Bones and Joints Flashcards

Question

What is kyphosis? Where can it be found?

Answer 1

1. Primary Curvature of the spinal column 2. anteriorly concave curvature in thoracic and sacral regions 3. It can be found on the thoracic vertebrae and sacral vertebrae

Answer 2

* posteriorly concave curvature in cervical and lumbar regions * secondary curvature of vertebral column * balance of body weight and maintenance of upright bipedal posture with the least amount of muscular energy expenditure * Found when infants start to sit upright ( when the lumbar lordosis starts to develop) * Found in cervical and lumbar regions

Answer 3

In the lumbar regions there are large gaps that continue to get wider but are useful for flexion and extension of the lumbar vertebrae. If the gaps were small then you would not have adequate movement of the lumbar vertebrate

Answer 4

* anulus fibrosus: * collagenous ring around a wider zone of fibrocartilage * prevention of excessive rotation between vertebrae * nucleus pulposus: * center of intervertebral disc * gelatinous in nature * absorption of compressive forces between vertebrae

Answer 5

* Cervical region- flexion and extension of the neck * Thoracic region- rotation of the trunk * Lumbar region- flexion/extension of the back

Answer 6

1. Uncinate process = elevated lateral margins of superior surface of cervical vertebral body 2. Uncoverterbral joints 1. Ex: C4 and C5

Answer 7

* **Found:** base of skull ↔ anterior surface of sacrum * attachment to anterior surfaces of vertebral bodies and intervertebral discs along its length * **Function:** resistance to hyper-extension of spine * **Injury:** “whiplash” injury due to damage to anterior longitudinal ligament during severe hyper- extension of neck

Answer 8

* Found at base of skull ↔ sacrum * lines anterior surface of vertebral canal * attachment to posterior surfaces of vertebral bodies and intervertebral discs along its length * Function: resistance to hyper-flexion of spine

Answer 9

* location between laminae of adjacent vertebrae * posterior surface of lamina of vertebra below ↔ anterior surface of lamina of vertebra above * Function: prevention of hyper-flexion of spine * extension of spine to anatomical position from previous state of flexion * **When you bend forward the ligamenta flava helps you come back to upright position**

Answer 10

* Attachment of tips of vertebral spinous processes from C7 to sacrum * Purpose: prevention of hyper flexion of the spine

Answer 11

* Extension: cranial part of supraspinous ligament * Location: attachments to cranial base + posterior tubercle of C1 + spinous processes of cervical vertebrae + tip of C7 spinous process * attachment sites for neck muscles * Function: prevention of hyper-flexion of neck * bringing head to anatomical position * support of skull

Answer 12

* location between adjacent vertebral spinous processes * base of spinous process ↔ apex of spinous process * fusion with supraspinous ligament and ligamenta flava

Answer 13

* anterior = vertebral body + anterior longitudinal ligament * * middle = vertebral body + posterior longitudinal ligament * * posterior = ligamenta flava + interspinous ligament + supraspinous ligament (+ ligamentum nuchae in cervical region)

Answer 14

C6 Spinous Process

Answer 15

Rib 1 Articulates with T1 ( thoracic vertebrae)

Answer 16

1. Inverterebral disc 2. C7 Spinous process

Answer 17

C. Transverse Process D. Spinous Process

Answer 18

A. Vertebral body B. Rib E. Pedicle

Answer 19

* development of vertebra on only one side * abnormal fusion of C1 and C2 OR C5 and C6 * possible association with high-riding scapula (Sprengel’s shoulder) and cardiac abnormalities

Answer 20

* Fusion of L5 and S1 * Partial separation of S1 from sacrum

Answer 21

* incomplete fusion of vertebral arches in the midline * w “open” vertebral canal * w typically happens in lower part of spinal column * w complete failure of fusion of vertebral arch at lumbosacral junction with a meningeal outpouching (MOST severe type)

Answer 22

* Meningocele → cerebrospinal fluid in outpouched meninges * Myelomeningocele → part of spinal cord in outpouched meninges * Spina bifida occulta: * most common variant of spina bifida * defect/incomplete fusion of vertebral arch of L5 or S1 * present in 10% of individuals * clinically asymptomatic * possible presence of tuft of hair over spinous processes

