The Ribcage, Sternum, and Upper Cervical Ligaments (quiz 3/exam 2) Flashcards

1
Q

Region of trunk between the neck and abdomen housing major organs of _______________ and _________________

A

respiration, blood circulation

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2
Q

What part(s) of the thorax are the site of formation of blood cells in adults and contain red bone marrow?

A

the manubrium of the sternum and the ribs

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3
Q

The thorax allows passage between….

A

compartments

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4
Q

What does the pleura and pleural cavity contain?

A

lungs

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5
Q

What does the mediastinum contain?

A

heart and great vessels

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6
Q

What is included in the thoracic cavity?

A

-pleura and pleural cavities containing the lungs
-mediastinum containing the heart and great vessels

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7
Q

What is another name for superior thoracic aperture?

A

thoracic inlet

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8
Q

If there is an impinged nerve at the superior thoracic aperture/thoracic inlet, then it is called….

A

thoracic outlet syndrome (this is where anatomy and clinical info do not agree!)

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9
Q

The superior thoracic aperture/thoracic inlet is bound anteriorly by what?

A

sternal manubrium and costal cartilages of 1st rib

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10
Q

The superior thoracic aperture/thoracic inlet is bound posteriorly by what?

A

T1

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11
Q

The superior thoracic aperture/thoracic inlet is bound laterally by what?

A

1st rib

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12
Q

The superior thoracic aperture/thoracic inlet transmits the trachea, esophagus, aortic arch and branches, superior vena cava, and….

A

several nerves and blood vessels to and from the neck

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13
Q

What is the other name for inferior thoracic aperture?

A

thoracic outlet

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14
Q

The inferior thoracic aperture/thoracic outlet is bounded anteriorly by what?

A

xiphysternal joint and costal margins (7-10)

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15
Q

The inferior thoracic aperture/thoracic outlet is bounded posteriorly by what?

A

T12

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16
Q

The inferior thoracic aperture/thoracic outlet is bounded laterally by what?

A

12th rib

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17
Q

The inferior thoracic aperture/thoracic outlet contains the ____________ and transmits esophagus, aorta, and inferior vena cava, nerves and blood vessels to and from the abdomen

A

diaphragm

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18
Q

What segments of the thoracic spine connects to the ribs directly?

A

T1-T7

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19
Q

What vertebral segment is in line with the arch of the aorta?

A

T4 (brachial plexus trunk is found here including the subclavian and common carotid artery)

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20
Q

How many ribs are there in total?

A

24

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21
Q

Where is the infrasternal (subcostal) angle found?

think vertebral segment

A

T9

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22
Q

Where is the xiphoid process found?

think vertebral segment

A

T10

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23
Q

What are the 3 parts of the sternum?

A

-manubrium (looks like roman shield)
-body
-xiphoid process

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24
Q

How many pairs of ribs are there?

A

12 pairs of ribs

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25
Q

How many ribs contain costal cartilage?

A

rib 1-10 (11/12 do not)

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26
Q

What are the 3 functions of the ribcage?

A

-protect viscera
-assist breathing
-assist body movement

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27
Q

The manubrium is found from T___ to T____

A

T1 to T4

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28
Q

What is another name for the manubrium?

A

manubrium sterni

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29
Q

What is the widest, thickest part of the sternum?

A

the manubrium

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30
Q

The jugular notch/suprasternal notch and clavicular notches are found on what part of the sternum?

A

manubrium (jugular is center top, clavicular is on L/R top

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31
Q

The clavicular notches form what type of joint with the clavicles and sternum?

A

synovial saddle joint

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32
Q

What part of the sternum can you find the costal notch for rib 1?

A

manubrium

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33
Q

What is another name for the body of the sternum?

A

corpus sterni

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34
Q

Where is the body of the sternum located?

think vertebral level

A

T5-T9

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35
Q

The body of the sternum has costal notches for which ribs?

