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Spinal Anatomy Final Exam > Spinal Anatomy Final > Flashcards

Spinal Anatomy Final Flashcards

1
Q

What is the radiological test for skeletal maturity?

A

The Risser sign, an indication of bone maturity in the iliac apophysis

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2
Q

What does the magnitude of scoliosis refer to?

A

The length and angle of the curve deviation on x-ray

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3
Q

What is often used to measure the magnitude of scoliosis?

A

The Cobb Method

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4
Q

What does location of scoliosis infer?

A

The location on the vertebral segment forming the apex of the curve deviation

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5
Q

What does direction of scoliosis refer to?

A

The side the convexity of the curve will bend toward

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6
Q

What does etiology of scoliosis mean?

A

The cause of the scoliosis

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7
Q

What is structural scoliosis?

A

A more radical form of scoliosis,

It may worsen,

Associated with structural deformities of the vertebra or intervertebral disc,

Frequently has a fixed angle of trunk rotation

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8
Q

What is nonstructural scoliosis?

A

A mild form of scoliosis,

Unlikely to worsen,

Not associated with structural deformities of the vertebra or intervertebral disc

Lacks a fixed angle of trunk rotation

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9
Q

What are some of the classifications of scoliosis based on etiology?

A

Congenital, neuromuscular, neurofibromatosis, nerve root irritation, idiopathic

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10
Q

What is the classification of scoliosis that is unique to the individual patient?

A

Idiopathic scoliosis

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11
Q

What does idiopathic scoliosis infer?

A

The scoliosis is unique to the individual, it has no known cause, unknown etiology

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12
Q

What is the incidence of idiopathic scoliosis in the population?

A

1% to 4% of the population

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13
Q

What is the age range for infantile idiopathic scoliosis?

A

From birth to 3 years old

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14
Q

What is the age range for juvenile idiopathic scoliosis?

A

From 3 years old to 10 years old

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15
Q

What is the age range for adolescent idiopathic scoliosis?

A

Over 10 years old

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16
Q

Identify the curve direction, location, gender bias and incidence of infantile idiopathic scoliosis

A

Left thoracic, male, less than 1% incidence

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17
Q

Identify the curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis

A

Right thoracic, females over 6 years old, and 12% - 21% incidence

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18
Q

Identify the curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis

A

Right thoracic or right thoracic and left lumbar, females, and 80% incidence

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19
Q

What is the genetic factor associated with adolescent idiopathic scoliosis?

A

An autosomal dominant factor that runs in families

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20
Q

What is the relationship between curve deviation, incidence, and curve worsening?

A

The greater the deviation, the lower the incidence, and the more likely to worsen

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21
Q

What is/are the characteristic(s) of occipitalization of C1

A

The atlas may be partially or completely fused to the occiput

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22
Q

What is another way of implying occipitalization of C1?

A

Atlas assimilation

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23
Q

What is the incidence of occipitalization of C1?

A

0.1% to 0.8%

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24
Q

When do the centers of ossification for the odontoid process first appear?

A

During the last trimester in utero

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25
Q

When do the bilateral ossification centers for the odontoid process fuse?

A

At or shortly after birth

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26
Q

What joint is formed between the odontoid process ossification centers and the centrum of C2?

A

The subdental synchondrosis

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27
Q

Ossification between the odontoid process and centrum joint of C2 first appears at what age?

A

4 years old

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28
Q

A joint between the odontoid process and centrum of C2 is last identified at what age?

A

7 years old

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29
Q

What is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 persists beyond age 7?

A

Os odontoideum

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30
Q

What is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7?

A

Persistent subdental synchondrosis

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31
Q

What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?

A

Tip of the dens synchondrosis

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32
Q

At what age will the tip of the dens center of ossification appear?

A

Sometime in early adolescence

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33
Q

At what age will the tip of the dens fuse with the odontoid process?

A

Before age 12

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34
Q

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?

A

Terminal ossicle

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35
Q

What is a basilar impression?

A

Persistence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain

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36
Q

What is a basilar invagination?

A

The upper cervical spine appears to be invaginated into the skull on x-ray analysis

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37
Q

What is the incidence of rib-related changes following dorsalization of C7?

A

From .5 to 2.5 percent of the population

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38
Q

Do patients typically present with symptoms specific for dorsalization of C7?

A

No, they are typically asymptomatic

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39
Q

What is the gender bias suggested in dorsalization of C7?

A

Female

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40
Q

What alteration in C7 facet orientation may accompany dorsalization?

A

The superior articular facet of C7 may change from back, upward, and medial (BUM) to that of a typical thoracic facet…back, upward, and lateral (BUL); the inferior articular facet is unchanged

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41
Q

What percent of the population may demonstrate thoracic-like features at C7?

A

Up to 46%

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42
Q

What T1 facet orientation changes may accompany cervicalization?

A

The superior articular facet may change from back, upward, and lateral (BUL) to back, upward, and medal (BUM); the inferior articular facet is unchanged

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43
Q

What is the incidence of cervicalization of T1 in the population?

A

Up to 28% of the population

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44
Q

What is the incidence of lumbar ribs in the population?

A

Over 7% of the population demonstrates lumbar ribs

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45
Q

What L1 facet orientation changes may accompany dorsalization?

A

The superior articular facet may change from concave, back, upward, and medial to flat, back, upward, and lateral; the inferior articular facet is unchanged

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46
Q

What is the gender bias associated with dorsalization of L1?

A

Males are two to three times more affected

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47
Q

What T12 facet orientation changes may accompany dorsalization?

