M1 module 2 extra info

Palpable landmarks in the back:

C7 spinous process

T3 spinous process

scapular spine

T7 spinous process

scapula inferior angle

T12 spinous process

L4 spinous process

iliac crest

posterior superior iliac spine

S2 spinous process

scapular movements:

Scapular Retraction = Scapular External Rotation = Scapular Adduction

Scapular Protraction = Scapular Internal Rotation = Scapular Abduction

two nerves in suboccipital region:

suboccipital nerve/dorsal ramus C1

greater occipital nerve/dorsal ramus C2

The suboccipital nerve emerges ___. The greater occipital nerve emerges ___.

• above obliques capitis inferior muscle

• below obliques capitis inferior muscle

course of vertebral artery:

• branch of ___ artery

• ascends through what openings in cervical spine:

• dissected within:

• enters what foramen to enter the head:

• terminates into what vessel:

• subclavian

• transverse foramina of C6 → C1

• suboccipital triangle

• foramen magnum of skull

• basilar artery at base of brain

superficial branch of transverse cervical artery:

• anterior to ___ muscle

• What nerve does this parallel?

• What muscle will this help supply?

• trapezius

• spinal accessory nerve (CN XI)

• trapezius

deep branch of transverse cervical artery:

• medial border of ___

• What nerve does this parallel?

• What muscles does this help supply?

• scapulae

• dorsal scapular nerve (C5)

• rhomboid minor & major, scapulae

The spinal cord relays ___ information from peripheral nerves to the bran stem and thalamus.

sensory (afferent)

The spinal cord relays ___ information from the cerebrum and brain stem to motor neurons.

motor (efferent)

What are dorsal and ventral roots?

• dorsal: incoming axons of sensory neurons

• ventral: exiting axons of motor neurons

What is a ganglion and a nucleus?

• ganglion: collection of neuronal cell bodies outside CNS

• nucleus: collection of neuronal cell bodies inside CNS

Dorsal roots are ___ and ___.

• somatosensory

• arriving

The ___ form a mesh-like substance that looks kind of like a spider web. It connects the arachnoid with the pia.

arachnoid trabeculae

The dorsal and ventral ___ refers to those parts of the spinal nerve distal to the dorsal root ganglion as it splits into dorsal and ventral branches. They are ___.

• rami

• mixed (motor and sensory)

Dorsal roots are ___ and ___.

• somatosensory

• arriving

Where are both dorsal and ventral roots located?

proximal to dorsal root ganglion

The ___ is a prominent blood vessel running in the ventral median fissure.

anterior spinal artery

A dorsal root and ventral root merge to form a ___. Joining of dorsal and ventral roots happens at, or just distal to, the ___, which contains the cell bodies of neurons that form the dorsal roots. That part of the spinal cord to which a single pair of dorsal and ventral roots attaches is termed a ___.

• single spinal nerve

• dorsal root ganglion

• spinal segment

The ___ is the origin of spinal nerves that innervate the upper limbs. The ___ is the origin of spinal nerves that innervate lower limbs.

• cervical enlargement (C4-T1)

• lumbosacral enlargement (L2-S3)

How many nerves are in each spinal region?

cervical: 8 pairs

thoracic: 12 pairs

lumbar: 5 pairs

sacral: 5 pairs

1 vestigial coccygeal nerve (can be up to 3-4)

Filum terminale: difference between internus and externus

• internus: inside dural sac

• externus: outside dural sac

The most common cause for Cauda Equina Syndrome is:

disk herniation in lumbar spine

Neurons in the ___ receive sensory information and relay it to higher brain centers.

Lower motor neurons in the ___ receive motor signals from higher brain centers and relay those signals to muscle.

• dorsal horn

• ventral horn

The medial division of the ventral horn contains ___. Thus, it is found at ___

• motor neurons that innervate the neck, trunk, intercostal and abdominal muscles

• all levels of the spinal cord

The lateral division of the ventral horn contains ___. Thus, it is found at ___.

• motor neurons that innervate the limbs

• only the enlargements (cervical enlargement for the upper limbs; lumbosacral enlargement for the lower limbs)

What are the 2 major nuclear groups located in the gray matter intermediate zone?

• intermediolateral nucleus (T1-L1/2)

• sacral parasympathetic nucleus (S2-S4)

An ___ is a collective term for the three articulations between any two adjacent vertebrae, consisting of the ___.

• intervertebral joint

• intervertebral disc joint (a cartilaginous joint) and the two zygapophysial or facet joints (synovial joints)

The manubriosternal joint occurs between the:

medial clavicle and manubrium of sternum (+ 1st costal cartilage)

• at sternal angle, T4-T5 level

The xiphisternal joint occurs between the:

body of the sternum and xiphoid process

A costotransverse joint is the articulation between ___.

the tubercle of a rib and the transverse process of the corresponding thoracic vertebra

T1 articulates with the ___ ribs, but the ___ rib only articulates with T1

• 1st and 2nd

• 1st

The point where the trachea bifurcates into the right and left main bronchi is called the ___.

carina

___ roots have no ganglion.

Ventral

Herniation of the 5th lumbar nerve root can result in numbness in the ___ and weakness through ___.

• 1st 3 toes of the lateral leg

• dorsiflexion of the great toe and foot (difficulty walking on heels, foot drop)

S1 nerve root herniation can result in numbness of the ___ and ___.

• back of the calf, lateral heel, and foot to toe

• decreased achilles reflex

Does thick or thin skin have hair follices?

Thick skin does NOT have hair follicles, thin skin does.

List the curvature of the spinal cord segments:

• cervical: lordotic

• thoracic: kyphotic

• lumbar: lordotic

• sacral: kyphotic

The vertebral arches form the posterior aspect of the vertebral canal and serve to protect the spinal cord. Failure of them to form correctly results in ___ and leaves the spinal cord and associated tissues vulnerable to injury.

spina bifida

The ___ is the sole remnant of the embryonic notochord, the initial longitudinal skeletal axis of the body.

nucleus pulposus

Each embryonic somite differentiates into three components:

myotome, dermatome, and sclerotome

The anterior tubercle of ___ is known as the carotid tubercle because deep pressure against it will stop or greatly slow flow in the common carotid artery.

C6