A

ribs 2-7

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36
Q

The transverse lines of fusion/transverse ridges of the body of the sternum are formed from how many sternebrae? Where does fusion begin?

A

formed from 4 sternebrae

fusion starts inferiorly and continues superiorly

fusion occurs between puberty and 25 y/o

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37
Q

What is another name for the xiphoid process?

A

processus xiphoideus

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38
Q

When does the xiphoid process ossify into the sternum body?

A

by age 40

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39
Q

What angle is found at the xiphoid process?

A

infrasternal angle/subcostal angle (found at T9)

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40
Q

The manubriosternal joint is found between the….

A

manubrium and the body of the sternum

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41
Q

What type of synovial joint is manubriosternal?

A

saddle (biaxial)

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42
Q

Is the manubriosternal joint primary or secondary cartilaginous?

A

SYMPHYSIS, secondary cartilaginous (this means its fibrocartilage)

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43
Q

What joint makes up the sternal angle at T4-5, and marks the transverse thoracic plane?

A

manubriosternal joint

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44
Q

T/F: the manubriosternal joint is amphiarthrotic but can ossify early

A

true

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45
Q

Is the xiphisternal joint primary or secondary cartilaginous?

A

primary synchondrosis that will turn to synostoses, which is primary cartilaginous (meaning hyaline cartilage)

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46
Q

Which joint is synarthrotic and anchors the rectus abdominis?

A

xiphisternal joint

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47
Q

Which joint is found at the infrasternal angle?

A

xiphisternal joint

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48
Q

What are the 4 ligaments of the anterior ribcage?

A

1) costoclavicular ligament
2) sternoclavicular ligament
3) interclavicular ligament
4) radiate sternocostal ligament

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49
Q

Which ligament is found between rib 1 and the clavicle and keeps the clavicle in place?

A

costoclavicular ligament

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50
Q

Which ligament is found between the sternum and the clavicle in a joint capsule?

A

sternoclavicular ligament

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51
Q

Which ligament is between the L/R clavicles, runs over the jugular notch of the sternum, and keeps the clavicles in place?

A

interclavicular ligament

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52
Q

Which ligament joins ribs 1-7 and sternum together and has a modified joint capsule from ribs 2-7 (planar)?

A

radiate sternocostal ligament

note: its called radiate bc all the fibers turn in different directions “radiate outward”

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53
Q

Is the first rib a synovial joint with the sternum?

A

NO, its a secondary synchondrosis with hyaline cartilage (primary cartilaginous) joint that remains as cartilage

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54
Q

What joint is found between the sternum and rib 1 at the manubrium?

A

sternocostal joint
-its a secondary synchondrosis, primary cartilaginous joint
-remains as synchondrosis/hyaline cartilage to allow movement

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55
Q

What joint is a modified planar joint from ribs 2-7 and is amphiarthrotic (slightly moveable)?

A

sternocostal joint

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56
Q

Is the costochondrial joint primary or secondary cartilaginous?

A

primary synchondrosis, primary cartilaginous (hyaline, slowly becomes bone)

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57
Q

Which joint unites the sternal end of the rib with the costal cartilage and is synarthrotic (immoveable)?

A

costochondrial joint

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58
Q

Which joint unites the cartilage of ribs 6 and 7, 7 and 8, 8 and 9, and 9 and 10?

A

interchondral joint

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59
Q

Which joint is a synovial plane joint with ribs from 6-7, 7-8, and 8-9?

A

interchondral joint

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60
Q

Which joint is a fibrous joint from ribs 9-10?

A

interchondral joint

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61
Q

Which joint is synovial and unites facet/demifacets on the head of the rib with facets/demifacets on bodies of adjacent vertebrae at IVD?

A

costovertebral joint (found from T1-T12)

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62
Q

Which joint is synovial planar and unites the facet on the tubercle of the rib with the facet on the vertebral transverse process?

