Week 1 SAQs - Vertebral Column Anatomy PDF

## Vertebral Column ### Cervical Vertebrae - **Boundaries of Cervical Transverse Foramina**: Surrounding transverse processes. - **Contents of Cervical Transverse Foramina**: Vertebral artery and vein (C6 to C1) and accompanying sympathetic plexus. - **Movement in the Sagittal Plane**: Flexion oc...

## Vertebral Column ### Cervical Vertebrae - **Boundaries of Cervical Transverse Foramina**: Surrounding transverse processes. - **Contents of Cervical Transverse Foramina**: Vertebral artery and vein (C6 to C1) and accompanying sympathetic plexus. - **Movement in the Sagittal Plane**: Flexion occurs in the sagittal plane, but is limited by rib attachments. - **Bilateral Action of Erector Spinae Muscles**: Extends the thoracic vertebral column. - **Most Distal Joint Influenced by the Sacral Vertebrae**: Sacroiliac joint. ### Thoracic Vertebrae - **Joint that Restricts Rotation**: Costovertebral joints restrict rotation due to rib attachments. - **Movement Restricted by Anterior Longitudinal Ligament**: Hyperextension in the cervical spine. - **Muscles Attaching to Spinous Processes**: Trapezius, rhomboid major, and latissimus dorsi. - **Movements in Cardinal Planes**: - **Sagittal**: Flexion and extension. - **Frontal**: Lateral flexion. - **Transverse**: Rotation - **Type of Contraction During Forward Flexion**: Eccentric contraction to control the descent. ### Lumbar Vertebrae - **Segments of Sacral Vertebrae Before Fusion**: Five segments before fusing into a single sacrum. - **Vertebral Region Characterized by Rib Articulation**: Thoracic region. - **Bilateral Action of Multifidus Muscles**: Extension of the lumbar vertebrae. - **Joint Not Affected by Anterior Longitudinal Ligament**: Atlanto-occipital joint. - **Movement Restricted by Posterior Longitudinal Ligament**: Hyperflexion. - **Muscle Challenged by Active/Passive Insufficiency During Rotation**: Multifidus. - **Muscles Attaching at Transverse Processes**: Levator costarum, longissimus, and intertransversarii. - **Movements in Cardinal Planes**: - **Sagittal**: Flexion and extension. - **Frontal**: Lateral flexion. - **Transverse**: Rotation. ### Vertebral Anatomy - **Cervical Vertebra**: Small, oval body, transverse foramina, and bifid spinous processes. - **Thoracic Vertebra**: Heart-shaped body, costal facets for rib attachment, and long, downward-sloping spinous processes. - **Sacral Vertebra**: Fused to form the sacrum, providing a stable base for the spine and transmitting weight to the pelvis. ### Innervation - **Nerve Supply to Intertransversarii Muscles (Cervical)**: Ventral rami of cervical spinal nerves. - **Nerve Supply to Intertransversarii Muscles (Lumbar)**: Dorsal and ventral rami of lumbar spinal nerves. - **Nerve Supply to Intervertebral Joints (Cervical):** Cervical spinal nerves. - **Nerve Supply to Intervertebral Joints (Lumbar):** Lumbar spinal nerves. - **Common Injury Mechanism to Cervical Vertebrae**: Hyperextension injuries, such as whiplash. - **Common Injury Mechanism to Lumbar Vertebrae**: Repetitive axial loading or improper lifting, leading to disc herniation. - **Common Action of Multifidus and Erector Spinae**: Stabilise the spine and assist in extension. - **Common Action of Intertransversarii and Interspinales**: Assist in vertebral stabilisation and fine-tune movements. ### Vertebral Development - **Segment of Paraxial Mesoderm Contributing to Cervical Vertebrae**: Sclerotome from cervical somites. - **Segment of Paraxial Mesoderm Contributing to Lumbar Vertebrae**: Sclerotome from lumbar somites. ### Spinal Nerve Exits - **Exit Point of Spinal Nerve (Cervical)**: Intervertebral foramen. - **Exit Point of Spinal Nerve (Lumbar)**: Intervertebral foramen. ### Foramen - **Boundaries/Contents of Cervical Transverse Foramen**: - **Boundaries**: Transverse processes. - **Contents**: Vertebral artery and vein, and sympathetic plexus. - **Boundaries/Contents of Intervertebral Foramen (Thoracic)**: - **Boundaries**: Superior and inferior notches, vertebral body, and zygapophyseal joints. - **Contents**: Spinal nerves and dorsal root ganglia. - **Sagittal Plane Movement of Cervical Vertebrae**: Flexion and extension. - **Sagittal Plane Movement of Lumbar Vertebrae**: Flexion and extension. - **Unilateral Action of Erector Spinae Muscles (Thoracic)**: Lateral flexion of the thoracic vertebrae. - **Bilateral Action of Multifidus Muscles (Lumbar)** : Extension of the lumbar vertebrae. ## Ligaments - **Ligamentum Flavum**: Dorsal, posterior to the spinal cord. - **Anterior Longitudinal Ligament**: Ventral, running along the anterior surface of the vertebral bodies. - **Posterior Longitudinal Ligament**: Dorsal, located on the posterior aspect of the vertebral bodies within the vertebral canal. - **Supraspinous Ligament**: Dorsal, running along the tips