DMI 403- Chapter 4- Spine
Thoracic vertebrae
12 vertebrae with typical vertebral configurations except for their characteristic costal facets
The Spinal cord is enlarged in ____ regions by the cell bodies of nerves that extend to the extremities
2
Vertebral arch formed by 2 pedicles projecting from the body to meet with the ____, which continue posteriorly and medially to form a spinous process, the transverse processes project laterally from the approximate junction of the pedicle and laminae
2 laminaes
Typical vertebra parts
2 main: Body (anterior element) in the vertebral arch (posterior element)
Vertebral arch formed by ____ projecting from the body to meet with the 2 laminaes, which continue posteriorly and medially to form a spinous process, the transverse processes project laterally from the approximate junction of the pedicle and laminae
2 pedicles
Anterior spinal artery runs the entire length of the spinal cord in the anterior median fissure and supplies the anterior ____ of the spinal cord
2/3
The erector spinae muscle group is the chief extensor of the vertebral column and is arranged in ___
3 vertical columns
How many vertebrae is in the vertebral column?
33; separated into cervical (7), thoracic (12), lumbar (5), sacral (5 fused), and coccygeal (3-5)sections
The entire weight of the upper body is transferred from the ____ to the base of the sacrum across the L5 - S1 intravertebral disc
5th lumbar vertebrae
Spinal nerve pairs
8(nerve pairs)-cervical region, 12 (nerve pairs)-thoracic section, 5 (nerve pairs)-lumbar region, 5 (nerve pairs)-sacrum, and 1 (nerve pairs)-coccyx.
Anterior longitudinal ligament
A broad fibrous band that extends downward from C1 along the anterior surface of the vertebral body to the sacrum.
Tectorial membrane
A broad ligament that extends from the clivus of the occipital bone to the posterior body of the axis, covering the dens, transverse , apical, and a alar ligaments
Sacral hiatus
An opening formed by the absence of the Spinous process of the 5th sacral segment
Dorsal root ganglion
And oval enlargement of the dorsal root that contains the nerve cell bodies of the sensory neurons, is located in the intravertebral foramen
Veins of the spinal cord
Anterior and posterior central vein, radial veins, anterior and posterior medial (spinal) veins, anterior and posterior radicular veins, intervertebral veins
The anterior and posterior median veins drains into what?
Anterior and posterior radicular veins
This ligament is a superior extension of the anterior longitudinal ligament
Anterior atlantooccipital membrane
Division of External venous plexus
Anterior external plexus and posterior external plexus
This ligament connects the anterior aspect of the vertebral body and intravertebral disk to maintain stability of the joints and to help prevent hyperextension of the vertebral column.
Anterior longitudinal ligament
The anterior median veins parallels which artery?
Anterior spinal artery
___________ runs the entire length of the spinal cord in the anterior median fissure and supplies the anterior 2/3 of the spinal cord
Anterior spinal artery
Posterior spinal arteries
Arise as small branches of either the vertebral or the posterior inferior cerebellar arteries and descend along the dorsal surface of the spinal cord
Semispinalis muscle origin
Arise from the transverse processes of the thoracic and cervical spine
Sacral plexus
Arises from L4-L5 and S1-S4, these nerves converged towards the inferior sacral foramina to unite into a large flattened band
Cervical plexus
Arises from the upper four ventral Rami of C1-C4 to innervate the neck, lower part of the face and ear, the side of the scalp, and upper thoracic area
Lumbar plexus
Arises from the ventral Rami T12 and L1-L4
Filum terminale
At the distal end of the spinal cord, at proximately L1, the Pia mater continues as this long slender strand
Lateral to the odontoid process on the upper surface of the body are the superior articular processes, on which the atlas articulates at the ____
Atlantoaxial joint
Besides the ligaments, what else supports and stabilizes the suboccipital region of the spine?
Atlantooccipital (anterior and posterior) and tectorial membranes
Drains the vertebral bodies
Basivertebral veins
Posterior longitudinal ligament is attached only at the intravertebral disk and adjacent margins. It is separated from the middle of each vertebra by epidural fat, which provides passage of the ____
Basivertebral veins
The anterior sections of the internal and external plexuses communicate via a network of veins called?
