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Questions and Answers
The vertebral column consists of a specific number of vertebrae and has distinct types based on their characteristics.
The vertebral column consists of a specific number of vertebrae and has distinct types based on their characteristics.
True
Intervertebral joints do not contain any tissues.
Intervertebral joints do not contain any tissues.
False
The gait cycle refers only to the act of running.
The gait cycle refers only to the act of running.
False
Herniated intervertebral discs have specific symptoms associated with them.
Herniated intervertebral discs have specific symptoms associated with them.
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The thoracolumbar fascia consists of multiple layers and is important for back muscle support.
The thoracolumbar fascia consists of multiple layers and is important for back muscle support.
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The vertebral column consists of 33 vertebrae, including both fused and unfused vertebrae.
The vertebral column consists of 33 vertebrae, including both fused and unfused vertebrae.
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Lordosis is characterized by an abnormal increase in the thoracic curvature.
Lordosis is characterized by an abnormal increase in the thoracic curvature.
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Kyphosis results from anterior rotation of the pelvis.
Kyphosis results from anterior rotation of the pelvis.
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The lumbar region contains large gaps between the laminae and spinous processes.
The lumbar region contains large gaps between the laminae and spinous processes.
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Scoliosis is a two-dimensional deformity of the spine.
Scoliosis is a two-dimensional deformity of the spine.
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The anterior longitudinal ligament helps limit the extension of the spine.
The anterior longitudinal ligament helps limit the extension of the spine.
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80% of scoliosis cases are classified as idiopathic.
80% of scoliosis cases are classified as idiopathic.
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The posterior longitudinal ligament helps limit hyperflexion of the spine.
The posterior longitudinal ligament helps limit hyperflexion of the spine.
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The intervertebral disc consists of an outer annulus fibrosus and an inner central nucleus pulposus.
The intervertebral disc consists of an outer annulus fibrosus and an inner central nucleus pulposus.
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The spinal cord extends from the foramen magnum to L1-L2 in adults.
The spinal cord extends from the foramen magnum to L1-L2 in adults.
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Ligamenta flava are located between the vertebral bodies.
Ligamenta flava are located between the vertebral bodies.
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Cervical joints slope inferiorly and allow for flexion and extension.
Cervical joints slope inferiorly and allow for flexion and extension.
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Herniated discs most commonly occur at the L1–L2 or L2–L3 levels.
Herniated discs most commonly occur at the L1–L2 or L2–L3 levels.
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The cauda equina consists of spinal nerves extending beyond the end of the spinal cord.
The cauda equina consists of spinal nerves extending beyond the end of the spinal cord.
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The annulus fibrosus serves as a coiled spring holding vertebrae together.
The annulus fibrosus serves as a coiled spring holding vertebrae together.
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Facet joints sustain about 50% of body weight in the spine.
Facet joints sustain about 50% of body weight in the spine.
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Aging causes the nucleus pulposus to become more hydrated and degenerate.
Aging causes the nucleus pulposus to become more hydrated and degenerate.
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The L5/S1 vertebral segment sustains the lowest contact force in the spine.
The L5/S1 vertebral segment sustains the lowest contact force in the spine.
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The sciatic stretch test involves pain radiating from the back down to the foot.
The sciatic stretch test involves pain radiating from the back down to the foot.
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Degenerative changes in the annulus fibrosus can lead to herniation of the nucleus pulposus.
Degenerative changes in the annulus fibrosus can lead to herniation of the nucleus pulposus.
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Approximately 98% of people recover from low back pain within one month.
Approximately 98% of people recover from low back pain within one month.
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Only 10% of back pain is attributed to herniated discs.
Only 10% of back pain is attributed to herniated discs.
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Spinal nerves C1-C7 emerge below their respective vertebrae.
Spinal nerves C1-C7 emerge below their respective vertebrae.
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Posterolateral herniation is most common in the thoracic region.
Posterolateral herniation is most common in the thoracic region.
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Cauda Equina Syndrome can lead to long-term complications such as incontinence and loss of lower limb function.
Cauda Equina Syndrome can lead to long-term complications such as incontinence and loss of lower limb function.
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The Levator scapulae originates from the lumbar spine and inserts on the scapula.
The Levator scapulae originates from the lumbar spine and inserts on the scapula.
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The Trapezius muscle is innervated by the thoracodorsal nerve.
The Trapezius muscle is innervated by the thoracodorsal nerve.
