Spinal Exam 1 Quiz Questions Flashcards
What is osteology?
The study of bone
What are the three primary cell types of bone?
Osteoblasts, Osteocytes, Osteoclasts
What is the function of each type of bone cell?
Osteoblast - form bone
Osteocyte - maintain or nurture bone
Osteoclast - remodels bone
What are the bone cells embedded in?
An amorphous matrix consisting of ground substance, protein fibers, and various materials
What is the primary constituent of the ground substance?
Glycosaminoglycans
What types of glycoaminoglycans predominate in bone?
Condroitin sulfates, keratin sulfates, and hyaluronic acid
What is the principal type of protein fiber in bone?
Collagen Type 1
What are the primary constituents of the bone mineral?
Calcium, phosphate, citrate, and carbonate ions
What is the most frequently described deposit in bone?
Hydroxyapatite
Bone is also the repository for what additional ions?
Sodium, magnesium, fluoride, lead, strontium, and radium
What is Wolff’s Law as it pertains to bone?
Living Tissue will respond to stressors; bone is formed or absorbed in response to stress
What are the three responses of bone that allow it to be described as “living”?
It has the ability to HEAL, to REMODEL under stressors and to AGE
What are the four basic tissues of the human body?
Epithelial, muscle, neural, connective
What is bone the embryological derivative of?
Mesenchyme or cartilage
What is the name given to the pattern of ossification in mesenchyme?
Intramembranous ossification
What is the timing for the appearance of intramembranous ossification?
From the second to third month in utero
What is the name given to the pattern of ossification in cartilage?
Endochondral ossification
What is the timing for the appearance of ossification in cartilage?
From the second to fifth month in utero
What part of the skull is derived from endochondral ossification?
Chondrocranium
Which bone of the appendicular skeleton is formed by both endochondral and intramembranous ossification?
The clavicle
What are the names give to the center of ossification based on time of appearance?
Primary centers of ossification appear before birth
Secondary centers of ossification appear after birth
Mature bone is described as being composed of what areas based on bone density?
Cortical or compact bone and spongy, cancellous or trabecular bone
What is the name given to the bone below an articulating surface?
Subchondral bone
What is the name of the outer fibro-cellular covering of bone?
The periosteum
What is the name given to the fibro-cellular lining of bone?
The endosteum
What are the primary sources of variation observed in bone?
Sexual dimorphism (gender variation), ontogenetic variation (growth or age variation), geographic or population-based variation (ethnic variation) and idiosyncratic variation (individual variation)
What are the six more commonly used classifications of normal bone?
Long bones, short bones, flat bones, irregular bones, paranasal sinus or pneumatic bones and sesamoid bones
What are the classifications given to abnormal bone stressed in Spinal II?
Heterotopic and accessory bones
What is the name given to bone formed from existing bone?
Accessory bone
What are the names given to the parts of a long bone?
Diaphysis (shaft) and typically two epiphysis (extremities)
What is the primary characteristic of short bones?
They are essentially cuboidal
What are examples of short bones?
Most of the bones of the carpus and tarsus
What are flat bones?
A thin layer of spongy bone is sandwiched between two layers of compact bone.
What are examples of flat bones?
The parietal bone and sternum
What are examples of pneumatic bone?
Frontal, ethmoid, maxilla, sphenoid, and temporal
What bones contain paranasal sinuses?
Frontal, ethmoid, maxilla, and sphenoid
What is the characteristic of sesamoid bone?
The bone develops within a tendon
What are examples of heterotopic bone?
Calcific deposits in the pineal gland, heart, and ligaments
What are examples of accessory bone?
Para-articular processes and bony spurs of vertebrae
What are the four basic surface feature categories?
Elevations, depressions, tunnels or passageways, and facets
What are the types of osseous elevations?
Linear, rounded, and sharp
What are the types of osseous linear elevation?
The Line, ridge, and crest
What is an example of the slightest type of osseous linear elevation?
Transverse lines of sternum
What are the types of rounded osseous elevations?
Tubercle, protuberance, trochanter, tuber or tuberosity and malleolus
What is the definition of an osseous malleolus?
A hammerhead-like elevation on the surface of bone
What are the categories of sharp osseous elevations?
Spine and process
What is the definition of the osseous elevation called “spine”?
