Study Questions Flashcards
What are the classifications of scoliosis according to the Scoliosis Research Society? (6) (N.D. ELMS)
magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis
What does magnitude of scoliosis refer to?
the length and angle of the curve deviation on x-ray
What is often used to measure the magnitude of scoliosis?
the Cobb Method
What does location of scoliosis infer?
the location of the vertebral segment forming the apex of the curve deviation
What does direction of scoliosis refer to?
the side the convexity of the curve will bend toward
What does etiology of scoliosis mean
the cause of the scoliosis
What is structural scoliosis
a more radical form of scoliosis, it may worse, associated with structural deformities of the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation
What is nonstructural scoliosis
a mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or intervertebral disc and lacks a fixed angle of trunk rotation
What are some of the classifications of scoliosis based on etiology (5)
congenital, neuromuscular, neurofibromatosis, nerve root irritation, idiopathic
What is the classification of scoliosis that is unique to the individual patient
idiopathic scoliosis
What does idiopathic scoliosis infer
the scoliosis is unique to the individual, it has no known cause, unknown etiology
What is the incidence of idiopathic scoliosis in the population
1% to 4% of the population
Based on age of onset, what are the types of idiopathic scoliosis (3)
infantile, juvenile, and adolescent
What is the age range for infantile idiopathic scoliosis
from birth to 3 years old
what is the age range for juvenile idiopathic scoliosis
from 3 years old to 10 years old
what is the age range for adolescent idiopathic scoliosis
over 10 years old
identify curve direction, location, gender bias and incidence of infantile idiopathic scoliosis
left thoracic, male, less than 1% incidence
identify curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis
right thoracic, females over 6 years old, and 12%-21% incidence
identify curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis
right thoracic or right thoracic AND left lumbar, females, and 80% incidence
what are the transition zones of the vertebral column
occipitocervical cervicothoracic thoracolumbar lumbosacral sacrococcygeal zones
what are the possible transition zone - segmental combinations
cervicalization of occiput, occipitalization of C1
dorsalization of C7, cervicalization of T1
lumbarization of T12, dorsalization of L1
sacralization of L5, dorsalization of S1
coccygealization of S5, sacralization of Co1
what is/are the characteristic(s) of cervicalization of occiput
an increase in occipital bone size, formation of new or larger lines, on the occipital bone
what is/are the characteristic(s) of occipitalization of C1
the atlas may be partially or completely fused to the occiput
what is another way of implying occipitalization of C1
atlas assimilation
what is the incidence of occipitalization of C1
0.1 to 0.8%
when do the centers of ossification for the odontoid process first appear
during the last trimester in utero
when do the bilateral ossification centers for the odontoid process fuse
at or shortly after birth
what joint forms between the odontoid process ossification centers and the centrum of C2
the subdental synchondrosis
ossification between the odontoid process and centrum joint of C2 first appears at what age
4 years old
a joint between the odontoid process and centrum of C2 is last identified at what age
7 years old
what is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 persists beyond age 7?
os odontoideum
what is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7
persistent subdental synchondrosis
what is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification
tip of the dens synchondrosis
at what age will the tip of the dens center of ossification appear
sometime in early adolescence
at what age will the tip of the dens fuse with the odontoid process
before age 12
what is a terminal ossicle
a persistence beyond age 12 of the joint formed between the tip of the dens and odontoid process centers of ossification
what is a basilar impression
persistence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain
what is a basilar invagination
the upper cervical spine appears to be invaginated into the skull on x-ray analysis
what is/are the characteristic(s) of dorsalization of C7
the addition of a rib and changes in superior articular facet orientation are typical
what is the incidence of rib-related changes following dorsalization of C7
for 0.5 to 2.5% of the population
what is the gender bias suggested in dorsalization of C7
female
what percent of the population may demonstrate thoracic-like features at C7
up to 46%
what rib-related changes may accompany cervicalization of T1
the first rib may decrease in mean relative length or become absent
what will result from fusion of a short rib to the T1 transverse process
the transverse foramen
what is the incidence of cervicatlization of T1 in the population
up to 28% of the population
what rib-related changes may accompany dorsalization of L1
elongated bones shaped like ribs may appear
what is the incidence of lumbar ribs in the population
over 7% of the population demonstrates lumbar ribs
what is the gender bias associated with dorsalization of L1
males are two to three times more affected
what alteration in C7 facet orientation may accompany dorsalization
the superior articular facet of c7 may change from back, upward, and medial to that of a typical thoracic facet…back, upward, and lateral; the inferior articular facet is unchanged
what alteration in c6 facet orientation may accompany dorsalization
c6 demonstrates a change in inferior articular facet orientation from forward, lateral, and downward to forward, medial, and downward; the superior articular facet unchanged
what t1 facet orientation changes may accompany cervicalization
the superior articular facet may change from back, upward, and lateral to back, upward, and medial; the inferior articular facet is unchanged
what c7 facet orientation changes may accompany cervicalization
the inferior articular facet may change from forward, medial, and downward to forward, lateral, and downward; the superior articular facet is unchanged
what l1 facet orientation changes may accompany dorsalization
the superior articular facet may change from concave, back, upward, and medial to flat, back, upward, and lateral; the inferior articular facet is unchanged
what t12 orientation changed may accompany dorsalization
the inferior articular facet may change from convex, forward, lateral, and downward to flat, forward, medial, and downward; the superior articular facet is unchanged
what rib-related changes may accompany lumbarization of t12
