L6: Vertebral Column & Thoracoabdominal Wall Flashcards
(170 cards)
1
Q
What is the primary structure of the vertebral column composed of?
A
Vertebrae, intervertebral discs, and accessory ligaments
The vertebral column is a segmented hard & soft tissue structure that is both rigid and flexible.
2
Q
What is the main part of the axial skeleton?
A
Vertebral column extending from the base of the skull to the pelvis
It has connections to both limb girdles.
3
Q
List three functions of the vertebral column.
A
- Supports body weight above the pelvis
- Protects the spinal cord and spinal nerve roots
- Critical to posture and locomotion
4
Q
How many vertebrae are typically found in adult humans?
A
33 vertebrae
5
Q
Into how many regions is the vertebral column divided?
A
5 regions
6
Q
What are the names of the 5 regions of the vertebral column?
A
- Cervical: 7 vertebrae (C1-C7)
- Thoracic: 12 vertebrae (T1-T12)
- Lumbar: 5 vertebrae (L1-L5)
- Sacral: 5 vertebrae (S1-S5)
- Coccygeal: 4 vertebrae (Co1-Co4)
7
Q
What is the relationship between the size of inferior and superior vertebrae?
A
Inferior vertebrae are larger than superior vertebrae
This is because lower vertebrae support more body weight than those above.
8
Q
What are the four natural curvatures of the vertebral column?
A
- Two kyphoses (anteriorly concave) – primary curvatures: Sacral, Thoracic
- Two lordoses (posteriorly concave) – secondary curvatures: Cervical, Lumbar
9
Q
True or False: Scoliosis is an abnormal lateral curvature of the spine.
A
True
10
Q
What is the most common cause of scoliosis?
A
Idiopathic (unknown cause)
11
Q
Which gender is more prevalent for scoliosis?
A
Women (~4:1 ratio compared to men)
12
Q
During which life stage does scoliosis typically develop?
A
Puberty
13
Q
List two potential consequences of scoliosis.
A
- Changes in posture
- Chronic back pain
- Respiratory issues
14
Q
How many thoracic vertebrae are there?
A
12 vertebrae
15
Q
What type of articular surfaces are present on the lateral surfaces of the body for the head of ribs in thoracic vertebrae?
A
Superior & inferior hemifacets on T2–T9; single costal facets on T1, T10–T12
16
Q
Describe the shape of thoracic vertebrae bodies.
A
Heart-shaped bodies
17
Q
What is notable about the vertebral foramina of thoracic vertebrae?
A
Smaller vertebral foramina
18
Q
Describe the transverse processes of thoracic vertebrae.
A
Long and posterolaterally directed; transverse costal facets on T1-T10
19
Q
What is the orientation of the spinous process in thoracic vertebrae?
A
Long spinous process that slopes inferiorly, overlapping the vertebra below
20
Q
What is the orientation of the articular facets in thoracic vertebrae?
A
Face anterior-posteriorly
21
Q
What movements are allowed by the thoracic vertebrae?
A
Rotation and lateral bend; very little flexion/extension
22
Q
How many lumbar vertebrae are there?
A
5 vertebrae
23
Q
Describe the vertebral bodies of lumbar vertebrae.
A
Large vertebral bodies
24
Q
What is notable about the vertebral foramina of lumbar vertebrae?
A
Enlarged vertebral foramina
25
Describe the spinous processes of lumbar vertebrae.
Short, hatchet-shaped spinous processes
26
What is the orientation of the articular facets in lumbar vertebrae?
Face mediolaterally
27
What movements are allowed by the lumbar vertebrae?
Flexing/extension and lateral bend; restricts rotation
28
What additional feature is present on the posterior surface of lumbar vertebrae?
Mammillary processes
29
How many sacral vertebrae are there?
5 vertebrae
30
Describe the shape of sacral vertebrae.
Fused vertebrae in a wedge shape
31
What is the function of the sacral vertebrae?
Transmits body weight to the pelvic girdle
32
What is the sacral promontory?
Anterior projection of the body of the first sacral vertebra (S1)
33
What is the auricular surface of sacral vertebrae?
Articular surface for joint between the ilia and sacrum
34
Where are the intervertebral foramina located in sacral vertebrae?
On the anterior (pelvic) and posterior surfaces
35
What does the vertebral canal end at in sacral vertebrae?
The V-shaped sacral hiatus
36
What borders the sacral hiatus laterally?
Bony projections called sacral cornua
37
How many coccygeal vertebrae are there?
4 vertebrae
38
What is the typical state of coccygeal vertebrae in adults?
