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Regions of the vertebral column
- 7 Cervical
- 12 Thoracic
- 5 Lumbar
- Sacrum (5 fused)
- Coccyx (3-5 fused)
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Intervertebral disc
- Shock absorbers between vertebrae
- Outer: annulus fibrosus (fibrous)
- Inner: nucleus pulposus (jelly like)
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Herniated disc
nucleus pulposus herniates out through annulus fibrosus and presses on spinal nerves or cord, in lumbar region can cause sciatica
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Intervertebral foramen
Where Spinal nerves emerge
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Why are there 8 cervical spinal nerves, but only 7 cervical vertebrae?
1st cervical spinal nerve emerges superior to C1 between C1 and the skull
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What major structures are found at the level of T4-T5?
Level of: Angle of Louis, Bifurcation of trachea, and beginning/end of aortic arch
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Curves of spine
- At birth only 1 curve (thoracic, C-shaped)
- Develop cervical and lumbar curves (secondary curvatures)
- Pelvic curve begins between L5-S1
- Convex curves: Cervical and Lumbar
- Concave curve: Thoracic
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Atlas and Axis
- Atlas: C1, nodding of head, no vertebral body
- Axis: C2, turning of head
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Atlanto-occipital joint
- Condylar, synovial
- Flexion and Extension of head, slight lateral motion
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Movements at thoracic vertebrae
rotation, limited flexion/rotation due to ribcage
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Movements at lumbar vertebrae
significant flexion and extension, lateral flexion, tiny amount of rotation
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Structures of vertebrae
- Body (anterior part)
- Neural arch (posterior part)
- 2 pedicles on superior part of neural archLaminae
- Transverse processes
- Superior articular facets
- Inferior articular facets
- Spinous process
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What runs through the vertebral foramen?
spinal cord
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What is a special structure found in cervical vertebrae?
- Transverse foramen in transverse processes
- Allow for passage of vertebral artery
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With what structures do thoracic vertebrae articulate?
- Articulates with heads of ribs at superior and inferior facets
- Facet on transverse process articulates with tubercle of ribs
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What are the extrinsic muscles of the back?
- Superficial, responsible for movements at shoulder and upper limbs
- All extrinsic muscles receive sensory info from ventral (anterior) rami of spinal nerves because they insert into the upper limbs
- Trapezius
- Latissimus Dorsi
- Rhomboid Major
- Rhomboid minor
- Levator scapulae
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Trapezius
- O: External occipital protuberance, ligamentum nuchae; spinous processes of C7-T12
- I: spine of scapula; posterior surface of lateral ⅓ of clavicle and acromion of scapula
- A: Elevates and depresses scapula; also retracts scapula
- N: Innervated by Spinal Accessory nerve (XI); Sensory info from ventral rami of C3 and C4
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Latissimus dorsi
- O: Spinous process of T7-L5; inferior angle of scapula; inferior 3-4 ribs; iliac crest; thoracolumbar fascia
- I: humerus in between insertion of pectoralis major and teres major“ Lady between two majors”
- A: Adducts the arm, extends arm, and internally rotates humerus
- N: C6, C7, and C8
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Rhomboid major
- Deep to trapezius
- O: Spinous processes of T2 to T5
- I: medial border of scapula inferior to insertion of rhomboid minor
- N: C4-C5
- A: Retracts scapula and rotates it to depress glenoid cavity; also fixes scapula to thoracic wall
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Rhomboid minor
- O: C7 and T1; nuchal ligaments
- I: medial border of scapula superior to rhomboid major insertion
- N: C4-C5
- A: Retracts and rotates scapula; fixes scapula to thoracic wall
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Levator scapulae
- O: Transverse process of C1
- I: Superior angle of scapula and medial border
- N: C4-C5
- A: Elevates scapula
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What are the 2 intermediate muscles of the back?
- Attach to ribs; involved in respiratory function
- Serratus posterior superior
- Serratus posterior inferior
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Serratus posterior superior
- Attached to ribs and spinous processes
- Elevate ribs
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Serratus posterior inferior
- Attached to ribs and spinous processes
- Depress ribs
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What are the Deep Muscles (Intrinsic) of the back?
- Move spine, neck, and head; innervated by posterior rami
- Splenius capitis
- Splenius cervicis
- Erector spinae muscles
- Transversospinalis muscles
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Splenius capitis
- O: Spinous processes of cervical vertebrae
- I: Skull
- A: If both, extends neck, draws head back; if contract individually, turns head
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Erector spinae muscles
- Largest group in back
- Primary extensors of vertebral column and head
- 3 Muscles:Iliocostalis (most lateral), Longissimus, Spinalis (Most medial)
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Transversospinalis muscles
- Transverse to spinous processes
- Semispinalis (most superficial)
- Multifidus
- Rotares (most deep)
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What are the 2 sources of arterial blood supply to the spinal cord?
- Vertical arteries
- Segmental arteries
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Vertical arteries
- 1 anterior spinal artery and 2 posterior spinal arteries
- Vertebral artery comes off subclavian artery on each side
- Rise up and pass through transverse foramen of cervical vertebrae
- Through foramen magnum and anastomose to form basilar artery and anterior spinal artery
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Anterior spinal artery
Anterior spinal artery runs down entire spinal cord along ventral median fissure
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Posterior spinal arteries
- Come off as 2 branches of vertebral artery
- Run length of spinal cord along posterolateral aspects of spinal cord
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Segmental arteries
- Feed into spinal cord at different levels
- Come through intervertebral foramina along with spinal nerve roots
- Come off of different arteries depending on level
- Split into posterior radicular and anterior radicular arteries along spinal cord
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Cervical segmental arteries
- Vertebral artery
- Deep cervical artery
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What arteries in the thorax supply blood to the spinal cord?
Posterior intercostal arteries
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What arteries in the abdomen supply blood to the spinal cord?
Lumbar arteries
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Segmental medullary arteries
At some levels, these arteries come off segmental arteries and directly join the anterior and posterior spinal arteries
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What veins provide venous drainage to the spinal cord?
- Anterolateral spinal veins
- Posterolateral spinal veins
- Anterior spinal vein
- Posterior spinal vein
- Radicular veins
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Anterolateral spinal veins
Sit anterolaterally to dorsal and ventral nerve roots; run down length of spinal cord
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Posterolateral spinal veins
Sit postterolaterally to dorsal and ventral nerve roots; run down length of spinal cord
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Anterior spinal vein and Posterior spinal vein
Anterior and posterior spinal veins run down length of spinal cord
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Radicular veins
- Drain blood from longitudinal spinal veins into internal vertebral venous plexus which sits in extradural space
- Internal vertebral venous plexus drains into external vertebral venous plexus which drain into systemic veins (ascending lumbar vein and azygos veins)
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