Spinal Anatomy Lecture 2 Exam Flashcards
What is the outline of the vertebral foramen of a typical cervical vertebra?
Heart-shaped or triangular
Which is the greatest diameter of the vertebral foramen of a typical cervical?
Transverse
The greatest transverse diameter of the typical cervical vertebra occurs at ___?
C6
The greatest frequency of osteophytes associated with the vertebral body occurs at which typical cervical vertebral couple?
C5/C6
What osseous parts form the typical cervical vertebra transverse process?
Costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process
What muscles will attach to the anterior tubercle of a typical cervical vertebra?
Anterior scalene, longus Capitis, longus Colli, anterior intertransversarii
What muscles may attach to the posterior tubercle of a typical cervical vertebra?
Splenius Cervicis, iliocostalis Cervicis, longissimus cervicis, levator scapulae, middle scalene, posterior scalene, rotators and posterior intertransversarii
What muscles will attach to the costotransverse bar?
Middle scalene and posterior intertransversarii
What produces the primary tension on the transverse process that will cause remodeling in the anterolateral and inferior directions?
Cervical spinal nerves as they are directed anterolaterally and inferiorly to form the cervical and brachial plexuses
What is the orientation and angulation of a typical cervical transverse process?
60 degrees anterolaterally (from midsagittal plane), 15 degrees inferiorly (from the horizontal plane)
What is the name given to the modification of the anterior tubercle of the C6 transverse process?
The carotid tubercle
What will occupy the typical cervical vertebra transverse foramen?
The vertebral artery, vertebral venous plexus and postganglionic sympathetic motor nerve fibers
What is the name of the surface creature observed between the ends of the articular pillar?
The groove/sulcus for the dorsal ramus of a cervical spinal nerve
What is the classic angulation of typical cervical articular facets?
40 to 45 degrees from the coronal plane
Recent work suggests what angulation for typical cervical articular facets?
55 to 60 degrees
What is the orientation of the typical cervical superior articular facet?
Backward, upward, medial (BUM)
What is the orientation of the typical cervical inferior articular facet?
Forward, lateral, downward (FoLD)
What muscles will attach to typical cervical articular processes?
The longissimus Capitis, longissimus cervicis, semispinalis Capitis, semispinalis cervicis, multifidis and rotators
What muscles been with the capsular ligament of cervical zygapophyses?
The semispinalis Capitis, multifidis and rotator longus
What is the joint classification for the typical cervical zygapophysis?
Synovial plane (diarthrosis arthrodia) joint
What modifications of the synovial joint are observed in the cervical spine?
Meniscoidal folds
What function will meniscoidal folds provide in cervical zygapophyses?
They are assumed to distribute pressure across the joint surface
The greatest range of flexion - extension among the typical cervical vertebrae a occurs at which vertebral couple?
Typically C5/C6
What motions are coupled in the cervical spine?
Lateral bending and axial rotation
Ranges of coupled motion among the typical cervical vertebrae will be similar for what cervical vertebral couple?
The C2/C3, C3/C4, C4/C5 vertebral couples
Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?
The C5/C6 vertebral couple
What is the usual condition for the Caucasian typical cervical spinous process?
They are bifid
What is the usual condition for the African-American typical cervical spinous process?
They are non-bifid
What muscles may attach to the typical cervical spinous process?
The spinalis cervicis, semispinalis cervicis, semispinalis Thoracis, multifidis, rotators and interspinalis
What ligaments will attach to the typical cervical spinous process?
The interspinous ligament and ligamentum nuchae
What will form the anterior boundary of a typical cervical intervertebral foramen?
The lateral groove and vertebral body of the segment above, the uncinate process and the vertebral body of the segment below, the intervertebral disc and the posterior longitudinal ligament
What will form the posterior boundary of a typical cervical intervertebral foramen?
The inferior articular process (post-zygapophysis), the superior articular process (pre-zygapophysis), the capsular ligament and the ligamentum flavum
What will form the superior boundary of a typical cervical intervertebral foramen?
The inferior vertebral notch or inferior vertebral incisure
What will form the inferior boundary of a typical cervical intervertebral foramen?
The superior vertebral notch or superior vertebral incisure
What is the unique anterior boundary of the intervertebral foramen for the C4 spinal nerve?
The lateral groove of C3 and uncinate process of C4 forming the joint of Luschka
What is the name of the first cervical vertebra?
Atlas
What features are lacking at C1?
Vertebral body, pedicle, a spinous process and the intervertebral disc
What is thought to represent the pedicle at C1?
The anterior arch
What osseous modification is observed to the front of the anterior arch of C1?
The anterior tubercle
What muscle attaches to the anterior arch of C1?
Longus Colli
What ligaments will attach to the anterior arch of C1?
