Exam Two Study Questions Flashcards
What should be carefully considered when applying research results to a population?
The condition of the subject material (fresh cadaver, fixed cadaver, living subject)
The age of the population studied
The method of measurment (X-ray, goniometer, MRI, CT, etc)
What will influence spinal kinematics?
Geometry of articular facets, mechanical properties of connective tissue, mechanical properties of muscle
The greatest range of flexion-extension among the typical cervical vertebrae occurs at which vertebral couple?
Typically C5/C6
What motions are coupled in the cervical spine?
Lateral bending and axial rotation
Ranges of coupled motion among the typical cervical vertebrae will be similar for what cervical vertebral couples?
The C2/C3, C3/C4, C4/C5 vertebral couples
Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?
The C5/C6 vertebral couple
What is the usual condition for the Caucasian typical cervical spinous process?
They are bifid
What is the usual condition for the African-American typical cervical spinous process?
They are non-bifid
What is the osseous modification at the distal end of the spinous process?
The spinous tubercle
What muscles may attach the typical cervical spinous process?
The spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis
What ligaments will attach to the typical cervical spinous process?
The interspinous ligament and ligamentum nuchae
What will form the unique anterior boundary of a typical cervical intervertebral foramen?
The uncinate process of the segment below and lateral groove of the segment above forms the joint of Luschka
What forms the unique anterior boundary of the intervertebral foramen for the C4 spinal nerve?
The lateral groove of C3 and the uncinate process of C4 forming the joint of Luschka
What muscle attaches to the anterior arch of C1?
Longus colli
What ligaments will attach to the anterior arch of C1?
The anterior longitudinal, anterior atlanto-occibital and anterior atlanto-axial ligaments
What is observed on the back of the anterior arch of C1?
The fovea dentis
WHat joint classificationis are observed on the anterior arch of C1?
Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint
What is the morphology of the superior articular facet of C1?
They are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces
What is the orientation of the superior articular facet of C1?
Backward, upward, medial (BUM)
What is the joint classification of the atlanto-occipital zygapophysis?
Synovial (diarthrosis) ellipsoidal joint
What are the morphological characteristics of the inferior articular facet of C1?
Asymmetrical, slightly concave or flattened
What is the orientation of the inferior articlar facet of C1?
Backward, medial, downward (BMD)
What is the joint classification of the atlanto-axial zygapophysis?
Synovial (diarthrosis) arthrodia joint
What muscles attach to the lateral mass of C1?
Levator scapula, splenius cervicis and rectus capitis anterior
What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?
Males: about fifty milimeters; Females: about thirty-seven millimeters
What attaches to the posterior tubercle of the posterior arch of C1?
Rects capitis posterior minor muscle and ligamentum nuchae
What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?
About age 7 years old
What other name may be used to identify a ponticulus posticus?
Kimmerle’s anomaly
What names are given to the opening formed y the ponticulus posticus?
Arcuate foramen or retroarticular canal
What is the gender bias now associated with ponticulus posticus?
Female
What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?
The incidence of a complete ponticulus posticus is about fifteen percent; the incidence of an incomplete ponticulus posticus is as high as forty-one percent.
What muscles attach to the transverse process of C1?
Rectus capitis anterior, rectus capitis lateralis, middle scalene, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles.
What suboccipital muscles are known to have fascial projections attaching to the spinal dura?
Rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior
What are the connections between suboccipital muscles and the spinal dura called?
Myodural bridges
What opening is identified when a complete lateral bridge is formed?
The retrotransverse foramen
What are the possible contents of the retrotransverse foramen?
The vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck
What is the gender variation for measurements of the transverse diameter of C1?
Males: 78 millimeters and Females: 72 millimeters
What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?
A little over 30 millimeters for both males and females
What joint classifications are observed at C1?
Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial (diarthrosis) trochoid joint and synovial (diarthrosis) arthroida joint.
How many synovial surfaces are observed at C1?
Five
What names are given to C2?
