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Spinal Anatomy 2 > Exam 2 > Flashcards

Exam 2 Flashcards

0
Q

What ligaments will attach to the anterior arch of C1?

A

The anterior longitudinal anterior atlanto-occipital and anterior alanto-axial ligaments

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1
Q

What muscle attaches to the anterior arch of C1?

A

Longus colli

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2
Q

What is observed on the back of the anterior arch of C1?

A

The fovea dentis

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3
Q

What joint classifications are observed on the anterior arch of C1?

A

Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint

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4
Q

What is the morphology of the superior articular facet of C1?

A

They are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces

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5
Q

What is the orientation of the superior articular facet of C1?

A

Backward, upward, medial (BUM)

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6
Q

What is the joint classification of the atlanto-occipital zygapophysis?

A

Synovial (diarthrosis) ellipsoidal joint

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7
Q

What are the morphological characteristics of the inferior articular facet of C1?

A

Asymmetrical, slightly concave or flattened

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8
Q

What is the orientation of the inferior articular facet of C1?

A

Backward, medial, downward (BMD)

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9
Q

What is the joint classification of the atlanto-axial zygapophysis?

A

Synovial (diarthrosis) arthrodia joint

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10
Q

What muscles attach to the lateral mass of C1?

A

Levator scapula, splenius cervicis, and rectus capitis anterior

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11
Q

What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?

A

Males: about 50 millimeters
Females: about 37 millimeters

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12
Q

What attaches to the posterior tubercle of the posterior arch of C1?

A

Rectus capitis posterior minor muscle and ligamentum nuchae

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13
Q

What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?

A

About age 7 years old

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14
Q

What other name may be used to identify a ponticulus posticus?

A

Kimmerle’s anomaly

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15
Q

What names are given to the opening formed by the ponticulus posticus?

A

Arcuate foramen or retroarticular canal

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16
Q

What is the gender bias now associated with the ponticulus posticus?

A

Female

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17
Q

What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?

A

The incidence of a complete ponticulus posticus is about 15 percent, the incidence of an incomplete ponticulus posticus is as high as 41 percent

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18
Q

What muscles attach to the transverse process of C1?

A

Rectus capitis anterior, rectus capitis lateralis, middle scalene, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles

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19
Q

What suboccipital muscles are known to have facial projections attaching to the spinal dura?

A

Rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior

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20
Q

What are the connections between suboccipital muscles and the spinal dura called?

A

Myodural bridges

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21
Q

What opening is identified when a complete lateral bridge is formed?

A

The retrotransverse foramen

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22
Q

What are the possible contents of the retrotransverse foramen?

A

The vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck

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23
Q

What is the gender variation for measurements of the transverse diameter of C1?

A

Males: 78 millimeters
Females: 72 millimeters

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24
Q

What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?

A

A little over 30 millimeters for both males and females

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25
Q

What joint classifications are observed at C1?

A

Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial (diarthrosis) trochoid joint and synovial (diarthrosis) arthrodia joint

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26
Q

How many synovial joint surfaces are observed at C1?

A

Five

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27
Q

What are the names given to C2?

A

Axis or epistropheus

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28
Q

What unique vertebral body modification is characteristic of C2?

A

The dens or odontoid process

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29
Q

What joint surfaces are present on the odontoid process of C2?

A

Facet for fovea dentis, groove for transverse altlantal-ligament, attachment sites for the alar ligaments, attachment site for apical-dental ligament

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30
Q

How many joint surfaces are present on the odontoid process of C2?

A

5

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31
Q

What joint classifications are represented at the odontoid process of C2?

A

Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint

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32
Q

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?

A

Lordotic dens

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33
Q

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?

A

Kyphotic dens

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34
Q

How many joints are formed by the inferior part of the vertebral body of C2?

A

5

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35
Q

What joint classifications are present at the inferior part of the vertebral body of C2?

A

Fibrous (amphiarthrosis) syndesmosis joint, modified synovial (diarthrosis) sellar joint and cartilaginous (amphiarthrosis) symphysis joint

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36
Q

How many joint surfaces are present at the vertebral body of C2?

A

10

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37
Q

What joint classifications are present at the vertebral body of C2?

