DPT 744 Lecture 2

Cervical vertebrae has how many?

C1-C7 but 8 cervical nerves

Thoracic vertebrae has how many?

T1-T12

Lumbar vertebrae has how many?

L1-L5

Sacral vertebrae has how many?

S2-S5

Palpating (most prominent cervical process)

C7

Palpating(Inferior tip of scapula)

T7

Palpating(Superior aspect of iliac crest; Tuffier’s line

L4

Palpating(Posterior superior iliac crest)

S2

In an adult human what are the degrees on the curvature of the back?

Cervical- 2 degrees

Thoracic- 1 degrees

Lumbar- 2 degrees

Sacral- 1 degree

What is the Vertebral Arch?

composed of the pedicles and the laminae

What is the Vertebral foramen

Space created by the body and the vertebral arch

What is the Vertebral canal

contains spinal cord and its coverings; created by successive vertebral foramina

Spinous Process

extension posterior from the meeting of the lamina

Transverse Process

lateral projections originating at junction of the lamina and pedicle

Superior articular process

2 superior projections from the superior portion of the lamina which form synovial joints (facet) with vertebra directly above

Inferior articular process

Superior vertebral notch

Inferior vertebral notch

Intervertebral foramen

space created by superior and inferior vertebral notches

Anulus fibrosus and Nucleus pulposus and if they push out the PLL what happens

between the spinal bones and its called herniated disk.

Cervical vertebrae facets are facing which way?

Thoracic vertebra facets which way?

vertical, allow rotation

Lumbar facet are facing which ways

Vertical face each other and allow flexion and extension

C0-C1 is also know as what?

atlantoccipital

C1-C2 is also known as

altantoaxial joint

Transverse ligament of atlas is important why?

Because it keeps the vertebrae in place

The nucleus pulposus and Anulus fibrosus (gel like) are always even in the joint (T or F)

False (because of the Uncinate process which causes upward growth from the superior aspect of each lateral vertebral towards the vertebral body above)

What do the Zygapophysical Joints for the intervertebral disc?

Creates stability by restraining exessive movement protecting the intervertebral disc from torsion (twisting) strain

Thoracic area, the height of body is slightly higher posteriorly and contributes to what?

normal kyphosis

Superior and inferior demi facet form a what

connection of rib

Same level (Rule of ‘threes’

T1-T3

Half a level below (Rule of ‘threes’

T4-T6

One whole level below

T7-T9

One whole level below (Rule of ‘threes’

T10

Half a level below (Rule of ‘threes’

Half a level below

Same Level (Rule of ‘threes’

T12

The Sacrum has how many fused vertebrae

5

The base of the sacrum what?

superior facets of S1 articulate with inferior facets of L5

Where does the sacarl nevers come out?

Anterior sacral foramina

What gives the spine stability and strength

Anulus fibrosus of disc 4

What are the ligaments of the spine?

Ligamentum flavum, Posterior longitudinal ligament, Anterior longitudinal ligament

Anterior Longitudinal Ligament (ALL) consist of ?

Pain sensitive (stretch too much), Attaches to Post Longitud( PLL), and allows blood to enter

Posterior Longitudinal Lig (PLL)

Very pain sensitive

Ligamentum Flavum

Look at picture

Interspinous ligament

tenses with flexion and pain sensitive

Supraspinous ligament

over the spinous processes and not pain sensitive

What does the IST complex consist of?

Thoracolumbar fascia, Supraspinous ligament, and Interspinous ligament (stabalizes the trunk and core)

What moves-’fold and unfolds’ with head, neck and trunk movments

Spinal cord

What bounds the Triangle of Auscultation?

Trapezius, Latissimus Dorsi, and Rhomboid major

What landmark is the tip of the spinal cord

Conus Medullaris

Dentate Ligament?

Has fibrous sheets of pua extending midway b/w posterior and anterior rootlets from lateral surface of spinal cored

At the Birth the Conus Medullaris is where?

L4/L5 level

At the adulthood the Conus Medullaris is where?

Cord ends at L1/L2 level

What are the loose bundle of lumbar and sacral spinal cords?

Cauda Equina

What is the Lumber cistern?

enlargement of the subarachnoid space between the conus medullaris of spinal cord and inferior end of subarachnoid space and dura mater.

How many Spinal nerves are there?

31!!

Where does the C1 exit?

Between skill(occiput) and atlas

Most Cervical nerves exit where

ABOVE their proper vertebrae (ex. C4 exits out the C3)

Where is the exception with the exiting of the cervical nerves?

The C8 exits below its proper vertebrae because is only 7 cervical vertebrae (Remeber 7up, C8 down)

Where do they usually do epidural shots and why?

in the cauda equina because its hard to hit nerves and the Nerves are like dried spaghetti noodles hanging

Where does the spinal cord stop?

L1 or L2,

If the the spinal cords ends at L1 or L2 what happens to the lower lumbar, sacral, and coccygeal nerves?

They descend as a bunch of nerve roots called cauda equina (horse’s tail)

What does the Filum terminale externum do?

Keeps spinal cord in place

Ventral (anterior) Primary rami

Immediately divide when spinal nerves exit intervertebral foramina

-Travels anterior providing motor and sensory innervation

Dorsal Primary Rami

Travel posterior to innervate structures in the back

What system regards the Brain and spinal cord only?

Central Nervous System (CNS)

What system regards outside the spinal cord?

Peripheral Nervous System (PNS)

What root of the nerve is in charge of sensory?

Posterior root

What root of the nerve is in charge of motor (movements)

Anterior root

What nervous system is in charge of fight or flight?

Sympathetic nervous system (SNS)- leads to increased alertness

What nervous system is in charge of rest-and-digest?

Parasympathetic Nervous System (PNS)- slows down most body activities

What nervous system uses “E situations” (exercise, emergency, excitment,embarassment)

SNS

What is SLUDD in the PNS?

Salivation,Lacrimation(tears),Urination,Digestion,Defecation

What are the “3 decreases” in the PNS

-Decerases HR

-Decreased diameter of airways

-Decreased diameter of pupils

Grey matter is inside or outside?

Inside

White matter is outside or inside

outside

What are the effects of spinal flexion?

Elongation and increased tension.

In Complete Spinal Cord injury results in what?

loss of all sensation and voluntary movment inferior to the injuried vertebrae.

Complete Spinal Cord injury (C1-C3)

no function below head level, ventilator is required

Complete Spinal Cord injury (C4-C5)

Quadriplegia (no function of upper and lower libs)

Complete Spinal Cord injury (C6-C8)

loss of lower limb function combined with a loss of hand and variable amount of upper limb function; individual may be able to self feed or propel a wheelchair

Complete Spinal Cord injury (T1-T9)

Paralegia (paralysis of both lower limbs)

Complete Spinal Cord injury (T10-L1)

some thigh muscle function, which may allow walking with long leg braces

Complete Spinal Cord injury (L2-L3)

retention of most leg muscle function; short leg braces may be required for walking

A herniated disc is caused by what?

The Nucleus Pulposus pressing into the posterior longitudinal ligament.

Broken neck at “Scotty dog” indicated what?

Spondyloysis

What are the curves of the spine?

Kyphosis, Lordosis, and Scoliosis

What is the main thing about Lumbar Stenosis?

There is bone growth in the vertebral foramen which causes narrowing of the canal