Functionally Oriented Regional Anatomy Chapter 2

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Chapter 2 The Trunk
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1

Vertebrae of the human body

7 cervical
12 thoracic
5 lumbar
5 sacral
4-5 coccygeal

2

Spinal regions

cervical, thoracic, lumbar, sacral, coccygeal

3

Primary Spinal Curves

Sacral and Thoracic

4

Secondary Spinal Curves

Cervical and Lumbar

5

Movements of the Vertebral Column

Flexion, extension, lateral flexion, and rotation

6

How many curvatures are in the adult vertebral column?

4

7

What is Kyphosis?

anteriorly concave curvatures in the vertebral column

8

What is lordoses?

anteriourly convex curvatures in the vertebral column

9

When does the cervical curvature become pronounced?

at three months when an infant is able to hold its head erect

10

When does the Lumbar curvature become apparent?

When the toddler tries to stand at the age of 9-10 months

11

body of a vertebrae

connects posteriorly with two vertebral arches

12

Vertebral foramen

formed by the fusing together of the two V.arches, contains the spinal cord, meninges, roots, vessels, and other tissue

13

Spinous Process

extends posteriorly from the point of fusion of the two V. arches

14

Pedicle

adjascent part of the body of the vertebra

15

Lamina

Continues posteriorly from the pedicle

16

Vertebral arches

made of up of the Pedicle and the Lamina

17

Transverse Process

a bony extension on each one of the vertebral arches

18

Superior Articular Process

found at the junction of the pedicle and lamina, on each side, projecting UPWARD

19

Inferior Articular process

found at the junction of the pedicle and lamina, on each side, projecting DOWNWARD

20

facet

Found on each articular process, it is an aticular surface made of hyaline cartilage, and is the site of articulation b/t the vertebrae

21

Vertebral notch

found b/t the articular process and the vertebral body, the bone has an indentation or depression

22

Vertebral foramen

formed from the articulation of the vertebral notches of vertebrae to vertebral column, and transmit nerve roots

23

Transverse Foramen

Transmit the vertebral artery on each side, develops as a result of incomplete fusion of the vertebral and costal elements of the transverse process of the cervical vertebrae during development

24

Vertebral Artery

originates from the subclavian arteries on each side, & provide the major blood supply to the spinal cord & brain stem, as well as partial blood supply to the brain

25

Cervical Vertebra

have smaller bodies
larger vertebral foramen
have transverse foramen
have bifid spinous processes

26

Atlas

C1
NO body
large vertebral foramen for DENS
NO spinous process

27

Axis

C2
Has an odontoid process
has an apex and two articular facets

28

What are the contents of the Verterbral Foramen?

the spinal cord and its surrounding meninges, nerve roots and spinal vessels, CSF (cerebral spinal fluid) and fat tissue

29

What are the different meningeal layers surrounding the spinal cord and the brain?

The meninges consist of three membranes, dura, pia, and arachnoid mater.

30

Meningeal membranes

Dura mater, Pia Mater, and arachnoid Mater

31

Dura Mater

outer layer of the meningeal membranes
Extends down to S2

32

Pia Mater

innnermost meningeal membrane, closely attached to the spinal cord
Extends to the Coccyx
Covers blood vessels

33

Arachnoid mater

middle meningeal membrane

34

denticulate ligaments

entension of pia mater from the surface of the spinal cord to the arachnoid mater, and supports the spinal cord in the vertebral canal, and separate the ventral and dorsal roots of the spinal nerves

35

contents of the IF (Intervetebral foramen)

DRG (dorsal root ganglion) on each side, and the spinal roots and vessels pass through the foramen

36

contents of the transverse foramen (only cervical vertebra have transverse foramen)

Verterbral artery, on each side, and veins
C7 TF- contains the accessory vertebral vessels

37

how do transverse processes develop?

asa result of incomplete fusion of the vertebral and costal elements of the transverse process of the cervical vertebrae during development

38

characteristics of cervical vertebrae

-smaller bodies, or no body (Atlas C1)
-larger vertebral foramen
-have transverse foramen
-have bifid spinous process

39

How many cervical nerves and how many cervical vertebrae are there?

There are 8 cervical nerves and 7 cervical vertebrae

40

special features of cervical vertebra 7

C7- has a vertebral prominence that we can feel when we bend out necks forward, the first protrusion on our necks
-anterior tubercle on transverse process is missing

41

contents of the I.F. (intervertebral Foramen)

-DRG- Dorsal root ganglion (at the sides of the foramen)
-The three menengial layers:
a. Dura Mater
b. Arachnoid Mater
c. Pia Mater
-The spinal Cord
-blood vessels

42

how many parts does the vertebral artery have?

3 parts

43

part one of the Vertebral artery

extends from the point of origin (at the subclavian artery) to the transverse foramen
insertion point is C6

44

Part two of the Vertebral artery

found ascending in the transverse foramina of the cervical vertebrae
c6-c1

45

Part three of the Vertebral Artery

turns medially on the posterior arch of the atlas and is found in the sub occipital triangle

46

Angle of the Spinous process of the Thoracic Verterbrae

Postinferior Slope

47

Distinguishing feature of the Thoracic vertebrae

body of the thoracic vertebrae have two costal facets that articulate with the head of the rib

48

Muscles that make up the sub occipital triangle

-rectus capitis posterior major
-oblique capitis superior
-oblique capitis inferior

49

Origin of the Spinal Cord

extends form the foramen magnum in the occipital lobe of the skull to L1 at the conus medullaris

50

Termination of the spinal cord

the spinal stops at the film terminale (the spinal cord roots), which insert into the coccyx

51

Swellings of the spinal cord

- at the cervical region -which innervates the upper limbs
-at the lumbar region- which innervates the lower limbs

52

epidural space

space between the vertebra and the dura mater- which contains adipose tissue

53

Subdural Space

space between the dura and arachnoid mater

54

Subarachnoid space

space between the arachnoid mater and the Pia mater, this space contains CSF

55

CSF (cerebral spinal Fluid)

Clear fluid produced in the ventricles (the Coroid Plexus) of the brain, contains almost NO blood cells.

