Final exam flash cards
what motion is particularly associated with lumbar spondylolysis?
hyper-extension 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 functions have been associated with the spondylolysis ligament?
nociception, neuromodulation and autonomic function
what is the appearance of the lumbar vertebra upon oblique xray view?
a Scotty dog
what is the appearance of a pars defect in a lumbar vertebra upon oblique xray view?
a collared Scotty dog
what is the appearance of a spondylolysis in a lumbar vertebra upon oblique xray view?
a collared scotty dog
in an oblique xray, spondylolysis below the superior articular process of a lumbar pars interarticularis is associated with what part of the scotty dog?
the neck of the scotty dog
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 is the incidence of sacral spondylolysis in the general population?
it is rare
what ethnic group is associated with a high incidence of sacral spondylolysis?
the native Alaskan (inuit) population
is sacral spondylolysis the result of congential conditions, acquired conditions or an age related condition?
it seems to be aquired
what activities are associated with sacral spondylolysis?
kayaking and harpooning
what is the ethnic, gender, and locational bia associated with sacral spondylolysis?
the native alaskan male at the S1 level
what is the definition of spondylolisthesis?
a vertebral slippage
what vertebral condition results in spondylolisthesis?
bilateral spondylolysis
what is the direction of spondylolisthesis?
anterior or forward displacement
what is the posterior direction of vertebral slippage called?
retrospondylolisthesis or retrolisthesis
identiy all names given to type 1 spondylolisthesis?
dysplastic spondylolisthesis, congenital spondylolisthesis
what is the locational bias of type 1 spondylolisthesis?
L5 or upper sacral segments
what is the location of the defect associated with type 1 spondylolisthesis?
more frequently the vertebral arch
what additional conditions are linked to type 1 spondylolisthesis?
spina bifida occulta and nerve root compression of the S1 nerve
identify all the names given to type II spondylolisthesis?
isthmic spondylolisthesis
which subtype of type II spondylolisthesis is stressed in Spinal II?
lytic spondylolisthesis or stress fracture induced spondylolisthesis
what is the cause most frequently given for type II spondylolisthesis?
microfractures as the result of repetitive stress during hyperflexion and rotation
what is the age group typically associated with type II spondylolisthesis?
teenagers or young adults
will spondylolisthesis always result in type II spondylolisthesis?
no, particularly in cases of unilateral spondylolysis
what spinal canal dimensions are associated with type II spondylolisthesis?
isthmic spondylolisthesis demonstrates an increase in sagittal diameter of spinal canal
what is the gender bias and locational bias associated with type II spondylolisthesis?
isthmic spondylolisthesis is common in men at the L5/S1 level
what conditions are often associated with type III spondylolisthesis?
degenerative spondylolisthesis is often associated with osteoarthritis, intervertebral disc degeneration, ligament laxity and articular facet remodeling
what is the gender bias, 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 cord
identify all names given to type IV spondylolisthesis?
traumatic spondylolisthesis
what causes type IV spondylolisthesis?
fracture of the neural arch components
is there a gender, locational, or age bias associated with type IV spondylolisthesis?
no
identify all the names given to type V spondylolisthesis?
pathologic spondylolisthesis
what are the causes associated with type V spondylolisthesis?
bone diseases such as Paget disease or osteogenesis imperfecta
what determines the length of intervertebral foramen?
the width of the pedicle
what may extend the length of the intervertebral foramen?
the TVP, muscles or ligaments
what forms the superior boundary for the typical intervertebral foramen?
the inferior vertebral notch of the pedicle above
what is the average height of the intervertebral foramen?
about 13mm
what percent of total vertebral column length does “true” intervertebral foramina height from C2 to S1 equal?
About 40%
what percent of total vertebral column length does all intervertebral foramina height from occiput Co1 equal?
53%
what are the generic contents of the intervertebral foramen?
neural tissue, connective tissue, vascular tissue, lymphatic tissue
what is the percent of neural tissue in the IVF?
from 8 to 50%
what are the characteristics of the Artery of Adamkiewicz?
it is a left side, anterior medullary feeder artery, located in the T9/T10 IVF, and the primary vascular supply to the lumbar enlargement
what is the most likely region of the thoracic spine for herniation?
below T8
what will the Intervertebral veins drain into?
the external vertebral venous plexus or Batson’s plexus
what is a unique histological feature of the veins of the vertebral column?
they appear to lack valves
what size of lymphatic vessels lie in the IVF?
medium sized lymphatics
what type of connective tissue will be present in the IVF?
adipose tissue and loose alveolar connective tissue
what is the relationship of cervical IVF height to nerve root size?
the height increases but the nerve root size stays about the same from cranial to caudal
what parts of the cervical vertebra will modify the IVF?
the lateral groove and uncinate processes
what is the relationship between aging and cervical spine nerve root characteristics?
the length of the nerve root increases as it descends fro its apparent origin on the spinal cord, but the cross-sectional area of the nerve root decreases
what are the specific attachment sites for a cervical spinal nerve?
the sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery
what contributes to the anterior boundary of the thoracic IVF?
the costocentral joint
what is the amount of contribution of the IVD to the height of the lumbar IVF?
about half
which are the largest spinal nerves?
