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Spinal Anatomy > Spinal Q&A Exam 2 > Flashcards

Spinal Q&A Exam 2 Flashcards

1
Q

What is the orientation and angulation of the pedicle of a typical cervical?

A

posterolateral, 45 degrees

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2
Q

In the vertebral couple, which cervical vertebral body will contribute more toward the height of the intervertebral foramen?

A

neither, both contribute equally to the intervertebral foramen height

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3
Q

Which spinal nerve will be accommodated on the superior vertebral notch of C5?

A

C5 spinal nerve

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4
Q

Which spinal nerve will be accommodated on the inferior vertebral notch of C5?

A

C6 spinal nerve

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5
Q

What direction of projection of the cervical lamina?

A

posteromedially

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6
Q

What ligament attaches to the lamina of a typical cervical?

A

ligamentum flavum

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7
Q

What joint classification will be associated with the ligamentum flavum and its attachment?

A

fibrous (amphiarthrosis) syndesmosis

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8
Q

Ossification of the ligamentum flavum at the attachment site on the lamina will result in what feature?

A

para-articular processes

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9
Q

Ossification of the ligamentum flavum at the attachment site on the lamina will be associated with which classification of bone?

A

accessory bone

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10
Q

Ossification within the length of the ligamentum flavum will be associated with which classification of bone?

A

heterotopic bone

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11
Q

What is the outline of the vertebral foramen of a typical cervical vertebra?

A

heart-shaped or triangular

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12
Q

Which is the greatest diameter of the vertebral foramen of a typical cervicals?

A

transverse

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13
Q

The greatest transverse diameter of the typical cervical vertebra occurs at ______?

A

C6

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14
Q

The greatest frequency of osteophytes associated with the vertebral body occurs at which typical cervical vertebral couple?

A

C5/C6

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15
Q

What muscles will attach to the anterior tubercle of a typical cervical vertebra?

A

anterior scalene, longus capitis, longus colli, anterior intertransversarii

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16
Q

What muscles may attach to the posterior tubercle of a typical cervical vertebra?

A

splenius crevicis, iliocostalis cervicis, longissimus cervicis, levator scapula, middle scalene, posterior scalene, rotators and posterior intertransversarii

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17
Q

What muscles will attach to the costotransverse bar?

A

middle scalene and posterior intertransversarri

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18
Q

What produces the primary tension on the transverse process that will cause remodeling in the anterolateral and inferior directions?

A

cervical spinal nerves as they are directed anterolaterally and inferiorly to form the cervical and brachial plexuses

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19
Q

What is the orientation and angulation of a typical cervical transverse process?

A

60 degrees anterolaterally (from midsagittal plane), 15 degrees inferiorly (from the horizontal plane)

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20
Q

What is the name given to the modification of the anterior tubercle of the C6 transverse process?

A

the carotid tubercle

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21
Q

What will cause remodeling of the anterior tubercle at C6?

A

common carotid artery

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22
Q

What will occupy the typical cervical vertebra transverse foramen?

A

the vertebral artery, vertebral venous plexus and postganglionic sympathetic motor nerve fibers

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23
Q

What is the name of the lamina-pedicle junction of typical cervical vertebrae?

A

articular pillar

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24
Q

What is the classic angulation of typical cervical articular facets?

A

40 - 45 degrees from the coronal plane

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25
Q

Recent work suggests what angulation for typical cervical articular facets?

A

55 - 60 degrees

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26
Q

What is the orientation of the typical cervical superior articular facet?

A

backward, upward, medial (BUM)

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27
Q

What is the orientation of the typical cervical inferior articular facet?

A

forward, lateral, downward, (FoLD)

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28
Q

What muscles will attach to typical cervical articular processes?

A

the longissimus capitis, longissimus cervicis, semispinalis capitis, semispinalis cervicis, multifidis and rotators

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29
Q

What muscles blend with the capsular ligament of cervical zygapophyses?

A

the semispinalis capitis, multifidis and rotator longus

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30
Q

What is the joint classification for the typical cervical zygapophysis?

A

synovial plane (diarthrosis arthrodia) joint

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31
Q

What modifications of the synovial joint are observed in the cervical spine?

A

meniscoidal folds

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32
Q

What function will meniscoidal folds provide in cervical zygapophyses?

A

they are assumed to distribute pressure across the joint surface

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33
Q

The greatest range of flexion - extension among the typical cervical vertebrae occurs at which vertebral couple?

A

typically C5/C6

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34
Q

What motions are coupled in the cervical spine?

A

lateral beding and axial rotation

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35
Q

Ranges of coupled motion among the typical cervical vertebrae will be similar for what cervical vertebral couples?

A

C2/C3, C3/C4, C4/C5 vertebral couples

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36
Q

Ranges of coupled motion among the typical cervical vertebrae will begin to descries at what cervical vertebral couple?

A

the C5/C6 vertebral couple

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37
Q

What is the usual condition for the Caucasian typical cervical spinous process?

A

they are bifid

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38
Q

What is the usual condition for the African-American typical cervical spinous process?

A

they are non-bifid

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39
Q

What muscles may attach to the typical cervical spinous process?

A

the spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

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40
Q

What ligaments will attach to the typical cervical spinous process?

A

the interspinous ligament and ligamentum nuchae

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41
Q

What will form the anterior boundary of a typical cervical intervertebral foramen?

A

the lateral groove and vertebral body of the segment above, the uncinate process and vertebral body of the segment below, the intervertebral disc and the posterior longitudinal ligament

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42
Q

What will form the posterior boundary of a typical cervivacl intervertebral foramen?

A

the inferior articular process (post-zygapophysis), the superior articular process (pre-zygapophysis), the capsular ligament and the ligamentum flavum

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43
Q

What will form the superior boundary of a typical cervical intervertebral foramen?

A

the inferior vertebral notch (or incisure)

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44
Q

What will form the inferior boundary of a typical cervical intervertebral foramen?

A

the superior vertebral notch (or incisure)

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45
Q

What is the unique anterior boundary of the intervertebral foramen for the C4 spinal nerve?

A

the lateral groove of C3 and uncinate process of C4 forming the joint of Luschka

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46
Q

What is the name of the first cervical vertebra?

A

atlas

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47
Q

What features are lacking at C1?

A

vertebral body, pedicles, a spinous process and the intervertebral disc

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48
Q

What is thought to represent the pedicle at C1?

A

anterior arch

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49
Q

What osseous modification is observed to the front of the anterior arch of C1?

A

anterior tubercle

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50
Q

What muscle attaches to the anterior arch of C1?

A

longus colli

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51
Q

What ligaments will attach to the anterior arch of C1?

A

the anterior longitudinal, anterior atlanto-occipital and anterior atlanto-axial ligaments

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52
Q

What joint classifications are observed on the anterior arch of C1?

A

fibrous (amphiarthrosis) syndesmosis joint and synovial pivot (diarthrosis trochoid) joint

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53
Q

What is the morphology of the superior articular facet of C1?

A

they are elliptical, slower together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces

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54
Q

What is the orientation of the superior articular facet of C1?

A

backward, upward, medial (BUM)

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55
Q

What is the joint classification of the atlanto-occipital zygapophysis?

A

synovial (diarthrosis) ellipsoidal joint

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56
Q

What are the morphological characteristics of the inferior articular facet of C1?

A

asymmetrical, slightly concave or flattened

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57
Q

What is the orientation of the inferior articular facet of C1?

A

backward, medial, downward (BMD)

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58
Q

What is the joint classification of the atlanto-axial zygapophysis?

A

synovial plant (diarthrosis arthrodia) joint

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59
Q

What muscles attach to the lateral mass of C1?

A

levator scapula, splenius cervicis and rectus capitis anterior

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60
Q

What is the contribution of the posterior arch to the circumference of C1?

A

about forty percent

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61
Q

What part of C1 represents the spinous process?

A

posterior tubercle of the posterior arch

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62
Q

What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?

A

males: about 50 millimeters; females: about 37 millimeters

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63
Q

What attaches to the posterior tubercle of the posterior arch of C1?

A

rectus capitis posterior minor muscle and ligamentum nuchae

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64
Q

What attaches to the arcuate rim of C1?

A

posterior atlanto-occipital ligament

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65
Q

Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?

A

accessory bone

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66
Q

What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?

A

about age 7 years old

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67
Q

Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?

A

an incomplete ponticulus posticus or a complete ponticulus posticus

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68
Q

What are the attachment sites of the ponticulus posticus?

A

it is attached to the arcuate rim of the posterior arch of atlas and the superior articular process of the lateral mass of the atlas

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69
Q

Ponticulus posticus has observed in what ethnic populations?

A

all ethnic population studied thus far

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70
Q

What is the general range of incidence of ponticulus posticus in the populations studied?

A

1-41%

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71
Q

What is the generic bias now associated with ponticulus posticus?

A

female

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72
Q

What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?

A

the incidence of a complete ponticulus posticus is about 15%; the incidence of an incomplete ponticulus posticus may be as high as 41%

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73
Q

What is observed on the undersurface of the posterior arch of C1?

A

inferior vertebral notch and an attachment site for the posterior atlanto-axial ligament

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74
Q

What is the location of the zygapophysis relative to the atlanto-occipital and the atlanto-axial intervertebral foramina?

A

it forms part of the anterior boundary of the intervertebral foramen in both cases

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75
Q

What are the osseous parts of the transverse process of C1?

A

costal element, posterior tubercle, true transverse process

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76
Q

What osseous parts of the transverse process are absent at C1?

A

anterior tubercle and costotransverse bar

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77
Q

What muscles attach to the transverse process of C1?

A

rectus capitis anterior, rectus capitis lateralis, middle scalene, elevator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles

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78
Q

What suboccipital muscles are known to have fascial projections attaching to the spinal dura?

A

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

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79
Q

What are the connections between sub occipital muscles an the spinal dura called?

A

myodural bridges

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80
Q

What are the lateral bridges of atlas connected to?

A

the lateral mass and the transverse process of atlas

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81
Q

What forms of the lateral bridges are observed in the population?

