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Spinal > Highlighted questions #2 > Flashcards

Highlighted questions #2 Flashcards

1
Q

What muscles may attach to the posterior tubercle of a typical cervical vertebra?

A

splenius cervicis, iliocostalis cervicis, longissimus cervicis, levator scapula, middle scalene, posterior scalene, rotators and posterior intertransversarii

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2
Q

What muscles will attach to the costotransverse bar?

A

middle scalene and posterior intertransversarii

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3
Q

What produces the primary tension on the transverse process that will cause remodeling in the anterolateral and inferior directions?

A

cervical spinal nerves as they are directed anterolaterally and inferiorly to form the cervical and brachial plexuses

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4
Q

What is the name given to the superior margin of the costotransvere bar?

A

sulcus for the ventral primary ramus of a cervical spinal nerve

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5
Q

What is the orientation and angulation of a typical cervical transverse process?

A

60 degrees anterolaterally (from midsagittal plane), 15 degrees inferiorly (from the horizontal plane)

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6
Q

What is the name given to the modification of the anterior tubercle of the C6 transverse process?

A

the carotid tubercle

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7
Q

What will occupy the typical cervical vertebra transverse foramen?

A

the vertebral artery, vertebral venous plexus and postganglionic sympathetic motor nerve fibers

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8
Q

What is the name of the surface feature observed between the ends of the articular pillar?

A

the groove/sulcus for the dorsal ramus of a cervical spinal nerve

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9
Q

What is the classic angulation of a typical cervical articular facets?

A

40 to 45 degrees from the coronal plane

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10
Q

Recent work suggests what angulation for typical cervical articular facets?

A

55 to 60 degrees

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11
Q

What is the orientation of the typical cervical superior articular facet?

A

BUM

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12
Q

What is the orientation of the typical cervical inferior articular facet?

A

FoLD

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13
Q

What muscles will attach to typical cervical articular processes?

A

the longissimus capitis, longissimus cervicis, semispinalis capitis, semispinalis cervicis, multifidis and rotators

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14
Q

What muscles blend with the capsular ligament of cervical zygaphophyses?

A

the semispinalis capitis, multifidis and rotator longus

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15
Q

What modifications of the synovial joint are observed in the cervical spine?

A

meniscoidal folds

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16
Q

What function will meniscoidal folds provide in cervical zygapophyses?

A

they are assumed to distribute pressure across the joint surface

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17
Q

The greatest range of flexion - extension among the typical cervical vertebrae occurs at which vertebral couple?

A

typically C5/C6

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18
Q

What motions are coupled in the cervical spine?

A

lateral bending and axial rotation

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19
Q

Ranges of coupled motion among the typical cervical vertebrae will be similar for what cervical vertebral couples?

A

the C2/C3, C3/C4, C4/C5 vertebral couples

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20
Q

Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?

A

the C5/C6 vertebral couple

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21
Q

What is the usual condition for the Caucasian typical cervical spinous process?

A

they are bifid

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22
Q

What is the usual condition for the African-American typical cervical spinous process?

A

they are non-bifid

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23
Q

What muscles may attach to the typical cervical spinous process?

A

the spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

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24
Q

What ligaments will attach to the typical cervical spinous process?

A

the interspinous ligament and ligamentum nuchae

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25
Q

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

A

the lateral groove and vertebral body of the segment above, the uncinated process and vertebral body of the segment below, the intervertebral disc and the posterior longitudinal ligament

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26
Q

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

A

the inferior articular process (post-zygapophysis), the superior articular process (pre-zygaphophysis), the capsular ligament and the ligamentum flavum

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27
Q

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

A

the inferior vertebral notch or inferior vertebral incisure

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28
Q

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

A

the superior vertebral notch or superior vertebral incisure

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29
Q

What is the unique anterior boundary of the intervertebral foramen for the C4 spinal nerve?

A

the lateral groove of C3 and uncinated process of C4 forming the joint of Luschka

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30
Q

What is the name of the first cervical vertebra?

