Anatomy- Deep Back And Suboccipital Triangle Iusm 2015

Front 1

What hold vertebrae together?

Back 1

1.ligaments
2. intervertebral discs
3. synovial joints between articular processes

Front 2

What level of movement is possible between 2 vertebrae?

Back 2

slight movement

Front 3

What is the weight bearing part of the thoracic vertebrae and what does it contain?

Back 3

1. body
2. contains red bone marrow

Front 4

What drains the red bone marrow in the thoracic vertebrae bodies?

Back 4

basivertebral veins

Front 5

The neural arch exists for what reasons?

Back 5

1. protection of the spinal cord
2. attachment of the muscles
3. articulation with the ribs
4. regulation of movements

Front 6

What type of joints are formed between thoracic vertebrae and what forms them?

Back 6

1.synovial joints
2. superior and inferior articular facets

Front 7

The spinous process is downturned so as to overlap the one below it. Why is this important?

Back 7

for better protection of the underlying spinal cord

Front 8

How do cervical vertebrae overlap the lower vertebra?

Back 8

anteriorly

Front 9

What appears on the transverse processes of cervical vertebrae?

Back 9

1. anterior and posterior tubercules
2. transverse foramen

Front 10

In cervical vertebrae what is the true transverse process and what is the true costal element?

Back 10

1. true transverse process-posterior tubercle
2. costal element- anterior tubercle

Front 11

The C7 anterior process may form what?

Back 11

a cervical rib

Front 12

What is the vertebra prominens?

Back 12

C7 (but it is still not as big of a spinous process as T1)

Front 13

The dens belong to what cervical structure and what does it extend through and what hold its there?

Back 13

1. belongs to C2
2. extends through ring of atlas
3. held in place by a transverse ligament

Front 14

The upper articular facets of C1 are what shape and what do they articulate with?

Back 14

1.concave
2. articulate with occipital condyles

Front 15

The lower articular facets of C2 are what shape and articulate with what?

Back 15

1. flat
2. articulate with upper articular facets of axis (C2)

Front 16

The motions of nodding yes and shaking no are controlled by what joints?

Back 16

1. YES- atlanto-occipital joint
2. NO- atlanto-axial joint

Front 17

What two major areas can show a hangman's fracture on a lateral neck xray?

Back 17

1. prevertebral swelling
2. fracture of the posterior aspect of C2 pedicles

Front 18

What is a type II dens fracture?

Back 18

1. fracture through base of the odontoid process
2. odontoid process and C1 moved posterior to C2

Front 19

What vertebrae are the most massive?

Back 19

lumbar

Front 20

How do the spinous processes of lumbar vertebrae project and why is this significant?

Back 20

1. project posteriorly, but do not overlap inferiorly
2. allows for lumbar puncture to be performed at this level

Front 21

What is spondylolisthesis?

Back 21

1.forward displacement of the body of a vertebrae (usually happens in lower spine)

Front 22

The sacrum is made up of what?

Back 22

1. 5 sacral vertebrae fused into one
2. 4 intervertebral foramina
3. articular surfaces

Front 23

What are the 4 intervertebral sacral foramina split into and what is transmitted through them?

Back 23

1. posterior and anterior sacral foramina
2. transmit anterior and posterior primary rami of sacral nerves

Front 24

The lower opening of the sacral canal can sometimes be used for what?

Back 24

introduction of anesthetic

Front 25

What does the sacrum articulate with on its articulating surfaces?

Back 25

ilium

Front 26

What layers make up the intervertebral disc?

Back 26

1.hyaline cartilage
2. fibrocartilage

Front 27

What is the nucleus pulposus made of?

Back 27

glycosaminoglycans

Front 28

What disorder is described as an upward herniation of an intervertebral disc that erodes the body of the adjacent vertebra?

Back 28

Schmorl's Node

Front 29

Paired components of the vertebra are each joined by how many ligaments?

Back 29

one

Front 30

Unpaired components of the vertebra are each joined by how many ligaments?

Back 30

2 ligaments

Front 31

The spines of adjacent vertebrae are joined by what ligaments?

Back 31

1. supraspinous ligament
2. interspinous ligaments

Front 32

The bodies of adjacent vertebra are joined by what ligaments?