A

costotransverse joint

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63
Q

Ribs attach to the transverse process of the same thoracic vertebra at their…

A

same number/level

ex: rib 1 to TP1, rib 2 to TP2, and this continues down to T10

note: rib 11/12 do not have neck and do not articulate T11/12

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64
Q

Which rib marks the border of the thorax and abdomen?

A

rib 12

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65
Q

What are the atypical ribs?

A

ribs 1, 2, 10, 11, and 12

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66
Q

Who do the atypical ribs (ribs 1, 2, 10, 11, and 12) articulate with?

A

only one vertebra

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67
Q

Which ribs are typical ribs?

A

3-9

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68
Q

What do the typical ribs (3-9) articulate with?

A

between the vertebrae (on 2 vertebrae)

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69
Q

Is vertebra T1 typical or atypical?

A

atypical

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70
Q

Vertebra T1 is an atypical vertebrae. How does it connect to the ribs?

A

pair of superior costal facets for rib 1

pair of inferior costal demifacets for rib 2

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71
Q

Are vertebrae T2-T8 typical or atypical?

A

typical

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72
Q

Vertebrae T2-T8 are typical vertebrae. How do they connect to the ribs?

A

pair of superior and inferior costal demifacets on the bodies for rib 2-8

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73
Q

Is vertebra T9 typical or atypical?

A

atypical

74
Q

Vertebra T9 is atypical. How does it connect to the ribs?

A

pair of superior costal demifacets on the body and pedicles for rib 9

75
Q

Are vertebrae T10, T11, and T12 typical or atypical?

A

atypical

76
Q

Vertebrae T10, T11, and T12 are atypical. How do they connect to the ribs?

A

pair of superior costal facets on the body and pedicles

77
Q

Which ribs have facets on their tubercles and articulate with the TP of matching number vertebra?

A

Ribs 1-10

78
Q

Which ribs have no tubercle?

A

11 and 12

79
Q

Ribs are held to the vertebrae via the:
1)
2)
3)
4)
5)

A

1) costotransverse ligament (from TP of superior vertebra to the neck of the rib)
2) ligament of the neck (same level TP to neck)
3) ligament of the tubercle (same level TP to tubercle)
4) joint capsules (at head and at tubercle)
5) intra-articular ligament (from IVD to the head of the rib, for only ribs 2-9, and separates demifacets)

80
Q

Which ligament is found from the IVD to the head of the rib for only ribs 2-9, and separates the demifacets?

A

intra-articular ligament

81
Q

Which joint in the thorax will fuse in old age?

A

manubriosternal joint

82
Q

What are the true ribs?

A

1-7

83
Q

What are the false ribs?

A

8-10 (no direct attachment to sternum, they are attached to the cartilage)

84
Q

What are the floating ribs?

A

11 and 12

85
Q

What are the typical thoracic vertebrae?

A

T2-8

86
Q

What are the atypical thoracic vertebrae?

A

T1, 9, 10, 11, 12

87
Q

What are the 2 big breathing movements of the ribcage needed for ventilation?

A

1) elevation and depression of the ribs
2) elevation and depression of the sternum

88
Q

What is known as the “bucket handle” movement?

A

elevation and depression of the RIBS

89
Q

What is elevation and depression of the ribs created by?

A

-gliding movements of planar synovial joint (costovertebral and costotransverse joints, sternocostal joints of ribs 2-7)
-sternocostal joint of rib 1 (secondary synchondrosis)

90
Q

Elevation and depression of the ribs and sternum are partially created by gliding movements of the planar synovial joint. This involves costovertebral and costotransverse joints, and sternocostal joints of ribs 2-7. How do elevation and depression of the ribs and sternum differ?

A

elevation and depression of the ribs are also created by the sternocostal joint of rib 1 (secondary synchondrosis)

elevation and depression of the sternum are also created by the manubriosternal joint

91
Q

Elevation and depression of the ribs is limited by what?

