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Flashcards in Trunk Deck (93):
1

vertebrae
-classification

unfused
-cervical: 7
-thoracic: 12
-lumbar: 5
fused
-sacral: 5 (fused as sacrum)
-coccygeal: 4 (may be 3 or 5)

2

What 2 types of natural curvatures occur in the spine?

primary
secondary

3

primary curvatures
-what are they?
-convex anterior or posterior?
-names

what
-curvatures present embryologically
-carried through during birth
convex posteriorly
-yield the curvature of the fetal position
names
-thoracic
-sacral

4

secondary curvatures
-what are they?
-result of...
-types

what
-curvatures that develop postnatally
result of neuromuscular development necessary for
-head support
-bipedal locomotion
types
-cervical
-lumbar

5

cervical curvature
-convex anterior or posterior
-purpose of development

convex anterior
develops to support the head

6

lumbar curvature
-convex anterior or posterior
-purpose of development

convex anterior
develops to support the body for bipedal locomotion

7

abnormal curvatures
-types

kyphosis
lordosis
scoliosis

8

kyphosis
-what is it?
-commonly seen in...
-due to...
-Poliomyelitis infection

what
-exaggerated posterior curvature
commonly seen in elderly with an exaggerated thoracic curvature giving the impression of a "humpback"
due to changes that occur during aging that result in
-bone loss
-loss of turgidity of the nucleus pulposus
can also be seen as a response to muscular changes following recovery from Poliomyelitis infection

9

lordosis
-what is it?
-commonly seen in...

what
-exaggerated anterior curvature
commonly seen in women during pregnancy
-response to shifting of weight

10

scoliosis
-what is it?
-result of...

what
-abnormal lateral curvature
result of...
-incomplete formation of vertebrae (hemivertebrae)
OR
-unequal muscle tension exerted on one side of the vertebral column

11

landmarks of a typical vertebrae (7)

body
vertebral arch
pedicles
lamina
spinous process
transverse process
articular processes (zygapophysis)

12

body
-anterior or posterior aspect of vertebra?
-how does size change throughout spinal column?
-why are the inferior and superior surfaces marked by a roughened circumference (perimeter)?
-what is the smooth center composed of and why?

anterior aspect
size
-size increases inferiorly from cervical region through lumbar region
-size decreases from lumbar region through coccygeal region
roughened perimeter is a result of the attachment of the annulus fibrosus fibrocartilage of IV disc
smooth center
-composed of hyaline cartilage
-corresponds to position of nucleus pulposus

13

vertebral arch
-encloses...
-what is the vertebral canal?
-arch formed by...

encloses the vertebral foramen
vertebral canal
-canal formed by all vertebral foraminae collectively
formed by
-pedicles and laminae as they join via the transverse and spinous processes

14

pedicles
-span what distance?
-pedicle contains which two notches?
-purpose of notches

span distance between body and transverse processes
notches
-superior and inferior vertebral notches
purpose
-from the intervertebral foramen (spinal nerve passes through)

15

lamina
-span what distance?

span distance between transverse process and spinous process

16

spinous process
-projects...

projects posterior inferiorly

17

transverse process
-projects...
-purpose

project posterolaterally and slightly superiorly
act as leverage for the attachment of the intrinsic muscles of the back
-specifically the intermediate and deep or transversospinalis layers of muscles

18

articular processes (zygopophysis)
-most commonly referred to as...
-composed of what two structures?
-joint type

most commonly referred to as facet joints
composed of paired superior and inferior articular processes with an articular facet (face)
synovial planar joint

19

superior articular facet face
-direction importance
-cervical direction (C3-C7)
-thoracic direction
-lumbar direction

direction importance
-used an an identifying characteristic of each level of vertebrae
*face points perpendicular to plane of articular process
-i.e. face of lumbar superior articular process points inward; plane of process is in sagittal plane
cervical direction
-posterosuperior
thoracic direction
-posterior
lumbar direction
-medial

20

cervical vertebrae
-unique characteristics (3)
-what is the vertebra prominens?

