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Spinal Anatomy > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the 6 different types of synovial joints?

A
  1. Pivot
  2. Ball and socket
  3. Saddle
  4. Ellipsoid
  5. Hinge
  6. Gliding
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2
Q

S2 tubercle is found approximately at the level of what other anatomical structure?

A

PSIS

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3
Q

The apex of the heart is found approximately at what vertebral layer?

A

T10

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4
Q

Vertebral notches are found as part of which vertebral structure?

A

Pedicle

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5
Q

Supination and pronation movements occur in which plane?

A

Transverse

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6
Q

List sympathetic responses

A

Pupils dilate, eyes widen
Mucous membranes of nose/mouth dry
Erector pili muscles contract, sweating
Blood supply to skin and GI tract constricted
Blood supply to heart, lungs, skel muscles dilated
Cardiac stroke volume increases, brachiodilation

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7
Q

List parasympathetic responses:

A

Pupils constrict
Mucous membranes secrete
Peristalsis of GI tract
Blood supply increased to GI tract and skin
Blood supply decreased to skel muscle, heart, lungs
Bronchoconstriction and decreased cardiac output

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8
Q

Medial and lateral movements occur in what plane?

A

Sagittal/Median

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9
Q

Anterior and posterior movements occur in what plane?

A

Coronal/frontal

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10
Q

Movement along an axis is what?

A

Translation

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11
Q

Movement around an axis is what?

A

Rotation

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12
Q

Theta movement moves in what direction?

A

Counterclockwise

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13
Q

How many fused vertebrae make up the coccyx?

A

3-5

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14
Q

Which 2 segments contain no discs between vertebrae?

A

C0-C1 and C1-C2

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15
Q

The 7 processes from the posterior aspect are made of which processes?

A

1 SP, 2 TP, 4 APs

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16
Q

The median furrow surface connects from ____ to ____.

A 
EOP 
Gluteal cleft (S3)
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17
Q

Inferior angle of scapula positioning while prone and while standing?

A

Prone- T6

Standing- T7

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18
Q

T1 is the most prominent SP in what population percentage?

A

30-40%

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19
Q

The mastoid process is felt by coming off the TP of which vertebra?

A

C1 (atlas)

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20
Q

Which cervical vertebra has the smallest SP?

A

C3

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21
Q

The C3 SP is approximately the same level as what feature of the hyoid bone?

A

Greater cornua

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22
Q

C4 disc sits level with ____.

A

Thyroid cartilage

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23
Q

Lamina contact point or the articular pillars are approximately how far lateral from the cervical SPs?

A

1.5 cm

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24
Q

Carotid tubercle (C6) is level with cricoid cartilage and which tracheal ring?

A

1st tracheal ring

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25
Q

The root of the spine of the scapula is found off which SP?

A

T3 SP

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26
Q

The most convex point of thoracic kyphosis is which SP?

A

T4

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27
Q

T12 is a 1/2 measurement point between ____ and ____.

A

IAS

Superior iliac crest

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28
Q

T5-9 are how many spinous interspaces superior to their SP?

A

2

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29
Q

Rib angles are approximately how far lateral to the midline at the level of their TP?

A

4 cm

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30
Q

Which SP is the last palpably movable through flex/extend?

A

L4

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31
Q

80% of the time, L4 SP is at level of ____.

A

Iliac crests

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32
Q

What processes are found 2cm lateral on the superior articular processes?

A

Mammillary

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33
Q

Mammillary processes are level with which bony landmark?

A

PSIS

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34
Q

Which sacral tubercle is located at the upper end of the gluteal cleft?

A

S3

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35
Q

Tip of coccyx is approximately how far posterior of the anus?

A

1cm

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36
Q

Spinal nerves exit at the same level as their vertebral body down the foramen magnum at what month of development?

A

3rd month

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37
Q

At birth, conus medullaris (spinal cord) extends to ____.

A

L3

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38
Q

In adults, conus medullaris is located at which vertebral body?