a significant shortening of the mean relative length of 113 mm of the 12th rib or it becomes absent
what t12 facet orientation changes may accompany lumbarization
the superior articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged
what t11 facet orientation changes may accompany lumbarization
the inferior articular facet may change from flat, forward, medial, and downward to convex, forward, lateral, and downward; the superior articular facet is unchanged
what unique characteristics of lumbarization of s1 were stressed in class
squaring of the the vertebral body of s1 and flaring of the sacral ala
what is characteristic of sacralization of l5
l5 may be partially or completely fused to the sacrum
what is the incidence of sacralization of l5 in the population
41 to 85%
which segment demonstrates the greatest morphological variation along the spine
l5
what is the incidence of variation within the sacrococcygeal region in the population
up to 14%
what is characteristic of sacralization of co1
the premature fusion of co1 to the sacrum
what is squaring of the vertebral body of s1
the s1 vertebral body has similar anterior and posterior heights, hence a lack of wedging
what if flaring of the sacral ala
the transverse process of the ala appears to elevate as though separating from the rest of the sacral ala
which of the muscles attaching to spinous processes represent layer one of the back
trapezius, latissimus dorsi
which of the muscles attaching to spinous processes represent layer two of the true back
rhomboid major, rhomboid, minor
which muscles attaching to transverse processes represent layer two of the true back
levator scapulae
the trapezius is innervated by what nerve
the spinal accessory nerve
what forms the spinal accessory nerve innervating the trapezius
c1-c5 cord levels contribute to the spinal root of the spinal accessory nerve
the latissimus dorsi is innervated by what nerve
the thoracodorsal nerve
what forms the thoracodorsal nerve innervating the latissimus dorsi
ventral rami from c6-c8
which of the muscles of the true back are innervated by the dorsalscapular nerve
levator scapulae, rhomboid major, rhomboid minor
what forms the dorsal scapular nerve
the ventral ramus of c5
the levator scapulae is innervated by what nerves
the dorsal scapular nerve (ventral ramus of c5) and branches from c3, c4 ventral rami
the rhomboid major is innervated by what nerves
the dorsal scapular nerve (ventral ramus of c5) and branches from c4 ventral ramus
the rhomboid minor is innervated by what nerves
the dorsal scapular nerve (ventral ramus of c5) and branches from c4 ventral ramus
what muscles lie just beneath the trapezius in the neck
splenius capitis and splenius cervicis
what does the word ‘splenius’ mean
it is the Greek word for bandage
what part of the vertebra forms the osseous origin for the splenius muscles
the spinous process
what is the innervation of the splenius capitis
dorsal rami of middle cervical spinal nerves (c3-c5 cord levels)`
splenius cervicis will attach to what locations on the spine
lateral mass of c1 and posterior tubercle of transverse process on c1-c4
what is the innervation of the splenius cervicis
dorsal rami of lower cervical spinal nerves (c5-c7 cord levels)
which muscles represent the fourth layer of the true back
the erector spinae or sacrospinalis muscles
which muscles are identified as erector spinae or sacrospinalis muscles
iliocostalis, longissimus, spinalis
what osseous parts of the vertebral column serve as an origin to the iliocostalis lumborum
spinous processes of t11-t12, l1-l5, median sacral crest, lateral sacral crest
what is the insertion for the iliocostalis lumborum
costal angles of the lower 6-9 ribs (rib 6-rib 12 or rib 3-rib 12)
what is the innervation of the iliocostalis lumborum
dorsal rami of lower thoracic and all lumbar spinal nerves
which subdivision of the iliocostalis muscle appears to have a reversal of origin-insertion
iliocostalis lumborum pars lumborum
what osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis
none
what osseous part of the vertebral column serves as an insertion for the iliocostalis thoracis
transverse process of c7
which subdivision of the iliocostalis primarily originates and inserts on the ribs
iliocostalis thoracis
what is the innervation of the iliocostalis thoracis
dorsal rami of upper 6 thoracic spinal nerves (t1-t6 cord levels)
what osseous parts of the vertebral column serve as an origin to the iliocostalis cervicis
none
what is the innervation of the iliocostalis cervicis
dorsal rami of t1, t2 spinal nerves, sometimes c8 spinal nerve (c8, t1, and t2 cord levels)
what osseous part of the vertebral column serve as an origin to the longissimus thoracis
accessory process and transverse processes of l1-l5, spinous processes of l3-l5 and median sacral crest s1-s3
which erector spinae muscle is attached to the accessory processy
longissimus thoracis
what is the innervation of the longissimus thoracis
dorsal rami of all thoracic and lumbar spinal nerves (cord levels t1-t12, l1-l5)
what ossesous parts of the vertebral column serve as an origin to the longissimus thoracis pars lumborum
accessory process and medial part of transverse process of l1-l5
what is the insertion for the longissimus thoracis pars lumborum
posterior superior iliac spine (PSIS) of the innominate bone
which subdivision of the longissimus muscle appears to have a reversal of origin-insertion
longissimus thoracis pars lumborum
what is the innervation of the longissimus cervicis
dorsal rami of c4-c8 and t1-t2 spinal nerves (c4-c8 and t1-t2 cord levels)
what is the innervation of the longissimus capitis
dorsal rami of c1-c3 or c4 spinal nerves (c1-c3 or c4 cord levels)
which erector spinae muscles attach to cervical articular processes
longissimus cervicis and longissimus capitis
what is the innervation of the spinalis thoracis
dorsal rami of all thoracic and upper lumbar spinal nerves
what is the innervation of the spinalis cervicis
dorsal rami of all cervical spinal nerves (c1-c8 cord levels)
what is the innervation of the spinalis capitis
dorsal rami of lower cervical and upper thoracic spinal nerves
which muscles are identified as transversospinalis muscles
semispinalis, multifidis, and rotators
based on the name of this group, what is the origin-insertion of the transversospinalis
transerve process origin, spinous process insertion
how many vertebrae can be attached to a single segment by the transversospinalis muscles
as many as nine vertebrae
what segment will represent the lowest attachment site for the semispinalis thoracis
t12
what is the innervation of the semispinalis thoracis
dorsal rami of t1-t6 spinal nerves (cord levels t1-t6)
what osseous parts of the vertebral column serve as an origin to the semispinalis cervicis