L5 and S1 spinal nerves
what increases the length of the IVF at L5
the lumbosacral tunnel
what forms the lumbosacral tunnel?
the lumbosacral ligament, transverse process of L5 and sacral ala
what condition is the result of encroachment on the L5 spinal nerve?
the far out syndrome
what ligaments may contribute to the loss of size in the lumbar IVF?
the transforaminal ligament and the corporotransverse ligament
what is unusual about the sacral IVF compared to other IVF?
a completely osseous boundary exists
what is more likely the cause of nerve irritation at the sacral IVF?
the tilt or position of the entire sacrum relative to the pelvis
what is unique about the relationship of spinal nerve to IVF at S5-Co1?
there are two nerves present, S5 nerve and Co1 nerve
what are some examples of destructive lesions of vertebral body?
tuberculosis, hemangiomas, osteoporosis
what may reduce the impact of IVD loss of integrity on the IVF in cervical and thoracic spine?
the joint of Lushka in the cervicals, the costocentral joint in the thoracics
what are examples of osteophyte formation that influence the IVF?
the bony spurs of the vertebral body and para-articular processes on the lamina
what are examples of acquired alterations of the spinal curves identified in class?
obesity, pregnancy and the use of heavy backpacks
what is the recommended weight of a backpack compared to individual weight for the developing spine?
backpack weight should not exceed 10% individual body weight
what are the curvatures of the vertebral column?
anterior, posterior, and lateral
what is the direction of the primary curve of the vertebral column?
posterior
why is the posterior curve also called the primary curve?
it is the first curve to appear embryologically
what are the adult remnants of the primary curve along the vertebral column
the thoracic or dorsal curve and the pelvic or sacrococcygeal curve
what are the names given to curves that form during development to reverse the direction of regions along the vertebral column
anterior curve, secondary curve, compensatory curve
what are the names of the anterior curves, secondary curves, and compensatory curves?
cervical curve and lumbar curve
what segmental levels form the cervical curve
C2-T1
what segmental levels form the lumbar curve?
T12 to L5
what is the earliest time of appearance of the cervical curve?
the third fetal month
what is the traditional time of appearance of the cervical curve said to be?
during the last timester in utero
what is the time during which the “adult” cervical curve is said to appear
within the first year after birth
what development 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 IVD height becomes greater anterior than posterior
at what age will the infant begin to hold the head erect?
usually between 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 for the apex of the cervical curve?
typically between C4 and C5
what is the location for the cervical kyphosis?
between occiput and C1
what is the name given to the primary cervical curve?
cervical kyphosis
what is the vertebral relationship between the cervical curve and the cervical enlargement?
cervical curve C2-T1; cervical enlargement C3-T1
what is the time of appearance of the lumbar curve?
between 12 to 18 months after birth
what infant activities are associated with the developmental of the lumbar curve?
crawling and walking
what developmental events are indicated in the formation of the adult lumbar curve?
- crawling will cause the abdomen to put tension on the lumbar region and pulls it forward
- muscle development is promoted to compensate for the swayback of the lumbars
- IVD height will become greater anterior compared to posterior
- walking in further promote muscle and IVD development
what its within the IVD to facilitate the lumbar curve development?
the nucleus pulposus of L4 will shift its position within the annulus fibrosis
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 is the vertebral relationship between the lumbar curve and the lumbar enlargement?
lumbar curve T12-L5; lumbar enlargement T9-T12
what is the formation of the lateral curve often correlated with?
faster development of the muscles on the side of handedness
what is the time of appearance of the lateral curves
they appear after 6 years old
what location of lateral curves are recognized?
cervical, thoracic or dorsal, and lumbar
which lateral curves are best developed
thoracic or dorsal, and lumbar
what is the relationship between curve direction and handedness?
a right handed person has a high probability for a right thoracic, left lumbar curve combination
what is the incidence of a right thoracic, left lumbar curve combination in the population
about 80% of the population demonstrates this
what does the suffix “osis” mean?
a condition
does osis infer a normal or an abnormal condition
neither, it is non-judgmental
what generic names identified abnormal curves of the vertebral column?
lordosis, kyphosis, scoliosis
what is the definition of lordosis
a forward bending condition
what is the definition of kyphosis
a humpback or hunchback condition
what is the definition of scoliosis
a warped or crooked condition
what is the direction of the curve deviation in lordosis?
to the anterior
what is the direction of the curve deviation in kyphosis
to the posterior
what is the direction of the curve devitation in scoliosis
to the side (it is a lateral curve deviation)
is there a locational bias for the classic definition of lordosis?
no, there would be an increase in the anterior direction in the cervical spine, a decrease in the posterior direction in the thoracic spine, an increase in the anterior direction in the lumbar spine and a decrease in the posterior direction in the pelvic or sacrococcygeal region
is there a locational bias for the classic definition of kyphosis?
