Intervertebral Foramen/Curvatures of the Column Flashcards

0
Q

What percent of total vertebral column length does all intervertebral foramina height from occiput-Co1 equal?

A

53%

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1
Q

What percent of total vertebral column length does “true” intervertebral height from C2-S1 equal?

A

40%

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2
Q

What are the segmental arteries of the cervical spine?

A

The vertebral artery, ascending cervical artery, and deep cervical artery

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3
Q

What are the segmental arteries of the thoracic spine?

A

The deep cervical artery, highest (superior) intercostal artery, posterior intercostal artery, and subcostal artery

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4
Q

What are the segmental arteries of the lumbar spine?

A

The lumbar arteries, iliolumbar artery, lateral sacral artery, and median sacral artery

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5
Q

What are the characteristics of the artery of adamkiewicz?

A

It is a left side, anterior medullary feeder artery located in the T9/T10 intervertebral foramen, and the primary vascular supply to the lumbar enlargement

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6
Q

What will the intervertebral veins drain into?

A

The external vertebral venous plexus or Batson’s plexus

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7
Q

What is a unique histological feature of the veins of the vertebral column?

A

They appear to lack valves

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8
Q

What increases the depth or length or the intervertebral foramen in the cervical spine?

A

The transverse process

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9
Q

What is the location of the spinal nerve within the cervical intervertebral foramen?

A

Toward the front and middle of the height of the cervical intervertebral foramen

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10
Q

What is the relationship between aging and cervical spine nerve root characteristics?

A

The length of the nerve root increases as it descends from its apparent origin on the spinal cord, but the cross-sectional area of the nerve root decreases

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11
Q

What is the relationship between aging and cervical spine intervertebral foramen size?

A

The cross-sectional area diminishes after age 50

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13
Q

What are the specific attachment sites for a cervical spinal nerve?

A

The sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery

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14
Q

What contributes to the anterior boundary of the thoracic intervertebral foramen?

A

The costocentral joint

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15
Q

Which are the largest spinal nerves?

A

L5 and S1 spinal nerves

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16
Q

What increases the length of the intervertebral foramen at L5?

A

The lumbosacral tunnel

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17
Q

What forms the lumbosacral tunnel?

A

The lumbosacral ligament, transverse process of L5, and sacral ala

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18
Q

What condition is the result of encroachment on the L5 spinal nerve?

A

The far out syndrome

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19
Q

What ligament may contribute to the loss of size in the lumbar intervertebral foramen?

A

The transforminal ligament

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20
Q

What is unusual about the sacral intervertebral foramen compared to other intervertebral foramina?

A

A completely osseous boundary exists

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21
Q

What is unique about the relationship of spinal nerve to intervertebral foramen at S5-Co1?

A

There are two nerves present, S5 nerve & Co1 nerve

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22
Q

What are some examples of destructive lesions of the vertebral body?

A

Tuberculosis, hemangiomas, osteoporosis

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23
Q

What may reduce the impact to intervertebral disc loss of integrity on the intervertebral foramen in the cervical and thoracic spine?

A

The joint of Luschka in the cervicals, the costocentral joint in the thoracics

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24
Q

What are examples of osteophyte formation that influence the intervertebral foramen?

A

The bony spurs of the vertebral body and para-articular processes on the lamina

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25
Q

What are examples of acquired alterations of the spinal curves identified in class?

A

Obesity, pregnancy, and the use of heavy backpacks

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26
Q

Why is the posterior curve also called the primary curve?

A

It is the first curve to appear embryologically

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27
Q

What are the adult remnants of the primary curve along the vertebral column?

A

The thoracic or dorsal curve and the pelvic or sacrococcygeal curve

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28
Q

What are the names given to curves which form during development to reverse the direction of regions along the vertebral column?

A

Anterior curve, secondary curve, compensatory curve

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29
Q

What are the names of the anterior curves, secondary curves, and compensatory curves?

A

Cervical curve and lumbar curve

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30
Q

What is the earliest time of appearance of the cervical curve?

A

The third fetal month

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31
Q

What is the traditional time of appearance of the cervical curve said to be?

A

During the last trimester in utero

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32
Q

What is the time during which the “adult” cervical curve is said to appear?

A

Within the first year after birth

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33
Q

What developmental events are indicated in the formation of the adult cervical curve?

A
  1. Centers for vision and equilibrium will appear in the brain
  2. Musculature attaching the skull, cervical region, and upper thorax together develops
  3. The head is held upright
  4. The intervertebral disc height becomes greater anterior than posterior
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34
Q

At what age will the infant begin to hold the head erect?

A

Usually between the third and fourth month after birth

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35
Q

What is the name given to the integration of visual and motor pathways associated with holding the head erect?

A

The righting reflex

36
Q

What is the location for the cervical kyphosis?

A

Between occiput and C1

37
Q

What is the time of appearance of the lumbar curve?

A

Between 12 and 18 months after birth

38
Q

What infant activities are associated with the development of the lumbar curve?

A

Crawling and walking

39
Q

What developmental events are indicated in the formation of the adult lumbar curve?

A
  1. Crawling will cause the abdomen to put tension on the lumbar region and pulls it forward
  2. Muscle development is promoted to compensate for the swayback of the lumbars
  3. Intervertebral disc height will become greater anterior compared to posterior
  4. Walking will further promote muscle and intervertebral disc development
40
Q

What is the vertebral relationship between the lumbar curve and the lumbar enlargement?