-larger vertebral foramen (spinal canal) - more nerves (axons) coming out of these areas
-foramen transversarium for passage of vertebral artery (may be diminished in C7)
-bifid spinous processes (C1 only has a posterior arch)
vertebra prominens
-spinous process of C7

21

C1 and C2 characteristics

C1
-has no body, only an anterior ventral (posterior) arch
C2
-has the odontoid process (dens)
--formed from body of C1

22

important cervical ligaments

cruciform ligament
alar ligaments

23

thoracic vertebrae unique characteristics
-costal facets
--purpose
--occur where
--what type of facets are they and why?
spinous process direction
-purpose
-rotation limited due to...

costal facets
-for articulation with ribs
where
-on side of vertebral body and transverse process of superior 10 ribs
-on pedicle for articulation with ribs 10-12
type
-demi- or hemifacets since articulation of head of the rib spans the intervertebral space
spinous processes are sloped posteroinferiorly
-restrict inferiorly
rotation limited due to true ribs
-more rotation in false and floating rib regions

24

lumbar vertebrae special characteristics (2)
-why is L5 transverse process elongated
-spina bifida occulta results due to...
-spinous processes point...

massive bodies and lamina
no costal facets
L5 transverse process elongated for attachment of iliolumbar ligament
spina bifida occulta
-failure of closure of the posterior neuropore at L4
spinous processes point posteriorly

25

sacral vertebrae
-foraminae: number, purpose, and size difference
-sacral base articulates with...
-sacral hiatus
-sacral cornu
-sacral promontory
-auricular surface
--articulates with...
--type of joint
--when does ossification occur?

foraminae
-4 dorsal pairs and 4 ventral pairs
-for exit of spinal nerves
-dorsal are smaller
base of sacrum articulates with body of L5
sacral hiatus
-inferior opening of spinal canal
-after S3 (due to lack of spinous process)
sacral cornu
-remnant of inferior articular process
-borders sacral hiatus
sacral promontory
-body of S1
auricular surface
-articular with ilium (SI joint)
-synovial planar joint (same as facet joints)
-ossifies following puberty in males; after menopause in females

26

coccygeal vertebrae
-remain as...

remain as bodies only

27

primary vertebrae ossification sites
-how many?
-what?

3
-body (centrum)
-two lateral parts of the arch (pedicles?)

28

secondary vertebrae ossification sites
-how many?
-what?

5
-tips of the spinous and transverse processes along the superior and inferior rims of the body (future site of attachment of annulus fibrosus)

29

intervertebral joints
-what type of joint?

secondary cartilaginous
similar to symphyses

30

ligaments of the trunk (5)

anterior longitudinal ligament
posterior longitudinal ligament
ligamentum flavum
interspinous limgament
supraspinous ligament

31

anterior longitudinal ligament
-attached to...
-functions
only ligament that...
-supports...
-inderdigitates with...

attached to periosteum of the anterior side of body and intervertebral disc
functions
-stability of the joint
only ligament that limits extension (prevents hyperextension)
supports
-anterior and lateral aspects of vertebral body
inderdigitates with
-annulus fibrosus/fibrous capsule of disc

32

posterior longitudinal ligament
-attached to
-purpose
-strength and size compared to ALL
-continues into what?
-what structures does it move through and attach to inside the skull?
-where is the least supported region of the disc?

attached to
-posterior side of the body
purpose
-stability
-prevention of hyperflexion
-prevents direct posterior protrusion of the nucleus pulposus into vertebral canal
weaker, narrower, and thinner than the ALL
continues as tectorial membrane from C2 onto the inferior surface of the skull
moves through foramen magnum to the inside of the posterior cranial fossa
least supported region of is posterolateral region

33

ligamentum flavum
-attaches...
-color and composition

attaches lamina to lamina
yellow in color
made primarily of elastic connective tissue

34

interspinous ligament
-connects...

connects successive spinous processes

35

supraspinous ligament
-connects
-also called the ____ in the _____ regions
-in humans, it is

continuous ligament connecting successive tips of each spinous process
also called the Ligamentum Nuchae in the upper thoracic and cervical region
mostly a fascial sheath in humans (most prominent in quadrupeds who need assistance extending the head)

36

intervertebral disc
-composition
-remnant of...
- between which vertebrae is a disc missing?

composition
-outer ring of fibrocartilage (annulus fibrosus)
-internal part primarily composed of water (nucleus pulposus)
remnant of the embryological notochord
no discs
-occiput and atlas (C0C1)
-atlas and axis (C1C2)
last intact disc is between sacrum and L5