transverse tubercles of t1-t5 or t6 and articular processes of c4-c7
what is the innervation of the semispinalis cervicis
dorsal rami of c6-c8 spinal nerves (cord levels c6-c8)
what ossesous parts of the vertebral column serve as an origin to the semispinalis capitis
transverse tubercles of c7, t1-t6 or t7 and articular processes of c4-c6
what is the innervation of the semispinalis capitis
dorsal rami of c1-c6 spinal nerves (cord levels c1-c6)
the biventer cervicis is formed by the fusion of what muscles
semispinalis capitis and spinalis capitis
what regional subdivisions are now identified with multifidis muscles
lumbar multifidis, thoracic multifidis and cervical multifidus
which transversospinalis muscle attaches to articular and mammillary processes along the spine
multifidis
what is the innervation of the classic multifidis
dorsal rami of c3-c8, t1-t12, l1-l5 and s1 spinal nerves (same cord levels)
contraction of multifidis cervicis will result in what movements (3)
alters the zygaphphyseal capsular ligament response to load distribution
determines the cervical spine response to injury as evidenced by neck pain
is a significant contributor to postural control of the head and neck
which subdivision of multifidis may demonstrate a reversal of origin-insertion
multifidis lumborum
contraction of multifidis lumborum will result in what movements (3)
lateral flexion and rotation of the lumbar spine
maintaining of the lumbar lordotic curve
prevents entrapment of lumbar zygapophyseal capsular ligament during movement
which muscles of the spine exhibit a reversal of the expected origin-insertion combination
iliocostalis lumborum pars lumborum, longissimus thoracic pars lumborum and multifidis lumborum
what will replace muscles spanning one or two segmental levels in the cervicals and lumbars
deep layers of the multifidis
which suboccipital muscle lacks an attachment to the skull
obliquus capitis inferior
which nerve will innervate all suboccipital muscles
the dorsal ramus of c1, the suboccipital nerve
what is the origin of the obliquus capitis inferior
c2 spinous process and lamina
what is the insertion of the obliquus capitis inferior
transverse process of c1
contraction of obliquus capitis inferior will result in what movement
turns the face to the side
an increase in the density of muscle spindles is most apparent in which suboccipital muscle
obliquus capitis inferior
suboccipital muscle feedback relays to what additional locations in the brain
extraocular nuclei of origin, primary visual cortex and vestibular nuclei
what is the result of communication between suboccipital muscles, visual centers and vestibular centers
coordination of head and eye position
what is the proposed function of the suboccipital muscle group
postural stabilizers of the atlanto-occipital and atlanto-axial joints
which suboccipital muscles are known to attach to dura mater
rrectus capitis posterior major, rectus capitis posterior minor and obliquus capitis inferior
interspinalis is paired in which regions of the spine
cervical and lumbar regions
based on the density of muscle spindles, what is the proposed function of the interspinalis
act as a proprioceptive transducer in conjunction with intertranversarii to coordinate the smooth movement of the spine and to maintain appropriate posture
intertransversarii are paired in which regions of the spine
cervical and lumbar regions
which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves
intertransversarii
based on the density of muscle spindles, what is the proposed function of the intertransversarii
acts as a proprioceptive transducer in conjunction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture
what is the origin of the longus colli
vertebral bodies of c5-c6, t1-t3 and anterior tubercles of transverse processes c3-c5
what will innervate the longus colli
ventral rami of c2-c6 or c7 spinal nerves
what is the insertion of the longus capitis
basilar part of the occipital bone
what will innervate the longus capitis
the ventral rami of c1-c3 spinal nerves
what is the origin of the rectus capitis anterior
lateral mass and costal element of the transverse process of c1
what will innervate the rectus capitis anterior
ventral rami of c1-c2 spinal nerves
what is the insertion of the rectus capitis lateralis
jugular process of the occipital bone
what will innervate the rectus capitis lateralis
ventral rami of c1-c2 spinal nerves
what is the insertion of the anterior scalene
ridge and anterior scalene tubercle of the first rib
what will innervate the anterior scalene
the ventral rami of c2-c6 spinal nerves
what is the insertion of the middle scalene
between the tubercle and groove for the subclavian artery on the first rib
contraction of middle scalene will result n what movements
laterally flex the neck; elevate the first rib
what will innervate the middle scalene
the ventral rami of c3-c8 spinal nerves
what will innervate the posterior scalene
the ventral rami of c6-c8 spinal nerves
the quadratus lumborum is implicated in the formation of which ligament
the iliolumbar ligament
what osseous part of the vertebral column serves as an origin to the quadratus lumborum
transverse process of l5
what will innervate the quadratus lumborum
the ventral rami of t12 and l1-l3 or l4 spinal nerves
what is the origin of the psoas major
vertebral bodies t12, l1-l5, s1 and transverse processes of l1-l5
what will innervate the psoas major
primarily the ventral rami of l2 and l3, may include ventral rami of l1 and l4 spinal nerves
what is the origin of the psoas minor
vertebral bodies t12, l1
what will innervate the psoas minor
the ventral ramus of l1 spinal nerve
what will innervate the iliacus
the femoral nerve, primarily the ventral rami of l2 and l3
what will innervate the levator costarum brevis
the dorsal rami of t1-t12 spinal nerves
what will innervate the levator costarum longus
the dorsal rami of the lower thoracic spinal nerves
what will innervate the serratus posterior superior
the ventral rami of t2-t5 spinal nerves…intercostal nerves
what will innervate the serratus posterior inferior
the ventral rami of t9-t11 (the intercostal nerves) and the ventral ramus of t12 (the subcostal nerve)
the ligamentous sacro-iliac joints (or most of the ligamentous joints of the vertebral column) are examples of which joint classification
syndesmosis
what are the four consistent features of synovial (diarthrosis) joints
articular or fibrous capsule, synovial membrane, articular cartilage and synovial fluid
what is the generic function of ligaments
stimulate reflex contraction of muscles around the joint
what are the characteristics of the type 1 articular receptors
located in the superficial layer of the fibrous capsule, resemble Ruffini endings, most numerous in cervical zygapophyses and they monitor the joint “at rest”
