Final Flashcards
What are the names of the anterior curves, secondary curves and compensatory curves?
cervical and lumbar curve
What segmental levels form the cervical curve?
C2-T1
What segmental levels form the lumbar curve?
T12-L5
What is the earliest time of appearance of cervical curve?
third fetal month
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 developental 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
At what age will the infant begin to hold the head erect?
usually betwen the third and fourth month after birth
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 location ofr the apex of the cervical curve?
typically between C4 and C5
What is the location for the cervical kyphosis?
between the occiput and C1
What is the vertebral relationship between cervical curve and the cervical enlargement?
cervical curve C2-T1; cervical enlargement C3-T1
What is teh time of appearance fo the lumbar curve?
between 12 and 18 months after birth
What infant activities are associated with the developmental of the lumbar curve?
crawling and walking
What developmental events are indicated int eh 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 lumbard
- intervertebral disc height will become greater anterior compared to posterior
- walking will further promote muscle intervertebral disc development
Which sense is a requirement for holding the head erect, standing, sitting and walking?
vision
What is the gender bias associated with lumbar curve convexity?
females have a greater convexity of the lumbar curve
What isthe vertebral relationship between the lumbar curve and the lumbar enlargement?
lumbar curve T12-L5; lumbar enlargement T9-T12
What is teh time of appearance of the lateral curves?
they appear after 6 years old
What is the relationship between curve direction and handedness?
a right-handed person has a high probability for a right htoracic, left lumbar curve combination
What names are given to conditions associated with abnormal curves of the vertebral column?
lordosis, kyphosis, scoliosis
What is the defeinitions of lordosis?
a forward bending condition
What is the definition of kyphosis?
a humpback or hunchback condition
What is the definition of scolosis?
a warped or crooked condition
What are the curve classifications for military neck?
kyphosis or hypolordotic curve
What are the curve classifications for humpback or hunchback?
kyphosis or hyperkyphotic curve
What are the curve classifications for swayback?
lordosis or hyperlordotic curve
What is the more complete, more accepted definition of scoliosis?
an abnormal lateral curve coupled with axial rotation
What is the radiological test for skeletal maturity?
the Risser sign, and indication of bone maturity in the iliac apophysis
What are the classifications of scoliosis according to the Scoliosis Research Society?
magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis
What does magnitude of scoloisis refer to?
the length and angle of the curve deviation onX-Ray
What is often used to measure the magnitude of scoliosis?
Cobb Method
What does location of scoliosis infer?
the location on the vertebral segment forming the apex of the curve deviation
What does direction of scoliosis refer to?
the side of convexity of the curve will bend toward
What does etiology of scoliosis mean?
cause of the scoliosis
What is structural scoliosis?
a more radical form of scoliosis, it way worsen, associated with structural deformities of the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation
What is nonstructural 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 ist he classification of scoliosis that si unique to individual patient?
idiopathic scoliosis
What is the incidence of idiopathic scoliosis in the population?
1-4% of the population
Based on age of onset, what are the types of idiopathic scoliosis?
infantile, juvenile, and adolescent
What is the age range for infantile idiopathic scoliosis?
birth to 3 years
What is eh age range for juvenile idiopathic scoliosis?
3-10 years old
What is the age range for adolescent idiopathic scoliosis?
over 10 years old
Idenfity 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 or right thoracic and left lumbar, females, 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 are the transition zones of the vertebral column?
occipitocervical, cervicothoracic, thoracolumbar, lumbosacral, sacrococcygeal zones
What is/are te characteristics of occipitalization of C1?
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 ossification for the odontoid process first appear?
during the last trimester in utero
When do the bilateral ossification centers for odontoid process fuse?
at or shortly after birth?
What joint is formed between the odontoid process ossification centers and the centrum of C2?
subdental synchondrosis
What is teh classification of the joint formed between the C2 odontoid process and centrum?
amphiarthrosis synchondrosis
Ossification be?
d
A joint between the odontoid process and centrum of C2 last identidied 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 ge 7?
persistent subdental synchondrosis
What is the name givento the joint formed between the tip of the dens and the odontoid process centers of ossification?
tip of dens synchondrosis
What is the classification of the joint formed between the tip of the dens and odontoid process centers of ossification?
amphiarthrosis synchondrosis
WAt what age will the tip of the dens center of ossification appear?
sometime in early adolescence
Based on the age of appearance, how is the tip of the dens center of ossification classified?
secondary center of ossification
At what age will the tip of the dens and odontoid process centers of ossification perisits beyond age 12, what is the condition calle?
terminal ossicle
What is a basilar impression?
persistence of the nonunoin 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?
upper cervical spine appears to be invaginated into the skull on X-Ray analysis
What is teh incidence of rib-related changes following dorsalization of C7?
from 1/2 to 2 1/2% of the population
Do symptoms specific for dorsalization of C7?
no, they are typically asymptomatic
What is teh gender bias suggested in dorsalization of C7?
female
What alteration of C7 facet orientation may accompany dorsalization?
superior articular facet of C7 may change from back, upward and medial to that of atypical thoracic facet…back, upward and lateraal; the inferior articular facet is unchanged
What percent of the populcation may demonstrate thoracic- like features at C7?
up to 46%
What T1 facet orientation changes may accompany cervicalization?
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 teh incidence of lumbar ribs in the population?
over 7% of the population demonstrates lumbar ribs
What L1 facet orientation changed may accompany dorsalization?
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 2 to 3 times more affected
What T12 facet orientation changes may accompany lumbarization?
superior 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 accompany lubarization?
the inferior articular facet may change from flat, forward, meidal and downward to convex, forward, lateral and downward; the superior articular facet is unchanged
What is the usual way of identifying the number of cerivals, thoracics and lumbar vertebrae during imaging studies?
idendify the vertebrae with ribs- they will be thoracics; those higher are cervicals, those lower are lumbars
What is characteristic of lumbarization of S1?
the filure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala
What is failure of synostisis between S1 and S2?
segments do not competely fuse together
What is squaring of the vertebral body of S1?
the S1 vertebral body has similar anterior and posterior heights, hence a lack of wedging
What is flaring of the sacral ala?
the transverse process of the ala appears to elevate as though separating from therest of the sacral ala
What is characteristic of sacralization of L5?
L5 may be partially or competely fused to the sacrum
What is the incidence of sacralization of L5 in the population?
41-85%
Which segment demonstrates the greatest morphological variation along the spine?
