Test 2 Flashcards
What will influence spinal kinematics?
geometry of articular facets, mechanical properties of connective tissue, mechanical properties of muscle
The greatest range of flexion-extension among the typical cervical vertebrae occurs at which vertebral couple?
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 be similar for what cervical vertebral couples?
C2/C3, C3/C4, C4, C5 vertebral couples
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 Caucasian typical cervical spinous process?
they are bifid
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?
spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis
What will form the anterior boundary of a typical cervical intervertebral foramen?
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
What will form the posterior boundary of a typical cervical intertertebral foramen?
the inferior articular process (post-zygapophysis), the superior articular process (pre-zygapophysis), the capsular ligament and the ligamentum flavum
What forms the unique anterior boundary of the intervertebral foramen for C4 spinal nerve?
the lateral groove of C3 and uncinate process of C4 forming the joint of Luschka
What is the name of the first cervical vertebra?
atlas
What features are lacking at C1?
vertebral body, pedicles, a spinous process and intervertebral disc
What muscle attaches to the anterior arch of C1?
longus colli
What ligaments will attach to the anterior arch of C1?
anterior longitudinal, anterior atlanto-occipital and anterior alanto-axial ligaments
What is observed on he back of the anterior arch of C1?
fovea dentis
What is the morphology of the superior articular facet of C1?
they are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces
What is the orientation of the superior articular facet of C1?
backward, upward, medial (BUM)
What is the joint classification of the alanto-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 plane (diarthrosis arthrodia) joint
What is the name of the rounded elevation on the medial aspect of the lateral mass of C1?
tubercle for the transverse atlantal ligament
What muscles attach to the lateral mass of C1?
levator scapula, splenius cervicis and rectus capitis anterior
What is the contribution of the posterior arch to the circumfrence of C1?
about 40%
What part of C1 represents the spinous process?
posterior tubercle of the posterior arch
What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?
Males: 50mm
Females: 37mm
What attaches to the posterior tubercle of the posterior arch of C1?
rectus capitis posterior minor muscle and ligamentum nuchae
What attaches to the arcuate rim of C1?
posterior atlanto-occipital ligament
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
What may be formed by ossification of the anterior free margin of the posterior atlanto-occipital ligament?
a partial ponticulus posticus or complete ponticulus posticus
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 ethnic populations studied thus far
What is the general range of incidence of ponticulus posticus in the populations studied?
1-41%
What is the gender bias now associated with ponticulus posticus?
female
What is the location of the “zygapophysis” relative to the atlanto-occipital and atlanto-axial intervertebral foramina?
it forms part of the anterior boundary of the interbertebral foramen in both cases
What are the osseous parts of the transverse process of C1?
costal element, posterior tubercle, true transverse process
What osseous parts of the transverse process are absent at C1?
anterior tubercle and costotransverse bar
What muscles atach 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 intertransversarii muscles
What supoccipital 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?
retrotransverse foramen
What are the possible contents of the retrotransverse foramen?
the vertebral artery, a branch from the supoccipital nerve and veins communicating with the venous sinuses of the neck
Which of the ponticles (bridges) of atlas is most numerous?
ponticulus posticus
Which of the ponticles (bridges) of atlas is only observed in humans?
lateral bridges
What is observed in the transverse foramen of C1?
vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is teh gender variation for measurements of the transverse diamteter of C1?
males: 78mm
females: 72mm
What is the distance from the posteiror tubercle of the transverse process of C1 to the skin for each gender?
a little over 30 mm for both males and females
What joint classifications are observed at C1?
fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial pivot (diarthrosis trochoid) joint and synovial plane (diarthrosis arthrodia) joint
How many synovial joint surfaces are observed at C1?
five
What synovial joint surfaces are observed at C1?
two superior articular facets, two inferior aricular facets and fovea dentis
What names are given to C2?
axis or epistropheus
What unique vertebral body modification is characteristic of C2?
dens or odontoid process
How many joint surfaces are present on the odontoid process of C2?
5
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, attachement site for the apical dental ligament
Which joint classifications are represented at the odontoid process of C2?
fibrous (amphiarthrosis) syndesmosis and synovial pivot (diarthrosis trochoid) joint
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 alarligaments appear to be directed anterior?
kyphotic dens
What joint surfaces are present at the inferior part of the vertebral body of C2?
anterior lip, posterior lip, right and left lateral grooves and cancellous bone
How many joints ar formed by the inferior part of the vertebral body of C2?
f5
What joint classifications are present at the inferior part of the vertebral body of C2?
fibrous (amphiarthrosis) syndesmosis, modified synovial saddle (diarthrosis sellar), and cartilaginous (amphiarthrosis) symphysis
How many joint surfaces are present at the vertebral vody of C2?
