lesson 2- The back

Question 1

what percentage of GP consultations are formed by back pain?

Answer 1

20%

Question 2

how many bones make up the vertebral column?

Answer 2

33 bones

Question 3

what are the main functions of the vertebral column?

Answer 3

weight bearing, protection, movement and site of muscle attachment

Question 4

the vertebral column carries transmits weight from….. to ……

Answer 4

the vertebral column carries and transmits weight from the upper body down to the lower limbs

Question 5

what provides the shock absorption in the vertebral column?

Answer 5

curvatures and intervertebral discs

Question 6

the foetus spine lacks what in its shape?

Answer 6

a foetus’s spine lacks lordes (dips in the spine).

Question 7

regarding the shape/curvature of the spine, what provides flexible support an shock-absorbing resilience?

Answer 7

the lordosis and kyphosis in the curvature of the spine provides flexible support and shock absorbing resilience

Question 8

when does the lordoses develop?

Answer 8

during infancy

Question 9

give examples of abnormal curvatures of the spine?

Answer 9

excessive thoracic kyphosis
excessive lumbar lordosis
scoliosis

Question 10

when can excessive lumber lordosis occur?

Answer 10

during pregnancy

Question 11

how does scoliosis develop?

Answer 11

imbalance in the growth of the vertebrae or back muscles between the left and right resulting in the spine being imbalanced.

Question 12

name the processes which make up the vertebral arch.

Answer 12

spinous process, transverse process and superior & inferior articular process

Question 13

name the different parts of the vertebrae?

Answer 13

vertebral body, pedicle, lamina, transverse process, spinous process, inferior and superior articular processes.

Question 14

describe what the intervertebral disk is made of.

Answer 14

intervertebral disc is made of water nucleus pulposa and is covered by rings of connective tissue called annulus fibrosis.

Question 15

describe how a ‘slip disc’ occurs.

Answer 15

when there is something wrong with the fibre cartilage- annulus fibrosis, the nucleus pulposa is able to leak out and pinch on the spinal nerves in the spinal root causing pain - herniated disc.

Question 16

a sliped disc is medically what?

Answer 16

a slipped disc

Question 17

what does the vertebral column protect?

Answer 17

spinal cord, spinal nerves, arteries and veins

Question 18

what covers the spinal cord?

Answer 18

the meninges - pia matter, arachnoid matter and dura matter

Question 19

what lies between the different membranes of the meninges?

Answer 19

cerebrospinal fluid

Question 20

what are the movements of the spine?

Answer 20

extension/flexion, lateral flexion/lateral extension, rotation of head and rotation of upper trunk.

Question 21

what type of joint is the facet?

Answer 21

synovial plane

Question 22

what type of joint is at the articulation of the vertebrae with the rib?

Answer 22

synovial plane

Question 23

what type of joint is between the skull and the atlas?

Answer 23

synovial condyloid

Question 24

what type of joint is at the atlas and axis?

Answer 24

synovial pivot.

Question 25

name the ligaments of the vertebral column?

Answer 25

anterior and posterior longitudinal, ligamentus flavum, interspinous and supraspinous.

Question 26

what is the main back muscle called?

Answer 26

erector spinae

Question 27

is the erector spine an intrinsic extrinsic back muscle?

Answer 27

intrinsic

Question 28

whats the difference between intrinsic and extrinsic muscles?

Answer 28

intrinsic- only attach to the back and not to the limbs. | extrinsic extend to the limbs as well

Question 29

what lies within the vertebral foramen?

Answer 29

the spinal canal which contains the spinal cord, spinal meninges, spinal nerve roots and vascular structures.

Question 30

how many spinal nerves are there attached to the spinal cord?

Answer 30

31 pairs of spinal nerves.

Question 31

what is the specific name for vertebra C7?

Answer 31

vertebra prominers.

Question 32

describe structure of the cervical vertebrae.

Answer 32

``` cervical vertebrae: small wide body small or absent transverse process short spinous process large triangular vertebral foramen ```

Question 33

describe the structure of the thoracic vertebrae.

Answer 33

``` thoracic vertebrae: heart shaped body largest transverse process long spinous process smaller vertebral foramen ```

Question 34

describe the structure of the lumbar vertebrae.

