quiz questions exam 2 Flashcards
what parts of the body will the right lymphatic duct drain?
1) the right side of teh head, neck and thoracic parietal wall
2) right lung and convex (diaphragmatic) surface of the liver
what is the location and structural origin for the thoracic duct?
L2 from the cisterna chyli
what are examples of aggregate lymph nodules?
the tonsils and peyer’s patches
what is the function of lymph nodules?
perpetuation of the lymphocyte cell line and to aid in the immune response
what is the function of lymph nodes?
primary function is to filter lymph but are also involved in lymphocytopoiesis and they do participate in the immune response
what attaches to the anterior arch of C1?
longus colli
what is the morphology of the superior articular facet?
1) elliptical
2) closer together in front
3) often demonstrate an elevation subividing the facet surface into 2 separate surfaces
what is the orientaion of the inferior articular facet of C1?
backward medial downward (BMD)
what is the name of the rounded elevation on the medial aspect of the lateral mass of C1?
tubercle for the transverse atlantal ligament
what muscles attach to the lateral mass of C1?
1) levator scapula
2) splenius cervicis
3) rectus capitis anterior
what is the distance from the posterior tubercle of the posterior arch to the skin in each gender
males ~ 50 mm
females ~ 37 mm
what attaches to the posterior tubercle of the posterior arch of C1
rectus capitis posterior minor muscle
ligamentum nuchae
with regard to ossification of the posterior atlanto-occipital ligament, what is the gender bias, bone classification, amount of ossification and general percent of the population?
male: accessory bone, complete ponticulus posticus, 15%
female: accessory bone, partial ponticulus posticus, 26%
what muscles attach to the transverse process of C1?
1) rectus capitis anterior
2) rectus capitis lateralis
3) middle scalene
4) levator scapula
5) splenius cervicis
6) obliquus capitis superior
7) obliquus capitis inferior
8 intertransversarii muscles
what is the gender variation for measurements of the transverse diameter of C1?
males: 78 mm
females: 72 mm
what is the distance from posterior tubercle of the transverse process of C1 to the skin for each gender?
a little over 30mm for males and females
what joint classifications are observed at C1?
1) amphiarthrosis syndesmosis
2) diarthrosis trochoid
3) diarthrosis ellipsoidal
4) diarthrosis arthrodia
what names are given to C2?
1) axis
2) epistropheus (know this one for shizzle)
what joint classifications are present at the vertebral body of C2?
1) amphiarthrosis syndesmosis
2) diarthrosis trochoid
3) modiefied diarthrosis sellar
4) amphiarthrosis symphsis
what attaches to the lamina of C2?
1) obliquus capitis inferior muscle
2) posterior atlanto-axial ligament
3) ligamentum flavum
what is the name given to the odontoid process when the facet for the fovea dentis lies below the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed anterior
kyphotic dens
what ligament forms the anterior boundary for the spinal canal above C2?
membrana tectoria
what is teh facet orientation of the superior articular facet of C2?
BUL
backward
upward
lateral
what is the gender variation for the transverse diameter of C2?
males: 57 mm
females: 50 mm
what name is given only to C7?
vertebral prominens
what is the segment and gender bias for vertebrae othe rthan C7 becoming the vertebral prominence?
C6 is more common in females and T1 is more common in males
how many joint surfaces are present at the vertebral body of C7?
8
what muscles attach to the transverse process of C7?
1) middle scalene
2) iliocostalis throacis
3) longissimus cervicis
4) semispinalis capitis
5) rotators
6) intertransversarii
7) levator costarum brevis
what is the orientation of the inferior articular facet of C7?
ForMeD
forward
medial
down
what muscles attach to the spinous process of C7?
1) trapezius
2) rhomboid minor
3) serratus posteior superior
4) splenius capitis
5) spinalis capitis
6) spinalis cervicis
7) semispinalis throacis
8) multifidis
9) rotators
10) interspinalis
the vertebral artery on which side is typically larger?
left vertebral artery
what is the gender bias regarding size of the vertebral artery?
men have larger vertebral arteries than women
what is the name of the physical exam used to determine vertebral artery patency?
the vertebrobasilar artery insufficiency test
which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?
the ipsilateral artery on the side of rotation
at what location will the vertebral artery form its compensatory loop?
the atlanto-axial interspace
at what segments will the vertebral artery be firmly attached to the transverse foramen?
both C1 and C2
what is the purpose of the vertebral artery loops between C2, C1 and occiput?
the increased length will accommodate the greater rotation at these locations
what happens to the vertebral artery after it enters the subarachnoid space at C1?
the vertebral artery ascends along the medulla oblongata to the pontine-medullary junction where the right and left arteries unite to form the basilar artery
what artery is formed by the union of the right and left vertebral arteries?
the basilar artery
what forms the boundaries for the exit of the C1 nerve from the spinal canal?