10
What joint classifications are present at the vertebral body of C2?
fibrous (amphiarthrosis) syndesmosis, synovial pivot (diarthrosis trochoid), modified synovial saddle (diarthrosis sellar) and cartilaginous (amphiarthrosis) symphysis
What ligaments will attach posteriorly, to the inferior epiphyseal rim of C2?
membrana tectoria and posterior longitudinal ligament
What ligament will represent the cranial continuation of the posterior longitudinal ligament?
membrana tectoria
What ligament forms the anterior boundary for the spinal canal below C2?
posterior longitudinal ligament
What lies on the upper surface of the pedicle of C2?
the superior articular process
What location of the superior vertebral notch of C2?
on the lamina-pedicle junction
What attaches to the lamina of C2?
obliquus capitis inferior, posterior atlanto-axial lig, ligamentum flavum
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 facet of C2?
backward, upward, lateral (BUL)
What is the orientation of the inferior articular facets of C2?
forward, lateral, 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: 57mm
females: 50mm
What muscles attach to the transverse process at C2?
levato scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii
What is the characteristic appearance of the C2 spinous process in humans?
bifid
What muscles attach to the spinous process of C2?
rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, 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 and T1 is more common in males
What joint surfaces are present at the superior margin of the vertebral body of C7?
anterior groove, posterior groove, right and left uncinate processes, cancellous bone
What joint surfaces are present at the inferior margin of the vertebral body of C7?
anterior and posterior margins of the inferior epiphyseal rim, cancellous bone
How many joint surfaces are present at the vertebral body of C7?
8
What joint classifications are observed at the vertebral body of C7?
fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis, modified synovial saddle (diarthrosis sellar)
How many synovial joint surfaces are observed at the vertebral body of C7?
2
What synovial joint surfaces are observed at the vertebral body of C7?
right and left uncincate processes
What muscle attaches to the vertebral body of C7?
longus colli
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 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?
longissius cervicis, longissimus capitis, semispinalis cervicis and multifidis
What are the features of the spinous process of C7?
long, horizontal, nonbifid
What muscles attache 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 was the anme of the physical exam used to determine vertebral artery patency?
vertebrobasilar artery insufficiency test
Which side artery was tested during the course of the vertebrobasilar artery insufficiency exam?
the ipsilateral artery on the side of rotation
What are they symptoms of failure of the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?
dizziness, vertigo, nausea are common complaints
The vertebral artery is typically a branch of which artery?
subclavian artery
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?
atlanto-occipital interspace
At what segments will the vertebral artery be firmly attached to the transverse foramen?
C1 and C2
What is the purpose of the vertebral artery loops between occiput, C1 and C2?
increased length will accommodate the greater rotation at these locations
What forms the boundaries for the exit of the C1 nerve from the spinal canal?
occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament
What forms the anterior boundary for the C2 nerve exit from the spinal nerve?
inferior articular process of C1, superior articular process of C2, capsular ligament
What forms the posterior boundary for the C2 nerve exit from the spinal canal?
the posterior arch of C1, lamina of C2 and posterior atlanto-axial ligament
What forms the anterior bodies for the C3-C7 nerve exit from the spinal canal?
intervertebral disc, posterior longitudinal ligament, uncinate process, lateral groove
How many synovial joints are identified for each cervical vertebrae?
C1= 5 C2= 8 C3-6= 8 C7= 6
How many joints are identified at the vertebral body of each cervical vertebra?
C1= 1 C2= 10 C3-6= 10 C7= 8
Which thoracic segments are considered the typical thoracics?
T2-T8
What features will allow discrimination between T2-T4 and T5-T8 segmental groups?
vertebral body, transverse process, articular process and spinous process
What is the outline of the vertebral body of a typical thoracic from superior view?
triangular
On cranial view, what is the outline of the vertebral body for T5-T8?
left side of the verteral body will be flattened, the right side convex
What is the name given to the left side appearance of the vertebral body of T5-T8?
aortic impression
What part of the vertebral body is most influenced by the aorta at T5-T8?
left side superior and inferior epiphyseal rims
What is the height pattern of the typical thoracic vertebral body?
posterior height is greater than the anterior height by one or two millimeters
What is the height pattern of intervertebral discs in the typical thoracic region?
the interbertebral discs are rather planar or flat with no apparent height difference between anterior and posterior heights
What is the principal cause of the posterior curve of the thoracic spine?
vertebral body height differences
In terms of the anterior-posterior curves of the vertebral column, what direction will the thoracic spine face?
posterior
What is another way of naming a posterior curve pattern?
kyphotic curve
What joint classifications are identified at the vertebral body of a typical thoracic?
fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis, synovial plante (diarthrosis arthrodia)
What does the costocentral intra-articular ligament connect to?
interarticular or intra-articular crest of the head of the rib and the intervertebral disc
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 syndesmosis joints are formed at the vertebral body of a typical thoracic?
typically four are identified (as many as 8 if the costocentral stellate/ratiate ligaments are included)
How many joints are formed at the vertebral body of a typical thoracic?
typically ten (fourteen if the costocentral stellate/ratiate ligaments are included)
What is the name given to the joint formed between the vertebral body and rib?
costocentral joint
How many costocentral joints are formed at the vertebral body of a typical thoracic?
four
Which part of the demi-facets on the vertebral body of a typical thoracic is larger?
superior costal demi-facet
What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?
costocentral joint or ribs
What ligaments support the costocentral joint?
costocentral stellate/radiate ligament and the costocentral interarticular or intra-articular ligament
The costocentral stellate/radiate ligament will attach to which segments at T3 spinal nerve intervertebral foramen?
vertebral body of T3 and vertebral body of T4
What is the size relationship between the articulating surface of the head of the rib and the costal demi-facet surface?
rib surface is greater than the costal demi-facet surface
Which muscle is attached to the vertebral body of T2 or T3
longus colli
What is the position and direction of the pedicle from the typical thoracic vertebral body?
pedicle arises from the upper third of the vertebral body and projects posterior and slightly laterally
What is the angulation of the pedicle in the typical thoracic region?
10-15 degrees posterolateral from the sagittal plane
Which X-Ray view is used to see into the intervertebral foramen of a typical thoracic?
lateral view
What is overlap of the lamina called in the typical thoracic region?
shingling
What is the outline of the vetebral foramen in the typical thoracic region?
oval to circular
In which plane will the size of the vertebral foramen of a typical thoracic be greatest?
transverse plane, vertebral transverse diameter
What is the direction of the transverse process in the typical thoracic?
transverse process projects more posterior with each inferior vertebra
What is present at the tip of the transverse process of a typical thoracic?
transverse tubercle
What are the osseous parts of the costotransverse joint?
the transverse costal facet and the articular surface of the tubercle of a rib
What ligaments support the costotransverse joint of a typical thoracic?
superior costotransverse, inferior costotransverse and lateral costotransverse ligaments
Which muscles may attach to the transverse process of a typical thoracic?
longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis thoracis, semispinalis cervicis, sempispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis
How can you distinguish between a T2-T4 from T5-T8 segment using the articular process?
T2-T4: width between the superior articular process is greater than the width between the inferior articular processes of that vertebra
T5-T8: width between superior articular processes is equal to or the same as the width between the inferior articular processes of that vertebra
What is the orientation of the superior articular facet of a typical thoracic?
backward, upward, lateral (BUL)
What is the orientation of the inferior articular facet of a typical thoracic?
forward, downward, medial (ForMeD)
How many synovial joint are present at a typical thoracic?
10
Which muscles may attach to the spinous process of a typical thoracic?
trapezius, latissimus dorsi, rhomboid major, serratus posterior superior, splenius cervicis, splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator previs and interspinalis
How many synovial joint surfaces for ribs are present on a typical thoracic?
6
Identify the synovial joint surafces for ribs that are present on a typical thoracic?
two superior costal demi-facets, two inferior costal demi-facets, two transverse costal facets
What is imbrication?
the overlap of spinous processes
Imbrication will be more pronounced for what region of the thoracics?
T5-T8
Which thoracic has the longest spinous process?
T8
What is the angulation of the spinous process in a typical thoracic region?
undersurface of T2-4 spinous processes will angle up to 40 degrees from horizontal plane
undersurface of T5-T8 spinous processes will angle up to 60 degrees from the horizontal plane
What joint classifications are identified at the vertebral body of T1?
fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and synovial plane (diarthrosis sellar) is only observed as an anatomical variation
How many joints are formed at the vertebral body of T1?
typically 10 (14 if the rib ligaments are included)
Costocentral stellate/ratiate ligament will attach to which segments at the C8 spinal nerve intervertebral foramen?
vertebral body of C7 and vertebral body of T1
Costocentral stellate/radiate ligament will attach to which segments at the T1 spinal nerve intervertebral foramen?
vertebral body of T1 and the vertebral body of T2
What are the osseous parts of the costransverse joint?
transverse costal facet and the articular surface of the tubercle of a tib
What ligaments support the costotransverse joint of T1?
inferior costotransverse and lateral costotransverse ligaments
What ligament is absent at the costotransverse joint of T1?
superior costotransverse ligament
The superior costotransverse ligament of rib one will attach to which segmental bony feature?
second rib
What muscles attach to the transverse process of T1?
longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis
What is the orientation of the superior articular facet of T1?
backward, upward and lateral (BUL)
What is the orientation of the inferior articular facet of T1?
forward, downward and medial (ForMeD)
How many synovial joints are present at T1?