Basivertebral veins
Spinal cord
Begins as a continuation of the Medulla at the inferior margin of the brainstem and extends to approximately the first lumbar vertebra
____________ emerges between the anterior and middle scalene muscles, where they continue laterally and inferiorly to divide into three chords just posterior to the clavicle
Brachial plexus roots
cauda equina (horse's tail)
Bundle of nerves that continue inferiorly from the termination of the spinal cord, this grouping of nerves has the appearance of a horses tail and exits through the lumbosacral foramina
Bifid spinous processes
C3-C6 have this unique configuration.
The transverse ligament is sometimes called ________ due to its cross like appearance when viewed in the coronal plane
Cruciform ligament
body of vertebra
Cylindrical in shape and is anteriorly located and functions to support bodyweight
Dermatome map
Demonstrates the specific cutaneous distribution that each spinal nerve provides
The cross-sectional images of the spinal cord at various levels have considerable _________ in size and shape because of the ___________ proportion of gray and white matter
Difference, changing
Division of the sciatic nerve
Divides into tibial and peroneal nerves
Shortly after emerging from the intravertebral foramen, each nerve divide into these two rami, which contain both motor and sensory fibers
Dorsal and ventral Rami
Anterior and posterior central veins
Drains the central gray matter of the spinal cord and it is located in the anterior median fissure and posterior sulcus respectively.
Radial veins
Drains the outer white matter that encircles the spinal cord within the Pia mater
Dural nerve root sleeve
Dura mater that surrounds each spinal nerve and extends through the intravertebral foramen
Basivertebral veins
Emerges from the posterior surfaces of the vertebral bodies
Intermediate layer muscle group name
Erector spinae muscle group
Efferent (motor) nerve roots
Exit the spinal cord via at the ventral route to be distributed throughout the body.
Segmental arteries
Extend toward the intravertebral foramen, where they divide into spinal branches
Transverse ligament
Extends across the vertebral foramen of C1 to form a sling over the posterior surface of the odontoid process. It has a small band of longitudinal fibers that ascend to attach to the posteroinferior aspect of the Clivus and inferiorly to attach to the body of the axis
Interspinous ligament
Extends between adjacent spinous process throughout the spinal column
Posterior atlantooccipital membrane
Extends from the posterior arch of C1 to the occipital bone, closing the posterior portion of the vertebral canal between the cranium and C1
Spinalis muscle group insertion
Extends from the spinous processes of the upper lumbar and lower thoracic region to inserts superiorly to skull and the spinous processes of the superior thoracic region and C2
Cervical enlargement
Extends from the vertebral bodies of approximately C3-C7
Cords of the brachial plexus
Extends through the axilla to form five terminal branches: the musculocutaneous, axillary, median, radial, and ulnar nerve
Internal and external venous plexuses
Extensive network of veins formed from the veins of the vertebral column (named according to their corresponding location in the vertebral column)
multifidus muscle insertion
Fibers expand 4-6 vertebral segments, running superior medially to spinous processes
Rotatores Insertion
Fibers run superomedially and attach to the junction of lamina and transverse processes on same vertebrae or spinous processes of vertebrae above their origin
After leaving the thecal sac, the _________ eventually exits the sacral canal through the sacral hiatus and attaches to the coccyx, providing an anchor between the spinal cord and the coccyx
Filum terminale
Annulus fibrosis
Firm outer portion of the intervertebral disk
Intravertebral foramina
Formed by the articulation of the superior and inferior notches of adjacent vertebrae, allows for the transmission of spinal nerves and blood vessels.
Lateral masses (ala)
Formed by the combined transverse processes
Anterior spinal artery
Formed by the union of two small branches of the vertebral arteries, just caudal to the basilar artery
Spinal meninges
Forms the thecal sac that surrounds and protects the delicate spinal cord and contains cerebrospinal fluid
Zygapophyseal joint (facet joints)
Four articular process, two superior and two inferior, arise from the junction of the pedicle and laminae to articulate with the adjacent vertebra and form this joint
