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