The anterior longitudinal, anterior Atlanto-occipital and anterior Atlanto-axial ligaments
What is observed on the back of the anterior arch of C1?
The fovea dentis
What joint classifications are observed on the anterior arch of C1?
Fibrous (amphiarthrosis) syndesmosis joint and synovial pivot (diarthrosis trochoid) joint
What is the morphology of the superior articular facet of C1?
They are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces
What is the orientation of the superior articular facet of C1?
Backward, upward, medial (BUM)
What is the joint classification of the Atlanta-occipital zygapophysis?
Synovial (diarthrosis) ellipsoidal joint
What are the morphological characteristics of the inferior articular facet of C1?
Asymmetrical, slightly concave or flattened
What is the orientation of the inferior articular facet of C1?
Backward, medial, downward (BMD)
What is the joint classification of the Atlanto-axial zygapophysis?
Synovial plane (diarthrosis arthrodial) joint
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?
Levator scapula, splenius cervicis and rectus Capitis anterior
What part of C1 represents the spinous process?
Posterior tubercle of the posterior arch
What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?
Males: about fifty millimeters; females: about thirty-seven millimeters
What attaches to the posterior tubercle of the posterior arch of C1?
Rectus Capitis posterior minor muscle and ligamentum nuchae
What superior surface modifications of the posterior arch of C1 are present?
Groove/sulcus for the vertebral artery and arcuate rim
What attaches to the arcuate rim of C1?
The posterior Atlanto-occipital ligament
Ossification of the free margin of the posterior Atlanto-occipital ligament results in which atypical bone classification?
Accessory bone
What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?
About age 7 years old
Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?
An incomplete ponticulus posticus or a complete ponticulus posticus
What are the attachment sites of the ponticulus posticus?
It is attached to the arcuate rim of the posterior arch of atlas and to the superior articular process of the lateral mass of atlas
What names are given to the opening formed by the ponticulus posticus?
Arcuate foramen or retroarticular canal
Ponticulus posticus has observed in what ethnic populations?
All ethnic populations studied thus far
What is the general range of incidence of ponticulus positicus in the populations studied?
1-41%
What is the gender bias now associated with ponticulus posticus?
Female
What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus
The incidence of a complete ponticulus posticus is about fifteen percent; the incidence of an incomplete ponticulus posticus may be as high as forty-one percent
What are the osseous parts of the transverse process of C1?
Costal element, posterior tubercle, true transverse process
What muscles attach to the transverse process of C1?
Rectus Capitis anterior, rectus Capitis lateralis, middle scalene, levator scapulae, splenius cervicis, obliquus Capitis superior, obliquus Capitis inferior and intertransversarii muscles
What suboccipital muscles are known to have fascial projections attaching to the spinal dura?
Rectus Capitis posterior minor, rectus Capitis posterior major, obliquus Capitis inferior
What are the connections between suboccipital muscles and the spinal dura called?
Myodural bridges
What are the lateral bridges of atlas connected to?
The lateral mass and the transverse process of atlas
What forms of the lateral bridges are observed in the population?
Incomplete lateral bridges and complete lateral bridges
What opening is identified when a complete lateral bridge is formed?
A retrotransverse foramen
What are the possible contents of the retrotransverse foramen?
The vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck
Which of the ponticles (bridges) of atlas is most numerous?
Ponticulus posticus
Which of the ponticles (bridges) of atlas is only observed in humans?
Lateral bridges
What is observed in the transverse foramen of C1?
Vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is the gender variation for measurements of the transverse diameter of C1?
Males: 78 millimeters and females: 72 millimeters
What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?
A little over 30 millimeters for both males and females
What joint classifications are observed at C1?
Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial pivot (diarthrosis trochoid) joint and synovial plane (diarthrosis arthroida) joint
How many synovial joint surfaces are observed at C1?
Five
What names are given to C2?
Axis or epistropheus
What unique vertebral body modification is characteristic of C2?
The dens or odontoid process
How many joint surfaces are present on the odontoid process of C2?
Five
What joint surfaces are present on the odontoid process of C2?
Facet for the fovea dentis, groove for the transverse atlantal ligament, attachment site for the alar ligaments, attachment site for the apical-dental ligament
Which joint classifications are represented at the odontoid process of C2?
Fibrous (amphiarthrosis) syndesmosis and synovial pivot (diarthrosis trochoid) joints
What is the name/classification given to the odontoid process when the tip of the dens is directed posterior?
Lordotic dens
What is the name/classification given to the odontoid process when the tip of the dens is directed anterior?
Kyphotic dens
What joint surfaces are present at the inferior part of the vertebral body of C2?
Anterior lip, posterior lip, right and left lateral grooves and cancellous bone
How many joints are formed by the inferior part of the vertebral body of C2?