1) occipital condyle
2) superior articular process of C1
3) capsular ligament
4) arcuate rim
5) groove for the vertebral artery
6) posterior atlanto-axial ligament
what forms the boundaries for the exit of the C2 nerve from the spinal canal?
1) inf. art.process of C1
2) sup. art. process of C2
3) inf. vert. notch of C1
4) sup. vert. notch of C2
5) post. arch of C1
6) lamina of C2
7) capsular ligament
8) post. atlanto-axial ligament
what forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?
1) vertebral bodies
2) intervertebral discs
3) PLL
4) uncinate process
5) lateral groove
what features will allow discrimination between T2-T4 and T5-T8 segmental groups?
1) vertebral body
2) transverse process
3) articular process
4) spinous process
what is the aortic impression?
the flattening of the superior and inferior epiphyseal rims on the left side of the vertebral body of T5-T8 which give the vertebral body a less scalloped or less indented appearance on that side
what is the principal cause of the posterior curve of the thoracic spine?
the vertebral body height differences
what joint classifications are identified at the vertebral body of a typical thoracic?
1) amphiarthrosis syndesmosis
2) amphiarthrosis symphysis
3) diarthrosis arthrodia
how many synovial joints are formed at the vertebral body of a typical thoracic?
four
how many joints are formed at the vertbral body of a typical thoracic?
typically ten
fourteen if the rib ligaments are included
what is the name given to the joint formed between the verebral body and the rib?
costocentral joint
what does the intra-articular or interarticular ligament connect to?
the interarticular or intra-articular crest of the capitulum of the rib and the intervertebral disc
what ligaments support the costocentral joint?
1) radiate costocentral (stellate costocentral) ligament
2) interarticular (intra-articular) ligament
which x-ray view is used to see into the intervertebral foramen of a typical thoracic?
lateral view
what ligaments support the soctotransverse joint of a typical thoracic?
1) superior costotransverse
2) inferior costotransverse
3) lateral costotransverse
the superior costotransverse ligament of the transverse process of T4 will attach to which rib?
fifth rib
which muscles may attach to the transverse process of a typical thoracic?
1) Longissimus thoracic, cervicis, capitis
2) semispinalis cervicis and capitis
3) rotator longus and brevis
4) levator costarum longus and brevis
5) Intertransverarii
6) multifidis
how can you distinguish between T2-T4 and T5-T8 segment using the articular process?
T2-T4 - the width between the sup. art. processes is greater than the width between the inf. art. process of that vertebra
T5-T8 - the width between the sup. art. processses is equal to the width between the inf. art. processes of that vertebra
what is the orientation of the inferior articular facet of a typical throacic?
(ForMeD)
Forward
Medial
Down
Imbrication will be more pronounced for what region of the thoracics?
T5-T8
what is the angulatoin of the spinous process in the typical thoracic regoin?
undersurface of T2-T4 spinous process will angle up to forty degrees from the horizontal plane
undersurface of spinous process T5-T8 will angle up to sixty degrees from the horizontal plane
which muscles may attach to the spinous process of a typical thoracic
1) trapiezius
2) latissimus dorsi
3) rhomboid major
4) serratus posterior superior
5) splenius cervicis and capitis
6) spinalis capitis
7) semispinalis thoracis
8) multifidis
9) rotator longus and brevis
10) interspinalis
what are the muscles associated with the 5 layers of the true back?
layer 1: trapezius and latissiumus dorsi layer 2: rhomboids and levator scapulae layer 3: serratus posterior layer 4: erector spinae layer 5: transversospinalis
how many joints are formed at the vertebral body of T1?
typically 10, fourteen if you include the rib ligaments
what ligament is absent at the costotransverse joint of T1?
superior costotransverse ligament
what ligaments attach to the transverse process of T1?