A

The superior articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged

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48
Q

What T11 facet orientation changes may accompany lumbarization?

A

The inferior articular facet may change from flat, forward, medial, and downward to convex, forward, lateral, and downward; the superior articular facet is unchanged

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49
Q

What is the usual way of identifying the number of cervicals, thoracics and lumbar vertebrae during imaging studies?

A

Identify the vertebrae with ribs - they will be thoracics; those higher are cervicals, those lower are lumbars

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50
Q

What is characteristic of lumarization of S1?

A

The failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala

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51
Q

What is failure of synostosis between S1 and S2?

A

The segments do not completely fuse together

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52
Q

What is squaring of the vertebral body of S1?

A

The S1 vertebral body has similar anterior and posterior heights, hence a lack of wedging

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53
Q

What is flaring of the sacral ala?

A

The transverse process of the ala appears to elevate as though separating from the rest of the sacral ala

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54
Q

What articular facet changes accompany lumarization of S1?

A

none

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55
Q

What is characteristic of sacralization of L5?

A

L5 may be partially or completely fused to the sacrum

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56
Q

What is the incidence of sacralization of L5 in the population?

A

41% to 85%

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57
Q

Which segment demonstrates the greatest morphological variation along the spine?

A

L5

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58
Q

What articular facet changes accompany sacralization of L5?

A

none

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59
Q

What is the incidence of variation within the sacrococcygeal region in the population?

A

Up to 14%

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60
Q

What is characteristic of sacralization of Co1?

A

The premature fusion of Co1 to the sacrum

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61
Q

What is characteristic of coccygealization of S5?

A

The separation of S5 from sacrum and its’ premature fusion to Co1

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62
Q

The trapezius is innervated by what nerve?

A

The spinal accessory nerve

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63
Q

What forms the spinal accessory nerve innervating the trapezius?

A

C1-C5 cord levels contribute to the spinal root of the spinal accessory nerve

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64
Q

The latissimus dorsi is innervated by what nerve?

A

The thoracodorsal nerve

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65
Q

What forms the thoracodorsal nerve innervating the latissimus dorsi?

A

Ventral rami from C6-C8

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66
Q

What forms the dorsal scapular nerve?

A

The ventral ramus of C5

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67
Q

What is the innervation of the splenius capitis?

A

Dorsal rami of middle cervical spinal nerves (C3-C5 cord levels)

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68
Q

Splenius cervicis will attach to what locations on the spine?

A

Lateral mass of C1 and posterior tubercle of transverse process on C1-C4

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69
Q

Which muscles are identified as erector spinae or sacrospinalis muscles?

A

Iliocostalis, Longissimus, Spinalis

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70
Q

What is the innervation of the iliocostalis lumborum?

A

Dorsal rami of lower thoracic and all lumber spinal nerves

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71
Q

What osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis?

A

none

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72
Q

What is the insertion for the iliocostalis thoracis?

A

Costal angles of the upper 6-7 ribs, transverse process of C7

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73
Q

What osseous parts of the vertebral column serve as an origin to the longissimus thoracis?

A

Accessory process and transverse processes of L1-L5, spinous processes of L3-L5 and median sacral crest S1-S3

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74
Q

What is the innervation of the longissimus cervicis?

A

Dorsal rami of C4-C8 and T1-T2 spinal nerves (C4-C8 and T1-T2 cord levels)

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75
Q

What osseous parts of the vertebral column serve as an origin to the spinalis thoracis?

A

Spinous processes of T11 & T12 - L1 & L2

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76
Q

Which muscles are identified as transversospinalis muscles?

A

Semispinalis, multifidis and rotators

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77
Q

How many vertebrae can be attached to a single segment by transversospinalis muscles?

A

As many as 9 vertebrae

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78
Q

What segment will represent the lowest attachment site for the semispinalis thoracis?

A

T12

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79
Q

What osseous parts of the vertebral column serve as an origin to the semispinalis cervicis?

A

Transverse tubercles of T1-T5 or T6 & articular processes of C4-C7

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80
Q

What osseous parts of the vertebral column serve as an origin to the semispinalis capitis?

A

Transverse tubercles of C7, T1-T6 or T7 & articular processes of C4-C6

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81
Q

The semispinalis capitis and spinalis capitis may fuse to form what muscle?

A

Biventer cervicis

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82
Q

What osseous parts of the vertebral column serve as an origin to the classic multifidis?

A

Articular process of C4-C7, transverse processes of T1-T12, mammillary processes of L1-L5 and the dorsal surface of S1-S4 or S5

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83
Q

Contraction of the classic multifidis will result in what movements of the vertebral column?

A

Lateral flexion & rotation of the spine,

Maintains the lumbar lordotic curve,

Prevents entrapment of zygapophyseal capsular ligament during movement

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84
Q

Contraction of multifidis cervicis will result in what movements?

A

Alters the zygapophyseal capsular ligament response to load distribution,

Determines the cervical spine response to injury as evidenced by neck pain,

Is a significant contributor to postural control of the head and neck

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85
Q

Contraction of multifidis lumborum will result in what movements?

A

Lateral flexion & rotation of the lumbar spine,

Maintains the lumbar lordotic curve,

Prevents entrapment of lumbar zygapophyseal capsular ligament during movement

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86
Q

Which muscles of the spine exhibit a reversal of the expected origin - insertion combination?

A

Iliocostalis lumborum pars lumborum, longissimus thoracic pars lumborum and multifidis lumborum

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87
Q

Rotator muscles are typically identified in what region of the spine?