no, there would be a decrease in the anterior direction in the cervical spine, and increase in the posterior direction in the thoracic spine, a decrease in the anterior direction in the lumbar spine, and an increase in the posterior direction in the pelvic or sacrococcygeal region
what clinical abnormal curvatures of the vertebral column were stressed in class
military neck, humpback/hunchback, and swayback
what is military neck
a decreased anterior curve in the cervical region, a straight neck
what is humpback or hunchback
an increased posterior curve in the thoracic region
what is swayback
an increased anterior curve in the lumbar region
what is classic classification of military neck
kyphosis
what is classic classification of humpback or hunchback
a kyphosis
what is classic classification of swayback
lordosis
what does the use of the term lordotic try to imply
a normal cervical and normal lumbar anterior curve
what does the use of the term kyphotic try to imply
a normal thoracic or dorsal and normal pelvic or sacrococcygeal posterior curve
what prefixes are used to convey abnormality in curve patterns
hyper and hypo
what does the term hyperlordotic infer
an increase in the anerior curve of the cervical or lumbar region
what does the term hypolordotic infer
a decrease in the anterior curve of the cervical or lumbar region
what does the term hyperkyphotic infer
an increase in the posterior curve of the thoracic/dorasal or pelvic/sacrococcygeal region
what does the term hypokyphotic infer
a decrease in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region
what are the curve classifications for military neck
a kyphosis or hypolordotic curve
what are the curve classifications for humpback or hunchback
a kyphosis or hyperkyphotic curve
what are the curve classifications for swayback
a lordosis or hyperlordotic curve
what is the more complete, accepted definition of scoliosis
an abnormal lateral curve coupled with axial rotation
what is the radiological test for skeletal maturity
the Risser sign, an indication of bone maturity in the iliac apophysis
what are the classifications of scoliosis according to the scoliosis research society
magnitude, location, direction, etiology, structural scoliosis and nonstructural scoliosis
what does magnitude of scoliosis refer to?
the length and angle of the curve deviation on xray
what is often used to measure the magnitude of scoliosis
the cobb method
what does the location of scoliosis infer
the location of the vertebral segment forming the apex of the curve deviation
what does the direction of scoliosis refer to
the side the convexity of the curve will bend toward
what does etiology of scoliosis mean
the cause of the scoliosis
what is structural scoliosis
a more radical form of scoliosis, it may worsen, associated with structural deformities of the vertebra or IVD, 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 IVD and lacks a fixed angle of trunk rotation
what is the classification of scoliosis that is unique to the individual patient?
idiopathic scoliosis
what does idiopathic scoliosis infer?
the scoliosis is unique to the individual, it has no known cause, unknown etiology
what is the incidence of idiopathic scoliosis in the population
1% to 4% of the population
based on age of onset, what are the types of idiopathic scoliosis
infantile, juvenile, and adolescent
waht is the age range for infantile idiopathic scoliosis
from birth to 3 years old
what is the age range for juvenile idiopathic scoliosis
from 3 years old to 10 years old
what is the age range for adolescent idiopathic scoliosis
over 10 years
identify curve direction, location, gender bias and incidence of infantile idiopathic scoliosis
left thoracic, male, less than 1% incidence
identify curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis
right thoracic, females over 6 years old, and 12% - 21% incidence
identify curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis
right thoracic or right thoracic and left lumbar, females, and 80% incidence
what is the genetic factor associated with adolescent idiopathic scoliosis
an autosomal dominant factor that runs in families
what is the relationship between curve deviation, incidence, and curve worsening?
the greater the deviation, the lower the incidence, and the more likely to worsen
what is the name given to segments that lie in the transition zones of the vertebral column
transition vertebrae
what are the transition zones of the vertebral column
occitiocervical, cervicothoracic, thoracolumbar, lumbosacral, and sacrococcygeal zones
how are specific segments within a transition zone identified
by adjacent region of the segment, process of transition, and specific segment (occipitalization of C1)
what doe the suffix “ization” refer to
in the process of becoming like
what are the possible transition zone - segmental combinations
cervicalization of occiput, occipitalization of C1, dorsalization of C7, cervicalization of T1, lumbarization of T12, dorsalization of L1, sacralization of L5, lumbarization of S1, coccygealization of S5, sacralization of Co1
what is/are the characteristic of cervicalization of occiput
an increase in occipital bone size, formation of new or larger lines on the occipital bone,
what is/are the characteristics of occipitalization of C1
the atlas may be partially or completely fused to the occiput
what is another way of implying occipitilization 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 the odontoid process fuse
at or shortly after birth
what joint forms between the odontoid process ossification centers and the centrum of C2
the subdental synchondrosis
what joint classification is present between the C2 odontoid process and centrum
amphiarthrosis synchondrosis
ossification between the odontoid process and centrum joint of C2 appears at what age
4 years old
a joint between the odontoid process and centrum of C2 is las 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 an os odontoideum
a persistence beyond age 7 of the joint formed between the centrum and odontoid process centers of ossification
what is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7
persistent subdental synchondrosis
what is the name given to the joint formd between the tip of the dens and the odontid process centers of ossifications
tip of the dens synchondrosis
what is the classification of the joint formed between the tip of the dens and odontoid process centers of ossifications
amphiarthrosis synchondrosis
at what age will the tip of the dens center 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 fuse with odontoid process
before age 12
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 a basilar impression
