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