Study Guide Questions- Exam 2 Flashcards
Ossification of the ligamentum flavum at the attachment site on the lamina will be associated with which classification of bone?
Accessory bone
Ossification within the length of the ligamentum flavum will be associated with which classification of bone?
Heterotopic bone
The greatest transverse diameter of the typical cervical vertebra occurs at ____?
C6
The greatest frequency of osteophytes associated with the vertebral body occurs at which typical cervical vertebral couple?
C5/C6
List, in order, the osseous parts of the typical cervical vertebra transverse process beginning at the vertebral body.
costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process
What muscles may attach to the posterior tubercle of a typical cervical vertebra?
splenius cervicis, iliocostalis cervicis, longissimus cervicis, levator scapula, middle scalene, posterior scalene, rotators and posterior intertransverse muscles.
What muscles will attach to the costotransverse bar?
Middle scalene and posterior intertransverse muscles
What is the orientation and angulation of a typical cervical transverse process?
60 degress anterolaterally (from midsagittal plane), 15 degrees inferiorly (from the horizontal plane)
What is the name given to the modification of the anterior tubercle of the C6 transverse process?
the carotid tubercle
What will occupy the typical cervical vertebra transverse foramen?
the vertebral artery, vertebral venous plexus and postganglionic sympathetic motor nerve fibers
What is the classic angulation of typical cervical articular facets?
forty to forty-five degrees from the coronal plane
What is the orientation of the typical cervical superior articular facet?
backward, upward, medial (BUM)
What is the orientation of the typical cervical inferior articular facet?
forward, lateral, down (FoLD)
What muscles will attach to typical cervical articular processes?
the longissimus capitis, longissimus cervicis, semispinalis capitis, semispinalis cervicis, mutifidus and rotators.
What muscles blend with the capsular ligament of cervical zygapophyses?
the semispinalis capitis, multifidis, and rotator longus
What modifications of the synovial joint are observed in the cervical spine?
meniscoidal folds
The greatest range of flexion- extension among the typical cervical vertebrae occurs at which vertebral couple?
typically C5/C6
What motions are coupled in the cervical spine?
lateral bending and axial rotation
Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?
the C5/C6 vertebral couple
What is the usual condition for the African-American typical cervical spinous process?
they are non-bifid
What muscles may attach to the typical cervical spinous process?
the spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis
What joint classifications are observed on the anterior arch of C1?
fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint
What is the orientation of the superior articular facet of C1?
backward, upward, medial (BUM)
What is the joint classification of the atlnato-occipital zygapophysis?
synovial (diarthrosis) ellipsoidal joint
What are the morphological characteristics of the inferior articular facet of C1?
asymmetrical, slightly concave or flattened
What is the orientation of the inferior articular facet of C1?
backward, medial, downward (BMD)
What is the joint classification of the atlanto-axial zygapophysis?
synovial (diarthrosis)arthrodia joint
What muscles attach to the lateral mass of C1?
levator scapula, splenius cervicis and rectus capitis anterior
What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?
males: about fifty millimeters;
females: about thirty-seven millimeters
What attaches to the posterior tubercle of the posterior arch of C1?
rectus capitis posterior minor muscle and ligamentum nuchae
Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?
accessory bone
What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?
about age 7 years old
Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?
an incomplete ponticulus posticus or a complete ponticulus posticus
What forms the types of ponticulus posticus?
ossification of the anterior free margin of the posterior atlanto-occipital ligament
What other name may be used to identify a ponticulus posticus?
Kimmerle’s anomaly
What names are given to the opening formed by the ponticulus posticus?
arcuate foramen or retroarticular canal
Ponticulus posticus has observed in what ethnic populations?
all ethenic populations studies thus far
What is the general range of incidence of ponticulus posticus in the populations studied?
