1: Back Osteology

Question 1

Jefferson Fracture / Burst Fracutre

Answer 1

Fracture of both arches of the atlas (C1)

Question 2

What causes Jefferson fracture

Answer 2

Blow to the top of the head

Question 3

Does the Jefferson fracture injury the spinal cord typically?

Answer 3

No; unless the transverse ligament is ruptured too

Question 4

Two types of Axis (C2) fractures

Answer 4

Hangman’s fracture, fracture of the dens

Question 5

Hangman’s fracture

Answer 5

Vertebral arch fracture of C2, usually from hyperextending the head

Question 6

What would break first, the dens or the transverse ligament?

Answer 6

Dens is weaker = breaks first

Question 7

Dens healing if it breaks at the base vs inferior to the base

Answer 7

At the base: will not heat (no blood supply there)

Inferior to the base: much more likely to heal

Question 8

Why are C spine vertebrae more likely to dislocate

Answer 8

They are more horizontal instead of anterior/posterior facing

Question 9

Why is there not always injury involved with cervical vertebrae dislocations

Answer 9

C spine vertebral foramen is pretty large and accommodating

Question 10

Spina bifida occulta

Answer 10

Vertebral lamina fails to close at vertebral canal of L5-S1

Question 11

Spina bifida cystica

Answer 11

Incorporates neural tissue and meninges into spina bifida occulta

Question 12

Spondylosis

Answer 12

DJD, calcification of edges of vertebral body -> pain and stiffness

Question 13

Spondylolysis

Answer 13

Separation of vertebral arch from vertebral body

Question 14

Spondylolisthesis

Answer 14

Anterior displacement of vertebral body on inferior vertebral segment, can occur secondarily to spondylolysis

Question 15

Lumbar spinal stenosis

Answer 15

Narrowing of lumbar vertebral foramen - May cause compression of 1+ spinal nerve roots

Question 16

Where to insert needle for lumbar puncture

Answer 16

Between L3/L4 or L4/L5

Question 17

What creates a pop noise when doing a lumbar puncture?

Answer 17

Passing needle through the ligamentum flavum

Question 18

Where do you want the needle to end up in a lumbar puncture?

Answer 18

Lumbar cistern; deep to arachnoid mater

Question 19

Sacrilization of L5 vertebra

Answer 19

Partial/complete incorporation of L5 vertebral segment into the sacrum

Question 20

Lumbarization of S1 vertebra

Answer 20

Separation of S1 from sacrum

Question 21

Coccygodynia cause

Answer 21

Coccygeal trauma

Question 22

Kyphosis vs lordosis

Answer 22

Kyphosis: exaggerated T spine curvature
Lordosis: exaggerated L spine curvature

Question 23

Two things transmitted in the mastoid foramen

Answer 23

Mastoid emissary V + meningeal branch of occipital A

Question 24

What does the mandibular fossa articulate with?

Answer 24

Condylar process of mandible at TMJ

Question 25

What do the occipital condyles articulate with?

Answer 25

Superior articulating process of the atlas

Question 26

Where is the groove for the vertebral artery on C1?

Answer 26

On the posterior arch

Question 27

What transmits the vertebral artery in the C spine?

Answer 27

Transverse foramen C1-C6

Question 28

Where are spinous processes often bifid?

Answer 28

C spine

Question 29

Anterior tubercle on C6 is called what?

Answer 29

Carotid tubercle

Question 30

Superior vs inferior costal facet on T spine

Answer 30

Superior costal facet: art w costal head of same numeric segment Inferior costal facet: art w costal head of rib below

Question 31

Transverse costal facets

Answer 31

Articulate with costal tubercle of same numeric segment

Question 32

Crest of the head of the rib

Answer 32

Separates superior and inferior articular facets of the rib

Question 33

What runs in the costal groove of ribs?

Answer 33

Intercostal N’s and vessels

Question 34

Accessory process of L spine transverse processes

Answer 34

At the base of the transverse process; attachment site for intertransversarii muscles

Question 35

Mammillary process: two attachments

Answer 35

Multifidi, intertransversarii

Question 36

Sacral promontory

Answer 36

Anteriorly-projecting edge of vertebral body of S1

Question 37

What do the auricular surfaces of the sacral alae articulate with?

Answer 37

Articular surface of ilium

Question 38

Medial, median, and lateral sacral crests

Answer 38

Medial: fused spinous processes Median: fused articulating processes Lateral: fused transverse processes

Question 39

What do the posterior and anterior sacral foramina transmit?

Answer 39

Posterior: posterior rami Anterior: anterior rami

Question 40

What forms the sacral hiatus?

Answer 40

Gap left due to absence of lamina and spinous processes of S5

Question 41

What what do the transverse lines of the anterior sacrum represent?

Answer 41

Fusion of the sacral vertebrae

Question 42

What does the sacral canal transmit?

Answer 42

Cauda equina

Question 43

What does the coccygeal cornua articulate with?

Answer 43

Sacral cornua