A

The thoracic region

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88
Q

Which suboccipital muscle lacks an attachment to the skull?

A

Obliquus capitis inferior

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89
Q

Which nerve will innervate all suboccipital muscles?

A

The dorsal ramus of C1, the suboccipital nerve

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90
Q

What is the origin of the obliquus capitis inferior?

A

C2 spinous process and lamina

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91
Q

An increase in the density of muscle spindles is most apparent in which suboccipital muscle?

A

Obliquus Capitis Inferior

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92
Q

What is the proposed function of the suboccipital muscle group?

A

Postural stabilizers of the atlanto-occipital and atlanto-axial joints

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93
Q

Which suboccipital muscles are known to attach to dura mater?

A

Rectus capitis posterior major, rectus capitis posterior minor & obliquus capitis inferior

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94
Q

Interspinalis is paired in which regions of the spine?

A

Cervical and lumbar regions

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95
Q

Based on the density of muscle spindles what is the proposed function of the interspinalis?

A

Acts as a proprioceptive transducer in conjunction with intertransversarii to coordinate the smooth movement of the spine and to maintain appropriate posture

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96
Q

What is the origin of the longus colli?

A

Vertebral bodies of C5-C7, T1-T3 & anterior tubercles of transverse processes C3-C5

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97
Q

What is the origin of the rectus capitis anterior?

A

Lateral mass & costal element of the transverse process of C1

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98
Q

What will innervate the rectus capitis anterior?

A

Ventral rami of C1-C2 spinal nerves

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99
Q

What will innervate the rectus capitis lateralis?

A

Ventral rami of C1-C2 spinal nerves

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100
Q

What is the insertion of the anterior scalene?

A

Ridge and anterior scalene tubercle of the first rib

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101
Q

What is the insertion of the middle scalene?

A

Between the tubercle and groove for the subclavian artery on the first rib

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102
Q

What is the insertion of the posterior scalene?

A

Outer surface of second rib

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103
Q

What will innervate the posterior scalene?

A

Ventral rami of C6-C8 spinal nerves

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104
Q

The quadratus lumborum is implicated in the formation of which ligaments?

A

The iliolumbar ligament

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105
Q

What is the origin of the psoas major?

A

Vertebral bodies T12, L1-L5, S1 and transverse processes of L1-L5

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106
Q

What is the origin of the psoas minor?

A

Vertebral bodies T12, L1

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107
Q

What will innervate the psoas minor?

A

Ventral ramus of L1 spinal nerve

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108
Q

What is the maximum number of common ligaments identified with a vertebral couple?

A

8

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109
Q

What is the reason that 9 common ligaments are identified but only 8 will be attached at any specific vertebral couple?

A

The ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only 1 of these will be identified at a single vertebral couple

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110
Q

What is the number of true intervertebral discs identified in the adult?

A

23

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111
Q

In the adult, which vertebral levels will demonstrate a true intervertebral disc?

A

Those between C2 and S1 inclusive

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112
Q

What is the percent of intervertebral disc height contribution to the length of each region of the vertebral column?

A

Cervical: 22-25% Thoracic: 20% Lumbar: 33%

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113
Q

What are the names of the central, peripheral, and horizontal zones of the intervertebral disc?

A

Nucleus pulposus - central zone

Annulus fibrosus - peripheral zone

Cartilaginous end plate - horizontal zone

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114
Q

What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?

A

Birth - 88% Thirty - 70%

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115
Q

What is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?

A

The nucleus pulposus will loose water under deformation conditions

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116
Q

What cell is associated with the nucleus pulposus until about age 11?

A

Notochord cells

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117
Q

Which type of collagen is dominant in the nucleus pulposus?

A

Collagen type II

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118
Q

What is the organizational pattern for collagen fibers in the nucleus pulposus?

A

They are irregularly oriented and randomly scattered

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119
Q

What is the appearance of the cervical annulus fibrosus?

A

A horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate process; the posterior margin is thin

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120
Q

What compensates for the thinness of the posterior part of the cervical annulus fibrosus?

A

Posterior longitudinal ligament

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121
Q

What is the organization of the lumbar annulus fibrosus?

A

It has 12-14 concentric cylindrical lamellae

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122
Q

What is the water concentration in the lumbar annulus fibrosus at birth and after 30?

A

Birth - 78% Thirty - 70%

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123
Q

What is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus?

A

They typically have a binding site for hyaluronic acid ad are thus aggregated

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124
Q

Which type of collagen is dominant the annulus fibrosus?

A

Collagen type 1

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125
Q

What is the organizational pattern for collagen fibers in the annulus fibrosus?

A

They are parallel with one another in a single lamellus and angled

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126
Q

What is the organization of collagen fibers between lamellae?

A

Collagen fibers will be angled in the opposite direction such that a spiral - counter spiral organization is observed

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127
Q

What is the attachment site for collagen fibers within the annulus fibrosus?

A

Collagen fibers of the outer lamellae will become Sharpey’s fibers and penetrate the epiphyseal rims Collagen fibers of the inner lamellae will attach to the cartilaginous end plate

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128
Q

What is the origin for the cells of the annulus fibrosus?

A

Sclerotomites

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129
Q

What is the principal type of collagen fiber within the cartilage end plate?

A

The type II collagen fiber

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130
Q

What is the direction of collagen fibers within the cartilage end plate?

A

Collagen fibers are aligned anterior to posterior

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131
Q

What is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus?

A

The cartilaginous end plate

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132
Q

What are the types of receptor endings in the intervertebral disc?

