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117 Cards in this Set
- Front
- Back
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How many vertebrae are there?
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32-34
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What 6 basic parts are found in almost all vertebrae?
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1. Body
2. Pedicles 3. Laminae 4. Spinous processes 5. Transverse processes (transverse/costal elements) 6. Articular processes (superior/inferior) |
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What are the 5 regions of the vertebral column?
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-Cervical
-Thoracic -Lumbar -Sacral -Coccyx |
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How many vertebrae are there per vertebral region?
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-Cervical: 7
-Thoracic: 12 -Lumbar: 5 -Sacral: 5 fused -Coccyx: 3-4 |
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What is the most constant feature of the cervical vertebrae?
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Transverse foramen
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What is common to C3-C6?
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Bifid spines
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What are the alternative names for C1 and C2 vertebrae?
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C1 = Atlas
C2 = Axis |
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What are the key features of the atlas?
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Arches - anterior/posterior
No body No spine - tubercle Facet for skull - occipital condyle |
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What is the key feature of the Axis?
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Odontoid process - the Dens.
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What is the purpose of the dens?
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To provide a pivot point for the Atlas to rotate on.
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What is the key feature of the thoracic vertebrae?
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Facets for ribs
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Which vertebrae are most palpatable?
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C7 - vertebral prominence
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What is the sacrum?
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The fused sacral vertebrae (5)
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When does fusion begin of the sacrum?
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20 yrs
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What is the site for injection of anesthesia in the sacrum called?
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Sacral hiatus
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What's the coccyx?
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3-4 fused coccygeal vertebrae, situated below sacrum
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What are the 3 types of joints in the vertebral column?
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1. Fibrous
2. Synovial 3. Cartilaginous |
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Where are the fibrous joints in the vertebral column?
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Between the spines, laminae, bodies, and transverce process of ADJACENT vertebrae
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What are the 3 fibrous joints in the vertebral column?
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1. Supraspinous/interspinous ligaments
2. Ligamentum flavum 3. Longitudinal ligaments (post/ant) |
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How do the supraspinosu and interspinous ligaments act?
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Limit ventral spine flexion.
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What is ligamentum nuchae?
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Thickened supraspinous ligament in cervical region; contains abundant elastic tissue.
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Where is ligamentum flavum?
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Interlaminar; its continuation between atlas and skull is the posterior atlanto-occipital membrane.
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what is the function of the longitudinal ligaments?
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To hold the vertebral bodies together.
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What is the Continuation of the posterior longitudinal ligament between the atlas and skull?
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The tectorial membrane.
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What is the action of the post longitudinal ligament?
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Prevents hyperflexion of spine; incomplete laterally b/c of the vertebral pedicles.
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What is the continuation of the anterior longitudinal ligament between teh atlas/skull?
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Anterior atlanto-occipital membrane.
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What is the fuction of the anterior longitud. ligament?
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Prevents hyperextension of spine.
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Where are interarticular synovial joints found?
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Between articular processes of adjacent vertibrae.
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What is the most restricted movement in the cervical region by the synovial joints?
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Rotation; moderate movement in all directions is allowed tho.
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What is the orientation of the plane of articulation between vertebrae in the cervical region?
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Transverse - horizontal
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What is the orientation of the plane of articulation between vertebrae in the thoracic region?
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Coronal - frontal
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What is the orientation of the plane of articulation between vertebrae in the lumbar region?
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Sagittal
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Where do spinal nerves exit the spinal canal?
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Anterior to the articulations between vertebrae, between adjacent pedicles.
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As spinal nerves exit the vertebral canal, what is their first branch?
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Sensory branches to the joint capsule.
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What are 2 conditions related to the articular process of the spine?
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Spondylolysis
Spondylolithesis |
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What is spondylolysis?
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A bilateral defect in the pars interarticularis in which the bone fractures.
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What is the pars interarticularis?
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The part of the lamina between the superior and inferior articular processes.