___________ has the appearance of a butterfly and cross-section and has posterior and anterior projections.
Gray matter
Pia mater
Highly vascular layer that closely adheres to the spinal cord
Spinal nerves
Just outside the intravertebral foramina, the ventral and dorsal roots unite to form the 31 pairs of these nerves
The entire weight of the upper body is transferred from the fifth lumbar vertebrae to the base of the sacrum across the ____
L5-S1 intravertebral disc
Spinal cord function
Large nerve cable that connects to brain with the body
Brachial plexus
Large, complex network of nerves arriving from the five ventral rami of C5-C8 and T1
Femoral nerve
Largest branch of the lumbar plexus, descending beneath the inguinal ligament
Sciatic nerve is the ___
Largest nerve in the body
Denticulate ligaments
Lateral extensions of the Pia mater, leaving the spinal cord to form pairs of ligament, which attaches to the dura (preventing lateral movement of the spinal cord within the thecal sac)
Sacral plexus location
Lies against the posterolateral wall of the pelvis between the piriformis muscle and internal iliac vessels, just anterior to the SI joints
Internal venous plexus
Lies within the vertebral canal in the epidural space and are divided into anterior and posterior internal plexus
Coccyx
Located inferior to the fifth sacral segment, consist of 3 to 5 small fused bony segments
Costal facets (Demi facets)
Located on the body and transverse process that articulates with the ribs
Vertebral foramen
Located posteriorly, is the ringlike arch that attaches to the side of the body, creating a space
Sacral foramina
Located within the lateral masses, allow for the passage of nerves
Phrenic nerve is a ____
Major motor branch of cervical plexus
The spinalis layer makes up the ___ column
Medial
Apical ligament
Midline structure that connects the apex of the odontoid process to the inferior margin of the clivus
Coccyx
Most inferior portion of the vertebral column
Muscle group regions
Muscle groups that run the length of spine can be divided into regions according to their location: capitis , cervicis, thoracis, lumborum
Splenius muscles
Muscles that are located on the lateral and posterior aspect of the cervical and upper thoracic spine
Posterior longitudinal ligament
Narrower and slightly weaker than the anterior longitudinal ligament
Ventral Rami
Nerves of T2 - T 12 passes anteriorly as the intercoastal nerve to supply the skin and muscles of the anterior and lateral trunk
Parts of the vertebral disks
Nucleus pulposus, annulus fibrosis
Lumbosacral enlargement
Occurs within the lower thoracic region
Anterior atlantooccipital membrane
Passes from the anterior arch of the atlas and connects to the base of the occipital bone at its anterior margin
Vertebral arch parts
Pedicles (2), lamina, spinous process (1), transverse process(2), and superior (2) and inferior (2) articular processes(2).
Vertebral arch formation
Pedicles project from the body to meet with the two laminaes, which continue posteriorly and medially to form a spinous process, the transverse processes project and laterally from the approximate junction of the pedicle and laminae
This ligament helps to prevent posterior protrusion of the nucleus purposes and hyperflexion of the vertebral column
Posterior longitudinal ligament
____ lies inside of the vertebral canal and runs along the posterior aspect of the vertebral bodies
Posterior longitudinal ligament
_____ is attached only at the intravertebral disk and adjacent margins. It is separated from the middle of each vertebra by epidural fat, which provides passage of the Basivertebral veins
Posterior longitudinal ligament
dorsal horns
Posterior projection of the gray matter. Contains neurons and sensory fibers that enter the cord from the body periphery via the dorsal roots
Subdural space
Potential space runs between the arachnoid and dura mater
Odontoid process (dens)
Projects into the anterior ring of the atlas to act as a pivot for rotational of movement of the atlas
Lateral masses of the atlas
Provide the only weight bearing articulation between the cranium and vertebral body
Spine curvature
Provides spinal flexibility and distribute compressive forces over the spine
Posterior external venous plexus
Runs along the posterior aspect of the vertebral arches
denticulate ligament path
Runs between the ventral and dorsal nerve roots within the spinal column
Anterior external venous plexus
Runs directly in front of the vertebral bodies
Iliocostalis muscles insertion
Runs superiorly to attach to the angles of the ribs and transverse processes of C7 to C4
Longissimus muscles insertion
Runs superiorly to insert into the tips of the transverse processes of the thoracic and cervical regions, the angles of the ribs, and the mastoid process
Used to separate the abdominal cavity from the pelvic cavity
Sacral promontory
Multifidus muscle origin
Sacrum, ilium, transverse processes of T1 - L5 and articular processes a C4 - C7
Axis
Second cervical vertebra, has a large odontoid process (dens) that project upward from the superior surface of the body.
