Back muscles, vertebral column, spinal cord, and nerve roots
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Questions and Answers

What is the area of skin innervated by a single spinal nerve called?

  • Tract
  • Axon
  • Dermatome (correct)
  • Ganglion

    • Where is a collection of cell bodies in the CNS located?

  • Nucleus (correct)
  • Tract
  • Dermatome
  • Ganglion

    • What is the primary function of the anterior spinal artery in the spinal cord?

  • To innervate the skin
  • To supply white matter
  • To transmit sensory information
  • To supply gray matter (correct)

    • Which artery communicates with the anterior spinal artery at specific levels only?

    <p>Anterior segmental medullary artery</p> Signup and view all the answers

    What is the term for a collection of cell bodies in the PNS?

    <p>Ganglion</p> Signup and view all the answers

    In the cross-sectional view of the spinal cord, what are the two distinct areas visible?

    <p>Gray matter and white matter</p> Signup and view all the answers

    During a lumbar puncture, where is cerebrospinal fluid withdrawn from?

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

    Which of the following best describes the blood supply to the spinal cord?

    <p>Branches of the vertebral arteries</p> Signup and view all the answers

    Flexion of the vertebral column during anesthesia administration widens gaps between the vertebrae. Which region is most preferred for this action?

    <p>Lumbar region</p> Signup and view all the answers

    Nerve cell bodies in the spinal cord are primarily found in which region?

    <p>Gray matter</p> Signup and view all the answers

    Which region of the spinal cord is the origin of the most important medullary artery (Adamkiewicz)?

    <p>T8-L2</p> Signup and view all the answers

    In anterior spinal artery syndrome, what structures are primarily damaged?

    <p>White matter of the spinal cord</p> Signup and view all the answers

    What does a segmental loss in a dermatome or myotome indicate?

    <p>Injury to a specific spinal nerve</p> Signup and view all the answers

    Where are the nerve cell bodies for sensory neurons located in the spinal cord?

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

    What is the key point about the venous drainage of the spinal cord?

    <p>It communicates both with venous sinuses of the brain and a venous plexus associated with the pelvis</p> Signup and view all the answers

    What happens in a 'level loss' of sensation or muscle strength?

    <p>Loss starts at a specific dermatome and progresses segmentally</p> Signup and view all the answers

    What radiographic image appearance is characteristic of a fracture of pars interarticularis?

    <p>A Scottie dog with a collar</p> Signup and view all the answers

    Which spinal condition can result from repeated stress to the spine?

    <p>Spondylolysis</p> Signup and view all the answers

    What is the defining feature of spondylolisthesis on radiographic imaging?

    <p>Decapitated dog representation</p> Signup and view all the answers

    What ligament is important for preventing hyperextension of the vertebral column?

    <p>Anterior longitudinal ligament</p> Signup and view all the answers

    Which structure limits flexion of the vertebral column?

    <p>Posterior longitudinal ligament</p> Signup and view all the answers

    From where is cerebrospinal fluid withdrawn during a lumbar puncture?

    <p>Between the L3 and L4 or L4 and L5 vertebrae</p> Signup and view all the answers

    What is the main difference between lumbar puncture and epidural anesthesia?

    <p>The anatomical layers penetrated</p> Signup and view all the answers

    In spondylolisthesis, what is the specific abnormality that occurs?

    <p>Anterior displacement of a vertebra over the one beneath it</p> Signup and view all the answers

    Which spinal cord segments are commonly affected in spondylolysis?

    <p>Lumbar</p> Signup and view all the answers

    During a lumbar puncture, where does the needle typically enter the spinal canal?

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

    What is the main function of dorsal roots in the spinal cord?

    <p>Carry sensory information towards the spinal cord</p> Signup and view all the answers

    Which term best describes the condition where the spinal cord is not in its normal position within the vertebral canal?

    <p>Tethered spinal cord</p> Signup and view all the answers

    What is the primary difference in the pattern of symptoms between a L5 disc herniation and a disc impinging on the S1 nerve root?

    <p>Weakness in L5 disc herniation, numbness in S1 nerve root impingement</p> Signup and view all the answers

    What is the main feature that distinguishes spondylolysis from spondylolisthesis? Spondylolysis is characterized by:

    <p>Presence of a stress fracture or defect in the pars interarticularis</p> Signup and view all the answers

    In which region of the vertebral column does flexion and extension predominate?

    <p>Lumbar region</p> Signup and view all the answers

    What is the primary purpose of a lumbar puncture procedure?