L5
What articular facet changes accompany sacralization of L5?
none
What is teh incidence of variation within the sacrococcygeal region in teh population?
up to 14%
What is characteristic of sacralization of Co1?
premature fusion of Co1 to the sacrum
What is characteristic of coccygealization of S5?
the separation of S5 from sacrum and its premature fusion to Co1
The trapezius is innervated by what nerve?
spinal accessory nerve
What forms the spinal accessory nerve innervating the trapezius
C1-C5 cord levels contribute to the spinal root fo the spinal accessory nerve
The latissumus dorsi is innervated by what nerve?
thoracodorsal nerve
What forms the thoracodorsal nerve innervating the latissumus dorsi?
ventral rami from C6-C8
Which of the muslces of the true back are innervated by the dorsal scapular nerve?
levator scapulae, rhomboid major, rhomboid minor
What forms the dorsal scapular nerve?
ventral ramus of C5
What is the innervation of the splenius capitis?
dorsal rami of middle cervical spinal nerves (c3-C5 cord levels)
Splenius cervidcis will attach to what locations on the spine?
lateral mass of C1 and posterior tubercle of transverse process on C1-4
Contraction of splenius cervicis will result in what movements?
lateral flexion and roataion of neck; bilaterally they extend the neck
Which muslces are identified as erector spinae or sacrospinous muscles?
iliocostalis, longissumus, spinalis
What is the innervation of the iliocostalis lumborum?
dorsal rami of lower thoracic and lal lumbar spinal nerves
What is tehinsertikon for the iliocostalis thoracis?
costal angles of the upper 6-7 ribs, transverse process of C7
What is the origin for the iliocostalis cervicis?
costal angles of the upper 3-6 ribs (ribs 1-3 or ribs 1-6)
What is teh insertion for the iliocostalis cervicis?
posterior tubercle of transverse process of C(3) C4-6
What is the innervation of the iliocostalis cervicis?
dorsal rami of T1, T2 spinal nerves, sometimes C8 spinal nerve (C8, T1, T2 cord levels)
What osseous parts of t?
3
Contraction of longissimus thoracis will result in what movements of the vertebral column??
lateral flexion of the htoracic spine (lumbar spine inadvertently)
bilaterally acts to extend thoracic and lumbar spine, holds thoracic and lumbar spine erect, increases lumbar lordotic curve
lateral pelvic movment
What is the innervation of the longissimus thoracis?
dorsal rami of all thoracic and lumbar spinal nerves (cord levels T1-T12, L1-5)
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
Contraction of multifidis will result in what movements?
lateral flexion and roation of the lumbar spine, mantains the lumbar lordotic curve and prevents entrapement of lumbar zygapophyseal capsular ligament during movement
Contraction of multifidis cervicis will result in what movements?
alters the zygapophyseal capuslar ligament response to load distribution
determines the cervical spine response to injury as evidenced by neck pain and is a significant contributor to postural control of teh head and neck
What is teh innervation of the classic multifidi?
dorsal rami of C3-8, T1-12, L1-5 and S1 spinal nerves (cord levels C3-8, T1-12, L1-5 and S1)
Contraction of the classic multifidis will result in what movements of the vertebral column?
lateral flexion and oration of the spine, maintains the lumbar lordotic curve and prevents entrapment of zygapophyseal capsular ligament during movement
What osseous parts of the vertebral column serve as an origin to the classic multifidis?
articular process of C4-7, transversse processes of T1-12, mammillary processes of L1-5 and the dorsal surface of S1-4 or S5
What is the innervation of the semispinalis capitis?
dorsal rami of C1-C6 spinal nerves (cord levels C1-6)
What osseous parts of the vertebral column serve as an origin to the semispinalis capitis?
transverse tubercles of C7, T1-6 or 7 and articular processes of C4-6
What is the innervation of the semispinalis cervicis?
dorsal rami of C6-8 spinal nerves (cord levels C6-8)
What osseous parts of the vertebral column serve asan origin to the semospinalis cervicis?
transverse tubercles of T1-5, or 6 and articular processes of C4-7
What is the innervation of the semispinalis thoracis?
Dorsal rami of T1-6 spinal nerves (cord levels T1-6)
What segment will represent the lowest attachment site for the semispinlis thoracis?
T12
How many vertebral can be attached to a single semgnet by transversospinalis muscles?
as many as 9 vertebrae
What osseous prats of the vertebral column serve as an insertion for the longissumus cervicis?
posterior tubercle of transverse processes from C2-6 or 7, articular processes from C2-6 or 7
What is the innervation of the longissimus cervisi?
dorsal rami of C4-8 and T1-2 spinal nerves (C4-8 and T1-2 cord levels)
What is the innervation of the longissimus capitis?
dorsal rami of C1-3 or 4 spinal nerves, (c1-3 or 4 cord levels)
Wich erector spinae muscles attach to cervical articular processes?
longissimus cervicis and longissimus capitis
What osseous parts of the vertebral column serve as an origin to the spinalis thoracis?
spinous processes of T11 and T12, L1 and L2
What is the innervation of the spinalis cervicis?
dorsal rami of all cervical spinal nerves (C1-8 cord levels)
What is the innervation of the spinalis capitis?
dorsal rami of lower cervical and upper thoracic spinal nerves
Which muscles are identified as transversospinalis muscles?
semispinalis, multifidis and rotators
Transversospinlis muscles represent what layer of the true back?
layer 5
Based on the name of this group, what is the origin-insertion of the transversopspinalis?
transverse process origin, spinous process insertion
Rotator muscles are typically identified in what region of the spine?
thoracic region
What is the classic origin of rotator brevis or its’ homolog?
transverse processes from C3 and each lower vertebra to the dorsal surface of sacrum (C3-C7, T1-T12, L1-L5, sacrum)
What is the classic orgin of rotator longus or its’ homolog?
spinous process two segmental levels above, from C2-7, T1-12, L1-5
What innervates the rotators?
dorsal rami at the level of insertion are velieved to do so
Which suboccipital muscle lacks an attachment to the skull?
obliquus capitis inferior
Which nerve will innervate all suboccipital muscles?
dorsal ramus of C1, suboccipital nerve
What is the origin of the rectus capitis posterior major?
spinous tubercle of C2
What is the origin of the rectus capitis posterior minor?
posterior tubercle of the posterior arch of C1
What is the origin of the obliquus capitis inferior?