A

incomplete lateral bridges and complete lateral bridges

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82
Q

What opening is identified when a complete lateral bridge is formed?

A

retrotransverse foramen

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83
Q

What are the possible contents of the retrotransverse foramen?

A

the vertebral artery, a branch from the sub occipital nerve and veins communicating with the nervous sinuses of the neck

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84
Q

Which of the pentacles (bridges) of atlas is most numerous?

A

ponticulus posticus

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85
Q

Which of the pentacles (bridges) of atlas is only observed in humans?

A

lateral bridges

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86
Q

What is observed in the transverse foramen of C1?

A

vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

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87
Q

What is the gender variation for measurements of the transverse diameter of C1?

A

males: 78 millimeters and females: 72 millimeters

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88
Q

What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?

A

a little over 30 mm for both male and females

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89
Q

What joint classifications are observed at C1?

A

fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial pivot (diarthrosis trochoid) joint and synovial plane (diarthrosis arthrodia) joint

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90
Q

How many synovial joint surfaces are observed at C1?

A

5

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91
Q

What synovial joint surfaces are observed at C1?

A

2 superior articular facets, 2 inferior articular facets and the fovea dentis

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92
Q

What names are given to C2?

A

axis or epistropheus

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93
Q

What unique vertebral body modification is characteristic of C2?

A

the dens or odontoid process

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94
Q

How many joint surfaces are present on the odontoid process of C2?

A

5

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95
Q

What joint surfaces are present on the odontoid process of C2?

A

facet for fovea dentist, groove for transverse Atlanta ligament, attachment sites for the alar ligaments, attachment site for the apical-dental ligament

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96
Q

Which joint classifications are represented at the odontoid process of C2?

A

fibrous (amphiarthrosis) syndesmosis and synovial pivot (diarthrosis trochoid) joints

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97
Q

What is the name/classification given to the odontoid process when the tip of the dens is directed posterior?

A

lordotic dens

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98
Q

What is the name/classification given to the odontoid process when the tip of the dens is directed anterior?

A

kyphotic dens

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99
Q

How many joints are formed by the inferior part of the vertebral body of C2?

A

5

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100
Q

What joint classifications are present at the inferior part of the vertebral body of C2?

A

fibrous (amphiarthrosis) syndesmosis, modified synovial saddle (diarthrosis sellar) and cartilaginous (amphiarthrosis) symphysis

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101
Q

How many joint surfaces are present at the vertebral body of C2?

A

10

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102
Q

What joint classifications are present at the vertebral body of C2?

A

fibrous (amphiarthrosis) syndesmosis, synovial pivot (diarthrosis trochoid), modified synovial saddle (diarthrosis sellar) and cartilaginous (amphiarthrosis) symphysis

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103
Q

What ligament will represent the cranial continuation of the posterior longitudinal ligament?

A

membrana tectoria

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104
Q

What ligament forms the anterior boundary for the spinal canal above C2?

A

membrana tectoria

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105
Q

What ligament forms the anterior boundary for the spinal canal below C2?

A

posterior longitudinal ligament

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106
Q

What is the location of the superior vertebral notch of C2?

A

on the lamina-pedicle junction

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107
Q

What attaches to the lamina of C2?

A

obliquus captifs inferior muscles, posterior atlanto-axial ligament, ligamentum flavum

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108
Q

What muscle attaches to the lamina of C2?

A

obliquus captifs inferior

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109
Q

What is the appearance of the superior articular facets of C2?

A

they are asymmetrical and slightly convex

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110
Q

What is the facet orientation of the superior articular facet of C2?

A

backward, upward, lateral (BUL)

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111
Q

What is the orientation of the inferior articular facets of C2?

A

forward, lateral, and down (FoLD)

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112
Q

What muscle attaches to the articular processes of C2?

A

longissimus cervicis

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113
Q

What osseous parts of the typical cervical transverse process are absent at C2?

A

anterior tubercle and costotransverse bar

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114
Q

What will be observed in the transverse foramen at C2?

A

vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

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115
Q

What is the gender variation for the transverse diameter of C2?

A

Males: 57mm and females: about 50 mm

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116
Q

What muscles attach to the transverse process at C2?

A

levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii

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117
Q

What is the characteristic appearance of the C2 spinous process in humans?

A

bifid

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118
Q

What is the location for palpation of the spinous process of C2?

A

in the middle, about 2 inches below the external occipital protuberance

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119
Q

What muscles attach to the spinous process of C2?

A

rectus capitis posterior major, obliquus capitis inferior, spinalis services, semispinalis services, multifidis, rotators and interspinalis muscles

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120
Q

What ligaments attach to the spinous process of C2?

A

ligamentum niche, interspinous ligaments

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121
Q

What names may be given to C7?

A

vertebra prominens and vertebral prominence

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122
Q

What is the name given to the topographical elevation observed at the base of the neck?

A

vertebral prominence

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123
Q

What name is given only to C7?

A

vertebra prominens

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124
Q

In what precent of men and women does C7 become the vertebral prominence?

A

men: 86% and women: 79%

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125
Q

What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?

A

C6 is more common in females and T1 is more common in males

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126
Q

How many joint surfaces are present at the vertebral body of C7?

A

8

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127
Q

What joint classifications are observed at the vertebral body of C7?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and modified synovial saddle (diarthrosis sellar) joint

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128
Q

What synovial joint surfaces are observed at the vertebral body of C7?

A

the right and left uncinate processes

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129
Q

What muscle(s) attach to the vertebral body of C7?

A

longus colli muscles

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130
Q

What features are typically present in the transverse foramen of C7?

A

vertebral venous plexus, postganglionic sympathetic motor fibers

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131
Q

What muscles attach to the transverse process of C7?

A

middle scalene, iliocostalis thoracic, longissimus crevices, semispinalis capitis, rotators, intertransversarii and levator costarum brevis

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132
Q

What is the angulation of the articular facet at C7?

A

more vertical at about 63 degrees

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133
Q

What is the orientation of the superior articular facet of C7?

A

backward, upward, medial (BUM)

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134
Q

What is the orientation of the inferior articular facet of C7?

A

forward, medial, downward (ForMeD)

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135
Q

What muscles will attach to the articular process of C7?

A

longissimus crevices, longissimus capitais, semispinalis cervicais and multifidis

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136
Q

What are the features of the spinous process of C7?

A

long, horizontal, nonbifid

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137
Q

What muscles attach to the spinous process of C7?

A

trapezius, rhomboid minor, serrates posterior superior, splenius capitis, spinalis capties, spinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

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138
Q

What ligaments attach to the spinous process of C7?

A

ligamentum niche and interspinous ligaments

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139
Q

The vertebral artery on which side is typically larger?

A

left vertebral artery

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140
Q

What is the gender bias regarding size of the vertebral artery?

A

men have larger vertebral arteries than women

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141
Q

What was the name of the physical exam used to determine vertebral artery latency?

A

the vertebrobasilar artery insufficiency test

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142
Q

Which side artery was tested during the course of the vertebrobasilar artery insufficiency exam?

A

the ipsilateral artery on the side of rotation

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143
Q

What are the symptoms of failure of the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?

A

dizziness, vertigo, nausea are common complaints

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144
Q

Typically, at what vertebral levels will the vertebral artery first become located in the transverse foramen?

A

C6

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145
Q

At what location will the vertebral artery form its first compensatory loop?

A

the atlanto-axial interspace

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146
Q

At what location will the vertebral artery form its second compensatory loop?

A

the atlanto-occipital interspace

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147
Q

At what segments will the vertebral artery be firmly attached to the transverse foramen?

A

both C1 and C2

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148
Q

What is the purpose of the vertebral artery loops between C2, C1, and occiput?

A

the increased length will accommodate the greater rotation at these locations

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149
Q

What happens to the vertebral artery after it enters the subarachnoid space at C1?

A

the vertebral artery ascends along the medulla oblongata to the pontine- medullary junction where the right and left arteries unite to form the basilar artery

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150
Q

Which sub occipital muscles attach to C1?

A

rectus wapitis posterior minor, obliquus capitis superior, obliquus capitis inferior

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151
Q

Which sub occipital muscles attach to C2?

A

rectus capitis posterior major, obliquus capitis inferior

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152
Q

What joint classifications are present at C1?

A

synovial (diarthrosis) ellipsoidal, synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodia) and fibrous (amphiarthrosis) syndesmosis

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153
Q

What joint classifications are present at C2?

A

synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis joint

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154
Q

What joint classifications are present at each typical cervical?

A

synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis

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155
Q

What joint classifications are present at C7?

A

synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis

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156
Q

What forms the anterior boundary for the C2 nerve exit form the spinal canal?

A

inferior articular process of C1, superior articular process of C2, capsular ligament

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157
Q

What forms the posterior boundary for the C2 nerve exit from the spinal canal?

A

the posterior arch of C1, lamina of C2, and posterior atlanto-axial ligament

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158
Q

What forms the boundaries for the exit of the C1 nerve from the spinal canal?

A

occipital condyle, superior articular process of C2, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament

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159
Q

What forms the boundaries for the exit of the C2 nerve from the spinal canal?

A

inferior articular process of C2, superior articular process of C2, capsular ligament, inferior vertebral notch of C2, superior vertebral notch of C2, posterior arch of C2, lamina of C2, posterior atlanto-axial ligament

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160
Q

What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?

A

vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinate process, lateral groove

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161
Q

What forms the anterior boundary for the C8 nerve exit from the spinal canal?

A

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

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162
Q

What are the superior articular facet orientations for the cervical vertebrae?

A

C1 is backward, upward, medial (BUM), C2 is backward, upward, lateral (BUL) C3-C7 is backward, upward, medial (BUM)

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163
Q

What are the inferior articular facet orientations for the cervical vertebrae?

A

C1 is backward, downward, medial (BMD), C2-C6 is forward, downward, lateral (FoLD), C7 is forward, downward, medial (ForMeD)

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164
Q

How many synovial joints are identified for each cervical vertebra?

