ANAT 711 Back I & II + Vertebral Column Lecture

vertebral prominens

Landmark for C7

inferior scapular angle

Landmark for T7

scapular spine

Landmark for T3

Highest point of iliac crest

Landmark for L4

posterior superior iliac spine

Landmark for S2

kyphosis

-Primary curvatures of spine that occur before birth

-located at thoracic and sacral regions

Lordosis

-secondary curvatures of spine that occur after birth

- cervical (1st) and lumbar (2nd)

before birth

when does primary ossification occur?

bends occur after birth, throughout development

when does secondary ossification occur?

Osteoporosis

a condition in which there is a reduction in bone mass/strength

intervertebral foramen

where spinal nerves exit

vertebral body

structure in green

vertebral arch

pedicle and lamina

what the vertebral arch is composed of

pedicle of vertebrae

Lamina of vertebra

pars interarticularis

the area between the superior and inferior articulations of the vertebrae; common site of fractures due to spondylolysis

vertebral foramen

contains spinal cord and meninges

superior, inferior, transverse, posterior processes

4 projections from vertebral arch

spondylosis

osteoarthritis of the intervertebral joint

spondylolysis

stress fracture of the pars interarticularis

spondylolisthesis

anterior displacement of a vertebra

spondylolysis (image)

Scotty Dog indicates...

Atlas (C1)

Name the bone.

Axis (C2)

Name the bone.

Vertebral artery and vein

passes through C1

cervical vertebrae

what part of the vertebrae has a transverse foramen?

nuchal ligament

-limits forward flexion of head & cervical spine. It also serves as the attachment for supraspinatus muscle

transverse ligament

forms the posterior support of the dens during head rotation

alar ligament

-extends from sides of the dens to occipital bone

-prevents head rotation

atlantooccipital joint

Condylar synovial joint involved in flexion, extension, and lateral flexion of the head.

whiplash injury

tearing of anterior longitudinal ligament and other soft tissue structures during hyper extension

Hangman's fracture

-traumatic spondylolysis of C2

-Bilateral fracture of pars interarticularis of C2 due to hyperextension

-Associated with spinal cord injury

Jefferson's fracture

-excessive axial loading resulting from a blunt injury

-rare damage to spinal cord

Posterior atlanto-occipital membrane

connects the posterior arch of the atlas with the occipital bone and is continuous with the lateral atlanto-occipital ligament

thoracic vertebrae

what has costal facets in their bodies and transverse processes with limited ROM

Thoracic

name the vertebral region

thoracic vertebrae

what contains long slender spinous processes that tilt inferiorly and form joints with ribs

inferior, ribs

the alphanumeric designation of the __________ thoracic vertebra is the same as ________

lumbar

name the vertebral region

mamillary and accessory processes

these processes are associated with the lumbar region

lumbar vertebrae

large for stability and weightbearing

limited ROM

sacrum

name the vertebral region

Coccyx

the end of the spinal cord attaches here

sacral hiatus

used for administration of caudal (extradural) anesthesia

posterior and anterior sacral foramina

spinal nerves exit here

sacral cornu

formed by pedicles of 5th sacral vertebrae

used to find the hiatus

intervertebral joint

formed by adjoining vertebral bodies

anterior longitudinal ligament

-attached to anterior surface of vertebral bodies and IVDs

-limits extension of vertebral column

-upward extension of anterior atlantooccipital membrane

posterior longitudinal ligament

-attached to posterior surface of vertebral bodies and IVDs

-limits flexion of vertebral column

-upward extension of tectorial membrane

anterior atlantooccipital membrane

upward extension of the anterior longitudinal ligament

tectorial membrane

upward extension of the posterior longitudinal ligament

ligamentum flava

-#3

-connects the adjacent laminae of the vertebrae

-forms posterior wall of vertebral canal between vertebrae

ligamentum flavum

what is pierced during lumbar puncture?

posterior atlantooccipital membrane

upward extension of the ligamentum flava is

IV Disc

-composed of a tough outer annulus fibrosus & squishy inner nucleus pulposus

-good shock absorbers

supraspinous and interspinous ligaments

-resist hyperflexion

-between spinous and transverse processes (Respectfully)

ligamentum nuchae

formed by thickened supraspinous ligaments that extend from C7 to external occipital protuberance

trapezius, latissimus dorsi, levator scapulae, rhomboids

superficial extrinsic back muscles

Extrinsic back muscles

this group of muscles is attached to either ribs, scapula, or humerus

Intrinsic back muscles

this group of muscles attaches only to vertebrae or the skull

ventral rami of spinal nerves

what are the extrinsic back muscles supplied by?

dorsal rami of spinal nerves

what are the intrinsic back muscles supplied by?

extend spine and/or head (bilateral contraction)

what do all intrinsic back muscles do?

Trapezius

innervated by CN 11 (accessory nerve)

latissimus dorsi

Name the muscle

Elevates & depresses scapula, retracts, and rotates scapula & arm

action of trapezius

2 multiple choice options

thoracodorsal nerve (C6-C8)

Latissimus Dorsi Innervation

-extension, adduction, and medial rotation of the arm

-raises body toward arms when climbing

Latissimus Dorsi action

accessory nerve

shrugging shoulders

how is the accessory nerve evaulated?

transverse cervical vessels (branch of thyrocervical trunk)

runs posteriorly and then inferiorly deep to the trapezius

dorsal scapular nerve (C4 and C5)

innervation for levator scapulae and rhomboid muscles

elevates scapula

action of levator scapula

retracts scapula

(major does most of the work)

action of rhomboids

elevates ribs

action of serratus posterior superior

depresses ribs

action of serratus posterior inferior

proprioceptive, motor

the actions of the serratus posterior muscles are more _______ than ________

splenius muscle

bilateral: extends cervical spine and head

unilateral: flexes and rotates head to the same side

bilateral and unilateral actions of the splenius

splenius innervation

1st muscles not supplied by a named nerve

dorsal rami of cervical spinal nerves

splenius innervation

Triangle of Auscultation

good location for listening to heart sounds

A- erector spinae

B- iliocostalis

C- longissimus

D- spinalis

A,B,C,D

dorsal rami of spinal nerves

erector spinae innervation

bilateral: extension of spine/neck

unilateral: ipsilateral flexion of spine/head

action of erector spinae muscles

rotatores, multifidus, semispinalis

transversospinalis muscles

rotatores

-allows vertebral flexibility

-sits in between transverse process & spinous process

Multifidus

-extends and rotates vertebral column

-Chronic lower back pain here

semispinalis

extends neck and vertebral column

dorsal rami of spinal nerves

transversospinalis muscles innervation

Bilateral: extension of spine/neck

unilateral: contralateral spine/head rotation

actions of the transversospinalis muscles

interspinales

muscle located between spinous processes

levatores costarum

expansion of ribs during breathing

dorsal rami of spinal nerves

interspinales & levatores costarum innervation

intertransversarii

lateral flexion of vertebral column

muscle located between transverse processes

dorsal rami AND ventral rami of spinal nerves

intertransversarii innervation

Extend spine

major role of deep minor intrinsic back muscles

under the semispinalis

location of suboccipital triangle

suboccipital triange