Lumbar arteries
Segmental arteries in the lumbar region
Intercostal arteries
Segmental arteries in the thoracic region
Forms the largest muscle mass in the posterior portion of the neck
Semispinalis muscle
Deep layer (transversospinal muscles) names
Semispinalis, multifidus, rotatores
Muscles groups of the back
Separated into three groupings or layers: the superficial layer (splenius muscles), the intermediate layer (erector spinae group), and the deep layer (transversospinal group)
Plexus function
Serve the motor and sensory needs of the muscle and skin of the extremities
ligamentum nuchae
Serves as an attachment point for muscles, extends from the external occipital Protuberance of the cranium to the spinous process of the cervical vertebrae.
Cervical vertebrae
Seven vertebraes varying in size and shape. Within the transverse process of this vertebra, is the transverse foramen
Intravertebral disc
Shock absorbing cartilage that separates the vertebral bodies
lumbar plexus location
Situated on the posterior abdominal wall, between the psoas major muscle and the transverse process of the lumbar vertebrae
Ligaments
Specific ligament of the spine serve to connect the cervical vertebrae and the cranium to provide mobility and protection for the head and neck
Splenius cervicis origin
Spinous process of T3-T7
Superficial layer splenius muscles name
Splenius capitis, splenius cervicis
Ligamentum flava location
Strong ligament (consisting of yellow elastic tissue) present at it either side of the spinous process
Vertebral canal
Succession of the vertebral foramina forms a canal that contains and protects the spinal cord
Cornu
Superior projections of the first coccygeal segment
Spinal cord supply
Supplied by a single anterior spinal artery, paired posterior spinal arteries,and by a series of spinal branches
Posterior spinal arteries supply
Supplies the posterior 1/3 of the spinal cord
Vertebral column
Supports the weight of the body, helps to maintain posture, and protects the delicate spinal cord and nerves.
conus medullaris Is the most inferior portion of the spinal cord and is located at approximately the level of ____
T12- L1
The _____ extends from the clivus of the occipital bone to the posterior body of the axis, covering the dens, transverse , apical, and alar ligaments
Tectorial membrane
Ventral horns
The anterior projection of the gray matter, Contains the nerve cell bodies of the efferent (motor) neurons
Sacroiliac joint
The articulation of the pelvic bone with the lateral masses (ala)
Atlantoaxial joint
The articulation with the atlas and the superior articular process on the upper surface of the body, lateral to the dens
Subarachnoid space
The space between the arachnoid mater and Pia mater, which is filled with cerebral spinal fluid and the blood vessels that supply the spinal cord
Anterior and posterior medial (spinal) veins
The venous blood collected by the tiny radial veins drains into these veins
The anterior and posterior radicular veins parallels what?
The ventral and dorsal nerve roots
Splenius muscles origin
These bandage like muscles originate on the spinous process of C7 - T6 and the inferior half of the ligamentum Nuchae
Ligamentum flava
They joined the laminae of adjacent vertebral arches, helping to preserve the normal curvature of the spine
Arachnoid mater
Thin transparent membrane that is attached to the inner surface of the Dura mater
Posterior longitudinal ligament location
This ligament runs the entire length of the vertebral column beginning at C2
Great anterior radicular artery (artery of Adamkiewicz) supply
This vessel makes a major contribution to the anterior spinal artery and provides the main blood supply to the inferior 2/3 of the spinal cord
Dura mater
Tough outer layer that extends to S2, creating the thecal sac
Rotatores Origin
Transverse processes of vertebrae, well developed in thoracic spine
True or false. The internal and external venous plexuses, along with the radicular veins, drain into the intervertebral veins, ending in the vertebral, intercostal, lumbar, and sacral veins
True
True or false. The veins that drain the spinal cord follow the same segmental organization as their arterial counterapart.