of the spinous processes. ### Ligament Position - **Ligamentum Flavum**: Post-axial. - **Anterior Longitudinal Ligament**: Pre-axial. - **Posterior Longitudinal Ligament**: Pre-axial. - **Supraspinous Ligament**: Post-axial. ### Ligament Function - **Ligamentum Flavum**: Connects the laminae of adjacent vertebrae, an elastic ligament. - **Anterior Longitudinal Ligament**: Broad, strong ligament preventing hyperextension. - **Posterior Longitudinal Ligament**: Narrow ligament restricting hyperflexion. - **Supraspinous Ligament**: Connects the tips of the spinous processes, continues as the ligamentum nuchae in the cervical region. ### Nerve Supply - **Erector Spinae Muscles**: Dorsal rami of mixed spinal nerves. - **Semispinalis Capitis Muscle**: Dorsal rami of cervical spinal nerves. - **Rectus Capitis Posterior Major**: Dorsal ramus of C1 (suboccipital nerve). - **Obliquus Capitis Inferior**: Dorsal ramus of C1 (suboccipital nerve). ### Ligamentum Flavum Injuries - **Common Injury Mechanism**: Degenerative thickening leading to spinal nerve root compression, causing radiculopathy. - **Nerve Affected**: Spinal nerve roots compressed by a buckling ligamentum flavum. ### Other Muscles - **Common Action of Rotatores and Multifidus**: Stabilise the vertebral column and resist rotational movement. - **Common Action of Semispinalis Capitis and Erector Spinae**: Extend the vertebral column. - **Common Action of Rectus Capitis Posterior Major and Obliquus Capitis Inferior**: Ipsilateral rotation of the head and neck. ### Spaces - **Anterior Longitudinal Ligament Pass Through**: Anterior surface of the vertebral bodies. - **Posterior Longitudinal Ligament Pass Through**: Vertebral canal along the posterior vertebral bodies. - **Boundaries/Contents of Suboccipital Triangle**: - **Boundaries**: Rectus capitis posterior major, obliquus capitis superior, obliquus capitis inferior. - **Contents**: Vertebral artery and dorsal ramus of C1. - **Boundaries/Contents of Intervertebral Foramen**: - **Boundaries**: Adjacent pedicles, vertebral bodies, and zygapophyseal joint. - **Contents**: Spinal nerve roots and dorsal root ganglia. ### Movement - **Moveable Planes (Thoracic Vertebrae)**: Sagittal, Frontal, Transverse. - **Moveable Planes (Cervical Vertebrae)**: Sagittal, Frontal, Transverse. - **Type of Contraction During Flexion of the Thoracolumbar Spine**: Eccentric contraction. - **Type of Contraction During Extension of the Cervical Spine**: Concentric contraction. - **Number of Vertebral Segments Crossed by Multifidus (Lumbar)**: 3-4. - **Number of Vertebral Segments Crossed by Semispinalis (Thoracic)**: 5-6. - **Where Semispinalis is Found**: Cervical and Thoracic Regions. - **Most Developed Location of Multifidus**: Lumbar region. - **Favoured Movements (Thoracic Vertebrae)**: Rotation. - **Not Possible Movements (Thoracic Vertebrae)**: Significant lateral flexion due to rib constraints. - **Favoured Movements (Lumbar Vertebrae)**: Flexion and extension. - **Not Possible Movements (Lumbar Vertebrae)**: Significant rotation - **Role of Multi-segmental Ligaments (Vertebral Column)**: - **Anterior Longitudinal Ligament**: Prevents hyperextension. - **Posterior Longitudinal Ligament**: Prevents hyperflexion. - **Supraspinous Ligament**: Stabilize spinous processes. - **Ligamentum Flavum Properties**: Highly elastic, preventing buckling during flexion. ### Joints - **Zygapophyseal Joint Capsular Ligaments**: Stabilize facet joints, restricting excessive movement, and protecting capsules. - **Most Sensitive Muscles to Length Changes**: Intertransversarii and interspinous muscles. - **Function of Transversospinales**: Resist rotational movements, stabilize the vertebral column. ### Multifidus - **Most Prominent Location of Multifidus**: Lumbar region. ### Suboccipital Triangle - **Clinical Relevance**: Contains the vertebral artery and dorsal ramus of C1, structures essential for movement, proprioception, and circulation. ### Rectus Capitis Posterior Muscles - **Function of Rectus Capitis Posterior Major**: Extension and ipsilateral rotation of the head. - **Function of Rectus Capitis Posterior Minor**: Extension of the head. ### Thoracolumbar Fascia - **Role of Thoracolumbar Fascia**: Stabilizes the lumbar spine with a dense sheath, with reinforcement from the latissimus dorsi and gluteus maximus. ### Thoracolumbar Fascia Layers - **Anterior**: Covers quadratus lumborum. - **Middle**: Between quadratus lumborum and erector spinae. - **Posterior**: Covers erector spinae and transversospinales. ### Extrinsic and Intrinsic Back Muscles - **Extrinsic Muscles**: Stabilize and move the spine, innervated by ventral rami. - **Intrinsic Muscles**: Stabilize and move the spine, innervated by dorsal rami. ### Extrinsic Muscles - **Muscles Attaching to Thoracolumbar Fascia**: Serratus posterior superior and