Exam 2 Flashcards
What ligaments will attach to the anterior arch of C1?
The anterior longitudinal anterior atlanto-occipital and anterior alanto-axial ligaments
What muscle attaches to the anterior arch of C1?
Longus colli
What is observed on the back of the anterior arch of C1?
The fovea dentis
What joint classifications are observed on the anterior arch of C1?
Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint
What is the morphology of the superior articular facet of C1?
They are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces
What is the orientation of the superior articular facet of C1?
Backward, upward, medial (BUM)
What is the joint classification of the atlanto-occipital zygapophysis?
Synovial (diarthrosis) ellipsoidal joint
What are the morphological characteristics of the inferior articular facet of C1?
Asymmetrical, slightly concave or flattened
What is the orientation of the inferior articular facet of C1?
Backward, medial, downward (BMD)
What is the joint classification of the atlanto-axial zygapophysis?
Synovial (diarthrosis) arthrodia joint
What muscles attach to the lateral mass of C1?
Levator scapula, splenius cervicis, and rectus capitis anterior
What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?
Males: about 50 millimeters
Females: about 37 millimeters
What attaches to the posterior tubercle of the posterior arch of C1?
Rectus capitis posterior minor muscle and ligamentum nuchae
What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?
About age 7 years old
What other name may be used to identify a ponticulus posticus?
Kimmerle’s anomaly
What names are given to the opening formed by the ponticulus posticus?
Arcuate foramen or retroarticular canal
What is the gender bias now associated with the ponticulus posticus?
Female
What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?
The incidence of a complete ponticulus posticus is about 15 percent, the incidence of an incomplete ponticulus posticus is as high as 41 percent
What muscles attach to the transverse process of C1?
Rectus capitis anterior, rectus capitis lateralis, middle scalene, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles
What suboccipital muscles are known to have facial projections attaching to the spinal dura?
Rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior
What are the connections between suboccipital muscles and the spinal dura called?
Myodural bridges
What opening is identified when a complete lateral bridge is formed?
The retrotransverse foramen
What are the possible contents of the retrotransverse foramen?
The vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck
What is the gender variation for measurements of the transverse diameter of C1?
Males: 78 millimeters
Females: 72 millimeters
What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?
A little over 30 millimeters for both males and females
What joint classifications are observed at C1?
Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial (diarthrosis) trochoid joint and synovial (diarthrosis) arthrodia joint
How many synovial joint surfaces are observed at C1?
Five
What are the names given to C2?
Axis or epistropheus
What unique vertebral body modification is characteristic of C2?
The dens or odontoid process
What joint surfaces are present on the odontoid process of C2?
Facet for fovea dentis, groove for transverse altlantal-ligament, attachment sites for the alar ligaments, attachment site for apical-dental ligament
How many joint surfaces are present on the odontoid process of C2?
5
What joint classifications are represented at the odontoid process of C2?
Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint
What is the name given to the odontoid process when the facet for the fovea dentis lies above the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed posterior?
Lordotic dens
What is the name given to the odontoid process when the facet for the fovea dentis lies below the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed posterior?
Kyphotic dens
How many joints are formed by the inferior part of the vertebral body of C2?
5
What joint classifications are present at the inferior part of the vertebral body of C2?
Fibrous (amphiarthrosis) syndesmosis joint, modified synovial (diarthrosis) sellar joint and cartilaginous (amphiarthrosis) symphysis joint
How many joint surfaces are present at the vertebral body of C2?
10
What joint classifications are present at the vertebral body of C2?
Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) trochoid joint, modified synovial (diarthrosis) sellar joint and cartilaginous (amphiarthrosis) symphysis joint
What ligaments will attach posteriorly, to the inferior epiphyseal rim of C2?
Membrana tectoria and posterior longitudinal ligament
What ligament will represent the cranial continuation of the posterior longitudinal ligament?
Membrana tectoria
What ligament forms the anterior boundary for the spinal canal above C2?
Membrana tectoria
What ligament forms the anterior boundary for the spinal canal below C2?
Posterior longitudinal ligament
What lies on the upper surface of the pedicle of C2?
The superior articular process
What is the location of the superior vertebral notch of C2?
On the lamina-pedicle junction
What attaches to the lamina of C2?
Obliquus capitis inferior muscle, posterior antlanto-axial ligament, ligamentum flavum
What is the appearance of the superior articular facets of C2?
