Human Anatomy: Vertebral Column and Spinal Cord

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Questions and Answers

What is the primary function of the vertebrae?

  • To facilitate muscle movement at the joints.
  • To form the facet joints and allow for articulation.
  • To protect the spinal cord within the vertebral canal.
  • To provide the body's musculoskeletal axis and connect different parts. (correct)

Which of the following describes the organization of the vertebral column?

  • 12 Cervical, 7 Thoracic, 5 Lumbar, 5 Sacral, 4 Coccygeal
  • 7 Cervical, 12 Thoracic, 5 Lumbar, 5 Sacral, 4 Coccygeal (correct)
  • 7 Cervical, 12 Thoracic, 5 Lumbar, 4 Sacral, 5 Coccygeal
  • 5 Cervical, 12 Thoracic, 7 Lumbar, 5 Sacral, 4 Coccygeal

What is the main function of the spinal cord within the vertebral canal?

  • To be protected by the vertebral column. (correct)
  • To act as the main musculoskeletal axis.
  • To form the primary curvatures of the spine.
  • To provide the main source of movement using muscles.

Where are spinous processes located on a vertebra?

<p>Posteriorly (C)</p> Signup and view all the answers

Which joint exhibits the greatest range of mobility?

<p>Shoulder Joint (D)</p> Signup and view all the answers

What is the name of the procedure involves breaking the lamina to provide space for the spinal cord and nerves?

<p>Laminectomy (B)</p> Signup and view all the answers

Which of the following describes primary spinal curvatures?

<p>Concave anteriorly and are present at birth (A)</p> Signup and view all the answers

What forms the facet joint?

<p>Superior and inferior articular processes (C)</p> Signup and view all the answers

What structure carries preganglionic fibers from the spinal nerve to the sympathetic ganglion?

<p>White ramus (D)</p> Signup and view all the answers

In which space is the cerebrospinal fluid (CSF) primarily located?

<p>Subarachnoid space (D)</p> Signup and view all the answers

Which meningeal layer is characterized by its avascular nature?

<p>Arachnoid mater (C)</p> Signup and view all the answers

A patient with a spinal nerve impingement is experiencing weakness in plantarflexion and reduced Achilles reflex. Which spinal nerve is MOST likely affected?

<p>S1 (B)</p> Signup and view all the answers

Damage to the nerve supply of which muscle would MOST directly impair the elevation of the acromion?

<p>Trapezius (A)</p> Signup and view all the answers

If an intervertebral disc herniation occurs between L4 and L5, which spinal nerve will be MOST directly affected?

<p>L5 (D)</p> Signup and view all the answers

Which of the following best describes the function of the rhomboid muscles?

<p>Adduction of the scapula (B)</p> Signup and view all the answers

Which spinal nerve primarily innervates the skin around the umbilical region?

<p>T10 (D)</p> Signup and view all the answers

Which of the following is NOT TRUE about the dorsal rami?

<p>They have action on the vertebral column (D)</p> Signup and view all the answers

What is the function of the trapezius muscle, when looking at the scapula??

<p>Retract the scapula (D)</p> Signup and view all the answers

Which muscle is primarily responsible for the retraction of the scapula?

<p>Rhomboid major (B)</p> Signup and view all the answers

The latissimus dorsi is responsible for all of the following actions EXCEPT:

<p>Abduction (A)</p> Signup and view all the answers

Which nerve innervates the rhomboid muscles?

<p>Dorsal scapular nerve (A)</p> Signup and view all the answers

The suboccipital triangle's floor is composed of:

<p>The first cervical vertebra (C1) (C)</p> Signup and view all the answers

A fracture of the midshaft of the humerus may endanger which nerve?

<p>Radial nerve (D)</p> Signup and view all the answers

The acromion process articulates with which bone?

<p>Clavicle (D)</p> Signup and view all the answers

Which of the following best describes the location of the conus medullaris?

<p>Between the L1 and L2 vertebrae (B)</p> Signup and view all the answers

Spinal nerves exit the vertebral column through the:

<p>Intervertebral foramina (A)</p> Signup and view all the answers

In a typical individual, the spinal cord ends at which vertebral level?

<p>L2 (C)</p> Signup and view all the answers

Which of the following root(s) is purely motor?

<p>Ventral root (C)</p> Signup and view all the answers

A spinal nerve that innervates the skin is most closely associated with:

<p>Dorsal root ganglion (C)</p> Signup and view all the answers

Where are the nerve cell bodies for the sympathetic nervous chain found?

<p>Thoracic and lumbar levels (C)</p> Signup and view all the answers

Which is the common location for a disc protrusion that can affect the spinal cord?

<p>C4-C5 (A)</p> Signup and view all the answers

Which of the following best describes the unique anatomical feature of the atlas (C1) vertebra?

<p>It lacks a vertebral body and has a ring-like structure. (D)</p> Signup and view all the answers

A white ramus carries what type of information?

<p>Preganglionic sympathetic (C)</p> Signup and view all the answers

What is the primary function of the odontoid process (dens) of the axis (C2) vertebra?

<p>To provide a pivot point for rotation of the atlas. (D)</p> Signup and view all the answers

Which characteristic is unique to thoracic vertebrae?

<p>They have coastal facets for rib articulation. (D)</p> Signup and view all the answers

Which of the following statements is correct regarding the relationship between cervical spinal nerves and vertebrae?

<p>Cervical spinal nerves emerge one vertebra above their corresponding vertebrae. (C)</p> Signup and view all the answers

What is the primary function of the mammillary process found on lumbar vertebrae?

<p>To provide attachment points for deep intrinsic back muscles. (B)</p> Signup and view all the answers

What anatomical structure is formed by the fusion of the spinous processes of the sacral vertebrae?

<p>The median sacral crest. (B)</p> Signup and view all the answers

Between which two vertebral structures are there no intervertebral discs?

<p>C1 and C2. (C)</p> Signup and view all the answers

Which component of an intervertebral disc is most likely to herniate?

<p>The nucleus pulposus. (D)</p> Signup and view all the answers

What is the function of the transverse ligament in the cervical region?

<p>To hold the dens against the anterior arch of the atlas. (B)</p> Signup and view all the answers

What feature distinguishes veins from arteries in terms of blood flow and pressure?

<p>Veins have valves to ensure unidirectional blood flow. (C)</p> Signup and view all the answers

What is the significance of Batson’s plexus of veins in the vertebral column?

<p>They can serve as a pathway for tumor metastasis. (B)</p> Signup and view all the answers

What is the primary function of the deep fascia in the back region?

<p>To allow for movement of the muscles. (C)</p> Signup and view all the answers

Damage to which nerve would most likely result in a winged scapula?

<p>Long thoracic nerve (B)</p> Signup and view all the answers

Which of the following is an example of an extrinsic muscle of the back?

<p>Latissimus dorsi. (B)</p> Signup and view all the answers

Which of the following actions is NOT a function of the trapezius muscle?

<p>Downward rotation of the scapula (B)</p> Signup and view all the answers

A patient presents with weakness in neck flexion and scapular retraction. Injury to which nerve is most likely?

<p>Spinal accessory nerve (D)</p> Signup and view all the answers

If the L4/L5 disc is herniated, which spinal nerve roots would be compressed?

<p>L5 (A)</p> Signup and view all the answers

An injury to the dorsal scapular nerve would directly impact which of the following muscle groups?

<p>Rhomboids and levator scapulae (D)</p> Signup and view all the answers

Damage to muscles innervated by posterior rami of T3-T6 would result in weakness of?

<p>Longissimus thoracic (B)</p> Signup and view all the answers

What is the most likely consequence of a C5 spinal nerve compression?

<p>Inability to retract and elevate the scapula (D)</p> Signup and view all the answers

What is the function of the rhomboid muscles?

<p>They retract the scapula (B)</p> Signup and view all the answers

Which ligament is also known as the ligamentum nuchae?

<p>Supraspinous ligament (B)</p> Signup and view all the answers

Which of the following describes the motion primarily facilitated by the atlantoaxial joint?

<p>Rotation of the head (C)</p> Signup and view all the answers

What is the primary action of the latissimus dorsi muscle when it contracts?

<p>Adduction, internal rotation, and extension of the arm (A)</p> Signup and view all the answers

Spondylolisthesis is best described as:

<p>Anterior displacement of a vertebra. (D)</p> Signup and view all the answers

A patient experiences unilateral lower back pain and is found to have a fracture at L5-S1. This condition is best described as?