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What is spondylolithesis?
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The slippage of one vertebrae over the one just below it; most commonly L5 slips over S
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What causes spondylolithesis?
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Lateral breaking in spondylolysis.
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What are the cartilaginous joints in the vertebral column?
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The intervertebral discs between adjacent vertebral bodies.
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How much height in the spinal column are the result of discs?
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1/4-1/5 of it.
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What are the 2 components of the discs?
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1. Nucleus pulposus
2. Annulus fibrosis |
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What is the nucleus pulposus?
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Central core made of glycosaminoglycan (GAG) and glycoprotein
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What is the purpose of GAGs in the vertebral column?
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Maintain turgor pressure b/c they bind water
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What else is in the liquid center called pulposus?
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Inflammatory mediators - NO, phospholipase, prostaglandins.
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What is the annulus fibrosis?
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The fibrocartilage surrounding the creamy liquid center.
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What are the characteristics of the annulus fibrosis?
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1. Thickest anteriorly
2. Avascular 3. Innervted 4. Contains free nerve endings (nociceptrs) that sense noxious stimuli (pain). |
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What are the important physics of the intervertebral discs?
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-Nucleus transmits compression via liquid to vertebral body and annulus pulposus.
-With compression waste/water exist the disc; with relaxation, nutrients/water enter. |
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What age related changes occur in the discs?
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-Water content decreases
-Degeneration affects integrity |
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Where does rupture of intervertebral discs mostly occur?
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Lumbar or cervical regions
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What is the most common direction of rupture?
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Posteriolateral
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What nerve will be affected when a disc is ruptured?
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The spinal cord one level higher than the disc.
Eg if disc is between L4/L5, the spinal nerve L5 is affected. |
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What is the most common musculoskeletal disorder in industrialized societies?
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Low back pain
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What are the 2 types of curvatures in the spinal column?
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1. Primary
2. Secondary |
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Where are primary curves located?
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Thoracic/Sacral regions
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What causes the thoracic primary curavture?
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Heigh of posterior aspect of vertebral bodies
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Where are the secondary curvatures?
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Cervical/Lumbar regions
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Why are they called secondary?
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May be eliminated by ventral flesion of the spine.
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What causes the cervical 2' curvature?
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Thicker anterior margin of discs
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What causes the lumbar 2' curvature?
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Thicker anterior margin of vertebral body/disc
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3 types of abnormal vertebral column curvatures:
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-Kyphosis (humpback)
-Lordosis (backbend) -Scoliosis (crooked) |
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What normal curves are related to kyphosis/lordosis?
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Kyphosis = primary thoracic
Lordosis = secondary lumbar |
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What are 2 types of alterations in the number of vertebrae?
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-Sacralization
-Lumbarization |
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What is sacralization?
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INcorporation of the 5th lumbar vertebra into sacrum
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What is lumbarization?
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Liberation of the first sacral vertebra.
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Which is worse?
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Lumbarization - it causes too much lumbar mobility.
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Where does the level of the spinal cord/dural sac terminate in the fetus?
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Coccyx
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Where does the level of the spinal cord/dural sac terminate in the newborn?
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Spinal cord - L2/L3
Dural sac - S3 |
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Where does the level of the spinal cord/dural sac terminate in the adult?
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Spinal cord - L1
Dural sac - S2 |
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What is conus medullaris?
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The pointed end of the spinal cord
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What is filum terminale?
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The ending of the dura mater; it connects to the sacrum.
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What is cauda equina?
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Dorsal and ventral rami along with filum terminale
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Where is a spinal tap done?
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At L1-L2, where filum terminale is; can enter the subarachnoid space.
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What is the origin of the back muscles?
-Extrinsic -Intrinsic |
Extr = hypaxial myotomes; part of the limb muscles and migrated on top of the back muscles.
Intr = Epaxial myotomes |
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What are the extrinsic back muscles innervated by?
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Ventral rami
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What are the intrinsic back muscles innervated by?