Often fused
39
Describe the shape of coccygeal vertebrae.
Triangular in shape; remnant of ancestral tail
40
What is the zygapophyseal (facet) joint?
Articulation point between the inferior and superior articular facets of successive vertebrae that permit gliding movement
## Footnote
The orientation of these joints dictates the types of movement possible within each region of the vertebral column.
41
What are the craniovertebral joints?
Synovial joints including the atlanto-occipital and atlanto-axial joints
## Footnote
Allow specific movements of the head.
42
What motion do the atlanto-occipital joints allow?
Flexion/extension of the head ('yes' motion)
## Footnote
Located between the lateral masses of the atlas and the occipital condyles of the skull.
43
What type of movements do the atlanto-axial joints permit?
Side-to-side movements of the head ('no' motion)
## Footnote
Composed of three joints: lateral atlanto-axial joints and the median atlanto-axial joint.
44
What are the components of the lateral atlanto-axial joints?
Articulation between the inferior facets of atlas and superior facets of axis
## Footnote
These joints allow for side-to-side head movements.
45
What is the median atlanto-axial joint?
Pivot joint; articulation between the dens and anterior arch of atlas
## Footnote
Allows for rotation of the head.
46
What role does the cruciate ligament play?
Holds dens against the anterior arch of atlas
## Footnote
Provides stability to the atlanto-axial joint.
47
What is the function of the alar ligament?
Attaches from the dens to the foramen magnum; supports the joint
## Footnote
Helps stabilize the craniovertebral junction.
48
What characterizes intervertebral joints?
Joint between the articular faces of the vertebral bodies of succeeding vertebrae; separated and connected by intervertebral discs
## Footnote
Classified as symphyses.
49
What is the function of intervertebral discs?
Permit movement between vertebrae and function as shock absorbers
## Footnote
Located between and attached to the vertebral bodies of vertebrae C2–S1.
50
What are the two parts of an intervertebral disc?
Annulus fibrosus and nucleus pulposus
## Footnote
Each part contributes to the disc's structure and function.
51
What is the annulus fibrosus?
Concentric rings composed of layers of fibrocartilage; attach from one vertebral body to the next
## Footnote
Provides structural integrity to the intervertebral disc.
52
What is the nucleus pulposus?
Semi-fluid center of the disc
## Footnote
Helps absorb shock and allows for flexibility.
53
What happens to intervertebral discs with age?
Diminish in size and flexibility, contributing to height loss
## Footnote
Aging affects the structural integrity of the discs.
54
What is disc herniation?
Protrusion of the fluid nucleus pulposus due to degeneration of the annulus fibrosus
## Footnote
Can compress the spinal cord or nerve roots, leading to pain.
55
Where are disc herniations most common?
Lumbar and lumbosacral regions
## Footnote
Typically affect the nerve assigned to the inferior vertebra.
56
True or False: A herniation of the disc at L4-L5 typically affects the L4 spinal nerve.
False
## Footnote
It typically affects the L5 spinal nerve.
57
What is the function of the anterior longitudinal ligament?
Prevents hyperextension
## Footnote
The anterior longitudinal ligament is a strong fibrous band extending from the sacrum to the foramen magnum on the anterior surface of the vertebral bodies.
58
Describe the posterior longitudinal ligament.
Narrower and weaker band that runs within the vertebral canal on the posterior surface of the vertebral bodies
## Footnote
It provides some support but is less robust compared to the anterior longitudinal ligament.
59
What is the role of the ligamentum flavum?
Connects the lamina of successive vertebrae
## Footnote
This ligament helps maintain the stability of the vertebral column.
60
What do supraspinous ligaments connect?
Connect the tips on the spinous processes
## Footnote
The nuchal ligament is a specific type of supraspinous ligament that attaches from the external occipital protuberance to cervical spinous processes.
61
What is the function of interspinous ligaments?
Connect superior/inferior surfaces of succeeding spinous processes
## Footnote
They provide additional support to the spinal column.
62
What are the primary movements of the vertebral column?
* Flexion/Extension
* Lateral Bending
* Rotation
## Footnote
These movements allow for a range of motion in different planes.
63
Which region of the vertebral column has the greatest range of motion?
Cervical
## Footnote
The order of range of motion from greatest to least is cervical > lumbar > thoracic >>> coccygeal = sacral.
64
What factors limit the range of motion in the vertebral column?
* IV disc
* Zygapophyseal joints
* Resistance of back muscles and ligaments
* Rib cage
* Bulk of surrounding tissue
## Footnote
These factors collectively constrain movement and provide stability.
