Unit 3 Vertebral Column/Spinal Column Flashcards

1
Q

What is the difference in vertebrae between a typical adult and a typical adolescent?

A

Adult: 26 Segments
Adolescent: 33 segments

Answer: 7 segments

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2
Q

How many segments unite to form the typical sacrum?

A

5 segments

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3
Q

How many segments unite to form the typical coccyx?

A

4 segments

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4
Q

Define the term “cervical”.

A

the region of the neck.

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5
Q

What does the term “thoracic” refer to?

A

Breast plate or chest

Referred to the armor bearing region of the torso.

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6
Q

Besides the term “thoracic” what is another term used to identify vertebral segments of the chest?

A

Dorsal segments or Dorsals

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7
Q

What does the term “lumbar” refer to?

A

Loin; region between the rib and hip.

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8
Q

Sacrum is a term used to refer to what?

A

Holy bone or Holy Region

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9
Q

What does the term coccyx refer to?

A

Cuckoo birds’ bill or beak

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10
Q

What is the most stable vertebral segmental region of the spine?

A

Cervical region

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11
Q

What are the typical measurements of a male and females spinal column. Give Inches and Centimeters.

A

Male: 70cm 28.75 Inches
Female: 60cm 25.75 Inches

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12
Q

What is the difference in length between a typical male and typical female spinal column?

A

3 inches.

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13
Q

Give the measurements of each individual cervical, thoracic, lumbar, and sacral regions in cm and inches.

A

Cervical: 12cm, 5”
Thoracic: 28cm, 11”
Lumbar: 18cm, 7”
Sacral: 12cm, 5”

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14
Q

How does the vertebral column specifically accommodate weight-bearing transfer?

A

S1–S3 at the auricular surface

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15
Q

How does the vertebral column participate in skeletal formation?

A

Ribs are formed from the Costal Process of the Embryonic Vertebral Template.

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16
Q

Distinguish between motion and locomotion.

A

Motion: movement w/o travel
Locomotion: Movement w/ travel.

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17
Q

What organ(s) is (are) specifically associated with the horizontal axis of the skull?

A

Eyes

Vestibular apparatus of inner ear

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18
Q

How is the vertebral column involved in stabilization of visceral function?

A

Integrity of the spinal column. This enhances the appropriate nerve system control of viscera.

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19
Q

When does the embryonic disc form?

A

Second week in Utero.

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20
Q

When does gastrulation occur or a 3-layered embryo form?

A

Third week in Utero.

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21
Q

What are the 3 layers of the embryo called?

A

Ectoderm
Mesoderm
Endoderm

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22
Q

Invagination of ectoderm along the primitive streak gives rise to what embryonic structure?

A

Notochord

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23
Q

What is the name given to the mesoderm that will give rise to the vertebral column?

A

Paraxial mesoderm

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24
Q

What does paraxial mesoderm give rise to that will form the vertebral column?

A

Somites

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25
Q

Name the areas of cellular differentiation formed within the somite.

A

Sclerotome
Myotome,
Dermatome

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26
Q

What part of the somite will give rise to the vertebral column?

A

Sclerotome

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27
Q

List, in order, the names of the successive vertebral columns formed during development.

A

Membranous
Cartilaginous
Skeletal or Osseous

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28
Q

Migration of sclerotomes to surround the notochord forms what developmental feature?

A

Perichordal Blastema

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29
Q

The perichordal blastema gives rise to what processes?

A

Neural processes

Costal processes

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30
Q

What is the name of the artery located between adjacent perichordal blastemae?

A

Intersegmental Artery

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31
Q

Cell proliferation within the perichordal blastema will result in what features?

A

Loss Cranial sclerotomite

Dense Caudal sclerotomite

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32
Q

What forms between the sclerotomites of a perichordal blastema?

A

Intrasclerotomal fissure

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33
Q

The intrasclerotomal fissure (fissure of von Ebner) gives rise to what developmental feature?

A

Perichordal disc

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34
Q

The perichordal disc in the presumptive location of what adult feature?

A

Intervertebral Disc

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35
Q

What is the earliest embryonic feature that will identify the position of the adult intervertebral disc?

A

Intrasclerotomal Fissure ( Fissure of Von Ebner)

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36
Q

The union of a dense caudal sclerotomite and a loose cranial sclerotomite from adjacent perichordal blastemae gives rise to what feature?