Axis or Epistropheus
What unique vertebral body modificatiion is characteristic of C2?
The Dens or Odontoid process
What joint surfaces are present on the odontoid process of C2?
Facet for fovea dentis, groove for transverse atlantal ligament, attachment site for the alar ligaments, attachment site for the apical-dental ligament
How many joint surfaces are present at the odontoid process of C2?
Five
Which joint classifications are represented at the odontoid process of C2?
Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint
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?
Lordotic Dens
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 anterior?
Kyphotic dens
How many joints are formed by the inferior part of the vertebral body of C2?
Five
What joint classifications are present at the inferior part of the vertebral body of C2?
Fibrous (amphiarthrosis) syndesmosis joint, modified synovial (diarthrosis) sellar joint and cartilaginous (amphiarthrosis) symphysis joint.
How many joint surfaces are present at the vertebral body of C2?
Ten
What joint classifications are present at the vertebral body of C2?
Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) trochoid joint, modified synovial (diarthrosis) sellar and cartilaginous (amphiarthrosis) symphysis joint
What ligaments will attach posteriorly, to the inferior epiphyseal rim of C2?
Membrana tectoria and posterior longitudinal ligament
What ligament will represent the cranial continuation of the posterior longitudinal ligament?
Membrana tectoria
What ligament forms the anterior boundary for the spinal canal above C2?
Membrana tectoria
What ligament forms the anterior boundary for the spinal canal below C2?
Posterior longitudinal ligament
What lies on the upper surface of the pedicle of C2?
The superior articular process
What is the location of the superior vertebral notch of C2?
On the lamina-pedicle junction
What attaches to the lamina of C2?
Obliquus capitis inferior muscle, posterior atlanto-axial ligament, ligamentum flavum.
What is the appearance of the superior articular facets of C2?
They are asymmetrical and slightly convex
What is the facet orientation of the superior articular facet of C2?
Backward, Upward, and Lateral (BUL)
What is the orientation of the inferior articular facets of C2?
Forward, lateral and down (FoLD)
What is the classification of the zygapophyseal joints of C2?
Synovial (diarthrosis) arthrodia joint
What muscle attaches to the articular process of C2?
Lognissimus cervicis
What osseous parts of the typical cervical transverse process are absent at C2?
Anterior tubercle and costotransverse bar
What will be observed inthe transverse foramen at C2?
Vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is the gender variation for the transverse diameter of C2?
Males: fifty-seven millimeters and Females: about fifty millimeters
What muscles attach to the transverse process at C2?
Levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii
What is the characteristic appearance of the C2 spinous process in humans?
Bifid
What muscles attach to the spinous process of C2?
Rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators and interspinalis muscles
What names may be given to C7?
Vertebra prominens and vertebral prominence
What is the name given to the topographical elevation observed at the base of the neck?
Vertebral prominence
What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?
C6 is more common in females and T1 is more common in males
How many joint surfaces are present at the vertebral body of C7?
Eight
What joint classifications are observed at the vertebral body of C7?
Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and modified synovial (diarthrosis) sellar joint.
How many synovial joint surfaces are observed at the vertebral body of C7?
Two
What are the osseous parts of the tranverse process of C7?
Costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process
What features are typically present in the transverse foramen of C7?
Vertebral venous plexus, postganglionic sympathetic motor fibers
What muscles attach to the transverse process of C7?
Middle scalene, iliocostalis thoracics, longissimus cervicis, semispinalis capitis, rotators, intertransversarii and levator costarum brevis
What is the orientation of the superior articular facet of C7?
Backward, Upward, Medial (BUM)
What is the orientation of the inferior articular facet of C7?
Forward, medial, downward (ForMeD)
What muscles will attach to the articular process of C7?
Longissimus cervicis, longissimus capitis, semispinalis cervicis and multifidis
What are the features of the spinous process of C7?
Long, horizontal, nonbifid
What muscles attach to the spinous process of C7?
Trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalisis thoracis, multifidis, rotators, and interspinalis
WHat ligaments attach to the spinous process of C7?
Ligamentum nuchae and interspinous ligaments
The vertebral artery on which side is typically larger?
Left vertebral artery
WHat is the gender bias regarding size of the vertebral artery?
Men have larger vertebral arteries than women
What is the name of the physical exam used to determine vertebral artery patency?
The vertebrobasilar artery insufficiency test
Which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?
The ipsilateral artery on the side of rotation
What are the symptoms of failure o the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?
Dizziness, vertigo, nausea are common complaints
Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?
C6
At what location will the vertebral artery form its first compensatory loop?
The atlanto-axial interspace
At what location will the vertebral artery form its second compensatory loop?
The atlanto-occipital interspace
At what segments will the vertebral artery be firmly attached to the transverse foramen?
Both C1 and C2?
What is the purpose of the vertebral artery loops between C2, C1, and occiput?
The increased length will accommodate the greater rotation at these locations
What happens to the vertebral artery after it enters the subarachnoid space at C1?
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.
What artery is formed by the union of the right and left vertebral arteries?
The basilar artery
Which Suboccipital muscles attach to C1?
Rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior
Which suboccipital muscles attach to C2?
Rectus capitis posterior major, obiquus capitis inferior
What forms the boundaries for the exit of the C1 nerve from the spinal canal?
Occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament.
What forms the boundaries for the exit of the C2 nerve from the spinal canal?
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.
What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?
The vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinate process, lateral groove
What forms the anterior boundary for the C8 nerve exit from the spinal canal?
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.
What are the superior articular facet orientations for the cervical vertebrae?
C1 is backward, upward, medial (BUM),
C2 is backward, upward, lateral (BUL)
C3-C7 is backward, upward, medial (BUM)
What are the inferior articular facet orientations for the cervical vertebrae?
C1 is backward, downward, medial (BMD),
C2-C6 is forward, downward, lateral (FoLD)
C7 is forward, downward, lateral
**Check page 27 number 15 and 16 I think the C7 is wrong
How many synovial joints are identified for each cervical vertebra?
C1 = 5
C2 = 8
C3-C6 = 8
C7 = 6
How many joints are identified at the vertebral body of each cervical vertebra?
C1 = none
C2 = 10
C3-C6 = 10
C7 = 8
What features will allow discrimination between T2-T4 and T5-T8 segmental groups?
The vertebral body, transverse process, articular process and spinous process
What is the outline of the vertebral body of a typical thoracic from superior view?
Triangular
On cranial view, what is the outline of the vertebral body for the T2-T4 group?
The vertebral body will have bilaterally convex sides
On cranial view, what is the outline of the vertebral body for the T5-T8 group?
The left side of the vertebral body will be flattened, the right side convex
What is the aortic impression?
The flattening of the superior and inferior epiphyseal rims on the left side of the vertebral body of T5-8 which give the vertebral body a less scalloped or less indented appearance on that side.
What is the principal cause of the posterior curve of the thoracic spine?
The vertebral body height differences
How many synovial joints are formed at the vertebral body of a typical thoracic?
Four
How many symphysis joints are formed with the vertebral body of a typical thoracic?
Two
How many syndesmosis joints are formed at the vertebral body of a typical thoracic?
Typically four are identified; as many as eight if the costocentral stellate/radiate ligaments are included
What is the name given to the joint formed between the vertebral body an rib?
Costocentral joint
How many costocentral joints are formed at the vertebral body of a typical thoracic?
Four
What synovial joint surfaces are present on the vertebral body of a typical thoracic?
The right and left superior and the right and left inferior costal demi-facets
What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?
The costocentral joint or ribs
What is the position and direction of the pedicle from the typical thoracic vertebral body?
The pedicle arises from the upper third of the vertebral body and projects posterior and slightly laterally
What is the angulation of the pedicle in the typical thoracic region?
Ten to fifteen degrees posterolateral from the sagittal plane
What is overlap of the lamina called in the typical thoracic region?
