exam 3 Flashcards
what is the radiological test for skeletal maturity?
The Risser sign, an indication of bone maturity in the iliac apophysis
What are the classifications of scholiosis according to the scoliosis research society?
Magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis
What does magnitude of scoliosis refer to?
The length and angle of the curve deviation on x-ray
What is often used ot measure the magnitude of scoliosis?
The Cobb Method
What does location of scoliosis infer?
The location on the vertebral segment forming the apex of the curve deviation
What does the direction of scoliosis refer to?
The side the convexity of the curve will bend toward
What does etiology of scoliosis mean?
The cause of the scoliosis
what is structural scoliosis?
A more radical fom of scoliosis, it may worsen, associated with structural deformities of the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation
What is non structural scoliosis?
A mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or intervertebral disc and lacks a fixed angle of trunk rotation.
What are some of the classifications of scoliosis based on etiology?
Congential, neuromuscular, neurofibromatosis, nerve root irritation, idiopathic
What is the classification of scoliosis that is unique to the individual patient?
Ideopathic scoliosis
What does idiopathic scoliosis infer?
The scoliosis is unique to the individual, it has no known cause, unknown etiology
What is the incidence of idiopathic scoliosis in the population?
1%-4% of the population
What is the age range for infantile idiopathic scoliosis?
From birth to 3 years old
What is the age range for juvenile idopathic scoliosis?
From 3-10 years
What is the age range for adolescent idiopathic scoliosis?
Over 10 years old
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 6 years old, and 12-21% incidence
Identify the curve direction, location, gender bias and incidence of adolescet idiopathic scoliosis
Right thoracic or right thoracic and left lumbar, females, and 80% incidence
What is the genetic factor associated with adolescent idiopathic scoliosis?
An autosomal dominant factor that runs in families
What is the relationship between curve deviation, incidence, and curve worsening?
The greater the deviation, the lower the incidence, and the more likely to worsen
What is/are the characteristic(s) 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 occipialization of C1?
0.1% - 0.8%
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 synchondrosis
What is the classification of the joint formed between the C2 odontoid process and centrum?
Amphiarthrosis synchondrosis
Ossification between the odontoid porcess and centrum joint of C2 first appears at what age?
4 Years old
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?
Os 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 o fthe dens center of ossification appear?
Sometime in early adolescence
at what age will the tip of the dens fuse with the odontoid process?
Before age 12
If the joint formed between the tip of the dens and odontoid process centers of ossification persists betyond age 12, what is the condition called?
Terminal ossicle
What is basilar impression?
Peristence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain
What is the incidence of rib-related changes following dorsalization of C7?
From one-half to two and one-half percent of the population
Do patients typically present with symptoms specific for dorsalization of C7?
No, they are typically asymptomatic
What is the gender bias suggested in dorsalization of C7?
Female
What alterations of C7 facet orientation may aaccompany dorsalization?
The superior articular facet of C7 may change from back, upward, and medial to that of a typical thoracic facet… back, upward, and lateral; the inferior articular facet is unchanged
What percent of the 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 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 is the gender bias associated with dorsalization of L1?
Males are two to three times more affected
What T12 facet orientation changes may accompnay lumbarization?
The supieror articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged
What T11 facet orientation changes may accompnay lumbarization?
The inferior articular facet may change from flat, foward, medial, and downward to convex, forward, lateral, and downward; the superior articular facet is unchanged
What is the usual way fo identifying the number of cervicals, thoracics and lumbar verebrae during imaging studies
Identify the vertebrae with ribs - they will be thoracics; those higher are cervicals, those lower are lumbars
What is characteristics 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 failure of synostosis between S1 and S2?
The segments do not completely fuse together
What is squaring of the vertebral body of S1?
The S1 vertebral bdy has similar anterior and posterior heights, hence a lack of wedging
what isf laring of the sacral ala?
The transverse process of the ala appears to elevate as though separating from the rest of the sacral ala
What articular facet changes accompnay lumbarization of S1
None
What is characteristic of sacralization of L5
L5 may be partially of completey fused to the sacrum
What is the inidence of sacralization of L5 in the population
41% - 85%
Which segment demonstrates the greatest morphological variation along the spine
L5
What articular facet changes accompnay saralization of L5
None
What is the incidence fo variation within the sacroccoygeal region in the population
Up to 14%
What is characteristic of sacralization of Co1
The premature fusion of Co1 to the sacrum
What is characteristic of coccygealization of S5
The separation of S5 from sacruma nd its premature fusion to Co1
The trapezius is innervated by what nerve?