Answer 23

1. Abnormal lateral curvature of vertebral column * Possible involvement of rotational element of one vertebra upon another 1. Idiopathic scoliosis (most common type): * may occur in infantile/juvenile/adolescent age-groups * NOT congenital * normal vertebral bodies + pedicles + laminae 2. Congenital scoliosis: * present from birth * associated with abnormalities of chest wall, genito-urinary tract, and heart disease 3. Neuropathic scoliosis: * manifestation of abnormalities in CNS/PNS * more common in children with cerebral palsy or polio 4. Scoliosis with muscular abnormalities: * rare occurrence * manifestation through muscular dystrophy * mal-alignment of spinal column

Answer 24

* Partial of total loss of lordotic curvature of the spine * Normal range 20-45 degrees Hyper Kyphosis \>45 * Two Types 1. Schuermann's disease * typical mid-thoracic region * common in teenagers * can't consciously correct posture * irregular shaped vertebral bodies and herniated discs 2. Postural kyphosis * most common form of hyper kyphosis * common in young and old * slouching is an example

Answer 25

* Increased extension of lumbar vertebrae * Flexion or anterior inferior rotation of the upper sacrum * Common causes * Pregnancy * Visceral fat * Weak trunk * Weak hamstrings or tight hip flexors

Answer 26

Nucleus pulposus herniates out through annulus fibrosus and it presses on the spinal nerve

Answer 27

* extremely high probability of significant spinal cord injury * quadriplegia/temporary disruption of respiratory function/hypotension (low blood pressure) are possible consequences * disruption of normal limb functions (upper + lower)

Answer 28

* fracture in region between superior and inferior zygapophyseal joints (= pars interarticularis) * possible compression of vertebral canal by vertebral body * L4 and L5 levels are common fracture sites * common trauma in athletes

Answer 29

Ø Inflammation of vertebral joints Ø Cervical spondylitis: * inflammation of cervical vertebrae Ø Lumbar spondylitis: * inflammation of lumbar vertebrae Ø Ankylosing spondylitis: * primarily affects sacroiliac joint

Answer 30

Combination of spondylitis and inflammation of adjacent intervertebral disc space.

Answer 31

* Degenerative osteoarthritis of intervertebral joint Ø Narrowing of space between adjacent vertebrae * caused by disc degeneration

Answer 32

* Defect in pars interarticularis of vertebral arch * detachment of pars interarticularis and separation of joints * more common in lumbar region ØTraumatic spondylolysis of C2 caused by * hyper-extension of head on neck Ø Typically caused by stress fracture of bone Ø Higher occurrence in adolescents engaging in tennis, diving, cheerleading, gymnastics, etc. Ø More common in males

Answer 33

Forward displacement of vertebra (especially L4/L5) Ø Commonly caused by spondylolysis Ø Degenerative spondylolisthesis: * vertebral displacement through joint arthritis, joint remodeling, and/or weakness in ligamenta flava * more common in females, individuals over 50, and African- Americans

Answer 34

Abnormal narrowing of vertebral canal Ø Compression of spinal cord and/or nerve roots Ø Possible causes include age, heredity, arthritis, spinal instability, trauma, and tumor Ø Lumbar spinal stenosis: compression of nerve roots/cauda equina in lower back possible cause of sciatica Ø Cervical spinal stenosis: w compression of spinal cord in neck w more dangerous than lumbar spinal stenosis w symptoms include major body weakness and paralysis Cervical is more damaging because it affects all those around it rather than lumbar which affects just the things below.

Answer 35

C. Meningomyelocele Meningomyelocele is protrusion of the meninges and spinal cord through the unfused arch of the vertebra. A sufficient amount of folic acid during preg- nancy is shown to prevent these kinds of neural tube defects. Spina bifida occulta is failure of the vertebral arch to fuse (bony defect only). Meningocele is protrusion of the meninges through the defective vertebral arch. Syringomyelocele is protrusion of the meninges and a pathologic tubular cavity in the spinal cord or brain.

Answer 36

(D) Ventral roots of the sacral spinal nerves The cauda equina is the collection of dorsal and ventral roots of the lower lumbar and sacral spinal nerves below the spinal cord. Dorsal and ventral primary rami and dorsal roots of the thoracic spinal nerves and lumbar spinal nerves do not par- ticipate in the formation of the cauda equina.

Answer 37

E. Kyphosis Kyphosis (hunchback or humpback) is an abnormally increased tho- racic curvature, usually resulting from osteoporosis. Lordosis is an abnormal accentua- tion of the lumbar curvature. Spina bifida occulta is failure of the vertebral arch to fuse (bony defect only). Meningocele is a protrusion of the meninges through the unfused arch of the vertebra, whereas meningomyelocele is a protrusion of the spinal cord and the meninges.