A

costal cartilage

92
Q

Which joint helps extend the ribs in breathing movements?

A

costochondral joint

93
Q

What is known as the “pump handle” movement?

A

elevation and depression of the sternum

94
Q

What is elevation and depression of the sternum created by?

A

-gliding movements of planar synovial joints (costovertebral and costotransverse joints, sternocostal joint ribs 2-7)
-manubriosternal joint

95
Q

The manubrium is anchored by ________________ ligament and ___________ ligament of rib 1

A

costoclavicular, transverse

96
Q

Movement of the manubrium is limited by what?

A

elasticity of costal cartilage, costoclavicular ligament and transverse ligament of rib 1

97
Q

Manubrium movement is assisted by what?

A

the costotransverse joint and costovertebral joint

98
Q

What part of the spine has the most movement?

A

cervical spine

99
Q

Which part of the spine has moderate movement?

A

lumbar

100
Q

which part of the spine has the least movement?

A

thoracic

101
Q

Do ribs move with the vertebrae?

A

YES

102
Q

_______________ spaces are widest anteriorly

A

intercostal

103
Q

What bilaterally widens with inspiration or inhalation?

A

ribs

104
Q

What contralaterally widens with lateral flexion or extension of the torso?

A

ribs

105
Q

What narrows with expiration or exhalation and flexion of the torso?

A

ribs

106
Q

Does scoliosis affect the ribs? If so, how?

A

yes, the ribs are connected to the vertebrae

so if theres lateral curvature, then both sides of ribs will be affected bc one side will attempt to compensate for the other

107
Q

Does extension promote inhalation or exhalation?

A

inhalation

108
Q

Does flexion promote inhalation or exhalation?

A

exhalation

109
Q

Ribs are curved/flat bones that form most of the thoracic wall and are remarkably light and highly resistant. Ribs are filled with ___________ bone filled with _____________________

A

spongy, red bone marrow (hematopoiesis)

110
Q

Costal cartilage is what type of cartilage?

A

hyaline cartilage

111
Q

What prolongs the length of the ribs and adds flexibility anteriorly?

A

costal cartilage

112
Q

Which rib has the longest length of costal cartilage?

A

rib 7 (length decreases superiorly and inferiorly)

113
Q

Which ribs have cartilage that joins to the cartilage of the superior rib to form the continuous costal margin?

A

ribs 8-10

114
Q

Intercostal spaces are the spaces between ribs and got the name from….

A

ribs forming superior border

115
Q

How many intercostal spaces are there and what is in the space?

A

11 paired intercostal spaces housing 11 pairs of spinal nerves (called the intercostal nerves)

VAN sits here (vein, artery, nerve- this is in order from superficial to deep)

116
Q

What is the subcostal space and what does it house?

A

space beneath the 12th rib, houses T12 ramus and the subcostal nerve (NO VAN here, just the nerve)

117
Q

What are the characteristics of a typical head on ribs (3-9)?

A

-wedge shaped (for the 2 joint surfaces for vertebrae and IVD)
-costal joint surfaces
-2 facets/demifacets separated by the crest of the head

118
Q

Do typical ribs (3-9) have a neck?

A

yes

119
Q

What are the typical characteristics of a tubercle on the rib (3-9)?

A

-tubercle is at the junction of the neck and body of the rib
-theres a facet at the tubercle for the TP of the vertebral body
-the tubercle is a rough site/surface for the costotransverse ligament

120
Q

What is the rough site/surface for the costotransverse ligament?

A

tubercle of ribs 3-9

121
Q

Where are most rib fractures?

A

costal angle of rib (on the body)

this is for ribs 3-9 only

122
Q

The costal angle of the rib is aligned with what?

A

medial border of the scapula (ribs 3-9)

123
Q

Where do ribs curve anterolaterally?

A

at the costal angle of rib (ribs 3-9)

124
Q

What is the lateral margin of back muscle attachments?