The spinal accessory nerve
What forms the spinal accessory nerve innervating the trapezius
C1-C5 cord levels contribute to the spinal root of the spinal accessory nerve
The latissimus dorsi is innervated by what nerve
The thoracodorsal nerve
what forms the thoracodorsal nerve innervating the latissimus dorsi
Ventral rami from C6-C8
What forms the dorsal scapular nerve
The ventral rami of C8
What is the innervation of the splenius capitis
Dorsal rami of middle cervical spinal nerves (C3-C5 cord levels)
Splenius cervicis will arrach to what locations on the spine
Lateral mass of C1 & posterior tubercle of transverse process on C1-C4
Which muscles are identified as erector spinae or sacrospinalis muscles
Iliocostalis, longissimus, spinalis
What is the innervation of the iliocostalis lumborum
Dorsal rami of lower thoracic and all lumbar spinal nerves
What osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis
None
What is the insertion for the iliocostalis thoracis
Costal angles of the upper 6-7 ribs, thransverse process o C7
What osseous parts of the vertebral column serve as an origin to the longissimus thoracis
Accessory process & transverse processes of L1-L5, spinous processes of L3-L5 and median sacral crest S1-S3
What is the innervation of the longissimus cervicis
Dorsal rami of C4-C8 and T1-T2 spinal nerves (C4-C8 & T1-T2 cord levels)
What osseous parts of the vertebral column serve as an origin to the spinalis thoracis
Spinous processes of T11 & T12-L1 & L2
Which muscles are identified as transversospinalis muslces
Semispinalis, multifid, and rotators
How many vertebrae can be attached to a single segment by transversospinalis muslces
As many as nine vertebrae
What segment will represent the lowest attachment site for the semispinalis thoracis
T12
What osseous parts of the vertebral column serve as an origin to the semispinalis cervicis
Transverse tubercles of T1-T5 or T6 & articular processes of C4-C7
What osseous parts of the vertebral column serve as an origin to the semispinalis capitis
Transverse tubercles of C7, T1-T6 or T7 & articular processes of C4-C6
The semispinalis ccapitis and spinalis capitis may fuse to form what muscle
Biventer cervicis
What osseous parts of the vertebral column serve as an origin to the classic multifidis
Articular process of C4-C7, transverse processes of T1-T12, mammillary processes of L1-L5 and the dorsal surface of S1-S4 or S5
Contraction of the classic multifidis will result in what movemnets of the vertebral column
Lateral flexion & rotation of the spine, maintains the lumbar lordotic curve and prevents entrapment of zygapophyseal capsular ligament during movement
Contraction of multifidis cervicis will result in what movements
Alters the zygapophyseal capsular ligament response to load distribution determines the cervical spine response to injury as evidenced by neck pain and is a significant contributor to postural conrol of the head and neck
contraction of multifidis lumborum will result in what movements
lateral flexion & rotation of the lumbar spine, maintains the lumbar lordotic curve and prevents entrapment of lumbar zygapophyseal capsular ligament during movemnt
which muscles of the spine exhibit a reversal of the expected origin - insertion combination
iliocostalis lumborum pars lumborum, longissimus thoracic pars lumborum and multifidis lumborum
rotator muscles are typically identified in what region of the spine
the thoracic region
which suboccipital muslce lacks an attachment to the skull
obliquus capitis inferior
which nerve will innervate all suboccipital muscles
dorsal ramus of C1, the suboccipital nerve
what is the origin of the obliquus capitis inferior
C2 spinous process and lamina
an increase in the density of muslce spindles is most apparent in which suboccipital muscle
obliquus capitis inferior
what is the proposed function of the suboccipital muscle group
postural stabilizers of the atlanto-occipital and atlanto-axial joints
which suboccipital muscles are known to attach to dura mater
rectus capitis posterior major/minor
obliquus capitis inferior
interspinalis is paired in which regions of the spine
cervical and lumbar regions
based on the density of muscle spindles what is the proposed function of the interspinalis
acts as a proprioceptive transducer in conjunction with intertransversarii to coordinate the smooth movement of the spine and to maintian appropriate posture
which of the cervical intertransversarii is innervated by dorsal rami of cervical spine nerves
posterior medial belly, cervical intertransversarii
what is the origin of the medial belly of the lumbar intertransversarii
accessory process of transverse process L1-L4
mammillary process of superior articular process L1-L4
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 conjuction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture
what is the origin of the longus colli
