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70 Cards in this Set
- Front
- Back
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occipital artery |
arises from external carotid artery and passes through apex of posterior triangle
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greater occipital nerve |
dorsal ramus of C2
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trapezius muscle |
Origin: superior nuchal line, external occipital protuberance, ligamentum nuchae, SP C7-T12 Insertion: lateral 1/3 of clavicle and acromion, spine of scapula Action: rotate, elevate scapula (superior part) retract scapula (middle part) depress scapula (inferior part) |
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external occipital protuberance |
palpable on posterior aspect of the head nuchal lines meet at this raised site |
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posterior/dorsal ramus of a spinal nerve |
posterior cutaneous branches of posterior rami pierce trapezius or lat dorsi to enter superficial fascia |
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spinal accessory nerve cranial nerve XI |
innervates trapezius and SCM (spinal division-contributes to cervical plexus )
originates from also innervates intrinsic muscles of larynx except cricothyroid (cranial division) |
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latissimus dorsi muscle |
Latin: widest Origin: SP T7-L5, thoracolumnar fascia, sacrum, iliac crest, ribs 10-12 Insertion: floor of intertubercular sulcus of humerus Innervation: thoracordorsal nerve (C6,C7,C8) Action: extends, adducts, medially rotates humerus |
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thoracodorsal nerve |
innervates latissimus dorsi along with artery, on anterior surface of lat dorsi near lateral attachment on humerus comes from posterior cord of brachial plexus (middle branch) also called middle subscapular nerve |
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thoracordorsal artery |
supplies latissimus dorsi runs with thoracodorsal nerve arises from third part of axillary artery, medial to anterior and posterior circumflex humeral artery branches distal to lateral thoracic artery branch (second part) |
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rhomboid major rhomboid minor |
latin: kite/rhombos Origin: SP t2-T5 (rhomboid major), ligamentum nuchae, SP C7-T1 (rhomboid minor) Insertion: medial border of scapula, below spine (major) at spine (minor) action: retracts and rotates scapula, tilt glenoid cavity inferiorly innervation: dorsal scapular nerve (C5) |
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triangle of auscultation |
Bounded by latissimus dorsi, trapezius, and rhomboid major intercostal space 6 has no overlying muscles here good for auscultation (listening) - e.g. lungs |
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lumbar triangle |
bound by latissimus dorsi, external oblique, and iliac crest can be site of lumbar hernia (rare) |
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dorsal scapular nerve |
arises from C5 ventral ramus of brachial plexus
courses through the substance of middle scalene crosses posterior triangle passes deep to vertebral border of scapula supplies levator scapulae, rhomboid major and minor |
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dorsal scapular artery |
may branch from subclavian artery (3rd part), or from transverse cervical artery |
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levator scapulae |
Latin: to raise Origin: TP C1-C4 Insertion: superior angle of scapula Innervation: dorsal scapular nerve Action: elevates and rotates scapula to tilt glenoid cavity inferiorly |
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transverse cervical artery |
along with corresponding vein, accompanies cranial nerve XI |
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serratus posterior inferior |
Latin: saw Origin: Lower thoracic, upper lumbar SP Insertion: ribs 9-12 Innervation: Intercostal nerves Action: respiration |
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Serratus posterior superior |
Latin: saw Origin: lower cervical, upper thoracic SP Insertion: Ribs 2-5 Innervation: intercostal nerves action: respiration |
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internal venous plexus |
connects veins that drain thorax, abdomen, and pelvis with dural venous sinuses of cranial cavity route for metastasis of neoplasms of prostate, uterus, and rectum to cranial cavity |
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anterior longitudinal ligament (ALL) |
covers anterolateral parts of vertebral bodies (edge of the bodies closest to abdomen, and around the sides- it's wide) limits vertebral extension |
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posterior longitudinal ligament (PLL) |
covers posterior parts of vertebral parties limits vertebral flexion narrower and weaker than ALL |
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elastic ligamentum flavum |
extends between laminae of adjacent vertebrae also limit vertebral flexion help maintain normal vertebral curvatures |
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annulus fibrosus |
fibrocartilaginous layer, outer part of intervertebral disk |
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nucleus pulposus |
inner layer of intervertebral disk protrudes through annulus fibrosus in a disk herniation postnatal remnant of fetal notochord gelatinous |
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intervertebral foramina |
transmit dorsal and ventral roots of spinal nerves into and out of the vertebral canal bounded by pedicles of adjacent vertebrae, posteriorly by facet joints, anteriorly by bodies and intervertebral disks |
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facet joints |
zygapophyseal joints (another name) between facets of superior and inferior processes at the junction of each pedicle and lamina permit gliding motions intrinsic or deep back muscles act at these joints |
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spina bifida (general problem) |
laminae fail to fuse to form a spinous process most commonly seen in lower lumbar or sacral levels |
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spina bifida occulta |
one or more spinous processes fail to form at lumbar/sacral levels asymptomatic tuft of hair over the defect |
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spina bifida cystica |
cyst protrudes through defect in vertebral arch may result in hydrocephalus/neuro defects |
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spina bifida cystica with meningocele |
cyst is lined by dura and arachnoid mater and contains CSF |
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spina bifida cystica with meningomyelocele |
lumbosacral spinal cord is displaced into cyst displacement of cord stretches lumbosacral spinal nerves may have bladder, bowel, lower limb weakness |
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spina bifida with myeloschisis/rachischisis |
caudal end of neural tube fails to close in dorsal midline and is exposed on surface of back |
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costal processes |
usually form transverse processes that project laterally at the junction between each lamina and pedicle |
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vertebral arch |
2 pedicles and 2 laminae pedicles attach to vertebral body, laminae unite to form spinous process |
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kyphosis |
