Clinical Anatomy of the Dorsum, Spine and Spinal Cord Flashcards

3D spinal column model: https://sketchfab.com/models/2e0cfd919dbb49c386ac93209de370d2

1
Q

List the surface muscles of the trunk dorsum

A

Trapezius

  • Descending (superior)
  • Transverse (middle)
  • Ascending (inferior)

Teres Major

Latissimus dorsi

Erector spinae

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2
Q

What are the extrinsic back muscles? List them

A

Muscles of the back which attach to the pectoral girdle and move the upper limb

Trapezius

Levator scapulae

Rhomboids

Latissimus dorsi

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3
Q

What are the intrinsic back muscles? List them

A

Muscles of the back which are and only act in the back

Erector spinae (superficial)

Transversospinalis (deep)

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4
Q

Name the three components of Erector spinae and where they attach

A

Iliocostalis: ribs superiorly

Longissimus: transverse process of vertebra

Spinalis: Spinous process of vertebra

Inferior attachments: common tendon to sacrum & Iliac crests

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5
Q

Where is Transversospinalis located and where do its fibres attach?

A

Located within the grooves between transverse & spinous processes

Individual fibres attach between:

  • a vertebra and the cranium
  • a vertebra and a rib
  • one vertebra and another vertebra
  • the sacrum and a vertebra
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6
Q

How are the intrinsic back muscles innervated?

A

Segmental nerve supply as the dermatome & myotome map

Posterior rami branches from cervix, thorax and lumborum

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7
Q

Label the dorsal muscles

A
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8
Q

Which muscles flex the spinal column?

A

Rectus abdominis

Psoas major

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9
Q

List the vertebrae found within the spinal column

A

33 vertebrae in total

  • 7 cervical (C1-C7)
  • 12 thoracic (T1-T12
  • 5 lumbar (L1-L5)
  • 5 sacral (fused to form 1 sacrum)
  • 4 coccygeal (fused to form 1 coccyx)
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10
Q

Describe the ligamentum flavum

A

Short individual pieces connect laminae between vertebrae, posterior to the spinal cord

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11
Q

Describe the physiological sagittal curvatures of the spinal column

A

Two primary curvatures (flexures)

  • Thoracic Kyphosis
  • Sacral Kyphosis

Two secondary Curvatures (extensions)

  • Cervical Lordosis
  • Lumbar Lordosis
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12
Q

Label the vertebra (thoracic)

A
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13
Q

Describe the intervertebral foraminae

A

Found between adjacent vertebrae

Spinal nerves are found within

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14
Q

What form of joint is formed between adjacent articular processes of vertebrae?

A

A facet joint

Hence vulnerable to osteoarthritis

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15
Q

Where in the spinal column are intervertebral discs not located?

A

None betwenn C1 - C2

None within the sacrum and coccyx as these are fused

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16
Q

Describe the physiology of intervertebral discs

A

Outer layer ‘Annulus fibrosis’

-Fibrous and strong

Inner core ‘nucleus pulposus’

  • soft pulp for flexibility
  • can herniate
17
Q

List the ligaments which support the spinal column

A

Ligamentum flavum

Anterior longitudinal ligament

Posterior longitudinal ligament

Supraspinous ligament

Interspinous ligament

18
Q

Describe the anterior longitudinal ligament

A

Anterior to the vertebral body

Broad and strong protection for dics

Prevents over-extension of the column

19
Q

Describe the posterior longitudinal ligament

A

Posterior to vertebral body

Narrow and week

Prevents over flexion of the column

20
Q

Describe the supraspinous ligament

A

Connects the tip of each spinous processes vertically

Strong and fibrous

21
Q

Describe the interspinous ligament

A

Connects superior and inferior surfaces of adjacent spinous processes

Weak and membranous

22
Q

Desccribe the C1 vertebra

A

‘Atlas’

No vertebral body or spinous process

instead has a posterior and anterior arch

23
Q

Describe the C2 vertebra

A

‘Axis’

Has an odontoid process whihc projects superiorly from the vertebral body to articulate with C1

24
Q

Describe the Atlanto-occipital joint

A

The Joint between the occipital condyles and superior articular facets of the atlas

Loose synovial joint with a loose capsule

Allows:

  • flexion/extension
  • lateral rotation
  • some lateral flexion`
25
Q

Label the vertebral column

A
26
Q

Describe the types of Cervical Vertebral Dislocation

A
  • A - Stage I- flexion sprain
  • B - Stage II – anterior subluxation, 25% translation
  • C - Stage III – 50% translation
  • D - Stage IV – complete dislocation
27
Q

Descirbe the atlanto-axial joints

A

3 articulations which are all synovial

  • bilateral joints between superior/inferior articular facets
  • midline joint between odontoid process and anterior arch

Mainly rotation movement

28
Q

Label the Sacrum

A
29
Q

How is caudal anaesthesia achieved?

A

In caudal anaesthesia local anaesthetic is injected into the sacral hiatus to anaesthetise the sacral spinal nerve roots of the cauda equina

30
Q

Describe the course of the spinal cord

A

Begins rostrally at the level of the foramen magnum, being continuous with the medulla oblongata

Ends caudally around L1-L2 as the conus medullaris

31
Q

Detail the spinal cord structure

A

A segmented structure, corresponding to the vertebral level of spinal nerves which origionate from its surface

Cervical cord segments lie roughly one spine higher than their corresponding vertebra

Thoracic, two

Lumbar, three to four

Enlarges in diameter at segments:

C4-T1

L1-S3

32
Q

Describe the cauda equina

A

All the spinal nerve roots from L2 to C0 that have to descend to their numbered vertebrae where their spinal nerve is located within the intervertebral foramen

33
Q

Label the spinal meninges

A
34
Q

Describe the layering approached during a laminectomy

A

Skin, superficial fascia, aponeurotic origin of trapezius/thoracolumbar fascia of latisimus dorsi, intrinsic muscles, ligaments (ligamentum flavum, supraspinous , interspinous), lamina, spinous process

-Epidural fat, dura mater and arachnoid mater