what are the characteristics of type 2 articular receptors
located in deeper strata of the fibrous capsule, resemble Pacinian corpuscles, most numerous in the cervical spine and monitor the joint during normal range of motion
what are the characteristics of type 3 articular receptors
present in collateral and intrinsic ligaments, resemble Golgi tendon organs, not initially observed along the vertebral column and monitor extreme joint motion
what is the function of type 4 articular receptors
nociceptive, they monitor pain
type 4a articular receptors would be present in what locations
fibrous capsule, articular fat pads or adventitia of blood vessels
type 4b articular receptors would be present in what locations
accessory ligaments in general, dense in the posterior longitudinal ligament of the spine
what are the three modifications of articular synovial membrane
synovial villi
articular fat pads or Haversian glands
synovial menisci and intra-articular discs
what is the apparent function of synovial villi
increase the surface of synovial membrane available for secretion-absorption phenomena
articular fat pads are most numerous in what location along the vertebral column
lumbar zygapophyses
what is the unique name of the inner or luminal layer of the synovial membrane
synovial lamina intima
what is the specific function of type b synovial cells
secrete proteinaceous substances and hyaluronic acid
which collagen fiber type predominates in articular cartilage
type 2
what is the primary function of bound glycosaminoglycans in articular cartilage
form a network for water retention
what is implied when cartilage is said to have elastic properties
cartilage can deform and returns to original volume rapidly, a time independent property
what is implied when cartilage is said to have viscoelastic properties
cartilage can deform but returns to original volume slowly, a time dependent property
what are the properties of synovial fluid
it is yellow-white, viscous, slightly alkaline and tastes salty
what is a complex synovial joint (diarthrosis)
within the simple joint or the compound joint, the articulating surfaces are separated by an articular disc (intra-articular disc) or meniscus
what morphological classification of synovial joints is classified as nonaxial
plane (diarthrosis arthrodial)
what morphological classifications of synovial joint would be classified as uniaxial
hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)
what morphological classifications of synovial joints would be classified as biaxial
(diarthrosis) bicondylar, (diarthrosis) condylar, (diarthrosis) ellipsoidal and saddle (diarthrosis sellar)
what morphological classification of synovial joints would be classified as multiaxial
ball and socket (diarthrosis enarthrosis, diarthrosis spheroidal, diarthrosis cotyloid) are all classifications given to the same type of joint
diarthrosis ginglymus joints are commonly called _______ joints based on action
synovial hinge
diarthrosis trochoid joints are commonly called ______ joints based on action
syonival pivot
what are the common ligaments of the vertebral column
those ligaments commonly found between vertebral couples from c2/c3 to l4/l5
what is the maximum number of common ligaments identified with a vertebral couple
8
what is the reason the nine common ligaments are identified but only eight will be attached at any specific vertebral couple
the ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple
in the fetus, which vertebral levels will demonstrate intervertebral discs
those between c2 and co1 exclusively
what is the number of true intervertebral discs identified in the adult
23
in the adult, which vertebral levels will demonstrate a true intervertebral disc
those between c2 and s1 inclusive
what is the percent of intervertebral disc height contribution to the length of each region of the vertebral column
cervical - 22-25%
thoracic - 20%
lumbar - 33%
what is the effect of aging on the intervertebral disc nucleus pulposus
it becomes more fibrous as water and proteoglycan concentrations diminish
what is the cervical nucleus polposus composed of
fibrocartilage
what is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus
the nucleus pulposus will lose water under deformation conditions
what cell is associated with the nucleus pulposus until about age eleven
notochord cells
which type of collagen is dominant in the nucleus pulposus
collagen type 2
what is unusual about the cervical annulus fibrosus
it lacks any lamellar or layered organization
what is the appearance of the cervical annulus fibrosus
a horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinated processes; the posterior margin is thin
what is the organization of the lumbar annulus fibrosus
it has 12-14 concentric cylindrical lamellae
what is the consequence of aggregated glycosaminoglycans in the lumbar annulus fibrosus
the annulus fibrosus will retain water under deformation conditions
which type of collagen is dominant in the annulus fibrosus
collagen type 1
what is the organizational pattern for collagen fibers in the annulus fibrosus
they are parallel with one another in a single lamellus and angled
what is the organization of collagen fibers between lamellae
collagen fibers will be angled in the opposite direction such that a spiral-counterspiral organization is observed
what is the average angle of collagen fibers within the annulus fibrosus
50 to 60 degrees
what is the principal type of collagen fiber within the cartilage end plate
the type 2 collagen fiber
what is the direction of collagen fibers within the cartilage end plate
collagen fibers are aligned anterior to posterior
what cell type is associated with the cartilage end plate
chondrocytes
what is the earliest indicator of intervertebral disc pathology or degeneration
changes in the histology of the cartilage end plate
what part of the intervertebral disc is the ‘growth plate’
the transition zone
what part of the intervertebral disc is innervated
the outer lamellae of the annulus fibrosus
what part of the cervical intervertebral disc is highly innervated
the middle third of the annulus fibrosus
what is the relationship between size of the intervertebral disc and receptor endings
the larger the disc, the greater the variety of receptor endings
what is the proposed function of receptor ending density in the anterior part of the intervertebral disc
they provide feedback during extension
what forms the posterior neural plexus of the vertebral column
the sinu-vertebral nerve (sinus vertebral nerve, recurrent meningeal nerve)
what forms the anterior neural plexus of the vertebral column
fibers from the ventral primary ramus
what is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebraldisc
the paradiscal ramus communicans
what innervates the outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc
fibers from the ventral primary ramus
fibers from the white ramus communicans
fibers from the paradiscal ramus communicans
fibers from the gray ramus communicans
what structure is formed following migration of sclerotomes to surround the notochord
the perichordal blastema
what is formed wihin the perichordal blastemal between the sclerotomites
the intrasclerotomal fissure or fissure of von Ebner
what does the intrasclerotomal fissure of von Ebner become
the perichordal disc
what part of the intervertebral disc will the notochord form
the nucleus pulposus
what part of the intervertebral disc will the peridchordal disc form
the annulus pulposus
what is the earliest indicator of the position of the adult intervertebral disc
the intrasclerotomal fissure of fissure of von Ebner
what will the ligamenetum nuchae be attached to
the external occipital protuberance
external occipital crest
posterior tubercle of the posterior arch of c1
spinous tubercles between c2 and c7 inclusive
what is the name given to the superficial layer of the ligamentum nuchae
the funicular layer or part
what is the name given to the deep layer of the ligamentum nuchae
the lamellar layer or part
what are the attachment sites for the superficial layer of the ligamentum nuchae
external occipital protuberance
external occipital crest
spinous tubercle c7
what is the histological make-up of the ligamentum nuchae in quadrupeds
it is a yellow elastic ligament
what is the primary yellow elastic or elastic ligament of the spine
the ligamentum flavum
what will the supraspinous ligament be attached to
the spinous tubercles along the vertebral from c7 to sacrum
what is the termination level inferiorly for the supraspinous ligament according to current literature
primarily at L4 (73%); between L4 and L5 (5%)
where is the supraspinous ligament said to be best developed
in the lumbar spine
what is now thought to be a major function of the supraspinous ligament
it is a proprioceptive transducer for the spinal reflex
what will the intertransverse ligament be attached to
the transverse tubercles and transverse processes of adjacent vertebrae along the vertebral column from C1 to L5
what is the status of the cervical intertransverse ligament
it is said to be paired with an anterior and a posterior intertransverse ligament present
what is the status of the lumbar intertransverse ligament
it is well developed with two parts identified; a ventral slips and a dorsal slip
what part of the lumbar intertransverse ligament covers the intervertebral foramen
the ventral slip
what part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment
the dorsal slip
what are the attachment sites of the anterior atlanto-occipital ligament
it is attached to the upper margin of the anterior arch of c1 and to the anterior margin of the foramen magnum
what is the median thickening of the anterior atlanto-occipital ligament called
the anterior longitudinal ligmanet
what is the classic function of the anterior atlanto-occipital ligament
it brakes or limits ‘extension’ of the skull over the cervical spine
what is the classic function of the posterior atlanto-occipital ligament
it brakes or limits axial rotation, flexion, and perhaps lateral bending of the skull on atlas
what amount of flexion-extension is accommodated by the atlanto-occipital joint
about 25 degrees
what amount of axial rotation is accommodated by the atlanto-occipital joint
about three to eight degrees one side axial rotation
what amount of lateral bending is accommodated by the atlanto-occipital joint
about five degrees
which motion is best accommodated by the atlanto-occipital joint
flexion-extension
what are the joint surfaces of the median atlanto-axia joint at the anterior bursa
the fovea dentis of c1 and the facet for fovea dentis of c2
what are the joint surfaces of the median atlanto-axial joint at the posterior bursa
the groove for the transverse atlantal ligament of c2 and the transverse atlantal ligmanent
what ligament is formed by the transverse atlantal ligament and its perpendicular extensions
the cruciate ligament or cruciform ligament
what is the function of the transverse atlantal ligament
it is the primary stabilizer of the atlanto-axial joint; restricting the distance of c2 from the anterior arch of c1
what is the ADI
the ATLANTO-DENTAL INTERSPACE, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
what is the ADI of children compared with that of adults
about 4.5 mm in children; a range of 2-3 mm or about 2.5 mm in adults
what are the characteristics of the capsular ligament of the lateral atlanto-axial joint
it is lax or loose and demonstrates a meniscoidal fold within the joint cavity
where is the accessory atlanto-axial ligament observed
anterior to the membrane tectoria/tectorial membrane
what are the attachment sites for the accessory atlanto-axial ligament
the base of the odontoid process and vertebral body of axis to the tubercle for the transverse atlantal ligament on the lateral mass of c1; a superior continuation may attach on the occipital bone just behind that of the alar ligament
what ligament forms the posterior boundary of the spinal canal at the c1/c2 vertebral couple
the posterior atlanto-axial ligament
what are the degrees of movement facilitated at the atlanto-axial joint
about 20 degree flexion-extension
40 degrees one side axial rotation
5 degrees of lateral bending
the occiput-c1-c2 joint complex accounts for what percent of all cervical axial rotation
about 60%
what name is given to the occipital-c2 region of the spine
the craniovertebral junction
what ligaments are present at the occipito-axial joint
the apical ligament of the dens/apicodental ligament
alar ligaments
mebrana tectoria/tectorial membrane
what ligament attaches to the anterior margin of the foramen magnum and the tip of the odontoid process of c2
the apical ligament of the dens or the apicodental ligament
embryologically, what forms the apical ligament of the dens or the apicodental ligament
the notochord
what is the function of the apical ligament of the dens or the apicodental ligament
it has no known function
what ligament attaches to the posterolateral part of the odontoid process of c2 and to surfaces on the medial border of the occipital condyle or as far anterior as the anterolateral margin of the foramen magnum
the alar ligament
what is the function of the alar ligament
together they function to resist axial rotation
what forms the cranial continuation of the posterior longitudinal ligament
the membrana tectoria
what ligament is anterior to the dura mater of the medualla oblongata-spinal cord junction
the membrana tectoria
what is the function of the membrana tectoria
it resists flexion and extension of the skull on the upper cervical spine
