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DCCJP Final Prep > Module 1, Year 1 - Clinical Anatomy, Introduction & Ossification > Flashcards

Module 1, Year 1 - Clinical Anatomy, Introduction & Ossification Flashcards

1
Q

Word that best describes the nature of human anatomy

A

Heterogeneity

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2
Q

CN V has a branch that passes through which foramen?

A

Foramen Ovale
Foramen Rotundum
Superior Orbital Fissure

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3
Q

Which radiometric normal measures less than 12mm? What does more indicate?

A

Harris Line

Craniocervical instability

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4
Q

Which radiometric normal has a ratio less than 1?

A

Power Ratio

Occipito-atlantal dissociation

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5
Q

Which radiometric normal has the dens at least 5mm below the line?

A

McRae’s Line

Basilar invagination

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6
Q

Which radiometric normal should be at least 150 degrees or more?

A

Clivoaxial angle

Ventral brainstem compression

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7
Q

Which radiometric normal should be less than 9mm?

A

Grabb-Oakes’ Line

Ventral brainstem compression

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8
Q

Occlusion of the left jugular vein may lead to immediate fluid back up into what structure? What symptoms may be associated with this?

A

Left jugular bulb

Tinnitus, dizziness

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9
Q

What are the strongest ligaments of the craniocervical junction?

A

Alar ligament

Transverse ligament

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10
Q

Which of the following muscles attache to C1?

a. Rectus capitus posterior major
b. Multifidus cervicis
c. Splenius cervicis
d. Anterior scalene
e. All of the above

A

C. Splenius cervicis

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11
Q

Which of the following arteries supply the choroid plexus?

a. Anterior choroidal artery from the anterior cerebral artery
b. Anterior choroidal artery from the anterior cerebellar artery
c. Anterior choroidal artery from the middle cerebral artery
d. Posterior choroidal artery from the posterior communicating arteries
e. Posterior choroidal artery from the posterior inferior cerebellar artery

A

c. Anterior choroidal from the middle cerebral artery

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12
Q

The vertebral vein drains which structure?

A

Radiculomedulary veins

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13
Q

Name the 2nd part of the subclavian artery.

A

Costocervical trunk

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14
Q

Ossification of the occiput begins and ends when?

A

Begins: 4 years old
Ends: 6 years old

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15
Q

Ossification tends to happen in what direction?

A

Posterior to anterior

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16
Q

Name for when the condyles develop into the lateral masses.

A

Endochondral ossification

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17
Q

How many primary and secondary ossification centers does the atlas bone have?

A

3 primary, 0 secondary

Posterior arch is variable

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18
Q

Region of the axis that should fuse by age 12

A

Os Terminale

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19
Q

How many primary ossification centers of axis fuse before birth?

A

2

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20
Q

What might cause ossification rates to differ from person to person?

A

Variable blood due to venous drainage and decrease compliance in the brain

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21
Q

Number of primary and secondary ossification centers for the lower cervicals.

A

3 primary, 5 secondary

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22
Q

When will all the lower cervical primary centers ossify?

A

6 years old

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23
Q

When will all lower cervical secondary centers appear and fuse?

A

Appear during puberty, fuse by age 25

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24
Q

Which sinus surrounds the foramen magnum?