Five
How many joints surfaces are present at the vertebral body of C2?
Ten
What joint classifications are present at the vertebral body of C2?
Fibrous (amphiarthrosis) syndesmosis, synovial pivot (diarthrosis trochoid), modified synovial saddle (diarthrosis sellar) and cartilaginous (amphiarthrosis) symphysis
What ligament will represent the cranial continuation of the posterior longitudinal ligament?
Membrana tectoria
What ligament forms the anterior boundary for the spinal canal above C2?
Membrana tectoria
What ligament forms the anterior boundary for the spinal canal below C2?
Posterior longitudinal ligament
What is the location of the superior vertebral notch of C2?
On the lamina-pedicle junction
What attaches to the lamina of C2?
Obliquus Capitis inferior muscle, posterior Atlanto-axial ligament, ligamentum flavum
What is the appearance of the superior articular facets of C2?
They are asymmetrical and slightly convex
What is the facet orientation of the superior articular facet of C2?
Backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facets of C2?
Forward, lateral, and down (FoLD)
What muscle attaches to the articular processes of C2?
Longissimus cervicis
What osseous parts of the typical cervical transverse process are absent at C2?
Anterior tubercle and costotransverse bar
What will be observed in the transverse foramen at C2?
Vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is the gender variation for the transverse diameter of C2?
Males: fifty-seven millimeters and females: about fifty millimeters
What muscles attach to the transverse process at C2?
Levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii
What is the characteristic appearance of the C2 spinous process in humans?
Bifid
What is the location for palpation of the spinous process of C2?
In the midline, about two inches below the external occipital protuberance
What muscles attach to the spinous process of C2?
Rectus Capitis posterior major, obliquus Capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators and interspinalis muscles
What ligaments attach to the spinous process of C2?
Ligamentum nuchae, interspinous ligaments
What names may be given to C7?
Vertebra prominens and vertebral prominence
What is the name given to the topographical elevation observed at the base of the neck?
Vertebral prominence
What name is given only to C7?
Vertebra prominens
In what percent of men and women does C7 become the vertebral prominence?
Men: eighty-six percent women: seventy-nine percent
What is the segment and gender bias for vertebrae other than 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?
Eight
What joint classification are observed at the vertebral body of C7?
Fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and modified synovial saddle (diarthrosis sellar) joint
What synovial joint surfaces are observed at the vertebral body of C7?
The right and left uncinate processes
What muscle(s) attaches to the vertebral body of C7?
Longus colli muscle
What features are typically present in the transverse foramen of C7?
Vertebral venous plexus, postganglionic sympathetic motor fibers
What muscles attach to the transverse process of C7?
Middle scalene, iliocostalis thoracis, longissimus cervicis, semispinalis Capitis, rotators, intertransversarii and levator costarum breves
What is the orientation of the superior articular facet of C7?
Backward, upward, medial (BUM)
What is the orientation of the inferior articular facet of C7?
Forward, medial, downward (ForMeD)
What muscles will attach to the articular process of C7?
Longissimus cervicis, longissimus Capitis, semispinalis cervicis and multifidis
What are the features of the spinous process of C7?
Long, horizontal, nonbifid
What muscles attach to the spinous process of C7?
Trapezius, rhomboid minor, serratus posterior superior, splenius Capitis, spinalis Capitis, spinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis
What ligaments attach to the spinous process of C7?
Ligamentum nuchae and interspinous ligaments
What 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 was the name of the physical exam used to determine vertebral artery latency?
The vertebrobasiliar artery insufficiency test
Which side artery tested during the course of the vertebrobasiliar artery insufficiency exam?
The ipsilateral artery on the side of rotation
Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?
C6
At what location will the vertebral artery form its first compensatory loop?
The atlanto-axial interspace
At what location will the vertebral artery form its second compensatory loop?
The Atlanto-occipital 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 untie to form the basilar artery
Which suboccipital muscles attach to C1?
Rectus Capitis posterior minor, obliques capitis superior, obliques capitis inferior
Which suboccipital muscles attach to C2?
Rectus capitis posterior major, obliquus capitis inferior
What joint classifications are present at C1?
Synovial (diarthrosis) ellipsoidal, synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthroida) and fibrous (amphiarthrosis) syndesmosis
What joint classifications are present at C2?
Synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis joint
What joint classifications are present at each typical cervical?
Synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis
What joint classifications are present at C7?
Synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis
What forms the boundaries for the exit of the C1 nerve from the spinal canal?
Occipital condole, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior Atlanto-occipital ligament
What forms the boundaries for the exit of C2 nerve from the spinal canal?