37

annulus fibrosus
-made of...
-how is the fibrocartilage oriented
-where is it thicker?
-supporeted by which ligament?
-where is it thinner and less supported?

made of concentric rings of fibrocartilage
each layer of fibrocartilage is oriented about 90 degrees differently for strength
thicker on the anterior side
supported more heavily by the anterior longitudinal ligament
thinner and less supporeted posteriorly
more logical direction of herniation of the internalized nucleus pulposus

38

nucleus pulposus
-contact with...
-location
-purpose

contact with hyaline cartilage
located centrally on the superior and inferior faces of the body of the vertebrae
purpose
-forms cushion

39

facet joint
-technical name for joint
-joint type
-what do all joint of this type have?

zygapophysial joint
synovial joint (of the planar type)
all synovial joints have hyaline cartilage on their articular surfaces

40

movement allowed at cervical joints (rough)
-flexion/extension
lateral bending
--C1C2
Axial rotation
--C1C2
--total

flexion/extension
-7-20
lateral bending
-3-10
-0 at C1C2
Axial rotation
-around 10
-47 at C1C2
-around 90 total

41

movement allowed at thoracic joints
-flexion/extension
-lateral bending
-axial rotation

flexion/extension
-7-20
-more in T10-L1 - false and floating ribs
lateral bending
-5-10
axial rotation
-8-10
-less in T9-L1

42

movement allowed at lumbar joints
-flexion/extension
-lateral bending
-axial rotation

flexion/extension
-12-20
lateral bending
-around 10
axial rotation
-3-5

43

what are the primary part of the rib (3)

head
neck
tubercle

44

ribs
-head of each rib has 2 _____ to match the _____ of the vertebrae
--exceptions to this rule
--why are these exceptions present

head of each rib has 2 demifacets to match the demifacets of the vertebrae
exception
-ribs 1, 11, and 12
-ribs 11 and 12 don't have an articular surface on the tubercle since they don't articulate with the transverse processes of vertebrae T11 and T12

45

movement of the vertebral column
-how are ribs situated and what effect does this have on movement?
-lumbar articular facet orientation effect on movement
-flexion/extension ability at C-spine
-flexion/extension at lumbar level

-ribs are anchored rostrally (couldn't find a great definition) to the sternum and thus make the thoracic region less flexible than the cervical or lumbar region
-articular facet orientation in the lumbar region allows for flexion/extension
-flexion good at cervical region
-extension compromised at cervical region due to the overlapping spinous processes
-lumbar region: greatest mobility is in extension and then in flexion
-lumbar flexion is limited due to the massive size of the bodies

46

bones of the pelvis
-combine to form...

ilium
ischium
pubis
-combined to form the coxal bone or os coxae (not coccyx)

47

ilium
-Ala contains..
-superior margin components
-tubercle of crest located at...
-SI joint type
-iliac tuberosity is an anchor point for...
-where is the greater sciatic notch

-ALA (wing-like portion) contains iliac fossa
-superior margin: iliac crest, bordered by anterior and posterior superior iliac spines (ASIS, PSIS)
-tubercle at superior end of anterior gluteal line
SI joint
-synovial planar joint
-matching auricular surfaces
iliac tuberosity is an anchor point for the iliolumbar and anterior sacroiliac ligaments
greater sciatic notch is below PIIS

48

ischium
-location
-body and ramus articulate with...
-landmarks (3)

posteroinferor 1/3 of hip
body articulates with ilium
ramus articulates with pubis
landmarks
-ischial tuberosity
-ischial spine
-ischiopubic ramus

49

ischial spine
-what is below this?
-what defines the greater sciatic foramen above?
-what defines the lesser sciatic foramen?

-lesser sciatic notch is below
-sacrospinous ligament defines the greater sciatic foramen above (by closing the greater sciatic notch)
-sacrotuberous ligament defines the lesser sciatic foramen (by closing the lesser sciatic notch)

50

ischiopubic ramus
-these define the...

articulation of ischial and inferior pubic rami define the obturator foramen

51

pubis
-components
-inferior ramus articulates with...
-superior ramus articulates with...
-pubis, ilium, and ischium all articulate within...
-bodies of the pubi? articulate with each other via...
-pubic crest location
-pubic tubercle location
-what attaches on pubic tubercle?

