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Flashcards in Vertebral Column & Thoracic Wall Deck (151)
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1
Q

Components of vertebral column

A

Cervical (7), thoracic (12), lumbar (5), sacrum (about 5 fused), coccyx (3-4 fused)

2
Q

Curvatures of spine and direction they curve in

A

2 primary (concave) and 2 secondary (convex)

3
Q

Is first curvature primary or secondary?

A

secondary

4
Q

lamina

A

separates traverse from spinous process

5
Q

How do vertebrae create motion?

A

joints between articular processes

6
Q

Cervical zygapophysial joint

A

sloped from anterior to posterior

7
Q

Motions from cervical vertebrae

A

rotation, flexion, and extension

8
Q

Thoracic zygapophysial joint direction and motion

A

vertical for rotation, flexion, and extension

9
Q

lumbar zygapophysial joint

A

processes of vertebrae below are wrapping around processes of vertebrae above

10
Q

What is the lumbar zygapophysial joint important for?

A

Stability

11
Q

Cervical vertebrae

A

Triangular shaped vertebral canal with small, short vertebral body w delicate arches, Foramen transversarium
Bifurcated spinous process

12
Q

Foramen transversarium

A

Provides place for vertebral artery to move down only cervical vertebrae

13
Q

Atlas

A

C1

14
Q

Axis

A

C2

15
Q

Axis shape and function

A

50% of rotation in neck from specialized vertebral body (dens) shaped like a tooth, hardly any traverse processes

16
Q

thoracic vertebrae

A

Round vertebral foramen, heart-shaped vertebral body, extra articulations for rib and vertebrae (costovertebral joints), spinous processes long, flat, & angled inferiorly

17
Q

lumbar vertebrae

A

small triangular foramen and large kidney-shaped body, stocky posteriorly projecting spinous processes, mammillary & accessory process

18
Q

Zygapophysial joint

A

Flat synovial plane joint that connects
sup & inf facets of adjacent vertebrae, allows gliding spinal motion, but articular process orientation aid or limit movement

19
Q

intervertebral discs/joints

A

Solid joint symphyses that connects adjacent vertebrae and shock absorption

20
Q

parts of intervertebral discs

A

annulus fibrosus and nucleus pulposus

21
Q

Annulus fibrosus structure and functon

A

Ring of fibrocartilage inserts on rim of vertebral bodies, Limit rotation between adjacent vertebrae

22
Q

nucleus pulposus structure and functon

A

Gelatinous center, absorbs compression forces, semi-fluid ball bearing; avascular

23
Q

spinal ligaments and location

A

anterior and posterior longitudinal ligaments, ligamentum flavum, supraspinous ligament, interspinous ligament, and ligamentum nuchae

24
Q

anterior vertebral ligament and function

A

courses along ant. vertebral bodies from skull base to sacrum, prevents hyperextension of vertebral column

25
Q

Posterior vertebral ligament

A

courses along post. vertebral bodies from C2 to sacrum, prevents hyperflexion of the vertebral column, smaller than anterior longitudinal ligament

26
Q

Supraspinous ligament and function

A

connects adjacent vertebral spines, resists flexion in head

27
Q

ligamentum nuchae and function

A

thickened extension of supraspinous and interspinous ligaments in cervical region, resists flexion in head

28
Q

interspinous ligament and function

A

between adjacent spinous processes and blends with suprapsinous ligament and ligamentum flava, limits flexion

29
Q

vertebral column functions

A

. Maintains erect posture and aids in locomotion
. Supports head, trunk, limbs
. Protects the spinal cord and spinal nerve roots

30
Q

typical structure of vertebrae

A

body, vertebral arch, 7 processes, sup/inf vertebral notches, intervertebral foramina

31
Q

body of vertebrae

A

also called centrum, weight bearing portion, covered by hyaline c.

32
Q

vertebral arch

A

also called neural arch, 2 pedicles & 2 laminae surrounding vertebral foramen

33
Q

muscle attachment sites in typical vertebrae

A

2 transverse process projecting laterally and 1 spinal process projects post/inferiorly

34
Q

articular process in typical vertebrae

A

sup & inf articular processes (zygapophyses) w facets for processes adjacent vertebrae articulate w one another at zygapophysial joints

35
Q

what determines direction and movement of zygapophysial joints?

A

orientation of articular processes

36
Q

sup & inf vertebral notches in typical vertebrae

A

indentations formed between projection of vertebral body & articular processes sup & inf to pedicles

37
Q

intervertebral foramina in typical vertebrae

A

lateral openings that form between sup & inf vertebral notches of adjacent vertebrae

38
Q

what do intervertebral foramina house?

