Exam III Flashcards
What characteristics are associated with sacral spondylolysis?
rare in the general public, within typical percents in the native Alaskan (inuit) population, seems to be acquired, gender biased toward men, most common at S1 and linked to activities such as kayaking and harpooning
What are the types/classifications of spondylolisthesis?
Type 1 spondylolistheses (dysplastic spondylolisthesis, congenital spondylolisthesis)
Type II spondylolisthesis (Isthmic spondylolisthesis)
Type III spondylolisthesis (degenerative spondylolisthesis)
Type IV spondylolisthesis (traumatic spondylolisthesis)
Type V spondylolisthesis (pathologic spondylolisthesis)
What gender bias, locational bias, and spinal canal dimensions are associated with type II spondylolisthesis?
isthmic spondylolisthesis is common in men, located at the L5/S1 level and demonstrates an increase in sagittal diameter of the spinal canal
What is the gender bias, locational bias, and spinal canal dimensions changes often associated with type III spondylolisthesis?
degenerative spondylolisthesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal cord
What causes type IV spondylolisthesis?
fracture of the neural arch components
Is there a gender, locational, or age bias associated with type IV spondylolisthesis?
NOPE
What are the cause(s) associated with type V spondylolisthesis?
bone diseases such as Paget disease and osteogenisis imperfecta
What muscles may attach to the median sacral crest?
latissimus dorsi, iliocostalis lumborum, longissimus thoracis
What features may be identified along the intermediate sacral crest?
the mammillary process of S1 and the 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, S5
What muscles may attach to the transverse processes of sacrum?
multifidis, iliocostalis lumborum
What feature does the anterior surface of the superior epiphyseal rim of S1 form?
Sacral promontory
The continuation of the anterior longitudinal ligament below S3 forms what ligament?
the anterior scarococcygeal ligament
The continuation of the posterior longitudinal ligament below S3 forms what ligament?
the deep posterior sacrococcygeal ligament
What ligament is attached to the sacral hiatus?
The superficial posterior sacrococcygeal ligament
What joint classifications are typically present at sacrum?
fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis, and synovial (diarthrosis) arthrodia
What is the homolog for the posterior longitudinal ligament at S5?
The deep posterior sacrococcygeal ligament
What is the homolog for the anterior longitudinal ligament at S5?
The anterior sacrococcygeal ligament
What is the homolog for the ligamentum flavum?
superficial posterior sacrococcygeal ligament
What is the direction of the coccygeal curve?
posterior, kyphotic
What is the major motion and range of motion for coccyx?
flexion - extension, 5-20 degrees
How many coccygeal nerves are present in the adult?
typically only one pair of coccygeal nerves remain in the adult
What forms the coccygeal nerve plexus?
S4, S5 and Co1 nerves
What is the coccygeal glomus or coccygeal body?
an enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx
What joint classifications are present for coccyx?
cartilaginous (amphiarthrosis) symphysis and fibrous (amphiarthrosis) syndesmosis
What forms the inferior boundary for the spinal canal?
the union of the superficial posterior and deep posterior sacrococcygeal ligaments
What does the suffix “ization” refer to?
in the process of becoming like
What is/are the characteristics of occipitalization of C1?
the atlas may be partially or completely fused to the occiput
What is another way of implying occipitalization of C1?
Atlas assimilation
What is the incidence of occipitalization of C1?
0.1% - 0.8%
When do the centers of ossicifation for the odontoid process first appear?
during the last trimesters in utero
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?
amphiartrhosis synchondrosis
Ossification between the odontoid process and centrum joint of C2 first appears at what age?
4 years old
What is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 persist beyond age 7?
os odontoideum
What is an os odontoideum?
A persistence beyond age 7 of the joint formed between the centrum and odontoid process centers of ossification
What is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7?
persistent subdental synchondrosis
What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?
tip of the dens synchondrosis
At what age will the tip of the dens 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 beyond age 12, what is the condition called?
terminal ossicle
What is a basilar impression?
persistence 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 a basilar invagination?
the upper cervical spine appears to be invaginated into the skull on x-ray analysis
What is the incidence of rib-related changes following dorsalization of C7?
from one-half to two and one-half percent of the population (0.5-2.5%)
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 alteration in C7 facet orientation may accompany dorsalization?
the superior articular facet of C7 may change from BUM to that of a typical thoracic facet…BUL; the inferior articular facet remains unchanged.
What percent of the population may demonstrate thoracic-like features at C7?
up to 46%
What rib-related changes may accompany cervicalization of T1?
the first rib may decrease in mean relative length or become absent
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 is characteristic of lumbarization of S1?
the failure of synostosis between S1 and S2, squaring of the vertebral body of S1, and flaring of the sacral ala
Which segment demonstrates the greatest morphological variation along the spine?
L5
What is the incidence of variation within the sacrococcygeal region in the population?
up to 14%
What is the characteristic of sacralization of Co1?