Inferior articular process of C1, superior articular process of C2, capsular ligament, inferior vertebral notch of C1, superior vertebral notch of C2, posterior arch of C1, lamina of C2, posterior atlanto-axial ligament
What forms the anterior boundary for the C2 nerve exit from the spinal canal?
Inferior articular process of C1, superior articular process of C2, capsular ligament
What forms the posterior boundary for the C2 nerve exit from the spinal canal?
The posterior arch of C1, lamina of C2 and posterior Atlanto-axial ligament
What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?
The vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinate process, lateral groove
What forms the anterior boundary for the C8 nerve exit from the spinal canal?
The vertebral bodies of C7 and T1, intervertebral disc, posterior longitudinal ligament, capsular ligament of the costocentral joint, superior costal facet of T1 and articular surface of the first rib
What are the superior articular facet orientations for the vertical vertebrae?
C1 is backward, upward, medial (BUM), C2 is backward, upward, lateral (BUL), C3-C7 is backward, upward, and medial (BUM)
What are the fine riot articular facet orientations for the cervical vertebrae?
C1 is backward, downward, medial (BMD), C2-C6 is forward, downward, lateral (FoLD), C7 is forward, downward, medial (ForMeD)
How many synovial joints are identified for each cervical vertebra?
C1 = five, C2 = eight, C3-6 = eight, C7 = six
How many joints are identified at the vertebral body of each cervical vertebra?
C1 = none, C2 = ten, C3-6 = ten, C7 = eight
Which thoracic segments are considered the typical thoracic?
T2-T8 segments
What features will allow discrimination between T2-T4 and T5-T8 segmental groups?
The vertebral body, transverse process, articular process and spinous process
What is the outline of the vertebral boy of a typical thoracic from superior view?
Triangular
What is the name given to the left side appearance of the vertebral body on T5-T8?
The aortic impression
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 gives the vertebral body a less scalloped or less indented appearance on that side
What part of the vertebral body is most influenced by the aorta at T5-T8?
The left side superior and inferior epiphyseal rim
What is the height pattern of the typical thoracic vertebral body?
The posterior height is greater than the anterior height by one to two millimeters
What is the height pattern of the intervertebral discs in the typical thoracic region?
The intervertebral discs are rather planar or flat with no apparent height difference between anterior and posterior heights
What is the principal cause of the posterior curve of the thoracic spine?
The vertebral body height differences
In terms of the anterior-posterior curves of the vertebral column, what direction will the thoracic spine face?
Posterior
What is another way of naming a posterior curve pattern?
A kyphotic curve
What joint classifications are identified at the vertebral body of a typical thoracic?
Fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial plane (diarthrosis arthrodia)
How many synovial joints are formed at the vertebral body of a typical thoracic?
Four
How many symphysis joints are formed at the vertebral body of a typical thoracic?
Two
How many joints are formed at the vertebral body of a typical thoracic?
Typically ten (fourteen if the costocentral stellate/radiate ligaments are included)
What is the name given to the joint formed between the vertebral body and rib?
Costocentral joint
How many costocentral joints are formed at the vertebral body of a typical thoracic?
Four
Which of the Demi-facets on the vertebral body of a typical thoracic is larger?
The superior costal demi-facet
What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?
The costocentral joint or ribs
What is the size relationship between the articulating surface of the head of the rib and the costal demi-facet surface?
The rib surface is greater than the costal Demi-facet surface
Which muscle(s) is attached to the vertebral body of T2 or T3?
The longus colli
What is the angulation of the pedicle in the typical thoracic region?
Ten to fifteen degrees posterolateral form the sagittal plane
Which X-ray view is used to see into the intervertebral foramen of a typical thoracic?
The lateral view
Which vertebral notch or incisure is said to be prominent?
The inferior vertebral notch or inferior vertebral incisure
What is the nerve - vertebral body relationship at the typical thoracic intervertebral foramen?
In the intervertebral foramen, the number of the nerve is the the same as the number of the upper thoracic in the vertebral couple
What is the rib - vertebral body relationship at the typical thoracic intervertebral foramen?
In the intervertebral foramen, the number of the rib is the same as the number of the lower thoracic in the vertebral couple
What is overlap of the lamina called in the typical thoracic region?
Shingling
In which plane will the size of the vertebral foramen of a typical thoracic greatest?
The transverse plane, the vertebral transverse diameter
What is present on the transverse tubercle of a typical thoracic?
The transverse costal facet
What is the rib - transverse process relationship for the typical thoracics?
The number of the rib is the same as the number of the vertebra whose transverse process is being studied; fifth rib with the T5 transverse process
What is the classification of the costotransverse joint?
Synovial plane (diarthrosis arthrodia) joint
What are the osseous parts of the costotransverse joint?
The transverse costal facet and the articular surface of the tubercle of a rib
What ligaments support the costotransverse joint of a typical thoracic?
