Organisation of the Body
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show | Bones of the upper and lower limbs
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show | Skull - cranium
Vertebral column
Ribs
Sternum
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show | Vertebrae + intervertebral discs + long and short ligaments
Central, flexible structure
Supported by muscles
Contains the spinal cord
Weightbearing axis
Transmission of weight through the spine
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Names of different vertebral regions | show 🗑
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show | Cervical lordosis - secondary curvature - 15-30 degrees
Thoracic kyphosis - primary curvature - 30 degrees
Lumbar lordosis - secondary curvature - 45 degrees
Sacral kyphosis - primary curvature - 30 degrees
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show | Primary curvatures develop in the fetus
Lumber lordosis - 6 months+
Cervical lordosis - when baby can support own head
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show | Excessive lumbar lordosis in late pregnancy
Weakness of anterior abdominal wall muscles'
Due to changes in centre of gravity
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show | Age related
Collapse of vertebral bodies (osteoporosis)
Curvature >30 degrees
IV disc disease
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Scoliosis | show 🗑
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Development of the spine - segmentation | show 🗑
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show | Resegmentation of the sclerotomes to form vertebrae
Each splits into cranial and caudal segments
Segmental spinal nerves grow to innervate the myotomes - cranial segment of sclerotome recombines with caudal segment of next sclerotome
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Regulation of segmentation | show 🗑
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Typical lumbar structure | show 🗑
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show | With superior and inferior vertebrae
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show | Annulus fibrosus ring of collage covered fibrocartilage
Layers in different directions
Strong annulus limits rotation between vertebrae
Nucleus pulpsosus - glycosaminoglycans for shock absorption and weightbearing
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show | Plane synovial joints between superior and inferior articular processes
Each joint has restricted range of movement
Combination of all gliding and sliding movements gives a large range of movement - flexion, extension, lateral flexion, rotation etc
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show | Articular facet joints lie on a loping, transverse plane
Rotation, flexion/extension
Small degree of lateral flexion is possible
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Vertebral column movements - Thoracic | show 🗑
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show | Articular facets aligned to a sagittal plane
Flexion and extension
Limited rotation
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show | Nodding
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show | Extensive rotation
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Long ligaments of the spine | show 🗑
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show | Limits extension
From base of the skull to the anterior surface of the sacrum
Attached to intervertebral discs and vertebral bodies
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Posterior Longitudinal ligament | show 🗑
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show | Ligamentum nuchae - between C7 and skull - strong abd thick triangle, base between occipital protuberance and foramen magnum, apex attached to spinous process of C7
Resists flexion and acts mechanically to restore the head to an upright position
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Short ligaments of the spine | show 🗑
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Ligamentum flavum | show 🗑
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Interspinous ligaments | show 🗑
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Intertransverse ligaments | show 🗑
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show | No body - became dens of C2
Anterior arch - articular facet for dens - transverse ligament of atlas
Transverse process with foramen transversarium
Superior articular facets - large, articulate with occipital condyle
Posterior tubercle -spinous process
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show | Body-large superior articular facets (articulate with inferior facets of atlas allowing rotation)
No intervertebral disc between C1 and C2
Dens - reinforced by transverse ligament of atlas and 2 alar ligaments
Transverse process
Spinous process-bifid
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show | Body smaller that thoracic/lumbar
Transverse process- foramen transversarium for vertebral arteries except C7
Anterior and posterior tubercles
Spinous process-bifid
C7 - long spinous process easily palpable - vertebra prominens
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show | Body heart shaped
Superior and inferior costal hemi-facets for articulation with tow pairs of ribs (except final 3)
Transverse process - facet for articulation with tubercle on neck of rib at same level
Spinous process - not bifid
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show | Body kidney shaped
Transverse processes - long
Superior and inferior articular facets orientated to reduce rotational movement
Spinous process - square
L5 may fuse with S1 - sacralisation - leads to lower back pain
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Sacrum | show 🗑
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Coccyx | show 🗑
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Contents of the vertebral spinal cord | show 🗑
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show | C1 nerve emerges between skull and C1
C2-C7 nerves emerge above vertebral pedicles
C8 nerve below pedicle of C7
T1- Co emerge below pedicles of respective vertebrae
Spinal cord ends at L1/L2 - safe access below this
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Termination of the spinal cord | show 🗑
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show | Jacobys/Tuffiers line
Intersects the L4 vertebrae L4/5 in most individuals
Where spine can be safely accessed
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show | Skin
Subcutaneous tissue
Supraspinous ligament
Interspinous ligament
Ligamentus flavum
Epidural space
Dura matter
Subdural space
Arachnoid mater
Sub-arachnoid space - CSF collected
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show | Skin
Subcutaneous tissue
Supraspinous ligament
Interspinous ligament
Ligamentus flavum
Epidural space
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Intervertebral disc herniation | show 🗑
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Sciatica | show 🗑
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show | Cervical region - C7 vertebra prominens easily palpable
Thoracic region - T12 spinous process is smaller than L1. Can also feel 12th rib
Lumbar region - Sacrum between posterior borders of iliac bones, palpate in cranial direction to find L5
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Imaging of spine | show 🗑
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