A thorn-like elevation from the surface of bone
What is the definition of an osseous process?
A relatively sharp bony projection from the surface of bone with an increased length
What are the categories of osseous depressions?
Linear and rounded depressions
What are the categories of osseous linear depressions?
Notch or incisure, groove, and sulcus
What is the definition on an osseous groove?
A long furrow of variable depth on the surface of bone
What is the definition of an osseous sulcus?
A wide groove of variable length and depth on the surface of bone
What are the categories of rounded osseous depressions?
Fovea and fossa
What is the definition of an osseous fovea?
A shallow depression of variable circumference on the surface of bone
What is the definition of an osseous fossa?
A deep depression of variable circumference on the surface of bone
What are the names given to openings on the surface of bone?
Ostium or orifice and hiatus
What is the definition of an osseous hiatus?
An irregular opening on the surface of bone
What are the names given to osseous ostia which completely penetrate bone?
Foramen or canal
What is the definition of an osseous foramen?
An ostium passing completely through a thin region of bone
What is the definition of an osseous canal?
An ostium passing completely through a thick region of bone
What is the name given to an ostium which does not completely penetrate through a region of bone but appears as a blind-ended passageway?
Meatus
What is the definition of an osseous fissure?
An irregular slit-like or crack-like appearance between the surfaces of adjacent bones
What are the categories of osseous facets?
Flat facets and rounded facets
What are examples of a flat osseous facet?
The articular facets of most zygoapophyses of the vertebral column
What are the categories of rounded osseous facets?
Articular heads and articular condyles
What is the definition of an osseous condyle?
A knuckle-shaped surface on bone for osseous articulation
How many bones from the typical adult skeleton?
206 bones
What are the subdivisions of the skeleton?
Axial skeleton and appendicular skeleton
How many bones form the typical adult appendicular skeleton?
126 bones
What is the total number of bones forming the typical adult skull?
28 bones
How many bones form the typical adult neurocranium?
8 bones
How many bones form the facial skeleton (splanchnocranium or visceral skeleton)?
14 bones
What is the name given to the presacral region of the typical adult vertebral column or spinal column?
The spine
What is the definition of “spine” as it pertains to the vertebral column?
The pre-sacral region of the vertebral column or spinal column
How many bones are present in the typical adult sternum?
One bone
What regions are present along the typical adult sternum?
The manubrium sterni, the corpus sterni, and the xiphoid process
How many ribs are present in the typical adult skeleton?
12 pairs or 24 ribs
What term is used to identify the study of joints?
Arthrology
What term is use to identify the study of ligaments?
Syndesmology
What are the three histological classifications of joints?
Fibrous
Cartilaginous
Synovial fluid
What were the three classifications of joints based on movement potential?
Synarthrosis
Amphiarthrosis
Diarhrosis
Which classification of synarthrosis joints implies a bond condition?
Syndesmosis
What is the classification of a joint held together with cartilage?
Synchondrosis
What is the classification of a joint formed by a growth condition?
Symphysis
What is the name given to a condition in which bones are fused together by bone?
Synostosis
What is the condition in which teeth are abnormally aligned during closure of the mouth?
Malocclusion
What fibrous connective tissue classically fills the joint space of a syndesmosis?
Interosseous ligament
What are the classic examples of the less moveable or “fixed” syndesmosis?
Tibia-fibula shaft articulation (or radio-ulnar shaft articulation, coraco-clavicular joint, or tympano-stapedial joint
What are the examples of the typical syndesmosis from the vertebral column?
Most of the ligamentous joints of the vertebral column and ligamentous sacro-iliac joints
What are the characteristics of the (amphiarthrosis) synchondrosis?
They are primary cartilage joints, temporary in longevity, composed of hyaline cartilage and form between ossification centers within a cartilage template
What are examples of temporary cartilage joints?
Metaphysis, neuro-central joint, neural arch joint, and chondrocranium
What are examples of a permanent (amphiarthrosis) synchondrosis?
Costochondral joints or the first sternochondral joint
Which cartilage joint classification would be considered secondary?
(Amphiarthrosis) symphysis
What type of cartilage is characteristic of the (amphiarthrosis) symphysis?
Fibrocartilage or fibrous cartilage
*Also characteristic of secondary cartilage
What are the characteristics of a (amphiarthrosis) symphysis?
Limited motion, median plane location, support ligaments both anterior and posterior to the joint, more permanent in longevity than synchondrosis and they occur between bones developing by endochondral ossification
What are the classic examples of a amphiarthrosis symphysis?
Intervertebral disc, pubic symphysis, sternal symphyses, and symphysis menti
Which example of a (amphiarthrosis) symphysis is temporary?
Symphysis menti
What are the four consistent features of synovial (diarthrosis) joints?
Articular or fibrous capsule, synovial membrane, articular cartilage, and synovial fluid
Thickening of the fibrous capsule connective tissue will form the what?
Capsular Ligament
What generic accessory ligaments may accompany and support the capsular ligament?
Intracapsular and extracapsular ligaments
What are the characteristics of the type 1 articular receptors?
Located in the superficial layer of the fibrous capsule, resemble Ruffini endings, most numerous in cervical zygapophyses and they monitor the joint “at rest”
What are the characteristics of type II articular receptors?
Located in deeper strata of the fibrous capsule, resemble Pacinian corpuscles, most numerous in the cervical spine and monitor the joint during normal range of motion
What are the characteristics of type III articular receptors?
Present in collateral and intrinsic ligaments, resemble Golgi tendons organs, not initially observed along the vertebral column and monitor extreme joint motion
What is the function of type IV articular receptors?
Nociceptive, they monitor pain
Type IVa articular receptors would would be present in what locations?
Fibrous capsule, articular fat pads or adventitia of blood vessels
Type IVb articular receptors would be present in what locations?
Accessory ligaments in general, dense in the posterior longitudinal ligament of the spine
Type IV articular receptors would be absent in what part(s) of the synovial (diarthrosis) joint?
Synovial membrane, articular cartilage and synovial menisci or intra-articular discs
What are the three modifications of articular synovial membrane?
(1) Synovial villi, (2) Articular fat pads or Haversian glands, (3) Synovial menisci and intra-articular discs
What is the generic function of modifications of articular synovial membrane?
Aid in spreading synovial fluid
What is the apparent function of synovial villi?
Increase the surface of synovial membrane available for secretion - absorption phenomena
Where are the articular fat pads located?
In the fibrous layer of synovial membrane; they are absent from articular cartilage, synovial menisci, intra-articular disc
Articular fat pads are most numerous in what location along the vertebral column?
Lumbar Zygapophyses
Intra-articular discs are a feature of what joints examples?
Temporomandibular
Sternoclavicular
Acromioclavicular
Radio-Ulnar joints
Synovial menisci are a feature of what joint examples?
Femur-tibia articulation, cervical zygapophyses and lumbar zygapophyses
What are the layers of the synovial membrane?
Outer fibrous layer and an inner (lumenal) cellular layer
AKA synovial lamina intima
What are the specific functions of type A synovial cells?
Are phagocytic
What is the specific function of type B synovial cells?
Secrete proteinaceous substances and hyaluronic acid
What are the primary constituents of articular cartilage?
Water
Cells
Collagen type II fibers
Proteoglycan gel
What is the primary function of bound glycosaminoglycans in articular cartilage?
Form a network for water retention
What is implied when cartilage is said to have elastic properties?
Cartilage can deform and returns to original volume rapidly, a time independent property
What is implied when cartilage is said to have viscoelastic properties?
cartilage can deform but returns to original volume slowly, a time dependent property
Which theory of joint lubrication implies a loss of fluid from the cartilage into the joint space during compression results in increased viscosity of the synovial fluid?
Weeping theory
Which theory of joint lubrication implies water loss from the synovial fluid increases viscosity of the remaining synovial fluid?
Boosted theory
Which theory of joint lubrication implies water loss from the synovial fluid increases viscosity of the synovial fluid?
Boosted theory
Which theory of joint lubrication implies an adsorption of lubricant onto cartilage surfaces is responsible for the low-friction observed during movement?
Boundary theory
What are the properties of synovial fluid?
It is yellow-white, viscous, slightly alkaline and tastes salty
Which substance in synovial fluid was first thought to be responsible for its viscosity and lubricating behavior?
Hyaluronate
What substance of synovial fluid has been proposed to be responsible for its viscosity and lubricating behavior?
Lubricin
What is a simple synovial joint (diarthrosis)?