A

Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) trochoid joint, modified synovial (diarthrosis) sellar joint and cartilaginous (amphiarthrosis) symphysis joint

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38
Q

What ligaments will attach posteriorly, to the inferior epiphyseal rim of C2?

A

Membrana tectoria and posterior longitudinal ligament

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39
Q

What ligament will represent the cranial continuation of the posterior longitudinal ligament?

A

Membrana tectoria

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40
Q

What ligament forms the anterior boundary for the spinal canal above C2?

A

Membrana tectoria

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41
Q

What ligament forms the anterior boundary for the spinal canal below C2?

A

Posterior longitudinal ligament

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42
Q

What lies on the upper surface of the pedicle of C2?

A

The superior articular process

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43
Q

What is the location of the superior vertebral notch of C2?

A

On the lamina-pedicle junction

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44
Q

What attaches to the lamina of C2?

A

Obliquus capitis inferior muscle, posterior antlanto-axial ligament, ligamentum flavum

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45
Q

What is the appearance of the superior articular facets of C2?

A

They are asymmetrical and slightly convex

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46
Q

What is the facet orientation of the superior articular facet of C2?

A

Backward, upward, and lateral (BUL)

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47
Q

What is the orientation of the inferior articular facets of C2?

A

Forward, lateral, and down (FoLD)

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48
Q

What is the classification of the zygapophyseal joints of C2?

A

Synovial (diarthrosis) arthrodia joint

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49
Q

What muscle attaches to the articular processes of C2?

A

Longissimus cervicis

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50
Q

What osseous parts of the typical cervical transverse process are present at C2?

A

Costal element, posterior tubercle, and true transverse process

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51
Q

What muscles attach to the transverse process at C2?

A

Levator scapulae, middle scalene, splenius cervicis, longissimus cervicis, and intertransversarii

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52
Q

Anterior and posterior intertransversarii are first observed at what vertebral couple?

A

C2 and C3

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53
Q

What is the characteristic appearance of the C2 spinous process in humans?

A

Bifid

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54
Q

What muscles attach to the spinous process of C2?

A

Rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators, and interspinalis muscles

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55
Q

What names may be given to C7?

A

Vertebra prominens and vertebral prominence

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56
Q

What is the name given to the topographical elevation observed at the base of the neck?

A

Vertebral prominence

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57
Q

What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?

A

C6 is more common in females and T1 is more common in males

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58
Q

How many joint surfaces are present at the vertebral body of C7?

A

8

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59
Q

What joint classifications are observed at the vertebral body of C7?

A

Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and modified synovial (diarthrosis) sellar joint

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60
Q

How many synovial joint surfaces are observed at the vertebral body of C7?

A

2

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61
Q

What are the osseous parts of the transverse process of C7?

A

Costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process

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62
Q

What features are typically present in the transverse foramen of C7?

A

Vertebral venous plexus, postganglionic sympathetic motor fibers

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63
Q

What muscles attach to the transverse process of C7?

A

Middle scalene, iliocostalis thoracis, longissimus cervicis, semispinalis capitis, rotators, intertransversarii, and levator costarum brevis

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64
Q

What will be observed in the transverse foramen at C2?

A

Vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

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65
Q

What is the gender variation for the transverse diameter of C2?

A

Males: fifty-seven millimeters
Females: about fifty millimeters

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66
Q

What is the orientation of the superior articular facet of C7?

A

Backward, upward, medial (BUM)

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67
Q

What is the orientation of the inferior articular facet of C7?

A

Forward, medial, downward (FoMeD)

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68
Q

What muscles will attach to the articular process of C7?

A

Longissimus cervicis, longissimus capitis, semispinalis cervicis, and multifidis

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69
Q

What are the features of the spinous process of C7?

A

Long, horizontal, nonbifid

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70
Q

What muscles attach to the spinous process of C7?

A

Trapezius, rhomboid minor, serrated posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalis thoracis, multifidis, rotators, and interspinalis

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71
Q

What ligaments attach to the spinous process of C7?

A

Ligamentum nuchae and insterspinous ligaments

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72
Q

The vertebral artery on which side is typically larger?

A

Left vertebral artery

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73
Q

What is the gender bias regarding size of the vertebral artery?

