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117 Cards in this Set

  • Front
  • Back
How many vertebrae are there?
What 6 basic parts are found in almost all vertebrae?
1. Body
2. Pedicles
3. Laminae
4. Spinous processes
5. Transverse processes (transverse/costal elements)
6. Articular processes (superior/inferior)
What are the 5 regions of the vertebral column?
How many vertebrae are there per vertebral region?
-Cervical: 7
-Thoracic: 12
-Lumbar: 5
-Sacral: 5 fused
-Coccyx: 3-4
What is the most constant feature of the cervical vertebrae?
Transverse foramen
What is common to C3-C6?
Bifid spines
What are the alternative names for C1 and C2 vertebrae?
C1 = Atlas
C2 = Axis
What are the key features of the atlas?
Arches - anterior/posterior
No body
No spine - tubercle
Facet for skull - occipital condyle
What is the key feature of the Axis?
Odontoid process - the Dens.
What is the purpose of the dens?
To provide a pivot point for the Atlas to rotate on.
What is the key feature of the thoracic vertebrae?
Facets for ribs
Which vertebrae are most palpatable?
C7 - vertebral prominence
What is the sacrum?
The fused sacral vertebrae (5)
When does fusion begin of the sacrum?
20 yrs
What is the site for injection of anesthesia in the sacrum called?
Sacral hiatus
What's the coccyx?
3-4 fused coccygeal vertebrae, situated below sacrum
What are the 3 types of joints in the vertebral column?
1. Fibrous
2. Synovial
3. Cartilaginous
Where are the fibrous joints in the vertebral column?
Between the spines, laminae, bodies, and transverce process of ADJACENT vertebrae
What are the 3 fibrous joints in the vertebral column?
1. Supraspinous/interspinous ligaments
2. Ligamentum flavum
3. Longitudinal ligaments (post/ant)
How do the supraspinosu and interspinous ligaments act?
Limit ventral spine flexion.
What is ligamentum nuchae?
Thickened supraspinous ligament in cervical region; contains abundant elastic tissue.
Where is ligamentum flavum?
Interlaminar; its continuation between atlas and skull is the posterior atlanto-occipital membrane.
what is the function of the longitudinal ligaments?
To hold the vertebral bodies together.
What is the Continuation of the posterior longitudinal ligament between the atlas and skull?
The tectorial membrane.
What is the action of the post longitudinal ligament?
Prevents hyperflexion of spine; incomplete laterally b/c of the vertebral pedicles.
What is the continuation of the anterior longitudinal ligament between teh atlas/skull?
Anterior atlanto-occipital membrane.
What is the fuction of the anterior longitud. ligament?
Prevents hyperextension of spine.
Where are interarticular synovial joints found?
Between articular processes of adjacent vertibrae.
What is the most restricted movement in the cervical region by the synovial joints?
Rotation; moderate movement in all directions is allowed tho.
What is the orientation of the plane of articulation between vertebrae in the cervical region?
Transverse - horizontal
What is the orientation of the plane of articulation between vertebrae in the thoracic region?
Coronal - frontal
What is the orientation of the plane of articulation between vertebrae in the lumbar region?
Where do spinal nerves exit the spinal canal?
Anterior to the articulations between vertebrae, between adjacent pedicles.
As spinal nerves exit the vertebral canal, what is their first branch?
Sensory branches to the joint capsule.
What are 2 conditions related to the articular process of the spine?
What is spondylolysis?
A bilateral defect in the pars interarticularis in which the bone fractures.
What is the pars interarticularis?
The part of the lamina between the superior and inferior articular processes.
What is spondylolithesis?
The slippage of one vertebrae over the one just below it; most commonly L5 slips over S
What causes spondylolithesis?
Lateral breaking in spondylolysis.
What are the cartilaginous joints in the vertebral column?
The intervertebral discs between adjacent vertebral bodies.
How much height in the spinal column are the result of discs?
1/4-1/5 of it.
What are the 2 components of the discs?
1. Nucleus pulposus
2. Annulus fibrosis
What is the nucleus pulposus?
Central core made of glycosaminoglycan (GAG) and glycoprotein
What is the purpose of GAGs in the vertebral column?
Maintain turgor pressure b/c they bind water
What else is in the liquid center called pulposus?
Inflammatory mediators - NO, phospholipase, prostaglandins.
What is the annulus fibrosis?
The fibrocartilage surrounding the creamy liquid center.
What are the characteristics of the annulus fibrosis?
1. Thickest anteriorly
2. Avascular
3. Innervted
4. Contains free nerve endings (nociceptrs) that sense noxious stimuli (pain).
What are the important physics of the intervertebral discs?
-Nucleus transmits compression via liquid to vertebral body and annulus pulposus.
-With compression waste/water exist the disc; with relaxation, nutrients/water enter.
What age related changes occur in the discs?
-Water content decreases
-Degeneration affects integrity
Where does rupture of intervertebral discs mostly occur?
Lumbar or cervical regions
What is the most common direction of rupture?
What nerve will be affected when a disc is ruptured?
The spinal cord one level higher than the disc.
Eg if disc is between L4/L5, the spinal nerve L5 is affected.
What is the most common musculoskeletal disorder in industrialized societies?
Low back pain
What are the 2 types of curvatures in the spinal column?
1. Primary
2. Secondary
Where are primary curves located?
Thoracic/Sacral regions
What causes the thoracic primary curavture?
Heigh of posterior aspect of vertebral bodies
Where are the secondary curvatures?
Cervical/Lumbar regions
Why are they called secondary?
May be eliminated by ventral flesion of the spine.
What causes the cervical 2' curvature?
Thicker anterior margin of discs
What causes the lumbar 2' curvature?
Thicker anterior margin of vertebral body/disc
3 types of abnormal vertebral column curvatures:
-Kyphosis (humpback)
-Lordosis (backbend)
-Scoliosis (crooked)
What normal curves are related to kyphosis/lordosis?
Kyphosis = primary thoracic