True
Quadratus lumborum and psoas muscle
Two additional muscle that are commonly visualize the lumbar region of the spine and are considered abdominal muscles
Anterior and posterior longitudinal ligament
Two of the larger ligaments that enclose the vertebral column to help protect the spinal cord and maintain stability of the vertebral column
Alar ligaments
Two strong bands that extend obliquely from the sides of the odontoid process, upward to the lateral margins of the occipital condyles to limit rotation and flexion of the head
Lumbar vertebrae
Typically consist of five vertebrae; their massive body increase in size from superior to inferior.
Spinous process of the thoracic vertebrae
Typically long and slender, projecting inferiorly over the vertebral arches of the vertebrae below
External Venous plexus
Valveless and communicates freely with the vertebral veins and intracranial venous sinuses and are located at the outer surfaces of the vertebral column
_____ formed by 2 pedicles projecting from the body to meet with the 2 laminaes, which continue posteriorly and medially to form a spinous process, the transverse processes project laterally from the approximate junction of the pedicle and laminae
Vertebral arch
The size of the _____ progressively increase from superior to inferior portion of the spine
Vertebral bodies
What allows movement and additional support for the vertebral column?
Zygapophyseal joint
Supraspinous ligament
a narrow band of fibers that runs over and connects the tip of the spinous process from the seventh cervical vertebra to the lower lumbar vertebrae
Dorsal roots are called ____
afferent (sensory) nerve roots
There exists frequent _____ joining the two posterior spinal arteries with each other and with the anterior spinal artery
anastomoses
After giving off an ____ to the walls of the vertebral column the spinal branches divide into anterior and posterior radicular arteries that pass along the ventral and dorsal root into the spinal cord
anterior and posterior branch
After giving off an anterior and posterior branch to the walls of the vertebral column the spinal branches divide into ____ that pass along the ventral and dorsal root into the spinal cord
anterior and posterior radicular arteries
The transverse ligament holds the odontoid process of C2 against the ____ of C1
anterior arch
The tectorial membrane forms the ____ of the vertebral canal and is continuous with the posterior longitudinal ligament
anterior boundary
Saphenous nerve innervation
anterior lower leg, some of the ankle, and part of the foot
Anterior spinal artery runs the entire length of the spinal cord in the _____ and supplies the anterior 2/3 of the spinal cord
anterior median fissure
Although the _____ is quite small in diameter, it is at its widest in the cervical and lumbar enlargement and is much reduced in the thoracic region
anterior spinal artery
The spinous process of the ____ is the first projection to be felt in the posterior groove of the neck
axis
The erector spinae muscle group is the ____ of the vertebral column and is arranged in three vertical columns
chief extensor
After leaving the thecal sac, the Filum terminale eventually exits the sacral canal through the sacral hiatus and attaches to the ____, providing an anchor between the spinal cord and the coccyx
coccyx
Plexus
complex network of nerves formed by the ventral Rami of all other spinal nerves
Vertebral notch
concave surface on the upper and lower surfaces of the pedicles
Sciatic nerve
continuation of the sacral plexus into the thigh, exits the pelvis through the greater sciatic foramen and continues to descend vertically along the posterior thigh
Each spinal nerve provides a specific cutaneous distribution that can be demonstrated on a ____
dermatome map
Shortly after emerging from the intravertebral foramen, each nerve divide into ____, which contain both motor and sensory fibers
dorsal and ventral rami
The filum terminale descends through the subarachnoid space to the inferior border of the thecal sac, where it is reinforced by the ____.
dura mater
Anterior spinal artery runs the ____ of the spinal cord in the anterior median fissure and supplies the anterior 2/3 of the spinal cord
entire length
Posterior longitudinal ligament is attached only at the intravertebral disk and adjacent margins. It is separated from the middle of each vertebra by _____, which provides passage of the Basivertebral veins
epidural fat
The ______ is the chief extensor of the vertebral column and is arranged in three vertical columns
erector spinae muscle group
epidural space contains _____
fat and vessels
At the level of the lesser trochanter the divides into several branches
femoral nerve
___________ descends through the subarachnoid space to the inferior border of the thecal sac, where it is reinforced by the dura mater.
filum terminale
Phrenic nerve
formed by the branches of C3, C4, and upper division at C5, this nerve descends vertically down the neck and passes into the superior thoracic aperture, where it continues inferiorly to the diaphragm.