A

C1 = 5, C2 = 8, C3-6 = 8, C7 = 6

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165
Q

How many joints are identified at the vertebral body of each cervical vertebra?

A

C1 = none, C2 = 10, C3-6 = 10, C7 = 8

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166
Q

Which thoracic segments are considered they typical thoracic?

A

T2-T8 segments

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167
Q

Which features will allow discrimination between T2-T4 and T5-T8 segmental groups?

A

the vertebral body, transverse process, articular process and spinous process

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168
Q

What is the outline of the vertebral body of a typical thoracic from superior view?

A

triangular

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169
Q

What is the name given to the left side appearance of the vertebral body of T5-T8?

A

the aortic impression

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170
Q

What is the aortic impression?

A

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

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171
Q

What part of the vertebral body is most influenced by the aorta at T5-T8?

A

the left side superior and inferior epiphyseal rims

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172
Q

What is the height pattern of the typical thoracic vertebral body?

A

the posterior height is greater than the anterior height bye one to two millimeters

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173
Q

What is the height patterns of intervertebral discs in the typical thoracic region?

A

the intervertebral discs are rather planar or flat with no apparent height difference between anterior and posterior heights

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174
Q

What is the principal cause of the posterior curve of the thoracic spine?

A

the vertebral body height differences

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175
Q

In terms of the anterior-posterior curves of the vertebral column, what direction will the thoracic spine face?

A

posterior

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176
Q

What is another way of naming a posterior curve pattern?

A

kyphotic curve

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177
Q

What joint classifications are identified at the vertebral body of a typical thoracic?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial plane (diarthrosis arthrodia)

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178
Q

How many synovial joints are formed at the vertebral body of a typical thoracic?

A

4

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179
Q

How many symphysis joints are formed with the vertebral body of a typical thoracic?

A

2

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180
Q

How many joints are formed at the vertebral body of a typical thoracic?

A

typically 10 (14 if the costocentral stellate/radiate ligaments are included)

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181
Q

What is the name given to the joint formed between the vertebral body and rib?

A

costcocentral joint

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182
Q

How many costocentral joints are formed at the vertebral body of a typical thoracic?

A

4

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183
Q

What synovial joint surfaces are present on the vertebral body of a typical thoracic?

A

the right and left superior and the right and left inferior costal demi-facets

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184
Q

Which of the demi-facets on the vertebral body of a typical thoracic is larger?

A

the superior costal demi-facet

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185
Q

What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracic?

A

the costocentral joint or ribs

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186
Q

What does the costocentral intra-articular or interarticular ligament connect to?

A

the interarticular or intra-articular crest of the head of the rib and the intervertebral disc

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187
Q

What is the size relationship between the articulating surface of the head of the rib and the costal demi-facet surface?

A

the rib surface is greater than the costal Demi-facet surface

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188
Q

Which muscle(s) is attached to the vertebral body of T2 or T3?

A

longus colli

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189
Q

What is the position and direction of the pedicle from the typical thoracic vertebral body?

A

the pedicle arises from the upper third of the vertebral body and projects posterior and slightly laterally

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190
Q

What is the angulation of the pedicle in the typical thoracic region?

A

10-15 degrees posterolateral from the sagittal plane

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191
Q

Which X-ray view is used to see into the intervertebral foramen of a typical thoracic?

A

lateral view

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192
Q

Which vertebral notch or incisure is said to be prominent?

A

the inferior vertebral notch or incisure

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193
Q

What is the nerve - vertebral body relationship at the typical thoracic intervertebral foramen?

A

in the intervertebral foramen, the number of the nerve is the same as the number of the upper thoracic in the vertebral couple

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194
Q

What is the rib - vertebral body relationship at the typical thoracic intervertebral foramen?

A

in the intervertebral foramen, the number of the rib is the same as the number of the lower thoracic in there vertebral couple

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195
Q

What is then overlap of the lamina called in the typical thoracic region?

A

shingling

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196
Q

What is the outline of the vertebral foramen in the typical thoracic region?

A

oval to circular

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197
Q

In which plane will the size of the vertebral foramen of a typical thoracic be greatest?

A

the transverse plane, the vertebral transverse diameter

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198
Q

What is the direction of the transverse process in the typical thoracic?

A

the transverse process projects more posterior with each inferior vertebra

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199
Q

What is present at the tip of the transverse process of a typical thoracic?

A

the transverse tubercle

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200
Q

What is the distance between the transverse tubercles in the typical thoracic region?

A

from T2 each transverse diameter becomes shorter as the transverse processes angle more posterior

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201
Q

What is present on the transverse tubercle of a typical thoracic?

A

the transverse costal facet

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202
Q

What is the rib - transverse process relationship for the typical thoracics?

A

the number of the rib is the same as the number of the vertebra whose transverse process is being studied; fifth rib with T5 transverse process

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203
Q

What is the classification of the costotransverse joint?

A

synovial plane (diarthrosis arthrodia) joint

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204
Q

What are the osseous parts of the costotransverse joint?

A

the transverse costal facet and the articular surface of the tubercle of a rib

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205
Q

What ligaments support the costotransverse joint of a typical thoracic?

A

the superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

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206
Q

The superior costotransverse ligament of the transverse process of T4 will attach to rib _____.

A

5

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207
Q

The inferior costotransverse ligament of the transverse process of T5 will attach to rib ____.

A

5

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208
Q

The lateral costotransverse ligament of the transverse process of T5 will attach to rib _____.

A

5

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209
Q

What ligaments attach to the transverse process of a typical thoracic?

A

inter transverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments

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210
Q

Which joint classification is associated with the inter transverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments?

A

fibrous (amphiarthrosis) syndesmosis joint

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211
Q

Which muscles may attach to the transverse process of a typical thoracic?

A

longissimus thoraces, longissimus crevices, longissimus capitis, semispinalis thoracis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

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212
Q

Of the muscles attaching to the transverse process of typical thoracic, which ones will attach only to the T5-T8 vertebral segments?

A

seemispinalis thoracis and levator costarum longus

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213
Q

How do the transverse diameters of the articular processes compare in the T2-T4 region?

A

the superior articular process transverse diameter is greater than the inferior articular process transverse diameter for a given segment

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214
Q

How do the transverse diameters of the articular processes compare in the T5-T8 region?

A

the superior articular process transverse diameter is the same as or equal to the inferior articular process transverse diameter for a given segment

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215
Q

What is the orientation of the superior articular facet of a typical thoracic?

A

backward, upward, lateral (BUL)

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216
Q

What is the angulation of the articular facet of a typical thoracic?

A

about 10-20 degrees from the coronal plane; 60 degrees from the horizontal plane

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217
Q

What is the orientation of the inferior articular facet of a typical thoracic?

A

the face forward, downward, and medial (ForMeD)

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218
Q

What is the curvature of the superior articular facet of a typical thoracic?

A

they are slightly convex

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219
Q

What is the curvature of the inferior articular facet of a typical thoracic?

A

they are slightly concave

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220
Q

What is the joint classification fo the articular facet joint?

A

synovial plane (diarthrosis arthrodia) joint

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221
Q

How many synovial joints are present at a typical thoracic?

A

10

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222
Q

Identify the synovial joint surfaces present on a typical thoracic.

A

2 superior costal demi-facets, 2 inferior costal demi-facets, 2 transverse costal facets, 2 superior articular facets, 2 inferior articular facets

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223
Q

What is the pars interarticularis?

A

the region between the superior and inferior articular processes

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224
Q

What is the name given to the overlap of spinous processes in the thoracic region?

A

imbrication

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225
Q

Imbrication will be more pronounced for what region of the thoracic?

A

T5-T8

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226
Q

Which thoracic has the longest spinous process?

A

T8

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227
Q

What is the angulation of the spinous process of T2-T4?

A

the undersurface of T2-T4 spinous processes will angle up to 40 degrees from the horizontal plane

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228
Q

What is the angulation of the spinous process of T5-T8?

A

the undersurface of T5-T8 spinous processes will angle up to 60 degrees from the horizontal plane

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229
Q

What ligaments attach to the spinous process of a typical thoracic?

A

the interspinous and supraspinous ligaments

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230
Q

What joint classification is associated with yip cal thoracic spinous process ligaments?

A

fibrous (amphiarthrosis) syndesmosis joint

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231
Q

Which muscles may attach to the spinous process of a typical thoracic?

A

trapezius, latissimus dorsi, rhomboid major, serrates posterior superior, splenius cervicis, splenius capitis, spinalis thoracis, spinalis services, spinalis capties, semispinalis thoracis, multifitis, rotator longus, rotator brevis and interspinalis

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232
Q

Which muscles attaching to the spinous process of a typical thoracic are not included in any muscle layer of the true back?

A

splenius cervicis, splenius capitis, and interspinalis

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233
Q

What joint classifications are present at every typical thoracic vertebra?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial plane (diarthrosis arthrodia)

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234
Q

The fibrous (amphiarthrosis) syndesmosis joint will occur at what parts of a typical thoracic vertebra?

A

vertebral body, lamina, transverse process, spinous process

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235
Q

At what part(s) of a typical thoracic vertebra will the synovial plane (diarthrosis arthrodia) joint be observed?

A

vertebral body, transverse process, articular process

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236
Q

What is the appearance of the superior surface of the vertebral body of T1?

A

it is somewhat cup-shaped with elevations at the posterior and lateral margin

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237
Q

What may the elevations on the vertebral body of T1 represent?

A

uncinate processes

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238
Q

What is the appearance of the inferior surface of the vertebral body of T1?

A

typically flat, lacking anterior and posterior lips characteristic of the cervicals

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239
Q

How many synovial joints are formed at the vertebral body of T1?

A

4 normally

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240
Q

How many symphysis joints are formed with the vertebral body of T1?

A

2

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241
Q

How many syndesmosis joints are formed at the vertebral body of T1?

A

typically 4 are identified (as many as eight if the rib articulation is included)

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242
Q

How many joints are formed at the vertebra body of T1?

A

typically 10 (14 if the rib ligaments are included)

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243
Q

How many costocentral joints are formed at the vertebral body of T1?