C2 spinous process and lamina
What is the insertion of the obliquus capitis inferior?
transverse process of C1
What is the origin of the obliquus capitis superior?
posterior tubercle of transverse process of C1
An increase in the density of muscle spindles is most appearnt in which suboccipital muscle?
obliquus capitis inferior
What is the result of communication between suboccipital muscles, visual centers and vestibular centers?
coordination of head and eye postion
What is the proposed function of the suboccpiptal muscle group?
postural stabilizers of the atlanto-occpital and atlanto-axial joints
Which suboccpiptal muscles are known to attach to dura mater?
rectus capitis posterior major, rectus capitis posterior minor and obliquus capitis inferior
Interspinalis is paired in which regions of the spine?
cervical and lumbar regions
At what locations will interspinalis be absent along the spine?
T3-T4 down to T10-T11
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 movemtn of teh 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 L1-4
mammillary process of superiro articular process L1-4
Which of the lumbar intertransversarii is innervated by dorsal rami of lumbar spinal nerves?
medial belly, lumbar intertransversarii
Which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves?
intertranversarii
Based on 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 longus colli?
vertebral bodies of C5-6, T1-3 and anterior tubercles of transverse processes C3-5
What will innervate the longus colli?
ventral rami of C2-6 or C7 spinal nerves
What will innervate the longus capitis?
ventral rami of C1-3 spinal nerves
What is the origin of the rectus capitis anterior?
lateral mass and costal element of the transverse process of C1
What will innervate the rectus capitis anterior?
ventral rami of C1-2 spinal nerves
What will innervated the rectus capitis lateralis?
ventral rami of C1-2 spinal nerves
What is the insertion of the anterior scalene?
ridge and anterior scalene tubercle of the first rib
What will innervate the anterior scalene?
transverse processes of C1, C2 and posterior tubercles of transverse process of C3-7
What is the insertion of the middle scalene?
between the tubercle and groove for the subclavian artery on the first rib
What will innervate the middle scalene?
ventral rami of C3-8 spinal nerves
What is teh insertion of the posterior scalene?
outer surface of the second rib
What will innervate the posterior scalene?
ventral rami of C6-8 spinal nerves
The quadratus lumborum is implicated in the formation of which ligament?
iliolumbar ligament
What is teh origin of the psoas major?
vertebral bodies T12, L1-5, S1 and transverse processes of L1-5
What will innervate the psoas major?
primarily the ventral rami of L2-3, may include ventral rami of L1 and L4 spinal nerves
What is teh origin of teh psoas minor?
vertebral bodies T12, L1
What will innervate the psoas minor?
ventral ramus of L1 spinal nerve
What will innervate the iliacus?
femoral nerve, primarily the ventral rami of L2 and 3
What is the origin of the levator costarum brevis?
transverse tubercles of transverse processes from C7, T1-11
What will innervate the levator costarum brevis?
dorsal rami of T1-12 spinal nerves
What is the origin of the levator costarum longus?
transverse tubercles of transverse processes from T7-10
What will innervate the levator costarum longus?
dorsal rami of te lower thoracici spinal nerves
What is the origin of the serratus posterior superior?
upper outer border of rib 2-5
What wil innervate the serratus posterior superior?
ventral rami of T2-5 spinal nerves…intercostal nerves
What is the origin of the serratus posterior superior?
spinous tubercles of spinous processes from T11, T12, L1-2 and possibly L3
What is the maximum number of common ligaments identified with a vertebral couple?
8
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
Which common ligaments will attach to the vertebral body?
anterior longitudinal ligament, intervertebral disc and posterior longitudinal ligament
What common ligament will attach to the vertebral body?
ligmentum flavum
What is the number of trueinterveretebral 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 percent of intervertrebral disc height contribution to the length of each region of the vertebral column?
cervical: 22-25%
thoracic: 20%
lumbar: 33%
What is the inervertebral disc hisologically composed of?
cells, collagen fibers and a hydrated proteoglycan gel
What are the names of the central, peripheral and horizontal zones of the intervertebral disc?
nucleus pulposus, central zone
annulus fibrosus: peripheral zone
cartilaginous end plate: horizontal zone
What is the name of the growth zone of the intervertebral disc?
transition zone
What maintains the height of the cervical intervertebral disc?
unicinate process
What is the effect of aging on the intervertebral disc nucleus puplosis?
it becomes more fibrous as water and proteoglycan concentrations diminish
What is the cervical nucleus pulposus composed of?
fibrocartilage
What is the water concentration in the lumbar nucleus pulposus at birht and after thirty?
birth: 88%
30: 70%
What is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?
the nucleus pulposus will loose water under deformation conditions
What cell is associated with the nucleus pulposus until about age 11?
notochord cells
What cells are associated with the mature nucleus pulposus?
reticulocyte-fibroblast and chondroblast
Which type of collagen is dominant in the nucleus pulposus?
collagen type II
What is the organizational patter for collagen fibers in the nucleus puplosus?
irregularly oriented and randomly scattered
What general tissue location is described as having an abundance of collagen type II fibers?
cartilage
What is the role of collagen type II fibers based on locations where it is dominant?
appears to be related to tissues having a deformation-reformation ability
What is the appearance of the cervical annulus fibrosus?
a horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate processes; the posterior margin is thin
What compensates for the thinness of the posterior part of teh cervical annulus fibrosus?
posterior longitudinal ligament
What is the organization of the lumbar annulus fibrosus?
it has 12-14 concentric cylindrical lamellae
Why is the posterior part of the lumbar annulus fibrosus more susceptible to rupture, herniation, prolapse or protrusion?
the posteiror margin of each lamellus is thin and the posterior longitudinal ligamgnet is also less developed
What is the water concentration in the lumbar annulus fibrosus at birth and after thirty
birth: 78%
30: 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 pattern forcollagen 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 ovserved
What is the average angle of collagen fibers within the annulus fibrosus?
they average 50-60 degrees
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; collage fibers of the inner lamellae will attach to teh cartilaginous end plate
What is the origin for the cells of the annulus fibrosus?
sclerotomites
What cell type is associated with the annulus fibrosus?
fibroblast and fibrocyte
What part of the vertebral body will the cartilage end plate cover?
the cancellous bone at the top or bottom of the vertebral body
What part of the vertebral body upper and lower surfaces will the cartilage end plate not cover?
the epiphyseal rim
What is the principal type of collagen fibers within the cartilage end plate?
type II collagen fiber
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 annlus fibrosus?
the cartilaginous end plate
What cell type is associated with the cartilage end plate?
chondrocytes
What is the earliest indicator of intervertebral disc pathology or degeneration?
changes in the histology of the cartilage end plate
What part of the intervertebral disc will exhibit constant remodeling?
transition zone
What is the area of maximum metabolic activity in the intervertebral disc?
the transition zone
What part of the intervertebral disc is innervated?
the outer lamellae of the annulus fibrosus
What part of the cervical intervertebral disc is highly innervated?
the middle third of the annulus fibrosus
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
The recurrent meningeal/sinu-vertebral/sinus vertebral nerve has typically been shown to originate from which source?
gray ramus communicans
What part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?