They are asymmetrical and slightly convex
What is the facet orientation of the superior articular facet of C2?
Backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facets of C2?
Forward, lateral, and down (FoLD)
What is the classification of the zygapophyseal joints of C2?
Synovial (diarthrosis) arthrodia joint
What muscle attaches to the articular processes of C2?
Longissimus cervicis
What osseous parts of the typical cervical transverse process are present at C2?
Costal element, posterior tubercle, and true transverse process
What muscles attach to the transverse process at C2?
Levator scapulae, middle scalene, splenius cervicis, longissimus cervicis, and intertransversarii
Anterior and posterior intertransversarii are first observed at what vertebral couple?
C2 and C3
What is the characteristic appearance of the C2 spinous process in humans?
Bifid
What muscles attach to the spinous process of C2?
Rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators, and interspinalis muscles
What names may be given to C7?
Vertebra prominens and vertebral prominence
What is the name given to the topographical elevation observed at the base of the neck?
Vertebral prominence
What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?
C6 is more common in females and T1 is more common in males
How many joint surfaces are present at the vertebral body of C7?
8
What joint classifications are observed at the vertebral body of C7?
Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and modified synovial (diarthrosis) sellar joint
How many synovial joint surfaces are observed at the vertebral body of C7?
2
What are the osseous parts of the transverse process of C7?
Costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process
What features are typically present in the transverse foramen of C7?
Vertebral venous plexus, postganglionic sympathetic motor fibers
What muscles attach to the transverse process of C7?
Middle scalene, iliocostalis thoracis, longissimus cervicis, semispinalis capitis, rotators, intertransversarii, and levator costarum brevis
What will be observed in the transverse foramen at C2?
Vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is the gender variation for the transverse diameter of C2?
Males: fifty-seven millimeters
Females: about fifty millimeters
What is the orientation of the superior articular facet of C7?
Backward, upward, medial (BUM)
What is the orientation of the inferior articular facet of C7?
Forward, medial, downward (FoMeD)
What muscles will attach to the articular process of C7?
Longissimus cervicis, longissimus capitis, semispinalis cervicis, and multifidis
What are the features of the spinous process of C7?
Long, horizontal, nonbifid
What muscles attach to the spinous process of C7?
Trapezius, rhomboid minor, serrated posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalis thoracis, multifidis, rotators, and interspinalis
What ligaments attach to the spinous process of C7?
Ligamentum nuchae and insterspinous ligaments
The vertebral artery on which side is typically larger?
Left vertebral artery
What is the gender bias regarding size of the vertebral artery?
Men have a larger vertebral arteries than women
What is the name of the physical exam used to determine vertebral artery patency?
The vertebrobasilar artery insufficiency test
Which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?
The ipsilateral artery on the side of rotation
What are the symptoms of failure of the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?
Dizziness, vertigo, nausea are common complaints
Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?
C6
At what location will the vertebral artery form its first compensatory loop?
The atlanto-axial interspace
At what location will the vertebral for its second compensatory loop?
The atlanto-occipital interspace
At what segments will the vertebral artery be firmly attached to the transverse foramen?
Both C1 and C2
What is the purpose of the vertebral artery loops between C2, C1, and occiput?
The increased length will accommodate the greater rotation at these locations
What happens to the vertebral artery after it enters the subarachnoid space at C1?
The vertebral artery ascends along the medulla oblongata to the pontine-medullary junction where the right and left arteries unite to form the basilar artery
What artery is formed by the union of the right and left vertebral arteries?
The basilar artery
Which suboccipital muscles attach to C1?
Rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior
Which suboccipital muscles attach to C2?
Rectus capitis posterior major, obliquus capitis inferior
What forms the boundaries for the exit of the C1 nerve from the spinal canal?
Occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament
What forms the boundaries for the exit of the C2 nerve from the spinal canal?
Inferior articular process of C1, superior articular process of C2, capsular ligament, inferior vertebral notch of C1. Superior vertebral notch of C2, posterior arch of C1, lamina of C2, posterior atlanto-axial ligament
What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?
The vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinate process, and lateral groove
What forms the anterior boundary for the C8 nerve exit from the spinal cord?
The vertebral bodies of C7 and T1, intervertebral disc, posterior longitudinal ligament, capsular ligament of the costocentral joint, superior costal facet of T1 and articular surface of the first rib
What are the superior articular facet orientations for the cervical vertebrae?
