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77 Cards in this Set
- Front
- Back
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Vertebra Column
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1) cervical = 7
2) thoracic = 12 3) lumbar = 5 4) sacral = 5 fused 5) coccygeal = 4 fused |
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primary curvatures
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- present in fetus
- 1) thoracic - 2) sacral - concave anteriorly |
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secondary curvature
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- appear when baby holds up head and sits upright
- 1) cervical - 2) lumbar - convex anteriorly |
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vertebrae basics
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1) body
2) vertebral arch: pr of pedicles, pr of laminae 3)processes: 1 spinous, 4 articular (zygapophyseal or facet between vertebrae) 4) intervertebral and vertebral foarmen |
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intervertebral foramen
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- spinal nerve and radicular blood vessels
- bound by pedicles of inferior and superior vertebrae |
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vertebral foramen
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- vertebral arch and body of vertebae
- foramina and canal: 1) spinal cord 2) roots of spinal nerves 3)anterior and posterior spinal blood vessels |
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Cervical Vertebrae
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- foramen transversarioum in transverse process: vertebral artery and vein through the c1-6
- bifid spines (not C7) |
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vertebra prominens
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- C7
- palpable non-bifid spine - |
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Atlas
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- C1
- no spine or body, but A & P arches and lateral masses - posterior arch: groove for vertebral artery |
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Axis
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- C2
- dens (odontoid process) - |
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atlanto-occipital joint
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- nodding (flexion - extension)
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atlanto-axial joint
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- rotation
-no |
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"first yes then no"
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Atlas first then Axis
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thoracic
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- T2-T9 have 2 demifacets to articulate with the head of rib, and 1 costal facet for tubercle of the neck of the rib
- long pointed spinous processes, point inferiorlu and overlap |
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lumbar
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- largest bodies
- straight, heavy spinous processes - mammillary process on tansverse process - larger intervertebral discs - articular processes large and oriented in saggital plane |
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Sacrum
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- 5 fused sacral vertebrae
- A & P sacral foramina for passage of A&P primary rami of spinal nerves - sacral promontory: upper end of the body of 1st sacral vertebra - sacral hiatus: caudal opening of vertebral canal - epdidural anesthesia done here |
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Coccyx
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- 3-4 fused coccygeal vertebrae
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intervertebral disc
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- symphysis type of joint
- nucleus pulposus - annulus fibrosus |
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nucleus pulposus
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- gelatinous with 70-80% water
- remnant of notochord - replaced with fibrous tissue with age |
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annulus fibrosus
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- outer portion of intervertebral disc
- surrounds and supports pulposus - supported by A&P longitudinal ligaments |
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Disc herniation
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- nucleus pulposus herniates through ruptured annulus fibrosus
- posteriolateral aspect of disc (no A&P support there) - L4-L5 disc, L5 impingement --> sciatica - C3-C4 C4 is compressed - C7-T1 8th cervical spinal nerve |
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Ligaments of vertebral column
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1. Anterior Longitudinal Ligament - over anterior surface of vertebral bodies; from
axis to sacrum - limits extension (hyperextension) of vertebral column and supports annulus fibrosus (IV disc) anteriorly - becomes atlanto-occipital ligament 2. Posterior Longitudinal Ligament - over posterior surface of vertebral bodies, extending from axis to sacrum - resists flexion of vertebral column - supports IV disc properly - becomes tectorial membrane 3. Supraspinous Ligament - attaches along tips of spinous processes and is continuous with the ligamentum nuchae in the cervical region 4. Interspinous Ligament - between adjacent spinous processes and fuse with supraspinous ligament 5. Ligamentum Flavum (yellow elastic tissue) - extends from lamina above to lamina below. Helps to maintain upright posture. The posterior arches of C1 and C2 are also connected to the posterior border of the foramen magnum by posterior atlanto-axial and atlanto-occipital ligaments, the continuation of the ligamentum FLAVUM. 6. Intertransverse Ligaments - between adjacent transverse processes 7. Ligamentum Nuchae - continuous with supraspinous ligament - extends from CV7 to the skull |
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Joints of Vertebral Columnae
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1. Atlantooccipital (flexion-extension or nodding and lateral bending of head)
2. Atlantoaxial (rotation of head) 3. Intervertebral discs (symphysis) between bodies - small amount of movement between any two vertebrae 4. Joints between vertebral arches |
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Scoliosis
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- abnormal lateral curvature of the spine (lateral bending of vertebral column);
usually in the thoracic region - can be associated with a congenital hemivertebra (absence of lateral half of vertebra) -- referred to us secondary structural scoliosis - can also be acquired from persistent severe sciatica (temporary bending due to severe pain) --- called sciatic scoliosis - compensatory scoliosis may be caused by a shortened lower limb |
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Kyphosis
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- abnormal exaggeration of the thoracic curvature
- senile kyphosis (round shoulders) can be due to degeneration of the intervertebral disc |
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Lordosis
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- an abnormal exaggerated lumbar curvature
- present in congenital double dislocation of the hip (support of pelvis posterior to acetabulum) - can be acquired from i ncreased weight of abnormal contents (obesity, pregnancy) - it is usually a compensatory curve |
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Spina Bifida
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- Failure of fusion of vertebral arch
1) Spina Bifida Occulta - simply bony defect - common in sacra and lumbar (may or may not be symptoms) - L5 or S1, tuft of hair 2) Spina bifida cystica - severe neural tube defect - meningocele: herniation of meninges - meningomyelocele: protrusion of meninges and spinal cord |
