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Spinal > Exam 2: Cervical > Flashcards

Exam 2: Cervical Flashcards

1
Q

Ligaments that attach to the typical cervical spinous process

A

the interspinous ligament and ligamentum nuchae

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2
Q

What forms the anterior boundary of a typical cervical intervertebral foramen?

A

the lateral groove and vertebral body of the segment above, the uncinate process and vertebral body of the segment below, the intervertebral disc and the posterior longitudinal ligament

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3
Q

Posterior boundary of a typical cervical intervertebral foramen

A

the inferior articular process (post-zygapophysis), the superior articular process (pre-zygapophysis), the capsular ligament and the ligamentum flavum

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4
Q

Superior boundary of a typical cervical intervertebral foramen

A

inferior vertebral notch or inferior vertebral incisure

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5
Q

Inferior boundary of a typical cervical intervertebral foramen

A

the superior vertebral notch or superior vertebral incisure

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6
Q

The unique anterior boundary of the intervertebral foramen for the C4 spinal nerve

A

the lateral groove of C3 and uncinate process of C4 forming the joint of Luschka

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7
Q

Name of first cervical vertebra

A

atlas

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8
Q

Features missing on C1

A

vertebral body, pedicles, a spinous process and the intervertebral disc

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9
Q

Represents the pedicle at C1

A

anterior arch

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10
Q

Osseous modification on the front of the anterior arch of C1

A

anterior tubercle

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11
Q

muscle that attaches to the anterior arch of C1

A

longus colli

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12
Q

Ligaments that attach to the anterior arch of C1

A

anterior longitudinal, anterior atlanto-occipital and anterior atlanto-axial ligaments

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13
Q

Joint classifications found on anterior arch of C1

A

fibrous (amphiarthrosis) syndesmosis joint and synovial pivot (diarthrosis trochoid) joint

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14
Q

Morphology of the superior articular facet of C1

A

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

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15
Q

orientation of the superior articular facet of C1

A

backward, upward, medial (BUM)

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16
Q

Joint classification of the atlanto-occipital zygapophysis

A

synovial (diarthrosis) ellipsoidal joint

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17
Q

morphological characteristics of the inferior articular facet of C1

A

backward, medial, downward (BMD)

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18
Q

joint classification of the atlanto-axial zygapophysis

A

synovial plane (diarthrosis arthrodia) joint

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19
Q

Muscles that attach to the lateral mass of C`

A

levator scapula, splenius cervicis and rectus capitis anterior

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20
Q

contribution of the posterior arch of the circumference of C1

A

about forty percent

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21
Q

Part of C1 that represents the spinous process

A

posterior tubercle of the posterior arch

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22
Q

Distance from the posterior tubercle of the posterior arch to the skin in each gender

A

Males: 50 millimeters
Females: 37 millimeters

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23
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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24
Q

Attachments to the arcuate rim of C1

A

posterior atlanto-occipital ligament

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25
Q

What atypical bone classification is ossification of the free margin of the posterior atlanto-occipital ligament?

A

accessory bone

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26
Q

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

A

about 7 years old

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27
Q

Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?

A

an incomplete ponticulus posticus or a complete ponticulus posticus

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28
Q

Attachment sites of the ponticulus posticus

A

it is attached to the arcuate rim of the posterior arch of atlas and to the superior articular process of the lateral mass of atlas

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29
Q

Ethnic populations who have a ponticulus posticus

A

all ethnic populations studied thus far

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30
Q

Percentages of incidence of ponticulus posticus’

A

1-41%

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31
Q

Gender bias associated with ponticulus posticus

A

female

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32
Q

Incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus

A

complete ponticulus posticus 15%;

incomplete ponticulus posticus as high as 41%

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33
Q

What is observed on the undersurface of the posterior arch of C1?

A

“Inferior vertebral notch” and an attachment site for the posterior atlanto-axial ligament

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34
Q

Location of the “zygapophysis” relative to the atlanto-occipital and atlanto-axial intervertebral foramina

A

forms part of the anterior boundary of the intervertebral foramen in both cases

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35
Q

Osseous parts of the transverse process of C1

A

Costal element, posterior tubercle, true transverse process

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36
Q

Osseous parts of the transverse process that are absent from C1

A

anterior tubercle and costotransverse bar

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37
Q

Suboccipital muscles known to have fascial projections attaching to the spinal dura

A

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

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38
Q

Connections between sub occipital muscles and the spinal dura

A

myodural bridges

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39
Q

what are the lateral bridges of atlas connected to?