list, in order, the ligaments in a midsagittal plane from the dura mater at the level of the medulla oblongata to the anterior bursa of the median atlanto-axial joint
membrana tectoria
the cruciate ligament
the capsular ligament of the posterior bursa of the median atlanto-axial joint
the apical ligament of the dens
for the cervical spine below c2, what is the range of flexion-extension
about 90 degrees or about 18 degrees per couple
for the cervical spine below c2, what is the range of one side lateral bending
about 50 degrees or about 10 degrees per couple
for the cervical spine below c2, what is the range of one side axial rotation
about 33 degrees or about six degrees per couple
what are the joint surfaces of the constocentral joint of the first, eleventh and twelfth ribs
the superior costal facet on the vertebral body of t1, t11 or t12 and the articular surface of the head of the first, eleventh or twelfth rib
an intra-articular ligament will be identified with which ribs
ribs 2-9
at what rib will the superior costotransverse ligament be absent
the first rib
what ligaments will attach to the neck of the twelfth rib
the superior costotransverse ligament from t11 and the lumbocostal ligament from l1
which ribs will have an attachment for the inferior costotransverse ligament
rib 1-11
what ligament ‘fills’ the costotransverse foramen
the inferior costotransverse ligament
which vertebrae will have an attachment for the lateral costotransverse ligament
t1-t11
at what rib will the lateral costotransverse ligament be absent
the twelfth rib
which vertebral couples of the thoracic spine have the great motion
t11/t12 and t12/l1
which range of motion is greatest for lower thoracic vertebral couples
flexion-extension
which range of motion is least for lower thoracic vertebral couples
one side axial rotation
which ligaments replace the intertransverse ligament at the lumbosacral joint
the iliolumbar ligament and lumbosacral ligament
what muscle is intimately attached to the superior iliolumbar ligament
quadratus lumborum
which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical description
the superior iliolumbar ligament
which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions
the inferior iliolumbar ligament
which vertebral couple of the lumbar spine has the greatest range of motion
l5/s1
which range of motion is greatest for all lumbar vertebral couples
flexion-extension
which range of motion is least for l1-l5 vertebral couples
one side axial rotation
which range of motion is least for the l5-s1 vertebral couple
one side lateral bending
what ligament represents the continuation of the posterior longitudinal ligament at the sacrococcygeal joint
the deep posterior sacrococcygeal ligament
list, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal
the membrana tectoria
posterior longitudinal ligament
deep posterior sacrococcygeal ligament
what ligament represents the homolog of the ligamentum flavum at the sacrococcygeal joint
the superficial posterior sacrococcygeal ligament
list, in order, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal
the posterior atlanto-occipital ligament
posterior atlanto-axial ligament
ligamentum flavum
superficial posterior sacrococcygeal ligament
which gender has greater unevenness of the auricular surfaces of the sacro-iliac joint
males
what forms the accessory sacro-iliac joint
the sacral tuberosity and the iliac sulcus
what pathological or age-related modifications of the sacro-iliac joint may occur
degenerative arthrosis and ankylosis
what is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint
age 40
the iliac auricular surface
what is the age and gender bias associated with ankylosis of the sacro-iliac joint
age 50
male (particularly African American males)
which is the strongest of the sacro-iliac ligaments
the interosseous sacro-iliac ligament
what passes between the layers of the interosseous sacro-iliac ligament
dorsal rami from the sacral spinal nerves
what ligament blends with the lateral border of the long posterior sacro-iliac ligament
the sacrotuberous ligament
what is formed by the continuation of the sacrotuberous ligament along the ischial ramus
the falciform process
what seperates the greater sciatic and lesser sciatic foramen
the sacrospinous ligament
what vertebral levels correspond to the position of the manubrium sterni
t3-t4
what separates the manubrium sterni and corpus sterni
the manubriosternal symphysis
what vertebral levels correspond to the position of the corpus sterni
t5-t9
how many sternabrae form the corpus sterni
4 sternabrae
what surface feature on the corpus sterni identifies the location of the synchondroses
transverse lines
what articular sites for the costal cartilage of ribs will be identified on the corpus sterni
costal notches 2-7
what feature of the corpus sterni is present in 4-7% of the population
a sternal foramen
what are the primary parts of the vertebral end of a typical rib
the head, neck and tubercle
what attaches to the crest of the neck of the rib
the superior costotransverse ligament
what attaches to the non-articular surface of the tubercle of a rib
the lateral costotransverse ligament
what features may be identified on the body (corpus or shaft) of a typical rib
the costal angle and costal groove
what attaches to the costal angle of a rib
the iliocostalis muscle and thoracolumbar aponeurosis/fascia
what attaches to the scalene tubercle of the first rib
the anterior scalene muscle
which groove on the body (corpus or shaft) of the first rib is close to the vertebral end
the groove for the subclavian artery and the first thoracic nerve
which grove on the body (corpus or shaft) of the first rib is close to the sternal end
the groove for the subclavian vein
is either the costal angle or costal groove apparent on the first rib
neither the costal angle nor the costal groove are apparent on the first rib
what does the interarticular ligament of the head of the second rib join to
the interarticular crest on the head of the second rib and the interbertebral disc between t1-t2
what specifically will attach to the crest of the neck of the second rib
the superior costotransverse ligament from the transverse process of t1
what specifically attaches to the back of the neck of the second rib
the inferior costotransverse ligament from the transverse process of t2
what specifically attaches tot he non-articular surface of the tubercle of the second rib
the lateral costotransverse ligament from the transverse tubercle of t2
what unique feature is present on the body (corpus or shaft) of the second rib
the tuberosity for the serratus anterior
what features are identified on the body (corpus or shaft) of rib 10
the costal angle and the costal groove
what features may be present on the body of the eleventh rib
the costal angle and costal groove are under-developed