A

Nociceptors and proprioceptors

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133
Q

What is the relationship between size of the intervertebral disc and receptor endings?

A

The larger the disc, the greater the variety of receptor endings

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134
Q

What part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?

A

The outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc

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135
Q

What forms the anterior neural plexus of the vertebral column?

A

Fibers from the ventral primary ramus

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136
Q

What forms the lateral neural plexus of the vertebral column?

A

Fibers from the ventral primary ramus,

Fibers from the white ramus communicans,

Fibers from the gray ramus communicans

Fibers from the paradiscal ramus communicans,

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137
Q

What is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc?

A

The paradiscal ramus communicans

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138
Q

What part of the intervertebral disc is innervated by fibers from the paradiscal ramus communicans?

A

The outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc

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139
Q

How does the intervertebral disc attach to the vertebral body?

A

Sharpey’s fibers from the outer lamellae of the annulus fibrosus are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies

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140
Q

Based on histology, what is the classification of the intervertebral disc?

A

A cartilaginous (amphiarthrosis) symphysis

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141
Q

What are the divisions of the embryonic somite?

A

The sclerotome, myotome, and dermatome

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142
Q

What structure is formed following migration of sclerotomes to surround the notochord?

A

The perichordal blastema

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143
Q

What is formed within the perichordal blastema between the sclerotomites?

A

The intrasclerotomal fissure or fissure of von Ebner

144
Q

What does the intrasclerotomal fissure or fissure of von Ebner become?

A

The perichordal disc

145
Q

What will the dense sclerotomite become?

A

The upper part of the vertebral segment forming below

146
Q

What structure forms following migration and subsequent mixing of the sclerotomites?

A

The vertebral blastema

147
Q

What part of the intervertebral disc will the notochord form?

A

The nucleus pulposus

148
Q

What part of the intervertebral disc will the perichordal disc form?

A

The annulus fibrosus

149
Q

What is the earliest indicator of the position of the adult intervertebral disc?

A

The intrasclerotomal fissure or fissure of von Ebner

150
Q

What vertebral levels will the anterior longitudinal ligament attach to?

A

Those between occiput and S3 inclusive are traditionally indicated

151
Q

What is the lowest extent of the anterior longitudinal ligament based on recent studies?

A

L3

152
Q

What is believed to form the anterior longitudinal ligament in the lumbar spine?

A

The tendon of the crura of the diaphragm

153
Q

What innervates the anterior longitudinal ligament?

A

The anterior neural plexus formed by fibers from the ventral primary ramus and sympathetic postganglionic fibers from the paravertebral ganglia

154
Q

What is the function of the anterior longitudinal ligament?

A

It brakes or limits dorsiflexion or hyperextension of the vertebral column

155
Q

What was ossification of the anterior longitudinal ligament in the lumbar region identified as?

A

Forestier’s Disease

156
Q

What is ossification of the anterior longitudinal ligament in the lumbar region now identified as?

A

Diffuse Idiopathic Skeletal Hyperostosis or DISH

157
Q

Newer research suggests what regional variation in the posterior longitudinal ligaments?

A

Prominent in the cervicals, occasional in the thoracics, rare in the lumbars

158
Q

What is the relationship of the posterior longitudinal ligament to the vertebral foramen?

A

It forms the anterior boundary of the spinal canal

159
Q

What is the innermost layer of the posterior longitudinal ligament called?

A

The perivertebral ligament

160
Q

What is the function of the posterior longitudinal ligament?

A

It brakes or limits flexion of the vertebral column

161
Q

Where is ossification of the posterior longitudinal ligament most commonly identified?

A

The cervical spine with an 80% incidence

162
Q

What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?

A

A loss of hand and finger dexterity

163
Q

What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?

A

Faltering gait

164
Q

What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?

A

It is greater in males over 50 and has a higher incidence in the Japanese

165
Q

What is the name given to the ligamentum flavum based on appearance and histology?

A

It is a yellow elastic ligament

166
Q

What fibers are most ligaments made up of?

A

Collagen type I fibers with are whitish in appearance

167
Q

Where is ossification of the ligamentum flavum most commonly identified?

A

The thoracic spine or thoracolumbar transition zone

168
Q

What is the relationship between the capsular ligament and mobility?

A

The more lax/loose the capsular ligament is, the greater the motion of the joint

169
Q

What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?

A

The cervical and lumbar regions

170
Q

What layers are present in the capsular ligament?

A

A superficial layer of collagen fibers and a deep layer of elastic fibers

171
Q

If the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its’ function?

A

It is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement

172
Q

What is now thought to be a major function of the interspinous ligament?

A

It is more likely a proprioceptive transducer for the spinal reflex

173
Q

What is the name given to the superficial layer of the ligamentum nuchae?

A

The funicular layer or part

174
Q

What is the name given to the deep layer of the ligamentum nuchae?

A

The lamellar layer or part

175
Q

What are the attachment sites for the superficial layer of the ligamentum nuchae?

A

The external occipital protuberance, the external occipital crest, and spinous tubercle of C7

176
Q

What is the histological make-up of the human ligamentum nuchae?

A

It is a yellow elastic ligament, but has more collagen fibers than in quadrupeds

177
Q

What is the classic function of the human ligamentum nuchae?

A

It brakes or limits flexion of the cervical spine

178
Q

What is the termination level inferiorly for the supraspinous ligament according to current literature?

A

Primarily at L4 (73%); between L4 and L5 (5%)

179
Q

What is now thought to be a major function of the supraspinous ligament?

