Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vertebral Column > Variation Of The Vertebral Column > Flashcards

Variation Of The Vertebral Column Flashcards

1
Q

What forms the vertebrae?

A

Sclerotome of somites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When the sclerotome surrounds the Spinal Cord and notochord, when does it fuse with the opposite side?

A

4th week of development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is resegmentation in regards to the development of vertebrae?

A

The caudal half of one somite an the cranial half of the next somite fuse to form the resegmented sclerotome that will become a vertebra
Eg. The caudal half of the 5th somite and the cranial half of the 6th somite forms C1 (Pang and Thompson, 2011)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What genes regulate formation of vertebrae? Where are these genes inherited from?

A

HOX genes

Maternal mRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What cells are found between two vertebrae?

A

Mesenchymal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the reference for vertebral embryology?

A

Sadler, 2012

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What features are fused in complete occipitalisation of the atlas?

A

Posterior arch
Anterior arch
Lateral masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is partial occipitalisation of the atlas?

A

Any osseous bridge uniting a focal areas of the atlas and occiput

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the three zones in the classification of occipitalisation of the atlas? (Reference?)

A

Zone 1 = Anterior arch
Zone 2 = Lateral masses
Zone 3 = Posterior arch
(Gholve et al., 2007)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the embryological origin of occipitalisation of the atlas?

A

Sclerotome fails to differentiate into cranial and caudal parts
Caudal part of occipital sclerotome 4 and cranial part of C1 sclerotome remain fused
Lack of resegmentation between loose and dense zones of cervical sclerotome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the sequelae of occipitalisation of the atlas?

A

Anomalous vertebral arteries
Torticollis
Neck pain and stiffness
Myelopathy
Atrophy of rectum capitis posterior major
Inadequate attachment for obliquus capitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Thavarajah and McKenna, (2012) case study?

A

Congenital absence of anterior arch of C1
35 year old female with 4 day history of neck pain
CT showed congenital absence and non fusion of anterior arch of C1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the Khanna et al., (2014) case study?

A

Complete absence of posterior arch of C1

46 year old male with upper cervical and occipital pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the prevalence of congenital absence of anterior arch of atlas?

A

0.1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the prevalence of congenital absence of the posterior arch of C1?

A

4-5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the five types of absence of posterior arch of C1? (Reference?)

A 
Type A = Two hemiarches (90%)
Type B = Unilateral cleft
Type C = Bilateral cleft
Type D = Absence of arch with tubercle
Type E = Absence of arch and tubercle
(Currarino et al., 1994)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the sequelae of congenital absence of anterior arch of C1?

A 
Instability
Torticollis
No articulation site for dens
Absence of transverse ligament of atlas
Lack of attachment for:
- Longus coli and ALL
- Atlanto-occipital membrane and anterior atlanto-occipital ligament
Subluxation and Cord compression = Quadriparesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the sequelae of congenital absence of the posterior arch of C1?

A 
Usually stable
Generally asymptomatic
Spinal canal stenosis
Myelopathy
Neck pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In what percentage of Down’s syndrome patients is atlantoaxial subluxation seen?

A

15-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the prevalence of accurate foramen of the atlas? (Reference?)

A

16.7%

Elliot and Tanweer, 2014

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What environmental factors could contribute to arcane foramen of the atlas?

A

Carrying heavy objects on head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an arcade foramen of the atlas?

A

A bony bar (ponticulus) arises from the lateral masses and turns the groove for the vertebral artery into a foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the pathogenesis of calcification of the posterior atlanto-occipital membrane and how it can result in an arcane foramen of the atlas?

A

Calcifies from posterior superior articular process to posterior arch of C1
Can be complete/incomplete
Can be unilateral/bilateral
Encloses the V3 portion of the vertebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why are ossified primitive ligaments an unlikely pathogenesis for arcuate foramen of atlas?

A

Ossification centres not identified in that location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Apart from calcification of the posterior atlanto-occipital membrane and ossified primitive ligaments, what are the other pathogeneses of arcuate foramen of the atlas?

A

Bony feature forming a bridge over the vertebral artery

Accessory transverse foramen of atlas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How can an arcuate foramen of C1 affect the vertebral artery?

A

Increased incidence of dissection as it is tethered:
- Neck movements = Repetitive trauma
Compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What syndrome can result from periarterial sympathetic plexus disruption in arcuate foramen of C1? How does it present? (Reference?)

A 
Barre-Lieou Syndrome:
- Headache
- Retro-orbital pain
- Facial vasomotor disturbance
- Visual disturbance
- Difficulty with swallowing and phonation
(Limousin, 1980)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can arcuate foramen of the atlas affect surgery?