Only one pair of articulating surfaces are observed
What is a compound synovial joint (diarthrosis)?
More than two articulating surfaces are present in the same synovial joint
What is a complex synovial joint (diarthrosis)?
Within the simple joint or the compound joint, the articulating surfaces are separated by an articular disc (intra-articular disc) or meniscus
What are the classifications of synovial joints (diarthroses) based on type of movement?
Nonaxial, uniaxial, biaxial, and multiaxial synovial joints
What movements are accommodated by nonaxial synovial joints?
Translational movement, a plane or gliding movement
What morphological classification of synovial joints is classified as nonaxial?
Plane (diarthrosis arthrodial)
What movements are accommodated by uniaxial synovial joints?
A single combination of movements relative to a single axis:
Flexion - extension
OR
Medial rotation - lateral rotation
What morphological classification of synovial joints is classified as uniaxial?
Hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)
what morphological classification of synovial joints would be classified as biaxial?
(diarthrosis) bicondylar, (diarthrosis) condylar, (diarthrosis) ellipsoidal and saddle (diarthrosis sellar)
What morphological classification of synovial joints would be classified as multiaxial?
Ball and socket (diarthrosis enarthrosis), (diarthrosis spheroidal), (diarthrosis cotyloid) are all classifications given to the same type of joint
What are examples of synovial plane (diarthrosis arthroidal) joint?
Most zygapophyses of the vertebral column
Intercarpal, carpometacarpal, and intermetacarpal joints of the hand
Intercuneiform, tarsometatarsal, and intermetatarsal joints of the foot
What are examples of synovial hinge (diarthrosis ginglymus) joints?
Humero-ulnar joint of the elbow and interphalangeal joints of the fingers and toes
What are the examples of synovial pivot (diarthrosis trochoid) joints?
Median atlanto-axial joint and proximal radio-ulnar joint
What is the shared morphological characteristic of diarthrosis trochoid joints?
An osseous pivot point and an osteo-ligamentous ring
What are examples of diarthrosis condylar or diarthrosis bicondylar joints?
Temporomandibular joint and femur-tibia joint of the knee
What are examples of diarthrosis ellipsoidal joints?
Radiocarpal joint of the wrist, metacarpo-phalangeal joints of the hand, metatarsal-phalangeal joints of hte foot and the atlanto-occipital joint of the vertebral column
Which synovial joint classifications are now often interchanged in textbooks?
Ellipsoidal and condylar synovial joints
What are examples of synovial saddle (diarthrosis sellar) joints?
Carpometacarpal joint of the thumb, talocrural joint of the ankle and the calcaneocuboid joint of the foot
What are examples of diarthrosis contyloid joints?
Femur-acetabulum of the innominate articulation at the hip and the humerus - glenoid cavity of the scapula articulation at the shoulder
What is the number of vertebrae in a typical adolescent?
33 segments
What is the number of vertebrae in a typical adult?
26 segments
What constitutes the spine?
the 24 sacral segments; the cervical, thoracic, and lumbar vertebrae
How many segments unite to form the typical sacrum?
5 segments
How many segments unite to form the typical coccyx?
4 segments
Which mammals do not have seven cervical vertebrae?
Two-toed sloth, manatee, ant bear, and three-toed sloth
Which mammals have more than seven cervical vertebrae
The ant bear and three-toed sloth
Which mammals have less than seven cervical vertebrae?
The manatee and two-toed sloth
What does the term “cervical” refer to?
The region of the neck
What does the term “thoracic” refer to?
Breast plate or chest; it referred to the armor bearing region of the torso
What other term is often used to identify the vertebral segments of the chest?
The dorsal segments; the dorsals
What is the typical number of segments in the dorsal or thoracic region?
12 segments
What does the term “lumbar” refer to?
The loin; the region between the rib and the hip
what is the typical number of segments in the lumbar region?
5 segments
What does the term “sacrum” refer to?
The holy bone or holy region
What does the term “coccyx” refer to?
A cuckoo birds’ bill or cuckoo birds’ beak
What is the length of a typical male spinal column?
About 70 centimeters or 28 inches
What is the length of a typical female spinal column?
About 60 centimeters or 25 inches
What is the length difference between a typical male and female spinal column?
about 3 inches
What is the length of the male cervical region (both measurements)?
about 12 centimeters or 5 inches
What is the length of the male thoracic region (both measurements)?
