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111 Cards in this Set

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  • Back
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C6 Dermatome goes where?
Thumb and second finger
C7 Dermatome goes where?
middle finger
C8 Dermatome goes where?
fifth finger (pinky) and ring finger
T2 Dermatome goes where?
Sternal Angle and back of arm
T4 Dermatome goes where?
nipples
T10 Dermatome goes where?
Umbilicus
L3 Dermatome goes where?
Knee
L5 Dermatome goes where?
medial foot mainly
S1 Dermatome goes where?
Lateral foot
Superficial -- Abdominal reflex tests what?
Upper quadrants test T7-T9 and lower quadrants test T10-T12
Superficial -- Cremasteric reflex tests what?
L1-L2
Superficial -- Planter reflex tests what?
L5-S1
Superficial -- Anal reflex tests what?
S2-S4
Deep-- Biceps brachii reflex tests for what?
C5 and C6
Deep--Brachioradilis reflex tests for what?
C5-C7
Deep--Triceps reflex tests for what?
C6-C8
Deep--Quadriceps femoris reflex tests for what?
L2-L4
Deep--Achilles tendon reflex tests for what?
S1 & S2
White rami communicans contains mylenated or unmlylenated preganglionic nerve fibers?
Mylenated
White rami communicans contains mylenated preganglionic nerve fibers or postganglionic nerve fibers?
preganglionic nerve fibers
Gray rami communicans contain unmylenated postganglionic nerve fibers? T or F
True
What innervates trapezius ?
motor: spinal accessory (XI), proprioception: C3-C4
What innervates latissimus dorsi?
thoracodorsal nerve (C7,8) from the posterior cord of the brachial plexus
What innervates levator scapulae?
dorsal scapular nerve (C5); the upper part of the muscle receives branches of C3 & C4
What innervates rhomboideus major?
dorsal scapular nerve (C5)
What innervates rhomboideus minor?
dorsal scapular nerve (C5)
What innervates serratus posterior superior?
branches of the ventral primary rami of spinal nerves T1-T4
What innervates serratus posterior inferior?
branches of the ventral primary rami of spinal nerves T9-T12
What innervates Splenius capitis ?
dorsal rami of spinal nerves
Bandage muscles with cervicis. Unilateral, lateral bending of head/neck
Bilateral, extension of head/neck
What innervates Splenius cervicis?
dorsal rami of spinal nerves
Bandage muscles with capitis. Unilateral, lateral bending of head/neck - Bilateral, extension of head/neck
What innervates Spinalis group: Thoracic, Cervicis, Capitis?
Innervated by posterior primary rami
Medial column, Extends head and vertebral column (bilateral). Bends vertebral column toward the same side (unilateral). Main extensor of the vertebral column
What innervates Longissimus group:Thoracic, Cervicis, Capitis?
Innervated by posterior primary rami
Intermediate column, Extends head and vertebral column (bilateral). Bends vertebral column toward the same side (unilateral). Main extensor of the vertebral column
What innervates Iliocostalis group:Lumborum, Thoracic, Cervicis?
Innervated by posterior primary rami
Lateral column, Extends head and vertebral column (bilateral). Bends vertebral column toward the same side (unilateral). Main extensor of the vertebral column
What innervates Semispinalis (T, C, Cap) ?
Innervated by posterior primary rami
Greater Occipital N pierces the obvious tendon.
What innervates Multifidus (L, T, C)?
Innervated by posterior primary rami
What innervates Rotatores?
Innervated by posterior primary rami
Long spans 2 joints short one joint
What muscles act on the vertebrae to produce movements at the intervertebral joints
Interspinales (C, L)
Intertransversarii (C, L)
Levatores costarum
This lies deep to the trapiezius and semispinalis capitis muscles and is the triangular area inferior to the occipital region of the head. It includes the posterior aspects of C1 (atlas) and C2 (axis) vertebrae.
Suboccipital region
Triangle of auscultation is identified by several muscular borders what are they?
Superior, trapezius - Inferior, latissimus dorsi - Lateral, vertebral border of scapula - Floor (in part), rhomboid major
The lack of overlying muscles at ribs 6 and 7 and intercostal space 6 provide a great avenue for sounds from thoracic organs (e.g., lungs) to be heard.