-composed of body and 2 rami
-inferior ramus articulates with ischial ramus
-superior ramus articulates with the ilium
-pubis, ilium, and ischium all articulate within the acetabular fossa
-bodies articulate via pubic symphysis (fibrocartilage)
-pubic crest on superior border of body
-pubic tubercle on lateral end of body
-inguinal ligament attaches on pubic tubercle

52

joints of pelvis
-name and joint type

SI joints
-synovial planar joints
-some books say both surfaces are of hyaline cartilage
-some say the sacral side is fibrocartilage
pubic symphysis
-fibrocartilaginous joint

53

SI joint supporting ligaments

anterior SI ligament
posterior SI ligament
iliolumbar ligament
-stretches from iliac tuberosity to transverse process of L5

54

extrinsic muscles of the back
-overall purpose
-names and individual purpose

overall purpose
-movement of the upper extremity and ribs
most superficial
-trapezius and latissimus dorsi
--act upon the upper extremity
deep to these
-serratus posterior, superior, and inferior
--involved in respiration due to their attachments and orientation

55

thoracolumbar fascia
-another name
-where is it attached?
-formed by
-number of layers and names
-purpose

-also called thoracodorsal fascia
-formed from aponeurotic (flattened tendinous attachment) connections of the abdominal muscles attaching to the lumbar vertebrae and iliac crest
3 layers
-posterior, middle, anterior
posterior and middle layers encase the deep back muscles (intrinsic muscles of the back)
anterior fascial layers form the rectus sheath, which encases the abdominis muscle

56

intrinsic muscle purpose

maintain posture
assist with flexion, extension, lateral flexion and rotation of the vertebral column
-head to a lesser extent

57

abdominal muscles
-functions
-function in upright posture
-activation when...

functions
-compress abdomen
-major function in flexion of the trunk against gravity
relatively inactive in upright posture
activated against gravity as in sit-ups
in rotational movements against gravity
-external abdominal oblique and contralateral internal abdominal oblique are active together

58

transverse abdominis
-purposes

involved in the stabilization of the lumbar spine to the pelvis
stabilizes lumbar vertebrae during training to prevent lower back pain

59

names of layers of intrinsic back muscles

superficial
intermediate
deep

60

superficial intrinsic back muscle names
-located where?

splenius cervicis
splenius capitis
only located at cervical region

61

intermediate intrinsic back muscles
-broad name
-extend to...
-muscles move...

erector spinae group
extend to base of skull
muscles move superolaterally

62

erector spinae muscle names (3)

iliocostalis
longissimus
spinalis

63

iliocostalis muscle names

lumborum
thoracis
cervicis

64

longissimus muscle names

thoracic
cervicis
capitis

65

spinalis muscle names

thoracic
cervicis
capitis
-spinalis cervicis and capitis are usually indistinguishable from semispinalis cervicis and capitis

66

common broad tendon
-importance
-where does it originate?

all erector spinae muscles originate from this
originates on...
-lumbar spinous processes
-median sacral crest
-PSIS
-posterior 1/3 of iliac crest

67

deep muscles names

transversospinalis (broad name)
-semispinalis
-multifidus
-rotatores

68

transversospinalis (general characteristic)
-move from where to where and in what direction?

move from transverse process superomedially to spinous process

69

semispinalis
-span what distance?
-names

span about 6 vertebrae
names
-thoracic
-cervicic
-capitis

70

multifidus
-span what distance?

3-4 vertebrae
most visible in lumbar and cervical regions

71

rotatores
-span what distance?

brevis: 1 segment
longus: 2 segments
most visible in thoracic region

72

actions of deep muscles compared to intermediate muscles

extension and ipsilateral lateral flexion
contralateral transverse rotation

73

other muscles that play a role in the movement or stability of the vertebral region and the head

interspinales
intertransversarii
levator costarum (some books describe as modified intertransversarii muscles)

74

generalities of intrinsic back muscles
-superficial and intermediate muscle groups performs what movements?
--why these movements
-deep muscle groups perform what movements?
--why these movements

superficial and intermediate muscle groups
-laterally flex and rotate trunk to same side
-muscle fibers travel superiorly and laterally from origin to insertion
-deep muscle groups rotate the column to the opposite side
-muscle fibers travel superiorly and medially from origin to insertion