About 28 centimeters or 11 inches
What is the length of the male lumbar region (both measurements)?
About 18 centimeters or 7 inches
What is the length of the male sacrum (both measurements)?
About 12 centimeters or 5 inches
Based on the number for individual regions of the vertebral column, what is the length of the male spine (both measurements)?
About 58 centimeters or 23 inches
What levels of the vertebral column specifically accommodate weigh-bearing transfer?
S1-S3 at the auricular surface
What is specifically responsible for shape and position of fthe human frame?
Comparative anterior vs. posterior height of the vertebral body and comparative anterior vs. posterior height of the intervertebral disc
What organ(s) is (are) specifically associated with the horizontal axis of the skull?
The eye and the vestibular apparatus of the inner ear
When does the embryonic disc form?
second week in utero
When does gastrulation occur or a 3-layered embryo form?
Third week in utero
Invagination of ectoderm along the primitive streak gives rise to what embryonic structure?
Notochord
What is the name given to the mesoderm that will give rise to the vertebral column?
paraxial mesoderm
What embryonic structure gives rise to the somites?
Paraxial mesoderm
Name the areas of cellular differentiation formed within the somite.
Sclerotome, myotome, and dermatome
What are the names of the successive vertebral columns formed during development?
Membranous, cartilaginous, skeletal or osseous
Migration of a somite pair to surround the notochord forms what developmental feature?
The perichordal blastema
The perichordal blastema gives rise to what processes?
Neural processes and costal processes
What is the name of the artery located between adjacent perichordal blastemae?
Intersegmental artery
What forms between the sclerotomites of the perichonrdal blastema?
the intrasclerotomal fissure (fissure of von Ebner)
The intrasclerotomal fissure (fissure of von Ebner) gives rise to what developmental feature?
The perichordal disc
The union of a dense caudal sclerotomite and a loose cranial sclerotomite from adjacent perichordal blastemae gives rise to what feature?
The vertebral blastema
What vessel will be identified adjacent to the vertebral blastema?
The segmental artery
When will cartilage first form in the membranous vertebral blastema?
Beginning in the 6th embryonic week
What is the name given to the replacement of mesoderm by cartilage?
Chondrification
What are the names given to the centers of chondrification within the vertebral blastema?
Centrum center, neural arch center, transverse process center
How many centers of chondrification typically appear in the vertebral blastema?
Six: 2 for the centrum, 2 for the neural arches, 2 for each transverse process
What is the earliest time that centers of ossification appear in cartilaginous vertebra?
During 7th embryonic week
What is the name given to centers of ossification for a typical vertebra?
3 Primary centers: 5 secondary centers
What are the names of the primary centers of ossification for a typical vertebra?
Centrum centers and neural arch centers
What are the names/locations of the five secondary centers of ossification for a typical vertebra?
Tip of the transverse process, tip of the spinous process, epiphyseal plate centers
What is the range of appearance for secondary centers of ossification of a typical vertebra?
During puberty, typically ages 11-16 years old
What are the three basic osseous parts of a vertebra?
The vertebral body, vertebral arch, and the apophyseal regions
What is the general shape of the vertebral body at each region of the spine?
Cervical - rectangular; thoracic - triangular; lumbar - reniform
What is the name given to the compact bone at the superior and inferior surfaces of the vertebral body?
Superior epiphyseal rim, inferior epiphyseal rim
What are the names of the openings found around the margins of the vertebral body?
Nutrient foramina or vascular foramina
What large opening is usually observed at the back of the vertebral body?
The basivertebral venous foramen
What is the name given to the anterior part of the vertebral arch?
The pedicle
What is the name given to the feature located at the upper and lower surfaces of the pedicle?
The superior vertebral notch or superior vertebral Incisure; the inferior vertebral notch or inferior vertebral incisure
What is the generic orientation of the pedicle at each region of the spine?
Cervical - posterolateral
Thoracic - posterior, slight lateral
Lumbar - posterior
All lamina are oriented in what direction?
Posterior and median
What ligament will attach to the lamina?
The ligamentum flavum
What is the name given to abnormal bone at the attachment site of the ligamentum flavum?
Para-articular process
What classification of bone will para-articular processes represent?
Accessory bone
What is the name given to the overlap of laminae seen on X-ray?