The premature fusion of Co1 to the sacrum
What is the traditional time of appearance of the cervical curve said to be?
during the last trimester in utero
What is the time during which the “adult” cervical curve is said to appear?
within the first year after birth
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 is the time of appearance of the lumbar curve?
between 12 and 18 months after birth
What infant activities are associated with the development of the lumbar curves?
crawling and walking
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 time of appearance of the lateral curves?
they appear after 6 years old
What is the relationship between the curve direction and handedness?
a right handed person has a high probability for a right thoracic, left lumbar curve combination
What is the definition of lordosis?
a forward bending condition
What is the definition of kyphosis?
a humpback or hunchback condition
What is the definition of scoliosis?
a warped or crooked condition
What clinical examples of abnormal curvatures along the vertebral column were stressed in class?
military neck, humpback or hunchback, and swayback
What is military neck?
a decreased anterior curve in the cervical region, a straight neck
What are the curve classifications for military neck?
a kyphosis or hypolordotic curve
What are the curve classifications for humpback or hunchback?
a kyphosis or hyperkyphotic curve
What are the curve classifications for swayback?
a lordosis or hyperlordotic curve
What are the classifications of scoliosis according to the scoliosis research society?
magnitude, location, direction, etiology and structural/non-structural
What is the incidence of idiopathic scoliosis in the population?
1%-4% of the population
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, 12&-21% incidence
The trapezius is innervated by what nerve?
the spinal accessory nerve
The latissimus dorsi is innervated by what nerve?
ventral rami from C6-C8
Splenius cervicis will attach to what locations on the spine?
lateral mass of C1 and posterior tubercle of transverse process on C1-C4
What is the insertion for the iliocostalis lumborum pars lumborum?
iliac crest of the innominate bone
Which subdivisions of the iliocostalis muscle appears to have a reversal of origin-insertion?
iliocostalis lumborum pars lumborum
What osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis?
NONE
Which subdivisions of the iliocostalis primarily originates and inserts on ribs?
Iliocostalis thoracis
What osseous parts of the vertebral column serve as an origin to the iliocostalis cervicis?
NONE
Which erector spinae muscle is attached to the accessory process?
longissimus thoracis
What is the insertion for the longissimus thoracis pars lumborum?
posterior superior iliac spine (PSIS) of the innominate bone
Which subdivision of the longissimus muscle appears to have a reversed origin - insertion?
longissimus thoracis pars lumborum
Which erector spinae muscles attach to cervical articular processes?
longissimus cervicis and longissimus capitis
How many vertebrae can be attached to a single segment by transversospinalis muscles?
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 capitis?
transverse tubercles of C7, T1-T6 or T7 and articular processes of C4-C6
The semispinalis capitis and spinalis capitis may fuse to form what muscle?
biventer cervicis
Which transversospinalis muscle attaches to articular and mammillary processes along the spine?
multifidis
What osseous parts of the vertebral column serve as an origin to the multifidis cervicis?
articular process of C4-C7
Which subdivision of multifidis may demonstrate a reversal of origin-insertion?
Multifidis lumborum
What is the proposed function of the suboccipital muscle group?
postural stabilizers of the atlanto-occipital and atlanto-axial joints
Based on the density of muscle spindles what is the proposed function of interspinalis?
acts as a proprioceptive transducer in conjunction with intertranscersarii to coordinate the smooth movement of the spine and to maintain appropriate posture
Which of the cervical intertransversarii is innervated by dorsal rami of cervical spinal 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 of the lumbar intertransversarii is innervated by dorsal rami of lumbar spinal nerves?
medial belly, lumbar intertransversarii
Based on the density of muscle spindles what is the proposed function of the intertransversarii?
acts as a proprioceptive transducer in conjunction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture
What is the origin of the rectus capitis anterior?
lateral mass and costal element of transverse process of C1
What are the possible locations of bipolar neurons?
the nasal olfactory epithelium, the retina, the vestibular or Scarpa’s ganglion, and the cochlear or spiral ganglion
What are the possible locations of pseudounipolar neurons?
any sensory ganglion other than those of the eight cranial nerve
What are the examples of multipolar neurons?
stellate neurons, the motor neurons of the brain and spinal cord
pyramidal neurons of the cerebral cortex
projection neurons or Golgi type 1 purkinje cells of the cerebellar cortex
Local circuit neurons or Golgi type II granule cells of the cerebral and cerebellar cortex and neurons of the motor ganglia
Where is the primary sensory neuron of a typical sensory pathway located?
in a sensory ganglion
Which projection from the primary sensory neuron conveys an impulse from a receptor ending to the perikaryon?
the peripheral sensory process
Which projection from the primary sensory neuron conveys an impulse from the perikaryon to the secondary sensory neuron?
the central sensory process
What is the morphology of most motor or efferent neurons associated with the peripheral nerve system?
multipolar
What is the generic location for primary motor neurons in the brain?
nucleus of origin
What is the generic location for primary motor neurons in the spinal cord?
ventral horn or lateral horn
What do chemoreceptors monitor?
hypoxia or decreased oxygen levels, hypercapnia or increased carbon dioxide levels and elevated hydrogen ions, an indication of circulating blood pH
What is the site or location for chemoreceptors?
a glomus or body
What are the types and examples of exteroceptors?
(a) general or cutaneous sense organs such as free nerve endings, encapsulated endings and epidermal endings
(b) special sense receptors for olfaction, vision, hearing, and taste
What are the examples of proprioceptors?
Golgi tendon organs, neuromuscular spindles, Pacinian corpuscles, inner ear receptors for equilibrium and specialized receptors in joints
What are the examples of epidermal nerve endings?
Palisade nerve endings, Merkel cell endings and Ruffini corpuscles or Ruffini nerve endings
What is the example of tactile corpuscles?
Meissner’s corpuscles
Which type of encapsulated nerve ending is sensitive to vibration?
lamellated corpuscles or Pacinian corpuscles
What is the example of the neurotendinous nerve ending?
Golgi tendon organs