A

Vertebral Blastema

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37
Q

What vessel will be identified adjacent to the vertebral blastema?

A

Segmental Artery

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38
Q

When will cartilage first form in the membranous vertebral blastema?

A

Beginning in the 6th embryonic week.

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39
Q

What is the name given to the replacement of mesoderm by cartilage?

A

Chondrification

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40
Q

Chondrification is first identified in which region of the embryonic vertebral column?

A

Cervical Region

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41
Q

What are the names given to the centers of Chondrification within the vertebral blastema?

A

Centrum Center
Neural arch center
Transvers Process center

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42
Q

How many centers of Chondrification typically appear in the vertebral blastema?

A

6 total

2—for the Centrum
2—for the Neural arch
2—for each Transverse process

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43
Q

What is the earliest time that centers of ossification appear in the cartilaginous vertebra?

A

7th embryonic week

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44
Q

Ossification begins in which region of the embryonic vertebral column?

A

Lower cervical

Upper thoracic

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45
Q

What is the ratio of primary to secondary centers of ossification for a typical vertebra?

A

3 primary

5 secondary

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46
Q

What are the names of the primary centers of ossification for a typical vertebra?

A

Centrum centers

Neural Arch centers

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47
Q

How many primary centers of ossification appear in the typical vertebra?

A

3 total

1—- Centrum
2— Neural arches

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48
Q

What is the classification of the joint forming between primary centers of ossification in the typical vertebra?

A

Neurocentral Synchondrosis

Neural Arch Synchondrosis

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49
Q

What are the names of the five secondary centers of ossification for a typical vertebra?

A

Tip of Transverse Process
Tip of the Spinous Process
Epiphyseal Plate Centers

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50
Q

How many secondary centers of ossification appear in the typical vertebra?

A

5 total
1–per Tip of Transverse Process (2)
1–Tip of the Spinous Process
1– for each Epiphyseal Plate Centers (2)

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51
Q

What are the names of the synchondrosis forming between secondary centers of ossification and the rest of the typical vertebra?

A

Tip of Transverse Process Synchondrosis
Tip of the Spinous Process Synchondrosis
Epiphyseal Plate Centers Synchondrosis

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52
Q

What is the range of appearance for secondary centers of ossification of a typical vertebra?

A

During Puberty

Typically ages 11-16 years old.

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53
Q

What are the three basic osseous parts of vertebra?

A

Vertebral body
Vertebral arch
Apophyseal regions

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54
Q

What is the general shape of the vertebral body at each region of the spine?

A

Cervical– Rectangular
Thoracic—Triangular
Lumbar— Reniform

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55
Q

What is the name given to the compact bone at the superior and inferior surfaces of the vertebral body?

A

Superior epiphyseal rim

Inferior epiphyseal rim

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56
Q

What are the names of the opening found around the margins of the vertebral body?

A

Nutrient Foramina or Vascular Foramina

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57
Q

What large opening is usually observed at the back of the vertebral body?

A

Basivertebral Venous Foramen

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58
Q

What is the name given to the anterior part of the vertebral arch?

A

Pedicle

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59
Q

What is the name given to the posterior part of the vertebral arch?

A

Lamina

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60
Q

What is the name given to the intermediate part of the vertebral arch where the transverse process and articular processes attach?

A

Lamina-Pedicle Junction

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61
Q

What is the name of the feature located at the upper and lower surfaces of the pedicle?

A

Superior Vertebral Notch or Incisure

Inferior Vertebral Notch or Incisure

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62
Q

What is the generic orientation of the pedicle at each region of the spine?

A

Cervical— Posterolateral

Thoracic— Posterior, slight lateral

Lumbar—- Posterior

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63
Q

All lamina are oriented in what direction?

A

Posterior and Median

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64
Q

What is the name given to the overlap of laminae seen on X-ray?

A

Shingling

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65
Q

What ligament will attach to the lamina?

A

Ligamentum Flavum

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66
Q

What is the name given to abnormal bone at the attachment site of the ligamentum flavum?

A

Para-articular Process

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67
Q

What classification of bone will para-articular processes represent?

A

Accessory bone

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68
Q

What is the name given to the lamina-pedicle junction at each region of the spine?

A

Cervical– Articular Pillar

Thoracic and Lumbar— Pars Interarticularis

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69
Q

What is the name given to the tubular bone growth regions of the vertebral arch?