Answer 38

B. Sacral Hiatus Caudal (epidural) anesthesia is used to block the spinal nerves in the epidural space by injecting local anesthetic agents via the sacral hiatus located between the sacral cornua. An intervertebral foramen transmits the dorsal and ventral primary rami of the spinal nerves. The vertebral canal accommodates the spinal cord. Dorsal and ventral sacral foramina transmit the dorsal and ventral primary rami of the sacral nerves.

Answer 39

C. Posterior Longitudinal Ligament The posterior longitudinal ligament interconnects the vertebral bodies and intervertebral disks posteriorly and runs anterior to the spinal cord within the verte- bral canal. The ligamentum nuchae is formed by supraspinous ligaments that extend from the seventh cervical vertebra to the external occipital protuberance and crest. The anterior longitudinal ligament runs anterior to the vertebral bodies. The alar and cruciform liga- ments also lie anterior to the spinal cord.

Answer 40

E. Rotation ## Footnote The atlantoaxial joints are synovial joints that consist of two plane joints and one pivot joint and are involved primarily in rotation of the head. Other movements do not occur at this joint.

Answer 41

The Answer is D. All cervical spinal nerves exit through the intervertebral foramina above the corresponding vertebrae, except the eighth cervical nerves, which run inferior to the seventh cervical vertebra. All other spinal nerves exit the intervertebral foramina below the corresponding vertebrae. Therefore, the fifth cervical nerve passes between the fourth and fifth cervical vertebrae, and the fourth thoracic nerve runs between the fourth and fifth thoracic vertebrae.

Answer 42

The Answer is D. Cerebrospinal fluid (CSF) is found in the subarachnoid space, which is a wide interval between the arachnoid layer and the pia mater. The epidural space contains the internal vertebral venous plexus and epidural fat. The subdural space between the arachnoid and the dura contains a little fluid to moisten the meningeal surface. The pia mater closely covers the spinal cord and enmeshes blood vessels on the surfaces of the spinal cord. Thus, the space between the spinal cord and the pia is a potential space.

Answer 43

TheAnswer is D. Thespacebetweenthevertebralcanalandtheduramateristheepidural space, which contains the internal vertebral venous plexus. The spinal cord and blood vessels lie deep to the pia mater. The space between the arachnoid and dura maters is the subdural space, which contains a film of fluid. The subarachnoid space contains cerebrospinal fluid (CSF).

Answer 44

The Answer is C. The denticulate ligament is a lateral extension of the pia mater. The filum terminale (internum) is an inferior extension of the pia mater from the tip of the conus medullaris. The coccygeal ligament, which is also called the filum terminale externum or the filum of the dura, extends from the tip of the dural sac to the coccyx. The vascular choroid plexuses produce the cerebrospinal fluid (CSF) in the ventricles of the brain. The tectorial membrane is an upward extension of the posterior longitudinal ligaments from the body of the axis to the basilar part of the occipital bone.

Answer 45

The Answer is C. The cauda equina is formed by a great lash of the dorsal and ventral roots of the lumbar and sacral nerves.

Answer 46

The Answer is B. The conus medullaris is a conical end of the spinal cord and terminates at the level of the L2 vertebra or the intervertebral disk between L1 and L2 vertebrae. A spinal cord injury at the level of the upper part of the first lumbar vertebra damages the conus medullaris.

Answer 47

The Answer is E. Epidural fat is shown in the magnetic resonance imaging (MRI) scan. In addition, the internal vertebral venous plexus lies in the epidural space; thus, venous blood from the plexus may spread into epidural fat.

Answer 48

The Answer is A. The intervertebral disk lies between the bodies of two vertebrae and con- sists of a central mucoid substance, the nucleus pulposus, and a surrounding fibrous tis- sue and fibrocartilage, the annulus fibrosus. The nucleus pulposus may herniate through the annulus fibrosus, thereby impinging on the roots of the spinal nerves.

Answer 49

The Answer is D. The cerebrospinal fluid (CSF) is found in the lumbar cistern, which is a subarachnoid space in the lumbar area. CSF is produced by vascular choroid plexuses in the ventricles of the brain, circulated in the subarachnoid space, and filtered into the venous system through the arachnoid villi and arachnoid granulations.