56

indications of a hemorrhage

too much blood in the CSF-most easily seen during a lumbar puncture

57

Dorsal Root ganglion (DRG)

sensory only
made up of the dorsal root and the ventral root coming together
NOT inside the Intervertebral foramen

58

dorsal ramus

go towards the back and innervate the back muscles

59

Types of Anesthesia

Spinal Block
Caudal Epidural Anesthesia

60

Spinal Block

This kind of anesthesia will paralyze from iliac crest down. (anesthesia goes into the CSF)

61

Caudal (Epidural) Anesthesia

Administered through the sacral hiatus
will anesthetize up to S2, maximum S1 (hocks the pelvic nerves)
Will maintain motor ability
Usually only administered for labor and delivery

62

Intervertebral Discs (I.D.)

made up of two parts:
Anulous Fibrosus- tough, made of fibrocartilage
Nucleus Pulposus- inner part of the I.D. remnants of embryonic tissue (starlight cells)
make up 20-25% of vertebral height

63

Anencephaly

birth defect, where the babies are born without parts of the brain & skull, a type of neural tube defect. The upper part of the neural tube must close by the 24th day of conception, if not this results in the baby missing the forebrain, and the cerebellum (the thinking, and coordinating parts)

64

Prominense

the name for C7

65

Muscles of the Suboccipital Triangle

rectus capitis major
oblique capitis superior
oblique capitis inferior

66

Vertebral Basilar ischemia

temporary set of symptoms due to decreased blood flow in the posterior circulation of the brain.

67

Site of circulation for the dens to C1

Atlanto-occipital articulation

68

Where is the basilar artery found?

in the anterior aspect of the brain stem

69

inside the sub occipital triangle

the suboccipital cranial nerve
the 3rd part of the vertebral artery
C2 Sensory Nerve- Runs OVER the triangle

70

Cruciate ligament

keeps the dens from posterior displacement

71

Exit points of cranial nervers

the cranial nerves will exit ABOVE the corresponding vertebra
i.e. CN1 exits about C1 and below the occipital bone.

72

Characteristics of the Lumbar Vertebra

5 vertebra
mammallary process on the posterior surface of the superior articulating process
Spinous process extends in the sagittal direction

73

Characteristics of the Sacrum

located between the two hip bones
has a concave anterior
has a convex dorsal surface

74

Sacral promontory

anterior edge of the S1 vertebra

75

Sacral Canal

Exit point for the Cauda Equina and the surrounding meninges, to continue downward

76

Sacral hiatus

located in the lower part of the dorsal surface of the sacrum

77

Cornua

2 sacral horns, that flank the sacral hiatus

78

Characteristics of the Coccyx

4 rudamentary vertebrae that are fused together

79

Herniation of a disc

happens in the nucleus pulposus, and usually lateral and posterior

80

Characteristics of Thoracic Vertebrae

longer spinous processes
body of the vertebrae have articular facets that articulate with the ribs

81

Osteophytes

bony processes that appear superiorly on the articulating surfaces of the vertebrae, can cause pain and pinch nerves (osteoarthritis)

82

uncinate processes

a raised area on the body of vertebrae that over time can cause a crack on I.D.

83

Coccydynia

Pain in the coccyx

84

Endochondral ossification

Formation of bone via hyaline cartilage model

85

Intermembranous Ossification

Formation of bone from mesenchyme cells, from within the bone

86

When does ossification of the epiphyseal plate happen?

During puberty, once all growth is completed

87

Unconvertebral Joint

AKA Secondary joints-occur b/t the uncinate processes and the inferolateral surfaces of the vertebral bodies superior to them in the cervical region

88

Zygapophysial joints

articulations between the facets of the vertebral articular processes

89

atlanto occipital articulation

consist of the medial and lateral atlanto-axial articulations between the atlas and the axis

90

ALL- anterior longitudinal ligament

prevents hyperextension of the vertebral column, extends from atlas to sacrum

91

How many layers does the PLL- Posterior longitudinal ligament have?

2- Superficial and Deep

92

Superficial layer of PLL

continuation of the tectoral membrane originating from the foramen magnum in the skull, starts on the body of the axis

93

Deep layer of PLL

continuation of the cruciate ligament from the atlas & down to into the sacral canal

94

What does the PLL do?

prevents hyperextension of the VC
Helps protect agains Posterior disc herniation

95

Functions of the Ligamentum Flavum (active ligament)

Brings the VC back to an erect position

96

Location of the Ligamentum Flavum

Between the vertebral arches

97

loation of the Interspinous ligaments

b/t the spinous process of the vertebrae

98

location of the supraspinous ligaments

spinous process of the vertebrae

99

location of the intertransverse ligaments

b/t the transverse processes of the vertebrae

100

location of the ligamentum nuchae

originates from the occipital bone, extends to the spinous processes of the cervical vertebrae and become continuous with the supraspinous ligaments

101

Location of the Cruciate ligaments

formed by the superior and inferior longitudinal bands, and the transverse ligament of the atlas

102

Apical ligament of the dens

extends from the head of the odontoid process to the aneroid border of the foramen magnum

103

Alar ligaments

originate form both sides of the Odontoid process to the lateral borders of the foramen magnum