1% - 41%
What are the osseous parts of the transverse process of C1?
costal element, posterior tubercle, true transverse process
What muscles attach to the transverse process of C1?
rectus capitis anterior, rectus capitis lateralis, middle scalene, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior, and intertranversarii muscles
What suboccipital muscles are known to have fascial projections attaching to the spinal dura?
rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior
What are the connections between suboccipital muscles and the spinal dura called?
myodural bridges
What are the lateral bridges of atlas connected to?
the lateral mass and the transverse process of atlas
What opening is identified when a complete lateral bridge is formed?
the retrotransverse foramen
What are the possible contents of the retrotransverse foramen?
the vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck
What is the gender variation for measurements of the transverse diameter of C1?
Males: 78 millimeters
Females: 72 millimeters
What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?
a little over 30 millimeters for both males and females
What joint classifications are observed at C1?
fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial (diarthrosis) rochoid joint and synovial (diarthrosis) arthrodia joint
How many synovial joint surfaces are observed at C1?
five
What names are given to C2?
axis or epistropheus
What joint surfaces are present on the odontoid process of C2?
facet for fovea dentis, groove for transverse atlantal ligament, attachment sites for the alar ligaments, attachment site for the apical-dental ligament
How many joint surfaces are present of the odontoid process of C2?
five
What is the name given to the odontoid process when the facet for the fovea dentis lies above the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed posterior?
lordotic dens
What is the name given to the odontoid process when the facet for the fovea dentis lies below the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed anterior?
kyphotic dens
What joint classifications are present at the vertebral body of C2?
fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) trochoid joint, modified synovial (diarthrosis) sellar and cartilagenous (amphiarthrosis) symphysis joint
What ligament forms the anterior boundary for the spinal canal above C2?
membrana tectoria
What ligament forms the anterior boundary for the spinal canal below C2?
posterior longitudinal ligament
What attaches to the lamina of C2?
Obliquus capitis inferior muscle, posterior atlanto-axial ligament, ligamentum flavum
What muscle attaches to the lamina of C2?
obliquus capitis inferior
What is the appearance of the superior articular facets of C2?
they are asymmetrical and slightly convex
What is the facet orientation of the superior articular facets of C2?
backward, upward and lateral (BUL)
What is the orientation of the inferior articular facets of C2?
forward, lateral and down (FoLD)
What muscle attaches to the articular processes of C2?
longissimus cervicis
What osseous parts of the typical cervical transverse process are present at C2?
costal element, posterior tubercle, and true transverse process
What is the gender variation for the transverse diameter of C2?
males: 57 millimeters
females: about 50 millimeters
What muscles attach to the transverse process at C2?
levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii
what muscles attach to the spinous process of C2?
rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, mulitfidis, rotators and interspinalis muscles.
What names may be given to C7?
vertebra prominens and vertebral prominence
What is the name given to the topographical elevation observed at the base of the neck?
vertebral prominence
What name is given only to C7?
vertebra prominens
What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?
C6 is more common in females
T1 is more common in males
How many joint surfaces are present at the vertebral body of C7?
eight
What joint classifications are observed at the vertebral body of C7?
fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and modified synovial (diarthrosis) sellar joint
How many synovial joint surfaces are observed at the vertebral body of C7?
two
What muscle(s) attaches to the vertebral body of C7?
longus colli muscle
What are the osseous parts of the transverse process of C7?
costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process
What features are typically present in the transverse foramen of C7?
vertebral venous plexus, postganglionic sympathetic motor fibers
What muscles attach to the transverse process of C7?
middle scalene, iliocostalis thoracis, longissimus cervicis, semispinalis capitis, rotators, intertransversarii and levator costorum brevis
What is the angulation of the articular facet at C7?
more vertical at about 63 degrees
What is the orientation of the superior articular facet of C7?
backward, upward, medial (BUM)
What is the orientation of the inferior articular facet of C7?
forward, medial, downward (ForMeD)
What muscles will attach to the articular process of C7?
longissimus cervicis, longissimus capitis, semispinalis cervicis and multifidis
What are the features of the spinous process of C7?
long, horizontal, nonbifid
What muscles attach to the spinous process of C7?
trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis.