10
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 articular facets
What muscles attach to the spinous process of T1?
trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, interspinalis
Which muscles attach to the transverse process of T9?
longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costaurum longus and levator costaurum brevis
How many synovial joints are typically present at T9?
10
Identify the synovial joint surfaces typically present on T9
two superior costal demi-facets, two inferior costal demi-facets, two superior articular facets, tow inferior articular facets and two transverse costal facets
How many synovial joint surfaces for the ribs are typically present on T9?
6
Para-articular processes are more commonly observed on which segment of the spine?
T10
What muscles attach to the transverse process of T10?
longissimus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis, intertransversarii, levator costaurum longus and levator costaurum brevis
How many synovial joints are typically present at T10?
8
Identify the synovial joint surfaces typically present at T10
two superior costal facets, two transverse costal facets, two superior articular facets, two inferior costal facets
Which rib related facet is absent on T10?
inferior costal demi-facet
What is the topographical indication of the spinous process of T10?
the skin often dimples or is depressed
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, multifidis, rotator lonnus, rotator brevis and interspinalis
What name is given to T11?
anticlinal vertebra
What is the outline of the vertebral body of T11 on superior view?
kidney-shaped or reniform
Which vertebral segment is the first to have a reniform vertebral body?
T11
How many synovial joints are formed at the vertebral body of T11?
2
How many symphysis joints are formed with the vertebral body of T11?
two
How many joints are typically formed at the vertebral body of T11?
typically 8 (twelve if the costocentral stellate/ratiate ligaments are included)
Which ligament of the costocentral joint is absent for the 11th rib?
the costcentral interarticular or intra-articular ligament
Which vertebra is the last segment to demonstrate a transverse costal facet?
T10
What ligaments form the costotransverse joint of T11?
superior costotransverse, and slightly developed inferior costotransverse and lateral costotransverse ligaments
Which costotransverse ligaments are absent at T11?
capsular costotransverse ligament
What muscles attach to the transverse process of T11?
longissimus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis
Which segment will be the last to demonstrate an attachment for the levator costaurum longus?
T10
How many synovial joints are typically present at T11?
6
What muscles attach to the spinous process of T11?
trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, interspinalis
Which muscles of the five layers of the true back are present at the spinous process of T11?
trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis
How many synovial joints are formed at the vertebral body to T12?
two
How many symphysis joints are formed with the vertebral body of T12?
two
How many joints are typically formed at the vertebral body of T12?
typically 8 (10 if the costocentral part stellate/radiate ligaments are included)
Which muscles are attached to the vertebral body of T12?
psoas major and minor
What does the lateral tubercle of T12 represent?
transverse process
What does the superior tubercle of T12 represent?
transverse process
What does the superior tubercle of T12 represent?
mammillary process of lumbar vertebrae
What does the inferior tubercle of T12 represent?
accesory process of lumbar vertebrae
What is the location of the lateral tubercle?
projects laterally from the pars interarticularis of T12
What joint surface of the typical thoracic transverse process is absent on T12?
transverse costal facet
What ligaments form the costotransverse joint of the 12th rib?
superior costotransverse ligament from T11 and the lumbocostal ligament from L1
Which costotransverse ligaments are attached at T12?
none
What muscles attach to the transverse process region of T23?
longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii
Which segment is the last to demonstrate a levator costarum brevis attachment?
T11
Which segment is the last to demonstrate a levator costarum longus attachment?
T10
What is the orientation of the superior articular facets of T12?
backward, upward, lateral (BUL)
What is the orientation of the inferior articular facets of T12?
forward, downward, lateral (FoLD)
How many synovial joints are typically present at T12?
6
What muscles attach to the spinous process of T12?
trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis
What is the generic shape of the typical lumbar vertebral body from the cranial view?
reniform or kidney-shaped
What accounts for the direction of the lumbar curve?
vertebral body and intervertebral disc have a greater anterior height than posterior height
How many joint surfaces are present on the vertebral body of a typical lumbar?
6
How many synovial joint surfaces are present on the vertebral body of a typical lumbar?
none
How many cartilaginous (amphiarthrosis) symphysis joint surfaces are on a typical lumbar vertebral body?
two
How many fibrous (amphiarthrosis) syndesmosis joint surfaces are on a typical lumbar?
four
What muscles may attach to the first lumbar vertebral body?
psoas major and minor
What muscles may attach from the second down to the fourth lumbar?
psoas major
Psoas minor will only attach to the vertebral body of which segments?