A

Men have a larger vertebral arteries than women

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74
Q

What is the name of the physical exam used to determine vertebral artery patency?

A

The vertebrobasilar artery insufficiency test

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75
Q

Which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?

A

The ipsilateral artery on the side of rotation

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76
Q

What are the symptoms of failure of the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?

A

Dizziness, vertigo, nausea are common complaints

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77
Q

Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?

A

C6

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78
Q

At what location will the vertebral artery form its first compensatory loop?

A

The atlanto-axial interspace

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79
Q

At what location will the vertebral for its second compensatory loop?

A

The atlanto-occipital interspace

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80
Q

At what segments will the vertebral artery be firmly attached to the transverse foramen?

A

Both C1 and C2

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81
Q

What is the purpose of the vertebral artery loops between C2, C1, and occiput?

A

The increased length will accommodate the greater rotation at these locations

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82
Q

What happens to the vertebral artery after it enters the subarachnoid space at C1?

A

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

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83
Q

What artery is formed by the union of the right and left vertebral arteries?

A

The basilar artery

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84
Q

Which suboccipital muscles attach to C1?

A

Rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior

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85
Q

Which suboccipital muscles attach to C2?

A

Rectus capitis posterior major, obliquus capitis inferior

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86
Q

What forms the boundaries for the exit of the C1 nerve from the spinal canal?

A

Occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament

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87
Q

What forms the boundaries for the exit of the C2 nerve from the spinal canal?

A

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

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88
Q

What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?

A

The vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinate process, and lateral groove

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89
Q

What forms the anterior boundary for the C8 nerve exit from the spinal cord?

A

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

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90
Q

What are the superior articular facet orientations for the cervical vertebrae?

A

C1 is backward, upward, medial (BUM), C2 is backward, upward, lateral (BUL), C3-C7 is backward, upward, medial (BUM)

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91
Q

What are the inferior articular facet orientations for the cervical vertebrae?

A

C1 is backward, downward, medial (BMD), C2-C6 is forward, downward, lateral (FoLD), C7 is forward, downward, lateral (ForMeD)

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92
Q

How many synovial joints are identified for each cervical vertebra?

A

C1: 5, C2: 8, C3-6: 8, C7: 6

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93
Q

How many synovial joints are identified at the vertebral body of each cervical vertebra?

A

C1: none, C2: 10, C3-6: 10, C7: 8

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94
Q

What features will allow discrimination between T2-T4 and T5-T8 segmental groups

A

The vertebral body, transverse process, articular process and spinous process

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95
Q

What is the outline of the vertebral body of a typical thoracic from superior view?

A

Triangular

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96
Q

On cranial view, what is the outline of the vertebral body for the T2-T4 group?

A

The vertebral body will have bilaterally convex sides

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97
Q

On cranial view, what is the outline of the vertebral body for the T5-T8 group?

A

The left side of the vertebral body will be flattened, the right side convex

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98
Q

What is the aortic impression?

A

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

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99
Q

What is the principal cause of the posterior curve of the thoracic spine?

A

The vertebral body height differences

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100
Q

How many synovial joints are formed at the vertebral body of the typical thoracic?

A

Four

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101
Q

How many symphysis joints are formed with the vertebral body of a typical thoracic?

A

Two

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102
Q

How many syndesmosis joints are formed at the vertebral body of a typical thoracic?

A

Typically four are identified; as many as eight if the costocentral stellate/radiate ligaments are included

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103
Q

What is the name given to the joint formed between the vertebral body and rib?

A

Costocentral joint

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104
Q

How many costocentral joints are formed at the vertebral body of a typical thoracic?

A

Four

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105
Q

What synovial joints are formed at the vertebral body of a typical thoracic?

A

The right and left superior and the right and leg inferior costal demi-facets

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106
Q

What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?

A

The costocentral joint or ribs

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107
Q

What is the position and direction of the pedicle from the typical thoracic vertebral body?

A

The pedicle arises from the upper third of the vertebral body and projects posterior and slightly laterally

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108
Q

What is the angulation of the pedicle in e typical thoracic region?

A

Ten to fifteen degrees posterolateral from the sagittal plane

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109
Q

What is the overlap of the lamina called in the typical thoracic region?

