Study Sheet 01 - The Back

Typical vertebrae are found in these regions (3):

Atypical vertebrae are found in these regions
(2):
Unique characteristic of cervical spinous
processes:
Why is the atlas's vertebral foramen so wide?
What is the odontoid projection on the axis?
Location of the carotid tubercle:
Significance of the carotid tubercle:
Definition of foramen transversarium:
C7 AKA:
C7 spinous process: bifid or not?
First cervical spinal nerve exits between:
How do the cervical spinal nerves generally exit
the vertebral column (relative to the vertebrae)?

cervical, thoracic, lumbar

sacrum, coccyx

they are bifid (have a cleft)

to accommodate the medulla
the dens (used to be the body of the atlas)
C6; anterior tubercle of the transverse process the common carotid artery lies against it
the common carotid artery can become
compressed against it
hole in the transverse processes of the cervical
vertebrae; transmits the vertebral artery and vein,
sympathetic nerve fibers
vertebra prominens
not bifid
C1 and occipital bone
through the intervertebral foramen above the
same-named vertebra, except for C8 (exits
between C7 and T1)

Aortic impression is found on these thoracic

vertebrae:

T5-T8, on the left side of the vertebral body

Function of the mammillary process in the

lumbar vertebrae:

gives muscle attachment for the multifidus and

medial intertransverse muscles

Contents of the sacral canal (3):

Translation of cauda equina:
The dural sac is the termination of this meninx
(yes, that's the crazy singular form of meninges):
These travel through the anterior and posterior
sacral foramina, respectively (2):
Anesthesia injected into sacral foramina is
called:
Location of the coccyx:

dura mater
ventral and dorsal rami of the sacral spinal nerves
caudal epidural anesthesia
at the anus
the coccyx may or may not be fused with the
sacrum

Relation of the coccyx to the sacrum:

During childbirth, what can happen to the
sacrococcygeal joint?
Coccygeal ligament AKA:
Function of the coccygeal ligament:

lower part of cauda equina, lower part of filum

terminale, distal end of dural sac
horse's tail

it can move posteriorly

external terminal filum
anchors the inferior end of the spinal cord and the
spinal meninges

- Created by Kirsten Schaeffer Spring 2006

Study Sheet 01 - The Back

shock absorption, weight bearing, permits movement
between two vertebrae (acts as a semi-fluid ballbearing)

Functions of the intervertebral disc (3):

Vertebral column comprises how much of
a person's height?
Outer portion of intervertebral disc called:
Inner portion of intervertebral disc called:
Nucleus pulposus made up of:
If the nucleus pulposus' water content
decreases, this can happen:
Superiorly, the anterior longitudinal
ligament communicates with (1):
Superiorly, the posterior longitudinal
ligament is continuous with this
membrane:
Ligamentum nuchae is in this vertebral
region:
Ligamentum nuchae is attached to this
bony landmark of the skull:

2/5
annulus fibrosus
nucleus pulposus
70-80% water, collagen and elastin fibers, mucoid
material
height of vertebral column decreases (i.e. shrinkage
during old age)
anterior atlanto-occipital membrane
tectorial membrane
cervical region
external occipital protuberance

These back muscles make up the

superficial group (2):

trapezius muscle, latissimus dorsi muscle

These back muscles make up the deep

group (6):

serratus posterior superior muscle, serratus posterior

inferior muscle, splenius muscle (capitis and cervicis),
three parts of erector spinae muscle: spinalis muscle,
longissimus muscle, iliocostalis muscle

Serratus posterior superior muscle:

Insertion:
Innervation:
Action:

nuchal ligament, spinous processes of C7 to T3

vertebrae
superior borders of 2nd to 4th ribs
2nd to 5th intercostal nerves
elevate ribs

Serratus posterior inferior muscle:

Origin:
Insertion:
Innervation:
Action:

spinous processes of T11 to L2 vertebrae

inferior borders of 8th to 12th ribs near their angles
anterior rami of T9 to T12 thoracic spinal nerves
depress ribs

Origin:

Splenius muscle:
Origin:

Insertion:
Innervation:
Action:

arises from nuchal ligament and spinous processes of

C7-T3 or T4 vertebrae
splenius capitus: fibers run superolaterally to mastoid
process of temporal bone and lateral third of superior
nuchal line of occipital bone; splenius cervicis: tubercles
of transverse processes of C1-C3 or C4 vertebrae
posterior rami of spinal nerves
acting alone: laterally flex neck and rotate head to side
of active muscles; acting together: extend head and
neck
- Created by Kirsten Schaeffer Spring 2006

Study Sheet 01 - The Back

Common origin of all erector
spinae muscles:

arises by a broad tendon from posterior part of iliac crest, posterior

surface of sacrum, sacroiliac ligaments, sacral and inferior lumbar
spinous processes, and supraspinous ligament

Insertion of spinalis muscle:

thoracis, cervicis, capitis; fibers run superiorly to spinous processes in the

upper thoracic region and to cranium

Insertion of longissimus muscle:

thoracis, cervicis, capitis; fibers run superiorly to ribs between tubercles

and angles to transverse processes in thoracic and cervical regions, and
to mastoid process of temporal bone

Insertion of iliocostalis muscle:

lumborum, thoracis, cervicis; fibers run superiorly to angles of lower ribs

and cervical transverse processes

Common innervation of all erector

spinae muscles:

posterior rami of spinal nerves (which spinal nerves depends on which

region of the spine the muscle in question is located)