A

L1 or L2

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39
Q

Cervical cord runs along foramen magnum

A

SP C6

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40
Q

Upper thoracic cord runs T1-T6 and approximates with ____.

A

SPs of C6-T4

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41
Q

Lower thoracic cord runs T7-T12 and approximates with ____.

A

SPs of T4-T9

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42
Q

Lumbosacral coccygeal cord approximates with ____.

A

SPs of T10-L1 conus medullaris

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43
Q

Cervical cord enlargement C4-T1 approximates with ____.

A

C4-C7 vertebral bodies

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44
Q

Lumbar cord enlargement L2-S3 approximates with ____.

A

T10-L1 vertebral bodies or T9-12 SPs

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45
Q

Aorta runs down which side of the vertebral bodies?

A

Left

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46
Q

Which portion of the aorta extends T12-L4?

A

Abdominal aorta

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47
Q

Abdominal aorta bifurcates as the ____ below L4.

A

Common iliac veins

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48
Q

Inferior vena cava forms at the joining of the common iliac veins at which level of the vertebral bodies?

A

L5

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49
Q

Inferior vena cava travels up which side of the vertebral bodies?

A

Right

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50
Q

3 functions of the spine:

A

Support body
Protect spinal cord/nerve roots
Movement of trunk

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51
Q

The neural groove is made of the combinations of ____ and ____.

A

Neural tube

Neural crest

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52
Q

Somites are derived from what?

A

Paraxial mesoderm

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53
Q

Somites develop into what? (3)

A

Dermatomes
Myotomes
Sclerotomes

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54
Q

Dermatomes make up ____.

A

Dermis and subcutaneous tissue

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55
Q

Myotomes make up ____.

A

Axial muscles

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56
Q

Sclerotomes migrate centrally forming ____.

A

Vertebral column and associated ligaments

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57
Q

What are the 3 layers that the inferior portion of neural tube differentiates into?

A

Ependymal
Mantle
Marginal

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58
Q

Ependymal layer is located ____.

A

Around central canal

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59
Q

Mantle layer makes up ____.

A

Neurons and glia

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60
Q

Marginal layer is associated with ____.

A

Axons of the tract cells (white matter)

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61
Q

Neural crest makes up sensory neurons of the ____ and postganglionic neurons of the ____.

A

PNS

ANS

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62
Q

Which type of cells form 3 pairs of chondrifaction centers forming a cartilage model?

A

Sclerotomal cells

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63
Q

Of the 3 primary centers of ossification, 1 forms the ____ of the vertebral body and 2 form the ____.

A

Future anterior portion

Future posterior portion

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64
Q

Fusion of either side of the vertebral body with the neural arch is called what?

A

Neurocentral synchdrosis

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65
Q

Secondary ossification centers develop between what ages?

A

10-13

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66
Q

Where are the 5 secondary ossification centers located?

A

Superior endplate-1
Inferior endplate aka annular or ring epiphyses- 1
TP- 1 each
SP- 1

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67
Q

Growth ends between what age range?

A

14 and 25 years

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68
Q

Thoracic kyphosis apex is at what vertebra?

A

T4

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69
Q

In thoracic kyphosis, the vertebral bodies are ____ posteriorly than anteriorly.

A

Taller

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70
Q

In pelvic kyphosis, lumbosacral junction to coccyx faces ____ and ____.

A

Anterior

Inferior

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71
Q

Cervical lordosis occurs around what age?

A

3-4 months, reinforced around 9 months

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72
Q

At what age does lumbar lordosis occur?

A

10-18 months

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73
Q

In lumbar lordosis, disc and vertebral bodies are ____ anteriorly than posteriorly.

A

Taller

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74
Q

What are the cervical segments where compression fractures from superior force occur?

A

C4-C6

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75
Q

What are the cervical segments where compression fractures from inferior force occurs?

