Intervertebral Foramen/Curvatures of the Column Flashcards
What percent of total vertebral column length does all intervertebral foramina height from occiput-Co1 equal?
53%
What percent of total vertebral column length does “true” intervertebral height from C2-S1 equal?
40%
What are the segmental arteries of the cervical spine?
The vertebral artery, ascending cervical artery, and deep cervical artery
What are the segmental arteries of the thoracic spine?
The deep cervical artery, highest (superior) intercostal artery, posterior intercostal artery, and subcostal artery
What are the segmental arteries of the lumbar spine?
The lumbar arteries, iliolumbar artery, lateral sacral artery, and median sacral artery
What are the characteristics of the artery of adamkiewicz?
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
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 increases the depth or length or the intervertebral foramen in the cervical spine?
The transverse process
What is the location of the spinal nerve within the cervical intervertebral foramen?
Toward the front and middle of the height of the cervical intervertebral foramen
What is the relationship between aging and cervical spine nerve root characteristics?
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
What is the relationship between aging and cervical spine intervertebral foramen size?
The cross-sectional area diminishes after age 50
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 intervertebral foramen?
The costocentral joint
Which are the largest spinal nerves?
L5 and S1 spinal nerves
What increases the length of the intervertebral foramen 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 ligament may contribute to the loss of size in the lumbar intervertebral foramen?
The transforminal ligament
What is unusual about the sacral intervertebral foramen compared to other intervertebral foramina?
A completely osseous boundary exists
What is unique about the relationship of spinal nerve to intervertebral foramen at S5-Co1?
There are two nerves present, S5 nerve & Co1 nerve
What are some examples of destructive lesions of the vertebral body?
Tuberculosis, hemangiomas, osteoporosis
What may reduce the impact to intervertebral disc loss of integrity on the intervertebral foramen in the cervical and thoracic spine?
The joint of Luschka in the cervicals, the costocentral joint in the thoracics
What are examples of osteophyte formation that influence the intervertebral foramen?
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
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 which 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 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 trimester in utero
What is the time during which the “adult” cervical curve is said to appear?
Within the first year after birth
What developmental 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 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 cervical kyphosis?
Between occiput and C1
What is the time of appearance of the lumbar curve?
Between 12 and 18 months after birth
What infant activities are associated with the development 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
- Intervertebral disc height will become greater anterior compared to posterior
- Walking will further promote muscle and intervertebral disc development
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 names are given to conditions associated with 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 clinical examples of abnormal curvatures along the vertebral column were stressed in class?
Military neck, humpback or 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 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 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 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 are the classifications of scoliosis according to the Scoliosis Research Society?
Magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis
What is often used to measure the magnitude of scoliosis?
The Cobb method
What does location of scoliosis infer?
The location in 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 to
What does etiology of scoliosis mean?
The cause of the scoliosis
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?
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 old
Identify 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, females over 6 years old, 12%-21% incidence
Identify the curve direction, location, gender bias, and incidence of adolescent idiopathic scoliosis.
Right thoracic or right thoracic and left lumbar, females, 80% incidence
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/are the characteristics 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 occipitalization of C1?
Atlas assimilation
What is the incidence of occipitalization of C1?
0.1% to 0.8%
What joint is formed between the odontoid process ossification centers and the centrum of C2?
The subdental synchondrosis
Ossification between the odontoid process and centrum joint of C2 first appears at which age?
4 years old
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 formed between the tip of the dens and the odontoid process centers of ossification?
Tip of the dens synchondrosis
At what age will the tip of the dens fuse with the odontoid process?
Before age 12
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?
Terminal ossicle
What is a basilar invagination?
The upper cervical spine appears to be invaginated into the skull on x-ray analysis
What is/are the characteristics of dorsalization of C7?
The addition of a rib and changes in superior articular facet orientation are typical
What is the incidence of rib-related changes following dorsalization of C7?
From one-half to two and one-half percent of the population
What is the gender bias suggested in dorsalization of C7?
Female
What alteration in C7 facet orientation may accompany dorsalization?
The superior articular facet of C7 may change from back, upward, and medial to that of a typical thoracic facet…back, upward, and lateral; the inferior articular facet is unchanged
What percent of the population may demonstrate thoracic-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 T1 facet orientation changes may accompany cervicalization?
The superior articular facet may change from back, upward, and lateral to back, upward, and medial; the inferior articular facet is unchanged