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Osteophyte formation is a result of abnormal loading of the facet joints.
Osteophyte formation is a result of abnormal loading of the facet joints.
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Bilateral lower limb weakness can be a symptom of Cauda Equina Syndrome.
Bilateral lower limb weakness can be a symptom of Cauda Equina Syndrome.
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The Rhomboid major muscle helps to extend and laterally rotate the humerus.
The Rhomboid major muscle helps to extend and laterally rotate the humerus.
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The thoracolumbar fascia covers the posterior surface of the deep muscles of the back.
The thoracolumbar fascia covers the posterior surface of the deep muscles of the back.
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The Erector spinae muscles are intrinsic muscles that maintain posture and control the spinal column.
The Erector spinae muscles are intrinsic muscles that maintain posture and control the spinal column.
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The vertebral column's normal curvature helps to distribute body weight effectively.
The vertebral column's normal curvature helps to distribute body weight effectively.
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Scoliosis is defined as a three-dimensional deformity of the spine.
Scoliosis is defined as a three-dimensional deformity of the spine.
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The intervertebral joints are primarily responsible for the stability of the vertebral column.
The intervertebral joints are primarily responsible for the stability of the vertebral column.
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Lordosis is characterized by an abnormal increase in the lumbar curvature.
Lordosis is characterized by an abnormal increase in the lumbar curvature.
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The thoracolumbar fascia is a single-layer structure providing support to the back muscles.
The thoracolumbar fascia is a single-layer structure providing support to the back muscles.
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The lumbar region's spine has overlapping laminae and spinous processes.
The lumbar region's spine has overlapping laminae and spinous processes.
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The vertebral column provides protection for the nervous system.
The vertebral column provides protection for the nervous system.
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Scoliosis affects only the coronal plane of the spine.
Scoliosis affects only the coronal plane of the spine.
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The anterior longitudinal ligament is narrow and primarily limits hyperflexion.
The anterior longitudinal ligament is narrow and primarily limits hyperflexion.
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Lordosis can cause an anterior rotation of the pelvis.
Lordosis can cause an anterior rotation of the pelvis.
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The vertebral column consists of 33 vertebrae with a mix of fused and unfused types.
The vertebral column consists of 33 vertebrae with a mix of fused and unfused types.
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Osteoporosis can lead to abnormalities in the vertebral column's curvature.
Osteoporosis can lead to abnormalities in the vertebral column's curvature.
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The intervertebral disc functions primarily to absorb compression.
The intervertebral disc functions primarily to absorb compression.
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The facet joints sustain approximately 40% of body weight in the spine.
The facet joints sustain approximately 40% of body weight in the spine.
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The Nucleus Pulposus and Annulus Fibrosis together allow the vertebrae to 'roll' during lateral bending.
The Nucleus Pulposus and Annulus Fibrosis together allow the vertebrae to 'roll' during lateral bending.
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Synovial joints between vertebrae enhance flexion and limit rotation.
Synovial joints between vertebrae enhance flexion and limit rotation.
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Degenerative changes in the spine primarily affect the nucleus pulposus.
Degenerative changes in the spine primarily affect the nucleus pulposus.
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The L5/S1 vertebral segment is known to sustain the highest contact force.
The L5/S1 vertebral segment is known to sustain the highest contact force.
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Annulus Fibrosis is involved in twisting motion and holds vertebrae together.
Annulus Fibrosis is involved in twisting motion and holds vertebrae together.
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Low back pain primarily emanates from herniated discs.
Low back pain primarily emanates from herniated discs.
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The spinal cord in adults extends from the foramen magnum to L3.
The spinal cord in adults extends from the foramen magnum to L3.
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A herniated disc can compress spinal nerves and lead to various symptoms.
A herniated disc can compress spinal nerves and lead to various symptoms.
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The cauda equina consists of spinal nerves that terminate at the coccyx.
The cauda equina consists of spinal nerves that terminate at the coccyx.
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Low back pain affects 60-80% of people throughout their lifetime.
Low back pain affects 60-80% of people throughout their lifetime.
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The pain radiating from the back down the front of the leg indicates L4 nerve root tension.
The pain radiating from the back down the front of the leg indicates L4 nerve root tension.
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The nucleus pulposus remains hydrated and intact as people age.
The nucleus pulposus remains hydrated and intact as people age.
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The L5/S1 level is where 95% of protrusions occur in herniated discs.
