Module 4: The Back Flashcards Preview

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Flashcards in Module 4: The Back Deck (93):
1

What is the pathology of referred back pain?

The pathology of the viscera may refer pain to back

2

What are some examples (2) of referred back pain?

AAA - abdominal aortic aneurysm

Renal calculi (Kidney Stones)

3

3 locations of kidney stones

1. Calyceal stone

2. Renal Pelvic stone

3. Upper ureteral stone

4

Name some examples of intrinsic back pain

1. Compression fracture
2. Spinal stenoisis
3. Ankylosing spondylitis
4. Osteomyelitis

5

Name some factors that contribute to postural/structural imbalances:

1. Overuse, misuse
2. Occupational
3. Recreational habits
4. Scoliosis
5. Spondylolisthesis

6

In total how many vertebrae are there?

33

7

How many cervical, thoracic, lumbar, sacral, and coccyx bones?

7 Cervical
12 Thoracic
5 Lumbar
5 (fused) sacral
4 (fused) coccyx

8

What is the average length of the vertebral column and is that length solely due to the vertebral bodies?

Ave length: 72-75 inches

1/4 of the length is due to the fibrocartilagenous discs (IVD)

9

What are the 4 functions of the vertebral column?

1. Protect spinal column
2. Support the weight of head/neck
3. Allow movement of rib cage - costovertebral joints
4. Critical role in posture/locomotion

10

Name the primary curves in the vertebral column

Thoracic and Sacral

11

Name the secondary curves in the vertebral column

Lumbar and Cervical

12

What is the function of the spinal curves specifically?

To absorb shock

* Curves can absorb 10x more than a straight spine

13

Describe the curvature of the spine in infants

Primary curve only

--> When infants can hold head up/sit upright this means they are beginning to develop secondary curve in cervical

--> when start to stand/walk, their secondary curve in lumbar is beginning to form

14

Name four curves of scoliosis

1. Thoracic
2. Thorocolumbar
3. Lumbar
4. Double Major

15

What are the treatments of scoliosis?

If 0-20 degrees: watch it

When it gets to 40-45 degrees: consider surgery

16

In what plane is scoliosis difficult to see?

Transverse plane

17

A typical vertebrae =

body + arch + 7 processes

18

What is the epiphyseal ring?

Smooth region of vertebrae along the periphery of the body formed from annular epiphysis (2ndary ossification center during growth)

19

Vertebral (neural) arch =

pedicles + lamina

20

When lamina fail to fuse resulting in a defect in the arch this is called....

Spina bifida

21

3 types of Spina Bifida:

1. Spina Bifida occulta

2. Meningocele

3. Myelomenigocele

22

Spina bifida occulta

failure of vertebral arch to fuse, bony defect

23

Meningocele

meninges protrude through bony defect of vertebral arch

24

Myelomenigocele

Spinal cord + meninges protrude defect of vertebral arch

25

What do articular processes form?

Facet (zygapophyseal) joint

26

What are the distinguishing regional characteristics of the different vertebrae?

i.e: how can you distinguish the different vertebrae?

Body
Vertebral foramen
Transverse, articular, and spinous process

27

Which vertebrae has the smallest vertebral foramen?

Thoracic vertebrae

28

What are the body shapes of the thoracic and lumbar vertebrae?

Thoracic: heart shaped

Lumbar: kidney shaped

29

What are the accessory and mamillary processes located and what vertebrae are they specific too?

Both specific to lumbar vertebrae!

Accessory: tubercles located at the base of transverse process

Mamillary: tubercles located on superior articular pillar of articular process

30

What is the shape of the SP on lumbar vertebrae?

"Hatchet" shaped
Very sturdy

31

What is the function of the sacrum?

Provide stability to pelvis

32

C1 is also known as:

Atlas

33

C2 is also known as:

Axis

34

Where does the superior portion of the lateral mass articulate with?

What is it's function?

Occipital condyles

Functions to flex and extend head

35

Where does the inferior portion of the lateral mass articulate?

What is it's function?

C2

Rotation

36

Which area of the atlas articulates w/ the dens of the axis?

Anterior arch facets

37

Describe the transverse processes of C1

They are wide and can be palpated inferior to mastoid process

38

A disc =

annulus fibrosus + nucleus pulposus

39

What is the function of a disc?

Acts as a shock absorber
Influences motion

40

Composition of a disc:

- Water
- Collagen fibers
- Proteoglycans

41

Places where there are no discs:

Between occiput and C1

Between C1 and C2

42

What is the annulus fibrosis layer composed of?

concentric layers of collagen fibers

43

What is the orientation of annulus fibrosis layer and why is this orientation important?

Oblique orientation to provide tensile strength

44

Describe the direction of fibers in annulus fibrosis layer of vertebral disc

Directions alternate creating a "crosswoven effect"

45

What is important to note about the outside layer of fibers in the annulus fibrosis layer of vertebral disc?

Outside layer will blend with ALL and PLL

Outside layers has innervation thus a potential source for pain

46

The nucleus pulposus layer of vertebral disc is composed of:

proteoglycans and water

DOES contain fine collagen fibers (loose and random)

47

What occurs to the nucleus pulposus when people age?

