EXAM 2 Flashcards
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 features will allow for discrimination between T2-T4 and T5-T8 segmental groups?
the vertebral body, transverse process, articular process, and spinous process
What is the principle cause of the posterior curve of the thoracic region?
the vertebral body height differences
What joint classifications are identified at the vertebral body of a typical thoracic?
amphiarthrosis syndesmosis,
amphiarthrosis symphysis,
diarthrosis arthrodia
How many joints are formed at the vertebral body of a typical thoracic?
typically ten, fourteen if the rib ligaments are included
What is the name given to the jointed formed b/w the vertebral body and the rib?
costocentral joint
What ligaments support the costocentral joint?
the radiate costocentral or stellate costocentral ligament,
and the
interarticular or intra-articular ligament
What does the intra-articular or interarticular ligament connect to?
the interarticular or intra-articular crest of the capitlum of the rib and the intervertebral discs
Which x-ray view is used to see into the intervertebral foramen of a typical thoracic?
lateral view
What ligaments support the costotransverse joint of a typical thoracic?
the superior costotransverse,
inferior costotransverse,
lateral costotransverse ligaments
The superior costotransverse ligament of the transverse process of T4 will attach to which rib?
5th rib
Which muscles may attach to the transverse process of a typical thoracic?
longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis thoracis, semispinalis cervicis, semispinalis capitis, multifidis, rotator brevis, rotator longus, intertransversarii, levator costarum brevis, levator costarum longus
How can you distinguish b/w a T2-T4 from T5-T8 using the articular process?
At T2-T4 the width b/w the superior articular process is greater than the width b/w the inferior articular processes of that vertebra,
At T5-T8 the width b/w the superior articular process is equal to or the same as the width b/w the inferior articular processes of that vertebra
What is the orientation of the inferior articular facet of a typical thoracic vertebra?
Forward, downward, and medial (ForMeD)
Imbrication will e more pronounced for what region of the thoracics?
T5-T8
What is the angulation of the spinous process in the typical thoracic region?
the undersurface of T2-T4 spinous processes will angle up to 40 degrees form the horizontal plane
the undersurface of T5-T8 spinous processes will angle up to 60 degrees from the horizontal plane
Which muscles may attach to the spinous process of a typical thoracic?
trapezius, latissimus dorsi, rhomboid major, serratus posterior superior, splenius cervicis, splenius capitis, semispinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator brevis, rotator longus, interspinalis
Which muscles are associated with the five muscle layers of the back?
1- trapezius and latissimus dorsi 2- rhomboids and levator scapulae 3- serratus posteriors 4- erector spinae 5- transversospinalis
Ow many joints are formed at the vertebral body of T1?
typically 10, 14 if the rib ligaments are included
What ligament is absent at the costotransverse joint of T1?
Superior costotransverse ligament
What ligaments attach to the transverse process of T1?
intertransverse, capsular costotransverse, superior costotranverse, inferior costotransverse, lateral costotransverse
Para-articular processes are more commonly observed on which segment?
T10
A dimpling or depression of the skin in the thoracic region is often characteristic of the location of which segment?
T10
What name is given to T11?
Anticlinal vertebra
Which muscle(s) is attached to the vertebral body of T12?
Psoas major and minor
What ligaments form the costotransverse joint of the 12th rib?
Superior costotransverse ligament from T11 and the lumbosacral ligament from L1
What is the orientation of the inferior articular facets of T12?
Forward, downward and lateral (FoLD)
How man synovial joints are typically present at T12?
6
What muscles attach to the spinous process of T12?
trapezius, latissimus dorsi, serratus posterior inferior, illiocostalis lumborum, spinalis thoracis, multifidis, rotator brevis, rotator longus, interspinalis
Which erector spinae muscle is unique in it’s attachment to the T12 spinous process?
illiocostalis lumborum
What accounts for the direction of the lumbar curve?
the vertebral body and intervertebral disc have a greater anterior height than posterior height
What muscles may attach to a typical lumbar vertebral body?
Psoas major and minor
What is the name given to ligaments which attach vertebral ody to articular process?
transforaminal ligaments
What ligaments attach the vertebral body to the transverse process?
corpotransverse ligaments
What is the proposed function of the Hoffmann ligaments in the cervical-upper thoracic region?
resist caudal movement of the dural sac
and
resist gravitational forces on the dura and cord
What is the proposed function of the lumbar Hoffmann ligaments?
resist cranial movement of the dural sac during flexion
What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
overlap of laminae shingling diminishes
and
overlap of spinous processes imbrication diminishes
A styloid process occurs with what frequency and as a result of what condition?
7% occurrence as a result of congenital elongation of the lumbar accessory process
What was believed to be entrapped b the mammilo-accessory ligament?
the medial branch of the dorsal ramus of a lumbar spinal nerve
What muscles attach to the lumbar accessory process?
longissimus thoracis
and
intertransversarii
What names are given to the condition in which one zygapophysis of a vertebral couple lies in a coronal plane or position and the other zygapophysis lies in the sagittal plane or position?
joint asymmetry
or
joint tropism
What is the name of the condition when the typical lumbar spinous process increases in length due to the aging process?
Basstrup’s syndrome AKA “kissing spines”
What ligaments attach to the transverse process of the fifth lumbar vertebra?
lumbosacral,
iliolumbar,
mammilo-accessory,
intertransverse
What names are given to the condition in which the right zygapophysis of a vertebral couple lies in a different plane from the left zygapophysis?
joint asymmetry
or
joint tropism
What is the name given to the congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida, and dorsiflexion produces pain?
