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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
Q

Which muscles attach to the styloid process? Name their innervators.

A

Stylohyoid (CN VII)
Stylopharengeous (CN IX)
Styloglossal (CN XII)

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26
Q

At what clivoaxial measurement would surgery be considered best option?

A

<130 degrees

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27
Q

At what abnormal clivoaxial range has upper cervical chiropractic shown it can make a difference?

A

Between 130 - 150 degrees

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28
Q

Is posterior cervical decompression an option for patients with a clivoaxial angle less than 130?

A

It is not advised, as recovery is less favorable.

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29
Q

What radiometric normal has a measurement between 125 - 143 degrees?

A

Cranial base angle

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30
Q

What is the rule of 12?

A

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
Q

What area of bone is where the confluence of sinuses is located?

A

Torcus/Torcular Herophili

32
Q

Generally, the ________ sinus drains into the right transverse, and the _________ sinus drains into the left transverse.

A

Superior sagittal sinus –> Right transverse

Straight sinus –> Left transverse

33
Q

What does Mandolesi’s study suggest about internal jugular vein blockage affecting the superior saggital sinus?

A

A right lateral anterior misalignment is seen 2x to 3x more in those with Multiple Sclerosis and Chronic Cerebra-Spinal Venous Insufficiency

34
Q

Does the jugular vein drain faster with standing or lying down?

A

Lying down

35
Q

This sinus surrounds the sella turcica.

A

Cavernous sinus

36
Q

Where does the marginal sinus drain into?

A

Internal vertebral venous plexus

37
Q

The superior petrosal sinus drains into the ______ sinus.

A

Sigmoid sinus

38
Q

The inferior petrosal sinus drains into the _________.

A

Internal jugular bulb

39
Q

Where is the internal jugular bulb located? What disease might this have relevance for?

A

Jugular foramen

Meniere’s Disease

40
Q

The jugular vein is posterior and lateral to this.

A

Internal carotid artery

41
Q

How would you measure and grade a Chiari?

A

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
Q

How are cerebellar tonsils naturally shaped? What if they are introduced to trauma?

A

Naturally, cerebellar tonsils are rounded. If they are introduced to trauma, they will be more pointed like a “v”.

43
Q

How much CSF is in a normal central nervous system? How much CSF is produced per day?

A

180mL; 500mL/day

44
Q

How many named muscles are in the neck?

A

40

45
Q

Name the anterior muscles of the neck.

A 
Platysma
Stylohyoid
Mylohyoid
Geniohyoid
Thyrohyoid
Stylothyroid
Omohyoid
Digastrics
Styloglossis
Hypoglossis
Hyoglossis
Longis Colli
Scalenes
SCM
Cricothyroid
Superior, middle, inferior pharyngeal constrictor muscles
46
Q

Trick to remembering anterior neck muscles

A

“Glossis”h! Anything with “hyoid” or “thyroid”, the list is “Longis” but I “Digastrics”… platysma.

47
Q

Name the posterior neck muscles

A 
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
Q

Trick to remembering posterior neck muscles

A

There are “multifidus”: “rec”, “cap”, “trap”, “scap”, and don’t forget “cervicis”

49
Q

How many muscles attach to the atlas bone? Name them.

A 
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
Q

How many muscles attach to the axis bone? Name them.

A 
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
Q

Which muscle connections do atlas and axis share?

A 
Obliquus capitis inferior
Splenus cervicis
Longus colli
Middle scalene (varies on atlas)
Interspinalis (varies on atlas)
52
Q

If one uses superficial muscles due to absence of deep muscle activation, what is likely the current state?

A

Muscular instability

53
Q

Name the major venous sinuses.

A

Superior sagittal sinus
Straight sinus
Transverse sinus
Sigmoid sinuses to IJV

54
Q

There are few pathways to consider when it comes to CSF drainage. Describe the path starting with the lateral ventricles.

A

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
Q

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.

A

Inf. Sagittal Sinus or internal cerebral vein –> Straight sinus –> Confluence of sinuses –> Transverse sinus –> Sigmoid sinus –> Internal Jugular bulb –> Internal Jugular vein

56
Q

There are few pathways to consider when it comes to CSF drainage. Describe the path beginning with the superficial middle cerebral veins.

A

Superficial middle cerebral veins –> Cavernous sinus –> [Superior petrosal sinus –> sigmoid sinus –> IJB –> IJV] or [Inferior petrosal sinus –> IJB –> IJV]

57
Q

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?

A

Either the Superior Sagittal Sinus or the Superficial Middle Cerebral Veins

58
Q

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?

A

Either the Transverse Sinus or the Superficial Middle Cerebral Veins

59
Q

The pharyngeal muscles are primarily innervated by what nerve? Are there any exceptions?

A

CN X/Vagus Nerve

Tensor Veli Palatini (CN V3)

60
Q

Of all the muscles in the neck, most are innervated by a cervical dorsal root. Which muscles are not (and name their innovator)?

A 
Mylohyoid (V3)
Digastric (V3 anterior, VII posterior)
Platysma (VII)
Stylohyoid (VII)
Stylopharyngeus (IX)
Upper Trapezius (XI)
Styloglossus (XII)
61
Q

Bilateral contraction of the SCM causes what action in the upper cervical region?

A

Extension

62
Q

Bilateral contraction of the SCM causes what action in the lower cervical region?

A

Flexion

63
Q

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?

A

Levator Scapulae

Upper Trapezius

64
Q

To which cervical segments does the Levator Scapulae attach? What clinical significance does this have?

A

The first four cervical segments - potentially inducing compressive forces due to ergonomic challenges at work and repetitive upper extremity movements.

65
Q

What innervates all the suboccipital muscles?

A

Dorsal Root C1

66
Q

What action do all the suboccipital muscles support?

A

Extension and rotation

67
Q

Which suboccipital muscle supports lateral flexion? Why might this be?

A

Obliquus Capitis Superior

The C1 tvp origin to the occiput structurally would support this action.

68
Q

Which of the sub occipital muscles is the only one without an occiput insertion?

A

Obliquus capitis inferior

69
Q

What are the ventral short muscles? What are their innervation?

A

Rectus capitis anterior
Rectus capitis lateralis

Both are innervated by Ventral Root C1

70
Q

Where does the rectus capitis anterior insert?

A

Basilar part of occiput

71
Q

Where does the rectus capitis lateralis insert?

A

Jugular part of the occiput

72
Q

How would you distinguish superficial muscles from deep muscles?

A

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
Q

What nerves innervate the tongue?

A

CN XII - motor
CN VII - anterior 2/3 sensory
CN IX - posterior 1/3 sensory

DCCJP Final Prep (9 decks)

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