vertebral bodies of C5-C6, T1-T3
anterior tubercles of transverse processes C3-C5
what will innervate the rectus capitis anterior
ventral rami C1-C2 spinal nerves
what will innervate the rectus capitis lateralis
ventral rami of C1-C2 spinal nerves
what is the insertion of the anterior scalene
ridge and anterior scalene tubercle of first rib
what is the insertion of the middle scalene
between the tubercle and groove for the subclavian artery on the first rib
what is the insertion of the posterior scalene
outer surface of second rib
what will innervate the posterior scalene
the ventral rami of C6-C8 spinal nerves
the quadratus lumborum is implicated in the formation of which ligament
the iliolumbar ligament
what is the origin of the psoas major
vertebral bodies T12, L1-L5, S1 and trasnverse processes of L1-L5
what is the origin of psoas minor
vertebral bodies of T12, L1
what will innervate the psoas minor
the ventral ramus of L1 spinal nerve
what is the maximum number of common ligaments identified with a vertebral couple
eight
what is the reason that nine common ligaments are identified but only eight will be attached at any specific vertebral couple
the ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple
what is the number of true intervertebral discs identified in the adult
23
in the adult, which vertebral levels will demonstrate a true intervertebral disc
those between C2 and S1 inclusive
what is the percent of intervertebral disc heigh contribution to the length of each region of the vertebral column
cervical 22-25%
thoracic 20%
lumbar 33%
what are the names of the central, peripheral, and horizontal zones of the intervertebral disc
nucleus pulposus-central
annulus fibrosus-peripheral
cartilaginous end plate-horizontal
what is the water concentration in the lumbar nucleus pulposus at birth and after thirty
birth 88%
thirty 70%
what is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus
nucleus pulposus will lose water under deformation conditions
what cell is associated with he nucleus pulposus until about age eleven
notochord cells
which type of collagen is dominant in the nucelus pulposus
collagen type II
what is the organizational pattern for collagen fibers in the nucleus pulposus
they are irregularly oriented and randomly scattered
what is the appearance of the cervical annulus fibrosus
a horse-shoe with the anterior margin thick and lateral margins tapering to the uncinate processes; the posterior margin is thing
what compensates for the thinness of the posterior part of the cervical annulus fibrosus
posterior longitudinal ligament
what is the organization of the lumbar annulus fibrosus
is has 12-14 concentric cylindrical lamellae
what is the water concentration in the lumbar annulus fibrosus at birth and after thirty
birth - 78%
thirty - 70%
what is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus
they typically have a binding site for hyaluronic acid and are thus aggregated
which type of collagen is dominant in the annulus fibrosus
collagen type I
what is the organizational patter for collagen fibers in the annulus fibrosus
they are parallel with one another in a single lamellus and angled
what is the organization of collagen fibers between lamellae
collagen fibers will be angled in the opposite direction such that a spiral - counterspiral organization is observed
what is the attachment site for collagen fibers within the annulus fibrosus
collagen fibers of the outer lamellae will become sharpey’s fibers and penetrate the epiphyseal rims; collagen fibers of the inner lamellae will attach to the cartilaginous end plate
what is the origin for the cells of the annulus fibrosus
sclerotomites
what is the principal type of collagen fiber within the cartilage end plate
type II collagen fibers
what is the direction of collagen fibers within the cartilage end plate
collagen fibers are aligned anterior to posterior
what is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus
cartilaginous end plate
what are the types of receptor endings in the intervertebral disc
nociceptors and proprioceptors
what is the relationship between size of the intervertebral disc and receptor endings
the larger the disc, the greater the variety of receptor endings
what part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve
the outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc
what forms the anterior neural plexus of the vertebral column
fibers from the ventral primary ramus
what forms the lateral neural plexus of the vertebral column
fibers from the ventral primary ramus, fivers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray rumus communicans
what is the name given to teh white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc
the paradiscal ramus communicans
what part of the intervertebral disc is innervated by fibers from the paradiscal ramus communicans
the outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc
how does the intervertebral disc attach to the vertebral body
sharpeys fibers from the outer lamellae of the annulus fibrosus are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies
based on the histology, what is the classification of the intervertebral disc
a cartilaginous (amphiarthorsis) symphysis
what are the divisions of the embryonic somite
the sclerotome, myotome, and dermatome
what structure is formed following migration of sclerotomes to surround the notochord
the perichordal blastema
what does the intrasclerotomal fissure or fissure of von ebner become
periochodral disc
what will the dense sclerotomite become
the upper part of the vertebral segment forming below
what structure forms following migration and subsequent mixing of the sclerotomites
the vertebral blastema
what part of the intervertebral disc will the notochord form
the nucleus pulposus
what part of the intervertebral disc will the perichordal disc form
the annulus fibrosus
what is the earliest indicator of the position of the adult intervertbral disc
the intrasclerotomal fissure or fissure of von ebner
what vertebral levels will the anterior longitudinal ligament attach to
those between occiput and S3 inclusive are traditionally indicated
what is the lowest extent of the anterior longitudinal ligament based on recent studies
L3
what is believed to form the anterior longitudinal ligament in the lumbar spine
the tendon of the crura of the diaphragm
what innervates the anterior longitudinal ligament
the anterior neural plexus formed by fibers from the ventral primary ramus and sympathetic postganglionic fibers from teh paravertebral ganglia
what is the function of the anterior longitudinal ligament
it brakes or limits dorsi-flexion or hyperextension of the vertebral column
what was ossification of the anterior longitudinal ligament in the lumbar region identified as
forestier’s disease
what is ossification of the anterior longitudinal ligament in the lumbar region now identified as
diffuse idiopathic skeletal hyperostosis or DISH
newer research suggest what regional variation in the posterior longitudinal ligament
prominent in the cervicals, occasional in the thoracics, rare in the lumbars
what is the relationship of the posterior longitudinal ligament to the vertebral foramen
it forms the anterior boundary of the spinal canal
what is the innermost layer of the posterior longitudinal ligament called
perivertebral ligament
what is the function of the posterior longitudinal ligament
it brakes of limits flexion of the vertebral column
where is ossification of the posterior longitudinal ligament most commonly identified
the cervical spine with an 80% incidence
what is the clinical sign of posterior longitudinal ligament ossification in the cervical spine
a loss of hand and finger dexterity
what is the clinical sign of posterior longitudinal ligament ossification of the posterior longitudinal ligament
faltering gait
what is teh gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament
greater in males
over 50
japanese
what is the name given to the ligamentum flavum based on appearance and histology
yellow elastic ligament
what fibers are most ligaments made of
collagen type 1 fibers which are whitish in appearanche
where is ossification of the ligamentum flavum most commonly identified
the thoracic spine of thoracolumbar transition zone
what is the relationship between the capsular ligament and mobility
the more lax the capsular ligament is, the greater teh motion of the joint
what regions of the vertebral column demonstrate the greatest laxity of capsular ligaments
the cervical and lumbar regions
what layers are present in the capsular ligament
a superficial layer of collagen fibers and a deep layer of elastic fibers
if the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its function
it is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement
what is now thought to be a major function of the interspinous ligament
it is more likely a proprioceptive transducer for the spinal reflex
what is the name given to the superficial layer of the ligamentum nuchae
funicular layer or part
what is the name given to the deep layer of the ligamentum nuchae
the lamellar layer or part
what are the attachment sites for the superficial layer of the ligamentum nuchae
the external occipital protuberance, external occipital crest, and spinous tubercle of C7
what is the histological make-up of the human ligamentum nuchae
it is a yellow elastic ligament, but has more collagen fibers than in quadrupeds
what is the classic function of the human ligamentum nuchae
it brakes or limits flexion of the cervical spine
what is the termination level inferiorly for the supraspinous ligament according to current literature
primarly at L4 (73%)
between L4-L5 (5%)
what is now thought to be a major function of the supraspinous ligament