A

Shingling

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110
Q

What is the direction do the transverse process in the typical thoracics?

A

The transverse process projects more posterior with each inferior vertebra

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111
Q

What is the distance between the transverse tubercles in the typical thoracic region?

A

From T2 each transverse diameter becomes shorter as the transverse processes angle more posteriorly

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112
Q

What is present on the transverse tubercle of a typical thoracic?

A

The transverse costal facet

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113
Q

What is the rib- transverse process relationship for the typical thoracics?

A

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

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114
Q

What is the classification of the costotransverse joint?

A

Synovial (diarthrosis) arthrodia joint

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115
Q

What are the osseous parts of the costotransverse joint?

A

The transverse costal facet and the articular surface of the tubercle of a rib

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116
Q

What ligaments support the costotransverse joint of a typical thoracic?

A

The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

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117
Q

The superior costotransverse ligament of rb five will attach to which segmental bony feature?

A

The transverse process of T4

118
Q

The superior costotransverse ligament of the transverse process of T4 will attach to which rib?

A

The fifth rib

119
Q

The inferior costotransverse ligament of rib five will attach to which segmental bony feature?

A

The transverse process of T5

120
Q

The inferior costotransverse ligament of the transverse process of T5 will attach to which rib?

A

The fifth rib

121
Q

What ligaments attach to the transverse process of a typical thoracic?

A

Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments

122
Q

Which joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments?

A

Fibrous (amphiarthrosis) syndesmosis joint

123
Q

Which muscles may attach to the transverse process of a typical thoracic?

A

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

124
Q

How can you distinguish between T2-T4 from T5-T8 segment using the articular process?

A

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

125
Q

What is the angulation of the articular facets of a typical thoracic?

A

About ten to twenty degrees from the coronal plane, sixty degrees from the horizontal plane

126
Q

What is the orientation of the superior articular facet of a typical thoracic?

A

Face backward, upward, and lateral (BUL)

127
Q

What is the orientation of the inferior articular facet of the a typical thoracic?

A

They face forward, downward, and medial (ForMeD)

128
Q

What is the classification of the articular facet joint?

A

Synovial (diarthrosis) arthrodia joint

129
Q

How many synovial joints are present at a typical thoracic?

A

Ten

130
Q

What is the angulation of the spinous process in the typical thoracic region?

A

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

131
Q

What muscles may attach to the spinous process of a typical thoracic?

A

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

132
Q

What is the joint classifications are present at every typical vertebra?

A

Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint and synovial (diarthrosis) arthrodia joint

133
Q

What ligaments attach to the transverse process of T1?

A

Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse

134
Q

What joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse and lateral costotransverse

A

Fibrous (amphiarthrosis) syndesmosis joint

135
Q

What muscles attach to the transverse process of T1?

A

Longissimus thoracis, longissimus cervicis, longissimus capitis
Semispinalis cervicis, semispinalis capitis
Multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis

136
Q

Which muscles attach to the transverse process of T9?

A

Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

137
Q

How many synovial joints are typically present at T9?

A

Ten

138
Q

Which rib related facet may be absent on T9?

A

The inferior costal demi-facet

139
Q

What muscles attach to the spinous process of T9?

A

The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis, interspinalis

140
Q

How many joints are typically formed at the vertebral body of T10?

A

Typically eight, twelve if the costocentral stellate/radiate ligaments are included

141
Q

Which synovial joint surface is absent from the vertebral body of T10?

A

Inferior costal demi-facets

142
Q

What feature is very commonly observed on the lamina of T10?

A

Para-articular processes

143
Q

What ligaments support the costotransverse joint of T10?

A

The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

144
Q

What muscles attach to the transverse process of T10?

A

Longissimus thoracis
Semispinalis thoracis, multifidis, rotator longus, rotator brevis
Intertransversarii, levator costarum longus, and levator costarum brevis

145
Q

How many synovial joints are typically present at T10?

A

Eight

146
Q

What is the topographical indication of the spinous process of T10?

A

The skin often dimples or is depressed

147
Q

What muscles attach to the spinous process of T10?

A

The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis, and interspinalis

148
Q

What is the name given to T11?