A

Mistaken for broad posterior arch
- Screws inserted into arcuate foramen
Complications posterior approaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is hypoplasia of the dens?

A

Short dens height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is os odontoideum?

A

Failed fusion of dens to centrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is os terminale persistens?

A

Failed fusion of ossiculum terminale to body of dens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How does a bifid dens arise?

A

Failed/Partial fusion of the two parts of the body of the dens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is pseudosubluxation of C2?

A

Anterior sliding of C2 on C3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why is pseudosubluxation of C2 more common in the juvenile skeleton?

A 
Hypermobility
Lax ligaments
Large head (in relation to weak neck muscles)
Shallow, angled facet joints
Incomplete ossification of dens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What effects does pseudosubluxation of C2 have on the juvenile skeleton?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What effects does pseudosubluxation of C2 have on the adult skeleton?

A

C2 dislocation

Possible Hangman’s fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What syndromes is pseudosubluxation of C2 seen in?

A

Down’s syndrome

Moquio’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the reference for pseudosubluxation of C2?

A

Kim, 2013

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is Klippel-Feil syndrome?

A

Abnormal congenital fusion of 2 or more cervical vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the epidemiology of Klippel-Feil syndrome?

A

0.71% prevalence

More common in females

41
Q

What factors can result in Klippel-Feil syndrome?

A

Genetics:
- Autosomal recessive or dominant
Environmental:
- Alcohol

42
Q

What is the pathogenesis of Klippel-Feil syndrome?

A

Improper segmentation of cervical vertebrae during 3rd-8th weeks of gestation

43
Q

What is Type 1 Klippel-Feil syndrome?

A

Cervical spine fusion

Many elements of many vertebrae are incorporated into a single block

44
Q

What is Type 2 Klippel-Feil syndrome?

A

Cervical spine fusion
Failure of complete segmentation at only 1 or 2 cervical levels
May include occipito-atlantal fusion

45
Q

What is Type 3 Klippel-Feil syndrome?

A

Type 1 or 2 PLUS
Co-existing segmentation errors in:
- Lower thoracic spine OR
- Lumbar spine

46
Q

What is the reference for types of Klippel-Feil syndrome?

A

Vaidyanathan et al., 2002

47
Q

Where is the most common level of fusion in Klippel-Feil syndrome? (Reference?)

A

C2-C3

Cho et al., 2014

48
Q

What did the Yadav et al., 2014 case study see in Klippel-Feil syndrome?

A

C2-C3 Completely fused on both anterior and posterior aspects
Foramen transversarium all present
No IV discs

49
Q

What did the Leung et al., (2011) study into Klippel-Feil syndrome at C2-C3 find?

A

All neck movements in a C2-C3 fused KFS spine displayed greater levels of stress compared to normal
Certain movements resulted in significantly higher stress:
- Neck extension
- Neck lateral flexion to the right

50
Q

What functional change can result from Klippel-Feil syndrome?

A

Reduced range of movement

51
Q

What degenerative changes can arise in Klippel-Feil syndrome?

A

Acquired cervical stenosis -> Myelopathy
Osteoarthritis -> Radiculopathy
Dens fracture

52
Q

What is the reference for functional and degenerative changes in Klippel-Feil syndrome?

A

Pizzutillo et al., 1994

53
Q

In what percentage of young Klippel-Feil syndrome patients is scoliosis present? (Reference?)

A

53.3%

Samartzis et al. 2011

54
Q

What results in neural arch variations?

A

Changes in ossification process

55
Q

What are retrosomatic clefts?

A

Vertical defects in the pedicle

56
Q

What are retroisthmic clefts?

A

Defects in lamina immediately dorsal to the inferior articular process

57
Q

What is spinal dysraphism?

A

Failure of neural arch fusion

58
Q

What is spinal dysraphism associated with?

A

Spina bifida:

  • Occulta
  • Meningocoele
  • Myelomeningocoele
59
Q

What is primary spondylolysis of the axis?

A

Clef through C2 pars interarticularis

60
Q

What is the reference for neural arch variations?

A

Mellado et al. 2011a and 2011b

61
Q

Where is spinal canal stenosis commonest?

A

Lumbar or cervical regions

62
Q

What are the symptoms of cervical spinal stenosis?

A

Gait disturbance
Partial paralysis of lower limbs
Limited Flexion of neck

63
Q

What are the symptoms of lumbar spinal stenosis?

A 
Pain in:
- Hips
- Groin
- Buttocks
Numbness/Weakness in lower limbs and lower back
64
Q

What can cause spinal canal stenosis?