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, fibers from the white ramus communicans, fibbers from the paradiscal ramus communicans, fibers from the grey ramus communicans
What is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc?
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
What is the popular theory of intra-abdominal pressure and intervertebral disc response to weight bearing?
increasing the intra-abdominal cavity pressure will diminish the amount of resistance the intervertebral disc needs to generate by up to 50%
Based on histology, what is the classification of the intervertebral disc?
cartilaginous (amphiarthrosis) symphysis
What are the divisions of the embryonic somite?
sclerotome, myotome, and dermatome
What structure is formed following migration of sclerotoms to surround the notochord?
perichordal blastema
What is formed within the perichordal blastema between the sclerotomites?
the intrasclerotomal fissure or fissure of von Ebner
What does the intrasclerotomal fissure or fissure of von Ebner become?
perichordal 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 sclerotomite?
vertebral blastema
What part of the intervertebral disc will the notochord form?
nucleus pulposus
What part of the intervertebral disc will the perichordal disc form?
annulus fibrosus
What is the earliest indicator of the position of the adult intervertebral disc?
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?
tendon of the crura of the diaphragm
What innervates the anterior longitudinal ligament?
anterior neural plexus formed by fibers from the ventral primary ramus and sympathetic postganglionic fibers from the paravertebral ganglia
what is the function of the anterior longitudinal ligament?
it brakes or limitis 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 (DISH)
What is the classification of the posterior longitudinal ligament-vertebral body joint?
fibrous (amphiarthrosis) syndesmosis
What vertebral levels will the posterior longitudinal ligament attach to?
those between C2 and S3 inclusive are traditionally indicated
What will the posterior longitudinal ligament attach to in addition to vertebral bodies?
intervertebral disc
Newer research suggests what regional variation in the posterior longitudinal ligament?
priminent in the cervicals, occational 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 appearance of the posterior longitudinal ligament in the cervical spine?
parallel along its lateral margins
What is the appearance of the posterior longitudinal ligament in the lumbar spine?
hourglass shaped along its lateral margins
What is the innermost layer of the posterior longitudinal ligament called?
perivertebral ligament
What innervates the posterior longitudinal ligament?
posterior neural plexus formed by fibers from the recurrent meningeal nerve/sinu-vertebral nerve/sinus vertebral nerve
What is the function of the posterior longitudinal ligament?
is brakes or limits flexion of the vertebral column
Where is ossification of the posterior longitudinal ligament most commonly identified?
cervical spine with an 80% incidence
What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?
loss of hand and finger dexterity
What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?
faltering gait
What is the gender, age and ethnic bias associated with ossification of the posterior longitudinal ligament?
males over 50 and higher incidence in Japanese
At one time ossification of the posterior longitudinal ligament was an example of what condition?
Diffuse Idiopathic Skeletal Hyperostosis (DISH)
What are the specific bony attaching sites for the ligamentum flavum?
laminae
What will the ligamentum flavum atach to in addition to the lamina?
may blend with the capsular ligament of the zygapophysis
How many ligamenta flava will attach to the lamina of a cervical segment?
two: one with the upper margin of the lamina and one with the the lower margin
In which region of the spine will the ligamentum flavum be paired?
lumbar spine
How many ligamenta flava will attach to the lamina of the lumbar segment?
four: two with the upper margin of the lamina and two with the lower margin
What is the relationship of the ligamentum flavum to the vertebral foramen?
forms the posterior boundary of the spinal canal
What is the name given to the ligamentum flavum based on appearance and histology?
yellow elastic ligament
What fibers are most ligaments made up of?
collagen type I fibers which are whitish in appearance
What is the color of most ligaments in the body?
whitish
What is the function of the ligamentum flavum?
brakes or limits flexion of the vertebral column
What is now thought to be a major function of the ligamentum flavum?
it is early prime factor in extension of the vertebral body
Where is ossification of the ligamentum flavum most commonly identified?
the thoracic spine or thoracolumbar transition zone
What is the relationship between the capsular ligament and mobility?
the more lax/loose the capsular ligament is, the greater the motion of the joint
What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?
cervical and lumbar regions
In what region of the vertebral column will the capsular ligament the tightest?
thoracic region
What layers are present in the capsular ligament?
superficial layer of collagen fibers and a deep layer of elastic fibers
The capsular ligament may blend with which other common ligament?
ligamentum flavum
What muscle will blend with the capsular ligament posteriorly?
multifidis
What is the pattern of innervation for the zygapophysis capsular ligament?
typically innervated by 3 spinal nerves
If the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its’ function?
probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement
What vertebral levels will the interspinous ligament be attached to?
those between C2 and S1 inclusive are traditionally indicated
What is the status of the cervical interspinous ligament?
lacking, poorly developed or simply considered the deep anterior part of the ligamentum nuchae
What is the status of the thoracic interspinous ligament?
narrow and elongated reflecting the shape of the spinous process
what is the status of the lumbar interspinous ligament?
brakes or limits flexion of the vertebral column
what is now thought to be a major function of the interspinous ligament?
more likely a proprioceptive transducer for the spinal reflex
What are the layers of the ligamentum nuchae?
a superficial and deep layer are identified
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?
lamellar layer or part
What are the attachment sites for the superificial layer of the ligamentum nuchae?
external occipital protuberance, external occipital crest, and spinous tubercle of C7
What is the histological make-up of the human ligamentum nuchae?
yellow elastic ligament, but has more collagen fibers than in gradrupeds
What is the primary yellow elastic or elastic ligament of the spine?
ligamentum flavum
What is the classic function of the human ligamentum nuchae?
brakes or limits flexion of the cervical spine
What is the classic termination level inferiorly for the supraspinous ligament?
upper sacral spinous tubercles`
What is the termination level inferiorly for the supraspinous ligament according to current literature?
primarily at L4 (73%); between L4 and L5 (5%)
Where is the supraspinous ligament said to be best developed?
lumbar spine
What is now believed to form the supraspinous ligament in the lumbar spine?
tendons or aponeurosis associated with the longissimus thoracis and the multifidis
What is the classic fucntion of the human supraspinous ligament?