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Dorsal rami
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What is the thoracolumbar fascia?
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L:arge central tendon in lower back; attachment for muscles
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What are the extrinsic muscles in the back?
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-Trapezius, latissimus, sternocleidomastoid - Superfic.
-Rhomboids, levator scap, serratos posterior (sup/inf) - Deep |
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What are the 5 groups of intrinsic true muscles of the back?
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1. Spinotransversocostal
2. Longitudinal 3. Transversospinalis 4. Suboccipital 5. Missellaneous |
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What are the spinotransversocostal muscles?
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Splenius capitis and cervicis
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What are the longitudinal muscles also called?
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Erector spinae
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What are the erector spinae muscles?
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-Iliocostalis
-Longissimus -Spinalis |
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What are the three transversospinalis muscles?
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Semispinalis, multifidus, and rotatores.
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What does spinal column stability depend on?
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1. Taut ligaments
2. Plane/placement of articular facet joints 3. Annulus fibrosis 4. Accurate muscle tone and strength. |
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What is the spine's mobility primarily due to?
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Compressability and elasticity of the intervertebral discs.
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What is the sesamoid bone in the hand?
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Pisiform
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What is a sesamoid bone?
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A bone that exists within a tendon; functions to improve movement.
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What is the main contribution to the deep palmer arch?
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Radial artery
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What is the main contributor to the superfical palmar arch?
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Ulnar
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What does the radial nerve innervate?
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-All the extensors of the forearm and arm
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What does an injury to the radial nerve cause?
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Wrist drop - inability to rase the wrist and extend fingers.
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What does the median nerve innervate?
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Thumb and forearm muscles.
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What action do the palmar interossei cause?
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Adduction
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What action do the dorsal interossei cause/
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Abduction
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Where does the FDP insert?
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Distal phalanges
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Where does the FDS insert?
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Medial phalanges
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What roots supply the Median Nerve?
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C6-T1
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What is "Hand of Benediction"? What causes it?
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Inability to flex digits 1,2,3
-Results from damaged median nerve proximal to elbow joint.W |
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What is wrist pain with weakness of digital flexion and thumb motion a sign of?
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Carpal tunnel syndrome
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What causes Carpal Tunnel syndrome?
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Compression of the median nerve in the carpal tunnel.
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What causes claw hand?
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Ulnar nerve injury proximal to the wrist
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What IS claw deformity?
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Deformity of 4/5th digits
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What muscle function loss causes claw deformity?
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Intrinsic muscles - lumbricles and interossei
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What does the loss of intrinsic hand muscles result in?
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-Hyperextension of metacarpophalangelal joints
-Partial flexion of interphalangeal joints. |
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What is TRUE (full) Claw hand?
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deformity of the 2-5th digits
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What causes a true full claw hand?
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Combined ulnar and median nerve injury proximal to the wrist joint.
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What are the 3 common injuries to the brachial plexus?
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1. Compression
2. Traction 3. Penetrating wound |
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What do supraclavicular injuries affect?
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-Brachial plexus roots, trunks and divisions.
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What are 2 types of supraclavicular injuries of the brachial plexus?
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1. Injuries from plexus traction
2. Injuries from plexus compression |
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What disease is associated with traction of the upper trunk of the brachial plexus?
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Duchenne paralysis
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What can cause Duchenne paralysis?
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Excessive separation of the shoulder from the neck.
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What symptoms will be seen from excessive separation of the shoulder from neck?
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Hand slightly flexed, shoulder problems.
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What is Klumpke paralysis associated with?
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Traction on the lower trunk
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What causes traction on the lower brachial plexus trunk?
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Hyperabduction of the upper limb.
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What injuries cause compression of the plexus?
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Presence of a cervical rib
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What does an infraclavicular injury affect?
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The cords and branches.
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What are examples of infraclavicular injuries?
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-Poorly fitting crutches
-trauma -nerve anoxia |
