BACK Spinal cord and Nervous system. BACK UNIT OVERVIEW Spinal cord & Nervous system review Meninges...
Transcript of BACK Spinal cord and Nervous system. BACK UNIT OVERVIEW Spinal cord & Nervous system review Meninges...
BACK Spinal cord and Nervous system
BACK UNIT OVERVIEW
Spinal cord & Nervous system review
Meninges and CSF
Vasculature
Skeletal structures / joint surfaces
Ligamentous support
Musculature
BACK OBJECTIVES
Describe the gross anatomy for each system (circulatory, muscular, nervous, and skeletal) in the region of the back.
Integrate the systems to discuss the vertebral column functions.
Analyze common dysfunctions in the vertebral column.
For each muscle, describe how the attachment sites result in an action around a joint.
For each muscle, identify the innervation (peripheral nerve and nerve roots).
GENERAL SKELETAL STRUCTURE
Lordosis vs. KyphosisJoints – vertebral discs & zygapophysial jointsMovements
VERTEBRAL SPINE DEVELOPMENT
Size (height) of vertebrae
SPINAL CORD DEVELOPMENT
Spinal cord level vs. vertebral level
LUMBAR CISTERN
Filled with CSF
Begins at L2
Contains cauda equina & internal filum terminale
Site of epidural anesthetic
Subarachnoid Space
NERVOUS SYSTEM OVERVIEW Central nervous system
Peripheral nervous system
Dermatomes and myotomes
NERVOUS SYSTEM OVERVIEW CONT’D Dorsal (posterior) and ventral (anterior) rami (ramus)
Spinal nerve roots vs peripheral nerves
Plexi (plexus)
AUTONOMIC VS SOMATIC
Functional divisions
Autonomic and somatic nerves throughout CNS and PNS
SPINAL CORD MENINGES
Dura Mater
Arachnoid Mater
Pia Mater
Epidural, Subdural, Subarachnoid spaces
WHICH OF THE FOLLOWING IS INCORRECT PERTAINING TO THE LUMBAR CISTERN?
A. It contains CSF.
B. It contains the cauda equina.
C. It contains the internal filum terminale.
D. It typically begins in adults at L2.
E. It contains epidural fat.
It co
ntains C
SF.
It co
ntains t
he cau
da equina.
It co
ntains t
he inter
nal filum
t...
It typ
ically
begins i
n adults at
L2.
It co
ntains e
pidural fa
t.
0% 3%
95%
0%3%
THE C1 SPINAL CORD SEGMENT IS LINED UP WITH THE C1 VERTEBRA, EVEN THOUGH IT IS NOT LINED UP IN THE LUMBAR REGION.
A. TrueB. False
3%
98%
A. They all doB. They all do notC. They do above
C8D. They do below
C8 0%
100%
0%0%
THE SPINAL NERVES EXIT THE INTERVERTEBRAL FORAMEN BELOW THE CORRESPONDING NUMBERED VERTEBRA.
VASCULAR SUPPLY
Vertebrae
Back muscles
Spinal cord
BLOOD SUPPLY OF VERTEBRAE
WHICH OF THE FOLLOWING IS INCORRECT PERTAINING TO THE NEUROVASCULAR SUPPLY OF THE VERTEBRAL COLUMN?
A. The vertebral bodies are supplied exclusively by the anterior and posterior spinal arteries.
B. Venous drainage is to both internal (within the vertebral canal) and external venous plexuses.
C. Zygapophyseal joints are supplied by medial branches of posterior rami of spinal nerves.
D. Pain fibers from the ligamentum flavum are conveyed by (recurrent) meningeal branches of spinal nerves.
E. Proprioceptive fibers from the anterior longitudinal ligament are conveyed by (recurrent) meningeal branches of spinal nerves. Th
e vert
ebral
bodies ar
e suppli..
Venous d
rainage is
to both in
ter..
.
Zyga
pophyseal
joints are su
ppli..
Pain fibers
from
the lig
amentum...
Proprio
ceptive
fibers f
rom th
e ...
97%
3% 0%0%0%
SKELETAL STRUCTURES – THE BACKBONE Physiological properties
General vertebral shape
CERVICAL REGION
Intervertebral foramina
Uncus (uncinated processes)
Bifid spinous processes
Angles of zygapophysial joints
VERTEBRAL ARTERY
Travels up in transverse foramina
Loops over C1 in groove for vertebral artery
Merges ventral to Pons to form Basilar artery
Supplies brainstem, cerebellum, and posterior cerebrum
ATLAS AND AXIS
Atlantoaxial joint
INTERPRETING LATERAL VIEW CERVICAL RADIOGRAPHS
JEFFERSON (BURST) FRACTURE
HYPERFLEXION WITH HERNIATION Disc herniation – nucleus pulposis squeezed posteriorly
OTHER VERTEBRAL INJURIES
Hyperextension (whiplash)
Hangman’s fracture
RUPTURE OF TRANSVERSE LIGAMENT OF ATLAS
WHICH OF THE FOLLOWING IS INCORRECT PERTAINING TO THE VERTEBRAL ARTERY?
A. It traverses the transverse foramina of the cervical vertebrae.
B. If partially occluded, it can cause dizziness upon turning the head.
C. It traverses a groove on the posterior arch of the atlas.
D. It only has branches that supply the brain.
It tra
verses t
he tran
sver
se fo
ra...
If parti
ally o
ccluded, it
can ca
use...
It tra
verses a
groove
on the p
ost...
It only has
branch
es th
at su
pply t..
0%
100%
0%0%
IN THE FOLLOWING IMAGE OF A LATERAL RADIOGRAPH OF THE CERVICAL PART OF THE VERTEBRAL COLUMN, THE ARROW POINTS TO A FRACTURE OF THE:
A. pars interarticularis of the axis (hangman's fracture).
B. posterior arch of the atlas.
C. lamina of the atlas.
D. spinous process of C3.
E. occipital condyles.par
s inte
rarticu
laris
of the a
xis (..
.
posterio
r arch
of the atla
s.
lamina o
f the atla
s.
spinous p
roce
ss of C
3.
occipita
l condyle
s.
95%
0% 0%5%0%
LIGAMENTOUS SUPPORT OF ATLANTOAXIAL JOINT Ligaments to hold atlantoaxial joint together: Cruciate ligaments (superior band, transverse, inferior band) Alar ligaments aka apical ligament (dens to occiput) Zygapophyseal articular capsule Atlanto-axial membranes Tectorial membrane