A

costal angle of the rib (ribs 3-9)

125
Q

Where is the costal groove of the rib found?

A

on the internal curved surface

126
Q

What has an articulation with the sternum via costal cartilage?

A

the sternal end of the rib (ribs 3-9)

127
Q

Which rib has a single facet on the head of the rib (posteriorly) to attach to T1 vertebra?

A

rib 1

128
Q

Which rib is the shortest, widest body, sharpest curve, and nearly horizontal?

A

rib 1

129
Q

Which rib has a scalene tubercle that separates 2 superior, transverse grooves formed around subclavian vessels (artery and vein)

A

rib 1

130
Q

Which rib is longer, thinner, and less curved than rib 1?

A

rib 2

131
Q

Which rib has 2 facets on the head for T1 and T2 vertebrae?

A

rib 2

132
Q

Which rib has a tuberosity for the serratus anterior on the superior surface?

A

rib 2

133
Q

Which ribs have only one facet on the head for T10-T12?

A

rib 10-12

134
Q

Which ribs are short, have a small costal angle and have no neck or tubercle?

A

ribs 11 and 12

135
Q

Which ribs have costal cartilage at the ends and do not attach anteriorly to any structures (sternum)?

A

ribs 11 and 12 (may have cartilage tip for protection)

136
Q

A single facet on the head of the rib means that it will attach to body of a single vertebra. Which ribs does this relate to?

A

Rib 1, 10, 11, 12

137
Q

What are the 3 types of ribs?

A

-true (pairs 1-7)
-false (pairs 8-10)
-floating (pairs 11/12)

138
Q

Which ribs are known as vertebrosternal?

A

true ribs (1-7)

139
Q

Which ribs directly attach to the sternum via costal cartilage?

A

true ribs (1-7)

140
Q

Which ribs are known as vertebrochondral?

A

false ribs (8-10)

141
Q

Which ribs have an indirect attachment to the sternum via the costal cartilage?

A

false ribs (8-10)

142
Q

Which ribs are known as vertebral or free ribs?

A

floating ribs 11/12

143
Q

What is the superior attachment for the anterior longitudinal ligament (ALL)?

A

occiput (C0) anterior to the foramen magnum at the basion (craniometric landmark)

144
Q

What is the inferior attachment for the anterior longitudinal ligament (ALL)?

A

anterior body of the Cc1

145
Q

What is the pathway for ALL? Is it continuous or segmented?

A

ALL attaches to the anterior tubercle of C1 and anterior bodies of C2-Cc1= continuous

146
Q

What are the 2 subdivisions of ALL?

A

anterior atlantocipital (AO) and anterior atlantoaxial (AA) ligament (both are lateral segments of ALL)

147
Q

What is the superior attachment of the anterior AO ligament (subdivision of ALL)?

A

anterior external border of the foramen magnum of occiput (C0)

148
Q

What is the inferior attachment of the anterior AO ligament (subdivision of ALL)?

A

superior border of the anterior arch of C1

149
Q

What is the superior attachment of the anterior AA ligament (subdivision of the ALL)?

A

inferior border of the anterior arch of C1

150
Q

What is the inferior attachment of the anterior AA ligament (subdivision of ALL)?

A

superior border of the body and TP of C2

151
Q

What is the superior attachment of the posterior longitudinal ligament (PLL)?

A

anterior border of the foramen magnum of the occiput (C0) and clivus

note: this is the same superior attachment for the subdivision of PLL- tectorial membrane

152
Q

What is the inferior attachment of the PLL?

A

posterior body of S1

153
Q

What is the pathway of the PLL? Is it continuous or segmented?

A

PLL attaches to the posterolateral surface of the anterior arch of C1 and posterior bodies of C2-S1 and runs within the anterior vertebral canal = continuous

154
Q

What is the subdivision of the PLL?