What is the lumbar triangle (of Petit)
It is a weak triangular space that can be the site for a lumbar hernia (rare).
Borders: Latissimus dorsi (Medial), External oblique (Lateral), Iliac crest (Inferior), Internal oblique (Floor).
How are Anatomical Images viewed?
viewed from above
How are Medical Images (e.g., CT scan) viewed?
Viewed from feet
In supine position
Celiac trunk common on boards
What is Back strain?
refers to some degree of stretching or microscopic tearing of muscle fibers and/or tendons of the back
What is Back sprain?
is an injury to a ligament
Sprain your ankle
Conventional Radiography includes what?
Film Radiography, Computed Radiography (CR), Digital Radiography, Fluoroscopy
Film Radiography
Utilizes a screen-film system within a film cassette as the x-ray detector
Computed Radiography (CR)
Filmless system eliminates chemical processing producing digital radiographic images
Digital Radiography
Film free and cassette free
Fluoroscopy
A continuous x-ray beam passes through patient onto a fluorescing screen
Provides real-time radiographic visualization of moving anatomic structures
Cross-Sectional Imaging Technique include what?
CT (Computed Tomograph), MR (Magnetic Resonance Imaging), US, Nuclear Radiology
CT (Computed Tomograph)
With CT remember it is fast good info but a lot of radiation.
Conventional CT
Spiral CT
Multidetector CT
Ct frequencies
Bone +400 to +1000H(Hounsfield Unit measure of density KNOW)
Soft Tissue +40 to +80H
Fat -60 to –100H
Lung Tissue -400 to –600H
Air -1000H
What are the CT Artifacts?
Volume Averaging
Beam-Hardening Artifact
Motion Artifact
Streak Artifact
LOOK AT PPT PICS
What are MR (Magnetic Resonance Imaging)?
MR Analyzes multiple tissue characteristics, Hydrogen (proton) density, T1 and T2 relaxation times of tissue, no radiation
Expensive, Great for non moving objects, Beware of patients with metal in them. Bullet in knee, . T1 is for fat weighted. T2 is water weighted
What are the MR Artifacts?
Magnetic susceptibility artifact
Motion artifact
Chemical shift misregistration
Look at ppt
US
US are hard to read. US cheap no ionization radiation. US for babies.
Look at ppt
Nuclear Radiology
Nuclear medicine images reflect not only the biodistribution of the radiopharmaceutical but also the anatomic, pathologic, and artifact overlays present at time of imaging
A typical adult vertebral column is composed of five types of vertebrae what are they?
C7, T12, L5, S5, 3-5 coccygeal
At each region of an adult vertebral column, basic curvatures are observable what are they?
Cervical - Convex anteriorly Thoracic -Concave anteriorly
Lumbar -Convex anteriorly
Sacrococccygeal -Concave anteriorly
Scoliosis is?
is any lateral curvature of the spine in the thoracic, lumbar, or thoracolumbar area
Idiopathic right thoracic scoliosis in adolescent females is the most common form
Kyphosis is?
curvature that is convex posteriorly (beyond normal) (Kyphosis is hump back.)
In osteoporosis, kyphosis of the thoracic spine may occur after compression fractures of the vertebral bodies. Although it is most common in postmenopausal women, kyphosis can occur in older men.
Lordosis is?
is a curvature that is convex anteriorly (abnormal curvature in lumbar region.)
Normal compensation of the lumbar spine during pregnancy but may develop with obesity in either gender.
Composition and structures of typical vertebrae include two key components what are they?
.Body is weight bearing and anteriorly placed, and Vertebral arches occur posteriorly and are associated with several processes (spinous, transverse, and articular), which form important structures or foramina
Which vertabrae are are all distinguished by their small size and a transverse process which is perforated by a transverse foramen for the passage of several structures
Cervical vertebrae (C1-C7)
C7 Differs in spinous process
Atlas (C1) Characteristics include
Lateral mass with facet is for articulation with occipital condyle
Facet joint is a pivot joint. Transverse foramen means it is a cervical vertebrae.