Saphenous nerve descends along the medial aspect of the leg to the ankle accompanied by the ____
great saphenous vein
The ____ runs superiorly to attach to the angles of the ribs and transverse processes of C7-C4
iliocostalis muscle
conus medullaris Is the most ____ portion of the spinal cord and is located at approximately the level of T12- L1
inferior
Sacral cornu
inferior articular process of the 5th sacral segment, located at the sides of the sacral hiatus, which project downward
Semispinalis muscle inertion
insert on the occipital bone and spinous processes in the thoracic and cervical regions.
Posterior longitudinal ligament lies ____ of the vertebral canal and runs along the posterior aspect of the vertebral bodies
inside
The longissimus layer makes up the ___ column
intermediate
Posterior longitudinal ligament is attached only at the ____. It is separated from the middle of each vertebra by epidural fat, which provides passage of the Basivertebral veins
intravertebral disk and adjacent margins
Shortly after emerging from the _____, each nerve divide into dorsal and ventral rami, which contain both motor and sensory fibers
intravertebral foramen
Arachnoid Mater
it is connected to the Pia mater by numerous delicate strands creating the spider like appearance
The iliocostalis layer makes up the ____ column
lateral
After leaving the thecal sac, the Filum terminale eventually exits the sacral canal through the sacral hiatus and attaches to the coccyx, providing an anchor between the ____ and the coccyx
spinal cord
The ____________ are continuous with the cranial meninges and can be broken into the same three layers: Dura, aeachnoid, and pia.
spinal meninges
Vertebral arch formed by 2 pedicles projecting from the body to meet with the 2 laminaes, which continue posteriorly and medially to form a ____, the transverse processes project laterally from the approximate junction of the pedicle and laminae
spinous process
The splenius muscles are bandage-like muscles originating on the ____ and the inferior half of the ligamentum Nuchae
spinous processes of C7-T6
The ____ are bandage-like muscles originating on the spinous processes of C7 - T6 and the inferior half of the ligamentum Nuchae
splenius muscles
The Cornu has ligamentous attachments to the sacral cornu that provide additional ____ to the articulation between the sacrum and the coccyx.
stability
The filum terminale descends through the ____ to the inferior border of the thecal sac, where it is reinforced by the dura mater.
subarachnoid space
Lateral to the odontoid process on the upper surface of the body are the _____, on which the atlas articulates at the Atlantoaxial joint
superior articular processes
The size of the Vertebral bodies progressively increase from ____ portion of the spine
superior to inferior
The ligamentum nuchae continues inferiorly as the ____
supraspinous ligament
The ____ forms the anterior boundary of the vertebral canal and is continuous with the posterior longitudinal ligament
tectorial membrane
The five terminal branches of the brachial plexus (the musculocutaneous, axillary, median, radial, and ulnar nerve) innervation
the muscles of the upper extremity and shoulder
The filum terminale descends through the subarachnoid space to the inferior border of the _____, where it is reinforced by the dura mater.