A

The anticlinal vertebra

149
Q

What joint classifications are identified at the vertebral body of T11?

A

Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and synovial (diarthrosis) arthrodia joint

150
Q

What ligaments form the costotransverse joint of T11?

A

The superior costotransverse, and slightly developed inferior costotransverse, and lateral costotransverse ligaments

151
Q

What is the orientation of the transverse costal facets of T11?

A

There are no transverse costal facets on T11

152
Q

What muscles attach to the transverse process of T11?

A

Longissimus thoracis,
Semispinalis thoracis, multifidis, rotator longus, and rotator brevis
Intertransversarii, and levator costarum brevis

153
Q

Which levator costarum muscle is absent at T11?

A

Levator costarum longus

154
Q

What muscles attach to the spinous process of T11?

A

Trapezius, latissimus dorsi, serrated posterior inferior, iliocostalis limbo rum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis

155
Q

At which segments of the thoracic spine will the spinalis muscles not attach?

A

T9, T10

156
Q

Why does the superior tubercle of T12 represent?

A

The mammillary process of the lumbar vertebrae

157
Q

What does the inferior tubercle of T12 represent

A

The accessory process of lumbar vertebrae

158
Q

What ligaments form the costotransverse joint of the twelfth rib?

A

The superior costotransverse ligament from T11 and the lumbocostal ligament of L1

159
Q

Which costotransverse ligaments lack an attachment to T12?

A

Capsular costotransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

160
Q

What muscles attach to the transverse process of T12?

A

The longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, and intertransversarii

161
Q

What muscles attach to the spinous process of T12?

A

The trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis

162
Q

Which erector spinae muscle is unique in its attachment to the T12 spinous process?

A

Iliocostalis lumborum

163
Q

How many synovial joints are maximally observed at each thoracic vertebra?

A

T1-T9: 10, T10: 8, T11-T12: 6

164
Q

How many joints are traditionally observed at each thoracic vertebral body?

A

T1-T9: 10, T10: 8, T11-T12: 6

165
Q

What is the generic shape of the typical lumbar vertebral body from the cranial view?

A

Reniform or kidney shaped

166
Q

What accounts for the direction of the lumbar curve?

A

The vertebral body and intervertebral disc have a greater anterior height than posterior height

167
Q

What is the effect of aging on the vertebral body of a lumbar vertebra?

A

Decrease in height, increase in circumference

168
Q

How many joint surfaces are present on the vertebral body of a typical lumbar?

A

Six

169
Q

What muscles may attach to a typical lumbar vertebral body?

A

Psoas major and psoas minor

170
Q

What is the name given to ligaments which attach the vertebral body to articular process?

A

Transforaminal ligaments

171
Q

What are the types of transforaminal ligaments?

A

Superior transforaminal, middle transforaminal ligaments, and inferior transforaminal ligaments

172
Q

What ligaments attach the vertebral body to the transverse process?

A

Corporotransverse ligaments

173
Q

What corporotransverse ligaments are identified?

A

Superior corporotransverse and inferior corporotransverse ligaments

174
Q

Cervical-upper thoracic Hofmann ligaments will attach what structures together?

A

Dura mater to segments above

175
Q

What is feh proposed function of the cervical-upper thoracic Hofmann ligaments?

A

Resist caudal movement of the dural sac, resist gravitational forces on the dura and cord

176
Q

Lumbar Hofmann ligaments will attach what structures together?

A

Dura mater to lower segments levels

177
Q

What is the proposed function of the lumbar Hofmann ligaments?

A

Resist cranial movement of the dural sac during flexion

178
Q

Congenital elongation of the lumbar accessory process results in what feature?

A

Styloid process

179
Q

What parts of a vertebra are attached via the mammillo-accessory ligament?

A

The mammillary process and accessory process of the same segment

180
Q

What was believed to be entrapped by the mammillo-accessory ligament?

A

The medial branch of the dorsal ramps of a lumbar spinal nerve

181
Q

What muscles attach to the lumbar accessory process?

A

Longissimus thoracis and intertransversarii

182
Q

What is the position of the lumbar zygapophysis in adults?

A

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

183
Q

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?

A

Joint asymmetry or joint tropism

184
Q

What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?