The atlas differs from most other cervical vertebrae in that it lacks a true body and spinous process
Axis (C2) is the strongest of all cervical vertebrae and have several characteristics including
dens, large bifid spinous process,
Hangman wants to snap of dens. Bifid spinous process unique,
cruciform ligament is where and why important?
Located in the axis(C2), cruciform ligament is what is torn in a hanging injury. Has superior, transverse and inferior bands
transverse ligament of axis does what?
holds axis in place which prevents horizontal displacement of the atlas
Which vertabrae can help control bleeding from a carotid artery?
Carotid tubercle on C6 can function as a pressure point to control bleeding from carotid artery.
Typical Thoracic vertebrae characteristics (T5-T8)
Intervertbral foramen is where spinal nerves exit. Look at plane of articulation which tells you what movement is allowed by that joints. Lack transverse foramina and have heart-shaped bodies, which increase in size from T1 to T12. They have two costal (rib) facets (except T10, T11, T12) at the junction of the body and arch.
Spinous processes of the middle four are nearly vertical, whereas in T1-T2 and T10-T12 the processes are nearly horizontal.
Non typical characters of thoracic vertebrae (T1-T4 and T9-T12)
T1 has a long spinous process similar to that of C7. T1-T4 resemble cervical ones in having a similar shaped body (small and wider from side-to-side) and vertebral foramen large and triangular. T9-T12 have tubercles similar to the accessory and mamillary processes of lumbar vertebrae.
Ribs 10-12 articulate with cartilage not directly to the sternum
Typical Lumbar vertebrae characteristics
All Lack transverse foramina! The kidney-shaped bodies are the largest and most massive to support the increase in body weight in this region. Articular processes project upward and downward, lying in the sagittal plane; facilitates flexion and extension and side-to-side bending but not rotation. Kidney shaped body.
Processes is where muscles attach to on the lumbar.
Typical Sacral and coccygeal vertebrae characteristics (S1-S5 and C01-C05)
Spinous and transverse Processes are reduced. Promontory is birthing landmark.
Sacral hiatus Distal end of spinal foramen and can palpate this. Also median crest cornua of sacrum and coccyx
The coccyx may be fused in some of its segments (usually four) or the first segment may be separate from the others
Two major components of vertebral discs include
. Annulus fibrous and Nucleus pulposus
No disc between C1 and C2
Nucleus pulposus is ...
Cartilaginous, Highly elastic,
Located posteriorly (not centered), High water content (decreases with age), -Shock absorbing feature of discs (axial forces)
Annulus fibrous is
are Outer fibrous part of discs and make a Concentric lamellae of fibrocartilage. They are Firmly attached to anterior and posterior longitudinal ligaments.
Facet Joints (=Zygapophyseal joints) are?
Synovial joints between superior and inferior articular facets of adjacent vertebrae provide varying amounts of flexion, extension, rotation, or lateral bending based on vertebral level (based on vertebral level because of the different planes of articulation at each level).
What are the two types of Craniocervical joints?
Atlantooccipital joint and Atlantoaxial joint
What is the Atlantooccipital joint ?
C1 articulating with the skull.
Allows flexion and extension of head (Yes)
What is the Atlantoaxial joint?
consists of three articulations: 1-2) paired lateral atlantoaxial joints (between inferior facet and lateral mass of C1 and superior facet of C2) and 3) median between the dens of C2 and the anterior arch of the atlas –
Spaces are for vertebral arties and C1 spinal nerve. Held in place by the transverse ligament (of atlas).Allows rotation of head (No)
What are Uncovertebral joint (of Luschka)?
Joint-like structures that can develop postnatally in cervical vertebrae between the lips of the bodies of adjacent vertebrae. Osteophyte formation here may cause neck pain (bone spurs)
Ligaments of the vertebral column include...
Supraspinous, Interspinous, Ligamentum flavum, Anterior longitudinal ligament, Posterior longitudinal ligament, and Nuchal ligament
Supraspinous liagament does what?
connects the tips of the spinous processes, limits flexion, and expanded in cervical region as the ligamentum nuchae
Interspinous liagament does what?
connects spinous processes of adjacent vertebrae and limits flexion
Ligamentum flavum does what?
is a paired structure that connects the laminae of adjacent vertebrae limits flexion and is yellow because of elastic tissue
Anterior longitudinal ligament
limits extension (prevents hyperextension) only this ligament. (extends from the occipital bone to the pelvic surface of the sacrum) Whip lash tears anterior longitudinal ligament
What ligamant is torn in whip last?