A

T9-L2

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76
Q

Hyperflexion of trunk injury most commonly affects which segments?

A

T5-T6

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77
Q

Trabeculae are orientated in which direction relative to lines of greatest stress (such as axial compression)?

A

Parallel

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78
Q

Smooth region around the edge of the superior and inferior surfaces of vertebral body is formed by what?

A

Annular apophysis

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79
Q

Most vertebral bodies concave posteriorly towards the ____.

A

Vertebral foramen

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80
Q

Pedicles attach to the posterior ____ aspect of vertebral body.

A

Lateral

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81
Q

Pedicles are ____ to the midpoint of the vertebral body.

A

Superior

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82
Q

Laminae are continuous with what structures?

A

Pedicles

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83
Q

Laminae thickness ____.

A

Varies regionally

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84
Q

Spinous processes may normally deviate in which directions?

A

Left and right

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85
Q

Borders of vertebral foramen are composed of what structures?

A

Vertebral body, R/L pedicles, R/L lamina, spinous process

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86
Q

Which ligaments are found within the the vertebral canal?

A

PLL, ligamentum flava

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87
Q

Transverse processes project laterally from the junction of which structures?

A

Lamina and pedicle

88
Q

Cervical transverse processes project ____.

A

Obliquely anterior between sagittal and coronal plane

Located anterior to articular process and lateral to pedicles

89
Q

Thoracic transverse processes project ____.

A

Obliquely posterior

Located posterior to articular processes, pedicles

90
Q

Lumbar transverse processes project ____.

A

Anterior to articular processes, posterior to pedicles

91
Q

Cervical costal element:

A

Anterior tubercle of transverse foramen

92
Q

Thoracic costal element:

A

Ribs

93
Q

Lumbar costal element:

A

Anterior aspect of TP

94
Q

Sacral costal element:

A

Sacral ala

95
Q

Superior articular process projects ____.

A

Superiorly from lamina pedicle junction

96
Q

Superior articular process forms ____.

A

Zygapophyseal joints (facets)

97
Q

Cervical and lumbar articular surfaces face ____.

A

Posteromedial

98
Q

Thoracic articular surfaces face ____.

A

Posterolateral

99
Q

Inferior articular processes articular surface faces ____.

A

Anterior

100
Q

Which functional components of a typical vertebra determine spinal movement?

A

Superior/inferior articular processes

101
Q

Which functional component of a typical vertebra acts to transfer weight?

A

Posterior arches

102
Q

What are the 3 AKAs for zygapophyseal joints?

A

Z joint, facet joint, interlaminar joint

103
Q

Z joints are what kind of synovial joint?

A

Planar

104
Q

What is the function of the z joint?

A

Determine direction/limitation of movement between vertebrae, help carry load during extension/rotation

105
Q

Anterior and medial portions of z joint are covered by the ____.

A

Ligamentum flavum

106
Q

Which layer of z joint has sensory and autonomic innervation?

A

Synovial

107
Q

Ligamentum flavum and z joint capsule have ____ receptors.

A

Nociceptive

108
Q

Z joints are innervated by the medial branch of the ____ primary rami.

A

Dorsal

109
Q

Broad pain referral pattern within z joints comes from innervation of what nerve?

A

Medial branch of dorsal primary rami

110
Q

What are the 3 types of sensory receptors which innervate the z joints?

A

Nociceptors, free nerve endings
Complex unencapsulated nerve endings
Proprioceptors, encapsulated nerve endings

111
Q

Z joint pathology for back pain?

A

Facet syndrome

112
Q

What are the facet angles in the cervical spine?

A

45 degrees, loose joint capsule

113
Q

What are the facet angles in the thoracic spine?

A

60 degrees

Allows rotation, limits flex/extend and lateral flex

114
Q

What are the facet angles in the lumbar spine?

A

90 degrees

Allows flex/extend, limits rotation and lateral flexion

115
Q

Movement is limited/determined by what 4 main structures?