A

Overlap of the laminae, shingling diminishes, overlap of spinous processes, limbrication diminishes

185
Q

What muscles will attach to the typical lumbar spinous process?

A

Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis

186
Q

What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?

A

Lumbosacral, iliolumbar, and mammillo-accessory ligaments

187
Q

What are the posterior elements of the vertebra?

A

Zygapophysis, lamina, and spinous process

188
Q

What are the anterior elements of the vertebra?

A

Vertebral body and pedicle

189
Q

What is the orientation of the fifth lumbar superior articular facet?

A

Backward, upward, medial (BUM) typically concave

190
Q

What is the orientation of the fifth lumbar inferior articular facet?

A

Forward, lateral, downward (FoLD) significant convexity

191
Q

What is the names of the condition in which the L5 spinous process increases in length due to the aging process?

A

Baastrup’s syndrome or “kissing spines”

192
Q

What is Knife Clasp Syndrome?

A

The congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida and dorsiflexion produces pain

193
Q

What is the superior articular facet orientation at each lumbar vertebra?

A

L1-L5: backward, ward, medial (BUM)

194
Q

What is the inferior articular facet orientation at each lumbar vertebra?

A

L1-L5: forward, lateral, downward (FoLD)

195
Q

What is the incidence of spondyloysis in the general population?

A

A range of 2.6% to 10%

196
Q

Lumbar spondyloysis has not been reported in what groups of individuals?

A

Fetuses, newborns, rarely in children under five years old, patients who have never walked and in non-erect species

197
Q

What does lumbar spondyloysis appear to be related to?

A

The uniquely human upright stance or erect posture

198
Q

What is the gender bias and locational bias associated with lumbar spondyloysis?

A

Men at L5/S1 and women at L4/L5

199
Q

What is the age range typically associated with the lumbar spondyloysis?

A

10-20 years old

200
Q

What motions are particularly associated with lumbar spondyloysis?

A

Hyperextension coupled with rotation

201
Q

What fills the space in a lumbar spondyloysis?

A

Fibrocartilagenous material

202
Q

What name has been given to the material filling the space in a lumbar spondyloysis?

A

Spondyloysis ligament

203
Q

What types of neural functions have been associated with the spondyloysis ligament?

A

Nociception, neuromodulation, and autonomic function

204
Q

What is the appearance of a spondyloysis Ina lumbar vertebra upon oblique x-ray view?

A

A collard Scotty dog

205
Q

What part of a lumbar vertebra forms the neck of a Scotty dog?

A

The pars interarticularis below the superior articular process

206
Q

What part of a lumbar vertebra forms the eye of a Scotty dog?

A

The pedicle

207
Q

What part of a lumbar vertebra forms the ear of a Scotty dog?

A

The superior articular process

208
Q

What part of the lumbar vertebra forms the nose of a Scotty dog?

A

The transverse process

209
Q

What characteristics are associated with the cervical spondyloysis?

A

Rare, congenital, gender biased toward men, most common at C6 and linked to spondyloysis and spina bifida

210
Q

What characteristics are associated with sacral spondyloysis?

A

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

211
Q

What is the posterior direction of a vertebral slippage called?

A

Retrospondylolisthesis or retrolisthesis

212
Q

What are the types/classifications of spondylolithesis?

A

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)

213
Q

What is the location bias of type I spondylolithesis?

A

L5 or upper sacral segments

214
Q

Which subtype of type II spondylolithesis is stressed in Spinal II?

A

Lyric spondylolithesis or stress fracture induced spondylolithesis

215
Q

What gender bias, location bias, and spinal canal dimensions are associated with type II spondylolithesis?

A

Isthmic spondylolithesis is common in men, located at the L5/S1 level and demonstrates an increase in sagittal diameter of the spinal canal

216
Q

What is the gender bias, locational bias, and spinal canal dimension changes often associated with type III spondylolithesis?

A

Degenerative spondylolithesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal canal

217
Q

What causes type IV spondylolithesis?

A

Fracture of the neural arch components

218
Q

What are the causes associated with type V spondylolithesis?

A

Bone diseases such as Paget diseases or osteogenesis imperfecta

219
Q

How many synovial joint surfaces are resent on the vertebral body of the first sacral segment?