what is the condition of the body of rib 12
the costal angle and costal groove are absent and it is the shortest of all the ribs
what are the classifications of ribs 3-7 in the typical adult skeleton
typical, true (costae verae), vertebrosternal
what are the classifications of ribs 1 and 2 in the typical adult skeleton
atypical, true (costae verae), vertebrosternal
what are the classifications of ribs 8 and 9 in the typical adult skeleton
typical, false (costae spuriae), vertebrochondral
what are the classifications of rib 10 in the typical adult skeleton
atypical, false (costae spuriae), vertebrochondral
what are the classifications of ribs 11 and 12 in the typical adult skeleton
atypical, false (costae) spuriae), vertebral
what are the examples of the typical syndesmosis from the vertebral column
most of the ligamentous joints of the vertebral column and anterior thorax
which cartilage joint forms between ossification centers within a cartilage template
ampiarthrosis synchondrosis
which classification of cartilage joint is primary, temporary and composed of hyaline cartilage
ampiarthrosis synchondrosis
what are examples of a permanent ampiarthrosis synchondrosis
costochondral joints or the first sternochondral joint
which cartilage joint occurs between bones formed by endochondral ossification
ampiarthrosis symphysis
what are the characteristics of an ampiarthrosis symphysis
limited motion, median plane location, support ligaments both anterior and posterior to the joint, more permanent in longevity than synchondrosis and the occur between bones developing by endochondral ossification
which ribs demonstrate costochondral joints
all 12 ribs
what are the joint surfaces of the costochondral joint
the costal cartilage with the sternal end of each rib
what is the joint classification of the costochondral joint
cartilaginous ampiarthrosis synchondrosis
what is the sternocostal or sternochondral joint
the joint between the costal cartilage and the costal notches of the sternum
what ribs will participate in the sternocostal or sternochondral joint
rib 1 to rib 7
what is the classification of the first sternocostal or sternochondral joint
cartilaginous ampiarthrosis synchondrosis
what is the classification of the secon-seventh sternocostal or sternochondral joint
synovial plane (diarthrosis arthrodia)
which of the sternocostal or sternochondral ligaments is unique to the second sternocostal or sternochondral joint
the intra-articular ligament
what joint classification is associated with the intra-articular ligament of the second sternocostal or sternochondral joint
fibrous ampiarthrosis syndesmosis
what is the classification of the sixth through the ninth interchondral joints
synovial plane diarthrosis arthrodia
what is the classification of the fifth-sixth or ninth-tenth interchondral joint
fibrous ampiarthrosis syndesmosis
which costal cartilages fail to form a joint at their sternal end
the eleventh and twelfth costal cartilges
what is the homolog of the intertransverse ligament at the sacrococcygeal joint
the lateral sacrococcygeal ligament
what is the homolog of the capsular ligament at the sacrococcygeal joint
the intercornual ligament
what is the auricular surface of sacrum composed of
true articular cartilage, a modification of hyaline cartilage
what is the auricular surface of the ilium composed of
articular cartilage, interspersed with fibrocartilage
how many primary centers of ossification appear in the manubrium
1-3 centers have been identified
how many primary centers of ossification appear in the corpus sterni
typically 6
what are the locations of the primary centers of ossification in the corpus sterni
one in each of the first two sternabrae and bilateral centers in the last two sternabrae
in what part of the sternum will a secondary center of ossification appear
the xiphoid process
in what part of the rib will primary centers of ossification appear
the body (corpus, shaft)
in what parts of the rib will secondary centers of ossification appear
the head, articular surface of the tubercle and the non-articular surface of the tubercle
which ribs will demonstrate primary centers of ossification for the body (corpus or shaft)
all ribs; ribs 1-12
which ribs will demonstrate secondary centers of ossification
ribs 1-10
how does rib 1 differ in ossification centers from typical ribs
rib 1 has two secondary centers of ossification; one for the head and one for the tubercle; typical ribs have three secondary centers of ossfication
how do ribs 11 and 12 differ in ossification centers from typical ribs
ribs 11 and 12 do not have secondary centers of ossification
what are the four sub-classifications of synarthrosis joints based on Latin groupings
suture, gomphosis, schindylesis and syndesmosis
what are the characteristics of sutura vera (true sutures)
sutures demonstrating interlocking of the adjacent bone surfaces; typically formed by intramembranous ossification
what are the characteristics of sutura notha (false sutures)
sutures lacking interlocking of adjacent bone surfaces; typically formed by endochondral ossification
which sutures will interlock and overlap at their edges
limbous sutures
which sutures demonstrate non-interlock, but will overlap at their edges
squamous sutures
which sutures will neither interlock nor overlap at their edges
harmonia sutures
what is the classification of a joint with a ‘fissure-like” condition
schindylesis
what are the typical examples of the plane suture or harmonia suture
cruciate suture made up of the intermaxillary, interpalatine and palate-maxillary sutures
what are the examples of the gomphosis joint
maxilla-root of tooth; mandible-root of tooth
what forms a bullet-like chin
a large mental protuberance
what forms an indented chin
well developed bilateral mental tubercles and a slight mental protuberance
what is the tip of the external occipital protuberance called
the inion
what is the name of the linear elevation lateral to the external occipital protuberance
superior nuchal line
what is the appearance of suture intersections just above the zygomatic arch called
the pterion
what point on the skull are used to measure the skull size
the nasion, vertex, inion and gnathion
what points on the skull are used to measure cranial vault capacity
the nasion, vertex and inion
what is the appearance of the suture intersections over the hard palate called
the cruciate or cruciform suture
what is the posterior boundary of the anterior cranial fossa
a line drawn along the lesser wing of the sphenoid, anterior clinoid processes, and sphenoidal jugum
what ostia are observed in the anterior cranial fossa
cribriform plate, anterior and posterior ethmoid foramina and foramen cecum
what passes through the cribriform plate
fila olfactoria of cranial nerve 1, the olfactory nerve