A

Degenerative disc bulging
Hypertrophied ligamentum flavum
Degenerative facet joint changes

65
Q

Why do symptoms arise in spinal stenosis?

A

Spinal cord compression

66
Q

What is the gold standard for classification of (lumbar) canal stenosis?

A

There is none

67
Q

What are the references for spinal canal stenosis?

A

Azimi et al., 2015; ManfrÃ, 2016

68
Q

What is the incidence of spina bifida?

A

0.5-0.8/1000 live births

69
Q

What is the pathogenesis of spina bifida? (Reference?)

A 
Failure of neural tube closure during week 4 of development
Vertebral arch is either:
- Incomplete
- Absent
(Copp et al., 2015)
70
Q

What is spina bifida occulta?

A

Absence of spinous process

Variable amount of laminae

71
Q

What is meningiocele?

A

Herniation of meningeal tissue and CSF

72
Q

What is myelomeningiocele?

A

Herniation of meningeal tissue, CSF and CNS tissue

73
Q

What is the prevalence of spina bifida occulta in the general population?

A

10-15%

74
Q

How can meningiocele present?

A

Usually asymptomatic so incidental finding

Low incidence of hydrocephalus

75
Q

What is the pathogenesis of the sensory and motor defects in myelomeingiocele?

A

Prolonged exposure of open neural tube to amniotic fluid
Neuronal differentiation occurs, even below lesion
Toxicity of amniotic fluid causes haemorrhage and neuronal death

76
Q

What is myelomeningiocele associated with?

A

Urinary and faecal incontinence
65-85% associated hydrocephalus
Type II Chiari malformation

77
Q

What is the reference for types of spina bifida?

A

Copp et al., 2015

78
Q

How does Butterfly vertebra present?

A

Usually asymptomatic

79
Q

When does butterfly vertebra arise?

A

Between weeks 3-6 of gestation

80
Q

What is the pathogenesis of butterfly vertebra?

A

Symmetric fusion defect -> ‘Split’ vertebra

Both chondrification centres fail to develop (related to hemivertebrae)

81
Q

What can butterfly vertebra be confused with?

A

Compression fracture if trapezoidal or cuneiform anterior wedging

82
Q

What does the Ozaras et al., (2015) case study on butterfly vertebra show?

A 
38 year old male with lower back pain:
- Worse when standing and walking
PMHx of Behçet's disease
Coronal CT showed butterfly vertebrae at:
- L3
- T9
83
Q

What syndromes is butterfly vertebra associated with?

A

Pfeiffer syndrome
Jarcho-Levin syndrome
Crouzon syndrome
Alagille syndrome

84
Q

What other spinal anomalies is butterfly vertebra associated with?

A

Kyphoscoliosis
Hemivertebrae
Spina bifida

85
Q

When does hemivertebrae arise?

A

During weeks 4-6 of development

86
Q

What is the pathogenesis of hemivertebrae?

A

One chondrification centre fails to develop -> Wedge of bone:

  • Half of a vertebral body
  • 1 pedicle
  • Hemilamina
87
Q

In what region(s) are hemivertebrae most common?

A

Thoracic

Lumbar

88
Q

What spinal deformity do hemivertebrae result in?

A

Congenital scoliosis

89
Q

What is a fully segmented hemivertebra?

A

Has no attachment to other vertebrae

90
Q

What is a semisegmented hemivertebra?

A

Half is fused with vertebra above or below

No IV disc

91
Q

What is an incarcerated hemivertebra?

A

Joined by pedicles to vertebrae above and below

92
Q

What is a non-segmented hemivertebra?

A

Connected to vertebrae above and/or below

93
Q

What is the most concerning type of hemivertebra?

A

Fully segmented

94
Q

What conditions are associated with hemivertebrae?

A

VATER syndrome
VACTERL syndrome
Jarcho-Levin syndrome
Klippel-Feil syndrome

95
Q

What are the references for hemivertebrae?

A

Johal et al., 2016
Ozaras et al., 2015
Weerakkody, 2017

96
Q

In regards to block vertebrae, what does Leviseth et al., (2005) show?

A

Causally adjacent disk height is significantly less

Discs not affected cranially

97
Q

In regards to block vertebrae, what did Guille et al., (1995) show?

A

59% of Klippel-Feil syndrome patients had degeneration adjacent to block vertebrae

98
Q

In regards to block vertebrae, what did Karuppal et al., (2013) show?

A

1st rib fracture associated with type 1 cervical block vertebra

99
Q

What can lumbar block vertebrae be associated with?

A

Weakness in muscles:

  • Abdominals
  • Hip flexor
  • Quadriceps

Vertebral Column (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions