VI. Regions of the Vertebral Column Flashcards
Which mammals do not have seven cervical vertebrae?
the two toed sloth, manatee, ant bear, and three toed sloth
Which mammals have more than seven cervical vertebrae?
ant bear, three-toed sloth
Which mammals have less than seven cervical vertebrae?
two-toed sloth, manatee
What is the number of vertebrae in the typical cervical spine?
seven segments
Which vertebrae are typical cervicals?
C3-C6
Which vertebrae are atypical cervicals?
C1, C2, C7
What is the shape of the typical cervical vertebral body from the cranial view?
rectangular
What is the effect of aging on the cervical vertebral body?
it diminishes the overall height of the vertebral body
What is the appearance of the typical cervical vertebral body from the lateral view?
posterior height is greater than anterior height by a few millimeters
What would be the direction of the cervical curve based on osseous features?
posterior or kyphotic
What accounts for the direction of the typical cervical curve?
the intervertebral disc height
What is the direction of the typical cervical curve?
anterior or lordotic
Which vertebral couples will demonstrate a decrease in intervertebral disc height?
C2/C3 down to C4/C5
At which vertebral couple will the cervical curve again increase intervertebral disc height?
C5/C6
What are the modifications of the superior epiphyseal rim of a typical cervical?
anterior groove, posterior groove, right and left uncinate processes
What are the names of the lateral modification of the superior epiphyseal rim?
unicate process, unciform process, uncovertebral process, uncus or lateral lip
At what developemental age will the uncinate process first be observed?
3rd-4th fetal month
What are the modifications of the inferior epiphyseal rim of a typical cervical?
anterior lip, posterior lip, right and left lateral grooves
What are the names given to the lateral modifications of the inferior epiphyseal rim?
lateral groove or enchancrure
What is the joint classification for the anterior lip - anterior longitudinal ligament - anterior groove articulation?
fibrous (amphiarthrosis) syndesmosis
What is the joint classification for the posterior lip - posterior longitudinal ligament - posterior groove articulation?
fibrous (amphiarthrosis) syndesomosis
What is the joint classification for the unicate process - lateral groove articulation?
modified synovial saddle (diarthrosis sellar)
What is the joint classification for the spongy bone - intervertebral disc articulation?
cartilaginous (amphiarthrosis) symphysis
What joint surfaces are present on the upper surface of the vertebral body of a typical cervical?
anterior groove, right uncinate process, left uncinate process, posterior groove and superior spongy bone surface
How many joints are present on the upper surface of a typical cervical vertebral body?
five
What joint surfaces are present on the lower surface of the vertebral body of a typical cervical?
anterior lip, right lateral groove, left lateral groove, posterior lip, and inferior spongy bone surface
How many joints are present on the lower surface of a typical cervical vertebral body?
five
How many total joint surfaces are present on the vertebral body of a typical cervical?
ten
What synovial joint surfaces are present on the vertebral body of a typical cervical?
right and left uncinate process, right and left lateral groove
What is the name given to the uncinate process - lateral groove articulation?
joint of Luschka or uncovertebral joint
The joint of Luschka is formed from what surfaces?
the uncinate process and lateral groove
How many total synovial joint surfaces are present on the vertebral body of a typical cervical?
four
What does the recent literature suggest as to the nature of the joint of Luschka?
the joint is representative of the intervertebral disc aging, which results in loss of lamellar integrity near the joint
What is the functional significance of the joint of Luschka?
it appears to stabilize the intervertebral disc while accommodating flexion - extension and requiring couple motion (axial rotation with lateral bending) in the cervical spine
How many spongy bone - intervertebral disc articulation - spongy bone articulations are present on the vertebral body of a typical cervical?
two
How many cartilaginous (amphiarthrosis) symphysis joints are present on the vertebral body of a typical cervical?
two
What muscle attaches to the typical cervical vertebral body?
the longus colli muscle
What is the orientation and angulation of the pedicle of a typical cervical?
posterolateral, 45 degrees
At what location on the vertebral body of a typical cervical will the pedicle attach?
to the side and in the center of the vertebral body
In the vertebral couple, which cervical vertebral body will contribute more toward the height of the intervertebral foramen?
neither, both contribute equally to the intervertebral foramen height
What surface feature is located at the lower margin of the pedicle?
inferior vertebral notch
Which spinal nerve will be accommodated on the superior vertebral notch of C5?