A

spinal nerve roots or dorsal root ganglia & vessels

39
Q

cervical vertebrae body

A

Superior surface of body: concave from side-to-side w uncus
Inferior surface of body is convex from side-to-side.

40
Q

uncus

A

superiorly projecting lateral margins on vertebral body of cervical vertebrae

41
Q

where do facets face on thoracic vertebrae

A

sup articular facets face posteriorly, inf facets face anteriorly

42
Q

costal hemifacets

A

small articular surfaces on lar. side of T2-9 (2 at each joint w rib head)

43
Q

costal facets

A

large articular surfaces on lat. side of T1 and T10-12 (1 facet per joint)

44
Q

mammillary process

A

located on sup. articular process on lumbar vertebrae, attachment for multifidus

45
Q

accessory process

A

located between mammillary and transverse processes on lumber vertebrae, attachment for longissimus

46
Q

sacral vertebrae

A

base, apex directed inf. to articulate w L5, apex directed inf. to articulate w coccyx, 4 pairs of dorsal & ventral foramina, median sacral crest, auricular surface

47
Q

sacral promontory

A

ventral projection of sacral base

48
Q

what do dorsal and ventral sacral foramina do?

A

transmit dorsal & ventral rami of sacral spinal nerves

49
Q

median sacral crest and how is it formed?

A

dorsal midline crest formed from fused spinous processes of S1-S3/4

50
Q

sacral canal and where does it end

A

vertebral canal through sacrum ends at sacral hiatus

51
Q

what is sacral hiatus site for?

A

injecting extradural anesthesia

52
Q

auricular surface

A

on sacru,, ear-shaped lat. surface contributes to sacroiliac joint

53
Q

coccygeal vertebrae formation

A

result of fusion of 4 rudimentary tail vertebrae

54
Q

how much length of spinal column is from discs?

A

1/4 of total length

55
Q

Is there a disc between C1 and C2?

A

NO

56
Q

caniovertebral joints

A

formed between skull and C1 & C2

57
Q

ligamenta flava

A

paired ligaments joining laminae of adjacent vertebrae on post. wall of vertebral canal

58
Q

ligamenta flava function

A

contributes to post. boundary of intervertebral foramina, elastic fibers aid in recoil from ant. flexion and maintaining upright posture

59
Q

where are cervical z-joints located and how large are discs?

A

horizontal plane & intervertebral discs are large relative to bodies

60
Q

where are thoracic z-joint, how large are discs and why?

A

coronal plane to allow rotation, discs thin compared to bodies

61
Q

why are flexion and extension limited in thoracic spine?

A

attachments to rib cage

62
Q

where are lumbar z-joints located and how large are discs and why?

A

sagittal plane for flexion, extension, &lat. flexion, discs large to limit rotation

63
Q

parts of thoracic skeleton

A

thoracic vertebrae, ribs and costal cartilages, and sternum

64
Q

thoracic skeleton function

A

rigid yet flexible cage that protects thoracic & abdominal viscera, supports weight of upper limbs, provides muscle attachments, & aids in respiration

65
Q

typical rib components

A

head, neck, tubercle, & body

66
Q

rib head

A

two facets that articulate w same-numbered & sup. adjacent vertebral bodies at the joint of the head of the rib

67
Q

rib neck

A

joins head and body

68
Q

rib tubercle location and function

A

junction of neck & body and has an articular part to articulate w transverse process of same-numbered vertebrae at costotransverse joint.

69
Q

rib body characteristics

A

thin, flattened portion, most curved at angle of the rib, costal groove along inferior margin

70
Q

costal groove function

A

transmits the intercostal nerve and vessels, on inferior inner side of rib body

71
Q

where does rib body attach to costal cartilage?

A

costochondral junction.

72
Q

atypical ribs

A

1, 10-12

73
Q

rib 1 characteristics

A

short and flattened w the most curvature, superior surface has grooves for the subclavian vessels, articulates w T1 only

74
Q

ribs 10-12 characteristics

A

articulate w only the same-numbered vertebral body or pedicle

75
Q

do ribs 11-12 have neck and tubercle?