65
What is the primary function of the thoracoabdominal wall?
Protects viscera
## Footnote
It plays a crucial role in respiration and supports structures in the head, neck, and upper limbs.
66
How does the thoracic wall assist in respiration?
Alters thoracic volume, resulting in air flowing in/out of the lungs
## Footnote
Movements of the thoracic wall during breathing are essential for ventilation.
67
What functions do abdominal wall muscles assist with?
* Exhalation
* Urination
* Defecation
* Childbirth
## Footnote
They alter pressure in the abdomen, which is vital for these processes.
68
What articulates with the head of the rib?
Two hemifacets on thoracic vertebrae
## Footnote
Ribs 1, 10–12 only have one costal facet on their respective vertebrae.
69
What connects the head of the rib to the rib body?
Neck
70
Where does the tubercle of the rib articulate?
Transverse processes of vertebrae
71
Which ribs do not have a tubercle?
Rib 11 & 12
72
Describe the body of the rib.
Thin, flat; majority of rib
73
What is the function of costal cartilage?
Increases flexibility and attaches rib to sternum/adjacent costal cartilages
74
What is the costal angle?
Point where the rib turns anterolaterally
75
What is located in the costal groove?
Intercostal nerves, arteries, veins
76
What is the intercostal space?
Space between each rib
77
What forms the costal margin?
Inferior edge of the anterior thoracic cage formed by costal cartilages 6–10 and the xiphoid process
78
Define true ribs.
Ribs 1–7; attach to sternum directly via their respective costal cartilages
79
Define false ribs.
Ribs 8–10; attach to the costal cartilage of the rib above them
80
Define floating ribs.
Ribs 11 & 12; costal cartilage ends in the abdominal musculature; do not attach to the sternum
81
What is the manubrium?
Superior most part of sternum; palpable suprasternal (jugular) notch on the superior surface
82
What is the sternal angle?
Palpable joint between manubrium and body of sternum
83
What is the body of the sternum?
Main middle part of sternum
84
What is the xiphoid process?
Small inferior process of the sternum
85
What type of joint is the costovertebral joint?
Synovial joint
86
How does the rib head articulate in the costovertebral joint?
With the superior costal hemifacet of the vertebra with the same number, and the inferior costal hemifacet of the vertebra above
87
What is unique about ribs T1 & T10–T12 in terms of costal facets?
Have a singular costal facet which articulates with one rib
88
What type of joint is the costotransverse joint?
Synovial joint
89
What does the tubercle of the rib articulate with in the costotransverse joint?
Transverse costal facet on the transverse process of the corresponding numbered vertebra for ribs T1–T10
90
What type of joints are costochondral joints?
Synchondrosis joints
91
What type of joint is the sternocostal joint between rib 1 and manubrium?
Not synovial
92
What type of joints are all sternocostal joints except between rib 1 and manubrium?
Synovial
93
What movements of the thoracic wall alter the volume of the thorax?
Movements of the thoracic wall, in conjunction with the diaphragm, alter the volume of the thorax and create a pressure differential that either draws air into the lung or expels air.
94
How does inhalation occur?
Inhalation occurs via increased thoracic volume by contraction of the diaphragm, intercostal, and accessory inspiration muscles.
95
Is exhalation generally passive or active?
Exhalation is generally passive.
96
What is the 'pump handle' movement?
The pump handle movement refers to the movement of the sternum, which changes the anterior-posterior dimension.
97
What is the 'bucket handle' movement?
The bucket handle movement refers to the movement of the body of ribs, which changes the lateral dimension.
98
What is the superior thoracic aperture?
The superior thoracic aperture is the communication between the thorax and neck/upper limbs.
99
What are the borders of the superior thoracic aperture?
Borders are:
* Posterior: T1
* Lateral: 1st rib
* Anterior: manubrium
100
What does the superior thoracic aperture contain?
Contents include:
* trachea
* esophagus
* major neurovasculature
101
What is the inferior thoracic aperture?
The inferior thoracic aperture is the communication with the abdominal cavity.
102
What separates the abdominal and thoracic cavities?
The diaphragm almost completely separates the abdominal and thoracic cavities.
103
What are the borders of the inferior thoracic aperture?
Borders are:
* Posterior: T12
* Anterolateral: costal margin
104
What does the inferior thoracic aperture contain?
Contents include:
* esophagus
* inferior vena cava
* aorta
* nerve plexuses
105
What are intercostal spaces?
The space separating one rib/costal cartilage from the one below, containing intercostal muscles, nerves, arteries, and veins.
