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MSK EXAM I > Osteology of Spine and Articulations > Flashcards

Osteology of Spine and Articulations Flashcards

1
Q

How many vertebrae are there? Divisions?

A

33

7 cervical, 12 thoracic, 5 lumbar, 5 sacral(fused) and 4 coccygeal(usually fused)

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2
Q

How consistent are sacral fusion patterns

A

vary in 5 % population

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3
Q

Differentiate between sacralization and lumbarization

A

sacralization- fusion of L5 with sacrum

lumbarization- lack of fusion of S1 with sacrum

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4
Q

what is the general size patterns of vertebrae

A

get larger as descent spine because of weight bearing

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5
Q

Describe composition of the body of the vertebrae

A

cancellous (spongy) bone. thing layer around of compact (cortical) bone

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6
Q

Compression fractures are usually due to

A

demineralization of the cancellous bone in vertebral body

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7
Q

What type of cartilage covers body of vertebrae

A

hyaline cartilage

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8
Q

What are the posterolateral processes that project from the vertebral body

A

pedicles

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9
Q

Structures found on pedicles

A

superior and inferior vertebral notches

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10
Q

What structures form vertebral foramina

A

when the superior and inferior notches of adjacent vertebrae come together

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11
Q

What passes through spinal foramina

A

spinal nerves and vessels

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12
Q

What is the continuation of the pedicles posteromedially to complete vertebral arch

A

Laminae

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13
Q

Name all of the articular processes

A

2 superior and 2 inferior located between the pedicel and lamina– articular facets

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14
Q

What makes up a spinal process

A

fusion of two laminae

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15
Q

What are the characteristics of the vertebral bodies of Cervical vertebrae

A

the body is small and shaped laterally

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16
Q

Describe the transverse process on cervical vertebrae

A

Arise from pedicle and articulating processes. Directed anterolateral
Form costotransverse foramen (transverse cervical foramen)

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17
Q

What travels through the costotransverse foramen

A

vertebral artery, vein and sympathetic nervous plexus

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18
Q

What parts of cervical vertebrae provide sites for attachment of neck and superficial back muscles

A

the anterior and posterior tubercles formed by termination of the costal and transverse processes

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19
Q

Why is the connection between the costal and transverse processes (Cervical) grooved

A

superior surface for passage of spinal nerve

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20
Q

Describe articular facets of Cervical vertebrae

A

posterior to transverse process
flat and oval shaped and oriented OBLIQUELY in coronal plane
Superior facets directed up and back
Inferior facets directed down and forward

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21
Q

What do the spinal processes look like on cervical vertebrae

A

short, bifid* and downward projecting

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22
Q

Describe vertebral arch of cervical vertebrae

A

triangularly shaped

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23
Q

Describe the C1 vertebra

A

Atlas. No body. Anterior arch and posterior arch with lateral masses

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24
Q

Anterior arch of C1 vs posterior

A

Anterior- tubercle and is the facet for dens of CV2

Posterior- tubercle and is the sulcus for vertebral artery

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25
Q

Describe the lateral masses on C1

A

Superior and Inferior articulating facets And transverse process
superior- articulate with occipital condyles
inferior- articulate with sup articulating on C2
Transverse process are attachments sites for head rotating muscles

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26
Q

Why does C1 have such a large vertebral foramen

A

space for caudal medulla

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27
Q

Describe C2 vertebra

A

Axis. has the dens (odontoid process)
dens has smooth articulating facet which receives anterior arch
Sup articular facets articulate with C1
Spinous process is thick and bifid

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28
Q

What is special about C7

A

Cervical prominens. Transition between C and T vertebrae

very long horizontal spinous pocess

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29
Q

What runs through the transverse foramina of C7

A

ONLY vertebral vein (if have the foramina- many times is not there)

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30
Q

Describe the vertebral body of thoracic vertebrae

A

Heart-shaped, intermediate size

2 costal facets per side

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31
Q

Which Thoracic Vertebra have a complete facet(not just half)

A

T1 T10 T11 T12

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32
Q

Describe T articulating processes

A

thing and flat- VERTICALLY in coronal plane
superior facets face posterior superior and lateral
inferior facets face anterior, inferior and medial

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33
Q

Describe T transverse processes

A

Thick, strong and long
directed posterolateral
facet on anterior surface for articulation with costal tubercle

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34
Q

Describe characteristic of T laminae

A

overlapping like roofing shingles

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35
Q

Describe spinous processes of T vertebrae

A

Overlap one another and directed inferiorly*

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36
Q

Which level of vertebra is the vertebral foramen the most narrow in diameter

A

Thoracic

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37
Q

Describe body of Lumbar vertebrae

A

largest because of weight bearing

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38
Q

Why are the pedicles closer in L vertebrae

A

stronger, less torque

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39
Q

Describe transverse processes of L vertebrae

A

anterior to articulating processes. direct laterally

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40
Q

Describe articulating processes of L vertebrae

A

VERTICALLY in SAGITTAL plane
superior- face medially and posteriorly
inferior- face laterally and anteriorly