Back 32

1.anterior longitudinal ligament
2. posterior longitudinal ligament

Front 33

The paired articular processes of adjacent vertebra are joined by what ligaments?

Back 33

capsular ligaments (synovial joints)

Front 34

The transverse processes of adjacent vertebra are joined by what ligaments?

Back 34

intertransverse ligaments

Front 35

The laminae of adjacent vertebra are joined by what ligaments?

Back 35

ligamentum flava

Front 36

Why isn't there a ligament between pedicles?

Back 36

because they make the intervertebral foramina which is where spinal nerves emerge

Front 37

What is the purpose of the cervical flexure?

Back 37

support of the head

Front 38

What is the purpose of the thoracic flexure?

Back 38

it was your original fetal curve

Front 39

What is the puprose of the lumbar flexure?

Back 39

support of trunk for standing and walking

Front 40

What are the movements of the vertebral column?

Back 40

1. anterior flexion
2. extension
3. lateral flexion
4. rotation

Front 41

Why is rotation free in the thoracic region and not in the lumbar region?

Back 41

1.the superior articular facets face posterolaterally in the thoracic
2. the superior articular facets face almost medially in the lumbar region

Front 42

What vertebrae level does the scapula lie between?

Back 42

T2-T7

Front 43

What vertebrae level does the supracristal plane(tops of both iliac crests) lie between?

Back 43

L4

Front 44

What vertebrae level does the posterior superior iliac spine lie between?

Back 44

S2

Front 45

At what spinal level does the spinal cord end in an adult?

Back 45

L1

Front 46

At what spinal level does the subarachnoid space end in an adult?

Back 46

S2

Front 47

What structures from superficial to deep does the needle pass through during a lumbar puncture?

Back 47

1. supra and interspinous ligaments
2. ligamentum flava
3. dura mater
4. arachnoid mater
(stops in subarachnoid space)

Front 48

What are the groups of muscle layers in the back?

Back 48

1.superficial
2. intermediate
3. deep

Front 49

What muscles form the intermediate group of the back muscles?

Back 49

1. serratus posterior superior
2. serratus posterior inferior

Front 50

What function are the serratus posterior superior and inferior muscles involved with?

Back 50

1. muscles of insperation (elongate the thoracic cavity)

Front 51

What innervates the serratus posterior superior and inferior?

Back 51

ventral rami of intercostal nerves

Front 52

What muscles make up the deep layer of the back?

Back 52

1. splenius capitis
2.splenius cervicis
3. interspinalis
4. levator costae
5. rotators
6. semispinalis thoracis
7. intertransversarii
8. multifudus

Front 53

When the deep muscles of the back act jointly what motions occur and when they act unilaterally what motions occur?

Back 53

1. acting jointly extends vertebral joints preventing/regulating flexion
2. unilaterally, will cause lateral flexion and rotation of the spinal column

Front 54

What are the attachments of the splenius capitis?

Back 54

1. inferior 1/2 of ligamentum nuchae and spines of T1-5
2. superior nuchal line and mastoid process (along with Sternocleidomastoid)

Front 55

What are the attachements of the splenius cervicis?

Back 55

1. inferior 1/2 of ligamentum nuchae and spines of T1-5
2. transverse processes of C1-4 (along with levator scapulae)

Front 56

The lumbar portion of the thoracolumbar fascia is also part of what else?

Back 56

dorsal aponeurosis of transverse abdominis

Front 57

The superficial layer and the deep layer of the thoracolumbar fascia attach to what in the lumbar portion?

Back 57

1. superficial: lumbar spines
2. deep: tips of the lumbar transverse processes

Front 58

What are the attachments of the thoracolumbar fascia in the thoracic portion?

Back 58

1. vertebral spines
2. angle of the ribs (over the deep dorsal muscles)

Front 59

Where do the erector spinae lie in relation to bony landmarks in the back?

Back 59

1. fill grooves between spines of the vert., transverse processes, and ribs

Front 60

What is the general form of the erector spinae muscles starting caudally and working up?

Back 60

1. start in sacral region
2. enlarge and are powerful in the lumbar region
3. split into columns of separate muscles attaching to spines, transverse processes and ribs in the thoracic region

Front 61

The longest bundle and shortest bundle of the erector spinae are spatially related to each other how (superficial vs deep)?

