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anatomy of the individual > bony variation > Flashcards

bony variation Flashcards

1
Q

what is the axial skeleton formed from?

A

the sclerotome component of somites

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2
Q

in the thorax what forms the ribs?

A

the costal processes elongates to form the ribs that articulate w/ the vertebral bodies and transverse processes

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3
Q

how does alteration in the number and orientation of ribs arise?

A

alteration in the standard pattern of development

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4
Q

changes in the axial skeleton are assoc w/ altered expression of which gene?

A

Hox gene

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5
Q

what is the most common rib anomaly?

A

the presence of an additional rib at the base of the neck (C7) aka cervical supernumerary rib

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6
Q

what causes cervical ribs?

A

the signalling intended to elongate the costal process of T1 also affecting C7

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7
Q

why is the true incidence of cervical ribs unknown?

A

because they are often v small and so go unnoticed

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8
Q

what are the symptoms of cervical ribs?

A

ofte asymptomatic

can cause compression of the brachial plexus and subclavian vessels (thoracic outlet syndrome is seen in ~10% of pts w/ cervical ribs)

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9
Q

what is an inter thoracic rib?

A

the rib does not form part of the thoracic cage but instead lies inside it

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10
Q

what is the incidence of interthoracic ribs?

A

very rare - only 40 cases reported in the literature since 1947

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11
Q

how many types of inter thoracic ribs are there and what is this based on?

A

4 types

based on the position and orientation (Kamans et al 2006)

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12
Q

what are the 3 potential causes of inter thoracic ribs?

A

thoracic super numerary rib
local depression of a rib
supernumerary varian of a bifid rib

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13
Q

what are the symptoms of inter thoracic ribs?

A

often asymptomatic
can cause pain if attached to the diaphragmatic pleura

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14
Q

what is the management for inter thoracic ribs?

A

no treatment needed if not causing any issues

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15
Q

how do vertebrae develop?

A

sclerotome component of somites > condense around the notochord > resegmentation > vertebral body

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16
Q

how is the vertebral arch formed?

A

from the vertebral body, cells migrate towards the spinal cord to form the vertebral arch

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17
Q

how does vertebral body variation arise?

A

disruption of the migration and development of the sclerotome cells

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18
Q

what is a limbus vertebrae?

A

when a fragment of the nucleus pulpous herniates through the ring of surrounding tissue before fragmentation has occurs

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19
Q

what does limbus vertebrae create?

A

an ossified fragment at the superior edge of the vertebral body

20
Q

what can limbus vertebrae be confused w/?

A

fracture of the superior endplate

21
Q

what condition is limbus vertebrae closely related to?

A

schmorls nodes

22
Q

how does segmentation failure occur and what does this lead to?

A

occurs when the IV disc does not develop fully, leading to partially fused vertebrae w/ an incomplete disc space

23
Q

what can segmentation failure be confused w/?

A

inflammatory spondylits

24
Q

how does butterfly vertebrae arise?

A

the notochord persists and so the two halves of the vertebrae do not fuse and the vertebral body is formed in two halves

25
Q

how does unfused spinous process arise?

A

failure in fusion of the neural arch leading to a true bony gap in the spinous process

26
Q

what can arise from unfused spinous process and why?

A

CNS abnormalities because the backbone that protects the spinal cord is not complete and so the spinal cord can get damaged

27
Q

what is unfused spinous process often confused w/?

A

fracture

28
Q

what causes enlargement of the spinous process?

A

spinous process hyperplasia (enlargement of the spinous process due to an increase in cell number)

29
Q

what can spinous process enlargement be confused w/?

A

a spinal mass

30
Q

name 3 other variations in the vertebrae

A

accessory tubercles
presence of foramina
vertebrae fused together

31
Q

what is the prevalence of supernumerary ribs in the lumbar region?

A

<2%

32
Q

what are the symptoms of lumbar supernumerary ribs?

A

asymptomatic because they do not cause any compression issues

therefore usually an incidental finding

33
Q

what is major impact limb variation?

A

entire bone / part of the bone missing

34
Q

give an example of major limb variation

A

radial deficiency and ulnar deficiency

35
Q

how do major changes the limb arise?

A

early development patterns being altered

36
Q

how do minor impact changes to the limb present?

A

usually silent because they cause little functional affect

37
Q

give 2 examples of bony changes in the limb that can lead to misdiagnosis

A

accessory bones in the feet are quite common and can be mistaken for tumours

sesamoid bones inside tendons are quite common and occur in response to stress on the tendon

38
Q

what are the implications of bony overgrowth of foramina, formation of bony tunnels or spurs?

A

may compress neurovasculature

39
Q

where is the most reported bony spur located and what can this cause clinically?

A

most reported bony spur is on the distal end of the humerus

can cause compression of the median nerve and / or brachial artery

40
Q

what are the findings of Kazanci et al (2012)?

A

C6 unilateral hyperplasia of the lamina and schisis of the spinous process in a 20y/o pt who presented following a car accident w/ no funcitnal issues from the hyperplasia

the hyperplasia was differentiated from a traumatic lesion using CT and MRI

41
Q

apart from the spinous process where else in the head and neck has hyperplasia been reported?

A

the styloid process

42
Q

what can cause further elongation of the spinous process?

A

ossification of the stylohyoid ligament

43
Q

what is the risk of styloid process hyperplasia?

A

it can compress the pharynx and make swallowing difficult

44
Q

what are the clinical implications of fusion of the atlas to the base of the skull?

A

no movement between the skull and C1

can alter the course of the vertebral artery and C1 spinal nerve and may compress them

45
Q

what are the findings of Ma et al (2012) in their study regarding the pterion?

A

investigation of the pterion and middle meningeal artery

found that the pterion was not the thinnest part

in 70% of pts the middle meningeal artery was enclosed in a bony tunnel

in one third of patients the middle meningeal artery did not pass close to the pterion

anatomy of the individual (7 decks)

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