Spine and Deep Back

Question 1

Describe the function of the vertebral arch

Answer 1

Protection of spinal cord

Question 2

Identify and describe the function of the orange structure.

Answer 2

Spinous process
Muscle attachment and movement

Question 3

Identify the green structure.

Answer 3

Pedicles

Question 4

Identify and describe the function of the red structure.

Answer 4

Transverse process
Muscle attachment and movement

Question 5

Identify the purple structure.

Answer 5

Lamina

Question 6

Identify and describe the function of the yellow structure.

Answer 6

Superior articular process
Restriction of movement

Question 7

Identify and describe the function of the blue structure.

Answer 7

Vertebral body
Supports bodyweight

Question 8

Identify and describe the function of the shaded structure.

Answer 8

Vertebral foramina
Spinal cord runs through

Question 9

Describe the changes in vertebrae with advancing age

Answer 9

Decreases in bone density
Articular surfaces bow inward
Periphery begins to compress
Osteophytes form in response

Question 10

Describe the development of spinal curvatures

Answer 10

Primary curvatures in spine at infancy are kyphotic
-Thoracic & Sacral
Secondary curvatures in spine develop with supporting head & body weight
- Cervical & Lumbar

Question 11

What are abnormal curvatures of the spine?

Answer 11

Excessive Kyphosis
Excessive Lordosis
Scoliosis

Question 12

What abnormal spinal curvature is this?

Answer 12

Excessive Kyphosis

Question 13

What abnormal spinal curvature is this?

Answer 13

Excessive Lordosis

Question 14

What abnormal spinal curvature is this?

Answer 14

Scoliosis

Question 15

Identify the labeled parts of this intervertebral disc

Answer 15

1: nucleus pulposus
2: annulus fibrosus
3: cartilaginous end plate
4: anterior longitudinal ligament
5: posterior longitudinal ligament

Question 16

Describe a posterolateral disc herniation.

Answer 16

Posterolateral disc herniations are most common
The nucleus pulposus protrudes out of the annulus fibrosus where it is thinnest and lacks structural support from the ant & post longitudinal ligaments
The herniation in this direction is more likely to compress the nerve root and cause sypmtoms

Question 17

What are the six ligaments of the spine?

Answer 17

• anterior longitudinal
• posterior longitudinal
• supraspinous
• interspinous
• ligamentum flavum
• intertransverse

Question 18

What motion does the anterior longitudinal ligament limit?

Answer 18

hyperextension

Question 19

What motion does the posterior longitudinal ligament limit?

Answer 19

hyperflexion

*can help prevent disc herniation

Question 20

What motion does the supraspinous ligament limit?

Answer 20

hyperflexion and separation of spinous processes during flexion

Question 21

What motion does the interspinous ligament limit?

Answer 21

flexion

Question 22

What motion does the intertransverse ligament limit?

Answer 22

lateral flexion

Question 23

What motion does the ligamentum flavum limit?

Answer 23

separation of the laminae during flexion

Question 24

Describe the structure of ligamentum nuchae and it’s function.

Answer 24

Spans the external occipital protuberance to the spinous process of C7
Thick and triangular ligament
Resists flexion of the cervical spine

Question 25

What are the six primary movements of the spine?

Answer 25

Flexion /Extension Lateral Flexion/ Lateral Extension Rotation of head/neck Rotation of trunk

Question 26

Describe spine movement at the cervical spine

Answer 26

*all movements Flex/Ext Lateral Flex/Ext Axial rotation (C1&C2)

Question 27

Describe spine movement at the thoracic spine

Answer 27

Does best in rotation Flexion/extension and lateral flexion limited by rib connections

Question 28

Describe spinal movement at the lumbar spine

Answer 28

Primarily flexion and extension, some lateral flexion/ext Limited rotation

Question 29

How does facet joint orientation affect spinal movements?

Answer 29

The facets of the articular processes are regions of joint contact. The angle of orientation allows for/limits spinal movement.

Question 30

What is the angle of orientation of the facets at the cervical spine?

Answer 30

45 degrees in frontal plane allows for all movements

Question 31

What is the angle of orientation of the facets at the thoracic spine?

Answer 31

60 degrees more oblique orientation allows more rotation and less flex/ext

Question 32

What is the angle of orientation of the facets at the lumbar spine?

Answer 32

90 degrees more vertical allows for flex/ext but less rotation

Question 33

Describe the meningeal coverings of the spinal cord

Answer 33

Dura mater Arachnoid mater Pia mater (dura narrows to denticulate ligaments/lateral expansions that anchor the spinal cord to the dura)

Question 34

Describe spinal stenosis at the lumbar level

Answer 34

Spinal stenosis is narrowing of the vertebral canal that can cause compression of one or more spinal roots that occupy the canal Patients may present with lower extremity motor & sensory symptoms

Question 35

What muscles make up the superficial layer of the extrinsic back muscles?

Answer 35

Trapezius Latissimus dorsi Levator scapulae rhomboids

Question 36

What muscles make up the intermediate layer of the extrinsic back muscles?

Answer 36

Serratus Posterior Superior Serratus Posterior Inferior

Question 37

What muscles make up the supericial layer of the Intrinsic muscles of the back?

Answer 37

Splenius capitus Splenius cervicis

Question 38

What muscles make up the intermediate layer of the Intrinsic muscles of the back?

Answer 38

Erector Spinae Group: Iliocostalis Longissimus Spinalis I Love Spaghetti!

Question 39

What muscles make up the deep layer of the Intrinsic back muscles?

Answer 39

Transversospinalis Group: Multifidus Rotatores Longus Rotatores Brevis Semispinales and Interspinales Intertransversarii

Question 40

What is the innervation of the Extrinsic mm. superficial layer?

Answer 40

ventral rami of spinal nn. *Except Trapezius - CN XI

Question 41

What is the innervation of the Extrinsic mm, intermediate layer?

Answer 41

Intercostal nn.

Question 42

What is the innervation of the intrinsic muscles of the back?

Answer 42

Dorsal rami of spinal nn.

Question 43

What is the segmental innveration of Serratus posterior superior?

Answer 43

T1-4

Question 44

Segmental innervation of serratus posterior inferior

Answer 44

T9-12

Question 45

P, D, A, I Serratus posterior superior

Answer 45

P: spinous processes of C7-T3 D: Inferior borders of ribs 2-5 A: proprioception of thoracic wall I: intercostal nn. (T1-4)

Question 46

P, D, A, I Serratus posterior inferior

Answer 46

P: spinous processes of T11-L2 D: inferior borders of ribs 9-12 A: proprioception of thoracic wall I: intercostal nn. (T9-12)

Question 47

Iliocostalis attachments

Answer 47

Thoracolumbar fascia to costal angles

Question 48

Longissimus attachments

Answer 48

ribs & transverse processes

Question 49

Spinalis attachments

Answer 49

spinous processes

Question 49

Semispinalis (transversospinales) Attachments

Answer 49

P: transverse processes D: distant superior spinous processes

Question 50

Multifidis (transversospinales) Attachments

Answer 50

P: sacrum, posterior SI lig, posterior iliac spine, transverse processes D: superior spinous processes

Question 51

Rotatores longus and brevis (transversospinales) Attachments

Answer 51

P: Transverse processes D: Spinous process of vertebra above

Question 52

Interspinales Attachments

Answer 52

between spinous processes of adjacent vertebrae

Question 53

Intertransversarii Attachments

Answer 53

between transverse processes of adjacent veretebrae