C1 is backward, upward, medial (BUM), C2 is backward, upward, lateral (BUL), C3-C7 is backward, upward, medial (BUM)
What are the inferior articular facet orientations for the cervical vertebrae?
C1 is backward, downward, medial (BMD), C2-C6 is forward, downward, lateral (FoLD), C7 is forward, downward, lateral (ForMeD)
How many synovial joints are identified for each cervical vertebra?
C1: 5, C2: 8, C3-6: 8, C7: 6
How many synovial joints are identified at the vertebral body of each cervical vertebra?
C1: none, C2: 10, C3-6: 10, C7: 8
What features will allow discrimination between T2-T4 and T5-T8 segmental groups
The vertebral body, transverse process, articular process and spinous process
What is the outline of the vertebral body of a typical thoracic from superior view?
Triangular
On cranial view, what is the outline of the vertebral body for the T2-T4 group?
The vertebral body will have bilaterally convex sides
On cranial view, what is the outline of the vertebral body for the T5-T8 group?
The left side of the vertebral body will be flattened, the right side convex
What is the aortic impression?
The flattening of the superior and inferior epiphyseal rims on the left side of the vertebral body of T5-T8 which give the vertebral body a less scalloped or less indented appearance on that side
What is the principal cause of the posterior curve of the thoracic spine?
The vertebral body height differences
How many synovial joints are formed at the vertebral body of the typical thoracic?
Four
How many symphysis joints are formed with the vertebral body of a typical thoracic?
Two
How many syndesmosis joints are formed at the vertebral body of a typical thoracic?
Typically four are identified; as many as eight if the costocentral stellate/radiate ligaments are included
What is the name given to the joint formed between the vertebral body and rib?
Costocentral joint
How many costocentral joints are formed at the vertebral body of a typical thoracic?
Four
What synovial joints are formed at the vertebral body of a typical thoracic?
The right and left superior and the right and leg inferior costal demi-facets
What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?
The costocentral joint or ribs
What is the position and direction of the pedicle from the typical thoracic vertebral body?
The pedicle arises from the upper third of the vertebral body and projects posterior and slightly laterally
What is the angulation of the pedicle in e typical thoracic region?
Ten to fifteen degrees posterolateral from the sagittal plane
What is the overlap of the lamina called in the typical thoracic region?
Shingling
What is the direction do the transverse process in the typical thoracics?
The transverse process projects more posterior with each inferior vertebra
What is the distance between the transverse tubercles in the typical thoracic region?
From T2 each transverse diameter becomes shorter as the transverse processes angle more posteriorly
What is present on the transverse tubercle of a typical thoracic?
The transverse costal facet
What is the rib- transverse process relationship for the typical thoracics?
The number of the rib is the same as the number of the vertebra whose transverse process is being studied; fifth rib with T5 transverse process
What is the classification of the costotransverse joint?
Synovial (diarthrosis) arthrodia joint
What are the osseous parts of the costotransverse joint?
The transverse costal facet and the articular surface of the tubercle of a rib
What ligaments support the costotransverse joint of a typical thoracic?
The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments
The superior costotransverse ligament of rb five will attach to which segmental bony feature?
The transverse process of T4
The superior costotransverse ligament of the transverse process of T4 will attach to which rib?
The fifth rib
The inferior costotransverse ligament of rib five will attach to which segmental bony feature?
The transverse process of T5
The inferior costotransverse ligament of the transverse process of T5 will attach to which rib?
The fifth rib
What ligaments attach to the transverse process of a typical thoracic?
Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments
Which joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments?
Fibrous (amphiarthrosis) syndesmosis joint
Which muscles may attach to the transverse process of a typical thoracic?
Longissimus thoracics, longissimus cervicis, longissimus capitis, semispinalis thoracics, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus, and levator costarum brevis
How can you distinguish between T2-T4 from T5-T8 segment using the articular process?
At T2-T4 the width between the superior articular processes is greater than the width between the inferior articular processes of that vertebra
At T5-T8 the width between the superior articular processes is equal to or the same as the width between the inferior articular processes of that vertebra
What is the angulation of the articular facets of a typical thoracic?
About ten to twenty degrees from the coronal plane, sixty degrees from the horizontal plane
What is the orientation of the superior articular facet of a typical thoracic?