A

Apophyseal regions

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70
Q

What names may be given to each apophysis of the spine?

A

Transverse apophysis or Process
Articular apophysis or Process
Spinous apophysis or Process

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71
Q

What is the generic orientation of the transverse process or transverse apophysis at each region of the spine?

A

Cervical— Anterolateral
Thoracic— Posterolateral
Lumbar— Lateral

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72
Q

All non-rib bearing vertebra of the spine retain what equivalent feature?

A

Costal Element

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73
Q

What is the name given to the rounded elevation at the end of the transverse apophysis or process?

A

Transverse tubercle

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74
Q

What will cause the transverse process/apophysis to alter its initial direction in the cervical region?

A

Cervical spinal nerves are pulled forward and downward to form the cervical and brachial nerve plexuses. Thus remodeling the transverse process to accommodate their new position.

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75
Q

What will cause the transverse process/apophysis to alter it initial direction in the thoracic region?

A

The growth of the lungs remodel the shape of the ribs which in turn push the transverse processes backward.

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76
Q

What will the articular process/apophysis support?

A

articular facet

77
Q

What is the name given to the joint formed between articular facets of a vertebral couple?

A

Zygapophysis

78
Q

What is the name given to the bone surface at the front of a zygapophysis?

A

Superior articular facet

79
Q

What is the name given to the bone surface at the back of a zygapophysis?

A

Inferior articular facet

80
Q

In the vertebral couple, the part of the vertebra which lies anterior to the zygapophysis is called the?

A

pre-zygapophysis

81
Q

In the vertebral couple, the part of the vertebra which lies posterior to the zygapophysis is called the?

A

Post-zygapophysis

82
Q

What is the method of calculating the angle of the spinous process/apophysis?

A

Calculate the angle formed between the undersurface of the spinous process/ apophysis and the horizontal plane.

83
Q

What is the name given to the normal overlap of spinous processes/apophyses as seen on X-ray?

A

imbrication

84
Q

What is the orientation of the spinous process/apophysis at each region of the spine?

A

Cervical— slight angle inferiorly
Thoracic— noticeable angle inferiorly
Lumbar—- NO inferior angle

85
Q

What will form the posterior boundary of a typical intervertebral foramen?

A

1) Inferior articular process or Post-zygapophysis
2) Superior articular process or Pre-zygapophysis
3) Capsular ligament
4) Ligamentum Flavum

86
Q

What will form the superior boundary of a typical intervertebral foramen?

A

Inferior vertebral notch/incisure

87
Q

What will form the inferior boundary of a typical intervertebral foramen?

A

Superior vertebral notch/Incisure

88
Q

What will form the anterior boundary of a typical intervertebral foramen?

A

1) Vertebral body of the segment above
2) Vertebral body of the segment below
3) Intervertebral Disc
4) Posterior longitudinal Ligament

89
Q

What name is given to the opening located within the vertebral body - vertebral arch enclosure?

A

Vertebral Foramen

90
Q

The union of all vertebral foramina forms an apparent vertical cylinder called the ?

A

Vertebral Canal or Spinal Canal

91
Q

What neural structures will occupy the vertebral foramen until the level of L2?

A

1) Spinal Cord/ Spinal Medulla/ Medulla Spinalis
2) Proximal part of the peripheral nerve system
3) Meninges

92
Q

What is the typical shape/outline of the vertebral foramen at each region of the spinal column/vertebral column?

A

Cervical— Triangular
Thoracic—Oval
Lumbar—-Triangular
Sacrum— Triangular

93
Q

At what vertebral level will the spinal cord typically terminate?

A

L1

94
Q

At what vertebral level will the dural sac typically terminate?

A

S2

95
Q

Identify all segmental arteries of the vertebral column?

A

1) Vertebral
2) Ascending Cervical
3) Deep Cervical
4) Superior intercostal
5) Posterior intercostal
6) Subcostal
7) Lumbar
8) Iliolumbar
9) Lateral Sacral and Median Sacral

96
Q

What are the segmental arteries of the cervical spine?

A

1) Vertebral Artery
2) Ascending Cervical artery
3) Deep Cervical artery

97
Q

What are the segmental arteries of the thoracic spine?

A

1) Deep Cervical A.
2) Superior intercostal A.
3) Posterior intercostal A.
4) Subcostal A.

98
Q

What are the segmental arteries of the lumbar spine?