A

It is a proprioceptive transducer for the spinal reflex

180
Q

What amount of flexion-extension is accommodated by the atlanto-occipital joint?

A

About 25 degrees

181
Q

What amount of axial rotation is accommodated by the atlanto-occipital joint?

A

About 3-8 degrees one side axial rotation

182
Q

What amount of lateral bending is accommodated by the atlanto-occipital joint?

A

About 5 degrees

183
Q

What motion is best accommodated by the atlanto-occipital joint?

A

Flexion-extension

184
Q

What is the function of the transverse atlantal ligament?

A

It is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1

185
Q

What movements are facilitated at the median atlanto-axial joint?

A

Flexion-extension, rotation, and telescoping (superior-inferior gliding)

186
Q

***What is the ADI?

A

The Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint

187
Q

***What is the ADI of children compared with that of adults?

A

About 4.5 mm in children; a range of 2-3 mm or about 2.5 mm in adults

188
Q

What are the degrees of movement facilitated at the atlanto-axial joint?

A

About 20 degrees flexion-extension,

40 degrees one side axial rotation,

5 degrees of lateral bending

189
Q

The occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation?

A

About 60%

190
Q

What is the embryonic derivative of the apical ligament of the dens or the apicodental ligament?

A

The notochord

191
Q

What is the function of the alar ligament?

A

Together they function to resist axial rotation

192
Q

What forms the cranial continuation of the posterior longitudinal ligament?

A

The membrana tectoria or tectorial membrane

193
Q

List, in order, the ligaments in a midsagittal plane from the dura mater at the level of the medulla oblongata to the anterior bursa of the median atlanto-axial joint.

A

The membrana tectoria or tectorial membrane

The cruciate ligament

The capsular ligament of the posterior bursa of the median atlanto-axial joint

The apical ligament of the dens or the apicodental ligament

194
Q

For the cervical spine below C2, what is the range of flexion-extension?

A

About 90 degrees or about 18 degrees per couple

195
Q

For the cervical spine below C2, what is the range of one side lateral bending?

A

About 50 degrees or about 10 degrees per couple

196
Q

For the cervical spine below C2, what is the range of one side axial rotation?

A

About 33 degrees or about 6 degrees per couple

197
Q

What are the locations for the costovertebral joints on the vertebra?

A

The costocentral joint at the vertebral body and the costotransverse joint at the transverse process

198
Q

At what rib will the superior costotransverse ligament be absent?

A

The 1st rib

199
Q

What ligaments will attach to the neck of the 12th rib?

A

The superior costotransverse ligament from T11 and the lumbocostal ligament from L1

200
Q

What are the attachment sites for the inferior costotransverse ligament?

A

The neck of the rib and the transverse process of the vertebra at the level

201
Q

At what rib will the inferior costotransverse ligament be absent?

A

The 12th rib

202
Q

What is the name of the space between the transverse process and the neck of the rib?

A

The costotransverse foramen

203
Q

Which ligament ‘fills’ the costotransverse foramen?

A

The inferior costotransverse ligament

204
Q

What are the attachment sites for the lateral costotransverse ligament?

A

The non-articular surface of the tubercle of the rib and the transverse tubercle of the transverse process of the vertebra at that level

205
Q

Which vertebra will lack an attachment for the lateral costotransverse ligament?

A

T12

206
Q

Which vertebral couples of the thoracic spine have the greatest motion?

A

T11/T12 and T12/L1

207
Q

Which range of motion is the greatest for lower thoracic vertebral couples?

A

Flexion-extension

208
Q

Which range of motion is least for lower thoracic vertebral couples?

A

One side axial rotation

209
Q

Which ligaments replace the intertransverse ligament at the lumbosacral joint?

A

The iliolumbar ligament and lumbosacral ligament

210
Q

What muscle is intimately attached to the superior iliolumbar ligament?

A

Quadratus lumborum

211
Q

Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions?

A

The superior iliolumbar ligament

212
Q

Which ligament from the iliolumbar ligament complex will attach to the sacral ala?

A

The inferior iliolumbar ligament

213
Q

Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?

A

The inferior iliolumbar ligament

214
Q

What are the attachment sites for the accessory iliolumbar ligament?

A

The transverse process of L4 and the iliac crest

215
Q

Which vertebral couple of the lumbar spine has the greatest range of motion?

A

L5/S1

216
Q

Which range of motion is greatest for all lumbar vertebral couples?

A

Flexion-extension

217
Q

Which range of motion is least for L1-L5 vertebral couples?

A

One side axial rotation

218
Q

Which range of motion is least for the L5/S1 vertebral couple?

A

One side lateral bending

219
Q

List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.

A

The membrana tectoria, posterior longitudinal ligament and the deep posterior sacrococcygeal ligament

220
Q

List, in order, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal.

A

The posterior atlanto-occipital ligament, posterior atlanto-axial ligament, ligamentum flavum and the superficial posterior sacrococcygeal ligament

221
Q

What is the auricular surface of the ilium composed of?

A

Articular cartilage, interspersed with fibrocartilage

222
Q

What does ankylosis mean?

A

A condition of fibrous adhesion occurs within the joint

223
Q

What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint?

A

Age 40, the iliac auricular surface

224
Q

What is the age and gender bias associated with ankylosis of the sacro-iliac joint?

A

Age 50 and male bias particularly in African American males

225
Q

What passes between the layers of the interosseous sacroiliac ligament?

A

Dorsal rami from the sacral spinal nerves

226
Q

What separates the manubrium sterni and corpus sterni?