Face backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facet of the a typical thoracic?
They face forward, downward, and medial (ForMeD)
What is the classification of the articular facet joint?
Synovial (diarthrosis) arthrodia joint
How many synovial joints are present at a typical thoracic?
Ten
What is the angulation of the spinous process in the typical thoracic region?
The undersurface of T2-T4 spinous processes will angle up to forty degrees from the horizontal plane
The undersurface of T5-T8 spinous processes will angle up to sixty degrees from the horizontal plane
What muscles may attach to the spinous process of a typical thoracic?
Trapezius, latissimus dorsi, rhomboid major, serrated posterior superior,
splenius cervicis, splenius capitis,
spinalis thoracis, spinalis cervicis, spinalis capitis
Semispinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis
What is the joint classifications are present at every typical vertebra?
Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint and synovial (diarthrosis) arthrodia joint
What ligaments attach to the transverse process of T1?
Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse
What joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse and lateral costotransverse
Fibrous (amphiarthrosis) syndesmosis joint
What muscles attach to the transverse process of T1?
Longissimus thoracis, longissimus cervicis, longissimus capitis
Semispinalis cervicis, semispinalis capitis
Multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis
Which muscles attach to the transverse process of T9?
Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
How many synovial joints are typically present at T9?
Ten
Which rib related facet may be absent on T9?
The inferior costal demi-facet
What muscles attach to the spinous process of T9?
The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis, interspinalis
How many joints are typically formed at the vertebral body of T10?
Typically eight, twelve if the costocentral stellate/radiate ligaments are included
Which synovial joint surface is absent from the vertebral body of T10?
Inferior costal demi-facets
What feature is very commonly observed on the lamina of T10?
Para-articular processes
What ligaments support the costotransverse joint of T10?
The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments
What muscles attach to the transverse process of T10?
Longissimus thoracis
Semispinalis thoracis, multifidis, rotator longus, rotator brevis
Intertransversarii, levator costarum longus, and levator costarum brevis
How many synovial joints are typically present at T10?
Eight
What is the topographical indication of the spinous process of T10?
The skin often dimples or is depressed
What muscles attach to the spinous process of T10?
The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis, and interspinalis
What is the name given to T11?
The anticlinal vertebra
What joint classifications are identified at the vertebral body of T11?
Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and synovial (diarthrosis) arthrodia joint
What ligaments form the costotransverse joint of T11?
The superior costotransverse, and slightly developed inferior costotransverse, and lateral costotransverse ligaments
What is the orientation of the transverse costal facets of T11?
There are no transverse costal facets on T11
What muscles attach to the transverse process of T11?
Longissimus thoracis,
Semispinalis thoracis, multifidis, rotator longus, and rotator brevis
Intertransversarii, and levator costarum brevis
Which levator costarum muscle is absent at T11?
Levator costarum longus
What muscles attach to the spinous process of T11?
Trapezius, latissimus dorsi, serrated posterior inferior, iliocostalis limbo rum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis
At which segments of the thoracic spine will the spinalis muscles not attach?
T9, T10
Why does the superior tubercle of T12 represent?
The mammillary process of the lumbar vertebrae
What does the inferior tubercle of T12 represent
The accessory process of lumbar vertebrae
What ligaments form the costotransverse joint of the twelfth rib?
The superior costotransverse ligament from T11 and the lumbocostal ligament of L1
Which costotransverse ligaments lack an attachment to T12?
Capsular costotransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments
What muscles attach to the transverse process of T12?
The longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, and intertransversarii
What muscles attach to the spinous process of T12?
The trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis
Which erector spinae muscle is unique in its attachment to the T12 spinous process?
Iliocostalis lumborum
How many synovial joints are maximally observed at each thoracic vertebra?
T1-T9: 10, T10: 8, T11-T12: 6
How many joints are traditionally observed at each thoracic vertebral body?
T1-T9: 10, T10: 8, T11-T12: 6
What is the generic shape of the typical lumbar vertebral body from the cranial view?
Reniform or kidney shaped
What accounts for the direction of the lumbar curve?
The vertebral body and intervertebral disc have a greater anterior height than posterior height
What is the effect of aging on the vertebral body of a lumbar vertebra?
Decrease in height, increase in circumference
How many joint surfaces are present on the vertebral body of a typical lumbar?
Six
What muscles may attach to a typical lumbar vertebral body?