persistence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain
what is a basilar invagination
the upper cervical spine appears to be invaginated into the skull on xray analysis
what is the incidence of rib related changes following dorsalization of C7
from one half to two and one half percent of the population
do patients typically present with symptoms specific for dorsalization of C7
no, they are typically asymptomatic
what is the gender bias suggested in dorsaliztion of C7
female
what alteration in C7 facet orientation may accompany dorsalization
the superior articular face of C7 may change from back, upward, and medial to that of a typical thoracic facet… backupward and lateral; the inferior articular facet is unchaged
that alteration in C6 facet orientation may accompany dorsalization
c6 demonstrates a change in infereor articular facet orientation from forward lateral downward to forward medial and downward; the superior articular facet unchaged
what percent of the population may demonstrate thoracici like features at c7
up to 46%
what rib related changes may accompany cervicalization of t1
the first rib may decrease in mean relative length or become absent
what will result from fusion of a short rib to the t1 TVP
the transverse foramen
what t1 facet orientation changes may accompany cervicalization
the superior articular facet may change from BUL to BUM; the inferior articular facet is unchanged
what c7 facet orientation changes may accompany cervicalization
the inf. articular facet may change from FMD to FoLD; the superior articular facet is unchanged
what is the incidences of cervicalization of t1 in the population
up to 28% of the population
what rib related changes may accompany dorsalization of L1
elongated bones shaped like ribs may appear
what is the incidence of lumbar ribs in the population
over 7% of the population demonstrates lumbar ribs
what L1 facet orientation changes may accompany dorsalization
the sup articular facet may change from concave BUM to flat BUL; the inf articular facet is unchanged
what T12 facet orientation changes may accompany dorsalization
the inf art facet may change from convex FLD to flat FMD; the sup art facet is unchanged
what is the gender bia associated with dorsalization of L1
males are two to three times affected
what rib related changes may accompany lumbarization of T12
a significant shortening of the mean relative lengt of 113 mm of the 12th rib or it becomes absent
what t12 facet orientation changes may accompany lumbarization
the sup art facet may change from flat BUL to concave BUM; the inf art facet is unchaged
what t11 facet orientation changes may accompany lumbarization
the inf art facet may change from flat FMD to convex FLD; the sup art facet is unchagned
what is characteristic of lumbarization of S1
the failure of synostosis between S1 and S2, squaring the VB of S1 and flaring of the sacral ala
what unique characteristic s of lumbarization of S1 were stressed in class
squaring of the VB of S1 and flaring of the sacral ala
what is failure of synostosis between S1 and S2
the segments do not completely fuse together
what art facet changes accompany lumbarization of S1
none
what is characteristic of sacralization of L5
L5 may be partially or completely fused to the sacrum
what is the incidence of sacralization of L5 in the population
41 to 85%
which segment demonstrates the greatest mophological variation along the spine
L5
what articular facet changes accompany sacralization of L5
none
what is the incidence of variation within the sacrococcygeal region in the population
up to 14%
what is the characteristic of sacralization of Co1
the premature fusion of co1 to the sacrum
what is characteristic of coccygealization of S5
the separation of S5 from sacrum and its premature fusion to Co1
what forms the spinal accessory nerve innervation the trapezius
C1-C5 cord levels contribute to the spinal root of the spinal accessory nerve
what forms the thoracodorsal nerve innnervation the lat dorsi
ventral rami from c6-c8
what forms the dorsal scapular nerve
the ventral ramus of c5
An increase in the density of muscle spindles is most apparent in which suboccipital muscle
Obliquus capitis inferior
What is the result of communication between suboccipital muscle, visual centers and vestibular centers
Coordination of head and eye
position
WHat is the proposed function of the suboccipital muscle group
Postural stabilizers of the Atlanto-occipital and Atlanto-axial joints
Which suboccipital muscles are known to attach to dura mater
Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior
Interspinalis is paired in which regions of the spine
Cervical and lumbar regions
BAsed on the density of muscle spindles what is the proposed function of the interspinalis
Acts as a proprioceptive transducer in conjunction with intertransversarii to coordinate the smooth movement of the spine and to maintain appropriate posture
Intertransversarii are paired in which regions of the spine
Cervical and lumbar regions
WHat are the names of the parts of the intertransversarii in the lumbar spine
Medial belly, ant. Lateral And posterior lateral belly
BAsed on the density of muscle spindles what is the proposed function of the intertransversarii
Acts as a proprioceptive transducer in conjunction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture
what are the four consistent features of synovial (diarthrosis) joints
articular or fibrous capsule, synovial membrane, articular cartilage and synovial fluid
thickening of the fibrous capsul connective tissue will form the ___
capsular ligament
what generic accessory ligaments may accompany and support the capsular ligament
intracapsular and extracapsular ligaments
what are common characteristics of type 1 articular receptors
located in the superficial layer of the fibrous capsule, resemble ruffini endings, most numerous in cervical zygapophyses and they monitor the joint “at rest”
what are the characteristics of type 2 articular receptors
located in deeper strata of the fibrous capsule, resemble pacinian corpuscles, most numerous in the cervical spine and monitor the joint during normal range of motion
what are the characteristics of type 3 articular receptors
present in collateral and intrinsic ligaments, resemble Golgi tendon organs, not initially observed along the vertebral column and monitor extreme joint motion
what is the function of type IV articular receptors
nociceptive, they monitor pain
type IVa articular receptors would be present in what locations
fibrous capsule, articular fat pads or adventitia of blood vessels
type IVb articular receptors are absent in what part of the synovial (diarthrosis) joint