brakes or limits flexion of the spine
What is now thought to be a major function of the supraspinous ligament?
proprioceptive transducer for the spinal reflex
What is the status of the cervical intertransverse ligament?
said to be paired with an anterior and posterior intertransverse ligament present
What is the status of the lumbar intertransverse ligament?
well developed with two parts identified, a ventral slip and a dorsal slip
Where in the vertebral column is the intertransverse ligament best developed?
lumbar spine
What part of the intertransverse ligament in the lumbar spine covers the intervertebral foramen?
ventral slip
What part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?
dorsal slip
What is the classification of the atlanto-occipital joint?
synovial (diarthorisis) ellipsoidal
What other joint space does the atlanto-occipital joint communicate with?
posterior bursa of the median atlanto-axial joint
Which atlanto-axial joint is identified as a synovial pivot (diarthrosis trochoid)?
median atlanto-axial joint
Which atlanto-axial joint is identified as a synovial plane (diarthrosis arthrodia)?
lateral atlanto-axial joint
What are the names given to the synovial joint spaces of the median atlanto-axial joint?
anterior bursa and posterior bursa
What is the classic function of the anterior atlanto-occipital ligament?
brakes or limits extension of the skull over the cervical spine
Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?
accessory bone
What other name may be used to identify a ponticulus posticus?
Kimmerly’s anomaly
What names are given to the opening formed by the ponticulus posticus?
arcuate foramen or retroarticular canal
What is the classic function of the posterior atlanto-occipital ligament?
brakes or limits axial rotation, flexion and perhaps lateral bending of the skull on atlas
What amount of flexion extension is accommodated by the atlanto-occpiptal joint?
25 degrees
What amount of axial rotation is accommodated by the atlanto-occpiptal joint?
3-8 degrees one side axial rotation
Which motion is best accommodated by the atlanto-occpiptal joint?
flexion-extension
What amount of lateral bending is accommodated by the atlanto-occipital joint?
5 degrees
What is the function of the transverse atlantal ligament?
primary stabilizer of the atlanto-acial joint restricting the distance of C2 from the anterior arch of C1
What is ADI?
atlanto-dental interspace, radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
The ADI is observed between which surfaces?
fovea dentis of C1 and facet for fovea dentis of C2
What is the ADI of children compared to that of adults?
about 4.5 mm in children; a range of 2-3mm or abound 2-5 mm in adults
What are the attachment sites for the accessory atlanto-axial ligament?
the base of the dens and vertebral body of axis to the tubercle for the transverse atlantal ligament on the lateral mass of C1; a superior continuation may attach on the occpital bone just behind that of the alar ligament
What are the degrees of movement facilitated at the atlanto0axial 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 percentage of all cervical axial rotation?
60%
What ligament attaches to the anterior margin of the foramen magnum and the top of the dens of C2?
apical dental ligament of the dens or the apicodental ligament
What is the embryonic derivative of the apical ligament of the dens or the apicodental ligament?
notochord
What is the function of the alar ligament?
together the function to resist axial rotation
What forms the cranial continuation of the posterior longitudinal ligament?
membrana tectoria or tectorial membrane
What are the attachment sites for the superficial layer of the membranan tectoria or tectorial membrane?
posterior part of the inferior epiphyseal rim and vertebral body of C2 to the capsular ligament of the atlanto-occipital joint and cranial dura of the posterior cranial fossa
List, in order, the ligaments in the midsagittal plane from the dura mater at the level of the medulla oblongata to the anterior bursa of the median atlanto axial joint.
membrana tectoria
crutiate ligament
capsular ligament of the posterior bursa of the median atlanto-axial joint
apical ligament of the dens
For the cervical spine below C2, what is the range of flexion-extension?
about 90 degrees or about 18 degrees per couple
For the cervical spine below C2, what is the range of one side lateral bending?
about 50 degrees or about 10 degrees per couple
For the cervical spine below C2, what is the range of one side axial rotation?
about 33 degrees or 6 degrees per couple
What are the locations for the costovertebral joints on the vertebra?
costocentral joint at the vertebral body and the costotransverse joint at the transverse process
Which costocentral ligament forms part of the anterior boundary of the intervertebral foramen?
costocentral capsular ligament
The costocentral radiate-stellate ligament is identified with which joint classification?
fibrous (amphiarthrosis) syndesmosis
An intra-articular ligament will be identified with which ribs?
2-9
What are the attaching surfaces of the intra-articular ligament?
intra-articular crest of the head of the rib and the intervertebral disc
Which vertebra will have a synovial plane (diarthrosis arthrodia) costotransverse joint?
typically T1-10
What are the accessory ligaments of the costotransverse joint?
superior costotransverse ligament, inferior costotransverse ligament and the lateral costotransverse ligament
At what rib will the superior costotransverse ligament be absent?
first rib
What ligaments will attach to the neck of the 12th rib?
superior costotransverse ligament form T11 and the lumbosacral ligament from L1
What is the age and gender bias associated with ankylosis of the sacro-iliac joint?
age 50 and male bias particularly in African American males
What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint?
age 40, iliac auricular surface
What does ankylosis mean?
a condition of fibrous adhesion occurs within the joint
What does degenerative arthrosis mean?
condition of degeneration of the joint, sometimes referred to as degenerative joint disease (DJD)
What pathological or age-related modifications of the sacro-iliac joint may occur?
degenerative arthrosis and ankylosis
What forms the accessory sacro-iliac joint?
sacral tuberosity and the iliac sulcus
Which gender is biased with greater unevenness of the auricular surface of the sacro-iliac joint?
males
What is the superficial appearance of the auricular surfaces of the sacro-iliac joint by age 15?
the sacrum develops a sacral groove while the ilium develops an iliac ridge
What is the auricular surface of the ilium composed of?
articular cartilage, interspersed with fibrocartilage
What does the sacral cornu represent?
inferior articular process and facet of S5
What is the homolog of the capsular ligament at the sacrococcygeal joint?
intercornual ligament
What is the homolog of the intertransverse ligament at the sacrococcygeal joint?
lateral sacrococcygeal ligament
What forms the closure for the spinal canal inferiorly?
the fusion of the deep posterior sacrococcygeal ligament with the superficial posterior sacrococcygeal ligament
List, inorder, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal.
posterior atlanto-occipital ligament, posterior atlanto-axial ligament, ligamentum flavum and the superficial posterior sacrococcygeal ligament
List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.
membrana tectoria, posterior longitudinal ligament and the deep posterior sacrococcygeal ligament
List, inorder, from cranial to caudal the ligaments forming teh anterior boundary of teh spinal column.
anterior atlanto-occipital ligament, anterior atlanto-axial ligament, anterior longitudinal ligament and the anterior sacrococcygeal ligament
Which rangeof motion is least for the L5/S1 vertebral couple?
oneside lateral bending
Which range of motion is least for L1-L5 vertebral couples?
one side axial rotation
Which range of motion is greatest for all lumbar vertebral couples?
flexion-extension
Which vertebral couple of the lumbar spine has the greatest range of motion?