A

NO

76
Q

true ribs

A

Ribs 1-7 attach directly to sternum via costal cartilages

77
Q

false ribs

A

Ribs 8-10 attach indirectly to sternum via costal cartilage of the next sup. rib

78
Q

floating ribs

A

Ribs 11-12: short w rudimentary cartilages w no attachment to sternum, terminate in abdominal wall musculature

79
Q

sternum components

A

manubrium, body of the sternum, and xiphoid process

80
Q

sternal angle

A

junction of the manubrium & sternum (manubriosternal joint); palpable surface landmark located between the 2nd pairs of costal cartilages at T4/T5

81
Q

costal notches

A

sites of articulation w costal cartilages, located along lat margins of sternal body

82
Q

costovertebral joints

A

synovial plane joints, joint of head of rib forms btw rib head & hemifacets on bodies of same-numbered and sup. thoracic vertebrae

83
Q

costotransverse joint

A

forms between the rib tubercle and transverse costal facet of transverse process of same-numbered vertebra (T1-T10 levels)

84
Q

sternocostal joints

A

formed between medial ends of the costal cartilages 1-7 and sternum

85
Q

which sternocostal joint is synchdrosis?

A

1st

86
Q

which sternocostal joints are synovial plane joints?

A

2-7

87
Q

costochondral joints characteristics

A

synchondrosis joints formed between each rib and its corresponding costal cartilage; no movements

88
Q

interchondral joints

A

synovial plane joints formed between costal cartilages of ribs 6-10

89
Q

manubriosternal joint

A

symphysis formed between the manubrium and sternal body

90
Q

xiphisternal joint

A

synchondrosis between xiphoid process and sternal body

91
Q

thoracic cage spaces

A

sup. thoracic aperture, inf. thoracic aperture, intercostal spaces

92
Q

sup. thoracic aperture

A

sup. boundary of thoracic cavity formed by T1 vertebra, first ribs and manubrium.

93
Q

sup. thoracic aperture function

A

transmits major vessels and other soft tissue structures btw thoracic cavity, neck & upper limb.

94
Q

inf. thoracic aperture

A

Formed by T12 vertebra, ribs 11-2 and their cartilages, the costal margin (costal cartilages 6-10), & xiphoid process

95
Q

inf. thoracic aperture function

A

attachments for the muscular thoracoabdominal diaphragm

96
Q

thoracoabdominal diaphragm function

A

separates the thoracic and abdominopelvic cavities

97
Q

intercostal spaces

A

Spaces between adjacent ribs/cartilages that extend from vertebral column posteriorly to sternum ant.

98
Q

how are intercostal spaces numbered?

A

sequentially sup. to inf. beginning w first intercostal space between ribs 1 and 2

99
Q

subcostal space

A

inf. to rib 12

100
Q

what do intercostal spaces contain?

A

intercostal muscles, nerves, and vessels

101
Q

intercostal muscles

A

external intercostal, internal intercostal, innermost intercostal,

102
Q

where do intercostal muscles attach?

A

attach along inf. border of sup. rib and sup. border of the next lower rib

103
Q

what are intercostal muscles supplied by?

A

intercostal nn. and ant. and post. intercostal aa.

104
Q

external intercostal mm.

A

most superficial of the intercostal group; muscle fibers are replaced anteriorly by membrane

105
Q

external intercostal mm fiber orientation

A

inferiorly and anteriorly (\\ ///) (hands in pockets).

106
Q

external intercostal mm. action

A

elevates ribs

107
Q

internal intercostal mm. location

A

Just deep to the external intercostals, muscle replaced posteriorly by a membrane.

108
Q

internal intercostal mm. fiber orientation

A

oriented inferiorly and posteriorly (/// \).

109
Q

internal intercostal mm. action

A

depresses ribs

110
Q

innermost intercostal mm. location

A

deepest layer; present only in the most lateral parts of the intercostal spaces

111
Q

innermost intercostal mm. fiber orientation

A

oriented inferiorly and posteriorly (/// \).

112
Q

innermost intercostal mm. action

A

depresses ribs

113
Q

subcostal m. OIA

A

O: Internal surface of inferiormost ribs, near their angles
I: fibers course inferior and posterior to insert on sup. borders of 2nd or 3rd rib below
A: Depresses ribs

114
Q

Transversus thoracis muscle OIA

A

O: post. surface of inf. sternum and xiphoid process
I: fibers course sup. & lateral to insert on internal surface of costal cartilages 2-6, spans 2-3 intercostal spaces per muscle
A: Depresses ribs

115
Q

intercostal nerves

A

ventral rami of T1-11 spinal nerves

116
Q

subcostal nerve

A

T12 ventral ramus

117
Q

intercostal nerve pathway

A

nerves enter same-numbered intercostal space & go laterally btw parietal pleura & membranous part of internal intercostal mm.
At costal angle, nerve enters costal groove and goes ant. btw internal and innermost intercostal mm.