106
What is the subcostal space?
The space below the 12th rib is called the subcostal space.
107
What do breasts contain?
Breasts contain mammary glands supported by fibrous tissue and adipose.
108
How are breasts functionally related to reproduction?
Breasts are functionally and developmentally related to reproduction.
109
What is the axillary process?
The axillary process is the extension of the mammary gland into the axilla.
110
What is the nipple?
The nipple is a central cylindrical structure where the lactiferous ducts drain.
111
What are suspensory ligaments in the breast?
Suspensory ligaments are attachments between the mammary glands and the dermis of the skin.
112
What is the mammary gland classified as?
The mammary gland is classified as a modified sweat gland.
113
What are lobules in the mammary gland?
Lobules are the functional portions of the gland that contain milk, typically 15-20 per breast.
114
What happens to lobules during pregnancy?
Lobules enlarge and multiply during pregnancy.
115
What are lactiferous ducts?
Lactiferous ducts independently drain the lobules of the mammary gland onto the nipple via a lactiferous sinus.
116
What is the arterial supply for the breast?
Arterial supply comes from perforating branches of adjacent arteries.
117
Where do most lymphatics from the breast drain?
Most drains to the axillary lymph nodes.
118
What innervates the breast?
Innervation comes from anterior & lateral cutaneous branches of the 4th-6th intercostal nerves.
119
True or False: The most common form of breast cancer arises from the epithelial cells of the lactiferous ducts.
True.
120
What can result from cancer affecting the suspensory ligaments?
Formation of large dimples or retraction of the nipple.
121
What leads to edema in breast tissue from cancer?
Metastatic cancer cells may enter the lymph system, leading to edema.
122
What is the peau d’orange sign?
Puffy skin with dimpled pores.
123
Where do cancer cells that enter the lymph system often travel?
To the axillary lymph nodes, allowing further spread of cancer.
124
What is the origin of the clavicular head of the Pectoralis major?
Clavicle
## Footnote
The clavicular head adducts and medially rotates the shoulder joint.
125
What is the insertion point for the Pectoralis major?
Intertubercular sulcus (groove) of humerus
## Footnote
This muscle has both clavicular and sternocostal heads.
126
Which nerves innervate the Pectoralis major?
Pectoral nerves (C5, C6, C7, C8, T1)
## Footnote
The lateral pectoral nerve innervates the clavicular head, while the medial pectoral nerve innervates the sternocostal head.
127
What are the main actions of the Pectoralis major?
Adducts, medially rotates shoulder joint, flexes humerus, extends flexed humerus
## Footnote
The actions depend on which part of the muscle is engaged.
128
What is the origin of the Pectoralis minor?
3rd–5th ribs near costal cartilages
## Footnote
It stabilizes the scapula by drawing it against the thoracic wall.
129
Which nerve innervates the Pectoralis minor?
Medial pectoral nerve (C8, T1)
## Footnote
This muscle can also receive innervation from the lateral pectoral nerve.
130
What is the main action of the Subclavius?
Anchors and depresses clavicle
## Footnote
The Subclavius also assists in protracting the scapula.
131
What is the origin of the Subclavius muscle?
Junction of 1st rib and its costal cartilage
## Footnote
This positioning allows it to effectively stabilize the clavicle.
132
What is the innervation of the Subclavius?
Subclavian nerve (C5, C6)
## Footnote
This nerve primarily provides motor function to the muscle.
133
What is the origin of the Serratus anterior?
Lateral surfaces of 1st–8th ribs
## Footnote
The serratus anterior plays a crucial role in scapular movement.
134
What is the main action of the Serratus anterior?
Protracts scapula and holds it against thoracic wall; rotates scapula
## Footnote
This muscle is essential for arm elevation.
135
Which nerve innervates the Serratus anterior?
Long thoracic nerve (C5, C6, C7)
## Footnote
Damage to this nerve can result in winged scapula.
136
What muscles are innervated by the intercostal nerves?
External intercostal m., Internal intercostal m., Innermost intercostal m., Transversus thoracis, Subcostal
## Footnote
These muscles play key roles in respiration and rib movement.
137
What is the function of the external intercostal muscle?
Elevates ribs during forced inspiration
## Footnote
It is the external most intercostal muscle.
138
What is the role of the internal intercostal muscle?
Assists respiration
## Footnote
It is the middle muscle among the intercostals.
139
Which intercostal muscle is the most internal?
Innermost intercostal m.
## Footnote
This muscle also assists in respiration.
140
Where does the transversus thoracis attach?