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41
Q

Describe laminae of L vertebrae

A

short- non overlapping.

facilitate lumbar puncture because when flexed can get needle through

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42
Q

What is the pars interarticularis

A

area of lamina between superior and inferior articulating processes

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43
Q

What does the erector spinae mm attach to on L vertebrae

A

spinous processes
mammillary processes
accessory mammillary processes

44
Q

Describe vertebral foramen in L vertebrae

A

triangular shaped with apex directed posteriorly

45
Q

What is the superior surface of the sacrum

A

Promontory- anteriorly facing

46
Q

What are the lateral surfaces of sacrum

A

Alae- fused costal and transverse processes of SV1

47
Q

What is the auricular surface of the sacrum

A

anterolateral surface of the alas- articulate with ilium

48
Q

Describe ventral surface of sacrum

A

concave and smooth

pierced by 4 paris of sacral foramina

49
Q

What runs through ventral sacral foramina

A

ventral primary rami of sacral spinal nerves

50
Q

Describe dorsal surface of sacrum

A

convex and rough. Four pairs of dorsal sacral foramina. Median sacral crest
Sacral hiatus

51
Q

What runs through the dorsal sacral foramina

A

dorsal primary rami of sacral spinal nerves

52
Q

What makes up the median sacral crest

A

fusion of sacral spinous processes

53
Q

Where is the site for epidural anesthetic injection

A

sacral hiatus

54
Q

What creates the sacral hiatus

A

failure of S5 fusion, sometimes S4 too

55
Q

What makes up the intermediate sacral crest

A

fused articular processes

56
Q

What are the sacral cornua

A

tubercles of inferior articulating processes of S5

57
Q

What makes up the lateral sacral crest, site for what?

A

fused transverse processes,

site for attachment of sacroiliac, sacrotuberous and sacrospinous ligaments

58
Q

What makes up the coccyx

A

4 fused segments- bodies only

coccygeal horns are posterior tubercles which articulate with sacral horns from S5 vertebral foramen

59
Q

What are the normal curvatures

A

Primary- anterior concavity of the vertebral column

Secondary- anterior convexity of the vertebral column (Cervical and Lumbar when we can walk)

60
Q

Abnormal curvatures and describe each

A

Lordosis- exaggerated secondary curve of lumbar
Kyphosis- exaggerated primary curve of thoracic
Scoliosis- lateral S shape in any region

61
Q

What are the components of an intervertebral disc

A

Annulus fibrosis and Nucleus Pulposis

62
Q

How much of the length of the spine is attributed to intervertebral discs and does this change?

A

1/4

decrease in thickness as age increases due to dehydration

63
Q

What is the shape of intervertebral discs

A

wedge shaped. thicker anteriorly in cervical and lumbar to maintain secondary curves

64
Q

What is a ruptured disc

A

tear of the annulus fibrosis leading to loss of integrity between contiguous vertebrae

65
Q

What is a herniated disc

A

nueclue pulposus squeezes through the ruptured disc and may contact roots of spinal nerves.

66
Q

Differences in herniated discs based on the level they occur

A

In Cervical regions- affect spinal nerves at same level

In Lumbar regions- affect spinal nerves one or more levels lower

67
Q

What is the ligament that runs on the anterior surface of all vertebrae

A

anterior longitudinal ligament

68
Q

Layers of anterior long lig

A

deep layer- short fibers that span contiguous vertebrae

superficial layer- long fibers that span many vertebrae

69
Q

What ligament prevents excessive extension

A

anterior long spinal lig

70
Q

Where is the post long lig and its function

A

located on post surface of all vertebral bodies- same fibers as anterior log.
Prevents excessive flexion
*directs intervertebral dis herniation posterolaterally

71
Q

Zygapophysis

A

facet joints. synovial joint

72
Q

Describe motion limits of zygapophysis regarding to the segment

A

Cervical- flexion, extension, rotation, lateral flexion
Thoracic- rotation, lateral flexion(little flexion no extension)
Lumbar- flexion, extension, side bending, very limited rotation

73
Q

Why is the zygapophysis in the thoracic region more restricted?

A

presence of ribs, long thoracic spinal processes and thin intervertebral discs

74
Q

What is the ligamentum flava

A

unites internal surfact of adjacent laminae from C2 downward.
Maintains upright posture by LIMITING flexion and ALIGNS facet joints

75
Q

Why is the ligamentum flava yellow

A

high in elastic fibers

76
Q

What is the strongest ligament posterior to vertebral bodies

A

ligamentum flava

77
Q

Describe the Interspinal ligament

A

Unites adjacent processes from tip to laminae

most robust at lumbar levels.