What ligaments attach to the spinous process of C7?
ligamentum nuchae and interspinous ligaments
The vertebral artery on which side is typically larger?
left vertebral artery
What is the gender bias regarding size of the vertebral artery?
men have larger vertebral arteries than women
What is the name of the physical exam used to determine vertebral artery patency?
eh vertebrobasilar artery insufficiency test
Which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?
the ipsilateral artery on the side of rotation
What are the symptoms of failure of the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?
dizziness, vertigo, nausea are common complaints
Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?
C6
At what location will the vertebral artery form its first compensatory loop?
the atlanto-axial interspace
At what location will the vertebral artery form its second compensatory loop?
the atlanto-occipital interspace
At what segments will the vertebral artery be firmly attached to the transverse foramen?
both C1 and C2
What is the purpose of the vertebral artery loops between C2, C1 and occiput?
The increase length will accommodate the greater rotation at these location
What happens to the vertebral artery as it enters the vertebral foramen of C1?
the adventitia of the artery blends with the dura mater and arachnoid mater; as a result the artery lies in the subarachnoid space
What happens to the vertebral artery after it enters the subarachnoid space at C1?
the vertebral artery ascends along the medulla oblongata to the pontine- medullary junction where the right and left arteries unite to form the basilar artery
What are the superior articular facet orientation for the cervical vertebrae?
C1 is backward, upward, medial (BUM)
C2 is backward, upward, lateral (BUL)
C3-C7 is backward, upward, medial (BUM)
What are the inferior articular facet orientations for the cervicial vertebrae?
C1 is backward, downward, medial (BMD)
C2-C6 is forward, downward, lateral (FoLD)
C7 is forward, downward, medial (ForMeD)
How many synovial joints are identified for each cervical vertebra?
C1 = 5 C2 = 8 C3-6 = 8 C7 = 6
How many joints are identified at the vertebral body of each cervical vertebra?
C1 = none C2 = 10 C3-6 = 10 C7 = 8
What features will allow discrimination between T2-T4 and T5-T8 segmental groups?
The vertebral body, transverse process, articular process and spinous process
What is the height patter of the typical thoracic vertebral body?
the posterior height is greater than the anterior height by one to two millimeters
What is another way of naming a posterior curve pattern?
a kyphotic curve
What joint classifications are identified at the vertebral body of a typical thoracic?
fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and synovial (diarthrosis) arthrodia joint
How many synovial joints are formed at the vertebral body of a typical thoracic?
four
How many symphysis joints are formed with the vertebral body of a typical thoracic?
two
How many joints are formed at the vertebral body of a typical thoracic?
typically ten; fourteen if the costocentral stellate/radiate ligaments are included
What ligaments support the costocentral joint?
the costocentral stellate/radiate ligament and the costocentral interarticular or intra-articular ligament
What is the size relationship between the articulating surface of the head/capitulum of the rib and the costal demi-facet surface?
the rib surface is greater than the costal demi-facet surface
Which X-ray view is used to see into the intervertebral foramen of a typical thoracic?
the lateral view
What is the nerve - vertebral body relationship at the typical thoracic intervertebral foramen?
in the intervertebral foramen, the number of the nerve is the same as the number of the upper thoracic in the vertebral couple.
What is the rib - vertebral body relationship at the typical thoracic intervertebral foramen?
in the intervertebral foramen, the number of the rib is the same as the number of the lower thoracic in the vertebral couple
What ligaments support the costotransverse joint of a typical thoracic?
the superior costotransverse,
inferior costotransverse,
and lateral costotransverse ligaments
What ligaments attach to the transverse process of a typical thoracic?
intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments.
How do the transverse diameters of the articular processes compare in the T2-T4 region?
the superior articular process transverse diameters is greater than the inferior articular process transverse diameter for a given segment.