A

Five

220
Q

What joint classifications will be observed at the first sacral vertebral body?

A

Cartilaginous (amphiarthrosis) symphysis, fibrous (amphiarthrosis) syndesmosis

221
Q

What muscle may attache to the first sacral vertebral body?

A

Psoas major

222
Q

What is the position of the sacral zygapophysis in adults?

A

The zygapophysis lies in the coronal plane for L5/S1

223
Q

What is the orientation of the first sacral superior articular facet?

A

Backward, upward, medial (BUM) typically concave

224
Q

What is the size relationship between ventral and dorsal sacral foramina?

A

Ventral sacral foramina are larger

225
Q

What part of the sacral ala continues along the ventral surface of sacrum to about S4?

A

The costal element

226
Q

What is the name of the region of bone lateral to the vertebral body of S5?

A

The transverse process

227
Q

An imaginary line drawn from the superior articular process of S1 to the sacral cornu will form what feature?

A

Intermediate sacral crest

228
Q

What features may be identified along the intermediate sacral crest?

A

The mammillary process of S1 and the sacral cornu of S5

229
Q

What is the name of the inferior opening of the sacral spinal canal?

A

The sacral hiatus

230
Q

What features may be identified along the lateral sacral crest?

A

S1 transverse tubercle, sacral tuberosity of S2, transverse tubercles of S3, S4, and S5

231
Q

What is the name of the joint formed by the sacral tuberosity?

A

The accessory sacro-iliac joint

232
Q

What feature is associated with the transverse tubercle of S5?

A

The inferior and lateral (inferolateral) sacral angle

233
Q

What classification of joint is formed by the auricular surface of sacrum?

A

Synovial (diarthrosis) arthrodia joint

234
Q

What feature does the anterior surface of the superior epiphyseal rim of S1 form?

A

The sacral promontory

235
Q

How many synovial joints are typically present at the sacrum?

A

Four

236
Q

What forms the posterior boundary for the fifth sacral spinal nerve intervertebral foramen?

A

Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament and intercornual ligament

237
Q

What is the homolog for the posterior longitudinal ligament of S5?

A

Deep posterior sacrococcygeal ligament

238
Q

What is the homolog for the anterior longitudinal ligament at S5?

A

Anterior sacrococcygeal ligament

239
Q

What is the homolog for the ligamentum flavum at S5

A

Superficial posterior sacrococcygeal ligament

240
Q

What is the homolog for the capsular ligament at S5?

A

Intercornual ligament

241
Q

What is the number of coccygeal somites?

A

Ten

242
Q

What is the typical number of segments which unite to form the adult coccyx?

A

4 segments

243
Q

When is ossification of coccyx completed?

A

About 30 years old

244
Q

What bony features are present on the coccyx?

A

All segments are represented by a vertebral body, Co1 has a coccygeal cornu and transverse process

245
Q

What is the direction of fusion of coccygeal segments?

A

From caudal to cranial, the last segments to fuse together are Co1 and Co2

246
Q

What is the direction of the coccygeal curve?

A

Posterior, kyphotic

247
Q

What is the major motion and range of motion for coccyx?

A

Flexion- extension, 5-20 degrees

248
Q

What is ganglion impar?

A

A midline sympathetic ganglion

249
Q

What is the coccygeal glomus or coccygeal body?

A

An enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx

250
Q

What forms the inferior boundary for the spinal canal?

A

The union of the superficial posterior and deep posterior sacrococcygeal ligaments

251
Q

What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments of Co1?

A

The posterior sacrococcygeal ligament

252
Q

What forms the posterior boundary for the first coccygeal spinal nerve intervertebral foramen?

A

Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament, intercornual ligament

253
Q

What forms the anterior boundary for the first coccygeal spinal nerve intervertebral foramen?

A

Vertebral body S5, vertebral body Co1, deep posterior sacrococcygeal ligament, intervertebral disc

254
Q

Superior articular facets of which vertebrae will be orientated backward, upward, and medial?

A

C1, C3-C7, L1-L5, S1

255
Q

Superior articular facets of which vertebrae are oriented back, up, medial, and concave?