A

the tectorial membrane (it covers smaller ligaments)

155
Q

What is the superior attachment of the tectorial membrane (subdivision of the PLL)?

A

anterior border of the foramen magnum of the occiput (C0) and clivus

note: this is the same superior attachment for the PLL

156
Q

What is the inferior attachment of the tectorial membrane (subdivision of the PLL)?

A

posterior body of C2

157
Q

Which ligament covers the cruciate, alar, and apical ligaments of the upper cervical vertebrae and is continuous with the inferior PLL?

A

tectorial membrane (subdivision of PLL)

158
Q

What is the superior attachment of ligamentum flavum?

A

occiput (C0) posterior to the foramen magnum at the inferior nuchal line

159
Q

What is the inferior attachment of the ligamentum flavum?

A

lamina of Cc1

160
Q

What is the pathway of ligamentum flavum? Is it continuous or segmented?

A

ligamentum flavum attaches to the lamina of C2-Cc1 and runs in the posterior vertebral canal = segmented

161
Q

What are the subdivisions of ligamentum flavum?

A

posterior atlantoccipital (AO) and posterior atlantoaxial (AA) ligament

162
Q

What is the superior attachment of the posterior AO ligament (subdivision of ligamentum flavum)?

A

inferior nuchal lines of the occiput (C0)

163
Q

What is the inferior attachment of the posterior AO ligament (subdivision of ligamentum flavum)?

A

superior border of the posterior arch of C1

164
Q

What is the superior attachment of the posterior AA ligament (subdivision of ligamentum flavum)?

A

inferior border of the posterior arch of C1

165
Q

What is the inferior attachment of the posterior AA ligament (subdivision of ligamentum flavum)?

A

superior border of the lamina of C2

166
Q

What are the superficial upper cervical ligaments?

A

cruciate
-superior longitudinal ligament
-inferior longitudinal ligament
-transverse ligament of the axis

167
Q

What is the superior attachment of the superior longitudinal ligament (cruciate)?

A

anterior border of the foramen magnum of the occiput

168
Q

What is the inferior attachment of the superior longitudinal ligament (cruciate)?

A

transverse ligament of the atlas (note: this is also the superior attachment of the inferior longitudinal ligament)

169
Q

What is the superior attachment of the inferior longitudinal ligament (cruciate)?

A

transverse ligament of the atlas (note this is also the inferior attachment for the superior longitudinal ligament)

170
Q

What is the inferior attachment of the inferior longitudinal ligament (cruciate)?

A

posterior body of C2

171
Q

What is the lateral attachment of the transverse ligament of the atlas (cruciate)?

A

lateral mass of C1 to lateral mass of C1 (between tubercles on medial aspects of the lateral masses of the atlas)

172
Q

What are the deeper upper cervical ligaments?

A

-alar ligaments (2)
-apical ligament of the dens
-anterior atlanto-dental ligament

173
Q

What is the superior attachment of the alar ligaments (2)?

A

anterolateral border of the foramen magnum

174
Q

What is the inferior attachment of the alar ligaments (2)?

A

lateral aspect of the dens (C2)

175
Q

Which deep upper cervical ligament has occipital and atlantal portions?

A

alar ligaments (2)

176
Q

What is the superior attachment of the apical ligament of the dens?

A

anterior border of foramen magnum

177
Q

What is the inferior attachment of the apical ligament of the dens?

A

apex of the dens of C2

178
Q

Which deep upper cervical ligament is deep to the superior longitudinal ligament of cruciate?

A

the apical ligament of the dens

179
Q

Which deeper upper cervical ligament holds the dens in place?

A

the anterior atlanto-dental ligament

180
Q

What is the anterior attachment of the anterior atlanto-dental ligament?

A

fovea dentis of the anterior arch of the atlas

181
Q

What is the posterior attachment of the anterior atlanto-dental ligament?

A

articular facet of the odontioid process (dens) of C2