A

atlas

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31
Q

What features are lacking at C1?

A

vertebral body, pedicles, a spinous process and the intervertebral disc

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32
Q

What is thought to represent the pedicle at C1?

A

the anterior arch

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33
Q

What osseous modification is observed to the front of the anterior arch of C1?

A

the anterior tubercle

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34
Q

What muscle attaches to the anterior arch of C1?

A

longus colli

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35
Q

What ligaments will attach to the anterior arch of C1?

A

the anterior longitudinal, anterior atlanto-occipital and anterior atlanto-axial ligaments

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36
Q

What is observed on the back of the anterior arch of C1?

A

the fovea dentis

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37
Q

What joint classifications are observed on the anterior arch of C1?

A

fibrous (amphiarthrosis) syndesmosis joint and synovial pivot (diarthrosis trochoid) joint

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38
Q

What is the morphology of the superior articular facet of C1?

A

they are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces

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39
Q

What is the orientation of the superior articular facet of C1?

A

BUM

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40
Q

What is the joint classification of the atlanto-occipital zygapophysis?

A

synovial (diarthrosis) ellipsoidal joint

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41
Q

What are the morphological characteristics of the inferior articular facet of C1?

A

asymmetrical, slightly concave or flattened

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42
Q

What is the orientation of the inferior articular facet of C1?

A

BMD

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43
Q

What is the joint classification of the atlanto-axial zygapophysis?

A

synovial plane (diarthrosis arthrodial) joint

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44
Q

What is the name of the rounded elevation on the medial aspect of the lateral mass of C1?

A

tubercle for the transverse atlantal ligament

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45
Q

What muscles attach to the lateral mass of C1?

A

levator scapula, splenius cervicis and rectus capitis anterior

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46
Q

What part of C1 represents the spinous process?

A

posterior tubercle of the posterior arch

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47
Q

What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?

A

males: about fifty millimeters; females: about thirty-seven millimeters

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48
Q

What attaches to the posterior tubercle of the posterior arch of C1?

A

rectus capitis posterior minor muscle and ligamentum nuchae

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49
Q

What superior surface modifications of the posterior arch of C1 are present?

A

groove/sulcus for the vertebral artery and arcuate rim

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50
Q

What attaches to the arcuate rim of C1?

A

the posterior atlanto-occipital ligament

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51
Q

Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?

A

accessory bone

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52
Q

What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed

A

about age 7 years old

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53
Q

Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?

A

an incomplete ponticulus posticus or a complete ponticulus posticus

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54
Q

What other name may be used to identify a ponticulus posticus?

A

Kimmerle’s anomaly

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55
Q

What names are given to the opening formed by the ponticulus posticus?

A

arcuate foramen or retroarticular canal

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56
Q

ponticulus posticus has observed in what ethnic populations?

A

all ethnic populations studied thus far

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57
Q

What is the general range of incidence of ponticulus posticus in the populations studied?

A

1%-41%

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58
Q

What is the gender bias now associated with ponticulus posticus?

A

female

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59
Q

What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?

A

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

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60
Q

What are the osseous parts of the transverse process of C1?

A

costal element, posterior tubercle, true transverse process

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61
Q

What muscles attach to the transverse process of C1?

A

rectus captitis anterior, rectus capitis lateralis, middle scalene, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles

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62
Q

What suboccipital muscles are known to have fascial projections attaching to the spinal dura?

A

rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior

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63
Q

What are the connections between suboccipital muscles and the spinal dura called?

A

myodural bridges

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64
Q

What are the lateral bridges of atlas connected to?

A

the lateral mass and the treansverse process of atlas

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65
Q

What forms of the lateral brideges are observed in the population?

A

incomplete lateral bridges and complete lateral bridges

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66
Q

What opening is identified when a complete lateral bridge is formed?

A

the retrotransverse foramen

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67
Q

What are the possible contents of the retrotransverse foramen?