Common action of all erector

spinae muscles:

acting bilaterally: extend vertebral column and head; acting unilaterally:

laterally flex vertebral column

Intercostal nerves in the thoracic

region made up of (1):

ventral rami (not plexuses)

Transversospinalis muscle group

made up of (6):

semispinalis muscle, multifidus muscles, rotatores muscles, interspinalis

muscles, intertransversarii muscles, levatores costarum muscles

Semispinalis muscle:
Origin:

arises from transverse processes of C4-T12 vertebrae (capitis: transverse

processes of the upper thoracic vertebrae)

Insertion:

thoracis, cervicis, capitis; fibers run superomedially to occipital bone and

spinous processes in thoracic and cervical regions, spanning 4-6
segments

Innervation:

posterior rami of spinal nerves

Action:

extends head and thoracic and cervical regions of vertebral column and
rotates them contralaterally

Multifidus muscle:

Origin:

arises from posterior sacrum, posterior superior iliac spine of ilium,

aponeurosis of erector spinae, sacroiliac ligaments, mammillary
processes of lumbar vertebrae, transverse processes of T1-T3, articular
processes of C4-C7

Insertion:

thickest in lumbar region; fibers pass obliquely superomedially to entire

length of spinous processes of vertebrae, located 2-4 segments superior
to origin

Innervation:
Action:

posterior rami of spinal nerves

stabilizes vertebrae during local movements of vertebral column

Rotatores muscle:
Origin:

arises from transverse processes of vertebrae; best developed in thoracic

region

Insertion:

fibers pass superomedially to attach to junction of lamina and transverse

process or spinous process of vertebra immediately (brevis) or 2
segments (longus) superior to vertebra of origin

Innervation:

posterior rami of spinal nerves

Action:

stabilize vertebrae and assist with local extension and rotatory

movements of vertebral column

- Created by Kirsten Schaeffer Spring 2006

Levatores costarum muscles:

Origin:
Insertion:
Innervation:
Action:

tips of transverse processes of C7 and T1-T11 vertebrae

pass inferolaterally and insert on rib between tubercle and angle
posterior rami of C8-T11 spinal nerves
elevate ribs, assisting respiration

- Created by Kirsten Schaeffer Spring 2006

Study Sheet 01 - The Back

Suboccipital muscle group made up of (4):

Common action of all suboccipital
muscles:
Common innervation of all suboccipital
muscles:

rectus capitis posterior major muscle, rectus capitis

posterior minor muscle, obliquus capitis inferior muscle,
obliquus capitis superior muscle
postural: extends head on vertebra C1 and rotates it on
vertebrae C1 and C2
suboccipital nerve (C1) = dorsal ramus of C1

Rectus capitis posterior major muscle:

Origin:
Insertion:

spinous process of vertebra C2

lateral part of inferior nuchal line of occipital bone

Rectus capitis posterior minor muscle:

Origin:
Insertion:

posterior tubercle of posterior arch of vertebra C1

medial part of inferior nuchal line of occipital bone

Obliquus capitis superior muscle:

Origin:
Insertion:

transverse process of vertebra C1

occipital bone between superior and inferior nuchal lines

Obliquus capitis inferior muscle:

Origin:
Insertion:

spinous process of vertebra C2*

transverse process of vertebra C1

What is the cerebellomedullary cistern

and what does it contain?

it is the enlarged part of the subarachnoid space; it

contains CSF

How is a cisternal puncture performed?

for children: the needle is inserted through the posterior

atlanto-occipital membrane into the cerebromedullary
cistern; for adults: the lumbar cistern is used most
frequently

Boundaries of the suboccipital triangle (3):

Roof of the suboccipital triangle (1):
Floor of the suboccipital triangle (1):
Contents of the suboccipital triangle (4):
Source of the occipital artery:
Source of the vertebral artery:
Dorsal rami of spinal nerves contain what
types of fibers (3)?
Dorsal rami of C1 AKA:
Dorsal rami of C2 AKA:
Dorsal rami of C3 AKA:

rectus capitis posterior major muscle, obliquus capitis

inferior muscle, obliquus capitis superior muscle
semispinalis capitis
posterior atlanto-occipital membrane
occipital artery, vertebral artery, greater occipital nerve,
suboccipital nerve
external carotid artery
subclavian artery
motor, sensory, sympathetic fibers
suboccipital nerve
greater occipital nerve
3rd occipital nerve

- Created by Kirsten Schaeffer Spring 2006

Study Sheet 01 - The Back

Blood supply to the vertebrae in the neck
by (2):
Blood supply to the vertebrae in the thorax
by (1):
Blood supply to the vertebrae in the
abdomen by (2):
Blood supply to the vertebrae in the pelvis
by (3):
Does the vertebral venous plexus have
valves? What is the consequence?
The vertebral venous plexus drains these
groups of structures (3):
The vertebral venous plexus has
connections with these structures (3):

vertebral arteries, ascending cervical arteries

posterior intercostal arteries
subcostal arteries, lumbar arteries
iliolumbar arteries, lateral sacral arteries, median sacral
arteries
no; blood can flow in either direction
back muscles, vertebrae, spinal cord
cranial dural sinuses, pelvic veins, azygos vein

Clinical significances of spread of disease

via the vertebral venous plexus (2):

prostate cancer can spread to the spinal cord and can

result in paralysis; provides a route by which pelvic
inflammatory diseases (like sepsis) can spread to other
regions

Vertebral venous plexus is made up of (2):

anterior and posterior spinal veins

- Created by Kirsten Schaeffer Spring 2006