L5/S1
What are the attachment sites for teh accessory iliolumbar ligament?
transverse process of L4 and iliac crest
Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?
inferior iliolumbar ligament
Which ligament from the iliolumbar ligament complex will attach to the sacral ala?
inferior iliolumbar ligament
Which of the current ligaments from the iliolumbar ligament complex repressents the iliolumbar ligament of classical descriptions?
superior iliolumbar ligament
Which ligaments replace the intertransverse ligment at the lubosacral joint?
iliolumbar ligament and lumbosacral ligament
Which range of motion is least for lower thoracic vertebral couples?
one side axial rotation
Which range fo motion is greatest for lower thoracic vertebral couples?
flexion-extnsion
Which vertebral copules of the thoracic spine have the greatest motion?
T11/T12 and T12/L1
What are the attachemtn sites for the lumbocostal ligament?
neck of the 12th rib and the transverse process of L1
What is the function of the superiro costotransverse ligment?
limitation of lateral bending or maintianing lateral stability
What are the attachment sites for teh inferior costotransvserse ligametn?
neck of the rib and transverse process of the vertebra at that level
Which vertebral will have an attachment for teh inferior costotransverse ligament?
T1-T11
What is the name of teh space between the transversse process and the neck of the rib?
costotransverse foramen
Which ligament “fills” the costotoransverse foramen?
infeiror costotransverse ligament
What are the attachment sites for the lateral costotransverse ligament?
non-atricular surface of teh tubercle of the rib and the transverse tubercle of the transverse process of the vertebra at that level
Which vertebral wil have an attachemtn for the lateral costotransverse ligament?
T1-T11
Which vertebra will lack an attachment for the lateral costotransverse ligament?
T12
What are the attachment sites of the interosseous sacroiliac ligament?
at the sacral tuberosity and iliac sulcus
What is the relationship between the capsular and interosseous sacroiliac ligaments?
interosseous sacro-iliac ligament replaces the capsular ligament posteriorly
What passes between the layers of the interosseous sacro-iliac ligament?
dorsal rami from the sacral spinal nerves
What forms the falciform process?
continuation of the sacrotuberous ligament along the ischial ramus
What separates the greater sciatic and lesser sciatic foramina?
sacrospinous ligament
What vertebral levels correspond to the position of the manubrium sterni?
T3-4
What separates the manubrium sterni and corpus sterni?
manubriosternal symphysis
What vertebral levels correspond to the position of the corpus sterni?
T5-9
How many sternabrae for the corpus sterni?
4 sternabrae
What articular sites for the costal cartilage of teh ribs will be identified on the corpus sterni?
costal notches II-VII
What feature of the corpus sterni is present in 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 muscle
Which groove on the body (corpus or shaft) of the first rib is close to the vertebral end?
groove for the subclavian artery and first thoracic nerve
Which groove on the body (corpus or shaft) of the first rib is close to the sternal end?
groove for the 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 unique feature is present on the body (corpus or shaft) of the second rib?
tuberosity of the serratus anterior
What are the classifications of ribs 8-9 in the typical adult skeleton?
typical ribs, false ribs, costa spuriae, vertebrochondral ribs
What are the classifications of rib 10 in the typical adult skeleton?
atypical rib, false rib, costa spuriae, vertebrochondral rib
What are the classifications of the ribs11 or 12 in a typical adult skeleton?
atypical ribs, false ribs, costa spuriae, vertebral ribs
What are the joints of the anterior thorax?
costochondral, sternocostal or sternochondral, interchondral and sternal joints
What ribs will participate in the sternocostal or sternochondral joint?
rib1-7
What is the classification of the first sternocostal or sternochondral joint?
cartilaginous (amphiarthrosis) synchondrosis
What is the classification of the second-seventh sternocostal or sternochondral joint?
synovial plane (diarthrosis arthrodia)
Which of the sternocostal or sternochondral ligaments is unique to the second sternocostal or sternochondral joint?
intra-articular ligament
The capsular ligament is present at which interchondral joints?
the 6-9th interchondral joint
What is the classification of the 6th-9th interchondral joints?
synovial plane (diarthrosis arthrodia)
What is the classification of the 5-6th or 9-10th interchondral joint?
fibrous (amphiarthrosis) syndesmosis
Which costal cartilages fil to form a joint at their sternal end?
11-12th costal cartilages
In the developing sternum, what joint classification is present between the manubrium, corpus and xiphoid process?
cartilaginous (amphiarthrosis) symphysis
Primary centers of ossification for the sternum first appear at what age?
5th fetal month
In what part of the sternum will a secondary center of ossification appear?
xiphoid process
In what part of the rib will secondary centers of ossification appear?
head, aritcular surface of the tubercle and the non-arituclar surface of the tubercle
Which ribs will deminostrate primary centers of ossification for the body (corpus or shaft)?
all ribs (1-12)
What are the contents of the optic canal?
optic nerve and opthalmic artery
What are the contents of the superior orbital fissure?
the opthalmic veins, oculomotor nerve, trochlear nerve, opthalmic division of the trigeminal nerve, abducent nerve
What bony feature is prominent in the median plane of the middle cranial fossa?
sella turcica
The olfactory nerve exits the cranial vault via what opening?
cribriform plate of the ethmoid bone
What points on the skull are used to measure cranial vault capacity?
nasion, vertex and inion
What points on the skull are used to measure the skull size?
nasion, vertex, inion and gnathion
What is the tip of the external occipital protuberance called?
inion
what forms the indented chin?
well developed bilateral mental tubercles and a slight mental protuberance
What forms a bullet-like chin?
large mental protuberance
What is the name given to the alveolar jugum of the canine tooth in the maxilla?
canine eminence
What is the name given to the outline of the nasal cavity at the front of the skull?
piriform apeture
what is the norma verticalis?
skull viewed from the top
what is the appearance of the intersection of the coronal and sagittal sutures called?
bregma
What is the appearance of the intersection of the lambdois and sagittal sutures called?
lambda
what is the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with both parietal 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 the frontal sinus between the orbits
What are the characteristics of sutura notha (false sutures)?