Shingling
What is the direction of the transverse process in the typical thoracis?
The transverse process projects more posterior with each inferior vertebra
What is the distance between the transverse tubercle in the typical thoracic region?
From T2 each transverse diameter becomes shorter as the transverse process angle more posteriorly
What is present on the transverse tubercle of a typical thoracic?
The transverse costal facet
What is the rib-transverse process relationship for the typical thoracics?
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
What is the classification of the costotransverse joint?
Synovial (dyarthrosis) arthrodia joint
What are the osseous parts of the costotransverse joint?
The transverse costal facet and the articular surface of the tubercle of a rib
What ligaments support the costotransverse joint of a typical thoracic?
The superior costotransverse, inferior costotransverse and lateral costotransverse ligaments.
The superior costotransverse ligament of rib five will attach to which segmental body feature?
The transverse process of T4
The superior costotransverse ligament of the transverse process of T4 will attach to which rib?
The fifth rib
The inferior costotransverse ligament of rib five will attach to which segmental bony feature?
The transverse process of T5
The inferior costotransverse ligament of the transverse process of T5 will attach to which rib?
The fifth rib
What ligaments attach to the transverse process of a typical thoracic?
Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments
Which joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments?
Fibrous (amphiarthrosis) syndesmosis joint
Which muscles may attach to the transverse process of a typical thoracic?
The longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis thoracis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis.
How can you distinguish between a T2-T4 from a T5 - T8 segment using the articular process?
T2-T4: width between the superior articular processes is greater than width between the inferior ones of that vertebra
T5-T8: Width between superior articular processes is equal to or the same as the width between the inferior ones of that vertebra
What is the angulation of the articular facet of a typical thoracic?
About ten to twenty degrees from the coronal plane; sixty degrees from the horizontal plane
What is the orientation of the superior articular facet of a typical thoracic?
They face backward, upward and lateral (BUL)
What is the orientation of the inferior articular facet of a typical thoracic?
They face forward, downward, and medial (ForMeD)
What is the joint classification of the articular facet joint?
Synovial (diarthrosis) arthrodia joint
How many synovial joints are present at a typical thoracic?
Ten
What is the angulation of the spinous process in the typical thoracic region?
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 60 degrees from the horizontal plane
Which muscles may attach to the spinous process of a typical thoracic?
The trapezius, latissimus dorsi, rhomboid major, serratus posterior superior, splenus cervics, splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis
What joint classifications are present at every typical thoracic vertebra?
Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint and synovial (diarthrosis) arthrodia joint.
What ligaments attach to the transverse process of T1?
Intertransverse, capsular costotransverse, superior costotransverse, Inferior costotransverse and lateral costotransverse
What joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments?
Fibrous (amphiarthrosis) syndesmosis joint
What muscles attach to the transverse process of T1?
The longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis
Which muscles attach to the transverse process of T9?
Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
How many synovial joints are typically present at T9?
Ten
Which rib related facet may be absent on T9?
The inferior costal demi-facet
Which muscles attach to the spinous process of T9?
The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis
How many joints are typically formed at the vertebral body of T10?
Typically eight: twelve if the costocentral stellate/radiate ligaments are included
Which synovial joint surface is absent from the vertebral body of T10?
Inferior costal demi-facets.
What feature is very commonly observed on the lamina at T10?
Para-articular processes
What ligaments support the costotransverse joint of T10?
The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments
What muscles attach to the transverse process of T10?
Longissimus thoracis, semispinals thoracis, multifidis, rotator longus and rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
How many synovial joints are typically present at T10?
Eight
What is the topographical indication of the spinous process of T10?
The skin often dimples or is depressed
What muscles attach to the spinous process of T10?
Trapezius, Latissimus dorsi, multifidis, rotator longus, rotator brevis, and interspinalis
What is the name given to T11?
The anticlinal vertebra
What joint classifications are identified at the vertebral body of T11?