Answer 34

``` lumbar vertebrae: largest/heaviest body long and thin transverse process short and sturdy spinous process triangular vertebral foramen ```

Question 35

concerning the vertebral column: what does the... ligament flavum connect? the anterior longitudinal connect? the posterior longitudinal ligament connect? supraspinous ligament connect? interspinous ligament?

Answer 35

``` the laminae of adjacent vertebral arches vertebral bodies vertebral bodies spinous process's spinous process's (in-between) ```

Question 36

how many adult curvatures are there in the back? | Also what type and where do they occur?

Answer 36

``` there are 4 curvatures of an adult back. cervical = lordose thoracid = kyphose lumbar = lordose sacral = kyphose ```

Question 37

in each of the 3 vertebrae, in what plane is movement permitted?

Answer 37

``` cervical = transverse plane thoracic = sagittal lumbar = sagittal ??? check this question! ```

Question 38

when the trunk flexors and extensors contract at the same time, what does this cause?

Answer 38

intra-abdominal pressure.

Question 39

where does the erector spinal muscles lie?

Answer 39

they lie posteriorly between the vertebral transverse and spinous process.

Question 40

what are the major anterior muscles which can act on the vertebral column?

Answer 40

sternocleidomastoid in the neck and the anterior abdominal wall muscles (rectus abdomens, oblique muscles and transverse abdominis).

Question 41

at what vertebra does the vertebra prominence lie?

Answer 41

C7

Question 42

at what vertebra does the spine of scapula lie?

Answer 42

T3

Question 43

at what vertebral level is the inferior angle of the scapula?

Answer 43

T7

Question 44

at what vertebral level is the summit of the iliac crest?

Answer 44

L4

Question 45

state some of the bony points which can be palpated on the back.

Answer 45

``` spine of scapula vertebra prominens lateral margin of acromion greater tubercle of humerus inferior angle of scapula summit of iliac crest ```

Question 46

what important structures in the thorax are located at T4?

Answer 46

sternomanubrial joint, arch of the aorta and bifurcation of the trachea.

Question 47

where is CSF taken in a lumbar puncture?

Answer 47

in an adult it is taken between the vertebrae L3 and L4 but in children it is between L4 and L5.

Question 48

the spinous process and the interspinous distance decreases when you move down from the thoracic region to the lumbar region. true or false.

Answer 48

true. | the spinous process is smaller and the distance between the process's gets closer as well in the lumbar region.

Question 49

where does the spinal cord end?

Answer 49

L1 in adult and L2/3 in neonates.

Question 50

What does the ligamentum flavum connect?

Answer 50

Adjacent vertebral lamina

Question 51

What does the anterior longitudinal ligament connect?

Answer 51

Connects the anterior of the vertebral bodies | Runs down anterior side of the adjacent vertebral bodies

Question 52

Where does the interspinous ligament and the supraspinous ligament lie?

Answer 52

Interspinous ligament lies between adjacent spinous processes Supraspinous ligament runs down the posterior side of the spinous processes

Question 53

What planes do the cervical, thoracic and lumbar vertebra permit movement in? And what is this difference between each vertebrae to do with?

Answer 53

Cervical —> transverse Thoracic —> coronal Lumber —> Sagittarius Permitting movement in certain planes is to do with the angle that the articulate facets lie

Question 54

What movements are permitted in the cervical, thoracic and lumbar regions?

Answer 54

``` Cervical = rotation, flexion & extension and lateral flexion & extension Thoracic = rotation and lateral flexion & extension Lumbar = flexion & extension and lateral flexion & extension ```

Question 55

What type of muscle is the erector spinal muscle? Flexor or extensor?

Answer 55

Extensor

Question 56

What are the major anteriorly situated muscles that act on the vertebral column?

Answer 56

Sternocleidomastoid and abdominal wall muscles

Question 57

Name the 3 abdominal wall muscles that act on the back.

Answer 57

Transverse abdominis, rectus abdominis and obliques

Question 58

Where does the spinal cord begin?

Answer 58

At the occipital bone

Question 59

The enlargement of the spinal cord at the cervical and lumbar regions is due to enlargement of white or grey matter?

Answer 59

Grey matter

Question 60

What drains the blood from the vertebrae and the spinal cord?

Answer 60

Vertebral Venous plexus