Anterior longitudinal ligament
Posterior longitudinal ligament
limits flexion, , extends from posterior edge of C2 and continues to the sacrum, and has many nociceptive (pain) nerve endings present
has many nociceptive (pain) nerve endings present
Nuchal ligament helps to prevent what?
also prevents excessive flexion
Movements of the vertebral column
Amount of movement depends upon the ratio between the height of the discs and the vertebral bodies
Limited by
IV disc (thickness)
 Ratio of disc shape to centrum thickness
- Plane of articulation
How many sites of attachment in the thoracic vertebral column?
6 sites or articulation
In the cervical region, discs are thick and articular processes are horizontally oriented allowing
flexion, extension, lateral bending, and rotation
In the thoracic region, movement is limited by several factors:
Attachment of ribs, Thin discs, and others
Flexion and extension is limited (lateral bending and rotation is limited by the ribs and sternum)
In the lumbar region, the thickness of the discs and the sagittally-oriented articular processes permit considerable flexion and extension. (Statement)
Facet joints in sagittal plane in lumbar region.
spondylolysis is?
fracture of bone resuting from Downward and forward displacement of the vertebral column at the lumbosacral junction
spondylolisthesis?
anterior sliding usually L5
This term refers to a defect in lamina formation so that L5 is displaced anteriorly.
Pars interarticularis is?
region between the superior and inferior articulating facets of a vertebra. It is frequently the site of fracture in spondylolysis (fracture of bone).
Spinal cord is?
inferior to the foramen magnum and continuous with the medulla oblongata
Spinal cord
Usually terminates at the level of L2 (range T12-L2)
Conus medullaris (terminal end of spinal cord proper)
What is Conus medullaris?
terminal end of spinal cord proper
Conus medullaris ends L2 so spinal procedures below that.
Enlargements of spinal cord
Lumbosacral enlargement related to lumbosacral plexus (in part, innervation of lower limb)
Enlargement in cervical due to reflexs
Blood supply of spinal cord include
Spinal arteries include branches from a single anterior and paired posterior vessels. follow spinal nerves through IV foramen.
Spinal meninges include three connective tissue membranes...
Dura mater, Arachnoid mater, . Pia mater, and a denticular ligament
Dura mater
outermost layer, covers brain and spinal cord, fuses with periosteal layer, and separated from vertebral wall by epidural space. TOUGH
Arachnoid mater
middle layer, delicate, follows nerve roots to IV foramen, and sends trabeculae to pia mater
Pia mater
very thin vascular layer, adheres to brain and spinal cord, follows nerve roots to spinal nerve, and continues inferiorly from the conus medullaris as the filum terminale
Denticulate ligaments: are extensions of the pia mater. What other structure does the pia form? filum terminale!
What structure does the pia form
filum terminale and denticular ligament
Caudal Epidural Anesthesia
Crest to crest is about L4
Anesthesia into epidural space not into subarachnoid space
sciatica is...
most common affliction of the sciatic nerve.
Irritation of any root from L4-S3 can produce sciatica to a varying degree. Often associated with the pain is reflex loss and weakness in certain muscles. (IV foramina in the lumbar region decrease in size, while the nerves of this region increase in size).
Paravertebral venous drainage of vertebral column:
this venous plexus provides a pathway for tumor cells to metastasize from pelvic, abdominal, and thoracic viscera to vertebrae, spinal cord, and rain. Prostate, lung, and breast cancer can spread to the brain via this venous plexus. Infections of the kin of the back may also spread to the dorsal venous sinuses of the cranial cavity by way of the venous lexus.
been on boards
Lumbar stenosis is what?
Stenotic (narrow) vertebral canal.
Stenosis at L5 causes compression of the spinal nerve and of the cauda equina. Surgical treatment of lumbar stenosis may consist of decompressive laminectomy. When IV disc protrusion occurs in patient with spinal stenosis it further compromises a vertebral canal that is already limited.