The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments
The superior costotransverse ligament of rib five will attach to which vertebral feature?
The transverse process of T4
What ligaments attach to the transverse process of a typical thoracic?
Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments
Which muscles may attach to the transverse process of a typical thoracic?
Longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis thoracis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
Of the muscles attaching to the transverse process of a typical thoracics, which ones will attach only to the T5-T8 vertebral segments?
Semispinalis thoracis and levator costarum longus
How do the transverse diameters of the articular processes compare in the T2-T4 region?
The superior articular process transverse diameter is greater than the inferior articular process transverse diameter for a given segment
How do the transverse diameters of the articular processes compare in the T5-T8 region?
The superior articular process transverse diameter is the same as or equal to the inferior articular process transverse diameter for a given segment
What is the orientation of the superior articular facet of a typical thoracic?
They face backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facet of a typical thoracic?
The face forward, downward, and medial (ForMeD)
What is the joint classification of the articular facet joint?
Synovial plane (diarthrosis arthrodia) joint
How many synovial joints are present at a typical thoracic?
Ten
Identify the synovial joint surfaces present on a typical thoracic
Two superior costal Demi-facets, two inferior costal demi-facets, two transverse costal facets, two superior articular facets, two inferior articular facets
What is the name given to the overlap of spinous processes in the thoracic region?
Imbrication
Imbrication will be more pronounced for what region of the thoracics?
T5-T8
Which thoracic has the longest spinous process?
T8
What is the angulation of the spinous process of T2-T4?
The undersurface of T2-T4 spinous processes will angle up to forty degrees from the horizontal plane
What is the angulation of the spinous process of T5-T8
The undersurface of T5-T8 spinous processes will angle up to sixty degrees from the horizontal plane
What joint classification is associated with typical thoracic spinous process ligaments?
Fibrous (amphiarthrosis) syndesmosis joint
Which muscles may attach to the spinous process of a typical thoracic?
Trapezius, latissimus dorsi, rhomboid major, serratus posterior superior, splenius cervicis, splenius capitis, Spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis
Which muscles attaching to the spinous process of a typical thoracic vertebra?
Fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial plane (diarthrosis arthrodia)
What is the appearance of the vertebral body of T1 from the anterior view?
Both sides will appear to be scalloped (indented) between the epiphyseal rims
What is the appearance of the superior surface of the vertebral body of T1?
It is somewhat cup-shaped with elevations at the posterior and lateral margin
What may the elevations on the vertebral body of T1 represent?
Uncinate processes
What is the appearance of the inferior surface of the vertebral body of T1?
Typically flat, lacking anterior and posterior lips characteristic of the cervicals
How many synovial joints are formed at the vertebral body of T1?
Four normally
How many symphysis joints are formed with the vertebral body of T1?
Two
How many syndesmosis joints are formed at the vertebral body of T1?
Typically four are identified (as many as eight if the rib articulation is included)
How many joints are formed at the vertebral body of T1?
Typically ten (fourteen if the rib ligaments are included)
How many costocentral joints are formed at the vertebral body of T1?
Four
What synovial joint surfaces are present on the T1 vertebral body?
The right and left superior costal facet
The right and left inferior costal Demi-facet
What is the rib - vertebral body combination at the intervertebral foramen for the eighth cervical nerve?
The superior costal facet of T1 will joint with the articular surface of the head of the first rib
What ligament supports the costocentral joint of the first rib?
The costocentral stellate/radiate ligament
What ligaments support the costocentral joint of the second rib?
The costocentral stellate/radiate ligament and the costocentral interarticular or intra-articular ligament
Which muscle(s) is attached to the vertebral body of T1?
The longus colli
What ligaments support the costotransverse joint of T1?
The inferior costotransverse and lateral costotransverse ligaments
What ligament is absent at the costotransverse joint of T1?
The superior costotransverse ligament
Which costotransverse joint will the superior costotransverse ligament of T1 support?
The second rib costotransverse joint
What muscles attach to the transverse process of T1?
Longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis
Which specific transversospinalis muscle is absent from T1?
Semispinalis thoracis
What is the orientation of the superior articular facet of T1?
They face backward, upward and lateral (BUL)
What is the orientation of the inferior articular facet of T1?
The face forward, downward and medial (ForMeD)
What is the classification of the articular facet joint?
Synovial plane (diarthorsis arthrodia)
How many synovial joints are present at T1?
Ten
How many synovial joint surfaces for ribs are present at T1?
Six
What name is used to identify the topographical landmark at the base of the neck?
Vertebral prominence
Which vertebrae have been identified as forming the vertebral prominence?
C6,C7, T1
What is the gender bias associated with T1 as the vertebral prominence?