abnormal increase in posterior curvature at the spine "hunchback" "Dogwager's hump" - women w/ kyphosis due to osteoporosis |
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lordosis |
abnormal increase in anterior curvature of the spine usually lumbar pregnancy/weight gain --> reversible "hollow back" "sway back" |
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scoliosis |
abnormal lateral curvature of spine may be caused by absent half of a vertebra or a wedge shaped vertebra or an asymmetric weakness in back musculature |
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epidural space |
outside dural layer of meninges and contains fat and internal vertebral venous plexus |
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dura mater |
continuous with meningeal dura of cranial cavity and ends at the level of the S2 vertebra lateral extensions of dural sac contain roots of spinal nerves |
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subdural space |
potential space between dura and arachnoid mater |
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arachnoid mater |
extends to the level of S2 vertebra pressed against dura by pressure of CSF |
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subarachnoid space |
contains CSF |
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pia mater |
covers the spinal cord and roots of spinal nerves |
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denticulate ligaments |
lateral extensions of the pia mater that anchor the spinal cord to the dura |
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filum terminale |
pia that extends from the inferior end of the cord at L2 and joins the dura and arachnoid to end in the sacral canal at the S2 level |
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spinal cord |
occupies superior 2/3 of vertebral canal ends inferiorly ~L2 |
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conus medullaris |
tapered inferior end of spinal cord that contains the sacral and coccygeal cord segments located at L2 |
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spinal nerve |
exits vertebral canal through intervertebral foramina, sacral foramina, or sacral hiatus |
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cauda equina |
formed by dorsal and ventral roots of lumbar and sacral spinal nerves that extend inferior to the end of the spinal cord at the L2 vertebra |
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lumbar puncture what is it, what layers does the needle traverse starting with skin? |
procedure to sample CSF or to introduce anesthetic agents into the subarachnoid space performed between L4 and L5 needle traverses (midline*) -skin -superficial and deep fascia -supraspinous and interspinous ligaments* -intralaminar space* -epidural space -dura -arachnoid *replace these with ligamentum flavum if puncture is off the midline |
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herniation of nucleus pulposus |
low back pain and low limb pain mostly occur at L4/L5 or L5/S1 (95%) nucleus pulposus bulges posterolaterally where annulus fibrosis is thinnest and there is no ALL or PLL to stop it x/y disc herniation will affect nerve y (usually) |
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sciatica |
pain in lower back and hip radiating down the back of the thigh into the leg Compression of sciatic nerve could be from herniated disk could be from osteophyte or other reason the foramena are narrowed straight leg raise test |
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osteophytes |
bone spurs can compress nerves |
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fracture of dens of axis |
doesn't heal well because dens gets stuck between fragments and it's cut off from its blood supply --> avascular necrosis |
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crush/compression fracture of vertebrae |
violent anterior movement (flexion) of could displace vertebrae anteriorly to the one below it ---usually dislocates and fractures articular facets between two vertebrae and ruptures interspinous ligaments usually with severe flexion injury, there is spinal cord injury |
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whiplash injury |
sudden, severe hyperextension of the neck ALL severely stretched, may be town can produce cervical spondylolysis (hangman's fracture) cann also rupture C2-C3 annulus fibrosis ----in this case, cranium,C1 and part of C2 are separated from rest of axial skeleton, severing spinal cord |
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spondylolysis |
fracture of the column of bones connecting the superior and inferior articular processes [the pars interarticularis] "neck of scotty dog" interlocking mechanism is broken "scotty dog wearing a collar" (posterolateral oblique view of lumbar vertebra) |
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spondylolisthesis |
dislocation between adjacent vertebrae due to a spondylolysis (fracture of pars interarticularis) especially likely with a L5 spondylolysis because of the downward tilt of L5/S1 IV "scotty dog is decapitated :(" (posterolateral oblique view of lumbar vertebra) |
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osteoporosis |
-atrophy of skeletal tissue -most prevalent metabolic disease of bone occurring in the elderly -affects horizontal trabeculae of trabecular bone of vertebral body |
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Localized lower back pain |
-muscular (spasms)-->ischemia, 2ndary to guarding -joint: osteoarthritis / RA - fibroskeletal pain fracture causes periosteal pain, dislocations cause ligamentous pain |
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supraspinous ligament |
on posterior surface of spinous processes |
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interspinous ligament |
between spinous processes |
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laminectomy |
surgical removal of one or more spinous processes |
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Jefferson/burst fracture |
fracture of anterior/posterior arch (or both) of atlas as a result of compression can also rupture transverse ligament |
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lumbar stenosis |
narrow vertebral canal could be hereditary or could be due to degenerative changes compression of spinal nerve rutes treat with laminectomy |
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cervical rib |
developmental costal element of C7: protuberance or complete rib unilateral or bilateral can cause thoracic outlet syndrome by compressing subclavian artery or inferior trunk of brachial plexus |
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caudal anesthesia |
goes through sacral hiatus below S4 sacral process |
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superficial muscles of back |
trapezius, latissimus dorsi, rhomboid major and minor, levator scapulae except for trap, innervated by ventral rami of spinal nerves attach to pectoral girdle on humerus, act on upper extremity |
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intermediate muscles of the back |
serratus posterior superior serratus posterior inferior innervated by ventral rami of spinal nerves attach to ribs and act as accessory respiration muscles |
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deep muscles of the back (intrinsic) |
erector spinae -iliocostalis -longissimus -spinalis splenius capitus, cervicis transversospinalis -semispinalis -multifidus -rotatores innervated by dorsal rami of spinal nerves attach to transverse/spinous processes of vertebrae and act on vertebral column/joints |