A

IVD
shape/orientation of articular facets
ligaments
muscles

116
Q

Spinal ligaments are most effective when carrying loads when ____.

A

The stress parallels the direction that ligament fibers run

117
Q

Ligamentum nuchae runs what length of the spinal column?

A

C7 SP to EOP

Lamellar and funicular portions

118
Q

Supraspinous ligament and ligamentum nuchae limit which range of motion?

A

Flexion

119
Q

Interspinous ligaments run what length of spinal column?

A

Inferior aspect of 1 SP to the superior aspect of 1 SP below
Limits flexion

120
Q

Intertransverse ligaments run what length of the spinal column?

A

Connect inferior aspect of 1 TP to superior aspect of 1 TP below
Limits contralateral lateral flexion

121
Q

Ligamentum flava connects ____ to ____.

A

Lamina to lamina

122
Q

Ligamentum flava lies directly ____ to the spinal cord.

A

Posterior

123
Q

PLL runs down which aspect of the vertebral canal?

A

Anterior

Posterior to vertebral bodies

124
Q

PLL begins at which vertebral body?

A

C2

125
Q

PLL functions to limit which movements?

A

Flexion

Posterior disc protrusion

126
Q

Tectorial membrane runs what length of the vertebral column?

A

Posterior body of C2 up to anterior rim of foramen magnum

127
Q

Tectorial membrane functions to limit what movement?

A

Flexion and extension of atlas and occiput

128
Q

What are the 4 specialized upper cervical ligaments?

A

Accessory atlanto-axial
Cruciate ligament of atlas
Alar ligaments
Apical

129
Q

Cruciate ligament of atlas functions to ____.

A

Keep the transverse ligament of C1 centered on the dens with superior/inferior bands

130
Q

Alar ligaments function to limit what movement?

A

Contralateral axial rotation

131
Q

Alar ligaments run what length of the vertebral column?

A

Posterior lateral dens to occipital condyle

132
Q

Apical ligament runs what length of the spinal column?

A

Posterior superior dens to anterior rim of foramen magnum

133
Q

ALL runs what length of the spinal column?

A

Runs occiput and anterior tubercle of atlas to each vertebral body limiting extension

134
Q

Anterior atlanto-occipital membrane runs what length of the spinal column?

A

Anterior margin of foramen magnum to superior aspect of anterior arch of atlas
Limits extension of occiput on C1

135
Q

Anterior atlanto-occipital membrane is located ____ to ALL.

A

Posterior

136
Q

Spinal flexion is limited by which ligaments?

A 
Posterior IVD
PLL
Ligamentum flava
Interspinous ligaments
Supraspinous ligaments
Ligamentum nuchae
Articular capsules
Articular facets
Muscles (extensors)
137
Q

Spinal extension is limited by which structures?

A 
Anterior IVD
ALL
Approximation of SPs
Articular processes
Laminae
138
Q

Spinal lateral flexion is limited by which structures?

A

Lateral IVD
Intertransverse ligaments
Approximation of articular processes
Muscles (antagonists)

139
Q

Spinal rotation is limited by which structures?

A

Annulus fibrosus of IVD

Orientation of articular processes/facets

140
Q

Coupled motion is a combined movement of ____.

A

Rotation with lateral flexion

141
Q

Which regions of the spine have slight vertebral body rotation due to orientation of superior and inferior articular facets when laterally flexed?

A

Cervical and lumbar

142
Q

Nucleus pulposus comes from the ____ and annulus fibrosus comes from the ____.

A

Notochord

Mesechyme/sclerotome

143
Q

A 12-20 layered annulus fibrosus is found in which region of the spine?

A

Lumbar

144
Q

A crescent shaped annulus fibrosus is found in which region of the spine?

A

Cervical

145
Q

The IVD is connected to the vertebral body by ____ cartilaginous endplates.

A

Superior and inferior

146
Q

Joint formed by IVD connecting 2 vertebral bodies is called the ____ or ____.

