Lecture 4: Spine & Trunk

Question 1

Name the parts of the sternum

Answer 1

Question 2

How many cervical vertebrae are there, how many thoracic, how many lumbar, how many sacrum segments and how many coccyx segments?

Answer 2

7 cervical

12 thoracic

5 lumbar

5 sacral

4 coccyx

Question 3

Name the bony prominences of the vertebrae

Answer 3

vertebral foramen- hole in the center

vertebral body - big piece

spinous process - big point posterior

transverse process - 2 lateral points

pedicle - from body to transverse process

facet - articulating surface

lamina - between spinous process and transverse process

Question 4

What are the 4 functions of vertebrae and where are the located on the bone?

Answer 4

Support body weight

Muscle attachment and movement

Protection of spinal cord

Restriction of movement

Question 5

What is the C1 and C2 vertebrae, how do you differentiate them?

Answer 5

C1 = atlas (holds the world, on top)

C2 = axis (pivot joint) has spine pointing ventrally (DENS)

Question 6

What are the 2 ligaments in the cervical and thoracic regions along the spine?

Answer 6

Ligamentum nuchae & supraspinous

Question 7

How can you distinguish the 3 types of vertebrae?

Answer 7

Look at all from the sagittal view.

Cervical = mouse

Thoracic = giraffe

Lumbar = moose

Question 8

What type of vertebrae has facets on the vertebral body and the vertebral foramen is large triangular shaped?

Answer 8

Cervical

Question 9

What is the strongest cervical vertebra?

Answer 9

Axis

Question 10

On what vertebra is the vertebral body heart-shaped?

Answer 10

Thoracic

Question 11

Is the picture anterior or posterior? Name the bony processes of the sacrum.

Answer 11

S1-S5–> coccyx

Ala

1st sacral body

Sacral formina

Question 12

Is the picture anterior or posterior? Name the bony processes of the sacrum.

Answer 12

Lateral, intermediate, median crests

Sacral canal, sacral hiatus

Sacral tuberosity

Facet and Articular surface

Sacral formina

Question 13

Is this anterior or posterior this? Name the ligaments.

Answer 13

Question 14

Is this anterior or posterior this? Name the ligaments.

Answer 14

Question 15

What are the two parts that make of the intervertebral disc?

Answer 15

Annulus fibrosus, nucleus pulposus

Question 16

What are the 3 different views of the intervertebral disc under relaxed, erect and later flexion states?

Answer 16

Question 17

What is a tear in the outer annulus fibrosus ring known as?

Answer 17

Slipped disc, intervertebral disc herniation

Question 18

What is the superior and inferior attachments of the intercostal muscles (external, internal, innermost)

Answer 18

Superior = inferior border of ribs

Inferior = superior border of ribs below

Question 19

What nerve innervates the intercostals?

Answer 19

Intercostal nerve

Question 20

What is the main action of the intercostals (hint: 2 have the same action)

Answer 20

External intercostal: during forced inspiration: elevate ribs

Internal & innermost intercostal: During forced respiration, interosses part depresses rib, interchondral part elevates ribs

Question 21

What is the superior and inferior attachment of the subcostal muscles and what is the action?

Answer 21

Superior = internal surface of lower ribs near angle

Inferior = superior border of 2nd or 3rd rib below

Action: act the same as internal intercostal muscles

Question 22

What are these two muscles, what are there superior and inferior attachments?

Answer 22

Serratus posterior superior & serratus posterior inferior

Superior attachement: Superior = nuchal ligament, spinous process of c7-T3, Inferior = inferior border of ribs 8-12 near angle

Inferior attachment: Superior = superior border of 2nd and 4th ribs, Inferior = spinous process of T11-L2 vertebrae

Question 23

What is the innervation and action of serratus posterior superior and serratus posterior inferior?

Answer 23

Innervation: Superior = 2-5th intercostal nerves, Inferior = 9-11 intercostal nerves, subcostal nerve

Action: Superior = elevate ribs, Inferior = depresses ribs

Question 24

What is the origin, insertion, innervation, and action of rectus abdominis?

Answer 24

Proximal = pubic symphysis and pubic crest

Distal = Xiphoid process, 5-7th costal cartilages

Innervation = Thoracoabdominal and sub-costal nerves

Action = flex trunk, compress abdominal viscera, stabilizes and controls tilt of pelvis

Question 25

What are the origin and insertions of the 3 oblique muscles?