A

1) Lumbar A.
2) Iliolumbar A.
3) Lateral Sacral A
4) MediaN Sacral A.

99
Q

What are the segmental arteries of the 5th lumbar vertebra?

A

1) Iliolumbar A.
2) Lateral Sacral A.
3) MediaN Sacral A.

100
Q

What are the segmental arteries of the Sacrum?

A

1) Iliolumbar A.
2) Lateral Sacral A.
3) MediaN Sacral A.

101
Q

What segmental levels are supplied by the vertebral artery?

A

C1-C6

102
Q

What segmental levels are supplied by the ascending cervical artery?

A

C1-C6

103
Q

What segmental levels are supplied by the deep cervical artery?

A

C7-T1

104
Q

What segmental levels are supplied by the superior intercostal artery?

A

T1, T2

105
Q

What segmental levels are supplied by the posterior intercostal artery?

A

T3 - T11

106
Q

What segmental level(s) is/are supplied by the subcostal artery?

A

T12

107
Q

What segmental levels are supplied by the lumbar arteries?

A

L1-L4

108
Q

What segmental levels are supplied by the median sacral artery?

A

L5, S1-S5 and Coccyx

109
Q

What segmental levels are supplied by the iliolumbar artery?

A

L5, S1-S5 and Coccyx

110
Q

What segmental levels are supplied by the lateral sacral artery?

A

L5, S1-S5 and Coccyx

111
Q

Which vertebra has the greatest number of segmental arteries associated with it?

A

L5

112
Q

Which branch of the dorsospinal artery will penetrate the meninges to enter subarachnoid space?

A

Spinal artery

113
Q

What branch of the segmental artery supplies the vertebra and the paravertebral region?

A

Dorsospinal artery

114
Q

Which branches of the spinal artery supply the contents of the epidural space?

A

1) Osseous A.
2) Anterior spinal Canal A.
3) Posterior spinal Canal A.

115
Q

What arteries are observed in the epidural space near the posterior longitudinal ligament?

A

Anterior spinal Canal artery and Plexus

116
Q

What arteries are observed in the epidural space near the ligamentum flavum?

A

Posterior spinal Canal artery and Plexus

117
Q

Which branches of the spinal artery supply the contents of the subarachnoid space?

A

1) Anterior and Posterior Radicular A.

2) Anterior and Posterior Medullary Feeder A.

118
Q

Which vessel will supply the ventral/anterior nerve rootlet and nerve root?

A

Anterior Radicular A.

119
Q

Which vessel will supply the dorsal/posterior nerve rootlets, nerve root and nerve root ganglion?

A

Posterior Radicular A.

120
Q

What is the name given to the artery that lies in front of the spinal cord along its length?

A

Anterior Spinal Artery

121
Q

The anterior spinal artery is a branch of which artery?

A

Vertebral Artery

122
Q

Is the anterior spinal artery a single, continuous artery along the spinal cord?

A

No

123
Q

As the anterior spinal artery continues along the spinal cord, which arteries unite along its length to give the appearance of a single continuous vessel?

A

Anterior Medullary Feeder A.

124
Q

The posterior spinal artery is a branch of which artery?

A

Posterior Inferior Cerebellar A.

125
Q

What is the position of the posterior spinal artery relative to the spinal cord?

A

It lies in the posterolateral sulcus along the spinal cord.

126
Q

Is the posterior spinal artery a single, continuous artery along the spinal cord?

A

NO

127
Q

As the posterior spinal artery continues along the spinal cord, which arteries unite along its length to give the appearance of a single continuous vessel?

A

Posterior Medullary Feeder A.

128
Q

What forms the arterial vasa corona?

A

Anterior Spinal A.
Posterior Spinal A.
Communicating Arteries

129
Q

What is the generic name given to arteries that penetrate the spinal cord?

A

Intramedullary arteries

130
Q

What are the intramedullary branches of the arterial vasa corona?

A

Pial Perforating arteries

Central/Ventral/Sulcal perforating arteries

131
Q

What artery gives off the ventral/central/sulcal perforating arteries?

A

Anterior spinal artery

132
Q

What arterial vasa corona branches supply gray matter and most of the spinal cord?

A

Ventral/central/sulcal perforating arteries

133
Q

What intramedullary branches supply about one third of the spinal cord?

A

Pial Perforating Arteries

134
Q

What is the source for pial perforating arteries?

