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Vertebral Column > Development of the vertebral column > Flashcards

Development of the vertebral column Flashcards

1
Q

How many true vertebrae are there?

A
  • PRESACRAL VERTEBRAE
  • 24 in total
  • 7 cervical
  • 12 thoracic
  • 5 lumbar
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2
Q

How many false vertebrae are there?

A
  • 9 in total
  • 5 sacral
  • ~4 coccygeal
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3
Q

Why are presacral vertebrae named ‘true’ vertebrae?

A

Because they are unfused

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4
Q

What happens to coccygeal vertebrae with advancing age?

A

They fuse, therefore there is a variable number of them

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5
Q

Identify the curvature

A

Cervical curvature

(Secondary)

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6
Q

Identify the curvature

A

Thoracic curvature

(Primary)

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7
Q

Identify the curvature

A

Lumbar curvature

(Secondary)

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8
Q

Identify the curvature

A

Sacral / coccygeal curvature

(Primary)

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9
Q

What shape is the vertebral column in the fetus?

A

C-shaped

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10
Q

When do the primary curvatures develop?

A

During fetal development

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11
Q

When do the secondary curvatures develop?

A

During infancy

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12
Q

When, specifically, does the cervical curvature form and what is it in response to?

A
  • At 2-3 months
  • When child can hold head up (postural muscles in neck develop)
    • compensatory secondary cervical curvature forms
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13
Q

When, specifically, does the lumbar curvature form and what is it in response to?

A
  • At 6-8 months
  • When the child sits up unaided, there is a change in the loading regime acting on the vertebral column
    • compensatory secondary lumbar curvature forms
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14
Q

How are the primary curvatures maintained?

A

By the shape of the vertebra

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15
Q

How do the secondary curvatures arise?

A

Arise from a modification in shape of the intervertebral disc.

There is a difference in thickness between anterior and posterior parts of the IV disc.

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16
Q

What is caused by degeneration of the IV disc in the elderly?

A

More pronounced primary curvature

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17
Q

What is kyphosis?

A

Hunchback deformity

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18
Q

What is lordosis?

A

Swayback deformity

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19
Q

Who is susceptible to lordisis and what does it cause?

A
  • Common in pregnancy
  • Causes forward pelvic tilt
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20
Q

What is scoliosis?

A

Lateral deviation of the spine greater than 10°.

Often accompanied by a rotational defect.

Can be idiopathic or secondary to a primary neuromuscular condition.

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21
Q

What is the adult vertebral body derived from?

A

The juvenile centrum plus a small portion of the neural arch.

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22
Q

Name the structure indicated by the red arrow

A

Neurocentral junction

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23
Q

Name the structure indicated by the red arrow

A

Bouton of the pedicle

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24
Q

Name the structure indicated by the red arrow

A

Posterior synchondrosis

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25
Q

Name the structure indicated by the red arrow

A

Left half of the neural arch

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26
Q

Name the structure indicated by the red arrow

A

Centrum

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27
Q

Where is ossification of the centra initiated?

A

Dorsal to the notochord.

It represents true endochondral ossification.

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28
Q

Where is the first endochondral ossification of the centra and when does it occur?

A
  • First appears in lower thoracic and upper lumbar regions (T10-L1).
  • Occurs between 9 and 10 fetal weeks.
  • Continues in bidirectional progression.
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29
Q

Where does endochondral ossification of the centra reach by the 3rd fetal month?

A

L5 by the 3rd fetal month

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30
Q

Where does endochondral ossification of the centra reach by the end of the 4th fetal month?

A

C2 by the end of the 4th fetal month

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31
Q

Describe the vascular penetration into the centra

A
  • Notochord cells contain angiogenic inhibiting factor which delays vascular penetration.
  • Vertebral centra from the first trimester display an axial avascular area around the notochord region.
    • Results in ring-shaped ossification
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32
Q

Where does ossification of the neural arches begin?

A

On the inner surface of each hemi-arch

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33
Q

What kind of ossification do the neural arches undergo?

A

Intramembranous ossification, followed by endochondral ossification.

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34
Q

What do neural arches form bone from?

A

Directly from a mesenchymal membrane

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35
Q

When and where do the neural arches ossify?

A
  • First, in lower cervical and upper thoracic regions in the second fetal month.
  • Subsequently spreads upwards and downwards.
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36
Q

What is ossification of the neural arches initiated by?

A
  • Initiated in response to the gasp reflex
  • Lower limb movement (muscle contraction) - kicking during pregnancy.
  • The muscle used during kicking is anchored to the vertebral column and twitching sets off bone formation via ENDOCHONRDAL OSSIFICATION.
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37
Q

Where does neural arch fusion commence?

A

Posteriorly at the spinous process.

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38
Q

When and in which region does neural arch fusion occur?

