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Spinal TRI 2 > Unit 7 and 8 Intervertebral Foramen/ Curvatures of spinal coulmn(Exam 2) > Flashcards

Unit 7 and 8 Intervertebral Foramen/ Curvatures of spinal coulmn(Exam 2) Flashcards

1
Q

What are the characteristics of the artery of Adamkiewicz?

A

It is a left side, anterior medullary feeder artery, Located in the T9/T10 intervertebral foramen, and the primary vascular supply to the lumbar enlargement.

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2
Q

What is the most likely region of the thoracic spine for herniation?

A

Below T8

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3
Q

What will the intervertebral veins drain into?

A

External vertebral venous plexus or Batson’s plexus

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4
Q

What is a unique histological feature of the veins of the vertebral column?

A

They appear to lack of valves.

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5
Q

What size lymphatic vessels lie in the intervertebral foramen?

A

Medium sized lymphatics

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6
Q

What type(s) of connective tissue will be present in the intervertebral foramen?

A

Adipose tissue and loose areolar connective tissue

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7
Q

What is the relationship of cervical intervertebral foramen height to nerve root size?

A

Height increases, nerve root size stays the same from Cranial to Caudal

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8
Q

What parts of the cervical vertebra will modify the intervertebral foramen?

A

The lateral groove and Uncinate process

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9
Q

What is the relationship between aging and cervical spine nerve root characteristics?

A

Length of the nerve root increases as it Descends from apparent origin on the spinal cord, but the cross-sectional area of the nerve root decrease.

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10
Q

What are the specific attachment sites for a cervical spinal nerve?

A

1) Sulcus for the ventral primary ramus on the costotransverse bar
2) Vertebral artery

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11
Q

What contributes to the anterior boundary of the thoracic intervertebral foramen?

A

Costocentral joint

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12
Q

What is the amount of contribution of the intervertebral disc to the height of the lumbar intervertebral foramen?

A

About half

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13
Q

Which are the largest spinal nerves?

A

L5 and S1 spinal nerves

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14
Q

What increases the length of the intervertebral foramen at L5?

A

The lumbosacral tunnel

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15
Q

What forms the lumbosacral tunnel?

A

1) Lumbosacral ligament

2) Transverse process of L5 sacral ala

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16
Q

What condition is the result of encroachment on the L5 spinal nerve?

A

The far out Syndrome

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17
Q

What is the relationship between intervertebral disc herniation and lumbar spinal nerves?

A

Intervertebral disc above the IVF is usually the source of damage.

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18
Q

What is unusual about the sacral IVF compared to other intervertebral foramina?

A

Completely osseous boundary exists

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19
Q

What is more likely the cause of nerve irritation at the sacral IVF?

A

Tilt or position of the entire sacrum relative to the pelvis

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20
Q

What is unique about the relationship of spinal nerve to intervertebral foramen at S5-Co1?

A

There are two nerves present, S5 nerve and Co1 nerve

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21
Q

What are some examples of destructive lesions of the vertebral body?

A

Tuberculosis, hemangiomas, osteoporosis

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22
Q

What may reduce the impact of intervertebral disc loss of integrity on the intervertebral foramen in the cervical and thoracic spine?

A

Joint of Luschka—-Cervicals

Costocentral joint—-Thoracics

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23
Q

What examples of osteophyte formation that influence the IVF?

A

Bony spurs—Accessory bone

Lamina—-Para-articular processes

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24
Q

What are examples of acquired alterations of the spinal curves identified in class?

A

Obesity, Pregnancy, Heavy backpacks

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25
Q

What is the recommended weight of a backpack compared to individual weight for the developing spine?

A

Backpack weight should not exceed 10% individual body weight

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26
Q

What are the curvatures of the vertebral column?

A

Anterior, Posterior, Lateral

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27
Q

What is the direction of the primary curve of the vertebral column?

A

Posterior

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28
Q

Why is the posterior curve also called the primary curve?

A

It is the first curve to appear embryologically

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29
Q

What are the adult remnants of the primary curve along the vertebral column?

A

Thoracic or Dorsal curve

Pelvic or Sacrococcygeal curve

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30
Q

What are the names given to curves that form during development to reverse the direction of regions along the vertebral column?

A

anterior curve,
Secondary curve
Compensatory curve

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31
Q

What are the names of the anterior curves, secondary curves, and compensatory curves?

A

Cervical curves

Lumbar curves

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32
Q

What segmental levels form the cervical curve?

A

C2-T1

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33
Q

What segmental levels form the lumbar curve?

A

T12-L5

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34
Q

What is the earliest time of appearance of the cervical curve?

A

3rd fetal month

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35
Q

What is the traditional time of appearance of the cervical curve said to be?

A

Last trimester in utero

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36
Q

What is the time during which the “adult” cervical curve is said to appear?

A

W/in 1st year AFTER birth.

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37
Q

What developmental events are indicated in the formation of the adult cervical curve?