it is a proprioceptive transducer for the spinal reflex
what amount of flexion-extension is accommodated by the atlanto-occipital joint
about 25 degrees
what amount of axial rotation is accommodated by the atlanto-occipital joint
about 3-8 degrees one side axial rotation
what amount of lateral bending is accommodated by the atlanto-occipital joint
about 5 degrees
which motion is best accommodated by the atlanto-occipital joint
flexion-extension
what is the function of the transverse atlantal ligament
it is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1
what movements are facilitated at the median atlano-axial joint
flexion-extension, rotation, and telescoping (superior/inferior gliding)
what is ADI
atlanto-dental interspace, a radiographif distance between the surfaces of the anterior bursa of the median atlanto-axial joint
what is the ADI of children compared to adults
children - 4.5 mm
adults - 2-3 mm or about 2.5 mm
what are the degrees of movement facilitated at the atlanto-axial joint
about 20 degrees flexion-extension, 40 degrees one side axial rotation, and 5 degrees of lateral bending
the occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation
about 60%
what is the embryonic derivative of the apical ligament of the dents or the apicodental ligament
the notochord
what is the function of the alar ligament
together they function to resist axial rotation
what forms the cranial continuation of the posterior longitudinal ligament
the membrana tectoria or tectorial membrane
list in order the ligaments in a midsagittal plane from the dura mater tat the level of the medulla oblongata to the anterior bursa of the median atlanto-axial joint
memrbana tectoria
cruciate ligament
capsular ligament of posterior bursa of median atlanto-axial joint
apical ligament of the dens or apicodental ligament
for the cervical spine below C2, what is the range of flexion-extension
~90 degrees or about 18 degrees per couple
for the cervical spine below C2, what is the range of one side lateral bending
~50 degrees or about 10 degrees per couple
for the cervical spine below C2, what is the range of one side axial rotatioin
~33 degrees or about 6 degrees per couple
what are the locations for costovertebral joints on the vertebra
costocentral joint at the vertebral body
costotransverse joint at the transverse process
at what rib will the superior costotransverse ligament be absent
first rib
what ligaments will attach to the neck of the 12th rib
the superior costotransverse ligament from T11 and the lumbocostal ligament from L1
what are the attachment sites for the inferior costotransverse ligament
neck of the rib and transverse process of the vertebra at that level
at what rib will the inferior costotransverse ligament be absent
12th rib
what is the name of the space between the transverse process and the neck of the rib
costotransverse foramen
which ligament “fills” the costotransverse foramen
inferior costotransverse ligament
what are the attachment sites for the lateral costotransverse ligament
non-articular surface of tubercle of rib
transverse tubercle of transverse process of vertebra at that level
which vertebra will lack an attachment for the lateral costotransverse ligament
T12
which vertebral couples of the thoracic spine have the greatest motion
T11/T12 and T12/L1
which range of motion is greatest for lower thoracic vertebral couples
flexion-extension
which range of motion is least for lower thoracic vertebral couples
one side axial rotation
which ligaments replace the intertransverse ligament at the lumbosacral joint
iliolumbar ligament and lumbosacral ligament
what muscle is intimately attached to the superior iliolumbar ligament
quadratus lumborum
which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions
superior iliolumbar ligament
which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions
inferior iliolumbar ligament
which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions
inferior iliolumbar ligament
what are the attachment sites for the accessory iliolumbar ligament
transverse process of L4 and the iliac crest
which vertebral couple of the lumbar spine has the greatest range of motion
L5/S1
which range of motion is greatest for all lumbar vertebral couples
flexion-extension
which range of motion is least for L1-L5 vertebral couples
one side axial rotation
whihc range of motion is least for the L5/S1 vertebral couple
one side lateral bending
list in order from cranial to caudal the ligaments forming the anterior boundary of the spinal canal
membrana tectoria
posterior longitudinal ligament
deep posterior sacrococcygeal ligament
list in order from cranial to caudal the ligaments forming the posterior boundary of the spinal canal
posterior atlanto-occipital ligament
posterior atlanto-axial ligament
ligamentum flavum
superficial posterior sacrococcygeal ligament