What is the orientation of the superior articular facet of a typical thoracic?
backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facet of a typical thoracic?
forward, downward, and medial (ForMeD)
How many synovial joints are present at a typical thoracic?
ten
How many synovial joint surfaces for ribs are present on a typical thoracic?
six
What is the angulation of the spinous process in the typical thoracic region?
the undersurface of T2-T4 spinous processes will angle up to forty degrees from the horizontal plane
the undersurface of T5-T8 spinous processes will angle up to sixty degrees from the horizontal plane
What joint classifications are present at every typical thoracic vertebra?
fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and synovial (diarthrosis) arthrodia joint
How many synovial joints are formed at the vertebral body of T1?
four normally
How many symphysis joints are formed with the vertebral body of T1?
two
How many joints are formed at the vertebral body of T1?
typically ten; fourteen if the rib ligaments are included
How many synovial joints are present at T1?
ten
Identify the synovial joint surfaces present at T1.
two superior costal facets, two inferior costal demi-facets two transverse costal facets two superior articular facets two inferior costal facets
How many joints are typically formed at the vertebral body of T9?
typically ten, fourteen if the costocentral stellate/radiate ligaments are included
How does the superior costal demi-facet [of T9] compare in size with those of T2-T8?
it is larger
How many joints are typically formed at the vertebral body of T10?
typically eight; twelve if the costocetnral stellate/radiate ligaments are included
Which synovial joint surface is absent from the vertebral body to T10?
Inferior costal demi-facet
Para-articular processes are more commonly observed on which segment?
T10
What muscles attach to the transverse process of T10?
longissimus thoracis,
semispinalis thoracis, multifidus, rotator longus and rotator brevis,
intertransversarii, levator costarum longus, and levator costarum brevis
How many synovial joints are typically present at T10?
eight
A dimpling or depression of the skin in the thoracic region is often characteristic of the location of which segment?
T10
What muscles attach to the spinous process of T10?
trapezius, latissimus dorsi, multifidus, rotator longus, rotator brevis and interspinalis
What name is given to T11?
the anticlinal vertebra
What is the outline of the vertebral body of T11 on superior view?
kidney-shaped or reniform
How many synovial joints are formed at the vertebral body of T11?
two
How many joints are typically formed at the vertebral body of T11?
typically eight; twelve if the costocentral stellate/radiate ligaments are included
Which synovial joint surface is absent from the vertebral body of T11?
inferior costal demi-facets
How does the superior costal facet compare in size with those of T10?
it is larger, below the superior epiphyseal rim, and is completely circular
Which ligament of the costocentral joint is absent for the eleventh rib?
the costocentral interarticular or intra-articular ligament
What ligaments form the costotransverse joint of T11?
the superior costotransverse, and slightly developed inferior costotransverse and lateral costotransverse.
How many synovial joints are typically present at T11?
six
Identify the synovial joint surfaces typically present on T11.
two superior costal facets,
two superior articular facets,
two inferior articular facets
Which muscle(s) is attached to teh vertebral body of T12?
psoas major and psoas minor
Which tubercle on T12 represents the transverse process?
the lateral tubercle
Which tubercle on T12 represents the mammillary process of the lumbars?
the superior tubercle
Which tubercle on T12 represents the accessory process of the lumbars?
the inferior tubercle
What joint surface of the typical thoracic transverse process is absent on T12?
the transverse costal facet
What ligaments form the costotransverse joint of the twelfth rib?
the superior costotransverse ligament from T11 and the lumbosacral ligament from L1
What muscles attach to the transverse process region of T12?
the longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and intertransversarii
What is the orientation of the superior articular facets of T12?
they face backward, upward, and lateral (BUL)
What is the orientation of the inferior articular facets of T12?
forward, downward, and lateral (FoLD)
What muscles attach to the spinous process of T12?
the trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis
What accounts for the direction of the lumbar curve?
the vertebral body height and intervertebral disc have a greater anterior height than posterior height.
What muscles may attach to a typical lumbar vertebral body?
psoas major and psoas minor
What is the name given to ligaments which attach the vertebral body to articular process?
transforaminal ligament
What ligaments attach the vertebral body to the transverse process?
corporotransverse ligaments
Cervical - Upper Thoracic Hofmann ligaments will attach what structures together?
dura mater to segments above
What is the highest level known to demonstrate Hofmann ligaments?
C6
What is the proposed function of the cervical - upper thoracic Hofmann ligaments?
resist caudal movement of the dural sac; resist gravitational forces on the dura and the cord.