The L5/S1 level is where 95% of protrusions occur in herniated discs.
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Osteophyte formation is primarily caused by excessive loading of the intervertebral disks.
Osteophyte formation is primarily caused by excessive loading of the intervertebral disks.
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Incontinence can result from untreated Cauda Equina Syndrome.
Incontinence can result from untreated Cauda Equina Syndrome.
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The rhomboid muscles primarily function to elevate and retract the scapula.
The rhomboid muscles primarily function to elevate and retract the scapula.
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Levator scapulae originates from the thoracic spine and connects to the scapula.
Levator scapulae originates from the thoracic spine and connects to the scapula.
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Bilateral lower limb weakness is a potential symptom of Cauda Equina Syndrome.
Bilateral lower limb weakness is a potential symptom of Cauda Equina Syndrome.
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The thoracolumbar fascia covers the posterior surface of the quadratus lumborum muscle.
The thoracolumbar fascia covers the posterior surface of the quadratus lumborum muscle.
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Facet arthritis typically develops due to abnormal loading of the intervertebral disks.
Facet arthritis typically develops due to abnormal loading of the intervertebral disks.
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Superficial muscles of the back include the Latissimus dorsi, which extends and adducts the humerus.
Superficial muscles of the back include the Latissimus dorsi, which extends and adducts the humerus.
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The lumbar region of the vertebral column is characterized by small gaps between the laminae and spinous processes.
The lumbar region of the vertebral column is characterized by small gaps between the laminae and spinous processes.
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The thoracolumbar fascia comprises multiple layers that are integral for back muscle support.
The thoracolumbar fascia comprises multiple layers that are integral for back muscle support.
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The anterior longitudinal ligament is wide and primarily limits hyperextension of the spine.
The anterior longitudinal ligament is wide and primarily limits hyperextension of the spine.
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Herniated discs most commonly occur at the L3-L4 or L4-L5 levels in the lumbar region.
Herniated discs most commonly occur at the L3-L4 or L4-L5 levels in the lumbar region.
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The interspinous ligaments connect the tips of adjacent spinous processes.
The interspinous ligaments connect the tips of adjacent spinous processes.
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Facet joints transmit approximately 30% of axial compression in the spinal column.
Facet joints transmit approximately 30% of axial compression in the spinal column.
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The annulus fibrosus serves as a compressive element that provides the main support for vertebrae.
The annulus fibrosus serves as a compressive element that provides the main support for vertebrae.
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The cervical vertebrae allow for a significant amount of rotation compared to the lumbar region.
The cervical vertebrae allow for a significant amount of rotation compared to the lumbar region.
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The lumbar region of the spine is primarily designed for flexion and extension, with limited lateral movement.
The lumbar region of the spine is primarily designed for flexion and extension, with limited lateral movement.
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The intervertebral discs account for 70% of axial compression within the vertebral column.
The intervertebral discs account for 70% of axial compression within the vertebral column.
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The posterior longitudinal ligament runs from the skull to the thoracic spine.
The posterior longitudinal ligament runs from the skull to the thoracic spine.
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Degenerative changes in the annulus fibrosus can lead to increased hydration of the nucleus pulposus.
Degenerative changes in the annulus fibrosus can lead to increased hydration of the nucleus pulposus.
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Posterolateral herniation is most commonly seen in the cervical region.
Posterolateral herniation is most commonly seen in the cervical region.
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The nucleus pulposus becomes more hydrated with increasing age.
The nucleus pulposus becomes more hydrated with increasing age.
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The L2/L3/L4 nerve root tension indicates pain radiating down the back of the leg to the foot.
The L2/L3/L4 nerve root tension indicates pain radiating down the back of the leg to the foot.
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Older patients are more likely to experience nerve root compression due to increased ossification of the IV foramen.
Older patients are more likely to experience nerve root compression due to increased ossification of the IV foramen.
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The cauda equina consists solely of the spinal cord's nerve roots terminating at the sacrum.
The cauda equina consists solely of the spinal cord's nerve roots terminating at the sacrum.
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Lumbar nerve root tension tests are best performed with the patient in a prone position.
Lumbar nerve root tension tests are best performed with the patient in a prone position.
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The spinal cord in adults extends from the foramen magnum to the L2-L3 region.
The spinal cord in adults extends from the foramen magnum to the L2-L3 region.
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Lordosis is characterized by an abnormal increase in the thoracic curvature and often results in posterior rotation of the pelvis.
