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  1. Regions of the vertebral column
    • 7 Cervical
    • 12 Thoracic
    • 5 Lumbar
    • Sacrum (5 fused)
    • Coccyx (3-5 fused)
  2. Intervertebral disc
    • Shock absorbers between vertebrae
    • Outer: annulus fibrosus (fibrous)
    • Inner: nucleus pulposus (jelly like)
  3. Herniated disc
    nucleus pulposus herniates out through annulus fibrosus and presses on spinal nerves or cord, in lumbar region can cause sciatica
  4. Intervertebral foramen
    Where Spinal nerves emerge
  5. 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
  6. 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
  7. 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
  8. Atlas and Axis
    • Atlas: C1, nodding of head, no vertebral body
    • Axis: C2, turning of head
  9. Atlanto-occipital joint
    • Condylar, synovial
    • Flexion and Extension of head, slight lateral motion
  10. Movements at thoracic vertebrae
    rotation, limited flexion/rotation due to ribcage
  11. Movements at lumbar vertebrae
    significant flexion and extension, lateral flexion, tiny amount of rotation
  12. 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
  13. What runs through the vertebral foramen?
    spinal cord
  14. What is a special structure found in cervical vertebrae?
    • Transverse foramen in transverse processes
    • Allow for passage of vertebral artery
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. Levator scapulae
    • O: Transverse process of C1
    • I: Superior angle of scapula and medial border
    • N: C4-C5
    • A: Elevates scapula
  22. What are the 2 intermediate muscles of the back?
    • Attach to ribs; involved in respiratory function
    • Serratus posterior superior
    • Serratus posterior inferior
  23. Serratus posterior superior
    • Attached to ribs and spinous processes
    • Elevate ribs
  24. Serratus posterior inferior
    • Attached to ribs and spinous processes
    • Depress ribs
  25. 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
  26. Splenius capitis
    • O: Spinous processes of cervical vertebrae
    • I: Skull
    • A: If both, extends neck, draws head back; if contract individually, turns head
  27. Erector spinae muscles
    • Largest group in back
    • Primary extensors of vertebral column and head
    • 3 Muscles:Iliocostalis (most lateral), Longissimus, Spinalis (Most medial)
  28. Transversospinalis muscles
    • Transverse to spinous processes
    • Semispinalis (most superficial)
    • Multifidus
    • Rotares (most deep)
  29. What are the 2 sources of arterial blood supply to the spinal cord?
    • Vertical arteries
    • Segmental arteries
  30. 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
  31. Anterior spinal artery
    Anterior spinal artery runs down entire spinal cord along ventral median fissure
  32. Posterior spinal arteries
    • Come off as 2 branches of vertebral artery
    • Run length of spinal cord along posterolateral aspects of spinal cord
  33. 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
  34. Cervical segmental arteries
    • Vertebral artery
    • Deep cervical artery
  35. What arteries in the thorax supply blood to the spinal cord?
    Posterior intercostal arteries
  36. What arteries in the abdomen supply blood to the spinal cord?
    Lumbar arteries
  37. Segmental medullary arteries
    At some levels, these arteries come off segmental arteries and directly join the anterior and posterior spinal arteries
  38. What veins provide venous drainage to the spinal cord?
    • Anterolateral spinal veins
    • Posterolateral spinal veins
    • Anterior spinal vein
    • Posterior spinal vein
    • Radicular veins
  39. Anterolateral spinal veins
    Sit anterolaterally to dorsal and ventral nerve roots; run down length of spinal cord
  40. Posterolateral spinal veins
    Sit postterolaterally to dorsal and ventral nerve roots;  run down length of spinal cord
  41. Anterior spinal vein and Posterior spinal vein
    Anterior and posterior spinal veins run down length of spinal cord
  42. 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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