Males (9%) are more likely than females (6%) to demonstrate T1 as the vertebral prominence
What muscles attach to the spinous process of T1?
The trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, interspinalis
How many joints are typically formed at the vertebral body of T9?
Typically ten (fourteen if the costocentral stellate/radiate ligaments are included)
How many costocentral joints are typically formed at the vertebral body of T9?
Four
Which synovial joint surfaces may be absent from the vertebral body of T9?
Inferior costal Demi-facets
What is present on the transverse tubercle of T9?
The transverse and costal facet
What ligaments attach to the transverse process of T9?
Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments
Which muscles attach to the transverse process of T9?
The longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
How many synovial joint surfaces for ribs are typically present on T9?
Six
Which is the last thoracic vertebra to have an inferior costal Demi-facet?
T9
What muscles attach to the spinous process of T9?
The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis
Which muscles are conspicuously absent at the T9 spinous process?
Spinalis and semispinalis
How many synovial joints are formed at the vertebral body of T10?
Two
How many joints are typically formed at the vertebral body of T10?
Typically eight ( twelve if the costocentral stellate/radiate ligaments are included)
Which synovial joint surface is absent from the vertebral body of T10?
Inferior costal Demi-facets
What is the rib - vertebral body combination is typically present at the intervertebral foramen for the tenth thoracic nerve?
The superior costal facet of T11 will joint with the articular surface of the head of the eleventh rib
Para-articular processes are more commonly observed on which segment of the spine?
T10
What part of the transverse process may be absent on T10?
The transverse costal facet
The superior costotransverse ligament of T10 will attach to which ribs?
The eleventh rib
What muscles attach to the transverse process of T10?
Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
Which rib related facet is absent on T10?
The inferior costal Demi-facet
A dimpling or depression of the skin in the thoracic region is often characteristic of the location of which segment?
T10
What muscles attach to the spinous process of T10?
The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis
What name is given to T11?
The anticlinal vertebra
Which vertebral segment is first to have a reniform vertebral body?
T11
How many synovial joints are formed at the vertebral body of T11?
Two
How many joints are typically formed at the vertebral body of T11?
Typically eight (twelve if the costocentral stellate/radiate ligaments are included)
What part of the transverse process is absent on T11?
The transverse costal facet
Which vertebra is the last segment to demonstrate a transverse costal facet?
T10
What ligaments form the costotransverse joint of T11?
The superior costotransverse, and slightly developed inferior costotransverse and lateral costotransverse ligaments
Which costotransverse joint will the superior costotransverse ligament at the transverse process of T11 support?
The twelfth rib costotransverse joint
What muscles attach to the transverse process of T11?
Longissmus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis, intertransversarii and levator costarum brevis
Which levator costarum muscle is absent at T11?
Levator costarum longus
Which segment is the last to demonstrate an attachment for the levator costarum longus?
T10
What is the orientation of the superior articular facets of T11?
They face backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facets of T11?
They face forward, downward, and medial (ForMeD)
How many synovial joints are typically present at T11?
Six
What muscles attach to the spinous process of T11?
Trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, mulftifidis, rotator longus, rotator brevis, and interspinalis
At which segments of the thoracic spine will the spinalis muscle not attach?
T9, T10
Which erector spinal muscle uniquely attaches to the spinous process of T11?
Iliocostalis lumborum
How many synovial joints are formed at the vertebral body of T12?
Two
How many symphysis joints are formed with the vertebral body of T12?
Two
How many syndesmosis joints are formed at the vertebral body of T12?
Four are typically identified (as many as six if the costocentral stellate/radiate ligaments are included
How many joints are typically formed at the vertebral body of T12?
Typically eight (ten if the costocentral stellate/radiate ligaments are included)
Which muscle(s) is attached to the vertebral body of T12?
Psoas major and psoas minor
What is present at the transverse process region of T12?
Three tubercles of variable size
Which tubercle on T12 represents the transverse process?
The lateral tubercle
Which tubercle on T12 represents the mammillary process of the lumbar?
The superior tubercle
Which tubercle on T12 represents the accessory process of the lumbar?
The inferior tubercle
What ligaments form the costotransverse joint of the twelfth rib?
The superior costotransverse ligaments from T11 and the lumbocostal ligament from L1
Which costotransverse ligament(s) are attached at T12?
None; the capsular, superior, inferior, and lateral costotransverse ligaments lack an attachment to T12
What muscles attach to the transverse process region of T12?
The longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and intertransversarii
Which segment is the last to demonstrate a levator costarum brevis attachment?
T11
Which segment is the last to demonstrate a levator costarum longus attachment?
T10
What is the orientation of the superior articular facets of T12?
They are faced backward, upward, and lateral (BUL)
What is the orientation of the inferior facets of T12?