    <p>To withdraw cerebrospinal fluid</p> Signup and view all the answers

    Which term best describes a congenital defect or stress fracture of the lamina presenting with no slippage of adjacent articulating vertebrae?

    <p>Spondylolysis</p> Signup and view all the answers

    In which region of the vertebral column is rotation the primary movement?

    <p>Thoracic region</p> Signup and view all the answers

    Which layer of back muscles contains the true back muscles that stabilize or move the axial skeleton?

    <p>Deep layer</p> Signup and view all the answers

    Which back muscle is an exception to the general rule of being innervated by ventral rami of spinal nerves?

    <p>Trapezius</p> Signup and view all the answers

    In which category are back muscles classified based on their embryological derivation?

    <p>Embryological classification</p> Signup and view all the answers

    Which back muscle is part of the superficial layer and is primarily responsible for moving the upper extremity?

    <p>Latissimus dorsi</p> Signup and view all the answers

    What is the main function of the splenius group of muscles within the deep layer of the back muscles?

    <p>Extend and rotate the head</p> Signup and view all the answers

    Which group of muscles are considered the primary ones for extending the vertebral column?

    <p>Erector spinae group</p> Signup and view all the answers

    Which muscle group primarily provides stabilization of the vertebral column and proprioceptive feedback?

    <p>Transversospinal group</p> Signup and view all the answers

    Which nerves innervate the skin of the back according to the text?

    <p>Posterior rami</p> Signup and view all the answers

    What is the function of the erector spinae group of muscles in controlling flexion against gravity?

    <p>Control extension against gravity</p> Signup and view all the answers

    Which group of muscles in the deep layer of back muscles are responsible for small postural movements and stabilizing the vertebral column?

    <p>Transversospinal group</p> Signup and view all the answers

    Which ligament connects adjacent laminae and forms part of the posterior wall of the vertebral canal?

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

    What limits rotation by attaching the dens of the axis to the occipital bone?

    <p>Alar ligaments</p> Signup and view all the answers

    If the transverse ligament of the atlas is ruptured, what structure could dislocate posteriorly, potentially compressing or transecting the spinal cord?

    <p>Dens of the axis</p> Signup and view all the answers

    Which ligaments are covered posteriorly by the tectorial membrane as a continuation of the posterior longitudinal ligament?

    <p>Cruciate ligaments</p> Signup and view all the answers

    What is a possible consequence if the dens dislocates posteriorly due to a ruptured transverse ligament of the atlas?

    <p>Compression of spinal cord</p> Signup and view all the answers

    Which structure supports the weight of the head and attaches superiorly to the external occipital protuberance?

    <p>Ligamentum nuchae</p> Signup and view all the answers

    Which part of the intervertebral disc cushions axial loads in the vertebral column?

    <p>Nucleus pulposus</p> Signup and view all the answers

    In which region of the spine is there no disc between specific vertebrae?

    <p>Sacral</p> Signup and view all the answers

    Which structure connects the bony parts of the vertebral column and consists of an outer layer of fibrocartilage and a gelatinous core?

    <p>Intervertebral disc</p> Signup and view all the answers

    What type of joint exists between the vertebral bodies in the vertebral column?

    <p>Symphysis joint</p> Signup and view all the answers

    Where is the most common location for herniated discs to occur?

    <p>Between L4 and L5 vertebrae</p> Signup and view all the answers

    Which ligament is crucial for preventing hyperextension of the vertebral column?

    <p>Anterior longitudinal ligament</p> Signup and view all the answers

    Which nerve is most likely to be compressed by a herniated disc between L4 and L5 vertebrae?

    <p>L5 nerve root</p> Signup and view all the answers

    Where does the C8 nerve exit the vertebral column?

    <p>Superior to the T1 vertebra</p> Signup and view all the answers

    Which spinal nerves pass superior to their corresponding vertebrae?

    <p>Cervical spinal nerves</p> Signup and view all the answers

    What distinguishes a L5 disc herniation from a disc impinging on the S1 nerve root?

    <p>Pattern of pain, numbness, weakness, atrophy, and reflexes</p> Signup and view all the answers

    What is the defining feature of spondylolysis?

    <p>Stress fracture of the lamina</p> Signup and view all the answers

    Which ligament spans the tips of the spinous processes and acts as an attachment site for muscles and tendons in the back?

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

    What is the main function of dorsal roots in the spinal cord?

