The Back and Spine

Question 1

How does the vertebral column allow for weight-bearing?

Answer 1

Carries and transmits weight from the upper body to the lower limbs.
Vertebral bodies increase in size from superior to inferior.
Curvatures and intervertebral discs provide shock absorption.

Question 2

How does the vertebral column allow for protection?

Answer 2

The vertebral foramen protects the spinal cord.
The intervertebral foramen protects the spinal nerves.

Question 3

How does the vertebral column allow for movement?

Answer 3

Cervical - flexion, extension and rotation.
Thoracic - rotation.
Lumbar - flexion, extension, lateral flexion and rotation.

Question 4

How does the vertebral column allow for muscle attachment?

Answer 4

Extrinsic back muscles attach to the head, limbs, thorax and abdomen.
Intrinsic back muscles (erector spinae) control flexion, extension and lateral flexion.

Question 5

What is the importance of spinal curvatures?

Answer 5

Primary curvatures - convex.
Secondary curvatures - concave.

Cervical - when infants have their head upright.
Lumbar - when infants stand and walk.

Question 6

What are abnormal spinal curvatures?

Answer 6

Lordosis - lumbar (pregnancy).
Kyphosis - thoracic (osteoporosis).
Scoliosis - common in adolescents.

Question 7

What is the structure of an intervertebral disc?

Answer 7

Nucleus pulposus - central core with high water content.
Annulus fibrosus - rings of fibrocartilage.

Question 8

What is a slipped disc?

Answer 8

A posteromedially herniated nucleus pulposus.
Can compress the nerve root.

Question 9

What are meninges?

Answer 9

Coverings of the spinal cord.
Dura mater, arachnoid mater, pia mater.
Epidural space, subdural space, subarachnoid space.

Question 10

What relationships does the spine have with surrounding anatomical structures?

Answer 10

Muscles - extrinsic, intrinsic, anterior, posterior.
Nerves and ganglia - paravertebral and prevertebral.
Arteries, veins, lymphatic vessels, lymph nodes.

Question 11

What is the ligamentum flavum?

Answer 11

The strongest ligament in the spine.
Runs in front of and between lamina.
Runs in front of facet joint capsules.

Question 12

What is the anterior longitudinal ligament?

Answer 12

A spine stabiliser, prevents hyperextension.
Connects anterior vertebral bodies to the front of the annulus fibrosis.

Question 13

What is the posterior longitudinal ligament?

Answer 13

A spine stabiliser, prevents hyperflexion.
Connects posterior vertebral bodies to the back of the annulus fibrosis.

Question 14

What is the supraspinous ligament?

Answer 14

Limits flexion.
Attaches the tip of each spinous process to the other.

Question 15

What is the interspinous ligament?

Answer 15

Limits flexion.
Attaches to the ligamentum flavum that runs deep into the spinal column.

Question 16

What are the types of joints in intervertebral discs?

Answer 16

Secondary cartilaginous joints.
Made of fibrocartilage and hyaline cartilage.

Question 17

What pathological changes occur with ageing in the back?

Answer 17

Weak back muscles cause an imbalanced loading of the spine (loss of strength and function).
Dehydration of intervertebral discs reduces shock absorption.

Osteoarthritis - pain and stiffness of joints.
Osteoporosis - compression factors alter the curvature of the spine.

Question 18

What are facet joints?

Answer 18

Synovial joints between adjacent vertebrae at articular facets.

Question 19

What are different structures at the spine?

Answer 19

Vertebral prominence - spinous process of C7.
Spine of scapula - T3.
Inferior angle of scapula - T7.
Summit of iliac crest - L4.

Question 20

What happens when the trunk flexors and extensors contract simultaneously?

Answer 20

Increases intra-abdominal pressure.
Facilitates coughing, vomiting and defecating.