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Trapezius
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O: external occipital protuberance, superior nuchal line,
ligamentum nuchae and spines of C1 - T12 I: acromion, scapular spine and lateral third of clavicle INN: spinal accessory 11th cranial (motor) and C3, - C4 (sensory BS: superficial branch of transverse cervical artery (br. of thyrocervical) AC: elevates or shrugs (upper fibers), retracts (middle fibers), depresses (lower fibers) and rotates the inferior angle of the scapula laterally. Upper and Lower fibers - working with serratus rotate glenoid cavity upwards thus allowing abduction of the arm between 90 and 180 degrees. |
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Latissimus Dorsi
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O: spinous processes of lower 6 thoracic vertebrae; those of all lumbar and
upper sacral vertebrae; iliac crest and lower 3 ribs. I: floor of intertubercular (bicipital) groove of humerus INN: thoracodorsal nerve (C6, C7, C8) from posterior cord of brachial plexus BS: thoracodorsal artery (branch of subscapular) AC: extends, adducts and medially rotates arm (e.g. chopping wood and doing the crawl while swimming) |
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Rhomboid Major
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O: spinous processes of T2 - T5
I: vertebral (medial) border of scapula INN: dorsal scapular nerve ( C5) BS: deep branch of transverse cervical AC: adducts or retracts and medially rotates the inferior angle of the scapula |
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Rhomboid Minor
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I: vertebral (medial) border of scapula
INN: dorsal scapular nerve ( C5) BS: deep branch of transverse cervical AC: adducts or retracts and medially rotates the inferior angle of the scapula |
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Levator Scapulae
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O: transverse processes of upper four cervical vertebrae
I: upper medial border and superior angle of scapula IN: C3, C4 and dorsal scapular nerve BS: deep branch of transverse cervical AC: elevates scapula |
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Triangle of Auscultation
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1) trapezius
2) latissiumus dorsi 3) rhomboid major (medial scapula) - enlarges within 6th intercostal space, when arms folded across chest and flexing chest with scapula drawn anteriorly - respiratory sounds from inferior lobes of lungs |
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Lumbar Triangle
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1) latissimus dorsi
2) external abdominal oblique 3) iliac crest - site of lumbar hernia and infection |
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Serratus Posterior Superior
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- deep to rhomboids
O: spinous processes of C7 to T3 I: 2nd to 5th ribs IN: ventral rami of T1 - T4 AC: elevates ribs 2 to 5 (respiratory function). Thereby increasing chest size |
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Serratus Posterior Inferior
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- deep to latissimus dorsi
O: spinous processes of T11 to L3 I: 9th to 12 ribs IN: ventral rami of T9 to T12 AC: depresses ribs 9 to 12 and draws them backwards (respiratory function) |
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Splenius
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- the bandage
- splenius capitis (inserts on skull) - splenius cervicis (inserts on upper cervical transverse processes) - innervated by dorsal rami of C4 to C8 - unilateral contraction rotates head so that the face is turned to the same side as the contracting muscle - bilateral contraction extends neck and head |
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Erector Spinae
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- divided into three columns from lateral to medial: iliocostalis,
longissimus and spinalis (I Love Sex) - extends from sacrum and iliac crest to neck and skull - Extends (acting bilaterally), laterally flexes to same side (acting unilaterally) and rotates vertebral column - primarily extensors of the vertebral column |
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Semispinalis Capitis
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- powerful vertical muscle located deep to splenius and superficial to the
suboccipital triangle O: transverse processes of C7 - T6 I: occipital bone (between nuchal lines) IN: dorsal rami of cervical spinal nerves AC: (bilateral contraction) extends head |
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Transversospinalis
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- these are rotators and extensors of the vertebral column
- bilateral contraction extends vertebral column and unilateral contraction rotates it to the opposite side (lateral flexion of spinal column) - semispinalis capitis is a very powerful extensor of the head when contracted bilaterally. - semispinalis cervicis, extending from transverse processes to spines, bilaterally extends and unilaterally turns body to opposite side. Transversospinalis also regulate or prevent FLEXION of vertebral column. |
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Suboccipital Region
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- a triangular area between the skull and upper end of vertebral
column. Contains 2 joints - atlanto - occipital and atlanto-axial Sub-occipital muscles (4 in number) extend head and acting unilaterally rotate Head to same side Rectus Capitis. Post. Major - spine of 2nd cervical to lateral ½ of INF. NUCHAL LINE Rectus Capitis-Post-Minor - spine of 1st cervical to medial ½ of INF. NUCHAL LINE OBL. Capitis INFERIOR - Spine of C2 to transverse process of C1 OBL. Capitis SUPERIOR - transverse process of C1 to occipital bone just above INF. NUCHAL LINE. INNERVATION - 1st cervical nerve (suboccipital) |
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Paravertebral Muscles
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1. Rectus Capitis Anterior
2. Rectus Capitis Lateralis 3. Longus Colli 4. Longus Capitis |
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Spinal cord
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- extends to L1/L2 (L3 in the newborn)
- ends at conus medullaris - pia mater extends to filum terminale - cervical and lumbar enlargements due to limb nerve supplies - 31 segements --> nerves |
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Spinal nerves
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- 31 pairs
Cervical: 8 Thoracic: 12 Lumbar: 5 Sacral: 5 Coccygeal: 1 - made up of dorsal and ventral rootlets from segment - located in intervertebral foramen - C1 nerve purely motor in |
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Dorsal Root
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- sensory fibers with cell bodies in DRG
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Ventral root
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- motor fibers
- cell bodies in ventral and lateral horns of gray matter |
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dorsal primary ramus
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- both skeletal motor and sensory fibers and autonomic fibers
- skin and deep muscles of back |
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ventral primary ramus
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- both skeletal motor and sensory fibers and autonomic fibers
- cervical plexus (C1-C4) brachial plexus (C5-T1) lumbar plexus (T12-L4) sacral plexus (L4-S4) |
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1st coccygeal
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sensory
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1st Cervical nerve
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in 50% purely motor
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where do cervical spinal nerves emerge?