T12, L1
What is the name given to the ligaments that attach the vertebral body to articular process?
transforaminal ligaments
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
Hofmann ligaments are identified in which regions along the vertebral column?
cervical-upper thoracic region and lumbar region
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 cord.
Lumbar Hofmann ligaments will attach what structure 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
What is the proposed function of the proximal root sleeve ligaments?
resist displacement of the peripheral nerve system in the intervertebral disc
What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?
overlap of the laminae, shingling, diminishes; overlap of spinous processes, imbrication, diminishes
What is the name of the elevation near the origin of the lumbar transverse process?
accessory process
A styloid process occurs with what frequency and as a result of what condition?
7% occurrence as a result of congenital elongation of lumbar accessory process
What ligament will attach to the lumbar accessory process?
mammillo-accessory process
What parts of a vertebra are attached via the mammmillo-accessory ligament?
mammillary process and accessory process of the same segment
What was believed to be entrapped by the mammillo-accessory ligament?
medial branch of the dorsal ramus of a lumbar spinal nerve
What muscles attach to the lumbar accessory process?
longissimus thoracis and intertransversarii
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?
lumbocostal, mammillo-accessory and intertransverse ligaments
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 muscles will attach to the mammillary process?
multifidis and intertransversarii
What ligament will attach to the lumbar superior articular process and transverse process?
mammillo-accessory ligament
What was believed to be entrapped by the mammillo-accessory ligament?
medial branch of the dorsal ramus of a lumbar spinal nerve
What is the joint classification for the typical lumbar zygapophysis?
synovial plane (diarthrosis arthrodia)
What additional ligaments are said to attach to lumbar articular processes?
transforaminal ligaments
How many synovial joints are present on a typical lumbar vertebra?
4
What is the position of the lumbar zygapophysis in children?
lies in a coronal plane
What is teh position of the lumbar zygapophysis in adults?
zygapophysis lies in the sagittal plane for L1/L2, L2/L3, and L3/L4
zygapophysis lies in the coronal plane for L4/L5 and L5/S1
What name is given to zygapophyses between vertebral couples that lie in the same place?
joint symmetry
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 of the condition in which the typical lumbar spinous process increases in length due to the aging process?
Baastrup’s syndrome “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, interspinalis
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
How many joint surfaces are present on the vertebral body of the fifth lumbar?
6
How many synovial joint surfaces are present on the vertebral body of the fifth lumbar?
none
How many cartilaginous (amphiarthrosis) symphysis joint surfaces are present on the vertebral body of L5?
2
How many fibrous (amphiarthrosis) syndesmosis joint surfaces are present on the vertebral body of L5?
4
What muscle attaches to the fifth lumbar vertebral body?
psoas major
What ligaments attach the vertebral body to the transverse process?
corporotransverse ligaments
What are the types of Hofmann ligaments?
anterior Hofmann ligaments, posterior Hofmann ligaments, lateral Hofmann ligaments and proximal root sleeve ligaments
What accounts for the shortness of the L5 transverse process?
the hip/innominate bones diminish the available space in the transverse plane
Congenital elongation of the lumbar accessory process results in what feature?
styloid process
What parts of a vertebra are attached via the mammillo-accessory ligament?
mammillary process and accessory process of the same segment
What muscles may attach to the transverse process of the fifth thoracic vertebra?
psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus, intertransversarii
What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?
lumbosacral, iliolumbar and mammillo-accessory ligaments
What is the orientation of the fifth lumbar superior articular facet?
backward, upward, medial (BUM); typically concave
What is the orientation of the fifth lumbar inferior articular facet?
forward, lateral, downward (FoLD); significant convexity
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 Syndrom
What muscles will attach to the fifth lumbar spinous process?
latissimus dorsi, iliocostalis lumborum, longissimus thoracis, multifidis, rotator longus, rotator brevis and interspinalis
What part of the sacral ala is derived from the costal element?
anterior 2/3
How many fibrous (amphiarthrosis) syndesmosis joint surafces are present on the S1 vertebral body?
4
How many joint surfaces are present on the vertebral body of the first sacral segment?