A

4

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244
Q

What synovial joint surfaces are present not he T1 vertebral body?

A

the right and left superior costal facet, the right and left inferior costal demi-facet

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245
Q

What is the rib - vertebral body combination at the intervertebral foramen for the 8th cervical nerve?

A

the superior costal facet of T1 will joint with the articular surface of the head of the first rib

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246
Q

What ligament supports the costocentral joint of the first rib?

A

the costocentral stellate/radiate ligament

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247
Q

What ligaments support the costocentral joint of the second rib?

A

the costocentral stellate/radiate ligament and the costocentral interarticular or intra-articular ligament

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248
Q

The costocentral stellate/radiate ligament will attach to which segment(s) at the C8 spinal nerve intervertebral foramen?

A

the vertebral body of C7 and the vertebral body of T1

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249
Q

Which muscle(s) is attached to the vertebral body of T1?

A

the longus colli

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250
Q

Which spinal nerve - vertebral notch or incisure combination is present at T1?

A

C8 spinal nerve - the superior vertebral notch or incisure of T1
T1 spinal nerve - the inferior vertebral notch or incisure of T1

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251
Q

What ligaments support the costotransverse joint of T1?

A

the inferior costotransverse and lateral costotransverse ligaments

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252
Q

What ligament is absent at the costotransverse joint of T1?

A

the superior costotransverse ligament

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253
Q

What ligaments attach to the transverse process of T1?

A

inter transverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse

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254
Q

Which costotransverse joint will the superior costotransverse ligament of T1 support?

A

the second rib costotransverse joint

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255
Q

What muscles attach to the transverse process of T1?

A

longissimus thoracis, longissimus cervicis, longissimus capitis
semispinalis cervicis, semispinalis capitis
multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis

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256
Q

What is the orientation of the superior articular facet of T1?

A

face backward, upward, lateral (BUL)

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257
Q

What is the orientation of the inferior articular facet of T1?

A

forward, downward, medial (ForMeD)

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258
Q

What is the curvature of the superior articular facet of T1?

A

slightly convex

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259
Q

What is the curvature of the inferior articular facet of T1?

A

slightly concave

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260
Q

How many synovial joints are present at T1?

A

10

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261
Q

How many synovial joint surfaces for ribs are present at T1?

A

6

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262
Q

What name is used to identify the topographical landmark at the base of the neck?

A

vertebral prominence

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263
Q

Which vertebrae have been identified as forming the vertebral prominence?

A

C6, C7, T1

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264
Q

What is the gender bias associated with T1 as the vertebral prominence?

A

males (9%) are more likely than females (6%) to demonstrate T1 as the vertebral prominence

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265
Q

What muscles attach to the spinous process of T1?

A

trapezius, rhomboid minor, serrates posterior superior, splenius capitis, spinalis thoracis, spinalis services, spinalis capties, semispinalis thoracis, multifitis, rotator longus, rotator brevis, interspinalis

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266
Q

How many syndesmosis joint are formed a the vertebral body of T9?

A

typically 4 are identified (as many as 8 if the costocentral stellate/radiate ligaments are included)

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267
Q

How many joint are typically formed at the vertebral body of T9?

A

typically 10 (14 if costocentral stellate/radiate ligaments are included)

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268
Q

How many costocentral joints are typically formed at the vertebral body of T9?

A

4

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269
Q

Which synovial joint surfaces may be absent from the vertebral body of T9?

A

inferior costal demi-facets

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270
Q

What is present on the transverse tubercle of T9?

A

transverse costal facet

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271
Q

What ligaments attach to the transverse process of T9?

A

inter transverse, capsular costotransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

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272
Q

Which costotransverse joint will the superior costotransverse ligament of T9 support?

A

10th rib costotransverse joint

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273
Q

Which muscles attach to the transverse process of T9?

A

longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

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274
Q

How many synovial joint surfaces for ribs are typically present on T9?

A

6

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275
Q

Which rib related facet may be absent on T9?

A

inferior costal demi-facet

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276
Q

Which is the last thoracic vertebra to have an inferior costal demi-facet?

A

T9

277
Q

What is the length of the spinous process of T9?

A

it will shorten significantly from the long spinous process of T8

278
Q

What muscles attach to the spinous process of T9?

A

trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis

279
Q

Which muscles are conspicuously absent at the T9 spinous process?

A

spinalis and semispinalis

280
Q

How many synovial joint are formed at the vertebral body of T10?

A

2

281
Q

How many symphysis joints are formed with the vertebral body of T10?

A

2

282
Q

How many joints are typically formed at the vertebral body of T10?

A

typically 8 (12 if the costocentral stellate/radiate ligaments are included)

283
Q

How many costocentral joints are typically formed at the vertebral body of T10?

A

2

284
Q

What synovial joint surfaces are present on the vertebra body of T10?

A

right and left superior costal facet

285
Q

Which synovial joint surface is absent from the vertebral body of T10?

A

inferior costal demi-facets

286
Q

What is the rib - vertebral body combination is typically present at the intervertebral foramen for the tenth thoracic nerve?

A

the superior costal facet of T11 will join with the articular surface of the head of the 11th rib

287
Q

Para-articular processes are more Emily observed on which segment of the spine?

A

T10

288
Q

What part of the transverse process may be absent on T10?

A

transverse costal facet

289
Q

The superior costotransverse ligament of T10 will attach to which rib?

A

11th rib

290
Q

What muscles attach to the transverse process of T10?

A

longissimus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

291
Q

How many synovial joints are typically present at T10?

A

8

292
Q

Which rib related facet is absent on T10?

A

the inferior costal demi-facet

293
Q

A dimpling or depression of the skin in the thoracic region is often characteristic of the location of which segment?

A

T10

294
Q

What muscles attach to the spinous process of T10?

A

trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis

295
Q

What name is given to to T11?

A

anticlinal vertebra

296
Q

Which vertebral segment is the first to have a reniform vertebral body?

A

T11

297
Q

How many synovial joints are formed at the vertebral body of T11?

A

2

298
Q

How many joints are typically formed at the vertebral body of T11?

A

typically 8 (12 if the costocentral stellate/radiate ligaments are included)

299
Q

What part of the transverse process is absent present on T11?

A

transverse costal facet

300
Q

Which vertebra is the last segment to demonstrate a transverse costal facet?

A

T10

301
Q

What ligaments form the costotransverse joint of T11?

A

superior costotransverse and slightly developed inferior costotransverse and lateral costotransverse ligaments

302
Q

Which costotransverse joint will the superior costotransverse ligament at the transverse process of T11 support?

A

12th rib costotransverse joint

303
Q

The inferior costotransverse ligament of T11 will attach to which rib?

A

11th rib

304
Q

The lateral costotransvserse ligament of the transverse process of T11 attaches to which rib?

A

11th rib

305
Q

Which costotransverse ligament(s) are absent at T11?

A

capsular costotransverse ligament

306
Q

What muscles attach to the transverse process of T11?

A

longissimus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis, intertransversarii and levator costarum brevis

307
Q

Which levator costarum muscle is absent at T11?

A

levator costarum longus

308
Q

Which segment is the last to demonstrate an attachment for the levator costarum longus?

A

T10

309
Q

What is the orientation of the superior articular facets of T11?

A

backward, upward, lateral (BUL)

310
Q

What is the orientation of the inferior articular facets of T11?

A

forward, downward, medial (ForMeD)

311
Q

How many synovial joints are typically present at T11?

A

6

312
Q

Identify the synovial joint surfaces typically present on T11.

A

2 superior costal facets, 2 superior articular facets, 2 inferior articular facets

313
Q

What muscles attach to the spinous process of T11?

A

trapezius, latissimus dorsi, serratura posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis

314
Q

At which segments of the thoracic spine will the spinalis muscle not attach?

A

T9, T10

315
Q

Which erector spinal muscle uniquely attaches to the spinous process of T11?

A

iliocostalis lumborum

316
Q

How many synovial joints are formed at the vertebral body of T12?

A

2

317
Q

How many symphysis joints are formed with the vertebral body of T12?

A

2

318
Q

How many syndesmosis joints are formed at the vertebral body of T12?

A

4 typically (as many as 6 fi the costocentral stellate/radiate ligaments are included)

319
Q

How many joints are typically formed at the vertebral body of T12?

A

typically 8 (10 if the costocentral stellate/radiate ligaments are included)

320
Q

Which muscle(s) is attached to the vertebral body of T12?

A

psoas major and psoas minor

321
Q

What is present at the transverse process region of T12?

A

3 tubercles of variable size

322
Q

Which tubercle on T12 represents the transverse process?

A

lateral tubercle

323
Q

Which tubercle on T12 represent the mammillary process of the lumbars?

A

superior tubercle

324
Q

Which tubercle on T12 represents the accessory process of the lumbars?

A

inferior tubercle

325
Q

What ligaments form the costotransverse joint of the 12th rib?

A

superior costotransverse ligament from T11 and the lumbocostal ligament from L1

326
Q

Which costotransverse ligament(s) are attached at T12?

A

none; the capsular, superior, inferior, and lateral costotransverse ligaments lack an attachment to T12

327
Q

What muscles attach to the transverse process region of T12?

A

longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, and intertransversarii

328
Q

Which segment is the last to demonstrate a levator costarum brevis attachment?

A

T11

329
Q

Which segment is the last to demonstrate a levator costarum longus attachment?

A

T10

330
Q

What is the orientation of the superior articular facets of T12?

A

backward, upward, lateral (BUL)

331
Q

What is the orientation of the inferior articular facets of T12?

A

forward, downward, lateral (FoLD)

332
Q

What is the curvature of the superior articular facets of a T12?

A

slightly concave

333
Q

What is the curvature of the inferior articular facets of T12?

A

significantly convex

334
Q

What is the joint classification of the articular facet joint?

A

synovial plane (diarthrosis arthrodia)

335
Q

How many synovial joints are typically present at T12

A

6

336
Q

Identify the synovial joint surfaces typically present on T12.