Lordosis is characterized by an abnormal increase in the thoracic curvature and often results in posterior rotation of the pelvis.
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The vertebral column primarily consists of 33 vertebrae arranged in distinct segments that are completely fused together.
The vertebral column primarily consists of 33 vertebrae arranged in distinct segments that are completely fused together.
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The laminae and spinous processes in the lumbar region are known to closely overlap, allowing minimal gaps.
The laminae and spinous processes in the lumbar region are known to closely overlap, allowing minimal gaps.
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Kyphosis is a condition that involves an abnormal increase in the cervical curvature of the spine.
Kyphosis is a condition that involves an abnormal increase in the cervical curvature of the spine.
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Scoliosis is primarily a two-dimensional deformity of the spine affecting mainly the sagittal plane.
Scoliosis is primarily a two-dimensional deformity of the spine affecting mainly the sagittal plane.
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The posterior longitudinal ligament is broad and is responsible for limiting extension in the vertebral column.
The posterior longitudinal ligament is broad and is responsible for limiting extension in the vertebral column.
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Treatment of idiopathic scoliosis is universally the same regardless of the age of onset or degree of curvature.
Treatment of idiopathic scoliosis is universally the same regardless of the age of onset or degree of curvature.
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The spinal column provides both structural support and protection for the central nervous system.
The spinal column provides both structural support and protection for the central nervous system.
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The thickening of the ligamentum flavum is a consequence of abnormal loading of the facet joints.
The thickening of the ligamentum flavum is a consequence of abnormal loading of the facet joints.
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Incontinence is a rare symptom related to Cauda Equina Syndrome.
Incontinence is a rare symptom related to Cauda Equina Syndrome.
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The Rhomboid minor muscle is primarily responsible for extending the humerus.
The Rhomboid minor muscle is primarily responsible for extending the humerus.
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Osteophyte formation, also known as heterotopic bone growth, can occur alongside facet arthritis.
Osteophyte formation, also known as heterotopic bone growth, can occur alongside facet arthritis.
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The functions of the deep muscles of the back include maintaining posture and controlling the spine.
The functions of the deep muscles of the back include maintaining posture and controlling the spine.
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Trauma is one of the causes of Cauda Equina Syndrome.
Trauma is one of the causes of Cauda Equina Syndrome.
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The superficial muscles of the back primarily function to support the spine's stability.
The superficial muscles of the back primarily function to support the spine's stability.
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The quadratus lumborum muscle is covered by the thoracolumbar fascia.
The quadratus lumborum muscle is covered by the thoracolumbar fascia.
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Study Notes
Weight-bearing, the Back & Locomotion
- This lecture covers the anatomy, function and movement of the vertebral column.
- Learning outcomes include understanding vertebral column anatomy, curvature, typical vertebrae, ligaments, intervertebral joints, thoracolumbar fascia, back muscle layers, gait cycle, gait abnormalities, and herniated intervertebral disc anatomy and symptoms.
Recommended Reading
- The recommended reading materials include several anatomy texts:
- McMinn & Abrahams' Clinical Atlas of Human Anatomy
- Gray's Anatomy for Students
- Essential Clinical Anatomy
- Atlas of Human Anatomy
- Gray's Surface Anatomy and Ultrasound
Back
- The back is the posterior aspect of the body and includes the vertebrae, ribs, skull base, and pelvis.
- Functions of the back include supporting the body weight, carrying and positioning the head, maneuvering the upper limb, and protecting the nervous system with movement as well.
Vertebrae
- There are 33 vertebrae:
- 7 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral (fused)
- 3-4 coccygeal (often fused)
Anatomy of the Vertebral Column
-
Curves: The vertebral column has both convex (kyphosis) and concave (lordosis) curves.
- Thoracic and sacral regions are convex (kyphosis).
- Cervical and lumbar regions are concave (lordosis).
- Lumbar region has large gaps in the overlapping laminae and spinous processes.
-
Abnormalities:
- Excess lordosis or kyphosis
- Scoliosis
Abnormal Curvature
- Results from developmental or pathological processes (e.g., osteoporosis).
- Lordosis: Abnormal increase in lumbar curvature resulting from anterior rotation of the pelvis.
- Kyphosis: Abnormal increase in thoracic curvature.
Scoliosis
- A three-dimensional deformity of the spine affecting the coronal (frontal plane), sagittal (vertical plane), and axial planes.