5
What muscle may attach to the first sacral vertebral body?
psoas major
What is the position of the sacral zygapophysis in adults?
the zygapophysis lies in the coronal plane for L5/S1
What is the orientation of the first sacral superior articular facet?
backward, upward, medial (BUM); typically concave
What is the name given to the projection on the first sacral superior articular process?
mammillary process
From the anterior view, the intervertebral discs of sacrum will be replaced by what feature?
transverse ridges
An imaginary line drawn along the dorsal midline of sacrum is identified as the what?
median sacral crest
What forms the median sacral crest?
fused spinous processes and their spinous tubercles
An imaginary line drawn from the superior articular process of S1 to the sacral cornu will form what feature?
intermediate sacral crest
What forms the intermediate sacral crest?
fused articular processes and their facets
What features may be identified along the intermediate sacral crest?
the mammillary procoss of S1 and the sacral cornu of S5
What is the remnant of the inferior articular process and facet of S5?
sacral cornu
What is the name of the inferior opening of the sacral spinal canal?
sacral hiatus
What forms the lateral sacral crest?
fused transverse processes and transverse tubercles from S1 to S5
What is the sacral tuberosity?
enlarged transverse tubercle of S2
What is the name of the joint formed by the sacral tuberosity?
accessory sacro-iliac joint
What muscles is said to attach to the dorsal surface of sacrum?
iliacus
What feature is identified on the lateral surface of S1-S3?
auricular surface
What classification of joint is formed by the auricular surface of sacrum?
synovial plane (diarthrosis arthrodia)
What feature does the anterior surface of the superior epiphyseal rim of S1 form?
sacral promontory
What ligmaent is attached to the sacral hiatus?
superificial posterior sacrococcygeal ligament
What is the homolog for the ligamentum flavum at S5?
superficial posterior sacrococcygeal ligament
What forms the inferior boundary for the spinal canal?
the union of the superficial posterior and deep posterior sacrococcygeal ligaments
What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments at Co1?
posterior sacrococcygeal ligametn
What ligament is a homolog of the intertransverse ligament at S5?
lateral sacrococygeal ligametn
What ligament divides the sciatic foramen into the greater and lesser sciatic foramen?
sacrospinous ligament
What ligament has a broad attachment along the lateral margin of sacrum and coccyx and then attaches to the ischial tuberosit?
sacrotuberous ligament
Which ligament represents a thickening of the fibrous capsule of the sacro-iliac joint?
anterior sacro-iliac ligametn
What ligament is the strongest of the sacro-iliac ligaments and is penetrated by dorsal rami of the sacral spinal nerves?
interosseous sacro-iliac ligament
What is the homolog for the capsular ligament at S5?
intercornual ligament
What is the number of coccygeal somites?
10
What is the typical number of segments that unite to form the adult coccyx?
4 segments
When is ossification of coccyx completed?
about age 30
What is the direction of fusion of occcygeal segments?
caudal to cranial, last segments to fuse together are Co1 and Co2
What is the direction of the coccygeal curve?
posterior (kyphotic)
What is the major motion and range of motion for coccyx?
flexion-extension, 5-20 degrees
How many coccygeal nerves are present in the adult?
typically only one pair of cocygeal nerve remain in the adult
What forms the coccygeal nerve plexus?
S4, S5, and Co1
What is the ganglion impar?
a midline sympathetic ganglion
What is the coccygeal glomus or coccygeal body?
an enlarged encapsulated arteriorvenous anastomosis located near the last segment of coccyx
What innervates the coccygeal glomus or coccygeal body?
both sympathetic and parasympathetic fibers are identified
What muscles attach to the coccyx?
ischiococcygeus and levator ani
Superior articular facets of which vertebrae will be oriented backward, upward, and medial?
C1, C3-C7, L1-L5, S1
Superior articular facets of which segments will be oriented backward, upward, and lateral?
C2, T1-T12
Inferior articular facets of which segments will be oriented backward, medial, and lateral?
C1
Inferior articular facets of which segments will be oriented forward, lateral and downward?
C2-C6, T12, L1-L5
Inferior articular facets of which segments will be oriented forward, medial and downward?
C7, T1-T11
Which segment has the only inferior articualr facet to face backward?
C1
What directions will all superior articular facets face?
backward and upward
Which segments will have facets that are specifically shaped as concave?
C1, L1-L5, S1 superior articular facets
What is the definition of spondylosis?
vertebral condition
What is the definition of spondylolysis?
a vertebral separation or vertebral cleavage
What is the definition of spondylolisthesis?
vertebral slippage
What is the location of spondylolysis that will be stressed in Spinal II?
a separation along the pars interarticularis (defect in pars interarticularis or pars defect)
What is the incidence of spondylolysis in the general population?
a range of 2.6% to 10%
What is the geographic ethnic bias for a higher incidence of spondylolysis?
native Alaskan (Inuit) population
Lumbar spondylolysis has not been reported in what groups of indiiduals?
fetuses, newborns, rarely in children under 5 years old, patients who have never walked and in non-erect species
What does lumbar sponlylolysis appear to be related to?
uniquely human upright stance or erect posture
Lumbar spondylolysis is associated with what characteristics?
familial association, spina bifida occulta, racial/ethnic disparities, gender and locational bias, youthful incidence and activities requiring repetitive stress on the spine
What is the gender bias and locational bias associated with lumbar spondylolysis?
men at L5/S1
women at L4, L5
What is the age rage typically associated with lumbar spondylolysis?