thecal sac
Anterior longitudinal ligament is ____ in the thoracic region than the cervical and lumbar regions, providing additional support to the thoracic spine
thicker
Deep layer (transversospinal muscles) function
to flex and rotate the vertebral column
Splenius muscle (capitis, cervicis) action
together they act to extend the head and neck
The ____ holds the odontoid process of C2 against the anterior arch of C1
transverse ligament
Vertebral arch formed by 2 pedicles projecting from the body to meet with the 2 laminaes, which continue posteriorly and medially to form a spinous process, the ____ project laterally from the approximate junction of the pedicle and laminae
transverse processes
Posterior median vein
typically presents as the largest vascular structure on the posterior surface of the spinal cord
After giving off an anterior and posterior branch to the walls of the vertebral column the spinal branches divide into anterior and posterior radicular arteries that pass along the ____ into the spinal cord
ventral and dorsal root
The tectorial membrane forms the anterior boundary of the _____ and is continuous with the posterior longitudinal ligament
vertebral canal
Segmental arteries supplies the ____
vertebral column and spinal cord
Sacral promontory
The first sacral segment that has a prominent ridge located at the anterior surface of the body
Atlantooccipital joint
The large superior articular process of the atlas articulates with the occipital condyles of the cranium deformed this joint
Saphenous nerve
The largest branch of the femoral nerve
L5
The largest of the lumbar vertebrae with massive transverse process
Great anterior radicular artery (artery of Adamkiewicz)
The largest of the radicular arteries
Lateral to the ____ on the upper surface of the body are the superior articular processes, on which the atlas articulates at the Atlantoaxial joint
odontoid process
The transverse ligament holds the ____ of C2 against the anterior arch of C1
odontoid process
Posterior longitudinal ligament is attached ___ at the intravertebral disk and adjacent margins. It is separated from the middle of each vertebra by epidural fat, which provides passage of the Basivertebral veins
only
Vertebral arch formed by 2 pedicles projecting from the body to meet with the 2 laminaes, which continue posteriorly and medially to form a spinous process, the transverse processes project laterally from the approximate junction of the ____
pedicle and laminae
The ventral rami of all other spinal nerves form complex networks of nerves called ____
plexuses
Posterior longitudinal ligament lies inside of the vertebral canal and runs along the ____ aspect of the vertebral bodies
posterior
Segmental arteries arises from the _____
posterior aspect of the descending aorta
The Tectorial membrane extends from the clivus of the occipital bone to the ____
posterior body of the axis, covering the dens, transverse , apical, and alar ligaments
The tectorial membrane forms the anterior boundary of the vertebral canal and is continuous with the ____
posterior longitudinal ligament
This muscle group, erector spinae muscle group, arises from a common broad tendon from the ____
posterior part of the iliac crest, spinous process of sacrum and inferior lumbar spine and supraspinous ligament
Brachial plexus location
posterior to the subclavian artery as it course toward the axillary region of the shoulder
Vertebral arch formed by 2 pedicles projecting from the body to meet with the 2 laminaes, which continue _____ to form a spinous process, the transverse processes project laterally from the approximate junction of the pedicle and laminae
posteriorly and medially
The posterior longitudinal ligament helps to ____
prevent posterior protrusion of the nucleus pulposus and hyperflexion of the vertebral column
Denticulate ligaments function
prevents lateral movement of the spinal cord within the thecal sac
Additional muscle commonly visualized in the lumbar region of the spine
quadratus lumborum, psoas muscle which are considered abdominal muscles
The iliocostalis muscle runs superiorly to attach to the angles of the ____
ribs and transverse processes of C7-C4
The Cornu has ligamentous attachments to the ____ that provide additional stability to the articulation between the sacrum and the coccyx.
sacral cornu
After leaving the thecal sac, the Filum terminale eventually exits the sacral canal through the ____ and attaches to the coccyx, providing an anchor between the spinal cord and the coccyx
sacral hiatus
The entire weight of the upper body is transferred from the fifth lumbar vertebrae to the base of the ___ across the L5 - S1 intravertebral disc
sacrum
The Cornu has ligamentous attachments to the sacral cornu that provide additional stability to the articulation between the _____.
sacrum and the coccyx
After giving off an anterior and posterior branch to the walls of the vertebral column the ____ divide into anterior and posterior radicular arteries that pass along the ventral and dorsal root into the spinal cord
spinal branches
Segmental arteries extend toward the intravertebral foramen, where they divide into ____
spinal branches
Anterior and posterior median (spinal) veins
Created by the longitudinal Venous channels within the pia mater on the anterior and posterior your surfaces of the spinal cord
Anterior thecal sac
Adheres to the posterior longitudinal ligament and is separated from the vertebral column by the epidural space
Dorsal rami
All spinal nerves extend posteriorly to innervate the skin and muscle of the posterior trunk
Transverse foramen of the C-spine
Allow passage of the vertebral arteries and veins as they ascend to and Descend from the head
Atlas
The first cervical vertebra that supports the head, a ringlike structure that has no body and no spinous process.