A

the lateral mass and the transverse process of atlas

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40
Q

What forms of the lateral bridges are observed in the population

A

incomplete lateral bridges and complete lateral bridges

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41
Q

Opening identified when a complete lateral bridge is formed

A

the retrotransverse foramen

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42
Q

Possible contents of the retrotransverse foramen

A

Vertebral artery and a branch from the sub occipital nerve and veins communicating with the venous sinuses of the neck

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43
Q

Which of the ponticles (bridges) of atlas is most numerous

A

ponticulus posticus

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44
Q

Which of the ponticles (bridges) of atlas is only observed in humans?

A

lateral bridges

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45
Q

What is in the transverse foramen of C1

A
  1. Vertebral artery
  2. Vertebral venous plexus
  3. Postganglionic sympathetic motor nerve fibers
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46
Q

Gender variation of measurements of the transverse diameter of C1?

A

Males: 78 millimeters
Females: 72 millimeters

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47
Q

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

48
Q

Joint classifications observed at C1

A

fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial pivot (diarthrosis trochoid) joint and synovial plane (diarthrosis arthrodia) joint

49
Q

How many synovial joint surfaces are observed at C1?

A

5

50
Q

Synovial joint surfaces observed at C1?

A

two superior articular facets, two inferior articular facets and the fovea dentis

51
Q

Names given to C2

A

Axis or epistropheus

52
Q

Unique vertebral body modification on C2

A

dens or odontoid process

53
Q

Number of joint surfaces present on the odontoid process of C2

A

five

54
Q

Joint surfaces present on the odontoid process of C2

A
  1. Facet for fovea dentis
  2. Groove for transverse atlantal ligament
  3. Attachment sites for the alar ligaments
  4. Attachment site for the apical-dental ligament
55
Q

Joint classifications represented at the odontoid process of C2

A

fibrous (amphiarthrosis) syndesmosis and synovial pivot (diarthrosis trochoid) joints

56
Q

Name/classification given to the odontoid process when the tip of the dens is directed posterior

A

lordotic dens

57
Q

Name/classification given to the odontoid process when the tip of the dens is directed anterior

A

kyphotic dens

58
Q

Number of joints formed by the inferior part of the vertebral body of C2

A

five

59
Q

Joint classifications present at the inferior part of the vertebral body of C2

A

fibrous (amphiarthrosis) syndesmosis, modified synovial saddle (diarthrosis cellar) and cartilaginous (amphiarthrosis) symphysis

60
Q

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

A

membrana tectoria

61
Q

Ligament that forms the anterior boundary for the spinal canal above C2

A

membrana tectoria

62
Q

Ligament that forms the anterior boundary for the spinal canal below C2

A

posterior longitudinal ligament

63
Q

Location of the superior vertebral notch of C2

A

on the lamina-pedicle junction

64
Q

What attaches to the lamina of C2?

A
  1. Obliquus captifs inferior muscle
  2. Posterior atlanto-axial ligament
  3. Ligamentum flavum
65
Q

What muscle attaches to the lamina of C2?

A

Obliquus capitis inferior

66
Q

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

A

they are asymmetrical and slightly convex

67
Q

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

A

Backward, upward, and lateral (BUL)

68
Q

What is the orientation of the inferior articular facets of C2

A

forward, lateral and down (FoLD)

69
Q

Muscle that attaches to the articular processes of C2

A

longissimus crevicis

70
Q

Osseous parts of the typical cervical transverse process that are absent at C2

A

Anterior tubercle and costotransverse bar

71
Q

What is observed in the transverse foramen at C2

A
  1. Vertebral artery
  2. Vertebral venous plexus
  3. Postganglionic sympathetic motor nerve fibers
72
Q

Characteristic appearance of the C2 spinous process in humans

A

bifid

73
Q

Location for palpation of the spinous process of C2

A

In the midline, about two inches below the external occipital protuberance

74
Q

Ligaments attached to the spinous process of C2

A

ligamentum nuchae, interspinous ligaments

75
Q

Names given to C7

A

vertebra prominens and vertebral prominence

76
Q

Name given to the topographical elevation observed at the base of the neck

A

vertebral prominence

77
Q

Name given only to C7

A

vertebra prominens

78
Q

Percentages of men and women that have C7 as the vertebral prominence

A

Men: 86%
Women: 79%

79
Q

Segment and gender bias for vertebrae other than C7 becoming the vertebral prominence

A

C6 more common in women

T1 more common in males

80
Q

Number of joint surfaces present on vertebral body of C7

A

eight

81
Q

Joint classification are observed at the vertebral body of C7

A

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

82
Q

Synovial joint surfaces observed at the vertebral body of C7

A

right and left uncinate processes

83
Q

Muscles attached to the vertebral body of C7

A

longus colli muscle

84
Q

Features are typically present in the transverse foramen of C7

A

vertebral venous plexus, postganglionic sympathetic motor fibers

85
Q

Angulation of the articular facet at C7

A

more vertical at about 63 degrees

86
Q

Orientation of the superior articular face of C7

A

backward, upward, medial (BUM)

87
Q

Orientation of the inferior articular facet of C7

A

forward, medial, downward (ForMeD)

88
Q

Features of the spinous process of C7

A

long, horizontal, nonbifid

89
Q

Ligaments attaching to the spinous process of C7

A

Ligamentum nuchae and interspinous ligaments

90
Q

Which vertebral artery is typically larger

A

Left

91
Q

Gender bias regarding size of vertebral artery

A

Men have larger vertebral arteries

92
Q

Name of physical exam used to determine vertebral artery patency

A

Vertebrobasilar artery insufficiency test

93
Q

Which side artery was tested during the course of vertebrobasilar artery insufficiency exam

A

Ipsilateral artery on side of rotation

94
Q

Symptoms of failure of vertebral artery to compensate during vertebrobasilar artery insufficiency exam

A

Dizziness, vertigo, nausea

95
Q

What vertebral level will the vertebral artery first become located in transverse foramen

A

C6

96
Q

What location will vertebra artery form its first compensatory loop

A

Atlanta-axial interspace

97
Q

What location will vertebral artery form its second compensatory loop

A

Atlanto-occipital interspace

98
Q

What segments will vertebral artery be firmly attached to transverse Foramen

A

Both C1 and C2

99
Q

Purpose of vertebral artery looping between C2, C1, and occipital

A

Increased length will accommodate greater rotation at these locations

100
Q

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

A

Ascends along MO to pontine-medullary junction where the R and L arteries unite to form the basilar artery

101
Q

Which suboccipital muscles attach to C1

A

RCP minor

Obliquus capitis superior and inferior

102
Q

Which suboccipital muscles attach to C2

A

RCP major, Obliquus capitis inferior

103
Q

What joint classifications are present at C1

A

Synovial ellipsoidal
Synovial pivot
Synovial plane
Fibrous syndesmosis

104
Q

What joint classification present at C2

A 
Synovial pivot 
Synovial plane 
Modified synovial saddle 
Fibrous syndesmosis 
Cartilaginous symphysis
105
Q

Joint classifications present at each typical cervical

A

Synovial plane
Modified synovial saddle
Fibrous syndesmosis
Cartilaginous symphysis

106
Q

Joint classifications present at C7

A

Synovial plane
Modified synovial saddle
Fibrous syndesmosis
Cartilaginous symphysis

107
Q

What forms boundaries for exit of C1 nerve from spinal canal

A 
Occipital condyle
Superior articular process of C1
Capuslarligament 
Arcuate rim 
Groove for vertebral artery 
Posterior Atlanto-Occipital ligament
108
Q

What forms the anterior boundary for C2 nerve exit from 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
109
Q

What forms the anterior boundary for the C2 nerve exit from spinal canal

A

Inferior articular process of C1
Superior articular process of C2
Capsular ligament

110
Q

What forms the posterior boundary for the C2 nerve exit from the spinal canal

A

Posterior arch of C1
Lamina of C2
Posterior atlanto-ligament

111
Q

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

A 
Vertebral bodies 
IVD
PLL
Uncinates 
Lateral groove
112
Q

What forms the anterior boundary for C8 nerve exit from spinal canal

A 
Vertebral bodies of C7 and T1
IVD
PLL
Capsular ligament of costocentral joint
Superior costal facet of T1
Articular surface of the first rib
113
Q

Superior articular facet orientations for cervical vertebrae

A

C1 is BUM
C2 is BUL
C3-C7 is BUM

114
Q

Inferior articular facet orientations for cervicals

A

C1 is BMD
C2-C6 is FoLD
C7 is ForMeD

115
Q

How many synovial joints are ID’d for each cervical

A 
C1 = 5
C2 = 8
C3-C6 = 8
C7 = 6
116
Q

How many joints are ID’d at vertebral body of each cervical

A 
C1 = 0 
C2 = 10
C3-6 = 10
C7 = 8

Spinal (27 decks)

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