118
Q

branches of intercostal nerve

A

lateral and ant. cutaneous n., branches to intercostal, subcostal, transversus thoracis, & serratus post. mm

119
Q

lat. cutaneous n. location

A

at midaxillary line, it leaves intercostal space & divides into the ant. & post. branches

120
Q

ant. cutaneous n. location

A

exits the intercostal space just lateral to the sternum

121
Q

what nerves enter and supply abdominal wall from thoracic wall?

A

nn. 7-11 and the subcostal n. after giving rise to lat. branches

122
Q

intercostal arteries come from what branches?

A

anastomosing branches from thoracic aorta & internal thoracic artery

123
Q

post. intercostal aa. location

A

enter intercostal spaces lateral to the vertebral column.

124
Q

lateral cutaneous a.

A

branches course with the lateral cutaneous nerves.

125
Q

what do post. intercostal aa. 1-2 arise from?

A

costocervical branch of the subclavian artery.

126
Q

what do post. intercostal aa. 3-11 branch from?

A

directly from the thoracic aorta

127
Q

what is internal thoracic a. a branch from?

A

subclavian a.

128
Q

internal thoracic a. location

A

descends lat. to sternum btw transversus thoracis mm. and ant. thoracic wall

129
Q

anterior intercostal aa.

A

arise directly from internal thoracic a., goes posteriorly to anastomose w the corresponding post. intercostal a.

130
Q

anterior perforating branches

A

emerge lat. to sternum & contribute to vasculature of chest & breast

131
Q

where does the internal thoracic a. divide and into what arteries?

A

6th costal cartilage into sup. epigastric (to abdominal wall) and musculophrenic a.

132
Q

intercostal veins

A

Anterior and posterior intercostal veins

133
Q

Anterior and posterior intercostal veins pathway

A

course immediately sup. to corresponding artery & nerve in intercostal spaces

134
Q

order of artery, vein and nerve in bundles

A

VAN, superior to inferior

135
Q

where does the venous blood from thoracic wall drain to?

A

sup. vena cava via internal thoracic vein & azygos venous system

136
Q

thoracic wall function

A

Coordinated movements btw thoracic wall & thoracoabdominal diaphragm increase intrathoracic dimensions (volume) which reduces pressure in lungs & allows lungs to inflate

137
Q

what does contraction of thoracoabdominal diaphragm do?

A

causes it to descend/flatten which increases vertical dimensions of thoracic cavity.

138
Q

what does rib elevation do?

A

(bucket-handle action) increases the transverse dimensions of the thoracic cavity.

139
Q

what does sternum elevation do?

A

Sternum elevation (pump-handle action) increases the anterior-posterior dimensions

140
Q

how does quiet inspiration occur?

A

primarily by contraction and descent of thoracoabdominal diaphragm
External intercostal mm. assist w rib elevation & stiffen intercostal spaces

141
Q

how does quiet expiration occur?

A

passive recoil of lung tissues and thoracic wall as the diaphragm relaxes and ascends.

142
Q

how does active inspiration occur?

A

assisted by accessory muscles of respiration that forcefully elevate the sternum and ribs

143
Q

muscles involve in active inspiration

A

levatores costarum, serratus, pectoral muscles, sternocleidomastoid & scalene muscles in neck.

144
Q

how does active expiration occur?

A

assisted by abdominal wall muscles whose contractions increase intra-abdominal & intra-thoracic pressure & depress the lower ribs (belly breathing).

145
Q

Why are primary curvatures in spine considered primary?

A

You have had them since you were a fetus, curve due to uneven size of vertebrae, secondary has the same size vertebrae ant. And post.

146
Q

Atlas shape and function

A

. Hold head weight, no spinous processes only tubercle, small transverse process, no vertebral body

147
Q

What angle are cervical spine facets oriented?

A

45 degrees from horizontal plane to allow for all movements

148
Q

How are facets oriented in thoracic spine?

A

. Oriented in coronal plane to allow rotation but limits lateral flexion

149
Q

Where are facets oriented in lumbar spine?

A

. Medically and laterally nearly in Sagittarius plane

. Limited rotation, but has flexion and extension and lateral flexion

150
Q

External intercostal membrane

A

Replaces external intercostal mm. Anteriorly to sternum

151
Q

Internal intercostal membrane

A

Replaces internal intercostal mm. Posteriorly towards vertebral column