<p>Spondylolysis (C)</p> Signup and view all the answers

Which of the following best describes the typical movement capabilities of the lumbar vertebrae?

<p>Flexion, extension, and lateral bending (B)</p> Signup and view all the answers

What is the last anatomical structure a lumbar puncture needle passes through before entering the spinal canal?

<p>Ligamentum flavum (C)</p> Signup and view all the answers

What is the primary action of the longus cervicis muscles?

<p>Flexion of the neck (C)</p> Signup and view all the answers

Klippel-Feil syndrome is characterized by:

<p>An abnormal fusion of cervical vertebrae (B)</p> Signup and view all the answers

The semispinalis cervicis muscle is most involved in which of the following actions?

<p>Extension of the head and neck (B)</p> Signup and view all the answers

Flashcards

Vertebral Column

The vertebral column, made up of stacked vertebrae, is the central axis of the musculoskeletal system. It connects the skull to the pelvis and provides support for the body.

Vertebral Canal

The space within the vertebral column that encloses and protects the spinal cord.

Joints in the Vertebral Column

The junction where two or more bones meet, allowing for movement. In the vertebral column, joints facilitate movement between vertebrae.

Primary Spine Curvatures

The primary curvature of the spine, present at birth, includes the thoracic and sacral curves. They are concave anteriorly, forming a gentle C-shape.

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Secondary Spine Curvatures

The secondary curvature of the spine, developing after birth, includes the cervical and lumbar curves. They are concave posteriorly, forming a gentle S-shape.

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Spinous Process

The bony projection that extends posteriorly from the vertebral arch. It is a characteristic feature of vertebrae.

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Vertebral Body

The primary body of the vertebrae, located anteriorly. It is the weight-bearing portion and increases in size as you move down the vertebral column.

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Vertebral Arch

The bony arch that surrounds the vertebral foramen, protecting the spinal cord. It is formed by the laminae, pedicles, and transverse processes.

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Atlas (C1)

The first cervical vertebra (C1), known for its ring-like shape and lack of a vertebral body, allowing for the skull to sit on top.

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Axis (C2)

The second cervical vertebra (C2), known for its strong structure and the presence of the odontoid process (dens), which allows for rotation of the head.

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Atlantoaxial Joint

The articulation between the atlas (C1) and the axis (C2) that allows for head rotation. The dens of the axis articulates with the anterior arch of the atlas.

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Symphysis

A specialized articulation between vertebrae that allows for limited movement, typically found in the spine to provide stability and support.

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Annulus Fibrosis

The tough outer layer of an intervertebral disc, composed of fibrous cartilage, which helps to contain the inner nucleus pulposus.

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Nucleus Pulposus

The soft, jelly-like center of an intervertebral disc, providing cushioning between vertebrae.

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Herniated Disc

A condition that occurs when the nucleus pulposus pushes through the annulus fibrosis, causing pain and potential nerve compression.

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Internal Vertebral Venous Plexus

The group of veins that drain blood from within the vertebral canal, including the epidural space and surrounding structures.

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Batson's Plexus

A unique characteristic of the internal vertebral venous plexus; these veins lack valves, meaning blood can flow in both directions.

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Deep Fascia

The outer layer of connective tissue that surrounds and supports muscles.

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Intrinsic Back Muscles

Muscles that act primarily on the vertebral column, responsible for movements like extension, flexion, and rotation.

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Extrinsic Back Muscles

Muscles that have their origin outside the vertebral column and insert on the upper limbs, scapula, or ribs.

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Scoliosis

A condition characterized by an abnormal lateral curvature of the spine, often affecting the thoracic and lumbar regions.

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Lumbar Disc Herniation

A condition where the nucleus pulposus pushes out of the annulus fibrosis, often compressing nerve roots and causing radiating pain.

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L5 Spinal Nerve Root

The spinal nerve root that exits between the L4 and L5 vertebrae. This root is often affected by L4/L5 disc herniations.

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Retraction (Scapula)

The muscle responsible for bringing the scapula closer to the spine.

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Upper Trapezius

The muscle that elevates the scapula, or shoulder blade.

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Lower Trapezius

The muscle that depresses the scapula, or shoulder blade.

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Rhomboid Major & Minor

Powerful muscles responsible for retracting the scapula.

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Serratus Posterior Superior

The muscle that elevates the ribs during inspiration.