what is the auricular surface of the ilium composed of
articular cartilage, interspersed with fibrocartilage
what does ankylosis mean
a condition of fibrous adhesion occurs within the joint
what is the age and surface bias associated with degenerative arthrosis of the sacroiliac joint
age 40
iliac auricular surface
what is the age and gender bias associated with ankylosis of the sacroiliac joint
age 50
male bias
particularly in african american males
what is the relationship between the capsular and interosseous sacroiliac ligaments
interosseous sacroiliac ligament replaces the capsular ligament posteriorly
what passes between the layers of the interosseous sacroiliac ligament
dorsal rami from the sacral spinal nerves
what separates the manubrium sterni and corpus sterni
manubriosternal symphysis
what vertebral levels correspond to the position of the corpus sterni
T5-T9
how many sternabrae for the corpus sterni
4 sternabrae
what surface feature on the corpus sterni identifies the location of the synchondroses
transverse lines
what articular sites for the costal cartilage of ribs will be identified on the corpus sterni
costal notches II-VII
what feature of the corpus sterni is present 4-7% of the population
sternal foramen
what causes the appearance of the sternal foramen
failure of the ossification centers of the sternum to fuse together normally
what attaches to the scalene tubercle of the first rib
anterior scalene msucle
which groove on the body of the first rib is close to the vertebral end
groove for the subclavian artery and first thoracic nerve
which groove on the body of teh first rib is close to the sternal end
groove for subclavian vein
what specifically will attach to the crest of the neck of the second rib
superior costotransverse ligament from the transverse process of T1
what specifically attaches to teh back of the neck of teh second rib
inferior costotransverse ligament from teh transverse process of T2
what unique feature is present on teh body of the second rib
tuberosity for the serratus anterior
which ribs are classified as typical ribs, true ribs, costa verae, and vertebrosternal ribs in the typical adult skeleton
ribs 3-7
which ribs are classified as atypical ribs, true ribs, costa verae, and vertebrosternal ribs in the typical adult skeleton
ribs 1-2
which ribs are classified as typical ribs, false ribs, costa spuriae, and vertebrochodral ribs in the typical adult skeleton
ribs 8 & 9
which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebrochondral ribs in the typical adult skeleton
rib 10
which ribs are classified as a typical ribs, false ribs, costa spuriae, and vertebral ribs in the typical adult skeleton
ribs 11 and 12
what is the classification of the first sternocostal or sternochondral joint
cartilaginous (amphiarthorsis) synchodrosis
what is the classification of the 2nd-7th sternocostal or sternochondral joint
synovial plane (diarthorsis arthordia)
which of teh sternocostal or sternochondral ligaments is unique to the second sternocostal or sternochondral joints
intra-articular ligament
what is the classification of the 6th-9th interchondral joints
synovial plane (diarthorsis arthrodia)
what is the classification of the 5th-6th or 9th-10th interchondral joint
fibrous (amphiarthrosis) syndesmosis
which costal cartilages fail to form a joint at their sternal end
11th and 12th costal cartilages
how many primary centers of ossification appear in the manubrium
1-3 centers have been identified
how many primary centers of ossification appear in the corpus sterni
typically 6
in what part of the sternum will a secondary center of ossification appear
xiphoid process
in what part of the rib will primary centers of ossification appear
the body
in what parts of the rib will secondary centers of ossification appear
the head
articular surface of the tubercle
non articular surface of the tubercle
which ribs will demonstrate secondary centers of ossification
ribs 1-10
which ribs lack secondary centers of ossification
ribs 11-12
which ribs demonstrate three secondary centers of ossification
ribs 2-9
which ribs have only two secondary centers of ossification
ribs 1 and 10
what are the four subclassifications of synarthrosis joints based on latin grouping
suture
comphosis
schindylesis
syndesmosis
what were the five types of suture based on latin grouping
serrate denticulate limbous squamous harmonia
what are the characteristics of sutura vera (true sutures)
sutures demonstrating interlocking of adjacent bone surfaces; typically formed by intermembranous ossification
what are the characteristics of sutura notha (false sutures)
sutures lacking interlockign of adjacent bone surfaces; typically formed by endochondral ossification
which sutures demonstrate non-interlock, but will overlap at their edges
squamous sutures
what were the classifications of suture notha based on latin groupings
squamous and harmonia