A

Marginal sinus

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25
Which muscles attach to the styloid process? Name their innervators.
Stylohyoid (CN VII) Stylopharengeous (CN IX) Styloglossal (CN XII)
26
At what clivoaxial measurement would surgery be considered best option?
<130 degrees
27
At what abnormal clivoaxial range has upper cervical chiropractic shown it can make a difference?
Between 130 - 150 degrees
28
Is posterior cervical decompression an option for patients with a clivoaxial angle less than 130?
It is not advised, as recovery is less favorable.
29
What radiometric normal has a measurement between 125 - 143 degrees?
Cranial base angle
30
What is the rule of 12?
The basion should be no more than 12 mm from the tip of the dens and 12mm from the posterior dens/posterior axial line
31
What area of bone is where the confluence of sinuses is located?
Torcus/Torcular Herophili
32
Generally, the ________ sinus drains into the right transverse, and the _________ sinus drains into the left transverse.
Superior sagittal sinus --> Right transverse Straight sinus --> Left transverse
33
What does Mandolesi's study suggest about internal jugular vein blockage affecting the superior saggital sinus?
A right lateral anterior misalignment is seen 2x to 3x more in those with Multiple Sclerosis and Chronic Cerebra-Spinal Venous Insufficiency
34
Does the jugular vein drain faster with standing or lying down?
Lying down
35
This sinus surrounds the sella turcica.
Cavernous sinus
36
Where does the marginal sinus drain into?
Internal vertebral venous plexus
37
The superior petrosal sinus drains into the ______ sinus.
Sigmoid sinus
38
The inferior petrosal sinus drains into the _________.
Internal jugular bulb
39
Where is the internal jugular bulb located? What disease might this have relevance for?
Jugular foramen Meniere's Disease
40
The jugular vein is posterior and lateral to this.
Internal carotid artery
41
How would you measure and grade a Chiari?
The cerebellar tonsils positioning is compared to McRae's line. If below the line and less than 5mm, it is a Chiari-0. If below the line and 5mm or greater, it is a Chiari-1.
42
How are cerebellar tonsils naturally shaped? What if they are introduced to trauma?
Naturally, cerebellar tonsils are rounded. If they are introduced to trauma, they will be more pointed like a "v".
43
How much CSF is in a normal central nervous system? How much CSF is produced per day?
180mL; 500mL/day
44
How many named muscles are in the neck?
40
45
Name the anterior muscles of the neck.
``` Platysma Stylohyoid Mylohyoid Geniohyoid Thyrohyoid Stylothyroid Omohyoid Digastrics Styloglossis Hypoglossis Hyoglossis Longis Colli Scalenes SCM Cricothyroid Superior, middle, inferior pharyngeal constrictor muscles ```
46
Trick to remembering anterior neck muscles
"Glossis"h! Anything with "hyoid" or "thyroid", the list is "Longis" but I "Digastrics"... platysma.
47
Name the posterior neck muscles
``` Upper trapezius Rectus capitus anterior Rec. cap. lateralis Rec. cap. major Rec. cap. minor Superior capitis oblique Inferior capitis oblique Semispinalis capitis Splenius Cervicis Levator Scapularis Semispinalis cervicis Rotator cervicis brevis Rotator cervicis longus Interspinalis cervicis Intertransverse cervicis anterior Intertransverse cervicis posterior Longissimus capitis Iliocostalis cervicis Multifidus ```
48
Trick to remembering posterior neck muscles
There are "multifidus": "rec", "cap", "trap", "scap", and don't forget "cervicis"
49
How many muscles attach to the atlas bone? Name them.
``` 11-12. Obliquus cap. inf. Obliquus cap. sup. Rec. cap. post. minor Rec. cap. lateralis Rec. cap. anterior Splenius capitis Splenius cervicis Seminspinalis cervicis Longus Colli Levator scapulae Middle scalene (varies) Interspinalis (varies) ```
50
How many muscles attach to the axis bone? Name them.
``` 15. Rectus capitis post. major Obliquus cap. inferior Splenius cervicis Interspinalis cervicis Middle scalene Longissimus cervicis Semispinalis cervicis Intertransverse cervicis anterior Intertransverse cervicis posterior Multifidus Rotator brevis Rotator longus Spinalis cervicis Spinalis capitis ```
51
Which muscle connections do atlas and axis share?
``` Obliquus capitis inferior Splenus cervicis Longus colli Middle scalene (varies on atlas) Interspinalis (varies on atlas) ```