A

2 superior costal facets, 2 superior articular facets, 2 inferior articular facets

337
Q

Which erector spinal muscle is unique in its attachment to the T12 spinous process?

A

iliocostalis lumborum

338
Q

Which muscles attaching to the spinous process of T12 are not included in any muscle layer of the true back?

A

interspinalis

339
Q

What joint classifications are present at T12?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial (diarthrosis) arthrodia joint

340
Q

Which muscle(s) attach to the vertebral body of a thoracic vertebrae?

A

longus colli, poses major, poses. minor

341
Q

Which thoracic segments will have muscles attaching to their vertebral bodies?

A

T1-T3, T12

342
Q

Which erector spinal muscle will attach along the length of the thoracic spine?

A

longissimus

343
Q

Which thoracic is the last to demonstrate an attachment at the transverse process for the semispinalis muscle group?

A

T12

344
Q

Which thoracic is the first to demonstrate the attachment of the levator costarum brevis?

A

T1

345
Q

Which thoracic is the last to demonstrate the attachment of levator costarum brevis?

A

T11

346
Q

Which thoracic is first to demonstrate the attachment of the levator costarum longus?

A

T7

347
Q

Which thoracic is last to demonstrate the attachment of the levator costarum longus?

A

T10

348
Q

Rhomboid moor will attach to the spinous process of which thoracic(s)?

A

T1 only

349
Q

Rhomboid major will attach to the spinous process of which thoracic(s)?

A

T2-T5

350
Q

Which thoracic vertebrae will demonstrate a spinous process attachment for the serrates posterior superior?

A

T1-T3

351
Q

Which thoracic vertebrae will demonstrate a spinous process attachment for the serrates posterior inferior?

A

T11-T12

352
Q

Which thoracics demonstrate a spinous process attachment for the splenius muscles?

A

T1-T6

353
Q

Which thoracics demonstrate a spinous process attachment for the iliocostalis lumborum?

A

T11-T12

354
Q

Which thoracics lack any spinalis muscle group attachment on their spinous process?

A

T9-T10

355
Q

What is the generic shape of the typical lumbar vertebral body from the cranial view?

A

reniform or kidney-shaped

356
Q

What accounts for the direction of the lumbar curve?

A

the vertebral body and intervertebral disc have a greater anterior height than posterior height

357
Q

What is the direction of the normal lumbar curve?

A

anterior (lordotic)

358
Q

What is the effect of aging on the vertebral body of a lumbar vertebra?

A

decrease in height, increase in circumference

359
Q

How many synovial joint surfaces are present at the typical lumbar vertebral body?

A

none

360
Q

How many joint surfaces are present on the vertebral body of a typical lumbar?

A

6

361
Q

How many synovial joint surfaces are present on the vertebral body of a typical lumbar?

A

none

362
Q

How many cartilaginous (amphiarthrosis) symphysis joint surfaces are on a typical lumbar vertebral body?

A

2

363
Q

How many fibrous (amphiarthrosis) syndesmosis joint surfaces are on a typical lumbar vertebral body?

A

4

364
Q

What joint classifications will be observed at the vertebral body of a typical lumbar?

A

cartilaginous (amphiarthrosis) symphysis joint and fibrous (amphiarthrosis) syndesmosis joint

365
Q

What muscle may attach to a typical lumbar vertebral body?

A

psoas major and psoas minor

366
Q

Psoas minor will only attach to the vertebral body of which segments?

A

T12, L1

367
Q

What is the name given to ligaments that attach the vertebral body to articular process?

A

transforaminal ligaments

368
Q

What are the types of transforaminal ligaments?

A

superior transforaminal, middle transforaminal and inferior transforaminal ligaments

369
Q

What ligaments attach the vertebral body to the transverse process?

A

corporotransverse ligaments

370
Q

What corporotransverse ligaments are identified?

A

superior corporotransverse and inferior corporotransverse ligaments

371
Q

What are the types of Hofmann ligaments?

A

anterior Hofmann ligaments, posterior Hofmann ligaments, lateral Hofmann ligaments and proximal root sleeve ligaments

372
Q

Hofmann ligaments are identified in which regions along the vertebral column?

A

cervical - upper thoracic region and lumbar region

373
Q

Cervical - upper thoracic Hofmann ligaments will attach what structures together?

A

dura mater to segments above

374
Q

What is the highest level known to demonstrate Hofmann ligaments?

A

C6

375
Q

What is the proposed function of the cervical - upper thoracic Hofmann ligaments?

A

resist caudal movement of the dural sac; resist gravitational forces on the dura and cord

376
Q

Lumbar Hofmann ligaments will attach what structures together?

A

dura mater to lower segmental levels

377
Q

What is the proposed function of the lumbar Hofmann ligaments?

A

resist cranial movement of the dural sac during flexion

378
Q

What is the proposed function of the proximal root sleeve ligament?

A

resist displacement of the peripheral nerve system in the intervertebral foramen

379
Q

What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?

A

overlap of the laminae, shingling, diminishes; overall of spinous processes, imbrication, diminishes

380
Q

What part of the central nerve system is present in the lumbar spine?

A

the conus medullar is is typically present in the vertebral foramen of L1

381
Q

What part of the peripheral nerve system is presenting the lumbar spine?

A

the caudal equine is typically present in the vertebral foramina of L2-L4

382
Q

Beginning with the L1 transverse process, what is the generic direction and relative length of each succeeding lumbar transverse process?

A

each transverse process is directed straight lateral and increases in length from L1-L3; L4 then begins to decrease in length

383
Q

What is the name of the elevation near the origin of the lumbar transverse process?

A

accessory process

384
Q

Congenital elongation of the lumbar accessory process results in what feature?

A

styloid process

385
Q

Congenital elongation of the lumbar accessory process occurs with what frequency?

A

7% occurrence

386
Q

What bony part of a cervical transverse process is lacking at the lumbar transverse process?

A

costotransverse bar

387
Q

What ligament(s) will attach to the lumbar accessory process?

A

mammillo-accessory ligament

388
Q

What parts of a vertebra are attached via the mammillo-accessory ligament?

A

the mammillary process and accessory process of the same ligament

389
Q

What was believed to be entrapped by the mammillo-accessory ligament?

A

the medial branch of the dorsal ramus of a lumbar spinal nerve

390
Q

What muscle(s) attach to the lumbar accessory process?

A

longissimus thoracis and intertransversarii

391
Q

What ligament attaches the twelfth rib to the transverse process of L1?

A

the lumbocostal ligament

392
Q

What muscles may attach to the transverse process of a typical lumbar vertebra?

A

psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus and intertransversarii

393
Q

Which trasnversospinalis muscle group attaches to the typical lumbar transverse process?

A

rotators

394
Q

What ligament attach to the transverse process of a typical lumbar vertebra?

A

the lumbocostal, mammillo-accessory and intertransverse ligaments

395
Q

What are the posterior elements of the vertebra?

A

zygapophysis, lamina and spinous process

396
Q

What are the anterior elements of the vertebra?

A

vertebral body and pedicle

397
Q

What is the orientation of the typical lumbar superior articular facet?

A

backward, upward, medial (BUM); typically concave

398
Q

What is the orientation of the typical lumbar inferior articular facet?

A

forward, lateral, downward (FoLD); significant convexity

399
Q

What is the name given to the projection on the lumbar superior articular process?

A

mammillary process

400
Q

What muscle(s) will attach to the mammillary process?

A

multifidis and intertransversarii

401
Q

What ligament will attach to the lumbar mammillary process and accessory process?

A

mammillo-accessory ligament

402
Q

What was believed to be entrapped by the mammillo-accessory ligament?

A

the medial branch of the dorsal ramus of a lumbar spinal nerve

403
Q

What additional ligaments are said to attach to lumbar articular processes?

A

transforaminal ligaments

404
Q

How many synovial joints are present on a typical lumbar vertebra?

A

4

405
Q

What is the position of the lumbar zygapophysis in children?

A

the zygapophysis lies in the coronal plane

406
Q

What is the position of the lumbar zygapophysis in adults?

A

zygapophysis lies in the sagittal plane for L1/L2, L2/3 and L3/4; the zygapophysis lies in the coronal plane for L4/5 and L5/S1

407
Q

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?

A

joint asymmetry or joint tropism

408
Q

What is the name(s) of the condition in which the typical lumbar spinous process increases in length due to the aging process?

A

Baastrup’s syndrome or “kissing spines”

409
Q

What is Baastrup’s Syndrome?

A

elongation of the lumbar spinous process as a result of aging

410
Q

What muscles will attach to the typical lumbar spinous process?

A

latissimus dorsi, serratura posterior inferior, iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis

411
Q

What is the appearance of the 5th lumbar vertebral body from the lateral view?

A

anterior height is greater than posterior height by several mm; it appears to form a wedge on a lateral x-ray view

412
Q

How many synovial joint surfaces are present the 5th lumbar vertebral body?

A

none

413
Q

How many fibrous (amphiarthrosis) syndesmosis joint surfaces are present on the L5 vertebral body?

A

4

414
Q

How many joint surfaces are present on the vertebral body of the 5th lumbar?

A

6

415
Q

How many cartilaginous (amphiarthrosis) symphysis joint surfaces are present on the vertebral body of L5?

A

2

416
Q

How many fibrous (amphiarthrosis) syndesmosis joint surfaces are present on the vertebral body of L5?

A

4

417
Q

What joint classifications will be observed at the vertebral body of the 5th lumbar?

A

cartilaginous (amphiarthrosis) symphysis and fibrous (amphiarthrosis) syndesmosis

418
Q

What muscle(s) attach to the 5th lumbar vertebral body?

A

psoas major

419
Q

What is the name given to ligaments that attach the vertebral body to articular process?

A

transforming ligaments

420
Q

What ligaments attach the vertebral body to the TVP?

A

corporotransverse ligaments

421
Q

What are the types of Hofmann ligaments?

A

anterior Hofmann ligaments, posterior Hofmann ligaments, lateral Hofmann ligaments, and proximal root sleeve ligaments

422
Q

What characteristic of the L1-L4 pedicle may be used to differentiate it from the L5 segment? Be specific and complete as the difference(s) on a segment from each group.

