2 - ANATOMY OF THE BACK (BRS) 2025

In what space can one obtain cerebrospinal fluid in a lumbar puncture procedure?

Subarachnoid space

The internal vertebral venous plexus would rupture into what space around the spinal cord?

Epidural space

What is the space located between the vertebral canal and the dura mater?

Epidural space

What is the space between the arachnoid and the dura maters of the spinal cord?

Subdural space

What fluid is located within the subarachnoid space around the spinal cord?

Cerebrospinal fluid (CSF)

A tumor in the intervertebral foramina between the fourth and fifth cervical vertebrae will damage what nerve?

Fifth Cervical Nerve (C5)

A tumor in the intervertebral foramina between the fourth and fifth thoracic vertabrae will damage what nerve?

Fourth Thoracic Nerve (T4)

What is the only cervical nerve without a corresponding vertebra?

C8

A herniated intervetebral disk between L4 and L5 vertebrae will likely affect nerve roots from whcih spinal nerves?

Fifth Lumbar Nerve Root (L5)

Spinal nerves generally exit BELOW their corresponding vertebra, EXCEPT for what spinal nerves?

C1 - C7

What structures in the brain are responsible for the absorption of CSF?

Arachnoid villi

Arachnoid granulations

CSF is produced by what structures located inside the ventricles?

Choroid plexus

What muscle originates from the transverse processes of the upper cervical vertebrae and insert on the medial border of the scapula?

Levator scapulae

The heads of the sixth and seventh ribs articulate with the vertebral body at what vertebral level?

T6

Which part of the vertebra articulates with the tubercle of the corresponding rib?

Transverse process

This congenital disorder is characterized by the protrusion of the meninges and a pathologic tubular cavity in the spinal cord or brain

Syringomyelocele

What B vitamin is shown to prevent neural tube defects?

Folic acid (Vitamin B9)

The deep muscles of the back are innervated by what nerves?

Dorsal primary rami of the spinal nerves

The superficial muscles of the back are innervated by what nerves?

Ventral primary rami of the spinal nerves

What muscles are innervated by the dorsal scapular nerve?

-Levator scapulae

-Rhomboid minor

-Rhomboid major

What structures are penetrated by the spinal needle during a lumbar puncture procedure? (From the most superficial structure)

-Skin

-Subcutaneous tissue

-Supraspinous ligament

-Interspinous ligament

-Ligamentum flavum

-Epidural space

-Dura mater

-Subdural space

-Arachnoid mater

-Subarachnoid space

What space is located between the arachnoid and pia mater?

Subarachnoid space

The cerebrospinal fluid (CSF) is located within what space?

Subarachnoid space

The lateral horn of the spinal cord containing sympathetic preganglionic neuron cell bodies is present at what levels of the spinal cord?

T1-L2

The lateral horn of the spinal cord containing parasympathetic preganglionic neuron cell bodies is present at what levels of the spinal cord?

S2-S4

What structures pass through the intervertebral foramen?

Dorsal and ventral primary rami of the spinal nerves

Local anesthetic agents are injected via what foramen located between the sacral cornua to block the spinal nerves in the epidural space?

Dorsal and ventral primary rami of the spinal nerves

What structure lies within the vertebral canal?

Spinal cord

The suboccipital nerve supplies what muscles?

-Rectus capitis posterior major

-Obliquus capitis superior

-Obliquus capitis inferior

-Semispinalis capitis

What nerve supplies the rectus capitis posterior major, obliquus capitis superior, obliquus capitis inferior and semispinalis capitis muscles?

Suboccipital nerve

What muscle is innervated by the dorsal primary rami of the middle and lower cervical nerves?

Splenius capitis

The atlantoaxial joint of the cervical vertebrae is responsible for what movement of the neck?

Rotation

This ligament interconnects vertebral bodies and intervertebral disks posteriorly and runs anterior to the spinal cord within the vertebral canal

Posterior longitudinal ligament

This ligament is formed by supraspinous ligaments extending from the seventh cervical vertebra to the external occipital protuberance and crest

Ligamentum nuchae

This ligament interconnects vertebral bodies and intervertebral disks anteriorly

Anterior longitudinal ligament

The transverse foramina is present up to what cervical vertebrae level?

C6

What structures occupy the transverse foramina?

Vertebral artery and vein

The vertebral artery and vein passes through what foramen to enter/exit the skull?