1) intertransverse
2) capsular costotransverse
3) superior costotransverse
4) inferior costotransverse
5) lateral costotransverse
para-articular processes are more commonly observed on which segment?
T10
a dimpling or depression of the skin in the thoracic region is often characteristic of the location on which segment?
T10
what name is given to the T11 vertebra?
the anticlinal vertebra
which muscles attach to the vertebral body of T12?
Psoas major and minor
what ligamentss ofrm the costotransverse joint of the twelfth rib?
the superior costotransverse ligament form the T11 and the lumbocostal ligament from L1
what is the orientation of the inferior articular facets of T12?
FoLD
Forward
Lateral
Down
how many synovial joints are typically present at T12?
six
what muscles artach to the spoinous process of T12?
1) trapezius
2) latissimus dorsi
3) serratus posterior inferior
4) iliocostalis lumborum
5) spinalis thoracis
6) multifidis
7) rotator longus and brevis
8) interspinalis
which erector spinae muscle is unique in it’s’ attachment to the T12 spinous process?
iliocostalis lumborum
what accounts for the direction of the lumbar curve?
the vertebral body and intervertebral disc have a greater anterior height than posterior height
what muscles may attach to a typical lumbar vertebral body?
psoas major and psoas minor
what is the name given to ligaments which attach vertebral body to articular process?
transforaminal ligaments
what ligaments attach the vertebral body to the transverse process?
coporotransverse ligaments
what is the proposed function of the Hofmann ligaments in the cervical-upper thoracic region? lumbar region?
resist caudal movement of the dural sac; resist gravitational forces on the dural and cord
resist cranial movement of the dural sac during flexion
what osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
1) overlap of laminae
2) shingling diminishes
3) overlap of spinous processes
4) imbrication diminishes
a styloid process occurs with what frequency and as a result of what condition?
7% occurence as a result of congneital elongation of the lumbar accessory process
what was believed to be entrapped by the mammillo-accessory ligament?
the medial branch of the dorsal rammus of a lumbar spnal nerve
what muscle(s) attach to the lumbar accessory process?
1) longissimus thoracis
2) intertransversarii
what names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane or position and the other zygapophysis lies in the sagittal plane or position?
joint asymmetry or joint tropism
what are the names of the condition when the typical lumbar spinous process increases in length due to the aging process?
Baqastrup’s syndrome or “kissing spines”
what ligaments attach to the trnasverse process of the fifth lumbar vertebrae?
1) lumbosacral
2) iliolumbar
3) mammillo-accessory
4) intertransverse
what names are given to the condition in which the right zygapophysis of a vertebral couple lies in a plane or position different from the left zygapophysis?
joint asymmetry or joint tropism
what is the name given to the congential condition in which the fifth lumbar spionous process is elongated, the sacrum exhibits spina bifida, and dorsiflexion produces pain?
knife clasp syndrome
lumbar spondylolysis has not been reported in what groups of individuals?
1) fetuses
2) newborns
3) rarely in children under 5
4) patients who have never walked
5) non-erect spines
what is the gender bias and locational bias associated with lumbar spondylolysis?
men at L5/S1
women at L4/L5
what characteristics are associated with the cervial spondylolysis?
rare, congenital, gender biased toward men, most common at C6, and linked to spondylolisthesis and spina bifida
what is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view
a collared scotty dog
what is the ethnic, gender, and locational bias associated with sacral spondylolysis?
the native Alaskan (Inuit) male at S1 level
identify all names given to the type 1 spondylolisthesis
dysplastic spondylolisthesis
congenital spondylolisthesis
what gender bias, locational bias and spinal canal dimensions are associated with type 2 spondylolisthesis?
isthmic spondylolisthesis is common in men, located at the L5/S1 level and demonstrates and increase in sagittal diameter of the spinal canal
what is the gender bias locational bias and spainal canal dimension changes often associated with type 3 somdylolisthesis?
degenerative spondylolisthesis is amore common in women, particularly at L4/L5 and demonstrates no change in sagittal diameter of the spinal canal
what are the causes associated with type 5 spondylolisthesis?
bone disease such as paget disease and osteogenesis imperfecta
what features may be identified along the intermediate sacral crest?
the mammillary process of S1 and the sacral cornu of S5
what features may be indentified along the lateral sacral crest:
1) S1 transverse tubercle
2) sacral tuberosity of S2
3) transverse tubercles of S3, S4, S5
what is the name of the joint formed by the sacral tuberosity?
the accessory scaro-iliac joint
what forms the posterior boundary for the first coccygeal spinal nerve inter-vertebral foramen?