75

suboccipital triangle
-composed of what four muscles
-purpose

rectus capitis posterior major (superomedial)
-spinous process of C2 to base of skull
rectus capitis posterior minor (medial to RCP major)
-C1 to base of skull
obliquus capitis superior
(superolateral)
obliquus capitis inferior (inferolateral)
purposes
-stabilization of C1, C2, and skull
-maintain relationship between these three structures

76

suboccipital triangle contents

-dorsal ramus of spinal nerve C1
-dorsal rami of C2
-vertebral artery
-greater occipital nerve
-lesser occipital nerve
if this area of the body becomes impinged, the brain and brain stem begins to lose blood supply

77

dorsal rami of spinal nerve C1

no cutaneous sensory component
only goes to the suboccipital muscles

78

dorsal rami C2 purpose

dermatome innervation of the posterior part of the head

79

vertebral artery
-identified where?

identified exiting the transverse foramen of C1
crosses anterosuperiorly to wrap to the anterior side of the brainstem and enter foramen magnum

80

greater occipital nerve
-initial location and purpose
-ending location
combination of...

crosses over suboccipital triangle to reach the posterior surface of the head
-provides sensory innervation
once it reaches back of head, it lies along side of the occipital artery (branch of external carotid artery)
combination of dorsal rami of C2-3

81

lesser occipital nerve
-purpose
-composed of...

provides sensory innervation to the lateral side of the neck
combination of the ventral rami of C2-3

82

muscles that cause posterior movement of the trunk and head

splenius muscles
erector spinae
transversospinales
suboccipitals
segmental muscles (interspinalis, intertransversarii)

83

muscles that cause anterior movement of the trunk and head

suboccipital muscles
longus colli and capitis
scalenes
sternocleidomastoid
abdominas
psoas major

84

superficial muscles that cause lateral movement of the trunk and head

scalenes
sternocleidomastoid
quadratus lumborum
psoas major
internal oblique

85

stabilization of the vertebrae
-posterior muscle functions
--examples
-psoas major
--location
-purpose

posterior muscles have vectors of pull that would allow for extension, rotation and lateral bending, but they work synergistically (some common actions while other are opposite and negated) with other muscles to effect actual motion
-rotation through the abdominal region - external and internal oblique muscles vs. erector spinae and transversospinalis
-side bending - lateral abdominals and quadratus lumborum vs. erector spinae and transversospinalis
psoas major
-anterior muscle of the trunk (posterior abdominal wall)
-prime mover and stabilizer of the trunk
-supports the trunk from falling posteriorly in unsupported setting

86

forward bending
-which muscles control movement and how?

eccentric contraction of hamstrings and erector spinae occur to control hip flexion and forward bending across trunk
concentric contractions return the trunk to upright posture

87

parts of a spinal nerve

dorsal and ventral root
spinal nerve
dorsal and ventral primary rami
dorsal and ventral division of primary rami

88

deep back muscle innervation

done by segmental dorsal rami of spinal nerves from the cervical, thoracic, and lumbar regions
segmental nerve stay segmental without joining other nerve segments
different organization than the larger ventral rami that form plexi (cervical, brachial, lumbosacral)

89

innervation exceptions

intertransversarii receive segmental branches of the ventral rami near their separation from the dorsal rami (just lateral to the intervertebral foramen)

90

lumbosacral plexus
-formed from...
-emerges through and around...
-innervated trunk muscles

-formed from ventral rami of lumbar and sacral spinal nerves
-emerges through and around posterior abdominal and pelvic walls, respectively
muscles
-psoas major
-QL
-muscles of the anterior abdominal wall
-intertransversarii

91

lateral raphe
-what is it?
-purpose

where
-deep to latissimus dorsi
-location where fascia of ext. oblique, int. oblique, and TA fuse
purpose
-assists with lumbar stabilization
-assists with maintenance of the lumbar lordotic curve (can alleviate lower back pain)

92

gluteal lines
-names
-attachments

posterior gluteal line: gluteus maximus
posterior to anterior: gluteus medius
anterior to inferior: minimum

93

quadratus lumborum

lateral flexor of trunk