Back 61

1. longest bundle is most superficial
2. shortest bundle is deep (contact with bone)

Front 62

What is another name for the erector spinae?

Back 62

sacrospinalis

Front 63

How far does the erector spinae run?

Back 63

from pelvis to skull

Front 64

Where does the erector spinae split and what does it split into?

Back 64

1. splits near the 12th rib
2. splits into:
-iliocostalis
-longissimus
-spinalis

Front 65

What are the attachments of the iliocostalis?

Back 65

1.inserts into angle of ribs and C4-6 transverse processes

Front 66

What are the attachments of the longissimus (thoracis, cervicis, and capitis)?

Back 66

1. inserts into lumbar accessory process and transverse processes
2. thoracic transverse processes and parts of T2-12
3. bundles arising from T1-4 inserts into C2-6

Front 67

Where is the spinalis portion of the erector spinae?

Back 67

found only in the thoracic region

Front 68

The transversospinalis muscles are deep to what?

Back 68

erector spinae

Front 69

Where do the transversospinalis muscles run?

Back 69

1. run from transverse processes to spines

Front 70

What are the three layers of transversospinalis muscles from superficial to deep?

Back 70

1. semispinalis
2. multifudus
3. rotatores

Front 71

What are the general attachments of the semispinalis thoracis and cervicis?

Back 71

attach near tips of transverse processes to tips of spinous processes (run almost vertically)

Front 72

What are the attachments of the semispinalis capitis?

Back 72

1. transverse processes of T1-5 and articular processes of C4-7
2. occipital bone

Front 73

What innervates the semispinalis capitis?

Back 73

dorsal primary rami of all cervical nerves

Front 74

What muscle covers the semispinalis capitis?

Back 74

trapezius

Front 75

What are the attachments of the multifidus?

Back 75

1. dorsal sacrum (between spinous and transverse crests) and all transverse processes up to C4 (also attach to adjacent ligaments and fascia of erector spinae
2. to inferior border of C2-L5 spinous processes

Front 76

What are the attachments of the rotatores?

Back 76

1. transverse processes
2. superior spinous process or lamina

Front 77

Where can the interspinales and intertransversarii be found?

Back 77

1. well developed in the cervical and lumbar regions
2. absent from thoracic region

Front 78

Where do the interspinales muscles run?

Back 78

1.unite the bifid tubercles of adjacent cervical spinous processes
2. unite adjacent borders of lumbar spines

Front 79

Where do the intertransversarii muscles (ant. and post.) run?

Back 79

1. unite adjacent anterior tubercles and adjacent posterior tubercles of cervical transverse processes
2. also unite transverse processes of lumbar vertebrae

Front 80

How do the cervical nerves pass when going from cord to the intervertebral foramina?

Back 80

horizontally

Front 81

As the nerve roots become vertical at L1 the start to form what and what is it composed of?

Back 81

1.cauda equina
2. composed of anterior and posterior nerve roots

Front 82

What is the true end of the spinal cord?

Back 82

conus medullaris

Front 83

What does the filum terminale attach to and what is it responsible for?

Back 83

1. attaches to conus medullaris
2. responsible for vertical stability of the spinal cord

Front 84

What are denticulate ligaments formed from and what are they responsible for?

Back 84

1. formed by reflections of pia mater
2. responsible for lateral stability of the spinal cord

Front 85

The filum terminale pierces the dura and runs where and becomes what?

Back 85

1. runs to the posterior aspect of coccyx
2. coccygeal ligament

Front 86

Which dorsal rami of spinal nerves are not typical?

Back 86

first 2 and last 3

Front 87

Where does the dorsal rami of spinal nerves typically originate and run?

Back 87

1. originates laterally to the spinal ganglion
2. passes dorsally on the lateral side of the superior articular process

Front 88

What do the dorsal rami of the spinal nerves supply and innervate?

Back 88

1. supply skin and deep muscles of back (medial to the angles of ribs)
2. innervate articular facets of vertebrae

Front 89

Some exceptions of dorsal rami of spinal nerve travel further. What are they and where do they run?

Back 89

1. C2 (greater occipital nerve to scalp)
2. T2 to acromion
3. L1,2,3 to gluteal region

Front 90

Each dorsal ramus divides into medial and lateral branches. What are the exceptions?