C5 spinal nerve
Which spinal nerve will be accommodated on the inferior vertebral notch of C5?
C6 spinal nerve
What is the direction of projection of the cervical lamina?
posteromedially
What ligament attaches to the lamina of a typical cervical?
ligamentum flavum
What joint classification will be associated with the ligamentum flavum and its attachment?
fibrous (amphiarthrosis) syndesmosis
Ossification of the ligamentum flavum at the attachment site on the lamina will result in what feature?
para-articular processes
Ossification of the ligamentum flavum at the attachment site on the lamina will be associated with which classification of bone?
accessory bone
Ossificaiton within the length of the ligament flavum will be associated with which classification of bone?
heterotopic bone
What is the outline of the vertebral foramen of a typical cervical vertebra?
heart-shaped or triangular
Which is the greatest diameter of the vertebral foramen of typical cervicals?
transverse
What soft tissue diameter mimics the outline of the typical cervical vertebral foramen?
the transverse diameter of the cervical enlargement of the spinal cord
The greatest transverse diameter of the typical cervical vertebra occurs at …
C6
The greatest frequency of osteophytes associated with the vertebral body occurs at which typical cervical vertebral couple?
C5/C6
What osseous parts form the typical cervical vertebrae transverse process?
costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process
List, in order, the osseous parts of the typical cervical vertebra transverse process beginning at the lamina pedicle junction.
true transverse process, posterior tubercle, costotransverse bar, anterior tubercle, costal element
What is the distal modification of the costal element of a typical cervical vertebra?
the anterior tubercle
What muscles will attach to the anterior tubercle of a typical cervical vertebra?
anterior scalene, longus capitis, longus colli, anterior intertransversarii
What is the distal modification of the true transverse process of typical cervicals?
the posterior tubercle
What muscles may attach to the posterior tubercle of a typical cervical vertebra?
splenius cervicis, iliocostalis cervicis, longissimus cervicis, levator scapula, middle scalene, posterior scalene, rotators, and posterior intertransversarii
What bony feature connects the anterior and posterior tubercles of a typical cervical transverse process?
costotransverse bar or intertubercular lamella
What muscles will attach to the costotransverse bar?
middle scalene and posterior intertransversarii
What is the name given to the collective rib-forming region?
the pleurapophysis
What produces the primary tension on the transverse process that will cause remodeling in the anterolateral and inferior directions?
cervical spinal nerves as they are directed anterolaterally and inferiorly to form the cervical and brachial plexuses
What is the name given to the superior margin of the costotransverse bar?
sulcus for the ventral primary ramus of a cervical spinal nerve
What is the orientation and angulation of a typical cervical transverse process?
60 degrees anterolaterally (from midsagittal plane), 15 degrees inferiorly (from the horizontal plane)
What is the name given to the modification of the anterior tubercle of the C6 transverse process?
the carotid tubercle
What will cause remodeling of the anterior tubercle at C6?
the common carotid artery
What will occupy the typical cervical vertebra transverse foramen?
the vertebral artery, vertebral venous plexus and postganglionic sympathetic motor nerve fibers
What part of the peripheral nerve system is observed in the transverse foramen of typical cervical vertebra?
postganglionic sympathetic motor nerve fibers of the autonomic (involuntary or visceral) nerve system
What is the name of the lamina-pedicle junction of typical cervical vertebrae?
the articular pillar
What is the name of the surface feature observed between the ends of the articular pillar?
the groove/sulcus for the dorsal ramus of a cervical spinal nerve
What nerve indents the articular pillar of typical cervical vertebrae?
the medial branch of the dorsal ramus of a cervical spinal nerve
What is the classic angulation of typical cervical articular facets?