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- C1-C7 over its own vertebra
- only c8 comes below CV7 |
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where do thoracic, lumbar, sacral and coccygeal nerves emerge from?
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- below their respective vertebra
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Anterior Spinal artery
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branch of vertebral
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posterior Spinal artery
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- 2
- branches of vertebral or cerebellar arteries |
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radicular arteries
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- reinforce spinal arteries
- from spinal branches of cervical, intercostal, lumbar and lateral sacral arteries |
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Dura Mater
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- continuous with cranial dura, dural sac ends at S2
- forms filum of dura mater (coccygeal ligament) at S2 |
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epidural space
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- between dura and vertebral canal
- internal vertebral venous plexus (drained by spinal veins) |
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vertebral venous plexus
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- veins are valveless (important for metastases of tumor cells or viruses)
- connections to caval and azygous systems, sinuses in cranial cavities |
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Arachnoid
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- subdural space between arachnoid and dural layer
- subarachnoid space over pia, ends at s2 |
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Vertebra Column
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1) cervical = 7
2) thoracic = 12 3) lumbar = 5 4) sacral = 5 fused 5) coccygeal = 4 fused |
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|
primary curvatures
|
- present in fetus
- 1) thoracic - 2) sacral - concave anteriorly |
|
|
secondary curvature
|
- appear when baby holds up head and sits upright
- 1) cervical - 2) lumbar - convex anteriorly |
|
|
vertebrae basics
|
1) body
2) vertebral arch: pr of pedicles, pr of laminae 3)processes: 1 spinous, 4 articular (zygapophyseal or facet between vertebrae) 4) intervertebral and vertebral foarmen |
|
|
intervertebral foramen
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- spinal nerve and radicular blood vessels
- bound by pedicles of inferior and superior vertebrae |
|
|
vertebral foramen
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- vertebral arch and body of vertebae
- foramina and canal: 1) spinal cord 2) roots of spinal nerves 3)anterior and posterior spinal blood vessels |
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Cervical Vertebrae
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- foramen transversarioum in transverse process: vertebral artery and vein through the c1-6
- bifid spines (not C7) |
|
|
vertebra prominens
|
- C7
- palpable non-bifid spine - |
|
|
Atlas
|
- C1
- no spine or body, but A & P arches and lateral masses - posterior arch: groove for vertebral artery |
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|
Axis
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- C2
- dens (odontoid process) - |
|
|
atlanto-occipital joint
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- nodding (flexion - extension)
|
|
|
atlanto-axial joint
|
- rotation
-no |
|
|
"first yes then no"
|
Atlas first then Axis
|
|
|
thoracic
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- T2-T9 have 2 demifacets to articulate with the head of rib, and 1 costal facet for tubercle of the neck of the rib
- long pointed spinous processes, point inferiorlu and overlap |
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lumbar
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- largest bodies
- straight, heavy spinous processes - mammillary process on tansverse process - larger intervertebral discs - articular processes large and oriented in saggital plane |
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arachnoid
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- subdural space contains lymph
- subarachnoid space has CSF and ends at S2 |
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Pia
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- denticulate ligaments are lateral extensions in 21 prs that
- extends from conus medullaris to dural sac as filum terminale |
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Lumbar Puncture
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- best down between L3 and L4 (iliac crest level at L4 spine serves as guide to
clinician - needles is passed through interlaminar space in the midline, as the spinal column is flexed - layers transversed: skin, superficial fascia, deep fascia, supraspinous ligament, interspinous ligament, interlaminar space, epidural space, dura, arachnoid and subarachnoid space (ligamentum flavum is not pierced because the needle passes through the midline |