A

Pial Plexus

135
Q

What arteries form the pial plexus?

A

Posterior spinal arteries

Communicating arteries

136
Q

What arteries are responsible for supplementing the arterial vasa corona along the cord?

A

Anterior Medullary Feeders

Posterior Medullary Feeders

137
Q

What vessels drain the spinal cord?

A

Pial Veins

138
Q

What will pial veins drain into?

A

Venous vasa corona

139
Q

Which vessels form the venous vasa corona?

A

Anterior longitudinal veins
Posterior longitudinal veins
Communicating veins

140
Q

Which vessels will drain the venous vasa corona?

A

Anterior Medullary Veins

Posterior Medullary Veins

141
Q

Which vessels will drain the ventral/anterior nerve roots?

A

Anterior Radicular Veins

142
Q

Which vessels will drain the dorsal/posterior nerve roots?

A

Posterior Radicular V.

143
Q

What veins will lie in the subarachnoid space?

A

1) Pial V.
2) Venous Vasa Corona
3) Anterior and Posterior Longitudinal V.
4) Communicating V.
5) Anterior and Posterior Medullary V.
6) Anterior and Posterior Radicular V.

144
Q

What veins are observed in the epidural space near the posterior longitudinal ligament?

A

Basivertebral V.

Anterior Internal Vertebral Venous Plexus

145
Q

T/F Veins of the spine are similar to the rest of the body in that they have bicuspid valve that help them move blood back to the heart.

A

False, They have no valves.

146
Q

What luminal feature of the anterior internal vertebral venous plexus vessels may function like valves of typical veins?

A

Trabeculae

147
Q

What veins are observed in the epidural space near the ligamentum flavum?

A

Posterior Internal Vertebral Venous Plexus

148
Q

Identify one very unique feature that veins along the spinal canal exhibit.

A

They lack bicuspid valves of typical veins.

149
Q

Identify the meninges of the spinal cord (spinal medulla or medulla spinalis) and the commonly accepted meaning of each.

A

1) Dura Mater—–“Tough Mother”
2) Arachnoid Mater—–“Spider Mother”
3) Pia Mater—-“Tender or Delicate Mother”

150
Q

Name and locate each space formed between the osseous vertebral foramen and the spinal cord (spinal medulla or medulla spinalis)?

A

Epidural space— Between the vertebral foramen and Dura Mater (Tough Mother)

Subdural Space— Between Dura Mater (Tough Mother) and Arachnoid Mater (Spider Mother)

Subarachnoid Space— Between Arachnoid Mater (Spider Mother) and Pia Mater (Tender/Delicate Mother)

151
Q

What is the name given to the fluid within the epidural space?

A

Interstitial fluid

152
Q

What are the neural contents of the epidural space?

A

Recurrent meningeal/sinu-vertebral/sinus vertebral nerve

153
Q

What ligaments are associated with the epidural space?

A

Hofmann/anterior dural or meningovertebral ligaments

Ligamentum Flavum

Posterior longitudinal ligament

154
Q

Which of the blood vessels of the epidural space will be found near the vertebral body?

A

Anterior spinal canal artery and plexus

Anterior internal vertebral venous plexus

Basivertebral vein

155
Q

Which of the blood vessels of the epidural space will be found near the lamina?

A

Posterior spinal canal artery and plexus

Posterior internal vertebral venous plexus

156
Q

Which of the nerves of the epidural space will be found near the lamina?

A

Recurrent meningeal or Sinu-vertebral or sinus vertebral nerve

157
Q

Which meningeal space is now thought to be a potential space, not an actual space?

A

Subdural space– between the dura mater and arachnoid mater.

158
Q

Which of the contents of the epidural space are more likely located near or around the posterior longitudinal ligament?

A

1) Anterior Spinal Canal artery and Plexus
2) Anterior internal vertebral venous plexus
3) Basivertebral vein
4) Recurrent meningeal or Sinu-vertebral or Sinus Vertebral nerve
5) Hofmann or Anterior Dural or Meningovertebral ligaments

159
Q

Which of the contents of the epidural space will be found near the lamina?

A

1) Posterior Spinal Canal artery and plexus
2) Posterior internal vertebral venous plexus
3) Ligamentum Flavum
4) Recurrent meningeal or Sinu-vertebral or Sinus vertebral nerve
5) Hofmann or Anterior Dural or Meningovertebral ligaments

160
Q

What is the name given to the fluid present within the subdural space?