Fibrous (amphiarthrosis) syndesmosis joint, cartilagenous (amphiarthrosis) symphysis joint and synovial (diarthroisis) arthrodia joint
What ligaments form the costotransverse joint of T11?
The superior costotransverse, and slightly developed inferior costotransvere and lateral costotransverse ligaments
What is the orientation of the transverse costal facets for T11
There are no transverse costal facets on T11
What muscles attach to the transverse process of T11?
Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii and levaor costarum brevis
Which levator costarum muscle is absent at T11?
Levator costarum longus
What muscles attach to the spinous process of T11?
Trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis.
At which segments of the thoracic spine will the spinalis muscle not attach?
T9, T10
What does the superior tubercle of T12 represent?
The mammillary process of lumbar vertebrae
What does the inferior tubercle of T12 represent?
The accessory process of lumbar vertebrae
What ligaments form the costotransverse joint of the twelfth rib?
The superior costotransverse ligament from T11 and the lumbocostal ligament from L1
Which costotransverse ligament(s) lack an attachment to T12?
Capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments
What muscles attach to the transverse process of T12?
Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii
What muscles attach to the spinous process of T12?
Trapezius, Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, interspinalis
Which erector spinae muscle is unique in its attachment to the T12 spinous process?
Iliocostalis lumborum
How many synovial joints are maximally observed at each thoracic vertebra?
T1-T9 = 10
T10 = 8
T11-T12 = 6
What is the superior articular facet orientation at each thoracic vertebra?
BUL
What is the generic shape of the typical lumbar vertebral body from the cranial view?
Reniform or kidney - shaped
What accounts for the direction of the lumbar curve?
The vertebral body and intervertebral disc have a greater anterior height than posterior height
What is the effect of aging on the vertebral body of a lumbar vertebra?
Decrease in height, increase in circumference
How many joint surfaces are present on the vertebral body of a typical lumbar?
Six
What muscles may attach to a typical lumbar vertebral body?
Psoas major and Psoas minor
What is the name given to ligaments which attach the vertebral body to articular process?
Transforaminal ligaments
WHat are the types of transforaminal ligaments?
Superior transforaminal, middle transforaminal ligaments and inferior transforaminal ligaments
What ligaments attach the vertebral body to the transverse process?
Corpotransverse ligaments
What corpotransverse ligaments are identified?
Superior corpotransverse and inferior corpotransverse ligaments
Cervical - upper thoracic Hofmann ligaments will attach what structures together?
Dura mater to segments above
What is the proposed function of the cervical - upper thoracic Hofmann ligaments?
Resist caudal movment of the dural sac; resist gravitational forces on the dura and cord
Lumbar Hofmann ligaments will attach what structures together
Dura mater to lower segmental levels
WHat is the proposed function of the lumbar Hofmann ligaments?
Resist cranial movment of the dural sac during flexion
Congenital elongation of the lumbar acessory process results in what feature?
Styloid process
WHat parts of vertebra are attached via the mammillo-accessory ligament?
The mammilllary process and accessory process of the same segment
WHat was believed to be entrapped by the mammillo-accessory ligament?
The medial branch of the dorsal ramus of a lumbar spinal nerve
What muscle(s) attach to the lumbar accessory process?
Longisimus thoracis and intertransversarii
What is the position of the lumbar zygapophysis in adults?
The sygapophysis 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
What names are given to the condition in which the right zygapophysis of a vertebral couple lies in a plane or position different from the left zygapophysis?
Joint asymmetry or joint tropism
What muscles will attach to the typical lumbar spinous process?
Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis.
What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?
Lumbosacral, iliolumbar and mammillo-accessory ligaments
What are the posterior elements of the vertebra?
Zygapophysis, lamina and spinous process
What are the anterior elements of the vertebra?
Vertebral body and pedicle
What is the orientation of the fifth lumbar superior articular facet?
Backward, upward, medial (BUM); typically concave
What is the orientation of the fifth lumbar inferior articular facet?