    <p>Contain sensory nerve cell bodies</p> Signup and view all the answers

    Where are nerve cell bodies for sensory neurons located in the spinal cord?

    <p>Dorsal root ganglia</p> Signup and view all the answers

    What is the term for the area of skin innervated by a single spinal nerve?

    <p>Dermatome</p> Signup and view all the answers

    Study Notes

    Spinal Nerve Organization

    • The spinal cord is divided into four segments: cervical, thoracic, lumbar, and sacral, which correspond to regions of the vertebral column.
    • In the fully developed spinal cord, two distinct areas are visible in the cross-sectional view: gray matter and white matter.
    • Collection of cell bodies in the CNS is called the nucleus, and in the PNS, it is called a ganglion.
    • Collection of axons in the CNS is called a tract.

    Dermatomes

    • A dermatome is the area of skin innervated by a single spinal nerve, specifically the cutaneous branch.
    • Dermatomes are important for understanding the distribution of sensation and pain in the body.

    Blood Supply of the Spinal Cord

    • The spinal cord is supplied by branches of the spinal artery.
    • The posterior radicular artery communicates with the posterior spinal artery, while the anterior medullary artery communicates with the anterior spinal artery.
    • The anterior spinal artery doesn't have enough flow to supply the entire length of the cord, and segmental contributions from anterior segmental medullary arteries boost flow.
    • Blockage of the anterior spinal artery causes the anterior spinal artery syndrome.

    Anterior Spinal Artery Syndrome

    • Damage to the anterior spinal artery syndrome results in loss of sensation or muscle strength in a specific location that correlates with either a dermatome or a myotome.
    • This is considered a segmental loss.

    Venous Drainage

    • The internal vertebral venous plexus communicates with both the venous sinuses of the brain and a venous plexus associated with the pelvis.
    • The subarachnoid space of the spinal cord is continuous with the subarachnoid space of the brain.

    Clinical Correlation

    • Clinicians need to access the vertebral canal for various reasons, including administration of anesthesia and obtaining a sample of CSF.
    • The region between L2 and S2 is favorable for accessing the vertebral canal because the spinal cord is not present.

    Anatomy of the Spinal Cord

    • The spinal cord is divided into four segments: cervical, thoracic, lumbar, and sacral, which correspond to regions of the vertebral column.
    • In the fully developed spinal cord, two distinct areas are visible in the cross-sectional view: gray matter and white matter.

    Sports Injuries

    • Spondylolysis is a common sports injury in young kids, caused by repeated stress to the spine.
    • Spondylolisthesis is a bilateral defect resulting in an anterior displacement of the L4 or L5 vertebral body and transverse process.

    Ligaments

    • The anterior longitudinal ligament is a continuous band found on the anterior aspect of the vertebral bodies, preventing hyperextension of the vertebral column.
    • The posterior longitudinal ligament is a continuous band found on the posterior aspect of the vertebral bodies, limiting flexion of the vertebral column.
    • The ligamentum flavum is a yellow ligament that connects adjacent laminae and forms part of the posterior wall of the vertebral canal.

    Spinal Cord Organization

    • The spinal cord can be divided into four segments: cervical, thoracic, lumbar, and sacral, which correspond to regions of the vertebral column.
    • In the fully developed spinal cord, two distinct areas are visible in the cross-sectional view: gray matter and white matter.
    • Gray matter contains cell bodies and dendrites, while white matter contains myelinated axons.

    Back Muscles

    • The muscles of the back are classified as extrinsic or intrinsic based on their embryological derivation.
    • Extrinsic back muscles migrated into the back region and are innervated by ventral rami of spinal nerves.
    • Intrinsic back muscles are the "true back muscles" that are innervated by dorsal rami of spinal nerves.

    Facet Joints

    • The vertebrae articulate with one another at the synovial facet (zygapophyseal) joints.
    • The orientation of the facet joints is different in each region of the vertebral column to facilitate different types of movement.

    Herniated Disc

    • A "herniated or ruptured disc" is a common source of back pain.
    • In this condition, the anulus fibrosus tears, and the nucleus pulposus protrudes through the torn area, compressing spinal nerve roots and causing back pain.

    How Spinal Nerves Exit the Vertebral Column

    • Spinal nerves exit the vertebral column through the intervertebral foramina.
    • The cervical spinal nerves exit the vertebral column superior to their same numbered vertebra.
    • The T1 nerve and below exit inferior to their corresponding vertebra.

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