A

The manubriosternal symphysis

227
Q

What vertebral levels corresponds to the position of the corpus sterni?

A

T5-T9

228
Q

How many sternabrae for the corpus sterni?

A

4 sternabrae

229
Q

What surface feature on the corpus sterni identifies the location of the synchondroses?

A

Transverse lines

230
Q

What articular sites for the costal cartilage of ribs will be identified on the corpus sterni?

A

Costal notches II-VII

231
Q

What feature of the corpus sterni is present in 4-7% of the population?

A

A sternal foramen

232
Q

What causes the appearance of the sternal foramen?

A

Failure of the ossification centers of the sternum to fuse together normally

233
Q

What attaches to the scalene tubercle of the first rib?

A

The anterior scalene muscle

234
Q

Which groove on the body (corpus or shaft) of the first rib is close to the vertebral end?

A

The groove for the subclavian artery and the first thoracic nerve

235
Q

Which groove on the body (corpus or shaft) of the first rib is close to the sternal end?

A

The groove for the subclavian vein

236
Q

What specifically will attach to the crest of the neck of the second rib?

A

The superior costotransverse ligament from the transverse process of T1

237
Q

What specifically attaches to the back of the neck of the second rib?

A

The inferior costotransverse ligament from the transverse process of T2

238
Q

What unique feature is present on the body (corpus or shaft) of the second rib?

A

The tuberosity for the serratus anterior

239
Q

Which ribs are classified as typical ribs, true ribs, costa verae, and vertebrosternal ribs in the adult skeleton ?

A

Ribs 3-7

240
Q

Which ribs are classified as atypical ribs, true ribs, costa verae, and vertebrosternal ribs in the adult skeleton ?

A

Ribs 1 and 2

241
Q

Which ribs are classified as typical ribs, false ribs, costa spuriae, and vertebrochondral ribs in the adult skeleton ?

A

Ribs 8 and 9

242
Q

Which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebrochondral ribs in the adult skeleton ?

A

Rib 10

243
Q

Which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebral ribs in the adult skeleton ?

A

Ribs 11 and 12

244
Q

What is the classification of the 1st sternocostal or sternochondral joint?

A

Cartilaginous (amphiarthrosis) synchondrosis

245
Q

What is the classification of the 2nd-7th sternocostal or sternochondral joint?

A

Synovial plane (diarthrosis arthrodia)

246
Q

Which of the sternocostal or sternochondral ligaments is unique to the 2nd sternocostal or sternochondral joint?

A

The intra-articular ligament

247
Q

What is the classification of the 6th-9th interchondral joints?

A

Synovial plane (diarthrosis arthrodia)

248
Q

What is the classification of the 5th-6th or 9th-10th interchondral joints?

A

Fibrous (amphiarthrosis) syndesmosis

249
Q

Which costal cartilages fail to form a joint at their sternal end?

A

The eleventh and twelfth costal cartilages

250
Q

How many primary centers of ossification appear in the manubrium?

A

1-3 centers have been identified

251
Q

How many primary centers of ossification appear in the corpus sterni?

A

Typically 6

252
Q

In what part of the sternum will a secondary center of ossification appear?

A

The xiphoid process

253
Q

In what part of the rib will primary centers of ossification appear?

A

The body (corpus,shaft)

254
Q

In what parts of the rib will secondary centers of ossification appear?

A

The head, articular surface of the tubercle and the non-articular surface of the tubercle

255
Q

Which ribs will demonstrate secondary centers of ossification?

A

Ribs 1-10

256
Q

Which ribs lack secondary centers of ossification?

A

Ribs 11 and 12

257
Q

Which ribs demonstrate three secondary centers of ossification?

A

Ribs 2-9

258
Q

Which ribs have only two secondary centers of ossification?

A

Ribs 1 and 10

259
Q

What are the four subclassifications of synarthrosis joints based on Latin groupings?

A

Suture, gomphosis, schindylesis and syndesmosis

260
Q

What were the five types of suture based on Latin groupings?

A

Serrate, denticulate, limbous, squamous and harmonia

261
Q

What are the characteristics of sutura vera (true sutures)?

A

Sutures demonstrating interlocking of the adjacent bone surfaces; typically formed by intramembranous ossification

262
Q

What are the characteristics of sutura notha (false sutures)?

A

Sutures lacking interlocking of adjacent bone surfaces; typically formed by endochondral ossification

263
Q

Which sutures demonstrate non-interlock, but will overlap at their edges?

A

Squamous sutures

264
Q

What were the classification of sutura notha (false sutures) based on Latin groupings?

A

Squamous and harmonia

265
Q

What are the typical examples of the plane suture or harmonia suture?

A

Cruciate suture made up of the intermaxillary, interpalatine and palato-maxillary sutures

266
Q

What are the examples of the schindylesis type of suture?

A

Sphenoid-ethmoid-vomer articulation, the palatine-maxilla-vomer articulation

267
Q

What are the examples of the gomphosis joint?

A

Maxilla-root of tooth; Mandible-root of tooth

268
Q

What are the five views of the skull called?

A

Norma verticalis, norma frontalis, norma occipitalis, normal lateralis, norma basalis

269
Q

What is the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with both parietal bones?

A

The anterior fontanelle

270
Q

What is the diamond shaped remnant of developing membrane bone at the intersection of the occipital bone with both parietal bones?

A

The posterior fontanelle

271
Q

What is the glabella?

A

The elevation of bone over the frontal sinus between the orbits

272
Q

What is the name given to the outline of the nasal cavity at the front of the skull?