A

C1, L1-L5, S1

256
Q

Superior articular facets of which segments will be oriented backward, upward, and lateral?

A

C2, T1-T12

257
Q

Inferior articular facets of which segments will be oriented backward, medial, and downward?

A

C1

258
Q

Inferior articular facets of which segments will be orientated forward, lateral, and downward?

A

C2-C6, T12, L1-L5

259
Q

Inferior articular facets of which segments will be orientated forward, lateral, downward, and convex?

A

T12, L1-L5

260
Q

Inferior articular facets of which segments will be orientated forward, medial, and downward?

A

C7, T1-T11

261
Q

What are the characteristics of cervicalization of occiput?

A

An increase in occipital bone size, formation of new or larger lines, on the occipital bone

262
Q

What is the characteristic of occipitalization of C1?

A

The atlas may be partially or completely fused to the occiput

263
Q

What is another way of implying occipitalization of C1?

A

Atlas assimilation

264
Q

What is the incidence of occipitalization of C1?

A

.1% to .8%

265
Q

When do the centers of ossification for the odontoid process first appear?

A

During the last trimester in utero

266
Q

When do the bilateral ossification centers for the odontoid process fuse?

A

At or shortly after birth

267
Q

What joint is formed between the odontoid process ossification centers and the centrum of C2?

A

The subdental snychondrosis

268
Q

What is the classification of the joint formed between the C2 odontoid process and centrum?

A

Amphiarthrosis synchondrosis

269
Q

A joint between the odontoid process and centrum of C2 is last identified at what age?

A

7 years old

270
Q

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?

A

So odontoideum

271
Q

What is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7?

A

Persistent subdental synchondrosis

272
Q

What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?

A

Tip of the dens synchondrosis

273
Q

At what age will the tip of the dens center of ossification appear?

A

Sometime in early adolescence

274
Q

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?

A

Terminal ossicle

275
Q

What is the incidence of rib-related changes following dorsalization of C7?

A

From one-half to two and one-half percent of population

276
Q

What is the gender bias suggested in dorsalization of C7?

A

Female

277
Q

What alteration in C7 facet orientation may accompany dorsalization?

A

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

278
Q

What alteration in C6 facet orientation may accompany dorsalization?

A

C6 demonstrates a change in inferior articular facet orientation from forward, lateral, and downward to forward, medial, and downward; the superior articular facet unchanged

279
Q

What percent of population may demonstrate thoracic-like features at C7?

A

Up to 46%

280
Q

What T1 facet orientation changes may accompany cervicalization?

A

The superior articular facet may change from back, upward, and lateral to back, upward, and medial; the inferior articular facet is unchanged

281
Q

What C7 facet orientation changes may accompany cervicalization?

A

The inferior articular facet may change from forward, medial, and downward; to forward, lateral, and downward; the superior articular facet is unchanged

282
Q

What is the incidence of cervicalization of T1 in the population?

A

Up to 28% of the population

283
Q

What is the incidence of lumbar ribs in the population?

A

Over 7% of the population demonstrates lumbar ribs

284
Q

What L1 facet orientation changes may accompany dorsalization?

A

The superior articular facet may change from concave, back, upward, and medial…to flat, back, upward, and lateral; the inferior articular facet is unchanged

285
Q

What T12 facet orientation changes may accompany dorsalization?

A

The inferior articular facet may change from convex, forward, lateral, and downward….to flat, forward, medial, and downward; the superior articular facet is unchanged

286
Q

What is the gender bias associated with the dorsalization of L1?

A

Males are two to three times more affected

287
Q

What rib related changes may accompany lumbarization of T12?

A

A significant shortening of the mean relative length of 113mm of the twelfth rib or it becomes absent

288
Q

What T12 facet orientation changes may accompany lumbarization?

A

The superior articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged

289
Q

What is the characteristic of lumbarization of S1?

A

The failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala

290
Q

What is the characteristic of sacralization of L5?

A

L5 may be partially or completely fused to the sacrum

291
Q

Which segment demonstrates the greatest morphological variation along the spine?

A

L5

292
Q

What is the incidence of variation within the sacrococcygeal region in the population?

A

Up to 14%

Spinal Anatomy 2 (5 decks)

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