accessory ligaments in general, dense in the posterior longitudinal ligament of the spine
what are the three modifications of articular synovial mebrane
- synovial villi
- articular fat pads or haversian glands
3synovial menisci and intra articular discs
what is the generic function of modifications of articular synovial membrane
aid in spreading synovial fluid
articular fat pads are most numerous in what location along the vertebral column
lumbar zygapophyses
condensed fibrous connective tissue or fibrocartilage projections of the synovial membrane are called
synovial menisci or intra articular discs
synovial menisci are a feature of what joint examples
femur-tibia articulation, cervical zygapophyses and lumbar zyga’s
what are the specific functions of type A synovial cells
are phagocytic
what is the specific function of type B synovial cells
secrete proteinaceous substances and hyaluronic acid
what is the common function of type A and type B synovial cells
formation and absorption of synovial fluid
what is the source of nutrition for articular cartilage
blood vessels in the synovial membrane, sinuses of the bone marrow cavity and synovial fluid itself
what are the primary constituents of articular cartilage
water, cells, collagen type II fibers and a proteoglycan gel
what is the primary function of bound gag’s in articular cartilage
form a network for water retention
what is implied when cartilage is said to have elastic properties
cartilage can deform and returns to original volume rapidly, a time independent property
what is implied when cartilage is said to have viscoelastic properties
cartilage can deform but returns to original volume slowly, a time dependent property
what is the function of articular cartilage
to provide a wear resistant, low friction, easily lubricated surface for joint movement
what are the properties of synovial fluid
it is yellow white, viscous, slightly alkaline and tastes salty
synovial fluid consists of what specific chemical groups
fats, salts, albumins, hyaluronate
which substance in synovial fluid was first thougt to be responsible for its viscosity and lubricating behavior
hyaluronate
what substance of synovial fluid has been proposed to be responsible for its viscosity and lubricating behavior
lubricin
what are the classifications of synovial joints (diarthroses) based on the number of articulating surfaces
simple and compound synovial joints
what is a complex synovial joint (diarthrosis)
within the simple joint or the compound joint, the articulating surfaces surfaces are separated by an articular disc (intra articular disc) or meniscus
identify the common ligaments of the vertebral column
the 9 column ligaments are the ALL, IVD, PLL, ligamentum flavum, capsular ligament, interspinous ligament, ligamentum nuchae, supraspinous ligament and intertransverse ligament
what is the maximum number of common ligamnets identified with vertebral couple
8
what is the reason that nine common ligaments are identifiied 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 column
what is the number of true IVD identified in the adult
23
in the adult which vertebral levels will demonstrate a true IVD
those between C2 and S1 inclusive
what percent of the vertebral column length is contributed by the IVD
20-25%
what is the length of the IVD constribution to the vertebral column length
about 7 inches
what is the percent of IVD height contribution to the length of each region of the vertebral column
cervical…22-25%, thoracic…20%, lumbar…33%
what is the cervical nucleus pulposus composed of
fibrocartilage
what is the water concentration in the lumbar nucleus pulposus at birth and after thirty
birth…88%, thirty…70%
what cell is associated with the nucleus pulpos usuntil about age 11
notochord cells
what cells are associated with mature nucleus pulposus
reticulocyte-fibrocblast and chondroblast
which type of collagen is dominant in the nucleus pulposus
collagen type II
what is the organizational pattern for collagen fibers in the nucleus pulposus
they are irregularly oriented and randomly scattered
what is unusual about the cervical annulus fibrosus
it lacks any lamellar or layered organization
what is the appearance of the cervical annulus fibrosus
a horse shoe with the anterior margin thick and lateral margins tapering to the uncinate processes, the posterior margin is thin
what compensates for the thinness of the posterior part of the cervical annulus fibrosus
PLL
what is the organization of the lumbar annulus fibrosus
it has 12-14 concentric cylindrical lamellae
what is the water concentration in the lumbar annulus fibrosus at birth and after thirty
birth = 78%, thirty = 70%
which type of collagen is dominant in the anulus fibrosus
collagen type I
what is the organizational pattern for collagen fibers in the annulus fibrosus
they are parallel with one another in a single lamellus and angled
what is the organization of collagen fibers between lamellae
collagen fibers will be angled in the opposite direction such that a spiral/counter-spiral organization is observed
what is the average angle of collagen fibers within the annulus fibrosus
they average 50 to 60 degrees
what is the thickest part of the cartilage end plate
around the periphery
what is the principle type of collagen fiber within the cartilage endplate
the 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 annulus fibrosus
the cartilaginous end plate
what part of the IVD is innervated
the outer lamellae of the annulus fibrosus
what are the types of receptor endings in the IVD
nociceptors and proprioceptors
what is the relationship between size of the IVD and receptor endings
the larger the disc, the greater the variety of receptor endings
what is the proposed function of receptor ending density in the anterior part of the IVD
they provide feedback during extension
what innervates the annulus fibrosus at the posterior part of the IVD
the recurrent meningeal/sinu-vertebral/sinus vertebral nerve
what innervates the annulus fibrosus at the anterior part of the IVD
the fibers from the ventral primary ramus
what is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the IVD
the paradiscal ramus communicans
what vertebral levels will the ALL attach to
those between occiput and S3 inclusive are traditionally indicated
what is the lowest extent of the ALL based on recent studies
L3
what is the function of the ALL
it brakes or limits dorsi-flexion or hyperextension of the vertebral column
what was ossification of the ALL in the lumbar region identified as
Forestier’s disease
ALL ossification in the lumbar region is now identified as
diffuse idiopathic skeletal hyperstosis or DISH