A

Piriform aperture

273
Q

What is the name given to the alveolar jugum of the canine tooth in the maxilla?

A

Canine eminence

274
Q

What forms a bullet-like chin?

A

A large mental protuberance

275
Q

What forms an indented chin?

A

Well developed bilateral mental tubercles and a slight mental protuberance

276
Q

What bones form the pterion?

A

Parietal, temporal, sphenoid and frontal bones

277
Q

What points on the skull are used to measure the skull size?

A

The nasion, vertex, inion and gnathion

278
Q

What points on the skull are used to measure cranial vault capacity?

A

The nasion, vertex and inion

279
Q

The olfactory nerve exits the cranial vault via what opening?

A

Cribriform plate of the ethmoid bone

280
Q

What are the contents of the optic canal?

A

The optic nerve and ophthalmic artery

281
Q

What are the contents of the superior orbital fissure?

A

Ophthalmic veins,

Ophthalmic division of the trigeminal nerve,

Oculomotor nerve,

Trochlear nerve,

Abducent nerve

282
Q

What are the contents of the foramen rotundum?

A

The maxillary division of the trigeminal nerve (cranial nerve Vb)

283
Q

What are the contents of the foramen ovale?

A

The mandibular division of the trigeminal nerve (Vc) and the lesser petrosal branch of the glossopharyngeal nerve

284
Q

What are the contents of the foramen spinosum?

A

The nervus spinosus from the mandibular division of the trigeminal nerve and the middle meningeal artery

285
Q

What are the contents of the internal acoustic meatus?

A

Cranial nerves VII (facial nerve) and VIII (vestibulocochlear/auditory nerve),

The nervus intermedius/nerve of Wrisberg/sensory root of VII and the motor root of VII,

The vestibular and cochlear roots of VIII,

The internal auditory/internal labyrinthine artery and vein

286
Q

What are the contents of the jugular foramen?

A

The jugular bulb,

The inferior petrosal sinus,

The tympanic body/tympanic glomus or jugular body/jugular glomus,

Cranial nerves IX (glossopharyngeal), X (vagus) and XI (spinal accessory)

287
Q

What can the five layers of the scalp spell?

A

Skin, connective tissue, aponeurosis, loose connective tissue, periosteum…SCALP

288
Q

What are the principal sources of blood to the scalp?

A

Internal carotid and external carotid artery branches

289
Q

Which divisions of the trigeminal nerve receive sensory information from the scalp?

A

All 3 divisions: ophthalmic nerve, maxillary nerve, & mandibular nerve

290
Q

Which ventral rami branches supply the scalp?

A

Greater auricular and lesser occipital nerves

291
Q

Which dorsal ramus nerve branch (name and cord level of origin) supplies the scalp?

A

Greater occipital nerve - C2, C3 communicating ramus

292
Q

What forms the roof of the posterior cranial fossa?

A

The tentorium cerebelli

293
Q

What part of the cerebrum occupies the posterior cranial fossa?

A

None; the tentorium cerebelli separates the cerebrum into a space above the posterior cranial fossa

294
Q

What part of the central nerve system occupies the posterior cranial fossa?

A

The cerebellum, pons, and medulla oblongata

295
Q

Which muscles lack any attachment to bone?

A

Orbicularis oris, procerus & risorius

296
Q

What type of motor fibers to skeletal muscle are given off by the facial nerve?

A

Branchial efferent (BE)

297
Q

Most of the seventh cranial nerve will exit the skull via what opening?

A

The stylomastoid foramen

298
Q

The optic canal is located along which wall of the orbit?

A

Superior wall of the orbit

299
Q

What are the contents of the optic canal?

A

Optic nerve & ophthalmic artery

300
Q

What are the openings located along the medial wall of the orbit?

A

Anterior ethmoid & posterior ethmoid foramina

301
Q

What is the name given to the medial wall of the orbit?

A

Lamina papyracea

302
Q

The superior orbital fissure is located along which wall of the orbit?

A

Lateral wall of the orbit

303
Q

What are the contents of the superior orbital fissure?

A

Oculomotor nerve

Trochlear nerve

Abducent/abducens nerve

Ophthalmic division of the trigeminal cranial nerve

Ophthalmic veins

304
Q

What opening(s) are located along the inferior wall of the orbit?

A

Inferior orbital fissure

305
Q

What is contained in the inferior orbital fissure?

A

Maxillary division of trigeminal nerve

306
Q

What are the names given to the modified sebaceous gland in the tarsus of the eyelid?

A

Tarsal or Meibomian gland

307
Q

What specific pathways are identified with Visceral Efferent (VE) innervation?

A

Sympathetic and parasympathetic motor pathways

308
Q

How many neurons are involved in the Visceral Efferent pathways from CNS to target cell?

A

2 motor neurons

309
Q

What is the location for the second neuron in the Visceral Efferent (VE) pathway?

A

Typically a ganglion

310
Q

Which cranial nerves are involved in the Visceral Efferent (VE) parasympathetic pathway to the lacrimal gland?

A

Facial and trigeminal (maxillary and ophthalmic divisions/branches)

311
Q

What is the origin for the sympathetic pathway to the lacrimal gland?

A

Lateral horn/intermediolateral cell column T1,T2

312
Q

What is the target of the preganglionic sympathetic visceral efferent (VE) fiber in the pathway to the lacrimal gland?