Knife clasp syndrome
Lumbar spondylolysis has not been reported in what groups of individual?
fetuses, newborns, rarely in children under five years old, patients who have never walked, non-erect species
What is the gender bias and locational bias associated with lumbar sponylolysis?
men at L5/S1;
women at L4/L5
What is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view?
collared Scotty dog
What characteristics are associated with cervical spondylolysis?
rare, congenital, gender biased towards men, most common at C5/C6, linked to spondylolisthesis and spina bifida
What is the ethnic, gender, and locational bias associated with sacral spondylolysis?
native American (Inuit) male at the S1 level
Identify all names given to type I spondylolisthesis?
dysplastic spondylolisthesis
or
congenital spondylolisthesis
What gender bias, locational bias and spinal canal dimensions are associated with type II spondylolisthesis?
isthmic spondylolisthesis is common in men,
located at L5/S1 level,
demostrates an increase in sagittal diameter of the spinal canal
What gender bias, locational bias, and spinal canal dimension changes are often associated with type III spondylolisthesis?
degenerative spondylolisthesis is more common in women,
particularly at L4/L5,
demonstrates NO change in sagittal diameter of the spinal canal
What are causes associated with type V spondylolisthesis?
bone disease such as Pagets disease
or
osteogenesis imperfecta
What features may be identified along the intermediate sacral crest?
mammillary accessory process of S1
and
sacral cornu of S5
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?
accessory sacro-iliac joint
What is the articular facet orientation of C3-C6?
Forward, Lateral and Down (FoLD)
What is the inferior articular facet orientation of T12?
Forward, Lateral, Down and conVEX (FoLD)
Superior articular facets of which vertebrae will be oriented backward, upward and medial?
C1
C3-C7
L1-L5
S1
Superior articular facets of which vertebrae will be oriented backward, upward, and lateral?
C2
T1-T12
Inferior articular facets of which segments will be oriented forward, lateral and downward?
C2-C6
T12
L1-L5
What is another way of implying occipitalization?
atlas assimilation
What joint is formed between the odontoid process ossification centers and the centrum of C2?
subdental synchondrosis
What is the name given to the condition in which the joint formed b/w the odontoid process and centrum of C2 persists beyond age 7?
os odontoideum
What name is given to the joint formed b/w the tip of the dens and the odontoid process centers of ossification?
tip of dens synchondrosis
If the joint formed b/w 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 dorsilization of C7?
from 1 - 2.5% of the population
What is the gender bias suggested in dorsalization of C7?
Female
What C7 facet orientation changes may accompany cervicalization?
the inferior articular facet may change from (ForMeD) to (FoLD)
the superior articular facet remains unchanged
What gender bias is associated with dorsalization of L1?
Males are 2-3 times more affected
What T12 facet orientation changes may accompany lumbarization?
the SAF may change from (FLAT BUL) to (CONCAVE BUM)
the IAF is unchanged
What is characteristic of lumbarization of S1?
failure of synostosis b/w S1 and S2,
squaring of the vertebral body of S1,
flaring of sacral ala
Which segment demonstrates the greatest morphological variation along the spine?
L5
What developmental events are indicated in the formation of the adult cervical curve?
Centers for vision and equilibrium will appear in the brain….
musculature attaching the skull, cervical, region, and upper thorax together develops….
the head is held upright…
the intervertebral disc height becomes greater anterior than posterior
What is the name given to the integration of visual and motor pathways associated with holding the head erect?
the righting reflex
What developmental events are indicated in the formation of the adult lumbar curve?
crawling will cause the abdomen to put tension on the lumbar region and pulls it forward….
muscle development is promoted to compensate for the swayback of the lumbars…
intervertebral disc height will become greater anterior compared to posterior…
walking will further promote muscle and intervertebral disc development
What is the relationship b/w the right thoracic curve, left lumbar curve combination in the population?
about 80% of the population demonstrates this
What clinical examples of abnormal curvatures along the vertebral column were stressed in class?
military neck…
humpback or hunchback…
swayback…
What are the curve classifications for military neck?
a kyphosis or HYPERlordotic curve
What does idiopathic scoliosis infer?
the scoliosis is unique to the individual…
has no known cause…
unknown etiology…
Identify the curve direction, location, gender bias and incidence of infantile idiopathic scoliosis.
left thoracic…
male…
less than 1% incidence
Identify the curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis.
right thoracic…
females over age 6…
12-21% incidence…
Identify the curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis.
right thoracic OR right thoracic and left lumber…
females…
80% incidence
What is the relationship b/w curve deviation, incidence, and curve worsening?
the greater the deviation, the lower the incidence and more likely to worsen
What is the vertebral column origin for the longissimus thoracis pars lumborum?
accessory process and medial part of transverse process of L1-L5
Which muscles are identified as transversospinalis muscles?
semispinalis. ..
multifidis. ..
rotators. ..
The semispinalis capitis may fuse to form what muscle?
biventer cervicis
Which transversospinalis muscle attaches to articular and mammillary processes along the spine?
multifidis
Which muscles of the spine exhibit a reversal of the expected origin-insertion combination?
illiocostalis lumborum pars lumborum…
longissimus thoracis pars lumborum…
multifidis lumborum…
What is the proposed function of the suboccipital muscle group?
postural stabilizers of the atlanto-occipital and atlanto-axial joints
Which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves?
intertransversarii
Based on the density of muscle spindles what is the proposed function of the intertransversarii?
acts as a proprioceptive transducer in conjunction with the interspinalis to coordinate the smooth movement of the spine and to maintain appropriate position
Which muscle is said to form the iliolumbar ligament?
quadratus lumborum
Identify all muscle groups innervated by dorsal rami branch patterns.
splenius... erector spinae... transversospinalis... suboccipital... interspinalis... levator costarum... intertransversarii...