Psoas major and psoas minor
What is the name given to ligaments which attach the vertebral body to articular process?
Transforaminal ligaments
What are the types of transforaminal ligaments?
Superior transforaminal, middle transforaminal ligaments, and inferior transforaminal ligaments
What ligaments attach the vertebral body to the transverse process?
Corporotransverse ligaments
What corporotransverse ligaments are identified?
Superior corporotransverse and inferior corporotransverse ligaments
Cervical-upper thoracic Hofmann ligaments will attach what structures together?
Dura mater to segments above
What is feh proposed function of the cervical-upper thoracic Hofmann ligaments?
Resist caudal movement of the dural sac, resist gravitational forces on the dura and cord
Lumbar Hofmann ligaments will attach what structures together?
Dura mater to lower segments levels
What is the proposed function of the lumbar Hofmann ligaments?
Resist cranial movement of the dural sac during flexion
Congenital elongation of the lumbar accessory process results in what feature?
Styloid process
What parts of a vertebra are attached via the mammillo-accessory ligament?
The mammillary process and accessory process of the same segment
What was believed to be entrapped by the mammillo-accessory ligament?
The medial branch of the dorsal ramps of a lumbar spinal nerve
What muscles attach to the lumbar accessory process?
Longissimus thoracis and intertransversarii
What is the position of the lumbar zygapophysis in adults?
The zygapophysis lies in the sagittal plane for L1/L2, L2/L3, and L3/L4
The zygapophysis lies in the coronal plane for L4/L5 and L5/S1
What are the names given to the condition in which the right zygapophysis of a vertebral couple lies in a plane or position different from the left zygapophysis?
Joint asymmetry or joint tropism
What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
Overlap of the laminae, shingling diminishes, overlap of spinous processes, limbrication diminishes
What muscles will attach to the typical lumbar spinous process?
Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis
What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?
Lumbosacral, iliolumbar, and mammillo-accessory ligaments
What are the posterior elements of the vertebra?
Zygapophysis, lamina, and spinous process
What are the anterior elements of the vertebra?
Vertebral body and pedicle
What is the orientation of the fifth lumbar superior articular facet?
Backward, upward, medial (BUM) typically concave
What is the orientation of the fifth lumbar inferior articular facet?
Forward, lateral, downward (FoLD) significant convexity
What is the names of the condition in which the L5 spinous process increases in length due to the aging process?
Baastrup’s syndrome or “kissing spines”
What is Knife Clasp Syndrome?
The congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida and dorsiflexion produces pain
What is the superior articular facet orientation at each lumbar vertebra?
L1-L5: backward, ward, medial (BUM)
What is the inferior articular facet orientation at each lumbar vertebra?
L1-L5: forward, lateral, downward (FoLD)
What is the incidence of spondyloysis in the general population?
A range of 2.6% to 10%
Lumbar spondyloysis has not been reported in what groups of individuals?
Fetuses, newborns, rarely in children under five years old, patients who have never walked and in non-erect species
What does lumbar spondyloysis appear to be related to?
The uniquely human upright stance or erect posture
What is the gender bias and locational bias associated with lumbar spondyloysis?
Men at L5/S1 and women at L4/L5
What is the age range typically associated with the lumbar spondyloysis?
10-20 years old
What motions are particularly associated with lumbar spondyloysis?
Hyperextension coupled with rotation
What fills the space in a lumbar spondyloysis?
Fibrocartilagenous material
What name has been given to the material filling the space in a lumbar spondyloysis?
Spondyloysis ligament
What types of neural functions have been associated with the spondyloysis ligament?
Nociception, neuromodulation, and autonomic function
What is the appearance of a spondyloysis Ina lumbar vertebra upon oblique x-ray view?
A collard Scotty dog
What part of a lumbar vertebra forms the neck of a Scotty dog?
The pars interarticularis below the superior articular process
What part of a lumbar vertebra forms the eye of a Scotty dog?
The pedicle
What part of a lumbar vertebra forms the ear of a Scotty dog?
The superior articular process
What part of the lumbar vertebra forms the nose of a Scotty dog?
The transverse process
What characteristics are associated with the cervical spondyloysis?
Rare, congenital, gender biased toward men, most common at C6 and linked to spondyloysis and spina bifida
What characteristics are associated with sacral spondyloysis?