A

1) Centers for vision and equilibrium will appear in the brain
2) Musculature attaching the skull, cervical region, and upper thorax together develops
3) The head is held upright
4) Intervertebral disc height becomes greater anterior than posterior.

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38
Q

At what age will the infant begin to hold the head erect?

A

3-4th month after birth

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39
Q

What is the name given to the integration of visual and motor pathways associated with holding the head erect?

A

Righting reflex

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40
Q

What is the location for the apex of the cervical curve?

A

Typically between C4 and C5

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41
Q

What is the location for the cervical kyphosis?

A

Between occiput and C1.

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42
Q

What is the name given to the primary cervical curve?

A

Cervical kyphosis

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43
Q

What is the vertebral relationship between the cervical curve and the cervical enlargement?

A

Cervical curve–C2-T1

Cervical Enlargement– C3-T1

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44
Q

What is the time of appearance of the lumbar curve?

A

12-18 months after birth

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45
Q

What infants activities are associated with the developmental of the lumbar curve?

A

Crawling, Walking

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46
Q

What developmental events are indicated in the formation of the adult lumbar curve?

A

1) Crawling will cause the abdomen to put tension on the lumbar region and pulls it forward.
2) Muscle development is promoted to compensate for the swayback of the lumbars
3) Intervertebral disc height will become greater anterior compared to posterior.
4) Walking will further promote muscle and intervertebral disc development.

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47
Q

What happens within the intervertebral disc to facilitate the lumbar curve development?

A

Nucleus pulposus of L4 will shift its position within the annulus fibrosis.

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48
Q

Which sense is requirement for holding the head erect, standing, sitting, and walking?

A

Vision

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49
Q

What is the gender bias associated with lumbar curve convexity?

A

Females have a greater convexity enlargement T9-T12

50
Q

What is the formation of the lateral curve often correlated with?

A

Faster development of the muscles on the side of handedness

51
Q

What is the time of appearance of the lateral curves?

A

after age 6.

52
Q

What locations of lateral curves are recognized?

A

Cervical, Thoracic, Lumbar

53
Q

Which lateral curves are best developed?

A

Thoracic or dorsal, and lumbar

54
Q

What is the relationship between curve direction and handedness?

A

Right handed person has a high probability for a right thoracic, Left lumbar curve combination.

55
Q

What is the incidence of a right thoracic, left lumbar curve combination in the population?

A

about 80%

56
Q

What does the suffix “osis” mean?

A

a condition

57
Q

Does “osis” infer a normal or abnormal condition?

A

Neither, it is non-judgmental

58
Q

What generic names identified abnormal curves of the vertebral column?

A

Lordosis
Kyphosis
Scoliosis

59
Q

What is the definition of lordosis?

A

Forward bending condition

60
Q

What is the definition of kyphosis?

A

humpback or hunchback condition

61
Q

What is the definition of scoliosis?

A

warped or crooked condition

62
Q

What is the direction of the curve deviation in scoliosis?

A

To the side (it is a lateral curve deviation)

63
Q

Is there a locational bias for the classic definition of lordosis?

A

No, There would be an increase in the anterior direction in the cervical spine,
Decrease in the posterior direction in the thoracic spine
Increases in the anterior direction in the lumbar spine
Decrease in the posterior direction in the pelvic or sacrococcygeal region.

64
Q

Is there a locational bias for the classic definition of kyphosis?

A

No, There would be decrease in the anterior direction in the cervical spine,
Increase in the posterior direction in the thoracic spine,
Decrease in the anterior direction in the lumbar spine,
Increase in the posterior direction in the pelvic or sacrococcygeal region

65
Q

What clinical abnormal curvatures of the vertebral column were stressed in class?

A

Military neck
Humpback or Hunchback
Swayback

66
Q

What is military neck?

A

Decreased anterior curve in the cervical region, a straight neck.

67
Q

What is humpback or hunchback?

A

Increased posterior curve in the thoracic region

68
Q

What is swayback?

A

Increased anterior curve in the lumbar region

69
Q

What is classic classification of military neck?

A

Kyphosis

70
Q

What is classic classification of humpback or hunchback?

A

Kyphosis

71
Q

What is classic classification of swayback?

A

Lordosis

72
Q

What does the use of the term lordotic try to imply?

A

Normal cervical and normal lumbar anterior curve

73
Q

What does the use of the term kyphotic try to imply?

A

Normal thoracic/dorsal and normal pelvic posterior curve.

74
Q

What prefixes are used to convey abnormality in curve patterns?

A

Hyper and Hypo

75
Q

What does the term hyperlordotic infer?

A

Increase in the anterior curve of the cervical and lumbar region

76
Q

What does the term hypolordotic infer?

A

a decrease in the anterior curve of the cervical and lumbar region.

77
Q

What does the term hyperkyphotic infer?

A

An increase in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region

78
Q

What does the term hypokyphotic infer?

A

Decrease in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region

79
Q

What are the curve classifications for military neck?