what are the typical examples of the plane suture or harmonia suture
cruciate suture made up of the:
intermaxially, interpalatine and palato-maxillary suture
what are the examples of the schindylesis type of suture
sphenioid, ethmoid, vomer articulation
palatine, maxilla, vomer articulation
what are the examples of teh gomphosis joint
maxilla - root of tooth
mandible - root of tooth
what are the five views of skull called
norma verticalis norma frontalis norma occipitalis norma lateralis norma basalis
what is the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with boht paretal bones
anterior fontanelle
what is the diamond shaped remnant of developing membrane bone at the intersection of the occipital bone with both parietal bones
posterior fontanelle
what is the glabella
elevation of bone over frontal sinus between orbits
what is the name given to the outline of the nasal cavity at the front of the skull
piriform aperture
what is the name given to the alveolar jugum at the canine tooth in the maxialla
canine eminence
what forms a bullet-like chin
large mental protuberance
what forms an indented chin
well developed bilateral mental tubercles and a slight mental protuberance
what bones form the pterion
patietal
sphenoid
temporal
frontal
what points on the skull are used to measure the skull size
nasion
vertex
inion
gnathion
what points on the skull are used to measure cranial vault capacity
nasion
vertex
inion
the olfactory nerve exits the cranial vault via what opening
cribriform plate of ethmoid bone
what are the contents of the optic canal
optic nerve and ophthalmic artery
what are the contents of the superior orbital fissure
ophthalmic veins oculomotor nerve trochlear nerve ophthalmic division of the trigeminal nerve abducent nerve
what are the contents of the foramen rotundum
maxillary division of the trigeminal nerve (cranial nerve Vb)
what are the contents of the foramen ovale
mandibular division of the trigeminal nerve (Vc)
lesser petrosal branch of glossopharyngeal nerve
what are the contents of the foramen spinosum
nervus spinosus from the mandibular division of the trigeminal nerve and middle meningeal artery
what forms the roof of the posterior cranial fossa
tentorium cerebelli
what part of the central nerve system occupies the posterior cranial fossa
cerrebellum
pons
medulla oblongata
what part of the cerebrum occupies the posterior cranial fossa
none; tentorium cerebelli separates the cerebrum into a space above the posterior cranial fossa
what are the contents of the internal acoustic meatus
cranial nerves VII and VIII
nervus intermedius/nerve of wrisberg/sensory root of VII
motor root of VII
vestibular and cochlear roots of VIII
internal auditory/internal labyrinthine artery and vein
what are the contents of the jugular foramen
jugular bulb
inferiro petrosal sinus
tympanic body/tympanic glomus or jugular body/jugular glomus
cranial nerves IX, X, XI
what can the five layers of scalp spell
Skin Connective tissue Aponeurosis Loose connective tissue Periosteum
what are the principal sources of blood to the scalp
internal carotid and external carotid artery branches
which divisions of the trigeminal nerve receive sensory info from scalp
all 3 divisions:
ophthalmic nerve
maxillary nerve
mandibular nerve
which ventral rami branhces supply the scalp
greater auricular and lesser occipital nerves
which dorsal ramus nerve branch supplies scalp
greater occipital nerve - C2, C3 communicating ramus
which muscles lack any attachment to bone
orbicularis oris
procerus
risorius
what type of motor fivers to skeletal muscle are given off by the facial nerve
branchial efferent (BE)
most of the seventh cranial nerve will exit the skull via what opening
stylomastoid foramen
the optic canal is located along which wall of the orbit
superior wall of orbit
what are the contents of the optic canal
optic nerve & ophthalmic arter
what are the openings located along the medial wall of the orbit
anterior ethmoid & posterior ethmoid formina
what is the name given to the medial wall of the orbit
lamina papyracea
the superior orbital fissure is located along which wall of the orbit
lateral wall of the orbit
what are the contents of the superior orbital fissure
oculomotor nerve trochlear nerve abducent nerve ophthalmic division of trigeminal nerve ophthalmic veins
what openings are located along inferior wall of orbit
inferior orbital fissure
what is contained in inferior orbital fissure
maxillary division of trigeminal nerve
what are the names given to teh modified sebaceous gland in tarsus of eyelid
tarsal or meibomian gland
what specific pathways are identified with visceral efferent (VE) innervation
sympathetic and parasympathetic motor pathways
how many neurons are involved in the visceral efferent pathways from CNS to target cell
2 motor neurons
what is the location for the second neuron in the visceral efferent (VE) pathway
