pain (depends on location)
- rest/ painkillers

Question 19

anterior longitudinal ligament attachments

Answer 19

base of skull to anterior surface of sacrum
attached to anterior surface of VBs and IVDs

Question 20

anterior longitudinal ligament function

Answer 20

prevents hyperextension

Question 21

posterior longitudinal ligament attachments

Answer 21

C2 to sacrum
attached to posterior surface of VBs and IVDs

Question 22

posterior longitudinal ligament function

Answer 22

lines the anterior surface of the vertebral canal
weakly resists hyperflexion

Question 23

ligamenta flava

Answer 23

pass between laminae
form part of vertebral canal
resist separation of vertebrae during flexion

Question 24

interspinous ligament

Answer 24

between spinous processes

Question 25

intertransverse ligament

Answer 25

between the transverse processes

Question 26

intrinsic back muscles nerve origin

Answer 26

posterior rami of spinal nerves

Question 27

intrinsic back muscles basic imfo

Answer 27

all directly act on the spine embryonically develop in the back maintain posture and control movement of vertebrae superficial, intermediate and deep layers

Question 28

thoracolumbar fascia

Answer 28

covers deep muscles of the back critical to organisation and integrity of the region latissimus dorsi and trapezius attached to it

Question 29

splenius muscles (superficial layer) shape

Answer 29

thick and flat (bandage - splenion)

Question 30

splenius muscles (superficial layer) origin

Answer 30

spinous processes (+ bottom of nuchal ligament)

Question 31

splenius muscles (superficial layer) insertions

Answer 31

base of skull, mastoid process (capitis)/ transverse processes C1-C3 (cervicis)

Question 32

splenius muscles (superficial layer) action

Answer 32

bilateral = extend neck unilateral = rotate the head to one side (turn to face the same side as muscle) supplied by dorsal rami of spinal nerves

Question 33

erector spinae (intermediate layer)

Answer 33

primary extensions of vertebral column 3 columns of muscle - iliocostalis, longissimus, spinalis common origin - broad tendon attached to sacrum, spinous processes of L and lower T vertebrae, iliac crest primary muscles that extend the spine (leaning backwards) each side independently = rotation

Question 34

iliocostalis

Answer 34

lumborum, thoracis, cervicis inserts angles of ribs and C transverse processes

Question 35

longissimus

Answer 35

thoracic cervicis capitis inserts T and C transverse processes and mastoid process

Question 36

spinalis

Answer 36

thoracic cervicis capitis inserts T spinous processes and skull

Question 37

deep layer - transversopinalis

Answer 37

fill groove between transverse and spinous processes semispinalis, multifidus, rotatores cross multiple vertebrae extend and rotate

Question 38

deep layer - addition muscles

Answer 38

levatores costarum interspinales and intertransversarii (postural muscles)

Question 39

deep layer - smaller muscles have more muscles spindles

Answer 39

increase proprioception of muscle 'fine-tuned' muscles

Question 40

clinical relevance - back pain

Answer 40

extremely common can be non-specific - important to identify cause muscle spasms, strained muscles, poor posture sprain - ligament injury (incorrect lifting procedures) nerve pain - prolapsed disc/ sciatica synovial joints - arthritis (rheumatoid or osteo) something else?