Anatomy Lecture 2 - Posterior Spine

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Anatomy Lecture 2 - Posterior Spine
2010-06-13 11:57:34

UNLV DPT 744 Gross Anatomy 1 Lecture 2 - Posterior Spine
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  1. How many irregular bones between C1 and the coccyx?
    • 33
    • 7 - Cervical
    • 12 - Thoracic
    • 5 - Lumbar
    • 5 - Sacral
    • 4 - Coccygeal
  2. Describe the cervical vertebrae
    • -Bifod spinous process. especially prominent on C2 (attachement for rectus capitis posterior major, oblicuus capitis inferior, and the spleniu cervicis)
    • -7 vertebra and 8 vertebral nerve roots
    • -Extremely mobile
    • -C1 and C2 are atypical
  3. When does the vertral artery begin entering the transverse foramen of the cervical vertebrae?
    the vertebral a. enter at C6 then go up to C1. When they meet up they become the basilar artery.
  4. Describe the C1 or atlas.
    • No spinous process, instead has a posterior tubercal on the posterior arch
    • No body.
    • Articulates with the accipital condyles and the axis.
    • Rotates around the dens or ondontoid process of the axis
  5. Describe the C2 of axis
    • Has a large bifod spinous process
    • Major origin site for muscle of the suboccipital triangle (Rectus capitis major and obliquus capitis inferior)
  6. Describe the thoracic Vertebrae
    • Transition between the crevical and lumbar regions.
    • Second lesat mobile due to the rib cage.
    • Disc to body ration of 1:5 instead of 1:4 (Decreases mobility)
    • Lond slender inferior projecting spinous process
    • Atritcular factes for articulating with ribs
  7. Describe the Lumbar Vertebrae
    • Discs are shock absorbant - Heavy bodies for weight bearing
    • 3/4 top and bottom of the body is covered by vertebral endplates. The rims are covered by the annuls fibrosus.
  8. Describe the sacrum
    • Five fused vertebrae
    • The most immobile segment
    • 4 sacral foramina translating nerves S1- S4
    • Base has superior facets that articulate with the inferior facets of L5
  9. What are some potential problems at the C6 transverse foramen?
    The vertebral artery is subject to entrapment with 90 degree turns.
  10. What are the main movements at atlanto-occipital joint?
    Flexion and extension. Some slight rotation.
  11. What are the main movements at the atlanto-axial joint?
    Both are convex. Also for more mobility. This is where the major rotation occurs as the atlas pivots around the dens or ondontoid process.
  12. Which part is considered the upper cervical?
    O, C1, and C2
  13. Describe the coccyx.
    • It is the remnant of the skeleton of the embryonic tail
    • No pedicles lamina nor spinous process
    • 4 fused bones
  14. What type of joints are the intervertebral joints at the body?
    • They are symphyses joints (caritlaginous) because of the fibrous cartilage connecting the joints.
    • Designed to bear weight. Also designed to handle radial pressure. We could say that the disc is primarily a ligament.
  15. What are the two parts of the vertebral discs?
    The annulus fibrosis and the nucleus pulposes.
  16. Describe the annulus fibrosus.
    It is an anchoring mechanism for the vertebral endplate. The outer 3rd of it is innervated. It has concentric layering to be able to handle radial pressure.
  17. Describe the nucleus pulposus
    Contains Proteoglycan. At the lumbar part of the spine, the nucleus pulposes is located more posteriorly. It is 90% water at birth, and 70% water by 20yrs. No circulating blood.
  18. What is proteoglycan?
    It is a hydrophylic gelatinous microprotein and collagen. It conforms to pressure and absorbs water. It reacts adversly with blood.
  19. What happens when there is a rupture of the vertebral end plate?
    The blood reacts with the proteoglycan causing inflammation.
  20. What do we call a rupture of the vertebral end plate?
    Schmorl's node.
  21. What type of joint is found in the vertebral arches?
    It is a zygapophysial joint (facet joint). These are synovial joints.