Shingling
What is the name given to the junction of the vertebral arch - spinous process on lateral X-ray?
The spinolaminar junction
What is the name given to the tubular bone growth regions of the vertebral arch?
The apophyseal regions
What is the name given to the lamina - pedicle junction at each region of the spine?
Cervical - articular pillar; thoracic and lumbar - pars interarticularis
What names may be given to each apophysis of the spine?
The transverse apophysis or transverse process; articular apophysis or articular process; spinous apophysis or spinous process
What is the generic orientation of the transverse process or transverse apophysis at each region of the spine?
Cervical - anterolateral; thoracic - posterolateral; lumbar - lateral
All non-rib-bearing vertebra of the spine retain what equivalent feature?
The costal element
What is the name given to the rounded elevation at the end of the transverse apophysis or transverse process?
The transverse tubercle
What will cause the transverse process/transverse apophysis to alter its initial direction in the cervical region?
Cervical spinal nerves are pulled forward to form the cervical and brachial nerve plexuses thus remodeling the transverse process to accommodate their new position
What will cause the transverse process/transverse apophysis to alter its initial direction in the thoracic region?
The growth of the lungs remodel the shape of the ribs which in turn push the transverse processes backward
What will the articular process/articular apophysis support?
The articular facet
What is the name given to the joint formed between articular facets of a vertebral couple?
The zygapophysis
What is the name given to the bone surface at the front of a zygapophysis?
The superior articular facet
What is the name given to the bone surface at the back of a zygapophysis?
The inferior articular facet
What names are given to the part of the vertebra which supports the front of the zygapophysis?
The superior articular apophysis, the superior articular process, or the pre-zygapophysis
What names are given to the part of the vertebra which supports the back of the zygapophysis?
The inferior articular apophysis, the inferior articular process, or the post-zygapophysis
What is the name given to the part of the vertebra forming the pre-zygapophysis?
The superior articular process or superior articular apophysis
What is the name given to the part of the vertebra forming the post-zygapophysis?
The inferior articular process or inferior articular apophysis
What will form the posterior boundary of a typical 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 intervertebral foramen?
The inferior vertebral notch or inferior vertebral incisure
What will form the inferior boundary of a typical intervertebral foramen?
The superior vertebral notch or superior vertebral incisure
What will form the anterior boundary of a typical intervertebral foramen?
The vertebral body of the segment above, the vertebral body of the segment below, the intervertebral disc, and the posterior longitudinal ligament
What is the method of calculating the angle of the spinous process/spinous apophysis?
Calculate the angle formed between the undersurface of the spinous process/spinous apophysis and the horizontal plane
What is the name given to the normal overlap of spinous processes or spinous apophyses as seen on X-ray?
Imbrication
What is the name given to the rounded elevation at the tip of the spinous process/spinous apophysis?
The spinous tubercle
what is the orientation of the spinous process/spinous apophysis at each region of the spine?
Cervical - slight angle inferiorly
Thoracic - noticeable
Lumbar - no inferior angle
What is the typical shape/outline of the vertebral foramen at each of the spinal column/vertebral column?
Cervical - Trianglular
Thoracic - Oval
Lumbar - Triangular
Sacrum - Triangular
At what vertebral level will the spinal cord typically terminate?
L1
At what vertebral level will the dural sac typically terminate?
S2
What are the segmental arteries?
The arteries whose branches supply the vertebra or segment
Identify all segmental arteries
Vertebral, ascending cervical, deep cervical, superior (highest) intercostal, posterior intercostal, subcostal, lumbar, iliolumbar, lateral sacral and median (middle) sacral
What are the segmental arteries of the cervical spine?
The vertebral artery, ascending cervical artery, and deep cervical artery
What are the segmental arteries of the thoracic spine?
The deep cervical artery, superior (highest) intercostal artery, posterior intercostal artery, and subcostal artery
What are the segmental arteries of the lumbar spine?
The lumbar arteries, iliolumbar artery, lateral sacral artery, and median (middle) sacral artery
What segmental levels are supplied by the vertebral artery?
C1-C6
What segmental levels are supplied by the ascending cervical artery?
C1-C6
What segmental levels are supplied by the deep cervical artery?
C7-T1
What segmental levels are supplied by the superior (highest) intercostal artery?