Forward, lateral, downward (FoLD); significant onvexity
What is the name(s) of the condition in which the L5 spinous process increases in length due to the aging process?
Baastrup’s syndrome or “kissing spines”
What is Knife Clasp syndrome?
The congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida and dorsiflexion produces pain
What is the superior articular facet orientation at each lumbar vertebra?
L1-L5 = backward, upward, medial (BUM)
What is the inferior articular facet orientation at each lumbar vertebra?
L1-L5 = forward, downward, lateral (FoLD)
What is the incidence of spondylolysis in the general population?
A range of 2.6% to 10%
Lumbar spondylolysis has not been reported in what groups of individuals?
Fetuses, newborns, rarely in children under five years old, patients who have never walked and in non-erect species
What does lumbar spondylolysis appear to be related to?
The uniquely human upright stance or erect posture
What is the gender bias typically associated with lumbar spondylolysis?
Men at L5/S1; women at L4/L5
WHat is the age range typically associated with lumbar spondylolysis?
10-20 year olds
What motion(s) is particularly associated with lumbar spondylolysis?
Hyperextension coupled with rotation
What fills the space in a lumbar spondylolysis?
Fibrocartilagenous material
What name has been given to the material filling the space in a lumbar spondylolysis?
Spondylolysis ligament
What types of neural function(s) have been assocated with the spondylolysis ligament?
Nociception, neuromodulation and autonomic function
What is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view?
A collared Scotty dog
What part of a lumbar vertebra forms the neck of a Scotty dog?
The pars interarticularis below the superior articular process
What part of a lumbar vertebra forms the eye of a Scotty dog?
The pedicle
What part of a lumbar vertebra forms the ear of a Scotty dog?
The superior articular process
What part of a lumbar vertebra forms the nose of a Scotty dog?
The transverse process
What characteristics are associated with cervical spondylolysis?
Rare, congenital, gender biased toward men, most common at C6 and linked to spondylolisthesis and spina bifida
What characteristics are associated with sacral spondylolysis?
Rare in general population, 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 is the posterior direction of vertebral slippage called?
Retrospondylolisthesis or retrolisthesis
What are the types/classifications of spondylolisthesis?
Type I: spondylolisthesis (dysplastic spondy, congenital spondy)
Type II Isthmic spondy
Type III Degenerative spondy
Type IV Traumatic Spondy
Type V Pathologic Spondy
What is the locational bias of type I spondylolisthesis?
L5 or upper sacral segments
Which subtype of Type II spondylolisthesis is stressed in Spinal II?
Lytic spondylolisthesis or stress fracture induced 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 and demonstrates an increase in sagittal diameter of the spinal canal
What is the gender bas, locational bias, and spinal canal dimension 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 canal
What causes type IV spondylolisthesis?
Fracture of the neural arch components
What are the cause(s) associated with type V spondylolisthesis?
Bone diseases such as Paget disease or osteogenesis imperfecta
How many joint surfaces are present on the vertebral body of the first sacral segment?
Five
What joint classifications will be observed at the first sacral vertebral body?
Cartilaginous (amphiarthrosis) symphysis, fibrous (amphiarthrosis) syndesmosis
What muscle(s) may attach to the first sacral vertebral body?
Psoas major
What is the position of the sacral zygapophysis in adults?
The zygapophysis lies in the coronal plane for L5/S1
What is the orientation of the first sacral superior articular facet?
Backward, upward, medial (BUM); typically concave
What is the size relationship between ventral and dorsal sacral foramina?
Ventral sacral foramina are larger
What part of the sacral ala continues along the ventral surface of sacrum to about S4?
The costal element
What is the name of the region of bone lateral to the vertebrl body of S5?
True transverse process
An imaginary line drawn from the superior articular process of S1 to the sacral cornu will form what feature?
Intermediate sacral crest
What features may be identified along the intermediate sacral crest?
The mammillary process of S1 and the sacral cornu of S5
What is the name of the inferior opening of the sacral spinal canal?
