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Spinal Anatomy -- Morter > Spinal Final Exam: Section IX. Transition Zones of the Vertebral Column > Flashcards

Spinal Final Exam: Section IX. Transition Zones of the Vertebral Column Flashcards

1
Q

What are the transition zones of the vertebral column?

A

occipitocervical, cervicothoracic, thoracolumbar, lumbossacral, and sacrococcygeal zones

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2
Q

How are specific segments within a transition zone identified?

A

by adjacent region of the segment, process of transition, and specific segment (occipitalization of C1)

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3
Q

What does the suffix “ization” refer to?

A

in the process of becoming like

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4
Q

What are the possible transition zone - segmental combinations?

A

cervicalization of occiput, occipitalization of C1
dorsalization of C7, cervicalization of T1
lumbarization of T12, dorsalization of L1
sacralization of L5, lumbarization of S1
coccygealization of S5, sacralization of Co1

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5
Q

What is/are the characteristic(s) of cervicalization of occiput?

A

an increase in occipital bone size, formation of new or larger lines on the occipital bone

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6
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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7
Q

What is another way of implying occipitalization of C1?

A

atlas assimilation

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8
Q

What is the incidence of occipitalization of C1?

A

0.1% - 0.8%

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9
Q

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

A

during the last trimester in utero

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10
Q

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

A

at or shortly after birth

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11
Q

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

A

the subdental synchondrosis

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12
Q

What joint classification is present between the C2 odontoid process and centrum?

A

amphiarthrosis synchondrosis

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13
Q

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

A

4 years old

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14
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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15
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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16
Q

What is an os odontoideum?

A

a persistence beyond age 7 of the joint formed between the centrum and odontoid process centers of ossification

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17
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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18
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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19
Q

What is the classification of the joint formed between the top of the dens and odontoid process centers of ossification?

A

amphiarthrosis synchondrosis

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20
Q

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

A

sometime in early adolescence

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21
Q

Based on the age of appearance, how is the tip of the dens center of ossification classified?

A

secondary center of ossification

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22
Q

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

A

before age 12

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23
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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24
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

25
Q

What is a basilar invagination?

A

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

26
Q

What is/are the characteristic(s) of dorsalization of C7?

A

the addition of a rib and changes in superior articular facet orientation are typical

27
Q

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

A

from 0.5 - 2.5% of the population

28
Q

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

A

no, they are typically asymptomatic

29
Q

What is the gender bias suggested in dorsalization of C7?

A

female

30
Q

What alteration in C7 facet orientation may accompany dorsalization?

A

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

31
Q

What alteration in C6 facet orientation may accompany dorsalization?

A

C6 demonstrates a change in inferior articular facet orientation from forward, lateral, and downward to forward, medial, and downward; the superior articular facet unchanged

32
Q

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

A

up to 46%

33
Q

What rib-related changes may accompany cervicalization of T1?

A

the first rib may decrease in mean relative length or become absent

34
Q

What will result from fusion of a short rib to the T1 transverse process?

A

the transverse foramen

35
Q

What T1 facet orientation changes may accompany cervicalization?

A

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

36
Q

What C7 facet orientation changes may accompany cervicalization?

A

the inferior articular facet may change from forward, medial, and downward to forward, lateral, and downward; the superior articular facet is unchaged

37
Q

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

A

up to 28% of the population

38
Q

What rib-related changes may accompany dorsalization of L1?

A

elongated bones shaped like ribs may appear

39
Q

What is the incidence of lumbar ribs in the population?

A

over 7% of the population demonstrates lumbar ribs

40
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

41
Q

What T12 facet orientation may accompany dosalization?

A

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

42
Q

What is the gender bias associated with dorsalization of L1?

A

males are two to three times more affected

43
Q

What T12 facet orientation changes may accompany lumbarization?

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

44
Q

What rib-related changes may accompany lumbarization of T12?

A

a significant shortening of the mean relative length of 113 mm of the twelfth rib or it becomes absent

45
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

46
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

47
Q

What is characteristic of lumbarization of S1?

A

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

48
Q

What unique characteristics of lumbarization of S1 were stressed in class?

A

squaring of the vertebral body of S1 and flaring of the sacral ala

49
Q

What is failure of synostosis between S1 and S2?

A

the segments do not completely fuse together

50
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

51
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

52
Q

What articular facet changes accompany lumbarization of S1?

A

none

53
Q

What is characteristic of sacralization of L5?

A

L5 may be partially or completely fused to the sacrum

54
Q

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

A

41% to 85%

55
Q

Which segment demonstrates the greatest morphological variation along the spine?

A

L5

56
Q

What articular facet changes accompany sacralization of L5?

A

none

57
Q

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

A

up to 14%

58
Q

What is characteristic of sacralization of Co1?

A

the premature fusion of Co1 to the sacrum

59
Q

What is characteristic of coccygealization of S5?

A

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

Spinal Anatomy -- Morter (21 decks)

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