They face forward, downward, and lateral (FoLD)
What is the curvature of the inferior articular facets of a T12?
They are significantly convex
How many synovial joints are typically present at T12?
Six
Identify the synovial joint surfaces typically present on T12
Two superior costal facets, two superior articular facets, and two inferior articular facets
What is the generic appearance of the spinous process of T12?
Lumbar-like, similar in length to T11
What muscles attach to the spinous process of T12?
The trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis
Which erector spinal muscle is unique in its attachment to the T12 spinous process?
Iliocostalis lumborum
Which muscles attaching to the spinous process of T12 are not included in any muscle layer of the true back?
Interspinalis
What joint classifications are present at T12?
Fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial (diarthrosis) arthrodia joint
Which muscle(s) attach tot he vertebral body of thoracic vertebrae?
Longus colli, psoas major, and psoas minor
Which thoracic segments will have muscles attaching to their vertebral bodies?
T1-T3, T12
Which erector spinae muscle will attach along the length of the thoracic spine?
Longissimus
Which thoracic is the last to demonstrate an attachment at the transverse process for the semispinalis muscle group?
T12
Which thoracic is first to demonstrate the attachment of the levator costarum brevis?
T1
Which thoracic is last to demonstrate the attachment of the levator costarum brevis?
T11
Which thoracic is first to demonstrate the attachment of the levator costarum longus?
T7
Which thoracic is last to demonstrate the attachment of the levator costarum longus?
T10
Rhomboid minor will attach to the spinous process of which thoracic(s)?
T1 only
Rhomboid major will attach to the spinous process of which thoracic(s)?
T2-T5
Which thoracic vertebrae will demonstrate a spinous process attachment for the serratus posterior superior?
T1-T3
Which thoracic vertebrae will demonstrate a spinous process attachment for the serratus posterior inferior?
T11-T12
Which thoracics demonstrate a spinous process attachment for the splenius muscles?
T1-T6
Which thoracics demonstrate a spinous process attachment for the iliocostalis lumborum?
T11-T12
Which thoracics lack any Spinalis muscle group attachment on their spinous process?
T9-T10
What is the generic shape of the typical lumbar vertebral body from the cranial view?
Reniform or kidney-shaped
What accounts for the direction of the lumbar curve?
The vertebral body and intervertebral disc have a greater anterior height than posterior height
What is the direction of the normal lumbar curve?
Anterior (lordotic)
What is the effect of aging on the vertebral body of a lumbar vertebra?
Decreases in height, increase in circumference
How many synovial joint surfaces are present at the typical lumbar vertebral body?
None
How many joint surfaces are present on the vertebral body of a typical lumbar?
Six
How many synovial joint surfaces are present on the vertebral body of a typical lumbar?
None
How many cartilaginous (amphiarthrosis) symphysis joint surfaces are on a typical lumbar vertebral body?
Two
How many fibrous (amphiarthrosis) syndesmosis joint surfaces are on a typical lumbar vertebral body?
Four
What joint classifications will be observed at the vertebral body of a typical lumbar?
Cartilaginous (amphiarthrosis) symphysis joint and fibrous (amphiarthrosis) syndesmosis joint
What muscles may attach to a typical lumbar vertebral body?
Psoas major and psoas minor
Psoas minor will only attach to the vertebral body of which segments?
T12, L1
What is the name given to ligaments that attach the vertebral body to articular process?
Transforaminal ligaments
What are the types of transforaminal ligaments?
Superior transforaminal, middle transforaminal and inferior transforaminal ligaments
What ligaments attach the vertebral body to the transverse process?
Corporotransverse ligaments
What corporotrasnverse ligaments are identified?
Superior corporotransverse and inferior corporotransverse ligaments
What are the types of Hofmann ligaments?
Anterior Hofmann ligaments, posterior Hofmann ligaments, lateral Hofmann ligaments and proximal root sleeve ligaments
Hofmann ligaments are identified in which regions along the vertebral column?
Cervical - upper thoracic region and lumbar region
Cervical - upper thoracic Hofmann ligaments will attach what structures together?
Dura mater to segments above
What is the highest level known to demonstrate Hofmann ligaments?
C6
What is the proposed function of the cervical - upper thoracic Hofmann ligaments?
Resist caudal movement of the dural sac; resist gravitational forces on the dura and cord
Lumbar hofmann ligaments will attach what structures together?
Dura mater to lower segmental levels
What is the proposed function of the lumbar hofmann ligaments?
Resist cranial movement of the dural sac during flexion
What is the proposed function of the proximal root sleeve ligament?
Resist displacement of the peripheral nerve system in the intervertebral foramen
What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
Overlap of the laminae, shingling, diminishes; overlap of spinous processes, imbrication, diminishes
What part of the central nerve system is present in the lumbar spine?