A

the vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck

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68
Q

Which of the ponticles (bridges) of atlas is most numerous?

A

ponticulus posticus

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69
Q

Which of the ponticles (bridges) of atlas is only observed in humans?

A

lateral bridges

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70
Q

What is observed in the transverse foramen of C1?

A

vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

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71
Q

What is the gender variation for measurements of the transverse diameter of C1?

A

males: 78 millimeters and females: 72 millimeters

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72
Q

What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?

A

a little over 30 millimeters for both males and females

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73
Q

How many synovial joint surfaces are observed at C1?

A

five

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74
Q

What names are given to C2?

A

axis or epistropheus

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75
Q

What unique vertebral body modification is characteristic of C2?

A

the dens or odontoid process

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76
Q

How many joint surfaces are present on the odontoid process of C2?

A

five

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77
Q

What joint surfaces are present on the odontoid process of C2?

A

facet for fovea dentis, groove for transverse atlantal ligament, attachment sites for the alar ligaments, attachment site for the apical-dental ligament

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78
Q

What is the name/classification given to the odontoid process when the tip of the dens is directed posterior?

A

lordotic dens

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79
Q

What is the name/classification given to the odontoid process when the tip of the dens is directed anterior?

A

kyphotic dens

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80
Q

What joint classifications are present at the vertebral body of C2?

A

fibrous (amphiarthrosis) syndesmosis, synovial pivot (diarthrosis trochoid), modified synovial saddle (diarthrosis sellar) and cartilaginous (amphiarthrosis) syndesmosis

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81
Q

What ligament will represent the cranial continuation of the posterior longitudinal ligament?

A

membrane tectoria

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82
Q

What ligament forms the anterior boundary for the spinal canal above C2?

A

membrane tectoria

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83
Q

What ligament forms the anterior boundary for the spinal canal below C2?

A

posterior longitudinal ligament

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84
Q

What is the location of the superior vertebral notch of C2?

A

on the lamina-pedicle junction

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85
Q

What attaches to the lamina of C2?

A

obliquus capitis inferior muscle, posterior atlanto-axial ligament, ligamentum flavum

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86
Q

What is the appearance of the superior articular facets of C2?

A

they are asymmetrical and slightly convex

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87
Q

What is the facet orientation of the superior articular facet of C2?

A

BUL

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88
Q

What is the orientation of the inferior articular facets of C2?

A

FoLD

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89
Q

What muscle attaches to the articular processes of C2?

A

longissimus cervicis

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90
Q

What will be observed in the transverse foramen at C2?

A

vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

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91
Q

What is the gender variation for the transverse diameter of C2?

A

males: 57 mm females: 50 mm

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92
Q

What muscles attach to the transverse process at C2?

A

levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii

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93
Q

What is the characteristic appearance of the C2 spinous process in humans?

A

bifid

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94
Q

What muscles attach to the spinous process of C2?

A

rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators and interspinalis muscles

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95
Q

What ligaments attach to the spinous process of C2?

A

ligamentum nuchae, interspinous ligaments

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96
Q

What names may be given to C7?

A

vertebra prominens and vertebral prominence

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97
Q

What is the name given to the topographical elevation observed at the base of the neck?

A

vertebral prominence

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98
Q

What name is given only to C7?

A

vertebra prominens

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99
Q

In what percent of men and of women does C7 become the vertebral prominence?

A

men: 86% women: 79%

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100
Q

What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?

A

C6 is more common in females and T1 is more common in males

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101
Q

How many joint surfaces are present at the vertebral body of C7?

A

8

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102
Q

What joint classifications are observed at the vertebral body of C7?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and modified synovial saddle (diarthrosis sellar) joint

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103
Q

What muscle(s) attaches to the vertebral body of C7?

A

longus colli muscle

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104
Q

What features are typically present in the transverse foramen of C7?

A

vertebral venous plexus, postganglionic sympathetic motor fibers

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105
Q

What muscles attach to the transverse process of C7?