A

On cranial view, lateral surface of pedicle is apparent on a L1-L4 segment. At L5 the transverse process originates from the vertebral body, pedicle and lamina-pedicle region

423
Q

What accounts for the shortness of the L5 TVP?

A

the hip/innominate bones diminish the available space in the transverse plane

424
Q

What muscle(s) attach to the 5th lumbar accessory process?

A

longissimus thoracis

425
Q

What muscles may attach to the TVP of the 5th thoracic vertebra?

A

psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus and intertransversarii

426
Q

What ligaments traditionally attach to the TVP of the 5th lumbar vertebra?

A

lumbosacral, iliolumbar, mammillo-accessory ligaments

427
Q

What is the reported angulation and x-ray appearance of the 5th lumbar articular facets?

A

the lie in the vertical plane and are coronal facets

428
Q

What is the orientation of the 5th lumbar superior articular facet?

A

backward, upward, medial (BUM); typically concave

429
Q

What is the orientation of the 5th lumbar inferior articular facet?

A

forward, lateral, downward (FoLD); significant convexity

430
Q

What muscle(s) will attach to the mammillary process?

A

multifidis and intertransversarii

431
Q

What is the position of the lumbar zygapophysis in adults?

A

the zygapophysis lies in the sagittal plane for L1/L2, L2/L3, and L3/L4; zygapophysis lies in the coronal plane for L4/L5, L5/S1

432
Q

What name are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane and the other zygapophysis lies int he sagittal plane?

A

joint asymmetry or joint tropism

433
Q

Define/describe joint tropism

A

the condition in which one zygapophysis of a vertebral couple lies in the coronal plane and the other in a sagittal plane

434
Q

What is the name given to the congenital condition in which the L5 spinous process is elongated, the sacrum exhibits Pina bifida, and dorsiflexion produces pain?

A

Knife Clasp Syndrome

435
Q

What is Knife Clasp Syndrome?

A

the congenital condition in which the L5 spinous process is elongated, the sacrum exhibits spina bifida and dorsiflexion produces pain

436
Q

What muscles will attach to the 5th lumbar spinous process?

A

latissimus dorsi, iliocostalis lumborum, longissimus thoracis, multifidis, rotator longus and brevis, and interspinalis

437
Q

How many synovial joints are maximally observed at each lumbar vertebra?

A

L1-L5 = 4 each

438
Q

How many joints are traditionally observed at each lumbar vertebral body?

A

L1-L5 = 6 each

439
Q

Where is the superior articular facet orientation at each lumbar vertebra?

A

L1-L5 = backward, upward, medial (BUM)

440
Q

Where is the inferior articular facet orientation at each lumbar vertebra?

A

L1-L5 = forward, downward, lateral (FoLD)

441
Q

What is the generic shape of the first sacral vertebral body from the base view?

A

reniform or kidney-shaped

442
Q

What muscle(s) may attach to the first sacral vertebral body?

A

psoas major

443
Q

How many joint surfaces are present on the vertebral body of the 1st sacral segment?

A

5

444
Q

What is the origin of the sacral ala?

A

on base view, the S1 transverse process and costal element appear to originate from the vertebral body and possible the pedicle to form the sacral ala

445
Q

What part of the sacral ala is derived from the costal element?

A

anterior two-thirds

446
Q

What is the position of the sacral zygapophysis in adults?

A

lies in the coronal plane for L5/S1

447
Q

What is the orientation of the first sacral superior articular facet?

A

backward, upward, medial (BUM); typically concave

448
Q

What muscle(s) will attach to the sacral mammillary processes?

A

multifidis

449
Q

Fusion of the vertebral bodies of the sacrum process the intervertebral disc is called ______.

A

synostosis

450
Q

From anterior view, the intervertebral discs of sacrum will be replaced by what feature?

A

transverse ridges

451
Q

What forms the medial sacral crest?

A

fused spinous processes and their spinous tubercles

452
Q

What muscles may attach to the medial sacral crest?

A

latissimus dorsi, iliocostalis lumborum, longissimus thoracis

453
Q

What forms the intermediate sacral crest?

A

fused articular process and their facets

454
Q

What features may be identified along the intermediate sacral crest?

A

mammillary process of S1 and sacral cornu of S5

455
Q

What does the sacral cornu represent?

A

inferior articular process and facet of S5

456
Q

What is the name of the inferior opening of the sacral spinal canal?

A

sacral hiatus

457
Q

What forms the lateral sacral crest?

A

fused TVP and transverse tubercles from S1-S5

458
Q

What features may be identified along the lateral sacral crest?

A

S1 transverse tubercle, sacral tuberosity of S2, transverse tubercles of S3-S5

459
Q

What is the name fo the joint formed by the sacral tuberosity?

A

accessory sacro-iliac joint

460
Q

What feature is associated with the transverse tubercle of S5?

A

inferior and lateral (inferolateral) sacral angle

461
Q

What muscles may attach to the lateral sacral crest?

A

multifidis, iliocostalis lumborum

462
Q

What muscle is said to attach to the dorsal surface of sacrum?

A

iliacus

463
Q

What feature is identified on the lateral surface of S1-S3?

A

auricular surface

464
Q

What classification of joint is formed by the auricular surface of sacrum?

A

synovial plane (diarthrosis arthrodia)

465
Q

What is the sacral promontory?

A

bulging anterior surface of the superior epiphyseal rim of S1

466
Q

The continuation of the anterior longitudinal ligament below S3 forms what ligament?

A

anterior sacrococcygeal ligament

467
Q

The continuation of the posterior longitudinal ligament below S3 forms what ligament?

A

deep posterior sacrococcygeal ligament

468
Q

What forms the posterior boundary for the 5th sacral spinal nerve intervertebral foramen?

A

sacral cornu, coccygeal cornu, superficial posterior sacroccygeal ligament and intercornual ligament

469
Q

What forms the anterior boundary for the 5th sacral spinal nerve intervertebral foramen?

A

vertebral body of S5, vertebral body of Co1, deep posterior sacrococcygeal ligament and intervertebral disc

470
Q

What ligament is attached to the sacral hiatus?

A

superficial posterior sacrococcygeal ligament

471
Q

What synovial joint surfaces are present at sacrum?

A

2 superior articular facets, 2 auricular surfaces

472
Q

How many synovial joints are typically present at sacrum?

A

4

473
Q

What joint classifications are typically present at sacrum?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial plane (diarthrosis arthrodia)

474
Q

What is the homolog for the posterior longitudinal ligament at S5?

A

deep posterior sacrococcygeal ligament

475
Q

What is the homolog for the ALL at S5?

A

anterior sacrococccygeal ligament

476
Q

What is the homolog for the ligamentum flavum at S5?

A

superficial posterior sacrococcygeal ligament

477
Q

What forms the inferior boundary for the spinal canal?

A

the union of the superficial posterior and deep posterior sacrococcygeal ligaments

478
Q

What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments at Co1?

A

posterior sacrococcygeal ligament

479
Q

What ligament is a homolog of the inter transverse ligament at S5?

A

lateral sacrococcygeal ligament

480
Q

What ligament divides the sciatic foramen into the greater and lesser sciatic foramina?

A

sacrospinous ligament

481
Q

Which ligament has a broad attachment along the lateral margin of sacrum and coccyx and then attaches to the ischial tuberosity?

A

sacrotuberous ligament

482
Q

Which ligament represent a thickening of the fibrous capsule of the scare-iliac joint?

A

anterior sacro-iliaca ligament

483
Q

Which ligament is the strongest of the SI ligaments and is penetrated by dorsal rami of the sacral spinal nerves?

A

interosseous sacro-iliac ligament

484
Q

Which ligament will attach the intermediate sacral crest of S1, lateral sacral crest of S2 to the posterior superior iliac spine?

A

short posterior sacro-iliac ligament

485
Q

Which ligament attaches the lateral sacral crest of S3 and S4 to the posterior superior iliac spine?

A

long posterior sacro-iliac ligament

486
Q

What is the homolog for the inferior articular process and facet at S5?

A

sacral cornu

487
Q

What is the homolog for the superior articular process and facet at Co1?

A

coccygeal cornu

488
Q

What is the homolog for the capsular ligament at S5?

A

intercornual ligament

489
Q

What is the number of coccygeal somites?

A

10

490
Q

What is the typical number of segments that unite to form the adult coccyx?

A

4 segments

491
Q

When is ossification of coccyx completed?

A

about age 30

492
Q

What bony features are present on the coccyx?

A

vertebral body; Co1 has a coccygeal cornu and transverse process

493
Q

What is the homolog of the superior articular process and facet on Co1?

A

coccygeal cornu

494
Q

What is the direction of fusion of coccygeal segments?

A

form caudal to cranial, the last segments to fuse together are Co1 and Co2

495
Q

What is the direction of the coccygeal curve?

A

posterior (kyphotic)

496
Q

What is the major motion and range of motion for coccyx?

A

flexion - extension, 5-20 degrees

497
Q

How many coccygeal nerves are presenting the fetus?

A

typically 5 pairs of coccygeal nerves are present

498
Q

What is the coccygeal glomus or coccygeal body?

A

an enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx

499
Q

What innervates the coccygeal glomus or coccygeal body?

A

both sympathetic and parasympathetic fibers are identified

500
Q

What muscles attach to the coccyx?

A

ischiococcygeus and levator ani

501
Q

What forms the inferior boundary for the spinal canal?

A

the union of the superficial posterior and deep posterior sacrococcygeal ligaments

502
Q

What lig is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments at Co1?

A

posterior sacrococcygeal lig

503
Q

What ligaments form the posterior boundary for the Co1 spinal nerve intervertebral foramen?

A

superficial posterior sacrococcygeal lig and intercornual lig

504
Q

What ligaments form the anterior boundary for the Co1 spinal nerve intervertebral foramen?

A

deep posterior sacrococcygeal lig and intervertebral disc

505
Q

What is the greek word for vertebra?