Rare in the general population, within typical percents in the native Alaskan population, seems to be acquired, gender biased toward men, most common at S1 and linked to activities such as kayaking and harpooning
What is the posterior direction of a vertebral slippage called?
Retrospondylolisthesis or retrolisthesis
What are the types/classifications of spondylolithesis?
Type I spondylolithesis (dysplastic spondylolithesis, congenital spondylolithesis)
Type II spondylolithesis (isthmic spondylolithesis)
Type III spondylolithesis (degenerative spondylolithesis)
Type IV spondylolithesis (traumatic spondylolithesis)
Type V spondylolithesis (pathologic spondylolithesis)
What is the location bias of type I spondylolithesis?
L5 or upper sacral segments
Which subtype of type II spondylolithesis is stressed in Spinal II?
Lyric spondylolithesis or stress fracture induced spondylolithesis
What gender bias, location bias, and spinal canal dimensions are associated with type II spondylolithesis?
Isthmic spondylolithesis is common in men, located at the L5/S1 level and demonstrates an increase in sagittal diameter of the spinal canal
What is the gender bias, locational bias, and spinal canal dimension changes often associated with type III spondylolithesis?
Degenerative spondylolithesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal canal
What causes type IV spondylolithesis?
Fracture of the neural arch components
What are the causes associated with type V spondylolithesis?
Bone diseases such as Paget diseases or osteogenesis imperfecta
How many synovial joint surfaces are resent on the vertebral body of the first sacral segment?
Five
What joint classifications will be observed at the first sacral vertebral body?
Cartilaginous (amphiarthrosis) symphysis, fibrous (amphiarthrosis) syndesmosis
What muscle may attache to the first sacral vertebral body?
Psoas major
What is the position of the sacral zygapophysis in adults?
The zygapophysis lies in the coronal plane for L5/S1
What is the orientation of the first sacral superior articular facet?
Backward, upward, medial (BUM) typically concave
What is the size relationship between ventral and dorsal sacral foramina?
Ventral sacral foramina are larger
What part of the sacral ala continues along the ventral surface of sacrum to about S4?
The costal element
What is the name of the region of bone lateral to the vertebral body of S5?
The transverse process
An imaginary line drawn from the superior articular process of S1 to the sacral cornu will form what feature?
Intermediate sacral crest
What features may be identified along the intermediate sacral crest?
The mammillary process of S1 and the sacral cornu of S5
What is the name of the inferior opening of the sacral spinal canal?
The sacral hiatus
What features may be identified along the lateral sacral crest?
S1 transverse tubercle, sacral tuberosity of S2, transverse tubercles of S3, S4, and S5
What is the name of the joint formed by the sacral tuberosity?
The accessory sacro-iliac joint
What feature is associated with the transverse tubercle of S5?
The inferior and lateral (inferolateral) sacral angle
What classification of joint is formed by the auricular surface of sacrum?
Synovial (diarthrosis) arthrodia joint
What feature does the anterior surface of the superior epiphyseal rim of S1 form?
The sacral promontory
How many synovial joints are typically present at the sacrum?
Four
What forms the posterior boundary for the fifth sacral spinal nerve intervertebral foramen?
Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament and intercornual ligament
What is the homolog for the posterior longitudinal ligament of S5?
Deep posterior sacrococcygeal ligament
What is the homolog for the anterior longitudinal ligament at S5?
Anterior sacrococcygeal ligament
What is the homolog for the ligamentum flavum at S5
Superficial posterior sacrococcygeal ligament
What is the homolog for the capsular ligament at S5?
Intercornual ligament
What is the number of coccygeal somites?
Ten
What is the typical number of segments which unite to form the adult coccyx?
4 segments
When is ossification of coccyx completed?
About 30 years old
What bony features are present on the coccyx?
All segments are represented by a vertebral body, Co1 has a coccygeal cornu and transverse process
What is the direction of fusion of coccygeal segments?
From caudal to cranial, the last segments to fuse together are Co1 and Co2
What is the direction of the coccygeal curve?
Posterior, kyphotic
What is the major motion and range of motion for coccyx?
Flexion- extension, 5-20 degrees
What is ganglion impar?
A midline sympathetic ganglion
What is the coccygeal glomus or coccygeal body?
An enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx
What forms the inferior boundary for the spinal canal?
The union of the superficial posterior and deep posterior sacrococcygeal ligaments
What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments of Co1?