Lumbar Hofmann ligaments will attach what structures together?
dura mater to lower segmental levels
What is the proposed function of the lumbar Hofmann ligaments:
resist cranial movement of the dural sac during flexion
Congenital elongation of the lumbar accessory process results in what feature?
styloid process
What muscle(s) attach to the lumbar accessory process?
longissimus thoracis and intertransversarii
What osseous components are attached via the lumbocostal ligament?
the transverse process of L1 and neck/collum of the twelfth rib
What muscles may attach to the transverse process of a typical lumbar vertebra?
psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus and intertransversarii
What ligaments attach to the transverse process of a typical lumbar vertebra?
the lumbocostal, mammillo-accessory and intertransverse ligaments
What are the anterior elements of the vertebra?
vertebral body and pedicle
What is the orientation of the typical lumbar superior articular facet?
backward, upward, medial (BUM); typically concave
What is the orientation of the typical lumbar inferior articular facet?
forward, lateral, downward (FoLD); significant convexity
What muscle(s) will attach to the mammillary process?
multifidis and intertransversarii
What was believed to be entrapped by the mammillo-accessory ligament?
the medial branch of the dorsal ramus of a lumbar spinal nerve
What is the position of the lumbar zygapophysis in children?
the zygapophysis lies in the coronal plane
What is the position of the lumbar zygapophysis in adults?
the zygapophysis lies in the sagittal plane for L1/L2, L2/L3, & L3/L4
the zygapophysis lies in the the coronal plane for L4/L5 & L5/S1
What names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane or position and the other zygapophysis lies in the sagittal plane or position?
joint asymmetry or joint tropism
What is the name(s) of the condition in which the typical lumbar spinous process increases in length due to the aging process?
Baastrup’s Syndrome or “Kissing Spines”
What muscles will attach to the typical lumbar spinous process?
latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis
What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
overlap of the laminae, shingling, diminishes;
overlap of the spinous processes, imbrication, diminishes
What is the appearance of the fifth lumbar vertebral body from the lateral view?
anterior height is greater than posterior height by several millimeters; it appears to form a wedge on a lateral x-ray view
What muscles may attach to the transverse process of the fifth thoracic vertebra?
psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus, and intertransversarii
What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?
lumbosacral, iliolumbar and mammillo-accessory ligaments
What are the posterior elements of the vertebra?
zygapophysis, lamina, and spinous process
What is the reported angulation and x-ray appearance of the fifth lumbar articular facets?
they lie in the vertical plane and are coronal facets
What is the orientation of the fifth lumbar inferior articular facet?
forward, lateral, downward (FoLD); significant convexity
What is Baastrup’s syndrome?
elongation of the lumbar spinous process as a result of aging
What is the name given to the congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida, and dorsiflexion produces pain?
Knife Clasp Syndrome
Lumbar spondylolysis has not been reported in what groups of individuals?
fetuses, newborns, rarely in children under 5 years old, patients who have never walked and in non-erect species
What does lumbar spondylolysis appear to be related to?
the uniquely human upright stance or erect posture
What is the gender bias and locational bias associated with lumbar spondylolysis?
men at L5/S1; women at L4/L5
What is the appearance of the lumbar vertebra upon oblique x-ray view?
a Scotty dog
What is the appearance of a pars defect in a lumbar vertebra upon oblique x-ray view?
a collared Scotty dog
What is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view?
a collared Scotty dog
In an oblique x-ray, spondylolysis below the superior articular process of a lumbar pars interarticularisis associated with what part of the Scotty dog?
the neck of the Scotty dog
What part of a lumbar vertebra forms the eye of a Scotty dog?
the pedicle
What part of a lumbar vertebra forms the ear of a Scotty dog?
the superior articular process
What part of a lumbar vertebra forms the nose of a Scotty dog?
the transverse process
What characteristics are associated with cervicial spondylolysis?
rare, congenital, gender biased toward men, most common at C6 and linked to spondylolysis and spina bifida.