A

spondylos

506
Q

What is the definition of the suffix “osis”?

A

condition

507
Q

What is the definition of the suffix “lysis”?

A

cleavage or separation

508
Q

What is the definition of the suffix “listhesis”?

A

slippage

509
Q

What is the definition of spondylosis

A

vertebral condition

510
Q

What is the definition of spondylolysis?

A

vertebral separation or vertebral cleavage

511
Q

What is the definition of spondylolisthesis?

A

vertebral slippage

512
Q

What is the current limited definition of spondylosis?

A

vertebral condition that is acquired or age-related

513
Q

What are some of the causes of spondylolysis?

A

congenital, acquired during development, result of aging, result of trauma

514
Q

What is the location of spondylolysis that will be stressed in spinal II?

A

a separation along the pars interarticularlis (defect in the pars interarticularis or pars defect)

515
Q

What parts of a vertebra are separated as a result of a pars defect?

A

anterior element from the posterior element

516
Q

What is the geographic or ethnic bias for a higher incidence of spondylolysis?

A

native alaskan (inuit) population

517
Q

What are the anterior elements of the vertebra?

A

vertebral body and pedicle, and articular process (the intervertebral disc is also indicated when looking at a vertebral couple)

518
Q

What are the posterior elements of the vertebra?

A

the other articular process, lamina, and spinous process

519
Q

What is the incidence of spondylolysis in the general population?

A

a range of 2.6% to 10%

520
Q

What is the incidence of spondylolysis in the native Alaskan population?

A

52.6%

521
Q

What characteristics are associated with cervical spondylolysis?

A

rare, congenital, gender biased toward men, MC at C6 and linked to spondylolisthesis and spina bifida

522
Q

Is cervical spondylolysis the results of congenital conditions, acquired conditions or an age-related conditions?

A

congenital conditions, with cartilage centers failing to form or unite

523
Q

What additional abnormalities are often associated with or linked to cervical spondylolysis?

A

spondylolisthesis and spina bifida

524
Q

What is the gender and vertebral location bias associated with cervical spondylolysis?

A

men at the C6 level

525
Q

Lumbar spondylolysis has not been reported in what groups of individuals?

A

fetuses, newborns, rarely in children under 5, patients who have never walked and in non-erect species

526
Q

Lumbar spondylolysis only been reported in what types of species?

A

those species that walk erect; humans

527
Q

What does lumbar spondylolysis appear to be related to?

A

uniquely human upright stance or erect posture

528
Q

What is the gender bias and locational bias associated with lumbar spondylolysis?

A

men at L5/S1; women at L4/L5

529
Q

Wha is the age range typically associated with lumbar spondylolysis?

A

10-20 year olds

530
Q

What activities are particularly stressful at the pars interarticularis of lumbar vertebrae?

A

gymnastics, dance, soccer

531
Q

What motion(s) is particularly associated with lumbar spondylolysis?

A

hyperextension coupled with rotation

532
Q

What name has been given to the material filling the space in a lumbar spondylolysis?

A

spondylolysis ligament

533
Q

What types of neural function(s) have been associated with the spondylolysis ligament?

A

nociception, neuromodulation and autonomic function

534
Q

What is the appearance of the lumbar vertebra upon oblique x-ray view?

A

a Scotty dog

535
Q

What is the appearance of a pars defect in a lumbar vertebra upon oblique x-ray view?

A

a collared Scotty dog

536
Q

What is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view?

A

a collared Scotty dog

537
Q

What is the appearance of a defect in the pars interarticularis in a lumbar vertebra upon oblique x-ray view?

A

a collared Scotty dog

538
Q

What part of a lumbar vertebra forms the neck of a Scotty dog?

A

pars interarticularis below the superior articular process

539
Q

In an oblique x-ray, spondylolysis below the superior articular process of a lumbar pars interarticularis is associated with what part of the Scotty dog?

A

the neck of the Scotty dog

540
Q

What part of a lumbar vertebra forms the eye of a Scotty dog?

A

the pedicle

541
Q

What part of a lumbar vertebra forms the ear of a Scotty dog?

A

superior articular process

542
Q

What part of lumbar vertebra forms the nose of a Scotty dog?

A

the transverse process

543
Q

What is the incidence of sacral spondylolysis in the general population?

A

it’s rare

544
Q

What ethnic group is associated with a high incidence of sacral spondylolysis?

A

the native Alaskan (Inuit) population

545
Q

Is sacral spondylolysis the result of congenital conditions, acquired conditions or an age-related condition?

A

seems to be acquired

546
Q

What activities are associated with sacral spondylolysis?

A

kayaking and harpooning

547
Q

What is the ethnic, gender, and locational bias associated with sacral spondylolysis?

A

native Alaskan (inuit) male at the S1 level

548
Q

What is the definition of spondylolisthesis?

A

a vertebral slippage

549
Q

What vertebral condition results in spondylolisthesis?

A

bilateral spondylolysis

550
Q

What is the direction of spondylolisthesis?

A

anterior or forward displacement

551
Q

What is the posterior direction of vertebral slippage called?

A

retrospondylolisthesis or retrolisthesis

552
Q

Identify all names given to type I spondylolisthesis?

A

dysplastic or congenital spondylolisthesis

553
Q

What is the locational bias of type I spondylolisthesis?

A

L5 or upper sacral segments

554
Q

What is the location of the defect associated with type I spondylolisthesis?

A

more frequently the vertebral arch

555
Q

What additional conditions are linked to type I spondylolisthesis?

A

spina bifida occult and nerve root compression of the S1 nerve

556
Q

Identify all names given to type II spondylolisthesis.

A

isthmus spondylolisthesis

557
Q

Which subtype of type II spondylolisthesis is stressed in Spinal II?

A

lytic spondylolisthesis or stress fracture induced spondylolisthesis

558
Q

What is the cause most frequently given for type II spondylolisthesis?

A

micro fractures as the result of repetitive stress during hyper flexion and rotation

559
Q

What is the age group typically associated with type II spondylolisthesis?

A

teenagers or young adults

560
Q

Will spondylolysis always result in type II spondylolisthesis?

A

no, particularly in cases of unilateral spondylolysis

561
Q

What spinal canal dimensions are associated with type II spondylolisthesis?

A

isthmus spondylolisthesis demonstrates an increase in sagittal diameter of the spinal canal

562
Q

What is the gender bias and locational bias associated with type II spondylolisthesis?

A

isthmus spondylolisthesis is common in men at the L5/S1

563
Q

Which type of spondylolisthesis is common in men at the L5/S1 level?

A

type II spondylolisthesis or isthmmic spondylolisthesis

564
Q

All names given to type III spondylolisthesis?

A

degenerative spondylolisthesis

565
Q

What conditions are often associated with type III spondylolisthesis?

A

degenerative spondylolisthesis is often associated with osteoarthritis, IVD degeneration, ligament laxity and articular facet remodeling

566
Q

What is the gender bias, locational bias, and spinal canal dimension changes often associated with type III spondylolisthesis?

A

degenerative spondylolisthesis is more common in women, particularly at L4/5 and demonstrates no change in sagittal diameter of spinal canal

567
Q

Which type of spondylolisthesis is MC in women at L4/5?

A

type III spondylolisthesis or degenerative spondylolisthesis

568
Q

All names given to type IV spondylolisthesis?

A

traumatic spondylolisthesis

569
Q

What causes type IV spondylolisthesis?

A

fracture of the neural arch components

570
Q

Is there a gender, locational, or age bias associated with type IV spondylolisthesis?

A

no

571
Q

All names given to type V spondylolisthesis?

A

pathologic spondylolisthesis

572
Q

What are the cause(s) associated with type V spondylolisthesis?

A

bone diseases such as Paget disease or osteogenesis imperfecta

573
Q

Result of type V spondylolisthesis?

A

bone of the neural arch is lengthened such that listless occurs

574
Q

What determines the length of the IVF?

A

width of the pedicle

575
Q

What may extend the length of the IVF?

A

transverse process, muscles or ligaments

576
Q

What forms the superior boundary for the typical IVF?

A

inferior vertebral notch of the pedicle above

577
Q

What is the average height of the IVF?

A

13 mm

578
Q

What percent of total vertebral column length does “true” IVF height from C2-S1 equal?

A

40%

579
Q

What percent of total vertebral column length does all intervertebral foramina height from occiput Co1 equal?

A

53%

580
Q

What are the generic contents of the IVF?

A

neural tissue, connective tissue, vascular tissue, lymphatic tissue

581
Q

What is the percent of neural tissue in the IVF?

A

from 8-50%

582
Q

Which branches of the spinal artery may occupy the IVF?

A

osseous arteries, anterior spinal canal artery, posterior spinal canal artery, anterior medullary feeder artery and the posterior medullary feeder artery

583
Q

What is the name of the largest medullary feeder artery?

A

artery of Adamkiewicz or the artery radicals magna anterior

584
Q

What are the characteristics of the Artery of Adamkiewicz?

A

it is a left side, anterior medullary feeder artery, located in the T9/10 intervertebral foramen, and the primary vascular supply to the lumbar enlargement

585
Q

What is the most likely region of the thoracic spine for herniation?

A

below T8

586
Q

What will the intervertebral veins drain into?

A

the external vertebral venous plexus or Batson’s plexus

587
Q

Which venous vessels of the vertebra will draining the segmental veins?

A

external vertebral venous plexus or Batson’s plexus

588
Q

What is a unique histological feature of the veins of the vertebral column?

A

they appear to lack valves

589
Q

What size lymphatic vessels lie in the IVF?

A

medium sized lymphatics

590
Q

What type(s) of connective tissue will be present in the IVF?

A

adipose tissue and loose areolar connective tissue

591
Q

What parts of the cervical vertebra will modify the IVF?

A

lateral groove and uncinate process

592
Q

What happens to cervical nerve roots between their origin from the spinal cord and exit from the IVF?

A

they descend along the spinal cord

593
Q

What is the relationship between aging and cervical spine nerve root characteristics?