what is the posterior boundary of the middle cranial fossa
superior border of petrous part of temporal bone, posterior clinoid processes and dorsum sella of sphenoid bone
what prominent parts of the brain rest on the middle cranial fossa
temporal poles of temporal lobes of cerebrum, hypophysis cerebri, optic chiasma
what bony feature is prominent in the median plane of the middle cranial fossa
sella turcica
which cranial nerves exit the skull via middle cranial fossa ostia
cranial nerves 2, 3, 4, 5 and 6
what are the contents of the optic canal
the optic nerve and ophthalmic artery
what are the contents of the superior orbital fissure
the ophthalmic veins, the oculomotor nerve, the trochlear nerve, the ophthalmic division of the trigeminal nerve, and the abducent nerve
the maxillary division of the trigeminal nerve exits the middle cranial fossa via which opening
the foramen rotundum
what are the contents of the foramen ovale
the mandibular division of the trigeminal nerve (Vc) and the lesser petrosal branch of the glossopharyngeal nerve
the mandibular division of the trigeminal nerve exits the middle cranial fossa via which opening
the foramen ovale
what are the contents of the foramen spinosum
the nervus spinosus from the mandibular division of the trigeminal never and the middle meningeal artery
what opening allows a branch of cranial nerve Vc to enter the middle cranial fossa from the infratemporal region
the foramen spinosum
which ostia will not exit the skull from the middle cranial fossa in the living person
the foramen lacerum, the hiatus for the greater (superficial) petrosal nerve and the hiatus for the lesser petrosal nerve
what forms the roof of the posterior cranial fossa
the tentorium cerebelli
what part of the central nerve system occupies the posterior cranial fossa
the cerebellum, pons, and medulla oblongata
which cranial nerves exit posterior cranial fossa ostia
cranial nerve 7 (facial), 8 (vestibulocochlear/auditory), 9 (glossopharyngeal), 10 (vagus), 11 (Spinal accessory), and 12 (hypoglossal)
meningeal nerves in the foramen magnum are derived from which cord levels
c1-c3 cord levels
which arteries arise in the posterior cranial fossa and descend through the foramen magnum to supply the spinal cord
anterior and posterior spinal arteries
what are the contents of the internal acoustic meatus
cranial nerves 7 (facial nerve) and 8 (vestibulcochlear/auditory nerve), the nervus intermedius/nerve of Wrisberg/sensory foot of 7 and the motor root of 7, the vestibular and cochlear roots of 8 and the internal auditory/internal labyrinthine artery and vein
what are the contents of the jugular foramen
the jugular bulb, the inferior petrosal sinus, the tympanic body/tympanic glomus or jugular body/jugular glomus, cranial nerves 9 (glossopharyngeal), 10 (vagus) and 11 (spinal accessory)
what can the five layers of the scalp spell
SCALP
skin, connective tissue, aponeurosis, loose connective tissue, periosteum
what are the principal sources of blood to the scalp
internal carotid and external carotid artery branches
which divisions of the trigeminal nerve receive sensory information from the scalp
all 3 divisions: ophthalmic nerve, maxillary nerve, and mandibular nerve
which ventral rami nerve(s) and cord levels of origin supply the scalp
greater auricular nerve - c2, c3 ventral rami branches;
lesser occipital nerve - c2, c3 ventral rami branches
which dorsal ramus nerve branch (name and cord level of origin) supplies the scalp
greater occipital nerve - c2, c3 communicating branch
what type of motor fibers to skeletal muscle are given off by the facial nerve
branchial efferent (BE)
what are the lymph nodes located along the base of the head collectively called
collar chain nodes
what is the third layer of the scalp associated with
muscular component of the scalp
what is unusual/unique about the muscles of the face
they do not act as lever muscles; they do not attach to bone at both origin and insertion
which muscles lack any attachment to bone
orbicularis oris, procerus and risorius
what is the source of innervation for all muscles of faciaql expression
facial nerve branches
which divisions of the trigeminal nerve receive sensory information from the face
all 3 divisions: ophthalmic, maxillary and mandibular
what opening(s) are located along the superior wall of the orbit
optic canal
what is the name given to the medial wall of the orbit
lamina papyracea
what features may be observed on the medial wall of the orbit
lacrimal groove, fossa for the lacrimal sac, anterior ethmoid foramen and posterior ethmoid foramen
what opening(s) are located along the lateral wall of the orbit
superior orbital fissure
what opening(s) are located along the inferior wall of the orbit
inferior orbital fissure
what is contained in the inferior orbital fissure
maxillary division of trigeminal nerve
what are the layers of the eyelid
skin, orbicularis oculi muscle, tarsal plate/tarsus, palpebral conjunctiva
what are the names given to the modified sebaceous gland in the tarsus of the eyelid
tarsal or Meibomian gland
what is the function of the Meibomian gland
produces a thick, hydrophobic substance that prevents tears from overflowing onto the cheeks along the margin of the eyelid
what is the ciliary gland
the modified sebaceous gland at the base of the eyelash
what are the names given to the modified sebaceous glands of the palpebra
tarsal gland or Meibomian gland and ciliary duct
what is the name given to the inner mucous membrane of the eyelid
palpebral conjunctiva
which cranial nerves are involved in the Visceral Efferent (VE) parasympathetic pathway to the lacrimal gland
facial and trigeminal (maxillary and ophthalmic divisions/branches)
preganglionic visceral efferent fibers of cranial nerve VII will exit the pons in what nerve
nervus intermedius, nerve of Wrisberg, sensory root of facial nerve
what are the names of the ganglion of synapse in the efferent pathway to the lacrimal gland
pterygopalatine ganglion, sphenopalatine ganglion, Meckel’s ganglion
parasympathetic stimulation of blood vessels in the lacrimal gland will result in what events
vasodilation of blood vessels, increased availability of water to secretory units, thinner or more watery product in lumen
what is the origin for the sympathetic pathway to the lacrimal gland
lateral horn/intermediolateral cell column T1, T2
sympathetic stimulation of the lacrimal gland will result in what events
vasoconstriction of blood vessels, limited availability of water to secretory units, more viscous or thicker product formed in glandular lumen
what are the names of the layers of the eyeball
fibrous tunic, uveal tract and retina
what are the parts of the fibrous tunic of the eyeball
cornea and sclera
what are the parts of the uveal tract of the eyeball
iris, ciliary body, choroid and pupil