A

Anterior interbody joint

Intervertebral symphysis

147
Q

The anterior interbody joint or intervertebral symphysis is classified as what kind of joint?

A

Cartilaginous, symphysis joint

148
Q

At what age has the IVD started to become nearly avascular?

A

20

149
Q

Sacral IVD remnants ossify into what structures?

A

Transverse lines

150
Q

IVD are thickest in which region of the spine?

A

Lumbar

151
Q

IVD are thinnest in what region of the spine?

A

Upper thoracic

152
Q

Cervical and lumbar IVDs are thicker ____ than ____ contributing to regional lordosis.

A

Anteriorly

Posteriorly

153
Q

Cervical IVDs are approximately ____ height of the vertebral bodies.

A

2/5

154
Q

Thoracic IVDs are approximately ____ the height of the vertebral bodies.

A

1/5

155
Q

Lumbar IVDs are approximately ____ the height of the vertebral bodies.

A

1/3

156
Q

IVDs are connected firmly to the ____ and loosely to the ____.

A

PLL

ALL

157
Q

IVD composition includes:

A

Water, chondrocytes, fibroblasts, proteoglycans aggregates, type I and II collagen fibers

158
Q

The process by which IVD uptakes fluid is called ____.

A

Imbibition

159
Q

What are the 3 regions of the IVD?

A

Annulus fibrosus
Nucleus pulposus
Vertebral (cartilaginous) endplates

160
Q

Annulus fibrosus is composed of what kind of tissue?

A

Type I collagen

161
Q

Nucleus pulposus is composed of what type of tissue?

A

Type II collagen

162
Q

Lumbar and thoracic annulus fibrosus are convex ____.

A

Anteriorly

163
Q

Collagen fibers of annulus fibrosus run parallel at ____ degrees from vertical.

A

65

164
Q

Most superficial lamella attach to the IVD of the ring apophysis via ____.

A

Sharpey fibers

165
Q

Cervical annulus fibrosus are composed of how many rings of crescent shaped fibrocartilage?

A

1

166
Q

What part of of the annulus fibrosis limits flexion?

A

Posterior annulus

167
Q

What part of the annulus fibrosus limits extension?

A

Anterior annulus

168
Q

What part of the annulus fibrosus limits lateral flexion?

A

Contralateral side of annulus

169
Q

What part of the annulus fibrosus limits axial rotation?

A

45 degrees off the plane of the disc, tensile force

170
Q

During lateral flexion, what direction does the IVD bulge towards?

A

Side of the concavity

171
Q

Which region of the IVD is the weakest?

A

Postero-lateral

172
Q

Which fibers innervate the annulus fibrosus?

A

GSA and GVA
Posterior aspect, recurrent meningeal nerve
Anterior/lateral aspect, branches of ventral rami and sympathetic chain

173
Q

What are the 2 different types of IVD tears?

A

Circumferential and radial tears

174
Q

Nucleus pulposus notochordal cells are completely replaced by what type of tissue around 11 years of age?

A

Fibrocartilage

175
Q

Nucleus pulposus is made up ____ percent of water?

A

70-90

176
Q

At what age does water begin to degenerate from within the nucleus pulposus?

A

30

177
Q

How does the nucleus pulposus receive nutrients?

A

Imbibition, sodium and potassium remain inside IVD as compressive forces force out water

178
Q

Vertebral (cartilaginous) end plate lines everywhere but where?

A

The most peripheral rim, superiorly and inferiorly

179
Q

The vertebral (cartilaginous) end plate attaches disc to ____ vertebral body.

A

Adjacent

180
Q

During compressive loading of the vertebral column, when does the vertebral (cartilaginous) end plate fail?

A

First

181
Q

Cervical (C1-C7) spinal nerves exit through ____ above their respective vertebra.

A

IVFs

182
Q

Which spinal nerve would a C4 disc protrusion affect?