The posterior sacrococcygeal ligament
What forms the posterior boundary for the first coccygeal spinal nerve intervertebral foramen?
Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament, intercornual ligament
What forms the anterior boundary for the first coccygeal spinal nerve intervertebral foramen?
Vertebral body S5, vertebral body Co1, deep posterior sacrococcygeal ligament, intervertebral disc
Superior articular facets of which vertebrae will be orientated backward, upward, and medial?
C1, C3-C7, L1-L5, S1
Superior articular facets of which vertebrae are oriented back, up, medial, and concave?
C1, L1-L5, S1
Superior articular facets of which segments will be oriented backward, upward, and lateral?
C2, T1-T12
Inferior articular facets of which segments will be oriented backward, medial, and downward?
C1
Inferior articular facets of which segments will be orientated forward, lateral, and downward?
C2-C6, T12, L1-L5
Inferior articular facets of which segments will be orientated forward, lateral, downward, and convex?
T12, L1-L5
Inferior articular facets of which segments will be orientated forward, medial, and downward?
C7, T1-T11
What are the characteristics of cervicalization of occiput?
An increase in occipital bone size, formation of new or larger lines, on the occipital bone
What is the characteristic of occipitalization of C1?
The atlas may be partially or completely fused to the occiput
What is another way of implying occipitalization of C1?
Atlas assimilation
What is the incidence of occipitalization of C1?
.1% to .8%
When do the centers of ossification for the odontoid process first appear?
During the last trimester in utero
When do the bilateral ossification centers for the odontoid process fuse?
At or shortly after birth
What joint is formed between the odontoid process ossification centers and the centrum of C2?
The subdental snychondrosis
What is the classification of the joint formed between the C2 odontoid process and centrum?
Amphiarthrosis synchondrosis
A joint between the odontoid process and centrum of C2 is last identified at what age?
7 years old
What is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 persists beyond age 7?
So odontoideum
What is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7?
Persistent subdental synchondrosis
What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?
Tip of the dens synchondrosis
At what age will the tip of the dens center of ossification appear?
Sometime in early adolescence
If then joint formed between the tip of the dens and odontoid process centers of ossification persists beyond age 12, what is the condition called?
Terminal ossicle
What is the incidence of rib-related changes following dorsalization of C7?
From one-half to two and one-half percent of population
What is the gender bias suggested in dorsalization of C7?
Female
What alteration in C7 facet orientation may accompany dorsalization?
The superior articular facet of C7 may change from back, upward, medial to that of a typical thoracic facet; back, upward and lateral; the inferior articular facet is unchanged
What alteration in C6 facet orientation may accompany dorsalization?
C6 demonstrates a change in inferior articular facet orientation from forward, lateral, and downward to forward, medial, and downward; the superior articular facet unchanged
What percent of population may demonstrate thoracic-like features at C7?
Up to 46%
What T1 facet orientation changes may accompany cervicalization?
The superior articular facet may change from back, upward, and lateral to back, upward, and medial; the inferior articular facet is unchanged
What C7 facet orientation changes may accompany cervicalization?
The inferior articular facet may change from forward, medial, and downward; to forward, lateral, and downward; the superior articular facet is unchanged
What is the incidence of cervicalization of T1 in the population?
Up to 28% of the population
What is the incidence of lumbar ribs in the population?
Over 7% of the population demonstrates lumbar ribs
What L1 facet orientation changes may accompany dorsalization?
The superior articular facet may change from concave, back, upward, and medial…to flat, back, upward, and lateral; the inferior articular facet is unchanged
What T12 facet orientation changes may accompany dorsalization?
The inferior articular facet may change from convex, forward, lateral, and downward….to flat, forward, medial, and downward; the superior articular facet is unchanged
What is the gender bias associated with the dorsalization of L1?
Males are two to three times more affected
What rib related changes may accompany lumbarization of T12?
A significant shortening of the mean relative length of 113mm of the twelfth rib or it becomes absent
What T12 facet orientation changes may accompany lumbarization?
The superior articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged
What is the characteristic of lumbarization of S1?
The failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala
What is the characteristic of sacralization of L5?
L5 may be partially or completely fused to the sacrum
Which segment demonstrates the greatest morphological variation along the spine?
L5
What is the incidence of variation within the sacrococcygeal region in the population?
Up to 14%