sutures lacking interlocking of adjacent bone surfaces; typically formed by endochondral ossification
What are the characteristics of the sutura vera (true sutures)?
sutures demonstrating interlocking of adjacent bone surfaces; typically formed by intramembranous ossification
What forms of the roof of the poserior cranial fossa?
tentorium cerebelli
What part of the cerebrum ocupies the posterior cranial fossa?
none; the tentorium cerebelli separates the cerebrum into a space above the posterior cranial fossa
What part os the central nerve system occupies the posterior cranial fossa?
cerebellum, pons, medulla oblongota
What are the contents of the internal acoustic meatus?
cranial nerves VII (facial nerve) and VIII (vestibulocochlear/auditory nerve), nerve intermedius/nerve of Wrisberg/sensory root of VII and the motor root of VII, the vestibular and cochlear roots of VIII and the internal auditory/internal labyrinthine artery and vein
What cranial nerves are located within the juglular foramen?
craial nerve IX (glossopharyngeal), X(vagus) and XI (spinal accessory)
What can the five layers of the scalp spell?
Skin, Connective tissue, Aponeurosis, Loose Connective Tissue, Periosteum (SCALP)
What are the principal sources of the blood to the scalp?
internal carotid and external carotid artery branches
Which divisions of the trigeminal nerve receive sensory information from the scalp?
all 3 divisions; opthalmic, maxillary and mandibular nerve
Which mandibular division, trigeminal nerve branch innervates the scalp?
auriculotemporal nerve
What type of motor fibers to skeletal muscles are given off by the facial nerve?
branchial efferent (BE)
What is the third layer of the scalp associated with?
musclar compnent of the scalp
What muscles are specifically associated with the scalp?
frontalis and occpiptalis bellies of the epicranius muscle
Which muscles lack any attachemtn to bone?
obicularis oris, procerus and risorius
Most of the seventh cranial nerve will exit the skull via what opening?
stylomastoid process
Which divisions of the trigeminal nerve contain somatic afferent (SA) pathways?
all three
The optic canal is located along which wall of the orbit?
superior wall of the orbit
What are the contents of the optic canal?
optic nerve and opthalmic artery
What is the name given to the medial wall of the orbit?
lamina papyracea
The superior orbital fissure is located along which wall of thorbit?
lateral wall fo the orbit
What are the contents of the superior orbital fissure?
oculomotor, trochlear and abducent cranial nerves, opthalmic division of the trigeminal cranial and opthalmic veins
What opening is located along the inferior wall of the orbit?
infeiror orbital fissure
What is contained in the inferior orbital fissure?
maxillary division of trigeminal nerve
What are the layers of the eyelid?
skin, obicularis oculi muscle, tarsal plate/tarsus and palpebral conjunctiva
What are the names given to the modified sebaceous gland in the tarsus of the eyelid?
tarsal or Meibomian gland
What is the function of the Meibomian gland?
produces a thick, hydrophobic substance that prevents tears from overflowing onto the cheeks along the margin of the eyelid
What is the ciliary gland?
modified sebaceous gland at the base of the eyelash
What are the anems given to the modified sebaceous glands of the palpebra?
tarsal gland or Meibomian gland and ciliary gland
What is the name given to the union of the skin at the eye lid margins?
medial palpebral commissure or lateral palpebral commisure
what is the name given to the elevation at the medial canthus?
lacrimal caruncle
What is the crescent shaped appearance of the conjunctiva at the medail canthus called?
plica semilunaris conjunctiva
What is the name given to the elevation at the medial margin of the eyelid?
superior lacrimal papilla or inferior lacrimal papilla
What is the name given to the opening at the lacrimal papilla?
lacrimal punctum
The lacrimal punctum is continuous with what structure?
lacrimal calaliculus
The lacrimal gland is an example of what classification of gland?
exocrine gland
Superior and inferior lacrimal canaliculi drain into what structure?
lacrimal sac
What is the name of the structure draining the lacrimal sac?
nasolacrimal duct
The nasolacrimal duct will open into what specific location?
inferior nasal meatus of nasal cavity
What specific pathways are identified with Visceral Efferent (VE) innervation?
sympathetic and parasympathetic motor pathways
Which cranial nerves are involved in teh Visceral Efferent (VE) parasympathetic pathway to the lacimal gland?
facial and trigeminal (maxillary and opthalmic divisions)
Parasympathetic stimulation of blood vessels in the lacrimal gland will result in what?
vasodilation of blood vessels, increased availability of water to secratory units, thinner or more watery product in lumen
Sympathetic stimulation of teh lacrimal gland will result in what events?
vasoconstriction of blood vessels, limited availability of water to secretory units, more viscous or thcker product formed in the glandular lumen
What are the names of the layers of the eyeball?
fibrous tunic, uveal tranct and retina
What are the parts of the fibrous tunic of teh eyeball?
cornea and sclera
What are the parts of the vascular tunic of the eyeball?
iris, ciliary body, choroid and pupil
What are the parts of the uveal tract of the eyeball?
iris, ciliary body, choroid, pupil
What is the name of the innermost layer of the eyeball?
retina
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 is the most numerous photoreceptor cell?
rod cell
What are the chambers of the eyeball in front of the lens?
anterior chamber and posterio chamber
Wat separates the anterior chamber and posterior chamber in the eyeball?
iris
What is the location of the antieror chamber of the eyeball?
between cornea and iris
What is the location of the posterior chamber of the eyeball?
aqueous humor
What is contained in the posterior chamber of the eyeball?
aqueous humor
What is the name given to the chamber behind the lens?
vitreous chamber
What is the location of the vitreous chamber?
behind the lens, infront of the retina
What fills the vitreous chamber?
vitreous body
What are the common characteristics in origin and insertion of all rectus extraocular muscles?
they all originate from a common annular tendon in the orbit
they all insert into the sclera in front of the corona equator of the eyeball
What is the common characteristic regarding the insertion of both oblique extraocular nuscles?
both insert onto sclera on the lateral margin of the eyeball behind the coronal equator
What is the common characteristic concerning the insertion of the superior and inferior rectus extraocular muscles?
they insert onto the sclera of the eyeball in front of the coronal equator and are displaced slightly medially
What is the apparent function of the medial rectus extraocular muscle?
pulls the cornea inward/medially; adducts the cornea
What is the apparent function of the lateral rectus extraocular muscle?
pulls the cornea outward/laterally; abducts the cornea
What is the apparent function of the superior rectus extraocular muscle?