Transverse foramina

This structure is the enlargement of the subarachnoid space between the inferior end of the spinal cord and the inferior end of the subarachnoid space

Lumbar cistern

The anterior part of the external vertebral venous plexus lies in front of what structure?

Vertebral column

The posterior part of the external vertebral venous plexus lies on what structure?

Vertebral arch

This condition is characterized by an abnormally increased thoracic curvature

Kyphosis/ Hunchback/ Humpback

This condition is characterized by the abnormal accentuation of the lumbar curvature

Lordosis

This condition is the failure of the vertebral arch to fuse (bony defect only)

Spina bifida occulta

This congenital condition is characterized by protrusion of the meninges through the unfused arch of the vertebra

Meningocele

Injury caused by force that hyperextends the cervical vertebrae after driving the trunk forward with the head lagging behind

Whiplash injury

This condition is a lateral deviation of the vertebrae resulting from unequal growth of the spinal column

Scoliosis

This is a fracture of the neural arch through the pedicle of the axis due to hanging or motor vehicle accidents

Hangman fracture

This congenital condition is characterized by protrusion of the spinal cord and its meninges through a defect at the back

Meningomyelocele

This condition occurs when the nucleus pulposus is protruded through the annulus fibrosus

Herniated disk

What muscle originates from the posterior tubercle of the atlas and inserts on the occipital bone (below the inferior nuchal line)

Rectus capitis posterior minor

This ligament extends from the apex of the dens to the medial side of the occipital bone

Alar ligament

This ligaments extends from the dens of the axis to the anterior aspect of the foramen magnum of occipital bone

Apical ligament

This muscle originates from the transverse processes and insert onto the spinous processes of the cervical vertebrae

Semispinalis cervicis

This muscle originates from the spine of the axis and inserts on to the transverse process of the atlas

Obliquus capitis inferior

Lateral extensions of the pia mater in the spinal cord

Denticulate ligament

This structure is an inferior extension of the pia mater from the tip of the conus medullaris

Filum terminale (internum)

This structure is the filum of the dura and extends from the tip of the dural sac to the coccyx

Coccygeal ligament or Filum terminale externum

This membrane is an upward extension of the posterior longitudinal ligaments from the body of the axis to the basilar part of the occipital bone

Tectorial membrane

The tectorial membrane is an upward extension of what ligament of the back?

Posterior longitudinal ligaments

What is the action of the rhomboid major muscle?

Adducts the scapula

The dorsal scapular nerve arises from ventral ramus of which cervical nerve?

C5

The latissimus dorsi forms boundaries of what 2 triangles of the back?

Auscultation and Lumbar triangles

The trapezius muscle forms a boundary of which triangle of the back?

Auscultation triangle

What artery supplies the levator scapulae, rhomboid minor, trapezius muscles

Transverse cervical artery

The splenius capitis muscle receives blood from what 2 arteries?

Occipital artery

Transverse cervical artery

The trapezius muscle receives blood from what artery?

Transverse cervical artery (superficial branch)

The latissimus dorsi receives blood from what artery?

Thoracodorsal artery

The rhomboid major muscle receives blood from what artery?

Transverse cervical artery (deep/descending branch)

The multifidus and longissimus capitis muscles receive blood from what arteries?

Segmental arteries

What is found in the epidural space around the spinal cord that is not found in the cranial epidural space?

Epidural fat

The internal vertebral venous plexus lies in what space around the spinal cord?

Epidural space

What venous plexus is located inside the epidural space of the spinal cord?

Internal vertebral venous plexus

What structure located at the caudal end of the spinal cord is formed by dorsal and ventral roots of the lumbar and sacral nerves?

Cauda equina

What do you call the conical end of the spinal cord?

Conus medullaris

The adult conus medullaris terminates at what vertebral level?

L2

What is the central mucoid substance in the intervertebral disk?

Nucleus pulposus

What is the fibrous tissue and fibrocartilage surrounding the nucleus pulposus of the intervertebral disk?

Annulus fibrosus

What structure produces cerebrospinal fluid?

Choroid plexus

After exiting the ventricles of the brain, the cerebrospinal fluid proceeds to circulate within what space around the brain and spinal cord?

Subarachnoid space

The choroid plexuses are located within what CSF-filled structures of the brain?

Ventricles

After passing through the subarachnoid space, CSF is filtered into the venous system by what structures?

-Arachnoid villi

-Arachnoid granulations

What is another term for subarachnoid space in the lumbar area?

Lumbar cistern