A

C5 nerve

183
Q

C8 spinal nerves and below enter through IVFs ____ their respective vertebra.

A

Below

184
Q

Lumbar spinal nerves exit below its respective vertebra but the nerve ____ preventing a disc protrusion below.

A

Hugs the pedicle

185
Q

Narrowing of he vertebral canal is called what?

A

Spinal canal stenosis

186
Q

Epidural space is how deep?

A

4-6 mm deep

187
Q

Internal vertebral venous plexus is also known as?

A

Batson’s plexus of veins

188
Q

What divides the spinal cord into spinal segments?

A

Rootlets

189
Q

Medial branches of the dorsal ramus supply what structures?

A

Z joints and transversospinalis muscles

190
Q

Lateral branches of the dorsal ramus supply what?

A

Erector spinae muscles

191
Q

IVF anterior border is located along what structures?

A

Vertebral bodies and IVDs

192
Q

IVF superior border is located along what structure?

A

Inferior vertebral notch of pedicle above

193
Q

IVF inferior border is located along what structure?

A

Superior pedicle notch of pedicle below

194
Q

IVF posterior border is located along what structure?

A

Z joints

195
Q

Function of spinal muscles:

A

Move spine, maintain posture, absorb shock, protect spine/viscera

196
Q

Which part of the nervous system controls muscle coordination?

A

CNS

197
Q

The 1st of the 6 layers of back muscles connects what portions of the body?

A

Upper limb to vertebral column

198
Q

Which muscles make up the 1st layer of the back muscles?

A

Trapezius and latissimus dorsi

199
Q

Trapezius is innervated by what structure?

A

Spinal accessory N (CN XI) and proprioceptive from C3 and C4 ventral rami

200
Q

Latissimus dorsi is innervated by what structure?

A

Thoracodorsal nerve (C6-C8 ventral rami off of posterior cord of brachial plexus)

201
Q

Thoracolumbar (thoracodorsal) fascia is made up of how many layers?

A

3

202
Q

2nd layer of the 6 layers of back muscles all attach on what structure?

A

Medial border of scapula

203
Q

Muscles of the 2nd layer of 6 layers of the back include:

A

Rhomboid major and minor

Levator scapular

204
Q

Rhomboid major and minor muscles are innervated by what structure?

A

Dorsal scapular nerve (C5 from ventral rami of brachial plexus)

205
Q

Levator scapula muscle is innervated by what structure?

A

Dorsal scapular nerve (C5) and ventral rami of C3 and C4 spinal nerves

206
Q

3rd layer of the 6 layers of back muscles contains the following muscles:

A

Serratus posterior superior and inferior

207
Q

Serratus posterior superior is innervated by what structure?

A

Ventral rami of T2-T5 (via intercostal nerves)

208
Q

Serratus posterior inferior is innervated by what structure?

A

Ventral rami of T9-T11 via intercostal nerves and subcostal nerve (ventral rami of T12)

209
Q

4th layer of 6 layers of back muscles has the following muscles:

A

Splenius capitis

Splenius cervicis

210
Q

All deep back muscles (4th-6th layers) are all innervated by what structure?

A

Dorsal (posterior) rami

211
Q

5th layer of the 6 layers of back muscles contain the following muscles:

A

Iliocostalis group
Longissimus group
Spinalis group

212
Q

5th layer of the 6 layers of the back are innervated by what portion of the dorsal primary rami?

A

Lateral portions

213
Q

6th layer of the 6 layers of back muscles contains the following muscles:

A

Semispinalis group
Multifidus group
Rotatores group

214
Q

6th group of 6 layers of back muscles are innervated by what portion of the dorsal rami?

A

Medial branches

215
Q

Suboccipital muscles are innervated by what structure?

A

Dorsal rami of C1 (suboccipital nerve)

216
Q

Diaphragm is innervated by what structure?

A

Phrenic nerve (ventral rami C3-C5 off cervical plexus)

Spinal Anatomy (3 decks)

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