78
Q

Describe the Supraspinal ligament

A

Connects tips of spinous procceses from C7 to sacrum

continuous with interspinous lig

79
Q

What are the two layers of supraspinal ligament

A

deep- span adjacent spinous process

superficial- span several vertebrae

80
Q

What is the Ligamentum Nuchae

A

Nuchal lig.
median sheet like upward extension of the supra spinal ligament
extends from C7 to external occiptal protuberance
acts ans intermuscular septum
Provides muscular attachment without limiting extension of cervical column

81
Q

What are the boundaries of the intervertebral foramina

A

Superior- inferior vertebral notch of vertebra
Inferior- Superior vertebral notch of vertebra
Anterior- Posterior portion of vertebra above intervertebral disc
Posterior- facet joint between 2 opposing vertebrae

82
Q

How deep is the intervertebral foramen

A

width of pedicle

83
Q

What runs within the intervertebral foramen

A

Dorsal and ventral roots
Dorsal root Ganglion
Spinal Nerve
Spinal a and intervertebral vein

84
Q

What type of joint is the Atlantoocciptal joint

A

gliding, or plane synovial joint between occipital condyles of skull and superior articulating facets (C1) atlas

85
Q

What movement does atlantoocciptal joint permit

A

Yes movement. flexion and extension

86
Q

What are the accessory ligaments of the atlantoocciptal joint

A

Anterior membrane- between ant margin of foramen magnum and anterior arch of atlas
Posterior membrane- between post margin of foramen magnum and post arch of atlas

87
Q

What runs through the openings in the posterior atlantooccipital membrane

A

lateral passage for vertebral arteries and suboccipital nerve (dorsal ramus C1)

88
Q

Where do the Ant and Post membranes of atlanto-occipital joint fuse

A

laterally

89
Q

What is the atlantoaxial joint: type and function

A

gliding synovial between atlas and axis

No movement- rotation because pivot at the dens on axis

90
Q

What are the ligaments of Atlantoaxial joint

A

Transverse lig of atlas- attaches to internal surface of anterior arch of C1 forming socket
Sueprior crus- from transverse log superiorly to attach to ant edge of foramen magnum
Inferior crus- transverse lig inferiorly to attach to post surface of axis body

91
Q

What is the collective name for the ligament of the atlantoaxial joint

A

Cruciform ligament of the atlas

92
Q

What are the accessory ligaments for C1/C2

A

Apical dental lig(deep to superior crus)
Alar ligaments- arise from dens laterally to attach to occipital condyles(rotation restriction)
Tectorial membrane- covers dens and assoc ligaments
Anterior atlantoaxial membrane and Posterior

93
Q

What does the tectorial ligament fuse with

A

anteriorly fuses with dura mater, inferiorly to C2 to the posterior longitudinal ligament

94
Q

Describe anterior and posterial atlantoaxial membranes

A

anterior- from ant arch of atlas to ant body of axis

Posterior- posterior arch of atlas to lamina of axis- continuous with ligamentum flava

95
Q

What is an injury seen with C1/C2 joint

A

fractures of dens. dislocation super rare because of extensive ligaments

96
Q

Spondylosis

A

usually developmental defect in pars interarticularis

97
Q

Spondylolisthesis

A

bilateral spondylosis. Entire column affected as it slide forward on vertebra below. Most commonly seen at L5 on S1

98
Q

What is the arterial supply in column

A

Spinal arteries:

vertebral a, ascending cervical a, posterior intercostal aa, lumbar aa, iliolumbar a, lateral sacral a

99
Q

What are the divisions of spinal arteries

A

Osseous and neural branches

100
Q

Describe osseous branches of spinal aa

A

anastomose with like branches above, below and opposite to form plexi within vertebral canal(epidural) posterior to the post long ligament and ant to ligamentum flava

101
Q

Describe the neural branches of spinal aa

A

Provide RADICULAR branches which enter dural sac along spinal nerve. (course along dorsal and ventral roots)

102
Q

What is a precaution in heart surgery because of spinal aa

A

Special procedures to supply this blood when aorta is clamped

103
Q

4 General considerations of Veins in vertebral column

A

1) Four venous plexi drain vertebral column
2) All four run the entire length
3) all four freely intercommunicate
4) They do NOT have valves

104
Q

What are the four plexuses

A

Anterior external- ant surface vertebral bodies
Posterior external- external surface of spinous, articular and transverse processes
Anterior internal- In epidural space adjacent to posterior long spinal ligament
Posterior internal- in epidural space adjacent to laminae and ligament flava

105
Q

Describe two components of venous flow in column

A

Basivertebral vv- drain bodies to anterior internal plexus
Intervertebral vv- drain all 4 venous plexuses
these drain into vertebral, posterior intercostal, lumbar and lateral sacral vv

106
Q

What is particular about the vertebral vascular plexus due to its no valves

A

receives blood from pelvic, abdominal, thoracic and cranial cavities. Changes in intra-thoracic and intra-abdominal Pressures also have changes in venous flow

107
Q

Why is this no valve system important clinically

A

metastatic spread of cancer cells(prostate and breast)

also spread of infectious disease to vertebral column

MSK EXAM I (9 decks)

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