T1-T2
What segmental levels are supplied by the posterior intercostal artery?
T3-T11
What segmental level(s) is/are supplied by the subcostal artery?
T12
What segmental levels are supplied by the lumbar arteries?
L1-L4
What segmental levels are supplied by the iliolumbar artery?
L5, S1-S5, and coccyx
Which branches of the spinal artery supply the contents of the epidural space?
Osseous arteries, anterior spinal canal artery, posterior spinal canal artery
What arteries are observed in the epidural space near the posterior longitudinal ligament?
Anterior spinal canal artery and plexus
What arteries are observed in the epidural space near the ligamentum flavum?
Posterior spinal canal artery and plexus
Which branches of the spinal artery supply the contents of the subarachnoid space?
Anterior radicular artery, posterior radicular artery, anterior medullary feeder artery, posterior medullary feeder artery
Which vessel will supply the ventral/anterior nerve rootlet and nerve root?
Anterior radicular artery
Which vessel will supply the dorsal/posterior nerve rootlets, nerve root, and nerve root ganglion?
Posterior radicular artery
What is the name given to the artery that lies in front of the spinal cord along its length?
Anterior spinal artery
The anterior spinal artery is a branch of which artery?
The vertebral artery
Is the anterior spinal artery a single, continuous artery along the spinal cord?
No
As the anterior spinal artery continues along the spinal cord, which arteries unite along its length to give the appearance of a single continuous vessel?
Anterior medullary feeder arteries
The posterior spinal artery is a branch of which artery?
The posterior inferior cerebellar artery
What is the position of the posterior spinal artery relative to the spinal cord?
It lies in the posterolateral sulcus along the spinal cord
Is the posterior spinal artery a single, continuous artery along the spinal cord?
No
As the posterior spinal artery continues along the spinal cord, which arteries unite along its length to give the appearance of a single continuous vessel?
Posterior medullary feeder artery
What changes to the arterial vasa corona occur between C3 and C6?
Right and left anterior spinal arteries fuse to become a single median anterior spinal artery, the right and left posterior spinal arteries are unchanged, and the four communicating arteries are reduced to three communicating arteries
What arterial vasa corona branches supply gray matter and most of the spinal cord?
Pial perforating arteries
What is the primary artery supplementing the arterial vasa corona?
Anterior medullary feeders and posterior medullary feeders
What vessels drain the spinal cord?
Pial veins
Which vessels will drain the venous vasa corona?
Anterior medullary veins, posterior medullary veins
Which vessels will drain the ventral/anterior nerve roots?
Anterior radicular veins
Which vessels will drain the ventral/anterior nerve roots?
Anterior radicular veins
Which vessels will drain the dorsal/posterior nerve roots?
Posterior radicular veins
What vessel will drain the dorsal/posterior nerve root ganglion?
Posterior radicular veins
What veins will lie in the subarachnoid space?
Pial veins, venous vasa corona, anterior longitudinal veins, posterior longitudinal veins, communicating veins, anterior medullary veins, posterior medullary veins, anterior radicular veins, posterior radicular veins
What veins are observed in the epidural space near the posterior longitudinal ligament?
Anterior internal vertebral venous plexus, basivertebral vein
What veins are observed in the epidural space near the ligamentum flavum?
Posterior internal vertebral venous plexus
What venous vessels are identified in the intervertebral foramen?
Intervertebral veins
Identify the meninges of the spinal or (spinal medulla or medulla spinalis) and the commonly accepted meaning of each
Dura mater - tough mother
arachnoid mater - spider mother
pia mater - tender or delicate mother
Name and locate each space formed between the osseous vertebral foramen and the spinal cord (spinal medulla or medulla spinalis)
Epidural space - between the vertebral foramen and the dura mater
Subdural space - between the dura mater and the arachnoid mater
Subarachnoid space - between the arachnoid mater and the pia mater
what is the name given to the fluid within the epidural space?
Interstitial fluid
What are the contents of the epidural space?
Anterior and posterior spinal canal artery and plexus
Anterior and posterior internal vertebral venous plexus
Basivertebral vein
Recurrent meningeal/sinu-vertebral, sinus vertebral nerve
Ligamentum flavum
Posterior longitudinal ligament
Which of the contents of the epidural space will be found near the vertebral body?