  22. What can occur with the compression of the zygapophysial joint?
    The compression can damage the highly innervated and vascular fatty plugs.
  23. What are the accesory ligaments in the intervertebral joints?
    • Anterior Longitudinal Ligament
    • Posterior Longitudinal Ligament
    • Ligamentum Flavum
    • Interspinous Ligament
    • Supraspinous Ligament
    • Ligamentum Nuchae
  24. Describe the ALL
    • The only ligament that prevents hyperextension.
    • It runs from the sacrum to the anterior tubercle of C1 and the occipital.
    • Strong and broad.
  25. Describe the PLL
    • Much more narrow and weak than the ALL.
    • Attached more to the discs and less to the vertebral bodies.
    • It is weak in resisting hyperflexion. It is highly innervated with nociceptive nerve endings.
  26. Describe the ligamentum flavum.
    Lines the whole inside of the lamina of each vertebrae. Thickens with age. When the muscle of the lateral raphe are pulled it pulls on the supraspinous ligament, which pulls on the interspinous ligament, which pulls on the ligamentu flavum, which is then lifted off of the vertebral formane, making more space for the spinal cord.
  27. Describe the intraspinous ligament
    It is a fan shaped ligament that connects the spinous process and the supraspinous ligament.
  28. Describe the supraspinous ligament
    It is a ligament that runs along the posterior aspect of the spinous process. It's not pain sensitive. It eventually becomes the ligamentum nuchea at it's most superior section.
  29. What is the intervertebarl disc?
    It is many things. Primarily a ligament helping to connect the vertebrae. It is also shock absorbant and creates greater movement in the spine. It can be the source of pain and neural impingment when dysfunctional.
  30. Trapezius OINA
    • O: Occipital bone, ligamentum nuchea, spinous process of C7 - T12
    • I: Lat 3rd of Clavicle, acromion, and spine of scapula
    • N: Accesory or cranial nerve 11
    • A: Elevate from the upper fibers, retraction of scapula from middle fibers, and depression from lower fibers.
  31. Latissumus Dorsi
    • O: Spinous process of inferior 6 thoracic vertebrea (T7-T12) Thoracolumbar fascia, Iliac crest, inferior 3 or 4 ribs
    • I: Intertubercular groove of humerus
    • N: Thoracodorsal n.
    • A: Extends, Adducts and medialy rotates the humerus, elevates the body when climbing.
    • *inserts close to the Teres Major.
  32. Levator Scauplae OINA
    • O: Xverse process of C1-C4
    • I: Superior part of medial border of scapula
    • N: Dorsal Scapular N.
    • A: Elevates the scapula, rotates the head to the same side.
  33. Rhomboid Major OINA
    • O: Spinous process of T2-T5
    • I: Medial border of scapula from level of spine to inferior angle.
    • N: Dorsal Scapular N.
    • A: Retracts the scapula and downwardly rotate the scapula
  34. Rhomboid Minor OINA
    • O: Spinous process of C7-T1 and ligamentum Nuchae
    • I: Smooth triangular area at medial end of scapular spine.