A

Kyphosis or hypolordotic curve

80
Q

What are the curve classifications for humpback or hunchback?

A

Kyphosis or Hyperkyphotic curve

81
Q

What are the curve classifications for swayback?

A

Lordosis, or Hyperlordotic curve

82
Q

What is the more complete, accepted definition of scoliosis?

A

An abnormal lateral curve coupled with axial rotation

83
Q

What is the radiological test for skeletal maturity?

A

Risser sign, an indication of bone maturity in the iliac apophysis.

84
Q

What are the classifications of scoliosis according to the scoliosis research society?

A

1) Magnitude
2) Location
3) Direction
4) etiology
5) Structural scoliosis
6) non-structural scoliosis

85
Q

What does magnitude of scoliosis refer to?

A

Length and angle of the curve deviation on xray.

86
Q

What is often used to measure the magnitude of scoliosis?

A

Cobb method

87
Q

What does location of scoliosis infer?

A

Location of the vertebral segment forming the apex of the curve deviation

88
Q

What does direction of scoliosis refer to?

A

side the convexity of the curve will bend toward

89
Q

What does etiology of scoliosis mean?

A

the cause of scoliosis

90
Q

What is structural scoliosis?

A

More radical form of scoliosis,
May worsen and associated with structural deformities of the vertebra or intervertebral disc,
Frequently has a fixed angle of trunk rotation

91
Q

What is nonstructural scoliosis?

A

Mild form, unlikely to worsen, no structural deformities of the vertebra or intervertebral disc, lacks a fixed angle of trunk rotation

92
Q

What is the classification of scoliosis that is unique to the individual patient?

A

idiopathic scoliosis

93
Q

What does idiopathic scoliosis infer?

A

scoliosis is unique to the individual, has no known cause or etiology.

94
Q

What is the incidence of the idiopathic scoliosis in the population?

A

1-4%

95
Q

Based on age of onset, what are the types of idiopathic scoliosis?

A

Infantile, Juvenile, and adolescent

96
Q

Identify the curve direction, location, gender bias, and incidence of infantile idiopathic scoliosis?

A

Left thoracic
Male
Less than 1% incidence

97
Q

Identify the curve direction, location, gender bias, and incidence of juvenile idiopathic scoliosis?

A

Right thoracic
Females over 6
12-21% incidence

98
Q

Identify the curve direction, location, gender bias, and incidence of adolescent idiopathic scoliosis?

A

Right thoracic, or Right thoracic and Left Lumbar
Females
80% incidence

99
Q

What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?

A

Tip of the dens synchondrosis

100
Q

At what age will the tip of the dens center of ossification appear?

A

Sometime in early adolescence

101
Q

Based on the age of appearance, how is the tip of the dens center of ossification classified?

A

Secondary center of ossification

102
Q

At what age will the tip of the dens fuse with the odontoid process?

A

Before age 12

103
Q

If the joint formed between the tip of the dens and odontoid process centers of ossification persists beyond age 12, what is the condition called?

A

terminal ossicle

104
Q

What is a basilar impression?

A

Persistence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain.

105
Q

What is a basilar invagination?

A

Upper cervical spine appears to be invaginated into the skull on xray analysis

106
Q

What is/are the characteristic(s) of dorsalization of C7?

A

The addition of a rib and changes in superior articular facet orientation are typical.

107
Q

What is the incidence of rib-related changes following dorsalization of C7?

A

From one-half to two and one-half percent of the population

108
Q

Do patients typically present with symptoms specific for dorsalization of C7?

A

No, They are Asymptomatic

109
Q

What is the gender bias suggested in dorsalization of C7?

A

Female

110
Q

What alteration in C7 facet orientation may accompany dorsalization?

A

Superior articular facet changes from BUM–>BUL

inferior articular facet is unchanged

111
Q

what alteration in C6 facet orientation may accompany dorsalization?

A

Inferior articular facet changes from FoLD–> ForMeD

Superior articular facet unchanged

112
Q

What percent of the population may demonstrate thoracic-like features at C7?

A

up to 46%

113
Q

What rib-related changes may accompany cervicalization of T1?

A

First rib may decrease in mean relative length or become absent

114
Q

What will result from fusion of a short rib to the T1 transverse process?

A

transverse foramen

115
Q

What T1 facet orientation changes may accompany cervicalization?

A

Superior articular facet may change BUL–>BUM

Inferior articular facet is unchanged

116
Q

What C7 facet orientation changes may accompany cervicalization?

A

Inferior articular facet may change ForMeD–> FoLD Superior articular facet unchanged

117
Q

What is the incidence of cervicalization of T1 in the population?

A

up to 28%

118
Q

What rib-related changes may accompany dorsalization of L1?

A

elongated bones shaped like ribs may appear

119
Q

What is the incidence of lumbar ribs in the population?

A

over 7% of population demonstrates lumbar ribes

120
Q

What is the gender bias associated with dorsalization of L1?

A

Male, 2-3x more

Spinal TRI 2 (13 decks)

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