nucleus pulposus
Central mass of soft semigelatinous material of the vertebral disk
Splenius cervicis insertion
Cervical portion, inserts on the transverse processes of C1-C3 or C4
Four major nerve plexus
Cervical, brachial, lumbar, sacral
The Tectorial membrane extends from the ___ of the occipital bone to the posterior body of the axis, covering the dens, transverse , apical, and alar ligaments
Clivus
Vertebral end plate
Compact bone on the superior and inferior surfaces of the body
gray matter of spinal cord
Composed of nerve cells and runs that entire length of the cord, is centrally located and surrounds the central canal, which contains cerebrospinal fluid and is continuous with the ventricles of the brain
Spinal cord composition
Composed of white and gray matter
White matter (myelinated axons) of the spinal cord
Comprises the external borders of the cord and is more abundant
Atlantooccipital membrane
Consist of an anterior and posterior portion, which serves to connect the arches of the Atlas with occipital bone
Parts of the atlas
Consist of anterior part, posterior arch, and two large lateral masses.
Sacrum
Consist of five fused vertebrae.
Multifidus muscles
Consist of many fibers bundles that extend the full length of the spine and are the most prominent in the lumbar region
Deep layer (transversospinal muscles)
Consist of several short muscles that are located in the groove between the transverse and spinous processes of the vertebrae
Erector spinae muscle group
Consists of massive muscles that form a prominent bulge on each side of the vertebral column.
Epidural space
Contains fat and vessels and separates the anterior thecal sac from the vertebral column
Anterior radicular arteries
Contribute blood to the anterior spinal artery
Posterior radicular arteries
Contribute blood to the posterior spinal arteries
The spinal cord tapers into a cone shaped segment called _____
Conus medullaris
Kyphotic curve
Convex backward curve of the thoracic and sacral section
Lordotic curves
Convex forward curve of Cervical and lumbar sections
The ____ has ligamentous attachments to the sacral cornu that provide additional stability to the articulation between the sacrum and the coccyx.
Cornu
The tubercle of the ribs articulate with the transverse process at the ____
Costotransverse joint
The head of the rib articulate with the vertebral body at the _____
Costovertebral joint
Splenius Capitis insertion
Cranial portion, Inserts on the mastoid process of the temporal bone and superior nuchal line of occipital bone
Intermediate layer (erector spinae muscle group) each name
Iliocostalis muscles, longissimus muscles, spinalis muscle group
Splenius Capitis origin
Inferior Nuchal ligament and spinous process of C7-T3
Tibial and peroneal nerves
Innervates of the posterior aspect of the lower extremity
Sacral plexus innervation
Innervates the buttocks, posterior thigh, and Feet
This, ______________, muscle group arises from a common broad tendon from the posterior part of the iliac crest, spinous process of sacrum and inferior lumbar spine and supraspinous ligament
Intermediate layer (erector spinae muscle group)
Veins of the vertebral column
Internal (anterior and posterior internal plexuses), external (anterior and posterior external venous plexuses) venous plexuses, Basivertebral vein
The anterior and posterior radicular veins drains into what?
Intervertebral veins
Rotatores
The deepest of the transversospinal muscles, which Connect the lamina of one vertebra to the transverse process of the vertebra below (They are best developed in the thoracic region)
Vertebral arch formed by 2 pedicles projecting from the body to meet with the 2 laminaes, which continue posteriorly and medially to form a spinous process, the transverse processes project ____ from the approximate junction of the pedicle and laminae
laterally
Saphenous nerve descends along the medial aspect of the _____ accompanied by the great saphenous vein
leg to the ankle
At the level of the _____ the femoral nerve divides into several branches
lesser trochanter
The Cornu has ____ to the sacral cornu that provide additional stability to the articulation between the sacrum and the coccyx.
ligamentous attachments
The splenius muscles are bandage-like muscles originating on the spinous processes of C7 - T6 and the inferior half of the ____
ligamentum Nuchae
Vertebral prominence
long spinous process of C7 that is typically not bifid and is easily palpable posteriorly at the base of the neck
lumbar plexus innervation
lower abdominopelvic region and anterior and medial muscles of the thigh
Great anterior radicular artery (artery of Adamkiewicz) arises in the _____
lower thoracic and upper lumbar region typically between T12 and L3
Saphenous nerve descends along the ____ aspect of the leg to the ankle accompanied by the great saphenous vein
medial
Shortly after emerging from the intravertebral foramen, each nerve divide into dorsal and ventral rami, which contain both ____
motor and sensory fibers
The large superior articular process of the atlas articulates with the ____
occipital condyles