Decrease of proteoglycan content -- thus less water attraction - thus decrease disc height

48

Spinal degeneration vs. Herniation

Osteoarthritis is an example of spinal degeneration:
--> bone and cartilage are damaged, which compress spinal nerve (pinched nerve)

Herniation is a protrusion of the disc and the hernia is compressing the nerve. No damage to bone or cartilage

49

What are the Joints of Luschka (uncovertebral) unique too?

Cervical spine

50

What joint is the joints of Luschka similiar too?

Synovial joint (cartilage and capsule) but debatable

51

What is the function of the facet joints?

Permit gliding movement between the vertebrae

Some weight baring function in Cervical and Lumbar sections

52

What is the innervation of facet joints?

Dorsal primary rami

53

Where does the ALL run? (start to finish)

Occiput to sacrum along anterior portion of vertebral column

54

Does the width of the ALL decrease, increase, or stay the same as it travels down the vertebral column?

Increases

55

Function of the ALL?

Limit extension
Support anterior annulus fibrosis of disc

56

Where does the PLL run? (start to finish)

C2 to Sacrum
Posterior vertebral column WITHIN VERTEBRAL CANAL (thus anterior to spinal cord)

57

Does the width of the PLL decrease, increase, or stay the same as it travels down the vertebral column?

Decreases

58

Function of PLL?

Limits flexion
Supports posterior annulus fibrosis of disc

59

The Ligamentum flavum connects ______ of each vertebrae

lamina

60

Does ligamentum flavum thicken or thin as it descends from cervical to lumbar regions?

Thickens

61

Functions (2) of the ligamentum flavum:

1. Allows "smooth" flexion of vertebrae --> thus decreases potential for IVD injury

2. Elastically assist w/ restoring neutral position after flexion of spine

62

Interspinour ligaments connect adjacent ______ _______.

Spinous processes

63

Supraspinous runs from ____ to _____.

C7 to Sacrum

64

Describe the differences is texture of interspinous and supraspnous ligaments

Interspinous = thin membranous ligament
Supraspinous = cord like ligament

65

Nucal ligament runs from ____ to ______.

EOP to C7

66

Nucal ligament connects:

EOP
Posterior tubercle of C1
Spinous processes of C2-7

67

Intertransverse ligament connects _____ between adjacent vertebrae.

Transverse processes

68

What is the function of the atlanto-occiptial joint as a whole?

Flexion and extension movement of head and neck

69

What is the function of the anterior and posterior atlanto-occipital membranes?

Help prevent excessive movement at atlanto-occipital joint (stability)

70

Where does the tectorial membrane run?

C2 to foramen magnum

71

Tectorial membrane runs _____ to the cruciate ligament.

Posterior

72

Cruciate ligament =

transverse ligament + superior and inferior longitudinal bands

73

Function of the cruciate ligament:

- stabilize dens against anterior arch of C1
- acts as posterior wall and forms "socket" for dens

74

The alar ligament extends from _____ to _____.

Sides of dens to lateral margin of foramen magnum

75

The thoracolumbar fascia of the trunk does what 3 things?

1. Invests the deep muscles of the back

2. Attaches to the SP's and TP's of T/L regions

3. Provides origin for latissimus dorsi, transverse abdominal, and internal oblique mm.

76

What does the superficial layer of the muscles of the back control?

Control of upper limb

EXTRINSIC

77

What does the intermediate layer of muscles of the back control?

Assist in control of respiration

EXTRINSIC

78

What does the deep layer of muscles of the back control?

Control vertebral column

INTRINSIC

79

Superficial layer of back muscles contain:

Trapezius
Latissimus dorsi
Rhomboids
Levator scapulae

80

Intermediate layer of back muscles contain:

Serratus posterior superior
Serratus posterior inferior

81

Deep layer of the back has 3 subgroups:

1. Superficial
2. Intermediate
3. Deep

82

Superior layer of the deep back muscles contain:

Splenius capitus
Cervicis

83

Intermediate layer of the deep back muscles contain:

Erector spinae muscles
--> Iliocostalis
--> longissimus
--> spinalis

84

Deep layer of the deep back muscles contain:

Transversospinal muscles
--> semispinalis
--> multifidi
--> rotators

85

The spinal cord is a continuation of ______.

Medulla oblongata

86

Spinal cord extends from ____ to _____.

Foramen magnum to T/L junction (varies from person to person)

87

What are the two enlargements of the spinal cord?

1. Cervical

2. Lumbar

88

Conus medullaris:

termination of the spinal cord

89

Cauda equina:

"horse's tail" - formed by spinal nerve roots of lumbar and sacral plexus

90

Where is the cauda equina located?

lumbar cistern

(subarachnoid space)

91

How many pairs of spinal nerves are there?

31

92

What nerve roots make up the spinal cord

dorsal (afferent)

ventral (efferent)

93

What are the coverings of the spinal cord?

1. Dura matter
2. Arachnoid
3. Pia matter