10-20 year olds
What activites are particularly stressful at the pars interarticularis of lumbar vertebrae?
gymnastics, dance, soccer
What fills the space in a lumbar spondylolysis?
fibrocartilagenous material
What name has been given to the material filling the space in a lumbar spondylolysis?
spondylolysis ligament
What types of neural functions have benn associated with the spondlylolysis ligament?
nociception, neuromodulation and autonomic function
What is the appearance of the lumbar vertebrae upon oblique X-Ray view?
Scotty dog
What is the appearance of a defect in the pars interarticularis in a lumbar vertebra upon oblique X-Ray view?
collared Scotty dog
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?
neck of the Scotty dog
What part of a lumbar vertebra forms the eye of a Scotty dog?
pedicle
What part of a lumbar vertebra forms in ear of a Scotty dog?
superior articular process
What part of a lumbar vertebra forms the nose of a Scotty dog?
transverse process
What characteristics are associated with cervical spondylolysis?
rare, congenital, gender biased toward men, most common at C6 and linked to sponlylolisthesis and spina bifida
What characteristics are associated with sacral spondylolysis?
rare in general population, within typical percents in the native Alaskan (Inuit) population, seems to be aquired, gender biased toward men, most common at S1 and linked to activities such as kayaking and harpooning
Identify all names given to type I sponlylolisthesis?
dysplastic spondylolisthesis, congenital spondlylolisthesis
What is the locational bias of type I spondylolisthesis?
L5 or upper sacral segments
What additional conditions are linked to type I spondylolisthesis?
spina bifida occulta and nerve root compression of the S1 nerve
What gender bias, locational bias, and spinal canal dimensions are associated with type II spondylolisthesis?
isthmic spondylolisthesis is common in men, located at the L5/S1 level and demonstrates an increase in sagittal diameter of the spinal canal
What is the gender bias, locational bias and spinal canal dimension changes often associated with type III spondylolisthesis?
degenerative spondylolisthesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal cord
What couses type IV spondylolisthesis?
fracture of the neural arch components
What are the causes associated with type V spondylolisthesis?
bone diseases such as Paget disease or osteogenesis imperfecta
What determines the length of the intervertebral foramen?
width of the pedicle
What is the average height of the intervertebral foramen?
about 13mm
What percent of total vertebral column length does “true” intervertebral foramina height from C2-S1 equal?
40%
What percent of total vertebral column length does all intervertebral foramina height from occiput to Co1 equal?
53%
What are the generic contents of the intervertebral foramen?
neural tissue, connective tissue, vascular tissue, lymphatic tissue
What is the percent of neural tissue in the interbertebral foramen?
from 8-50%
What are the characteristics of the Artery of Adamkiewicz?
it is a left side, anterior meduallary feeder artery, located in the T9/T10 intervertebral foamen, and the primary vascular supply to the lumbar enlargement
What will the intervertebral veins drain into?
external vertebral venous plexus or Batson’s plexus
What is a unique histological feature of the veins of the vertebral column?
appear to lack valves
What size lymphatic vessels lie in the intervertebral foramen?
medium sized lymphatics
What types of connective tissue will be percent in the intervertebral foramen?
adipose tissue and loose areolar connective tissue
What parts of the cerveical vertebra will modify the intervertebral foramen?
lateral groove and uncinate process
What happens to cervical nerve roots between their origin from the spinal cord and exit from the intervertebral foramen?
they descend along the spinal cord
What is the relationship between aging and cervical spine nerve root characteristics?
the length of the nerve root increases as it descends from its apparent origin on the spinal cord, bu the cross-sectional area of the nerve root decreases
What is the relationship bdtween aging and cervical spinal intervertebral foramen size?
cross-sectional area diminishes after age 50
What are the specific attachment sites for a cervical spinal nervve?
sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery
What contributes to the anterior boundary of the throacic intervertebral foramen?
costocentral joints
What is the shape of the lumbar intervertebral foramen?
reniform or earlobe-shaped
What is the relationship of lumbar nerve root size to intervertebral foramen size above L4?
the nerve root size will account for less than 22% of the available size
Which ar the largest spinal nerves?