From posterior surface of lower sternum to internal surface of costal cartilages 2–6
## Footnote
It is a proprioceptive muscle that may depress ribs.
141
What is the action of the subcostal muscle?
Same action as internal intercostal muscle
## Footnote
It attaches from the internal surface of lower ribs to the superior border of ribs 2-3 further inferior.
142
What are the branches of the posterior intercostal aa. primarily derived from?
Aorta
## Footnote
Posterior intercostal arteries are located in the costal groove and anastomose with anterior intercostal arteries.
143
Where do the internal thoracic aa. branch from?
Subclavian a.
## Footnote
Internal thoracic arteries run inferiorly just lateral to the sternum.
144
What do the internal thoracic aa. give off for ribs 1–6?
Anterior intercostal aa.
## Footnote
These arteries supply blood to the intercostal spaces.
145
At which intercostal space do the internal thoracic aa. split into superior epigastric and musculophrenic aa.?
6th intercostal space
## Footnote
This bifurcation is important for supplying the abdominal wall and diaphragm.
146
What does the superior epigastric aa. supply?
Superior anterior abdominal wall
## Footnote
This artery is a continuation of the internal thoracic artery.
147
What does the musculophrenic aa. supply?
Part of abdominal/thoracic walls and diaphragm
## Footnote
It is also a branch of the internal thoracic artery.
148
What do intercostal veins accompany?
Intercostal aa.
## Footnote
They drain into the superior vena cava via the azygos venous system.
149
What are intercostal nn. derived from?
Ventral rami of spinal nerves T1–T11
## Footnote
These nerves course within the costal groove and provide motor and sensory functions.
150
What type of branches do intercostal nn. have?
Motor and sensory branches
## Footnote
Motor branches supply intercostal muscles, while sensory branches include lateral and anterior cutaneous branches.
151
What is the chief muscle of respiration?
Diaphragm
## Footnote
It plays a crucial role in increasing thoracic volume during inspiration.
152
What happens to the diaphragm during inspiration?
Contracts and descends
## Footnote
This action increases thoracic volume to facilitate breathing.
153
What is centrally located in the diaphragm?
Tendon (aponeurosis)
## Footnote
Muscle fibers are located on the periphery of the diaphragm.
154
What are the crura of the diaphragm?
Musculotendinous bands that anchor the diaphragm
## Footnote
The right crus is larger and extends from L1–L4, while the left crus extends from L1–L3.
155
What innervates the diaphragm?
Phrenic nerve
## Footnote
It is derived from ventral rami of C3–C5 spinal nerves.
156
What is the most anterior aperture of the diaphragm?
Caval opening
## Footnote
It allows the inferior vena cava to pass through the central tendon at the level of the IV disc between T8 & T9.
157
What structures pass through the esophageal hiatus?
Vagus n. and esophagus
## Footnote
This opening is located through the right crus at approximately T10.
158
What does the aortic hiatus allow to pass?
Aorta and thoracic duct
## Footnote
It is the posterior-most opening between the crura of the diaphragm at T12.
159
What is the anterolateral abdominal wall?
A muscular-connective tissue structure extending from the costal margin to the superior margin of the pelvic inlet and inguinal ligament
160
What is the umbilicus?
Remnant of umbilical cord; centrally located; height dictated by body composition (typically ~L3-L4)
161
Define the linea alba.
A vertical fibrous raphe in the midline of the anterior abdominal wall where the aponeuroses of the lateral abdominal muscles interweave
162
What does the inguinal groove demarcate?
The inguinal ligament, which separates the thigh from the anterolateral abdominal wall
163
Where is the anterior superior iliac spine (ASIS) located?
Superior attachment of the inguinal ligament
164
What is the function of the superior epigastric artery?
Enters the rectus sheath and supplies the superior anterior abdominal wall; anastomoses with inferior epigastric artery
165
What is the inferior epigastric artery a branch of?
The external iliac artery; enters the rectus sheath below the arcuate line
166
What is Camper’s fascia?
Superficial layer of mostly adipose tissue that is continuous with the thigh and perineum
167
Describe Scarpa’s fascia.
Deeper, membranous layer; superficial to the external oblique muscle; continues into the perineum but not the thigh
168
What are investing fascias?
Each lateral muscle (obliques & transversus abdominis) has a superficial and deep investing fascia attached to their inner and outer surfaces
169
What forms the inguinal ligament?
Formed from the aponeurosis of the external oblique; runs from the ASIS to the pubic tubercle
170
True or False: The inguinal ligament marks the boundary between the abdomen and the thigh.
True