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Serratus Posterior Inferior

The muscle that depresses the ribs during exhalation.

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Latissimus Dorsi

A large muscle that extends, internally rotates, and adducts the arm.

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Erector Spinae

A group of muscles that extend the vertebral column.

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Dorsal Scapular Nerve

The nerve that supplies the rhomboid major and minor muscles.

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Suboccipital Triangle

A triangular space in the neck containing important structures like the vertebral artery and nerve.

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Subscapular Fossa

The large depression on the anterior surface of the scapula.

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Suprascapular Notch

The notch on the superior border of the scapula, where the suprascapular nerve and vessels pass.

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Glenohumeral Joint

The joint formed by the articulation of the glenoid fossa of the scapula and the head of the humerus.

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Intertubercular Sulcus

A groove on the humerus that separates the greater and lesser tubercles.

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Surgical Neck of the Humerus

A common site of fracture in the humerus.

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Subdural space

A space between the dura mater and arachnoid mater, potentially filled with fluid during an infection.

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Dura mater

The outermost layer of the meninges, a tough and fibrous membrane that surrounds the spinal cord and brain.

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Spinal nerve

Containing both sensory and motor information, it is a mixed nerve responsible for connecting the CNS to muscles and receptors.

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Cauda equina

The region where the spinal nerves from the lumbar and sacral regions emerge from the spinal cord, forming a 'horse's tail' appearance.

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Pia mater

The innermost layer of the meninges, directly adhering to the surface of the brain and spinal cord.

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Subarachnoid space

A space between the arachnoid mater and pia mater, filled with cerebrospinal fluid (CSF)

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Dorsal root

The portion of a spinal nerve that emerges from the spinal cord and carries sensory information to the CNS.

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Ventral root

The portion of a spinal nerve that emerges from the spinal cord and carries motor commands from the CNS to muscles.

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Intervertebral disc herniation

A condition where a portion of an intervertebral disc protrudes, compressing nearby spinal nerves and causing pain, numbness, and weakness.

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Dermatome

The spinal nerve root that innervates the skin of a specific body region.

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Spinal Bifida Occulta

A condition where the vertebral arch fails to fully fuse, typically with no visible external signs.

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Radiating Back Pain

A type of back pain that radiates down the leg, often associated with a herniated disc in the lumbar region.

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Hyperextension Injury

The backward bending or extension of the spine, specifically in the cervical region.

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Long Thoracic Nerve Injury

A condition causing a 'winged' appearance of the scapula due to weakness of the serratus anterior muscle. This muscle is responsible for anchoring the scapula to the rib cage.

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Thoracodorsal Nerve

The nerve that supplies the latissimus dorsi. Damage to this nerve affects many arm movements such as elevation, medial rotation, and adduction at the shoulder.

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Spondylolisthesis

A condition where one vertebra slips forward onto the one below it, often between L4 and L5. This can cause pain and instability in the lower back.

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Spondylitis

Inflammation of the spine. This can cause stiffness and pain, and can sometimes lead to fusion of the vertebrae.

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Spondylolysis

A fracture of the L5-S1 vertebrae, often caused by repetitive activities like jumping. It causes unilateral lower back pain.

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Hyperlordosis

An exaggerated outward curve of the spine in the lumbar region.

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Kyphosis

An exaggerated inward curve of the spine in the thoracic and sacral regions.

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Klippel-Feil syndrome

An abnormal fusion of two or more cervical vertebrae, leading to neck shortening and limited movement.

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Lumbosacral Junction

The point where the lumbar region connects to the sacrum. It plays a key role in transferring weight from the spine to the pelvis.

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Study Notes

Vertebral Column Anatomy and Function

  • The vertebral column forms the musculoskeletal axis of the back, connecting the skull and pelvis to other body parts.
  • It houses the spinal cord and protects it. There are 33 vertebrae in total: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal (fused).
  • Movements occur at joints, facilitated by muscles. The shoulder and hip joints are the most mobile, due to ball-and-socket joint structure.
  • Vertebrae size increases caudally (toward the tail) to accommodate increasing weight-bearing forces.
  • The vertebral column has primary and secondary curvatures. Primary curvatures (thoracic and sacral) are present at birth and are concave anteriorly. Secondary curvatures (cervical and lumbar) develop later in life and are concave posteriorly/convex anteriorly, allowing for head and postural support.
  • Spinous processes are located posteriorly; vertebral bodies are situated anteriorly.
  • Intervertebral disk protrusions can cause pressure on nerves which is relieved by procedures like laminectomy to remove part of a vertebra and to make room for the spinal cord and nerve.
  • Vertebral foramina house the spinal cord. Lamina lies between transverse and spinous processes; pedicle connects the body and transverse process.
  • Superior and inferior articular processes form facet (zygoepiphyseal) joints.