A
  • Occurs first in lower thoracic and upper lumbar regions in the latter part of the first year.
  • Progresses systematically in a cranial and caudal direction.
  • Cervical arches may not fuse until the beginning of the 2nd year.
  • Lowest lumbar arches may not fuse until the end of the end of the 5th year.
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39
Q

What are the first and last fusion points of the neural arches?

A
  • First fusion point - posterior synchondrosis
  • Last fusion point - sacral area
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40
Q

What is neurocentral fusion?

A

Fusion between the neural arches and the centra

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41
Q

Where does neurocentral fusion occur?

A

Ventral to the pedicles at the neurocentral junction

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42
Q

When does neurocentral fusion occur?

A

Between 2 and 5 years

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43
Q

With what does the head of the costal process articulate?

A

The boutons of the pedicles.

NEVER with the centrum.

44
Q

In what order do the regions of the vertebral column undergo neurocentral fusion?

A
  • First in the lumbar region
  • Followed by cervical segment
  • Lastly, thoracic vertebrae are the last to fuse
45
Q

Which structure takes the place of the centrum in C1?

A

Anterior bar or anterior arch.

THERE IS NO CENTRUM.

46
Q

What forms first in C1?

A

Neural arch

(converse to other vertebrae)

47
Q

Describe the superior and inferior articular surfaces of C1

A
  • Superior - very large articular surfaces for articulation with the occipital condyles.
  • Inferior - much smaller articular surfaces.
48
Q

When and how does the anterior bar in C1 form?

A
  • Forms late - first or second year of life.
  • Forms as a single piece but from 2 centres (bilateral ossification).
49
Q

Where and when does the centre for the lateral masses of C1 appear?

A
  • Posterior to the articular pillar
  • In the 7th week
50
Q

Describe C1 at birth

A
  • Two bony masses
  • Larger concave articular facets anteriorly on the superior surface
  • Smaller, flatter articular facets on the inferior surface
  • Morphology remains unchanged throughout the first year after birth
51
Q

When does the posterior arch of the atlas fuse?

A

4-5 years

Can remain open into adulthood (1% incidence)

52
Q

When do the anterior neurocentral junctions close?

A

5-6 years

53
Q

When is the adult size of C1 reached?

A

4-6 years

54
Q

How would you differentiate between spina bifida atlantis and fusion which hasn’t happened yet?

A
  • Pointed ends which taper off towards one another are true spina bifida atlantis.
  • Flared appearance are just posterior arches which have not yet fused.
55
Q

How does the axis (C2) ossify?

A
  • From 5 primary ossification centres:
    • One for each half of the neural arch
    • One for the true centrum of the axis
    • One for each half of the body of the dens
56
Q

When do the centres of ossification in the neural arches of C2 appear?

A
  • At 7-8 fetal weeks
  • This is before the centra
57
Q

Ossification of the centrum of the axis

A
  • Commences ossification from a single centre
  • 4-5 months intra-uterine life
58
Q

What appears in the odontoid process at 4-5 months intra-uterine life?

A
  • 2 laterally placed ossification centres
  • These rapidly coalesce so that the intra-dental synchondrosis fuses by birth
    • this forms the forked appearance of the juvenile dens
59
Q

When does the posterior synchndrosis between the neural arches of the axis (C2) fuse?

A

3-4 years

60
Q

When and how does the dens fuse?

A
  • Fuses laterally to the neural arches at the dentoneural synchondrosis
  • At 3-4 years
61
Q

What is the superior articular facet of the axis (C2) comprised of?

A
  • Medial 1/3 by the dens (odontoid process)
  • Lateral 2/3 by the neural arch
62
Q

What is the inferior articular facet of the axis (C2) comprised of?

A
  • Formed entirely of the neural arch
63
Q

When does complete fusion of the foramen transversarium in the axis (C2) occur?

A

3-5 years

64
Q

When do the dentocentral junction and the paired neurocentral junctions in the axis (C2) fuse?

A

4-6 years

65
Q

When do all lines of fusion disappear by?

A
  • 9-10 years
  • A small horizontal crevice may remain in the region of the posterior dentocentral junction - this is a site of fracture weakness
66
Q

What happens to the axis (C2) at ~2 years?

A
  • Small ossific nodule - ‘ossiculum terminale’ - appears in the cartilage plug that fills the apical cleft.
67
Q

When does the ossiculum terminale fuse with the dens?

A

~12 years

68
Q

What kind of ossification centre is the ossiculum terminale?

A

Can be referred to as primary or secondary - secondary because it forms so late (start of puberty).

69
Q

What are the secondary ossification centres of the axis (C2)?

A
  • FIVE secondary ossification centres.
    • 2 flake-like epiphyses for the transverse processes
    • 2 flake-like epiphyses for the bifid spinous processes
    • Inferior annular ring
  • Rises to 6 if os terminale is considered epiphyseal
70
Q

What happens at the inferior annular ring?