L5 and S1 spinal nerves
What increases the length of the intervertebral foramen at L5?
lumbosacral tunnel
What forms the lumbosacral tunnel?
lumbosacral ligament, transverse process of L5 and sacral ala
What condition is the result of encroachment on the L5 spinal nerve?
the far out syndrome
What is the relationship between intervertebral disc herniation and lumbar spinal nerves?
intervertebral disc above the intervertebral foramen is ususally the source of damage
What is unusual about the sacral intervertebral foramen compared to other intervertebral foramina?
a completely osseous boundary exists
What is more likely the cause of nerve irritation at the sacral intervertebral foramen?
the tilt of position of the entire sacrum relative to the pelvis
What is the relationship of lumbar nerve root size to intervertebral foramen size above L4?
nerve root size will account for less than 22% of the available size
What is unique about the relationship of spinal nerve to intervertebral foramen atS5-Co1?
there are two nerves present, S5 nerve and Co1 nerve
What are some examples of destructive lesions of the vertebral body?
tuberculosis, hemangiomas, osteoporosis
What may reduce the impact of intervertebral disc loss of integrity on the intervertebral foramen in the cervical and throacic spine?
joint of Luschka in the cervicals, the costocentral joint int the thoracics
What are examples of osteophyte formation that influence intervertebral foramen?
bony spurs of the vertebral body and para-articular processes on the lamina
What are examples of acquired alterations of the spinal curves identified in class
obesity, pregnancy and the use of heavy backpacks
What is the recommended weight of a backpack compared to individual weight for the developing spine?
backpack weight should not exceed 10% individual body weight
What embryonic event causes the direction of the posterior curve of the vertebral column?
embryonic disc will undergo flexion in a cranial to caudal direction
Why is the posterior curve also the primary curve?
it is the first curve to appear embryologically
What are the adult remnants of the primary curve along the vertebral column?
thoracic or dorsal curve and the pelvic or sacrococcygeal curve
What are the names given to curves that form during development to reverse the direction of regions along the vertebral column?
anterior curve, secondary curve, compensatory curve
What are the curve classifications for swayback?
lordosis or hyperlordotic curve
What are the curve classifications for humpback or hunchback?
kyphosis or hyperkyphotic curve
What are the curve classifications for military neck?
kyphyosis or hypolordotic curve
What is the definition of scoliosis?
warped or crooked condition
What is the definition of kyphosis?
humpback or hunchback condition
What is the definition of lordosis?
forward bending condition
What names are given to conditions aassociated with abnormal curves of the vertebral column?
lordosis, kyphosis, scoliosis
What is the relationship between curve direction and handedness?
right-handed person has high probability for a right thoracic, left lumbar curve combination
What is the time of appearance of the lateral curves?
they appear after 6 years old
What is the vertebral relationship between lumbar curve and the lumbar englargement?
lumbar curve T12-L5; lumbar enlargement T9-T12
What is the gender bias associated with lumbar curve convexity?
females have a greater convexity of the lumbar curve
Which sense is a requirement for holding the head erect, standing, sitting and walking?
visison
What developmental events are indicated in the formation of the adult lumbar curve?
- crawling will cause the abdomen to put tension ofn the lumbar region and pulls it forward
- muscle development is promoted to compensate for the swayback of the lumbars
- intervertebral disc height will become greater anterior compared to posterior
- walking will furter promote muscle and intervertebral disc development
What are the adult remnants of the primary curve along the vertebral column?
thoracic or dorsal curve and the pelvic or sacrococcygeal curve
What are the names given to curves that form during development to reverse the direction of regions along the vertebral column?
anterior curve, secondary curve, compensatory curve
What are the names of the anterior curves, secondary curves and compensatory curves?
cervical and lumbar curve
What segmental levels form the cervical curve?
C2-T1
What segmental levels form the lumbar cruve?
T12 to L5
What is the earliest time of appearance of the cervical curve
third fetal month
What ist hetraditional time of appearance of the cervical curve said to be?
during the last trimester in utero
What is the time during which the adult cervical curve si said to appear?
within the first year after birth
Whatdevelopmental events are indicated in the formation of the adult cervical curve?
- centers for vision and equilibrium will appear in the brain
- musculatrure attaching the skull, cervical region and upper thorax together develops
- the head is held upright
- the intervertebral disc height becomes greater anterior than posterior
At what age will the infant begin to hold the head erect?
usually between the third and fourth month after birth
What is the name given tot eh integration of visual and motos pathways associated with holding the head erect?
the righting reflex
What is the location for the apex of the cervical curve?
typically between C4 and C5
What is the location for the cervical kyphosis?
between occiput and C1
What is the vertebral relationship between the cervical curve and the cervical enlargement?
cervical curve C2-T1; cervical enlargement C3-T1
What is the time of appearance of the lumbar curve?
between 12 and 18 months after birth
What infant activities are associated with the development of the lumbar cruve?
crawling and walking