Cervical Vertebrae (C1-C7)

  • Cervical vertebrae are smaller and have larger foramina than other types.
  • C1 (atlas) lacks a vertebral body and its ring-like shape is important for head movements.
  • C2 (axis) is crucial for head rotation and has a dens (odontoid process) for atlantoaxial joint movement.
  • The transverse foramina allow for the passage of the vertebral artery and vein, crucial for the brain’s blood supply.

Thoracic Vertebrae (T1-T12)

  • Thoracic vertebrae have a heart shape and two costal facets for rib attachment.
  • Each thoracic vertebra has two coastal facets (costal fossa) located on the transverse process and vertebral body.

Lumbar Vertebrae (L1-L5)

  • Lumbar vertebrae have large, robust vertebral bodies to handle immense weight.
  • Mammillary and accessory processes provide attachment for deep, intrinsic back muscles.

Sacrum (S1-S5)

  • Five sacral vertebrae fuse to form a single sacrum.
  • The fusion of sacral vertebrae forms the sacral crest: median sacral crest formed by fused spinous processes; intermediate sacral crest by fused auricular processes (superior part of the surface of each sacral bone); lateral by fused transverse processes.
  • Sacral foramina allow the passage of sacral nerves.
  • The sacral cornu are crucial for administering caudal anesthesia.
  • Epidural anesthesia is given in the epidural space.

Intervertebral Disks

  • Intervertebral discs are fibrocartilaginous pads between adjacent vertebrae.
  • Annuli fibrosus (outer rings of fibrocartilage) and nucleus pulposus (inner gelatinous center) form the disks.
  • Herniation can occur via posterolateral protrusion, resulting from annulus fibrosis tear.
  • There are no discs between C1 and C2 or between C1 and the skull, or in the coccyx.
  • Spinal ligaments act by limiting joint movements and protecting the joints.

Vertebral Ligaments (Specific Examples)

  • Transverse ligament: holds dens against C1 arch and injury to it would impact spinal cord.

Vertebral Veins and Drainage

  • Veins have valves for unidirectional blood flow to the heart and lungs.
  • Batson's plexus is part of the vertebral venous system, but without valves. Its lack of valves can allow tumor metastasis to various parts of the body.
  • Infections of internal vertebral plexus can affect meninges.

Back Muscles (Extrinsic and Intrinsic)

  • Extrinsic muscles (e.g., trapezius, latissimus dorsi) have actions outside the vertebral column.
  • Intrinsic muscles (transversospinalis, spinalis, longissimus, iliocostalis) act on vertebrae.

Nerve Roots and Spinal Nerves

  • Spinal nerves are mixed nerves (carry motor, sensory, and autonomic signals).
  • The nerve rootlets combine to form a dorsal root (sensory) and ventral root (motor). With the combination of sympathetic nervous system, these become a mixed spinal nerve.
  • Spinal nerves exit through the intervertebral foramina.

Spinal Cord

  • The spinal cord extends from the foramen magnum to the conus medullaris (L1-L2).
  • Lumbar and sacral spinal nerves extend beyond the cord to form the cauda equina.
  • Spinal nerves' emergence location differs from vertebral location with cervical nerves emerging above the corresponding vertebrae, thoracic/lumbar below.
  • Spinal segments and nerves are related to spinal nerves but not necessarily to vertebral levels.

Vertebral Column Injuries and Disorders

  • Common injuries occur to the cervical region or at the lumbosacral junction.
  • Herniation of intervertebral discs is common in the lumbar region.
  • Scoliosis, hyperlordosis, and kyphosis are examples of spinal deformities.

Additional Information

  • Dermatomes describe areas of skin innervated by specific spinal nerves. (e.g. C5, T4, T10, L4-S1, S1-S4)
  • Spinal cord injuries above C5 will not affect nerves below C5.
  • Lumbar puncture placement is critical.

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