A
  • A recognisable secondary centre of ossification appears.
  • A small tongue of bone progresses up the posterior surface of the dens, infilling the interdental groove.
71
Q

What is the interdental sulcus?

A

The groove between the fused right and left halves of the odontoid process

72
Q

How many ossification centres form a typical cervical vertebra?

A

3

73
Q

When and where do the laminae of typical cervical vertebrae unite?

A

Unite posteriorly within the 2nd year of life

74
Q

When is neurocentral fusion complete in the cervical segment?

A

3-4 years

75
Q

What happens once neurocentral fusion has taken place in typical cervical vertebrae?

A

Synovial uncovertebral joints of Luschka form on the sloping and elevated articular sides of the neural elements of the vertebral body.

76
Q

Describe the secondary ossification centres of a typical cervical vertebra.

A
  • SIX CENTRES
  • 2 transverse processes
  • 2 spinous processes
  • 1 superior annular ring
  • 1 inferior annular ring
77
Q

When do the secondary ossification centres appear in typical cervical vertebrae?

A

At the beginning of puberty

78
Q

When do the secondary ossification centres of a typical cervical vertebra begin to fuse?

A

End of puberty (18+)

79
Q

When is fusion of a typical cervical vertebrae complete?

A

~24 years

80
Q

When are the three primary ossification centres present by in the thoracic and lumbar vertebrae?

A

All 3 primary centres present by the end of the 3rd intra-uterine month, and identifiable by the 4th intrauterine month.

81
Q

Describe the ossification pattern of the sacrum

A
  • Complex - 21 centres of ossification
  • Each vertebrae has the typical centres:
    • 1 centrum
    • 2 neural arches
    • S1-S3 - incorporated paired lateral elements
    • These form the ventral aspect of the alae and are the site of sacroiliac articulation
  • Cranial to caudal ossification pattern
  • By birth, all 21 ossification centres are represented, but are not identifiable
82
Q

What is formed in the 3rd intra-uterine month in the sacrum?

A
  • S1 centrum
  • S2 centrum
83
Q

What is formed in the 4th intra-uterine month in the sacrum?

A
  • S3 centrum
  • S4 centrum
  • S1-S3 neural arches
84
Q

What is formed in the 5th intra-uterine month in the sacrum?

A
  • S5 centrum
  • S4-S5 neural arches
85
Q

What is formed in the 6th-8th intra-uterine months in the sacrum?

A
  • S1-S3 paired costal elements
86
Q

When does the neural arch unite with the lateral elements in a sacral vertebrae?

A

2-5 years

87
Q

When does the united component (neural arch + lateral elements) fuse with the centrum in the sacrum?

A

2-6 years

88
Q

Describe the state of fusion of the sacrum in a 6 year old

A

All the primary centres have fused except posteriorly at the spinous process

89
Q

When does posterior fusion at the spinous process occur in the sacrum?

A

7-15 years

90
Q

What is the last thing to fuse in the sacrum?

A

Posterior synchondrosis

91
Q

What are the directions of appearance and fusion in the sacrum?

A
  • Appearance is craniocaudal
  • Fusion is caudocranial
92
Q

Describe the secondary ossification centres in the sacrum

A
  • Not consistent, varies between individuals
  • 14 constant centres
    • 10 annular rings
    • 2 auricular epiphyses
    • 2 lateral margin epiphyses
  • Flake-like epiphyses
93
Q

When does fusion of the secondary centres in the sacrum occur?

A

~12 years when the lateral elements are fusing, the annular epiphyses commence fusion in a caudocranial direction.

94
Q

What age is an individual if spaces can be seen between the vertebral bodies?

A

<20 years

95
Q

What age is an individual is a space can be seen only between S1 and S2?

A

<27 years

96
Q

Describe the epiphyses for the sacroiliac joint

A
  • Several ossific nodules which coalesce
  • Appears at 15-16 years
  • Fuses by ~18 years
  • Lateral margin epiphyses follows the same pattern
97
Q

When does the sacroiliac joint form?

A

2nd intra-uterine month

98
Q

When is the sacroiliac joint complete?

A

7th intra-uterine month

99
Q

What is the form of the sacroiliac joint at birth?

A
  • Straight
  • Parallel to vertebral column
    • this reflects quadrupedal form
100
Q

What forces the sacroiliac joint to curve caudodorsally into the adult morphology?

A

Mechanical forces associated with growth and bipedalism

101
Q

Describe the ossification centres in the coccyx

A

Each coccygeal vertebrae forms its own ossification centre.

Co1 may form multiple

102
Q

When does the ossification centre in Co1 appear?

A

Late fetal period and first year of life

103
Q

When does ossification centre of Co2 appear?

A

3-6 years

104
Q

When does ossificaition centre of Co3 appear?

A

10 years

105
Q

When does ossification centre of Co4 appear?

A

Puberty

Vertebral Column (13 decks)

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