A

Serous Fluid

161
Q

What is the name given to the fluid within the subarachnoid space?

A

Cerebrospinal fluid

162
Q

What ligaments may be present in the subarachnoid space?

A

Dentate or Denticulate ligament

163
Q

What contents of the subarachnoid space are changed below the level C6?

A

1) Arterial vasa corona
A) 1 anterior spinal artery + 2 Posterior spinal A.
B) 3 communicating arteries

164
Q

What is the name given to the lateral extension of pia mater along the spinal cord?

A

Dentate or Denticulate Ligament

165
Q

What is the unique feature of veins along the spinal cord?

A

They lack Bicuspid valves

166
Q

In horizontal view, what direction of the spinal cord tend to be largest?

A

Transverse

167
Q

What are the spinal cord enlargement locations, and the name given to each?

A

1) C3-T1= Cervical Enlargement

2) T9-T12– Lumbar Enlargement

168
Q

Where is the greatest transverse diameter of the spinal cord?

A

C6

169
Q

In which plane (or direction) will the diameter of the spinal decrease form C2-T1?

A

Midsagittal or Anterior-Posterior plane

170
Q

What spinal nerves originate form the lumbar enlargement?

A

L1-L3 spinal nerves

171
Q

What is the generic cord level of origin - vertebral level combination for the lumbar enlargement?

A

L1,L2 cord levels= T9 Vertebra
L3,L4 cord levels= T10 Vertebra
L5,S1 cord levels= T11 Vertebra
S2,S3 cord levels= T12 Vertebra

172
Q

What is the caudal end of the spinal cord called? And what spinal nerves originate from it?

A

Conus Medullaris

S4,S5, and Co1

173
Q

In which vertebral foramen will the conus medullaris typically be observed?

A

L1

174
Q

What is the name given to the nerve roots that are below L1?

A

Cauda Equina

175
Q

What is the continuation of pia mater below the conus medullaris called?

A

Filum terminale internum

176
Q

What is the location and name given to the area where all meninges first converge at the caudal part of the vertebral column?

A

Typically S2

The Dural Cul De Sac

177
Q

Neural tissue has been identified in what part of the filum terminale?

A

Proximal part of Filum Terminale Internum

178
Q

What is the fate of the neural tissue identified along the filum terminale internum?

A

Joins peripheral nerve roots of spinal nerves as high as L3 and low as S4.

179
Q

What does the neural tissue associated with the filum terminale externum appear to innervate?

A

Lower limbs

External anal sphincter

180
Q

The last arterial vasa corona creates what feature on angiogram?

A

Cruciate anastomosis

181
Q

What is the name given to the condensation of meninges below S2?

A

Filum Terminale Externum

182
Q

What is the name given to the caudal attachment of the meninges?

A

Coccygeal medullary vestige

183
Q

What is the name given to the condition in which the conus medullaris is located below L1 and the filum terminale is thickened?

A

Tethered cord syndrome

184
Q

What is the relationship between scoliosis and tethered cord syndrome?

A

The column will change normal curvature to mitigate damage to the spinal cord caused by a tethered cord.

185
Q

At the intervertebral foramen, what is the relationship between spinal nerve number and vertebral number along the cervical spine?

A

Spinal nerves exit above the segment they are numbered after.

Except C8

Example: C3 spinal nerve exits above C3 or between C2/C3

186
Q

At the intervertebral foramen, what is the relationship between spinal nerve number and vertebral number along the thoracic, lumbar, and sacrum?

A

Thoracic, Lumbar, Sacrum—-Spinal nerves exit below the segment they are numbered after.

Co1 is the exception.

Example: T6 nerve exits below T6 or between T6/T7

187
Q

What is the relationship between rib number and vertebral numbers at the costocentral joint?

A

Rib numbers equate to same vertebral number at the costocentral joint.

Except Ribs 1,11, 12—They are typically on a single segment.

Example: Rib 3 articulates with T3 and T2 segments

188
Q

What is the relationship between spinal nerve number. rib number and vertebral number in a thoracic intervertebral foramen?

A

Spinal Nerve– relates to the upper segment number in the vertebral couple
Rib number– relates to the lower segment number in the vertebral couple

Example: T3 nerve exits IVF formed by T3/T4 and rib 4 joints with this vertebral couple.