52
If one uses superficial muscles due to absence of deep muscle activation, what is likely the current state?
Muscular instability
53
Name the major venous sinuses.
Superior sagittal sinus Straight sinus Transverse sinus Sigmoid sinuses to IJV
54
There are few pathways to consider when it comes to CSF drainage. Describe the path starting with the lateral ventricles.
Lateral ventricle [x2] --> Interventricular foramen (Monro) [x2] --> 3rd ventricle --> Cerebral Aqueduct (Sylvius) --> 4th ventricle --> Lateral aperture (Luschka) [x2] & Median aperture (Magendie) --> Subarachnoid Space --> Arachnoid villi --> Superior Sagittal sinus --> Confluence of sinuses --> Transverse sinus --> Sigmoid sinus --> Internal Jugular Bulb --> Internal Jugular Vein
55
There are a few pathways to consider when it comes to CSF drainage. Describe the path beginning with the inferior sagittal sinus or the internal cerebral vein.
Inf. Sagittal Sinus or internal cerebral vein --> Straight sinus --> Confluence of sinuses --> Transverse sinus --> Sigmoid sinus --> Internal Jugular bulb --> Internal Jugular vein
56
There are few pathways to consider when it comes to CSF drainage. Describe the path beginning with the superficial middle cerebral veins.
Superficial middle cerebral veins --> Cavernous sinus --> [Superior petrosal sinus --> sigmoid sinus --> IJB --> IJV] or [Inferior petrosal sinus --> IJB --> IJV]
57
There are few pathways to consider when it comes to CSF drainage. The superior anastomotic vein of Trolard has multiple paths it could drain. Where could it potentially drain?
Either the Superior Sagittal Sinus or the Superficial Middle Cerebral Veins
58
There are few pathways to consider when it comes to CSF drainage. The inferior anastomotic vein of Labbe has multiple paths it could drain. Where could it potentially drain?
Either the Transverse Sinus or the Superficial Middle Cerebral Veins
59
The pharyngeal muscles are primarily innervated by what nerve? Are there any exceptions?
CN X/Vagus Nerve Tensor Veli Palatini (CN V3)
60
Of all the muscles in the neck, most are innervated by a cervical dorsal root. Which muscles are not (and name their innovator)?
``` Mylohyoid (V3) Digastric (V3 anterior, VII posterior) Platysma (VII) Stylohyoid (VII) Stylopharyngeus (IX) Upper Trapezius (XI) Styloglossus (XII) ```
61
Bilateral contraction of the SCM causes what action in the upper cervical region?
Extension
62
Bilateral contraction of the SCM causes what action in the lower cervical region?
Flexion
63
Which two muscles are tasked with absorbing forces induced to the cervical spine during upper limb function and therefore may introduce compressive loading on cervical motion segments?
Levator Scapulae | Upper Trapezius
64
To which cervical segments does the Levator Scapulae attach? What clinical significance does this have?
The first four cervical segments - potentially inducing compressive forces due to ergonomic challenges at work and repetitive upper extremity movements.
65
What innervates all the suboccipital muscles?
Dorsal Root C1
66
What action do all the suboccipital muscles support?
Extension and rotation
67
Which suboccipital muscle supports lateral flexion? Why might this be?
Obliquus Capitis Superior The C1 tvp origin to the occiput structurally would support this action.
68
Which of the sub occipital muscles is the only one without an occiput insertion?
Obliquus capitis inferior
69
What are the ventral short muscles? What are their innervation?
Rectus capitis anterior Rectus capitis lateralis Both are innervated by Ventral Root C1
70
Where does the rectus capitis anterior insert?
Basilar part of occiput
71
Where does the rectus capitis lateralis insert?
Jugular part of the occiput
72
How would you distinguish superficial muscles from deep muscles?
Superficial muscles have large lever arms and a greater capacity to exert torque. Deep muscles contribute to head movement and more involved with postural support (low-threshold, slow twitch) - their higher spindle density, being shorter and stiffer, and their segmental arrangement structurally support this view.
73
What nerves innervate the tongue?
CN XII - motor CN VII - anterior 2/3 sensory CN IX - posterior 1/3 sensory

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