The sacral hiatus
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?
The accessory sacro-iliac joint
What feature is associated with the transverse tubercle of S5?
The inferior and lateral (inferolateral) sacral angle
What classification of joint is formed by the auricular surface of sacrum?
Synovial (diarthrosis) arthrodia joint
What feature does the anterior surface of the superior epiphyseal rim of S1 form?
The sacral promontory
How many synovial joints are typically present at sacrum?
Four
What forms the posterior boundary for the fifth sacral spinal nerve intervertebral foramen?
Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament and intercornual ligament
What is the homolog for the posterior longitudinal ligament at S5?
Deep posterior sacrococcygeal ligament
What is the homolog for the anterior longitudinal ligament at S5?
Anterior sacrococcygeal ligament
What is the homolog for the ligamentum flavum at S5?
Superficial posterior sacrococcygeal ligament
What is the homolog for the capsular ligament at S5?
Intercornual ligment
What is the number of coccygeal somites?
Ten
What is the typical number of segments which unite to form the adult coccyx?
4 Segments
When is ossification of coccyx completed?
About age 30
What bony features are present on the coccyx?
All segments are represented by a “vertebral body; Co1 has a coccygeal cornu and transverse process
What is the direction of fusion of coccygeal segments?
From caudal to cranial, the last segments to fuse together are Co1 and Co2
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
What is the ganglion impar?
A midline sympathetic ganglion
What is the coccygeal glomus or coccygeal body?
An enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx
What forms the inferior boundary for the spinal canal?
The union of the superficial posterior and deep posterior sacrococcygeal ligaments
What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments at Co1?
The posterior sacrococcygeal ligament
What forms the posterior boundary for the first coccygeal spinal nerve intervertebral foramen?
Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament, intercornual ligament
WHat forms the anterior boundary for the first coccygeal spinal nerve intervertebral foramen?
Vertebral body of S5, vertebral body of Co1, deep posterior sacrococcygeal ligament, intervertebral disc
Superior articular facets of which vertebrae will be orientated backward, upward, and medial?
C1, C3-C7, L1-L5, S1
Superior articular facets of which vertebrae are riented back up medial and concave?
C1, L1-L5, S1
Inferior articular facets of which segments will be orientated backward medial and downward?
C1
Superior articular facets of which segments will be orientated backward, upward, and lateral?
C2, T1-T12”
Inferior articular facets of which segments will be orientated forward, lateral, and downward?
C2-C6, T12, L1-L5
Inferior articular facets of which segments are orientated forward, lateral, downward and convex?
T12, L1-L5
Inferior articular facets of which segments will be orientated forward, medial, and downward?
C7, T1-T11
What is/are the characteristic(s) of cervicalization of occiput?
An increase in occipital bone size, formation of new or larger lines, on the occipital bone
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 occipitalization of C1?
0.1% to 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
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 of the dens center of ossification appear?
Sometime in early adolescence
If the joint formed between the tip of 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 dorsalization of C7?
From one-half to two and one-half percent of the population
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 back, upward, and medial to that of a typical thoracic facet…back, upward, and lateral; the inferior articular facet is unchanged.
What alteration in C6 facet orientation may accompany dorsalization?
C6 demonstrates a change in inferior articular facet orientation from forward, lateral, and downward to forward, medial, and downward; the superior 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 C7 facet orientation changes may accompany cervicalization?
The inferior articualr facet may change from FMD to FLD; the superior articular facet is unchanged
What is the incidence of the cervicalization of T1 in the population?
up to 28% of the population
What rib-related changes may accompany lumbarization of T12?
A significant shortening of the mean relative length of 113 mm of the twelfth rib or it becomes absent
What T12 facet orientation changes may accompany lumbarization?
Superior articular facet may change from flat, BUL to concave BUM; inferior unchanged
What is the characteristic of lumbarization of S1?
Failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala
What is the characteristic of sacralization of L5?
L5 may be partially or completely fused to the sacrum
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%