A

the length of the nerve root increases as it descends from its apparent origin on the spinal cord, but the cross-sectional area of the nerve root decreases

594
Q

What is the relationship between aging and cervical spine IVF size?

A

cross-sectional area diminishes after age 50

595
Q

What are the specific attachment sites for a cervical spine nerve?

A

the sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery

596
Q

What contributes to the anterior boundary of the thoracic IVF?

A

costocentral joint

597
Q

What is the relationship of lumbar nerve root size to IVF size above L4?

A

the nerve root size will account for less that 22% of the available size

598
Q

What is the relationship of Lumbar nerve root size to IVF size below L4?

A

nerve root size will account for up to 30% of the available size

599
Q

Which are the largest spinal nerves?

A

L5 and S1 spinal nerves

600
Q

What increases the length of the IVF at L5?

A

lumbosacral tunnel

601
Q

What forms the lumbosacral tunnel?

A

the lumbosacral ligament, transverse process of L5 and sacral ala

602
Q

What condition is the result of encroachment on the L5 spinal nerve?

A

the far out syndrome

603
Q

What ligaments may contribute to the loss of size in lumbar IVF?

A

transforaminal lig and the corporotransverse lig

604
Q

What is the relationship between IVD herniation and lumbar spinal nerve?

A

IVD above the IVF is usually the source of damage

605
Q

What is unusual about the sacral IVF compared to other IVFs?

A

a completely osseous boundary exists

606
Q

What is more likely the cause of nerve irritation at the sacral IVF?

A

the tilt or position of the entire sacrum relative to the pelvis

607
Q

What is the relationship of lumbar nerve root size to IVF size above L4?

A

the nerve root size will account for less than 22% of the available size

608
Q

What is unique about the relationship of spinal nerve to IVF at S5-Co1?

A

2 nerves present, S5 and Co1

609
Q

What are some examples of destructive lesions of the vertebral body?

A

tuberculosis, hemangioma, osteoporosis

610
Q

What are examples of osteophyte formation that influence the IVF?

A

the bony spurs of the vertebral body and para-articular processes on the lamina

611
Q

What are examples of acquired alternations fo the spinal curves identified in class?

A

obesity, pregnancy and use of heavy backpacks

612
Q

What is the recommended weight of a backpack compared to individual weight for the developing spine?

A

backpack weight should not exceed 10% individual body weight

613
Q

What are the curvatures of the vertebral column?

A

anterior, posterior, lateral

614
Q

What is the direction of the primary curve of the vertebral column?

A

posterior

615
Q

Why is the posterior curve also called the primary curve?

A

it is first curve to appear embryologically

616
Q

What are the adult remnants of the primary curve along the vertebral column?

A

the thoracic or dorsal curve and the pelvic or sacrococcygeal curve

617
Q

What are the names given to curves that form during development to reverse the direction of regions along the vertebral column?

A

anterior curve, secondary curve, compensatory curve

618
Q

What are the names of the anterior curves, secondary curves, and compensatory curves?

A

cervical curve and lumbar curve

619
Q

What segmental levels form the cervical curve?

A

C2-T1

620
Q

What segmental levels form the lumbar curve?

A

T12-L5

621
Q

What is the earliest time of appearance of the cervical curve?

A

third fetal month

622
Q

What is the traditional time of appearance of the cervical curve said to be?

A

during the last trimester in utero

623
Q

What is the time during which then “adult” cervical curve is said to appear?

A

within the first year after birth

624
Q

What developmental events are indicated in the formation of the adult cervical curve?

A
  1. centers for vision and equilibrium will appear in the brain
  2. musculature attaching the skull, cervical region, and upper thorax together develops
  3. the head is held upright
  4. the IVD height becomes greater anterior than posterior
625
Q

At what age will the infant begin to hold the head erect?

A

usually between the third and fourth month after birth

626
Q

What is the name given to the integration of visual and motor pathways associated with holding the head erect?

A

righting reflex

627
Q

What is the location for the apex of the cervical curve?

A

typically between C4 and C5

628
Q

What is the location for the cervical kyphosis?

A

between occiput and C1

629
Q

What is the name given to the primary cervical curve?

A

cervical kyphosis

630
Q

What is the vertebral relationship between the cervical curve and the cervical enlargement?

A

cervical curve C2-T1; cervical enlargement C3-T1

631
Q

What is the time of appearance of the lumbar curve?

A

between 12 and 18 months after birth

632
Q

What infant activities are associated with the developmental of the lumbar curve?

A

crawling and walking

633
Q

What developmental events are indicated in the formation of the adult lumbar curve?

A
  1. crawling will cause the abdomen to put tension on the lumbar region and pulls it forward.
  2. muscle development is promoted to compensate for the swayback of the lumbars
  3. IVD heigh will become greater anterior compared to posterior
  4. walking will further promote muscle and IVD development
634
Q

What happens within the IVD to facilitate the lumbar curve development?

A

the nucleus pulpous of L4 will shift its position within the annulus fibrosis

635
Q

Which sense is a requirement for holding the head erect, standing, sitting, and walk-in?

A

vision

636
Q

What is the gender bias associated with lumbar curve convexity?

A

females have a greater convexity of the lumbar curve

637
Q

What is the vertebral relationship between lumbar curve and lumbar enlargement?

A

lumbar curve T12-L5; lumbar enlargement T9-T12

638
Q

What is the formation of the lateral curve often correlated with?

A

faster development of the muscles on the side of handedness

639
Q

What is the time of appearance of the lateral curves?

A

they appear after 6 years old

640
Q

What locations of lateral curves are recognized?

A

C, T/dorsal, and L

641
Q

What lateral curves are best developed?

A

thoracic or dorsal and lumbar

642
Q

What is the relationship between curve direction and handedness?

A

right-handed person has a high probability for a right thoracic, left lumbar curve combination

643
Q

What is the incidence of a right thoracic, left lumbar curve combination in the population?

A

about 80% of the population demonstrates this

644
Q

What does the suffix “osis” mean?

A

condition

645
Q

Does “osis” infer a normal or an abnormal condition?

A

neither, it is non-judgemental

646
Q

What generic names identified abnormal curves of the vertebral column?

A

lordosis, kyphosis, scoliosis

647
Q

Definition of lordosis?

A

forward bending condition

648
Q

Kyphosis?

A

humpback or hunchback condition

649
Q

What is definition of scoliosis?

A

warped or crooked condition

650
Q

What is the direction of the curve deviation in scoliosis?

A

to the side (it is a lateral curve deviation)

651
Q

Is there a locational bias for the classic definition of lordosis?

A

no, there would be an increase in the anterior direction in the cervical spine, lumbar spine or a decrease in the posterior direction in the thoracic spine and pelvic or sacrococcygeal region

652
Q

What clinical abnormal curvatures of vertebral column were stressed in class?

A

military neck, humpback, swayback

653
Q

Military neck

A

decreased anterior curve in cervical region, straight neck

654
Q

Humpback

A

increased pos. curve in thoracic region

655
Q

Swayback

A

increased anterior curve in lumbar region

656
Q

Classic classification of military neck

A

kyphosis

657
Q

Classic classification of humpback

A

kyphosis

658
Q

Classic classification of swayback

A

lordosis

659
Q

What does the use of the term lordotic try to imply?

A

normal cervical and normal lumbar anterior curve

660
Q

Kyphotic

A

normal thoracic or dorsal and normal pelvic or sacrococcygela posterior curve

661
Q

Prefixes are used to convey abnormality in curve patterns?

A

hyper or hypo

662
Q

What does there term hyperlordotic infer?

A

increase in anterior curve of cervical or lumbar region

663
Q

Hypolordotic

A

decrease in anterior curve of cervical/lumbar region

664
Q

Hyperkyphotic

A

increase in posterior curve of thoracic/dorsal or pelvic/sacrococcygeal region

665
Q

What does the term hypokyphotic infer?

A

decrease in posterior curve or thoracic/dorsal or pelvic/sacrococcygela region

666
Q

What are the curve classifications for military neck?

A

kyphosis or hypolordotic curve

667
Q

What are the curve classifications for humpback?

A

kyphosis or hyperkyphotic curve

668
Q

What are the curve classifications for swayback?

A

lordosis or hyperlordotic curve

669
Q

What is there complete, accepted definition of scoliosis?

A

abnormal lateral curve coupled with axial rotation

670
Q

What is the radiological test for skeletal maturity?

A

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

671
Q

What are the classification of scoliosis according to Scoliosis Research Society?

A

magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis

672
Q

What does magnitude of scoliosis refer to?

A

length and angle of curve deviation on x-ray

673
Q

What is often used to measure the magnitude of scoliosis?

A

the Cobb Method

674
Q

What does location of scoliosis infer?

A

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

675
Q

What does direction of scoliosis refer to?

A

the side the convexity of the curve will bend toward

676
Q

What does etiology of scoliosis mean?

A

the cause of the scoliosis

677
Q

What is structural scoliosis?

A

a more radical form of scoliosis, it may worsen, associated with structural deformities of the vertebra or IVD, frequently has a fixed angle of trunk rotation

678
Q

What is nonstructural scoliosis?

A

a mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or IVD and lacks a fixed angle of trunk rotation

679
Q

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

A

idiopathic scoliosis

680
Q

What does idiopathic scoliosis infer?

A

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

681
Q

What is the incidence of idiopathic scoliosis in the population?

A

1-4% of the population

682
Q

Based on age of onset, what are the types of idiopathic scoliosis?

A

infantile, juvenile, adolescent

683
Q

What is the age range for infantile idiopathic scoliosis?

A

birth to 3 years

684
Q

What is the age range for juvenile idiopathic scoliosis?

A

3-10 years old

685
Q

What is the age range for adolescent idiopathic scoliosis?

A

over 10 years old

686
Q

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

A

left thoracic, male, less than 1%

687
Q

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

A

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

688
Q

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

A

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

689
Q

What is the genetic factor associated with adolescent idiopathic scoliosis?

A

an autosomal dominant factor that runs in families

Spinal Anatomy (3 decks)

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