what is the function of the ligamentum flavum
it brakes or limits flexion of the vertebral column
what is now thought to be a major function of the ligamentum flavum
it is an early prime factor in extension of the vertebral column
where is ossification of the ligamentum flavum most commonly identified
the thoracic spine or thoracolumbar transition zone
what is the acronym for ossification of the ligamentum flavum
OLF
what is the relationship between the capsular ligamnet and mobility
the more lax/loose the capsular ligament is, the greater the motion of the joint
what regions of vertebral column demonstrate the greatest laxity of capsular ligaments
the cervical and lumbar regions
the capsular ligament may blend with which other common ligament
the ligamentum flavum
what muscle will blend with the capuslar ligament posteriorly
the multifidis
if the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its function
it is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement
what vertebral levels will the interspinous ligament be attached to
those between C2 and S1 inclusive are traditionally indicated
what is now thought to be a major function of the interspinous ligament
it is more likely a proprioceptive transducer for the spinal reflex
what will the ligamentum nuchae be attached to
the EOP, EOC, posterior tubercle of the posterior arch of C1, and spinous tubercles between C2 and C7 inclusive are traditionally indicated
what is the name given to the superficial layer of the ligamentum nuchae
the funicular layer or part
what is the name given to the deep layer of the ligamentum nuchae
the lamellar layer or part
what are the attachment sites for the superficial layer of the ligamentum nuchae
the EOP, EOC, and spinous tubercle of C7
what is the histological makeup of the ligamentum nuchae in quadrupeds
it is a yellow elastic ligament
what is the histological makeup of the human ligamentum nuchae
it is a yellow elastic ligament, but has more collagen fibers than in quadrupeds
what is the primary yellow elastic or elastic ligament of the spine
the ligamentum flavum
what is the classic function of the human ligamentum nuchae
it brakes or limits flextion of the cervical spine
what will the supraspinous ligament be attached to
the spinous tubercles along the vertebral column from C7 to sacrum
what is the termination level inferiorly for the supraspinous ligament according to current literature
primrily at L4 (73%); between L4 and L5 (5%)j
where is the supraspinous ligament said to be best developed
in the lumbar spine
what is now thought to be a major function of the supraspinous ligament
it is a proprioceptive transducer for the spinal reflex
what will the intertransverse ligament be attached to
the transverse tubercles and TVP of adjacent vertebra along the vertebral column from C1 toL5
what is the status of the cervical intertransverse ligament
it is said to be paried with an anterior and posterior intertransverse ligament present
what is the status of the lumbar intertransverse ligament
it is well developed with two parts identified, a ventral slip and dorsal slip
what part of the lumbar intertransverse ligament covers the intervertebral foramen
the 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
the dorsal slip
what are the characteristics of the capsular ligament of the antlanto-occipital ligament
it is said to be loose, thin, and composed of collagen fibers
what other joint space does the atlanto occipital joint communicate with
the posterior bursa of the median atlanto axial joint
what is the median thickening of the anterior atlanto occipital ligament called
the ALL
which ribs are classified as typical ribs, true ribs, costa verae, and vertebrosternal ribs in the typical adult skeleton?
ribs 3-7
which ribs are classified as atypical ribs, true ribs, costa verae and vertebrosternal ribs in the typical adult skeleton
ribs 1 and 2
which ribs are classified as typical ribs, false ribs, costa spuriae, and vertebrochoncal ribs in the typical adult skeleton
ribs 8 and 9
which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebrochoncal ribs in the typical adult skeleton
rib 10
which ribs are classified as atypical ribs, false ribs, costa spuriae and vertebral ribs in the typical adult skeleton
ribs 11 and 12
what joint classification is now given to the joint between the sternum, clavicle, and first rib
synovial saddle (diarthrosis sellar) joint
what ribs will participate in the sternocostal or sternochondral joint
rib 1 to 7
what is the classic classification of the first sternocostal or sternochondral joint
cartilaginous (amphiarthrosis) synchondrosis
what is the newer suggested classification of the first sternocostal or sternochondral joint
cartilaginous (amphiarthrosis) symphysis
what is the classification of the second - seventh sternocostal or sternochondral joint
synovial plane (diathrosis arthrodia)
what is the classification of the sixth through the ninth interchondral joints
synovial plane (diathrosis arthrodia)
what is the classification of the fifth - sixth or ninth - tenth interchondral joints
fibrous (amphiarthrosis) syndesmosis
which costal cartilages fail to form a joint at their sternal end
the eleventh and 12th costal cartilages
what is the name given to the segments of the sternum
sternabrae (for sternal bodies)
how many primary centers of ossification appear in the manubrium
1-3 centers have been identified
how many primary centers of ossifications appear in the corpus sterni
typically 6
in what part of the sternum will a secondary center of ossification appear
the xiphoid process
when does the xiphoid process first demonstrate a center of ossification
sometime during or after 3 years old
in what part of the rib will primary centers of ossification appear
the body (corpus, shaft)
in what parts of the rib will secondary centers of ossifications appear
the head, articular surface of the tubercle and the non articular surface of the tubercle
which ribs will demonstrate primary centers of ossification for the body (corpus or shaft)
all ribs; ribs 1-12
which ribs will demonstrate secondary centers of ossification
ribs 1-10
which ribs lack secondary centers of ossifications
ribs 11-12
what part of the skull is derived from endochondral ossification
chondrocranium
which skull bones are ossified by both endochondral and intrammbranous ossification
mandible, sphenoid, temporal, and occipital bones
whcih bone of the appendicular skeleton is formed by endochondal and intramembranous classification
the clavicle
how many bones form the skull
28 including the auditory ossicles
exluding the auditory ossicles how many bones form the skull
22
what is the cranium