A

The VE fiber ascends to the superior cervical ganglion to synapse

313
Q

****Sympathetic stimulation of the lacrimal gland will result in what events?

A

Vasoconstriction of blood vessels,

Limited availability of water to secretory units,

More viscous or thicker product formed in glandular lumen

314
Q

****Parasympathetic stimulation of targets in the lacrimal gland will result in what events?

A

Vasodilation of blood vessels,

Increased availability of water to secretory units,

Thinner or more watery product in lumen;

Constriction of myoepithelial cells leading to release of product from secretory lumen into duct system

315
Q

What are the names of layers of the eyeball?

A

Fibrous tunic, uveal tract and retina

316
Q

What are the parts of fibrous tunic of the eyeball?

A

Cornea and sclera

317
Q

What are the parts of the uveal tract of the eyeball?

A

Iris, ciliary body, choroid & pupil

318
Q

What muscles are present in the iris?

A

Sphincter pupillae and dilator pupillae

319
Q

What is the innervation of the sphincter pupillae?

A

Oculomotor nerve, parasympathetic pathway

320
Q

What is the innervation of the ciliaris muscle?

A

Oculomotor nerve, parasympathetic pathway

321
Q

What is the function of the rod cell?

A

Provide vision in dim light conditions

322
Q

What is the function of the cone cell?

A

Provide vision in bright light conditions and mediate color vision

323
Q

What is the most numerous photoreceptor cell?

A

Rod cell

324
Q

What forms the optic nerve?

A

Axons of ganglion cells

325
Q

What occurs at the optic chiasma?

A

Part of the optic nerve decussates

326
Q

What is the location of the anterior chamber of the eyeball?

A

Between the cornea and iris

327
Q

What is the location of the posterior chamber of the eyeball?

A

Between the iris and lens

328
Q

What is contained in the anterior chamber of the eyeball?

A

Aqueous humor

329
Q

What is contained in the posterior chamber of the eyeball?

A

Aqueous humor

330
Q

What is the name given to the chamber behind the lens?

A

Vitreous chamber

331
Q

What fills the vitreous chamber?

A

Vitreous body

332
Q

What are the common characteristics in origin and insertion of all rectus extraocular muscles?

A

They all originate from a common annular tendon in the orbit

They all insert in the sclera in front of the coronal equator of the eyeball

333
Q

What is the common characteristic regarding the insertion of both oblique extraocular muscles?

A

Both insert onto sclera on the lateral margin of the eyeball behind the coronal equator

334
Q

What is the common characteristic concerning the insertion of the superior and inferior rectus muscles?

A

They insert onto the sclera of the eyeball in front of the coronal equator and are displaced slightly medially

335
Q

What is the embryonic origin of the extraocular muscles or extrinsic muscles of the eyeball?

A

The skeletal muscle is derived from the somites hence somatic efferent (SE)

336
Q

Which nerves will innervate specific extrinsic/extraocular muscles?

A

Oculomotor - superior rectus, medial rectus, inferior rectus, inferior oblique

Trochlear - superior oblique

Abducens/Abducent - lateral rectus

337
Q

Which of the cranial nuclei of termination contain primary afferent neurons?

A

Mesencephalic nucleus of the trigeminal nerve

338
Q

What is the location of synapse for preganglionic parasympathetic efferent fibers of the third cranial nerve?

A

Ciliary ganglion

339
Q

What is unique about the vascular supply of the retina?

A

A single vessel supplies it

340
Q

What vessel supplies the inner tunic of the eyeball?

A

Central artery of the retina

341
Q

What is the name given to the “goat’s beard” of the auricle?

A

Tragus

342
Q

What is the name of the palpable posterior projection of the eminentia concha of the auricle?

A

Ponticulus

343
Q

Which cranial nerve will innervate the muscles of the auricle?

A

The facial nerve

344
Q

Sensory innervation of the auricle is derived from which nerves?

A

Greater auricular (ventral rami C2,C3)

Lesser occipital nerve (ventral rami C2, possibly C3)

Auriculotemporal nerve (mandibular division, trigeminal)

Posterior auricular cutaneous nerve (facial)

Auricular nerve (vagus)

345
Q

The lateral third of the external acoustic meatus is protected by ____?

A

Cartilage

346
Q

The medial third of the external acoustic meatus is protected by ____?

A

The temporal bone

347
Q

Skin lining the external acoustic meatus contains what modified sebaceous glands?

A

Ceruminous glands

348
Q

What is cerumen?

A

The product of ceruminous glands forming the bulk of ear wax

349
Q

What are the characteristics of the parotid gland?

A

It is lobulated, yellowish, encapsulated and an exocrine gland

350
Q

What vein is formed within the parotid gland?

A

The retromandibular vein

351
Q

Within the parotid gland what does the facial nerve form?

A

The facial nerve plexus

352
Q

What are the branches of the facial nerve plexus?

A

Temporal, zygomatic, buccal, marginal mandibular, and cervical branches

353
Q

What branch of the facial nerve penetrates the parotid gland, but is not given off within it?

A

The chorda tympani nerve

354
Q

Which of the cervical intertransversarii is innervated by dorsal rami of cervical spinal nerve?

A

Posterior medial belly, cervical intertransversarii

355
Q

What is the origin of the medial belly of the lumbar intertransversarii?

A

Accessory process of transverse proccess L1-L4

Mammillary process of superior articular process L1-L4

356
Q

Which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves?

A

Intertransversarii

357
Q

Based on the density of muscle spindles what is the proposed function of the intertransversarii?

A

Acts as a proprioceptive transducer in conjuction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture

Spinal Anatomy Final Exam (1 decks)

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