Answer 25

External: Origin = external surface of 5-12th ribs, Insertion = linea alba, pubic tubercle, anterior half of iliac crest Internal: Origin = Thoracolumbar fascia, anterior iliac crest, connective tissue deep to inguinal ligament, Insertion = Inferior border 10-12 ribs, linea alba, pubis via conjoint tendon Transverse (abdominis): Origin = internal surface 7-12 costal cartilidge, thoracolumbar fascia, iliac crestand connective tissue deep to inguinal ligament, Insertion = lineal alba w/ aponeruosis of internal oblique, pubic crest, pubis via conjoint tendon

Question 26

What is the innervation of the 3 oblique muscles?

Answer 26

External: Thoracoabdominal nerves and subcostal nerve Internal and Transverse: Thoracoabdominal, subcostal and first lumbar nerves

Question 27

What is the action of the 3 obliques?

Answer 27

External and Internal: Compress and support abdominal viscera; flex and rotate trunk Transverse: compress and support abdominal viscera

Question 28

Label the muscles, nerves, and blood flow of this cross section.

Answer 28

Question 29

What are the three posterior wall muscles? What are there superior and inferior attachments?

Answer 29

Psoas major: Superior = transverse process of lumbar vertebrae; sides of bodies of T12-S1 vertebrae and intervening IV discs, Inferior = Strong tendon to lesser trochanter of femur Illiacus: Superior = superior two-thirds of iliac fossa, ala of sacrum, anterior sacroiliac ligaments, Inferior = lesser trochanter of femur and shaft inferior to it, psoas major tendon Quadratus lumborum: Superior = medial of inferior border of 12th rib and tips of lumbar transverse process, Inferior = iliolumbar ligament, internal lip of iliac crest

Question 30

What is the innervation of Psoas major, iliacus and quadratus lumborum?

Answer 30

Psoas major: lumbar plexus via anterior branches of L2-L4 Iliacus: femoral nerve Quadratus lumborum: anterior branches of T12 and L1-L4 nerves

Question 31

What is the action of psoas major, iliacus, and quadratus lumborum?

Answer 31

Psoas major: flexes thigh, flexes vertebral column, laterally balance trunk, while sitting; w/ iliacus to flex trunk Iliacus: flex thigh, stablize hip joint, acts w/ psoas major Quadratus lumborum: extends and laterally flex vertebral column; fixes 12th rib during inspiration

Question 32

Label the structures in this image.

Answer 32

Question 33

Where does the diaphragm attach? What are the sensory and motor nerves it is innervated by?

Answer 33

Inferior margin of thoracic cage superior to lumbar vertebrae Phrenic nerve (motor), subcostal (sensory)

Question 34

What is the superficial muscle of the spinal column, where is it located, what is its action?

Answer 34

Splenius: Acting alone = laterally flex neck and rotate head to the side of active muscles, Acting together = extend head and neck

Question 35

What are the 3 muscles comprised of the intermediate layer of the spinal column and what is there action?

Answer 35

Iliocostalis, Longissimus, Spinalis Action: Bilateral = extend vertebral column, and head as back is flexed, control movement by gradually lengthening fibers Unilateral = laterally flex column

Question 36

What are the deep muscle layers of the intrinsic back?

Answer 36

Semispinalis (capitis, cervicis, and thoracis) Multifundis Rotares (brevis and longus)

Question 37

What are the actions of the deep muscle of the intrinsic back?

Answer 37

Semispinalis: extends head and thoracic and cervical regions of vertebral column and rotates them contralaterally Multifundus: Unilateral contraction = rotates contralateral side; stabilizes vertebrae during the local movements of vertebral column Rotatores: stabilize vertebrae and assist w/ local extension and rotary movements of vertebral column

Question 38

What are these 3 muscles of the deep layer of the intrinsic back and their actions?

Answer 38

Interspinalis: Aid in extension and rotation of vertebral column Intertransverssi: aid in lateral flexion of vertebral column, acting bilaterally, stabilize vertebral column Levatores costarum: elevate ribs, assisting respiration; assist w/ lateral flexion of vertebral column

Question 39

Name the vasculature of this thoracic vertebra.

Answer 39

Question 40

What is the vasculature of the thoracic cavity?

Answer 40

Question 41

What are the nerves that are located at the lower end of the spinal cord in the lumbosacral spine.

Answer 41

Cauda equina

Question 42

What are the 3 meninges layers of the spinal cord?

Answer 42

Outer = Dura Middle = Arachnoid Inner = Pia