1) sacral cornu
2) coccygeal cornu
3) superficial dorsal sacrococcygeal ligament
4) intervertebral disc
what forms the inferior boundary for the spinal canal?
the union of the superficial dorsal and deep dorsal sacrococcygeal ligaments
superior articular facets of which vertebrae will be oriented BUM; backward upward and medial
C1, C3-C7, L1-L5, S1
superior articular facets of which segments will be oriented backward upward and lateral?
C2, T1-T12
inferior articular facets of which segments will be oriented forward lateral and downward?
C2-C6, T12, L1-L5
what is another way of implying occipitalization of C1?
atlas assimilation
what joint is formed between the odontoid process ossification centers and the centrum of C2?
the subdental synchondrosis
what is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 perseist beyond age 7?
os odontoideum
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
if the joint formed between the tip of the dens and the odontoid process centers of ossification persists beyond age 12, what is the condition called?
terminal ossicle
what is the incidence of rib-related changes following dorsalization of C7?
from .5% - 2.5% of the population
what is the gender bias suggested in dorsalization of C7?
female
what C7 facet orientation changes may accompany cervicalizaion?
the inferior articular facet may change from forward, medial, and downward to forward lateral and downward. the superior is unchanged
what is the gender bias associated with dorsalization of L1?
males are two to three times more affected
what T12 facet orientation changes may accompany lumbarization?
the superior articular facet may change from flat, back, upward, and lateral to concave, back, upward, and media; the inferior articular facet is unchanged
what is the characteristic of lumbarization of S1?
the failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala
which segment demonstrates the greatest morphological variation along the spine?
L5
what developmental events are indicated in the formation of the adult cervical curve?
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.
what is the name given to the integration of visual and motor pathways associated with holding the head erect?
the righting reflex
what developmental events are indicated in the formation of the adult lumbar curve?
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
what developmental events are indicated in the formation of the adult cervical curve?
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.
what is the relationship between curve direction and handedness?
a right handed person has a high probability ofr a right thoracic, left lumbar curve combination
what clinical examples of abnormal curvatures along the vertebral column were stressed in class?
military neck, humpback or hunchback, and swayback
what are the curve clasifications for military neck?
a kyphosis or hypolordotic curve
what are the classifications of scoliosis according to the scoliosis research society?
magnitude, location, direction, etiology, and structural/non-structural
what does idiopathic scoloiosis infer?
the scoliosis is unique to the individual, it has no known cause, unknown etiology
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 the more likely to worsen?
the greater the deviation, the lower the incidence, and the more likely to worsen
which subdivision of the iliocostalis muscle appears to have a reversal of origin - insertion?
iliocostalis lumborum pars lumborum
which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves?
intertransversarii
the semispinalis capitis and spinalis capitis may fuse to form what muscle?
biventer cervicis
identify all muscle groups innervated by dorsal primary rami branch patterns
1) splenius
2) erector spinae
3) transversospinalis
5) suboccipital
6) interspinalis
7) levator costarum
8) intertransversarii
which muscle is said to form the iliolumbar ligament
quadratus lumborum
based on the density of muscle spindles, what is the proposed function of the intertransversarii?
acts as a proprioceptive transducer in conjunction with interspinalis to corrdinate the smooth movement of the spine and to maintain appropriate posture
what is the proposed function of the suboccipital muscle group?
postural stabilizers of the atlanto-occipital adn atlanto-axial joints
which muscles of the spine exhibit a reversal of the expected origin - insertion combination?
iliocostalis lumborum pars lumboru, longissimus thoracic pars lumborum and multifidis lumborum
which muscles are identified as transversospinalis muscles?
semispinalis, multifidis, and rotators
which transversospinalis muscle attaches to articular and mammillary processes along the spine?
multifidis
what is the vertebral column origin for the longissimus thoracis pars lumborum?
posterior superior iliac spine (PSIS) of the innominate bone