40 to 45 degrees from the coronal plane
Recent work suggests what angulation for typical cervical articular facets?
55 to 60 degrees
What is the orientation of the typical cervical superior articular facet?
backward, upward, medial (BUM)
What is the orientation of the typical cervical inferior articular facet?
forward, lateral, downward (FoLD)
What muscles will attach to typical cervical articular processes?
the longissimus capitis, longissimus cervicis, semispinalis capitis, semispinalis cervicis, multifidus, and rotators
What muscles blend with the capsular ligament of cervical zygapophyses?
the semispinalis capitis, multifidus, and rotator longus joint
What is the joint classification for the typical cervical zygapophysis?
synovial plane (diarthrosis arthrodia) joint
What modifications of the synovial joint are observed in the cervical spine?
meniscoidal folds
What function will meniscoidal folds provide in cervical zygapophyses?
they are assumed to distribute pressure across the joint surface
The greatest range of flexion - extension among the typical cervical vertebrae occurs at which vertebral couple?
typically 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?
the C2/C3, C3/C4, C4/C5 vertebral couples
Ranges of coupled motion among the typical cervical vertebrae will being 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 is the osseous modification at the distal end of the spinous process?
the spinous tubercle
What muscles may attach to the typical cervical spinous process?
the spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidus, rotators, and interspinalis
What ligaments will attach to the typical cervical spinous process?
the interspinous ligament and ligamentum nuchae
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 intervertebral foramen?
the inferior articular process (post-zygapophysis), the superior articular process (pre-zygapophysis), the capsular ligament, and the ligamentum flavum
What will form the superior boundary of a typical cervical intervertebral foramen?
the inferior vertebral notch or inferior vertebral incisure
What will form the inferior boundary of a typical cervical intervertebral foramen?
the superior vertebral notch or superior vertebral incisure
What is the unique anterior boundary of the intervertebral foramen for the 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 the intervertebral disc
What is though to represent the pedicle at C1?
the anterior arch
What osseous modification is observed to the front of the anterior arch of C1?
the anterior tubercle
What muscle attaches to the anterior arch of C1?
longus colli
What ligaments will attach to the anterior arch of C1?
the anterior longitudinal, anterior atlanto-occipital, and anterior atlanto-axial ligaments
What is observed on the back of the anterior arch of C1?
the fovea dentis
What joint classifications are observed on the anterior arch of C1?
fibrous (amphiarthrosis) syndesmosis joint and synovial pivot (diarthrosis trochoid) joint
What is the contribution of the lateral mass to the circumference of C1?
forty percent; twenty percent for each lateral mass
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 atlanto-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, and 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 circumference of C1?
about forty percent
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: about fifty millimeters
females: about thirty-seven millimeters
What attaches tot he posterior tubercle of the posterior arch of C1?
rectus capitis posterior minor muscle and ligamentum nuchae
What superior surface modifications of the posterior arch of C1 are present?
groove/sulcus for the vertebral artery and arcuate rim
What attaches to the arcuate rim of C1?
the posterior atlanto-occipital ligament
What are the attachment sites of the posterior atlanto-occipital ligament?
it is attached to the arcuate rim of the posterior arch of atlas, to the superior articular process of the lateral mass of atlas, and to the posterior margin of the foramen magnum of the occipital bone
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 what structures will form?
about age 7 years old
Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?
an incomplete ponticulus posticus or a complete ponticulus posticus
What may be formed by ossification of the anterior free margin of the posterior atlanto-occipital ligament?
a partial ponticulus posticus or incomplete ponticulus posticus
What forms the types of ponticulus posticus?
ossification of the anterior free margin of the posterior atlanto-occipital ligament
What are the attachment sites of the ponticulus posticus?
it is attached to the arcuate rim of the posterior arch of atlas and to the superior articular process of the lateral mass of atlas
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 posticushas 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 incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?
the incidence of a complete ponticulus posticus is about fifteen percent; the incidence of an incomplete ponticulus posticus may be as high as forty-one percent
What is observed on the undersurface of the posterior arch of C1?