The conus medullaris is typically present in the vertebral foramen of L1
What part of the peripheral nerve system is present in the lumbar spine?
The cauda equina is typically present in the vertebral foramina of L2-L4
Beginning with the L1 transverse process, what is the generic direction and relative length of each succeeding lumbar transverse process?
Each transverse process is directed straight lateral and increases in length from L1-L3; L4 then begins to decrease in length
What is the name of the elevation near the origin of the lumbar transverse process?
Accessory process
Congenital elongation of the lumbar accessory process results in what feature?
Styloid process
A styloid process occurs with what frequency and as a result of what condition?
7% occurrence as a result of congenital elongation of the lumbar accessory process
What bony part of a cervical transverse process is lacking at the lumbar transverse process?
The costotransverse bar
What ligament(s) will attach to the lumbar accessory process?
Mammillary-accessory ligament
What parts of a vertebra are attached via the mammillo-accessory ligament?
The mammillary process and accessory process of the same segment
What was believed to be entrapped by the mammillo-accessory ligament?
The medial branch of the dorsal Ramus of a lumbar spinal nerve
What muscle(s) attach to the lumbar accessory process?
Longissimus thoracis and intertransversarii
What ligament attaches the twelfth rib to the transverse process of L1?
The lumbocostal ligament
What is the joint classification for the lumbocostal ligament and its attachments?
Fibrous (amphiarthrosis) syndesmosis
What muscles may attach to the transverse process of a typical lumbar vertebra?
Psoa mjaor, quadratics lumborum, longissimus thoracis, rotator brevis, rotator longus and intertransversarii
Which transversospinalis muscle group attaches to the typical lumbar transverse process?
Rotators
What ligaments attach to the transverse process of a typical lumbar vertebra?
The lumbocostal, mammillo-accessory and intertransverse ligaments
What is the name of the lamina-pedicle junction of a typical lumbar vertebrae?
Pars interarticularis
What are the posterior elements of the vertebra?
Zygapophysis, lamina and spinous process
What are the anterior elements of the vertebra?
Vertebral body and pedicle
What is the orientation of the typical lumbar superior articular facet?
Backward, upward, medial (BUM); typically concave
What is the orientation of the typical lumbar inferior articular facet?
Forward, lateral, downward (FoLD); significant convexity
What is the name given to the projection on the lumbar superior articular process?
Mammillary process
What muscle(s) will attach to the mammillary process?
Multifidis and intertransversarii
What ligament will attach to the lumbar superior articular process and transverse process?
Mammillo-accessory ligament
What ligament will attach to the lumbar mammillary process and accessory process?
Mammillo-accessory ligament
What was believed to be entrapped by the mammillo-accessory ligament?
The medial branch of the dorsal ramus of a lumbar spinal nerve
What additional ligaments are said to attach to lumbar articular processes?
Transforaminal ligaments
How many synovial joints are present on a typical lumbar vertebra?
Four
What is the position of the lumbar zygapophysis in children?
The zygapophysis lies in the coronal plane
What is the position of the lumbar zygapophysis in adults?
The zygapophysis lies in the sagittal plane for L1/L2, L2/L3 and L3/L4; the zygapophysis lies in the coronal plane for L4/L5 and L5/S1
What names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane and the other zygapophysis lies in the sagittal plane?
Joint asymmetry or joint tropism
What is the name(s) of the condition in which the typical lumbar spinous process increases in length due to the aging process?
Baastrup’s syndrome or “kissing spines”
What is basstrup’s syndrome?
Elongation of the lumbar spinous process as a result of aging
What muscles will attach to the typical lumbar spinous process?
Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, longissimus thoracis, Spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis
What is the appearance of the fifth lumbar vertebral body from the lateral view?
Anterior height is greater than posterior height by several millimeters it appears to form a wedge on a lateral X-ray view
How many synovial joint surfaces are present at the fifth lumbar vertebral body?
None
How many fibrous (amphiarthrosis) syndesmosis joint surfaces are present on the L5 vertebral body?
Four
How many joint surfaces are present on the vertebral body of the fifth lumbar?
Six
How many cartilaginous (Amphiarthrosis) symphysis joint surfaces are present on the vertebral body on L5?
Two
How many fibrous (amphiarthrosis) syndesmosis joint surfaces are present on the vertebral body of L5?
Four
What joint classifications will be observed at the vertebral body of the fifth lumbar?
Cartilaginous (amphiarthrosis) symphysis and fibrous (amphiarthrosis) syndesmosis
What muscle(s) attach to the fifth lumbar vertebral body?
Psoas major
What is the name given to ligaments that attach the vertebral body to articular process?
Transforaminal ligaments
What ligaments attach the vertebral body to the transverse process?
Corporotransverse ligaments