Anterior spinal canal artery and plexus
Anterior internal vertebral venous plexus
Basivertebral vein
Recurrent meningeal/sinu-vertebral, sinus vertebral nerve
Posterior longitudinal ligament
Hofmann/anterior dural/meningovertebral ligaments
Which of the contents of the epidural space are more likely located near or around the posterior longitudinal ligament?
Anterior spinal canal artery and plexus
Anterior internal vertebral venous plexus
Basivertebral vein
Recurrent meningeal/sinu-vertebral/sinus vertebral nerve
Hofmann/anterior duralmeningovertebral ligament
Which of the contents of the epidural space will be found near the lamina?
Posterior spinal canal artery and plexus
Posterior internal vertebral venous plexus
Ligamentum Flavum
What is the name given to the fluid with the subarachnoid space?
Cerebrospinal fluid
What are the typical contents of the subarachnoid space down to the level C3?
- Anterior spinal arteries (and veins), *posterior spinal arteries, *communicating arteries, arterial vasa corona, pial perforating arteries, central/sulcal perforating arteries, *anterior radicular arteries, *posterior radicular arteries, anterior medullary feeder arteries, posterior medullary feeder arteries, dentate/denticulate ligament
- Venous vasa corona, Pial veins, Anterior medullary veins, posterior, medullary veins, intervertebral veins
What contents of the subarachnoid space are changed below the level C6?
The arterial vasa corona consists of one anterior spinal artery, two posterior spinal arteries, and three communicating arteries
What is the name given to the lateral extension of pia mater along the spinal cord?
Dentate (denticulate) ligament
What is the unique feature of veins along the spinal canal?
They lack the bicuspid valve of typical veins
In horizontal view, what direction of the spinal cord tends to be largest?
Transverse
What are the spinal cord enlargement locations and the name given to each?
C3-T1, the cervical enlargement; T9-T12, the lumbar (lumbrosacral) enlargement
Where is the greatest transverse diameter of the spinal cord?
C6
In which plane (or direction) will the diameter of the spinal decrease from C2-T1?
Midsagittal or anterior-posterior plane
What is the generic cord level of origin - vertebral level combination for the lumbar (lumbosacral) enlargement?
L1, L2 cord levels in T9 vertebra; L3, L4 cord levels in T10 vertebra; L5, S1 cord levels in T11 vertebra; S2, S3 cord levels in T12 vertebra
What is the caudal end of the spinal cord called?
Conus Medullaris
What spinal nerves originate from the conus medullaris?
Typically S4, S5, and Co1
In which vertebral foramen will the conus medullaris typically be observed?
L1
What is the name given to the nerve roots below L1?
Cauda Equina
What is the continuation of pia mater below the conus medullaris called?l
Filum Terminale Internum
What is the fate of the neural tissue identified along the filum terminale internum?
It joins peripheral nerve roots of spinal nerves as high as L3 and as low as S4
What is the location and name given to the area where all meninges first coverage at the caudal part of the vertebral column?
Typically S2, the dural cul de sac
Neural tissue has been identified in what part of the filum terminale?
Proximal part of the filum terminale internum
What does the neural tissue associated with the filum terminale externum appear to innervate?
Lower limbs and the external and sphincter
The last arterial vasa corona creates what feature on angiogram?
Cruciate anastomosis
What is the name given to the condensation of meninges below S2?
Filum Terminale Externum
What is the name given to the caudal attachment of the meninges?
Coccygeal medullary vestige
What is the name given to the condition in which the conus medullaris is located below L1 and the filum terminale is thickened?
Tethered cord syndrome
What is the relationship between scoliosis and tethered cord syndrome?
It is suggested that the column will change normal curvatures to mitigate damage to the spinal cord
What is the relationship between rib number and vertebral numbers at the costocentral joint?
Rib number always equates to same vertebral number at the costocentral joint
Rib 3 articulates with T3 segment and also with the T2 segment
Only ribs 1, 11, and 12 typically joint with a single segment
What is the relationship between spinal nerve number, rib number and vertebral number in a thoracic intervertebral foramen?
The spinal nerve number relates to the upper segment number in the vertebral couple
The rib number relates to the lower segment number in the vertebral couple i.e. T3 nerve exits the intervertebral foramen formed by T3/T4 and rib 4 joints with this vertebral couple