- 80% of cases are idiopathic (no known cause). Treatment depends upon age of onset and severity of curvature.
Ligaments of the Vertebral Column
- Include the anterior longitudinal ligament (broad, supports the intervertebral discs, limits extension)
- Posterior longitudinal ligament (narrow, limits hyperflexion and posterior herniation)
- Ligamenta flava (between laminae)
- Supraspinous (triangular sheet between skull and C7)
- Interspinous (between spinous processes)
Joints Between Vertebrae
- Symphyses: Composed of layers of hyaline cartilage and an intervertebral disc.
- Intervertebral disc: Contains outer annulus fibrosus (fibrocartilage ring) and the inner nucleus pulposus(gelatinous).
- Synovial (zygapophysial joints): The joints between articular processes, allowing for flexion, extension, and rotation in different areas of the spine.
The Motion Segment
- The functional unit of the spine, consisting of two adjacent vertebrae and the intervertebral disc.
- Two facets and capsule which connect ligaments.
- Nucleus pulposus functions like a ball-bearing, allowing flexing and extension of vertebrae.
- Annulus fibrosus functions as a coiled spring, holding vertebrae together.
- Normal range of movement can change with age. Degenerative changes in the annulus fibrosus can lead to herniation of the nucleus pulposus.
Distribution of Weight
- Vertebral bodies and intervertebral discs transmit approximately 70% and 30% of the axial compression, respectively.
- L5-S1 sustains the highest direct contact force.
Back Pain
- A significant health problem.
- Can originate from fibroskeletal structures, meninges, synovial joints, muscles, or nervous tissue.
- Common causes include bulging/ruptured discs, spine osteoarthritis, spinal stenosis, osteoporosis, muscle strain/sprain, stress fractures, and sciatica.
Spinal Nerves
- Spinal cord extends from foramen magnum to L1-L2 in adults.
- Nerves extend beyond the end of the spinal cord as the cauda equina
- Spinal nerves (C1-C7) emerge above their vertebrae, and (C8 and below) emerge below their respective vertebrae.
Herniated Disc
- Herniation occurs when the gelatinous nucleus pulposus protrudes through the annulus fibrosus.
- Can compress the spinal cord or nerves, often occurring in L4-L5 or L5-S1 regions.
- More likely to compress nerves in older individuals due to ossification in foramina.
- Specific herniation locations have corresponding presentations, e.g., L3/L4 herniation presents with anterior thigh pain and weak quadriceps.
Stretch Tests
- Sciatic: Pain down the back of the leg, increased with dorsiflexion of the ankle (L4/5/S1 nerve root tension)
- Femoral: Pain from the back down the front of the leg to the knee (L2/L3/L4 nerve root tension).
Aging and the Spine
- With advancing age, the normally gelatinous nucleus pulposus dehydrates and degenerates.
- This leads to a progressive loss of height in the intervertebral discs causing abnormal loading of the facet joints.
Cauda Equina Syndrome
- Caused by various issues, including midline herniations, trauma, tumors, haematoma.
- Symptoms include bilateral lower limb weakness, numbness (perianal), impairment of bowel/bladder, and sexual function.
- Urgent surgical referral is essential for immediate treatment to prevent long-term complications.
Superficial Muscles of the Back
- Includes the Trapezius (movement of scapula), the Latissimus dorsi (humerus movement), and the Rhomboid muscles (scapula movement)
Deep Muscles of the Back
- Includes the Transversospinal muscles and Splenius muscles.
- Functions in posture and control of spinal column
Movements of the Back
- Include extension, flexion, lateral bending, and rotation of the head, neck, trunk, and upper body.
Thoracolumbar Fascia
- Covers deep back and trunk muscles, including quadratus lumborum.
- Attaches to transverse processes, iliac crest, and rib 12.
Gait-walking
- Locomotion is a complex process with distinct swing and stance phases, cyclical.
Gait-running
- Does not have a double support phase. It has alternating single-support periods separated by a double float/flight phase.
Gait Analysis
- Useful for initial diagnosis of gait abnormalities associated with various conditions (Hemiplegic, antalgic, Trendelenburg, high-stepping, festination).
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Description
This quiz covers essential concepts related to the vertebral column, including its structure, types of vertebrae, and common conditions such as lordosis, kyphosis, and scoliosis. Test your knowledge on intervertebral discs, spinal ligaments, and the gait cycle. Perfect for students studying anatomy or related healthcare fields.