Back 90

C1, S4, S5, Co1

Front 91

When the dorsal ramus divides, one of the divisions will end up as cutaneous. What are the levels where neither ends up cutaneous?

Back 91

C1, C6, C7, C8, L4, L5

Front 92

What are the venous plexus?

Back 92

dense plexus of thin-walled valveless veins surrounding the spinal dura mater

Front 93

How does the venous plexus communicate superiorly?

Back 93

with the occipital and basilar sinuses of the cranium

Front 94

How is the vertebral venous plexus divided?

Back 94

anterior and posterior longitudinal channels

Front 95

What veins run into the vertebral venous plexus?

Back 95

1. vein from spinal cord
2. basivertebral vein from body of vert. at each segment

Front 96

What drains the vertebral venous plexus?

Back 96

1. drained by intervertebral veins coming through the intervertebral foramina to the vertebral, intercostal, lumbar, and lateral sacral veins

Front 97

What is formed by veins from the anterior body of the vertebrae?

Back 97

anterior vertebral plexus

Front 98

What is formed by veins passing through the ligamentum flava?

Back 98

posterior vertebral plexus

Front 99

What forms the apex of the suboccipital triangle?

Back 99

posterior border of the sternocleidomastoid and anterior border of trapezius

Front 100

What is under the trapezius and where does it attach?

Back 100

1. semispinalis capitis
2. attaches to skull between superior and inferior nuchal lines

Front 101

What vessel emerges from under the splenius capitis and what does it supply?

Back 101

1. occipital artery
2. supplies back of the scalp

Front 102

What 2 nerves emerge through the semispinalis capitis and what do they supply?

Back 102

1. greater occipital nerve (dorsal primary ramus of C2)
2. third occipital nerve (dorsal primary ramus of C3)
3. both supply the skin of the scalp

Front 103

What are the bony landmarks of C1?

Back 103

1. posterior tubercle (no spine) for head extension/looking up
2. long transverse processes / for levers in rotation of head and C1 on the dens

Front 104

What are the muscles of the suboccipital triangle?

Back 104

1. rectus capitis posterior major
2. RCP minor
3. obliquus superior
4. obliquus inferior

Front 105

What are the attachments of the rectus capitis posterior major?

Back 105

1. from spine of the axis
2. below inferior nuchal line (lateral to RCP minor)

Front 106

What are the attachments of the rectus capitis posterior minor?

Back 106

1.posterior tubercle of atlas (C1)
2. to below inferior nuchal line (bilaterally)

Front 107

What are the attachments of the obliquus superior?

Back 107

1. transverse process of atlas
2. area between nuchal lines lateral to semispinalis

Front 108

What are the attachments of the obliquus inferior?

Back 108

1. from spine of axis
2. transverse process of atlas

Front 109

Where does the vertebral artery run?

Back 109

1. runs through the transverse foramina of upper 6 cervical vert.
2. emerges onto upper surface of atlas
3.passes posteriorly to reach a deep groove of the posterior arch of the atlas
4.passes into the foramen magnum to meet with opposite vert. artery and to form basilar artery

Front 110

The two vert. arteries join to form what?

Back 110

basilar artery

Front 111

How does atherosclerosis of the vertebral arteries affect you?

Back 111

1. movement of head and neck could affect blood flow and cause fainting and unconsciousness
2. or a TIA

Front 112

Where does the C1 nerve emerge and run?

Back 112

1. emerges from spinal cord
2. runs in C1 groove between artery and bone
3. splits into dorsal and ventral primary ramus

Front 113

What does the dorsal primary ramus of C1 become and what does it do?

Back 113

1. suboccipital nerve
2. enters suboccipital triangle and innervates the muscles

Front 114

Where does the ventral primary ramus run and what does it join?

Back 114

1. runs forward, lateral to the superior articular face and joins the hypoglossal nerve (CN XII)

Front 115

Where does the C2 spinal nerve run and what does it become?

Back 115

1. emerges between atlas and axis and travels superiorly over the suboccipital triangle
2. becomes the greater occipital nerve

Front 116

Where does the C3 spinal nerve run?

Back 116

emerges between axis and C3 vertebra