Lordosis = secondary lumbar
What are 2 types of alterations in the number of vertebrae?
What is sacralization?
INcorporation of the 5th lumbar vertebra into sacrum
What is lumbarization?
Liberation of the first sacral vertebra.
Which is worse?
Lumbarization - it causes too much lumbar mobility.
Where does the level of the spinal cord/dural sac terminate in the fetus?
Where does the level of the spinal cord/dural sac terminate in the newborn?
Spinal cord - L2/L3

Dural sac - S3
Where does the level of the spinal cord/dural sac terminate in the adult?
Spinal cord - L1

Dural sac - S2
What is conus medullaris?
The pointed end of the spinal cord
What is filum terminale?
The ending of the dura mater; it connects to the sacrum.
What is cauda equina?
Dorsal and ventral rami along with filum terminale
Where is a spinal tap done?
At L1-L2, where filum terminale is; can enter the subarachnoid space.
What is the origin of the back muscles?
Extr = hypaxial myotomes; part of the limb muscles and migrated on top of the back muscles.
Intr = Epaxial myotomes
What are the extrinsic back muscles innervated by?
Ventral rami
What are the intrinsic back muscles innervated by?
Dorsal rami
What is the thoracolumbar fascia?
L:arge central tendon in lower back; attachment for muscles
What are the extrinsic muscles in the back?
-Trapezius, latissimus, sternocleidomastoid - Superfic.
-Rhomboids, levator scap, serratos posterior (sup/inf) - Deep
What are the 5 groups of intrinsic true muscles of the back?
1. Spinotransversocostal
2. Longitudinal
3. Transversospinalis
4. Suboccipital
5. Missellaneous
What are the spinotransversocostal muscles?
Splenius capitis and cervicis
What are the longitudinal muscles also called?
Erector spinae
What are the erector spinae muscles?
What are the three transversospinalis muscles?
Semispinalis, multifidus, and rotatores.
What does spinal column stability depend on?
1. Taut ligaments
2. Plane/placement of articular facet joints
3. Annulus fibrosis
4. Accurate muscle tone and strength.
What is the spine's mobility primarily due to?
Compressability and elasticity of the intervertebral discs.
What is the sesamoid bone in the hand?
What is a sesamoid bone?
A bone that exists within a tendon; functions to improve movement.
What is the main contribution to the deep palmer arch?
Radial artery
What is the main contributor to the superfical palmar arch?
What does the radial nerve innervate?
-All the extensors of the forearm and arm
What does an injury to the radial nerve cause?
Wrist drop - inability to rase the wrist and extend fingers.
What does the median nerve innervate?
Thumb and forearm muscles.
What action do the palmar interossei cause?
What action do the dorsal interossei cause/
Where does the FDP insert?
Distal phalanges
Where does the FDS insert?
Medial phalanges
What roots supply the Median Nerve?
What is "Hand of Benediction"? What causes it?
Inability to flex digits 1,2,3
-Results from damaged median nerve proximal to elbow joint.W
What is wrist pain with weakness of digital flexion and thumb motion a sign of?
Carpal tunnel syndrome
What causes Carpal Tunnel syndrome?
Compression of the median nerve in the carpal tunnel.
What causes claw hand?
Ulnar nerve injury proximal to the wrist
What IS claw deformity?
Deformity of 4/5th digits
What muscle function loss causes claw deformity?
Intrinsic muscles - lumbricles and interossei
What does the loss of intrinsic hand muscles result in?
-Hyperextension of metacarpophalangelal joints
-Partial flexion of interphalangeal joints.
What is TRUE (full) Claw hand?
deformity of the 2-5th digits
What causes a true full claw hand?
Combined ulnar and median nerve injury proximal to the wrist joint.
What are the 3 common injuries to the brachial plexus?
1. Compression
2. Traction
3. Penetrating wound
What do supraclavicular injuries affect?
-Brachial plexus roots, trunks and divisions.
What are 2 types of supraclavicular injuries of the brachial plexus?
1. Injuries from plexus traction
2. Injuries from plexus compression
What disease is associated with traction of the upper trunk of the brachial plexus?
Duchenne paralysis
What can cause Duchenne paralysis?
Excessive separation of the shoulder from the neck.
What symptoms will be seen from excessive separation of the shoulder from neck?
Hand slightly flexed, shoulder problems.
What is Klumpke paralysis associated with?
Traction on the lower trunk
What causes traction on the lower brachial plexus trunk?
Hyperabduction of the upper limb.
What injuries cause compression of the plexus?
Presence of a cervical rib
What does an infraclavicular injury affect?
The cords and branches.
What are examples of infraclavicular injuries?
-Poorly fitting crutches
-nerve anoxia