pulls the cornea upward/superiorly and at the same time rotates the conea inward; elevation and adduction of the cornea; conjunct movement of intorsion
What is the apparent function of the inferior rectus extraocular muscle?
pulls the cornea upward/superiorly and at the same time rotates the cornea inward; depresssion and adduction of the cornea; conjunct movement of extorsion
What is the apparent function of the superior oblique extraocular muscle?
pulls the back of the eyeball upward and inward which causes the corena to rotate conjunct movement of intorsion
What is the apparent function of the inferior oblique extraocular muscle?
pulls the back of the eyeball downward and inward which causes the cornea to rotate upward and outward; elevation and abduction of the cornea; conjunct movement of extorsion
What is the embryonic origin of the extraocular muscles or extrinsic muscles of the eyeball?
skeletal muscle is derived from the somites hence somatic efferent (SE)
Which nerves will innervate specific extrinsic/extraocular muscles?
oculomotor- superior rectus, medial recuts, inferior rectus, inferior oblique
trochlear- superior oblique
abducens- lateral rectus
What type of cartilage forms the auricle?
elastic cartilage
What feature are commonly observed in the skin of the ear?
hair follicles, sweat glands, sebaceous glands
What is the helix of the external ear?
rounded outer rim of the auricle
What is the rounded outer rim of the auricle called?
helix
What is teh name given to the anterior fold of the helix above the tragus?
crus of helix
What consititutes the crus of the helix of the external ear?
anterior fold of the helix above the tragus
What is the spine of the helix of the external ear?
palpable anterior projection of the helix
What is the palpable anterior projection of the helix of the external ear called?
spine of the helix
What is the scaphoid fossa of the external ear?
depression under the rim of the helix
The depression under the rim of the helix of the external ear is called…?
scaphoid fossa
The rounded inner rim of the external ear is called the…?
antihelix
What is the antihelix of the exernal ear?
rounded inner rim of the external ear
The antihelix of the external ear divides to form the…?
superior crus and inferior crus of the antihelix
What is the superior crus of the antihelix of the external ear?
rounded linear upper extension of the antihelix
What is the inferior cruse of the antihelix of the external ear?
rounded linear lower extension of the antihelix
What is formed between the crura of the atihelix of the external ear?
triangular fossa
What is teh cymba concha of the external ear?
part of the concha between the helix and the inferior crus of the antihelix
What feture is between the inferior crus of the antihelix and the helix of the auricle?
cymba concha
What is the name of the cavity leading to the external auditory meatus?
chona
What is the name of the eminence anterior to the concha?
tragus
What is the name given to the “goat’s bear” of the auricle?
tragus
What is the name of the indentation between teh tragus and antitragus?
intertragic incisure
What is the name of the rounded elevation superior to the lobule of the auricle?
antitragus
What is the name given to the fatty, suspensory, inferior part of the auricle?
lobule
The lateral third of the external acoustic meatus is protected by…?
cartilage
The medial part of the external acoustic meatus is protected by…?
temporal bone
Skin lining the external acoustic meatus contains what modified sebaceousglands?
ceruminous glands
What is cerumen?
product of ceruminous glands forming the bulk of ear wax
What vein is formed within the parotid gland?
retromandibular vein
What veins unite to form the retromandibular vein?
superficial temporal and internal maxillary veins
Within the parotid gland what does the facila 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 facila nerve penetrates the parotid gland, but is not given off within it?
chorda tympani nerve
What is the superior boundary for the temporal region?
temporal lines of the paritetal and frontal bones
What forms the floor of the temporal region?
pterion (sphenoid, parital, temporal, frontal bones)
What is teh major feature of the temporal region?
temporalis muscle
The temporal region is vascularized by which branches of the external carotid artery?
superficial temporal artery
The temporal region is drained by which vein?
superficial temporal vein
What are the contents of the infratemporal region?
medial and lateral pterygoid muscles, internal maxillary artery and branches, pterygoid venous plexus, internal maxillary vein, branches of the trigeminal and facila nerves and otic ganglion
What is the innervation of each muscle of mastication?
medial pterygoid (medial pterygoid nerve, mandibular division, trigmeninal)
lateral pterygoid (lateral pterygoid nerve, mandibular division, trigeminal)
masseter (masseteric nerve, mandibular division, trigeminal)
temporalis (anterior and posterior deep temporal nerves, mandibular division, trigeminal)
What are the extracapsular ligaments of the temporomandibular joint?
temporomandibular/lateral ligament, stylomandibular ligament, sphenomandibular ligament
What does the lateral/temporomandibular ligament represent?
thickening of the fibrous capsule of the temporomandibular joint
What are the attachment sites of the stylomandibular ligament?
styloid process of the temporal bone to the angle of the mandible
What does the stylomandibular ligament represent?
a thickening of the deep cervical fascia
What are the attachemtn sites of the spenomandibular ligament?
spine of the sphenoid bone to the lingula of the mandible
What muscles act to depress the mandible or open the mouth?
lateral pterygoid along with the suprahyoid and infrahyoid muscles
What muscles act to elevate the mandible or close the mouth?
temporalis, masseter and meidal pterygoid
What muscles act to protract the mandible or protrude the chin?
masseter, meidal pterygoid and lateral pterygoid
What muscles act to retract the mandible or pull the chin back?
temporalis
What are the names given to the opening of the mouth?
oral orifice, oral fissure, rima oris, or the rima of the mouth
What is the name given to the space between the lips and the teeth?
labial vestibule
What is the name given tot he space between the cheecks and teeth?
buccal vestibule
What is the name given to the junction between the skin and the red region of the lip?
vermillion border
What is the name given to the red region of the human lip?
vermillion zone
What is the name given to the median depression of the upper lip?
philtrum
What is the name given to the depression extending from the nasal ala to the corner of the upper lip?
nasolabial groove/sulcus
What is the name given to the horizontal furrow between teh lower lip and the chin?
mentolabial groove, the labiomental groove, mentolabial sulcus or the labiomental sulcus
What is the name given to the union of the upper and lower lips at the corner of teh mouth?
labial commissure
Wat is the name given to the attaching material in the midan plane from thelip to the gingiva proper?
supeiror labial frenulum or the inferior labial frenulum
What cutaneous or superficial branches arise from the cervical nerve plexus?
lesser occipital nerve, ventral primary ramus of C2
greater auricular nerve, ventral rami of C2, C3
transverse cervical nerve, ventral primary rami of C2 and C3
Supraclavicular nerve, ventral primary rami of C3 and C4