“inferior vertebral notch” and an attachment site for the posterior atlanto-axial ligament
What joint classification(s) may be observed on the posterior arch of C1?
fibrous (amphiarthrosis) syndesmosis joint
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 intervertebral foramen in both cases
What is the general appearance of the transverse process of C1?
triangular
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 attach 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 suboccipital 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 forms of the lateral bridges are observed in the population?
incomplete lateral bridges and complete lateral bridges
What opening is identified when a complete lateral bridge is formed?
the retrotransverse foramen
What are the possible contents of the retrotransverse foramen?
the vertebral artery, a branch from the suboccipital 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 C1?
vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is the gender variation for measurements of the transverse diameter of C1?
males: 78 millimeters
females: 72 millimeters
Is there a gender variation for the distance from the posterior tubercle of the transverse process of C1 to the skin?
not a significant difference
What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?
a little over 30 millimeters 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 articular facets, and the fovea dentis
What names are given to C2?
axis or epistropheus
What unique vertebral body modification is characteristic of C2?
the dens or odontoid process
How many joint surfaces are present on the odontoid process of C2?
five
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, attachment 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) joints
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/classification given to the odontoid process when the tip of the dens is 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 attachment sites for the apical-dental and alar ligaments appear to be directed anterior?
kyphotic dens
What is the name/classification given to the odontoid process when the tip of the dens is 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 are formed by the inferior part of the vertebral body of C2?
five
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 body of C2?
ten
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 above C2?
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 is the location of the superior vertebral notch of C2?
on the lamina-pedicle junction
What attaches to the lamina of C2?
obliquus capitis inferior muscle, posterior atlanto-axial ligament, and ligamentum flavum
What muscle attaches to the lamina of C2?
obliquus capitis inferior
What is the outline of the vertebral foramen of C2?
oval to triangular
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, and lateral (BUL)
What is the orientation of the inferior articular facets of C2?
forward, lateral, and down (FoLD)
What is the classification of the zygapophyseal joints of C2?
synovial plane (diarthrosis arthrodia) joint
What muscle attaches to the articular processes of C3?
longissimus cervicis
What osseous parts of the typical cervical transverse process are present at C2?
anterior tubercle and costotransverse bar
What will be observed in the transverse foramen at C2?
vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers
What is the gender variation for the transverse diameter of C2?
males: fifty-seven millimeters
females: fifty millimeters
What muscles attach to the transverse process at C2?
levator scapulae, middle scalene, splenius cervicis, longissimus cervicis, and intertransversarii
Anterior and posterior intertransversarii are first observed at what vertebral couple?
C2 and C3
What is the characteristic appearance of the C2 spinous process in humans?
bifid
What is the location for palpation of the spinous process of C2?
in the midline, about two inches below the external occipital protuberance
What muscles attach to the spinous process of C2?
rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidus, rotators, and interspinalis muscles
What ligaments attach to the spinous process of C2?
ligamentum nuchae, interspinous ligaments
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
In what percent of men and of women does C7 become the vertebral prominence?
men: eighty-six percent
women: seventy-nine percent
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?
the anterior and posterior margins of the inferior epiphyseal rim, cancellous bone
How many joint surfaces are present at the vertebral body of C7?
eight
What joint classifications are observed at the vertebral body of C7?
fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis, and modified synovial saddle (diarthrosis sellar) joint
How many synovial joint surfaces are observed at the vertebral body of C7?
two
What synvoial joint surfaces are observed at the vertebral body of C7?
the right and left uncinate processes
What muscle(s) attaches to the vertebral body of C7?
longus colli muscle
What are the osseous parts of the transverse process of C7?
costal element, anterior tuberlce, costotransverse bar, posterior tuberlce, 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 costarum brevis
What is the angulation of the articular facet at C7?
more vertical at about 63 degrees
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, and downward (ForMeD)
What muscles will attach to the articular process of C7?
longissimus cervicis, longissimus capitis, semispinalis cervicis, and multifidus