typically a ganglion
which cranial nerves are involved in visceral efferent parasympathetic pathway to the lacrimal gland
facial and trigeminal (maxillary and ophthalmic divisions/branches)
what is the origin for the sympathetic pathway to the lacrimal gland
lateral horn/intermediolateral cell column T1, T2
what is the target of preganglionic sympathetic visceral efferent fiber in the pathway to the lacrimal gland
VE fiber ascends to the superior cervical ganglion to synapse
sympathetic stimulation of the lacrimal gland will result in what events
vasoconstriction of blood vessels
limited availability of water to secretory units
more viscous or thicker product formed in glandular lumen
parasympathetic stimulation of targets in the lacrimal gland will result in what events
vasodilation of blood vessels
increased availability of water to secretory units
thinner or more watery product in lumen
constriction of myoepithelial cells leading to release of product from secretory lumen into duct system
what are the names of the layers of the eyeball
fibrous tunic
uveal tract
retina
what are the parts of the fibrous tunic
cornea
sclera
what are the parts of the uveal tract of the eyeball
iris
ciliary body
choroid
pupil
what muscles are present in iris
sphincter pupillae
dilator pupillae
what is the innervation of the sphincter pupillae
oculomotor nerve
parasympathetic pathway
what is the innervation of ciliaris muscle
oculomotor nerve
parasympathetic pathway
what is the function of the rod cell
provide vision in dim light conditions
what is the function of the cone cell
provide vision in bright light conditions and mediate color vision
what ist he most numerous photoreceptor cell
rod cell
what forms the optic nerve
axons of ganglion cells
what occurs at the optic chiasma
part of the optic nerve decussates
what is the location of the anterior chamber of the eyball
between cornea and iris
what is the location of posterior chamber of eyeball
between iris and lens
what is contained in anterior chamber
aqueous humor
what is contained in the posterior chamber of eyeball
aqueous humor
what is the name given to the chamber behind the lens
vitreous chamber
what fills the vitreous chamber
vitreous body
what are the common characteristics in origin and insertion of all rectus extraocular muscles
all originate from a common annular tendon in orbit
all insert into sclera in front of coronal equator of eyeball
what is the common characteristic regarding insertion of both oblique extraocular muscles
both insert onto sclera on lateral margin of eyeball behind coronal equator
what is the common characteristic concerning the insertion of the superior and inferior rectus extra ocular muscles
insert onto sclera of eyeball in front of coronal equator
displaced slightly mediall
what is the embryonic origin of extraocular muscles of extrinsic muscles of eyeball
skeletal muscle is derived from somites hence somatic efferent
which nerves will innervate specific extrinsic/extraocular muscles
oculomotor- sup rec, med rec, inf rec, inf obl
trochlear- sup obl
abducens- lat rec
which of the cranial nuclei of termination contain primary afferent neurons
mesencephalic nucleus of trigeminal nerve
what is the location of synapse for preganglionic parasympathetic efferent fibers of the third cranial nerve (oculomotor)
ciliary ganglion
what is unique about the vascular supply of the retina
single vessel supplies it
what vessel supplies the inner tunic of the eyeball
central artery of the retina
what is the name given to the ‘goats beard’ of the auricle
tragus
what is the name of the palpable posterior projection of the eminentia concha of the auricle
ponticulus
what cranial nerve will innervate the muscles of the auricl
facial nerve
sensory innervation of the auricle is derived from which nerves
greater auricular (ventral rami C2, C3)
lesser occipital nerve (ventral rami C2, possibly C3)
auriculotemporal nerve (mandibular division, trigeminal)
posterior auricular cutaneous nerve (facial)
auricular nerve (vagus)
the lateral third of the external acoustic meatis is protected by __________________.
cartilage
the medial part of the external acoustic meatus is protected by ______________________.
the temporal bone
skin lining the external acoustic meatus contains what modified sebaceous glands
ceruminous glands
what is cerumen
product of ceruminous glands forming the bulk of ear wax
what is the superior boundary of the parotid region
zygomatic arch
temporomandibular joint
what vein is formed within the parotid gland
retromandibular gland
within the parotid gland what does the facial nerve form
facial nerve plexus
what are the branches of the facial nerve plexus
temporal zygomatic buccal marginal mandibular cervical branches
what branch of the facial nerve penetrates the parotid gland, but is not given off within it
the chorda tympani nerve