the skull minus the mandible
how many bones form the cranium
27 bones
what is the calvaria
the skullcap
what is the neurocranium
the part of the skull that surrounds the brain
how many bones form the neurocranium
8 bones
what bones form the neurocranium
frontal, parietal, occipital, temporal, sphenoi, and ethmoid
what is the facial skeleton
the bones that support the face
what is the facial skeleton
the bones that support the face
how many bones form the facial skeleton
14 bones
what bones form the facial skeleton
mandible, vomer, nasal, maxilla, lacrimal, inf. nasal concha, palatine, and zygomatic
what is another name for the facial skeleton
the viscerocranium
what are the four subclassifications of synarthrosis joints based on latin groupings
suture, gomphosis, schindylesis and syndesmosis
what are the characteristics of sutura vera (true sutures)
sutures demonstrating interlocking of the adjacent bone surfaces; typically formed by intramembranous ossification
what are the characteristics of sutura notha (false suture)
sutures lacking interlocking of adjacent bone surfaces; typically formed by endochondral ossification
what is the classification of a joint with a “nail like condition
gomphosis
what is the classification of a joint with a “fissure-like” condition
schindylesis
what is the anterior fontanelle
the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with both parietal bones
what is the posterior fontanelle
the diamond shaped remnant of developing membrane bone at the intersection of the occipital bone with both parietal bones
what is the name given to the indentation of bone between the nasal and frontal bones
nasion
what is the name given to the outline of the nasal cavity at the front of the skull
piriform aperature
what is the name given to the alveolar jugum of the canine tooth in the maxilla
canine eminence
what forms a bullet like chin
a large mental protuberance
what forms an indented chin
well developed bilateral mental tubercles and slight mental protuberance
what is the tip of the EOP called
the inion
what is the name of the linear elevation lateral to the EOP
superior nuchal line
what points on the skull are used to measure the skull size
the nasion, vertex, inion, and gnathion
what points on the skull measure cranial vault capacity
nasion, vertex, and inion
what is the appearance of the suture intersections over the hard palate called
the cruciate/cruciform suture
what is the posterior boundary of the anterior cranial fossa
a line drawn along the lesser wing of sphenoid , anterior clinoid processes, and sphenoidal jugum
what passes through the cribriform plate
fila olfactoria of cranial nerve 1, the olfactory nerve
an emissary vein leaves the anterior cranial fossa via what opening
foramen cecum
what is the post boundary of the middle cranial fossa
superior border of petrous part of tympanic bone, posterior clinoid processes and dorsum sella of sphenoid bone
what bony feature is prominent in the median plane of the middle cranial fossa
sella turcica
what cranial nerves exit the skull via middle crania fossa ostia
CN 2-6
what are the contents of the optic canal
the optic nerve and ophthalmic artery
what are the contents of the superior orbital fissure
ophthalmic veins, oculomotor nerve, trochlear nerve, ophthalmic division of trigeminal nerve, and abducent nerve
which single opening will allow the exit of the greatest number of cranial nerves
the sup orbital fissure
what is unique about the ophthalmic artery and veins
they will not share the same opening, the artery is in the optic canal, and veins are in sup orbital fissure
what are contents of foramen ovale
mandibular division trigeminal nerve (Vc) and lesser petrosal branch of the glossopharyngeal nerve
the maxillary division of the trigeminal nerve exits the middle cranial fossa via what opening
the foramen rotundum
what opening allws a branch of cranial nerve Vc to enter the mid cranial fossa from the infratemporal region
the foramen spinosum
which vessel is located within the foramen spinosum
middle meiningeal artery
what forms the roof of the post cranial fossa
the tentorium cerebeli
what part of the cerebrum occupies the post cranial fossa
none, the tentorium cerebelli separates the cerebrum into space above the post cranial fossa
what part of the CNS occupies the post ranial foss
the cerebellum, pons, and medulla oblongata
what bony feature is prominent in the median plane of the post cranial fossa
the clivus or basilar part of the occipital bone
which cranial nerve exit post cranial fossa ostia
CN VII-XII
what are the contents of the internal acoustic meatus
CN VII and VIII, the nervus intermedius/nerve of Wrisberg/sensory root of VII and motor root of VII, the vestibular and cochlear roots of VIII and internal auditory/internal labyrinth artery and vein
what are the contents of the jugular foramen
the jugular bulb, inf. petrsal sinus, the tympanic body/tympanic glomus or jugular body/jugular glomus, CN IX-XI
what is the jugular bulb
venous expansion between the sigmoid dural venous sinus and internal jugular vein
what is the function of the jugular body/jugular glomus
a chemoreceptive organ that monitors hypoxia, hypercapnia, and increases the hydrogen ion
what can the five layers of the scalp spell
skin, connective tissue, aponeurosis, loose connective tissue, periorsteum….SCALP
what are the principal sources of blood to the scalp
internal carotid and external carotid artery branches
what veins drain the scalp
superficial temporal, post. auricular, occipital, and ophthalmic veins
which divisions of the trigeminal nerve receive sensory info from the scalp
all 3; ophthalmic, maxillary, and mandibular`
what is the third layer of the scalp associated with
muscular component of the scalp
what muscle are specifically associated with the scalp
frontalis and occipitalis bellies of the epicranius
the bellies of the epicranius are connected by what
galea aponeurotica
what specific nerves provid motor control to the scalp
facial nerve; post. auricular and temporal branches
what is unusual about the muscles of the face
they don’t act as lever muscles, no origin or instertion on bone
which muscle lack any attachement to bone
orbicularis oris, proceris, risorius
what type of motor fibers to skeletal muscle are given off by facial nerve
branchial efferent (BE)
what openings are located at the sup. wall of the orbit
optic canal
what are the contents of optic canal
optic nerve and ophthalmic artery
what is the name given to the medial wall of the orbit
lamina papyracea
what features may be observed on medial wall of orbit
lacrimal groove, fossa for lacrimal sac, ant. ethmoid foramen and post.
what opening are located along the lateral wall of orbit
sup. orbital fissure
what are contents of sup. orbital fissure
oculomotor, trochlear and abducaent
CN ophthalmic division trigeminal CN and ophthalmic veins
what openings are located along the inf. wall of orbit
inf. orbital fissure
what is contained in inf. orbital fissure
maxillary division of trigeminal nerve
identify the openings found along each wall of the orbit
superior: optic canal,
medial: ant./post. ethmoid foramina,
lateral: sup. orbital fissure,
inferior: inf. orbital fissure
what are the layers of the eyelid
skin, orbicularis 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 thick, hydrophobic substance that prevents tears from overflowing onto cheeks along the eyelid
what is the name of the gland located at base of the eyelash
ciliary gland
what are names give to the modified sebaceous glands of palpebra
tarsal or Meibomian gland or ciliary gland
wht is the name given to the elevation at the medial canthus
lacrimal caruncle
what is the name given to the opening of the lacrimal papilla
lacrimal punctum
parasympathetic stimulation of blood vessels in the lacrimal gland will result in what events?
vasodilation, increased availability of water to secretory units, thinner or more watery product in lumen
sympathetic fibers synapse in which ganglion in the pathway to the lacrimal gland
the superior cervical ganglion
sympathetic stimulation of the lacrimal gland will result in what events
vasoconstriction of blood vessels, limited availability of water to secretory units, more viscous or thicker product formed in glandular lumen
what are the names of layers of the eyeball
fibrous tunic, uveal tract and retina
what are the parts of the fibrous tunic of eyeball
cornea and sclera
what are the parts of the uveal tract of the eyeball
iris, ciliary body, choroid and pupil
what muscles are present in the iris
scphincter pupillae and dilator pupillae
what is the innervation of sphincter pupillae
oculomotor nerve, parasymp. pathway
what iss the innervation of ciliaris muscle
oculomotor nerve, parasymp. pathway
what is innervation of dilator pupillae
internal carotid artery plexus, symp. path
what are chambers of the eyeball in front of the lens
anterior chamber and posterior chamber
what separates the ant. from post. chamber in eyball
the iris
what is contained in the ant. chamber of eyeball
aqueous humor
what is the primary cause of glaucoma
excess aqueous humor in the chambers in front of the eyeball
what is the name given to the chamber behind the lens
the vitreous chamber
what fills the vitreous chamber
vitreous body
what are the functions of the vitrous body
maintain retinal curvature, allow light distortion from lens to retina
what are the common characteristics in origin and insertion of all rectus extraocular muscles
they all originate from common annular tendon in the orbit they all insert into the sclera in front of the coronal equator
what is the common characteristic regarding the instertion of both oblique extraocular eye muscles
both insert onto sclera on the lateral margin of eyeball behind the coronal equator
what are the two unique features of the fourth cranial nerve
it is the only cranial nerve with apparent origin from the brains dorsal surface; it is the only cranial efferent nerve to decussate within the midbrain from its nucleus
intrinsic muscles of the eyeball are innervated by which visceral efferent pathways
ciliaris and sphincter pupillae are innervated by parasympathetics, dilator pupillae is innervated by sympathetics
the auricule transmits sensory innervation via which specific cranial nerve branches
auriculotemporal nerve (mandibular division, trigeminal)posterior auricular cutaneous nerve (facial) auricular nerve (vagus)
what part of the external acoustic meatus is protected by cartilage
lateral one third
what pat of the external acoustic meatus is protected by bone
medial two thirds
what is the cerumen
the product of ceruminous glands form the bulk of the earwax
skin lining the external acoustic meatus contains what modified sebaceous gland
ceruminous glands
what vein is formed within the parotid gland
retromandibular vein
what branche of the facial nerve penetrates parotid gland, but is not given off within it
the chorda tympani nerve
what forms the boundary of the infratemporal region
ramus of the mandible