    • N: Dorsal Scapula Nerve
    • A: Retract and downwardly rotate the scapula
  35. What are the superficial back muscles?
    Trapezius, Latissimus Dorsi, Levator Scapula, Rhomboid Major and Minor
  36. What are the intermediate back muscles?
    Serratus posterior superior and inferior
  37. Serratus Posterior Superior OINA
    • O: Ligamentum Nuchae, spinous process of C7-T3
    • I: 2nd - 5th rib
    • N: Ventral Rami of first 3-4 Thoracic Nerves
    • A: Elevates the superior 4 ribs to increase the size of the thorax
  38. Serratus Posterior Inferior OINA
    • O: Spinous process of T11-L2
    • I: Inferior 3-4 ribs
    • N: Ventral rami of the last 4 thoracic nerves
    • A: Depress the inferior 3-4 ribs to prevent superior pull by the diaphragm
  39. What are the deep muscles of the back?
    • Superficial Layer: Splenius capitis, Splenius Cervicis
    • Intermediate Layer: Erractor Spinae Muscles:
    • Iliocostalis: Lumborum, Thoracis, Cervicis
    • Longissimus: Thoracis, Cervicis, Capitis
    • Spinalis
    • Deep Layer: Semispinalis (Thoracis, Cervicis, Capitis), Multifidus, Rotatores
  40. Splenius Capitis OINA
    • O: Ligamentum Nuchae nad spinous process of C7-T3
    • I: Mastoid Process, Occipital bone
    • N: Dorsal Primary Rami
    • A: Rotate head and neck to the same sine, Neck and head extension
  41. Splenius Cervicis OINA
    • O: Spinous Process of T3-T6
    • I: Xverse process of C1-C4
    • N: Dorsal Primary Rami
    • A: Rotate the head and neck to the same side, Extend the head and neck
  42. Iliocostalis OINA
    • O: Errector Spinae common tendon.
    • I: Lumborum-angles of the inferior 6 ribs, Thoracis-From 6 lower ribs to six upper ribs, Cervicis-from 6 upper ribs to xverse process of C4-C6
    • N: Dorsal Primary Rami
    • A: Extend vertebral column and lateral flexion
  43. Longissimus OINA
    • O: Errector Spinae common tendon.
    • I: Thoracis-From lower lumbar and sacrum tolower 9 ribs and associate xverse processes, Cervicis-from xverse process of T1-T4-6 to xverse process of C2-C6, Capitis-From lower 4 cervical vertebra to mastoid process of temporal bone.
    • N: Dorsal Primary Rami
    • A: Extend vertebral column and lateral flexion
  44. Spinalis OINA
    • O: Spinous process of T11-L2
    • I: Spinous Process of upper 4-8 thoracic vertebrae
    • N: Primary Dorsal Rami
    • A: Extensors of Vertebral column
  45. Semispinalis Capitis OINA
    • O: From xverse processes of T1-T6
    • I: Occipital bone
    • N: Dorsal Rami of cervical Spinal Nerves
    • A: Bilaterally extends head, Unilaterally rotates the head to the same side.
  46. Multifidus
    • From C2 to S4 region. Most prominent in the lumbar region
    • O:Vertebral arches
    • I: Spinous Processes. Spanning 203 vertebrae at a time.
    • N Dorasl Rami of the spinal nerves
    • A: Unilaterally-Flexes the trunk, rotates the vertebrea to opposite side. Bilaterally-extends the trunk
  47. Rotatores
    • Found aling the entire length of the vertebral column. Most discernable in the thoracic region
    • O: xverse process
    • I: superior spinous process
    • N. Dorsal rami of spinal nerves
    • A: Rotation of superior vertebrea to opposite side. Functionally more for proprioceotive sensory information generation.
  48. What are the percentages of weight distribution in the vertebrae?
    80% in the body, 20% in the arch
  49. What is a laminectomy?
    Removal of the lamina of a vertebrae.
  50. What are the borders of the Intervertebral Foramen?
    • Sup: Inferior vertebral notch
    • Inf: Superior vertebral notch
    • Lateral: Intervertebral disc, body of vertebrea, mass of the arch.
  51. Describe thickness of the spinal cord from superior to inferior.
    It gets thinner as it descends away from the brain. It is also flattened A-P
  52. Give some details on thoracis vertebrea.
    • Square like body with long spinous process.
    • Slightly taller posteriorly, inducing a kyphotic curve.
    • Has facets and demifacets for the ribs. House the costalvertebral joint and costaltransverse joint. Joints limit thoracic extension.
  53. Where do most intervertebral disc ruptures occur?
    Posterolaterally. This may cause mechanical or chemical inrritaion, and/or irritate the nerve.
  54. What is the PLL called at the superior aspect?
    The tectorial Membrane.