A

Lumbar curve T12-L5; lumbar enlargement T9-T12

41
Q

What is the formation of the lateral curve often correlated with?

A

Faster development of the muscles on the side of handedness

42
Q

What is the time of appearance of the lateral curves?

A

They appear after 6 years old

43
Q

What names are given to conditions associated with abnormal curves of the vertebral column?

A

Lordosis, kyphosis, scoliosis

44
Q

What is the definition of lordosis?

A

A forward bending condition

45
Q

What is the definition of kyphosis?

A

A humpback or hunchback condition

46
Q

What is the definition of scoliosis?

A

A warped or crooked condition

47
Q

What clinical examples of abnormal curvatures along the vertebral column were stressed in class?

A

Military neck, humpback or hunchback, and swayback

48
Q

What is military neck?

A

A decreased anterior curve in the cervical region, a straight neck

49
Q

What is humpback or hunchback?

A

An increased posterior curve in the thoracic region

50
Q

What is swayback?

A

An increased anterior curve in the lumbar region

51
Q

What does the use of the term lordotic try to imply?

A

A normal cervical and normal lumbar anterior curve

52
Q

What does the use of the term kyphotic try imply?

A

A normal thoracic or dorsal and normal pelvic or sacrococcygeal posterior curve

53
Q

What prefixes are used to convey abnormality in curve patterns?

A

Hyper and hypo

54
Q

What are the curve classifications for military neck?

A

A kyphosis or hypolordotic curve

55
Q

What are the curve classifications for humpback or hunchback?

A

A kyphosis or hyperkyphotic curve

56
Q

What are the curve classifications for swayback?

A

A lordosis or hyperlordotic curve

57
Q

What are the classifications of scoliosis according to the Scoliosis Research Society?

A

Magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis

58
Q

What is often used to measure the magnitude of scoliosis?

A

The Cobb method

59
Q

What does location of scoliosis infer?

A

The location in the vertebral segment forming the apex of the curve deviation

60
Q

What does the direction of scoliosis refer to?

A

The side the convexity of the curve will bend to

61
Q

What does etiology of scoliosis mean?

A

The cause of the scoliosis

62
Q

Based on age of onset, what are the types of idiopathic scoliosis?

A

Infantile, juvenile, and adolescent

63
Q

What is the age range for infantile idiopathic scoliosis?

A

From birth to 3 years old

64
Q

What is the age range for juvenile idiopathic scoliosis?

A

From 3 years old to 10 years old

65
Q

What is the age range for adolescent idiopathic scoliosis?

A

Over 10 years old

66
Q

Identify the curve direction, location, gender bias, and incidence of infantile idiopathic scoliosis.

A

Left thoracic, male, less than 1% incidence

67
Q

Identify the curve direction, location, gender bias, and incidence of juvenile idiopathic scoliosis.

A

Right thoracic, females over 6 years old, 12%-21% incidence

68
Q

Identify the curve direction, location, gender bias, and incidence of adolescent idiopathic scoliosis.

A

Right thoracic or right thoracic and left lumbar, females, 80% incidence

69
Q

What is the relationship between curve deviation, incidence, and curve worsening?

A

The greater the deviation, the lower the incidence, and the more likely to worsen

70
Q

What is/are the characteristics of cervicalization of occiput?

A

An increase in occipital bone size, formation of new or larger lines, on the occipital bone

71
Q

What is/are the characteristics of occipitalization of C1?

A

The atlas may be partially or completely fused to the occiput

72
Q

What is another way of implying occipitalization of C1?

A

Atlas assimilation

73
Q

What is the incidence of occipitalization of C1?

A

0.1% to 0.8%

74
Q

What joint is formed between the odontoid process ossification centers and the centrum of C2?

A

The subdental synchondrosis

75
Q

Ossification between the odontoid process and centrum joint of C2 first appears at which age?

A

4 years old

76
Q

What is an os odontoideum?

A

A persistence beyond age 7 of the joint formed between the centrum and odontoid process centers of ossification

77
Q

What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?

A

Tip of the dens synchondrosis

78
Q

At what age will the tip of the dens fuse with the odontoid process?

A

Before age 12

79
Q

If the joint formed between the tip of the dens and odontoid process centers of ossification persists beyond age 12, what is the condition called?

A

Terminal ossicle

80
Q

What is a basilar invagination?

A

The upper cervical spine appears to be invaginated into the skull on x-ray analysis

81
Q

What is/are the characteristics of dorsalization of C7?

A

The addition of a rib and changes in superior articular facet orientation are typical

82
Q

What is the incidence of rib-related changes following dorsalization of C7?

A

From one-half to two and one-half percent of the population

83
Q

What is the gender bias suggested in dorsalization of C7?

A

Female

84
Q

What alteration in C7 facet orientation may accompany dorsalization?

A

The superior articular facet of C7 may change from back, upward, and medial to that of a typical thoracic facet…back, upward, and lateral; the inferior articular facet is unchanged

85
Q

What percent of the population may demonstrate thoracic-like features at C7?

A

Up to 46%

86
Q

What rib-related changes may accompany cervicalization of T1?

A

The first rib may decrease in mean relative length or become absent

87
Q

What T1 facet orientation changes may accompany cervicalization?

A

The superior articular facet may change from back, upward, and lateral to back, upward, and medial; the inferior articular facet is unchanged