A

middle scalene, iliocostalis thoracis, longissimus cervicis, semispinalis capitis, rotators, intertransversarii and levator costarum brevis

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106
Q

What is the orientation of the superior articular facet of C7?

A

BUM

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107
Q

What is the orientation of the inferior articular facet of C7?

A

ForMeD

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108
Q

What muscles will attach to the articular process of C7?

A

longissimus cervicis, longissimus capitis, semispinalis cervicis and multifidis

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109
Q

What muscles attach to the spinous process of C7?

A

trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

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110
Q

What ligaments attach to the spinous process of C7?

A

ligamentum nuchae and interspinous ligaments

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111
Q

The vertebral artery on which side is typically larger?

A

left vertebral artery

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112
Q

What is the gender bias regarding size of the vertebral artery?

A

men have larger vertebral arteries than women

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113
Q

What was the name of the physical exam used to determine vertebral artery patency?

A

the vertebrobasilar artery insufficiency test

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114
Q

Which side artery was tested during the course of the vertebrobasilar artery insufficiency exam?

A

the ipsilateral artery on the side of roation

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115
Q

Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?

A

C6

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116
Q

At what location will the vertebral artery form its first compensatory loop?

A

the atlanto-axial interspace

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117
Q

At what location will the vertebral artery form its second compensatory loop?

A

the atlanto-occipital interspace

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118
Q

At what segments will the vertebral artery be firmly attached to the transverse foramen?

A

both C1 and C2

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119
Q

What is the purpose of the vertebral artery loops between C2, C1, and occiput?

A

the increased length will accommodate the greater rotation at these locations

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120
Q

What happens to the vertebral artery after it enters the subarachnoid space at C1?

A

the vertebral artery ascends along the medulla oblongata to the pontine-medullary junction where the right and left arteries unite to form the basilar artery

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121
Q

Which suboccipital muscles attach to C1?

A

rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior

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122
Q

Which suboccipital muscles attach to C2?

A

rectus capitis posterior major, obliquus capitis inferior

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123
Q

Which erector spinae muscles attach to the cervical spine?

A

iliocostalis thoracis, iliocostalis cervicis, longissimus cervicis, longissimus capitis, spinalis cervicis, spinalis capitis

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124
Q

Which trasversospinalis muscles attach to the cervical spine?

A

semispinalis cervicis, semispinalis capitis, multifidis, rotators

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125
Q

What joint classifications are present at C1?

A

synovial (diarthrosis) ellipsoidal, synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodial) and fibrous (amphiarthrosis) syndesmosis

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126
Q

What joint classifications are present at C2?

A

synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodial), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis joint

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127
Q

What joint classifications are present at each typical cervical?

A

synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis

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128
Q

What joint classifications are present at C7?

A

synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis

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129
Q

What forms the boundaries for the exit of the C1 nerve from the spinal canal?

A

occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament

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130
Q

What forms the boundaries for the exit of the C2 nerve from the spinal canal?

A

inferior articular process of C1, superior articular process of C2, capsular ligament, inferior vertebral notch of C1, superior vertebral notch of C2, posterior arch of C1, lamina of C2, posterior atlanto-axial ligament

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131
Q

What forms the anterior boundary for the C2 nerve exit from the spinal canal?

A

inferior articular process of C1, superor articular process of C2, capsular ligament

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132
Q

What forms the posterior boundary for the C2 nerve exit from the spinal canal?

A

the posterior arch of C1, lamina of C2 and posterior atlanto-axial ligament

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133
Q

What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?

A

the vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinated process, lateral groove

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134
Q

What forms the anterior boundary for the C8 nerve exit from the spinal canal?

A

the vertebral bodies of C7 and T1, intervertebral did, posterior longitudinal ligament, capsular ligament of the costocentral joint, superior costal facet of T1 and articular surface of the first rib

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135
Q

What are the superior articular facet orientations for the cervical vertebrae?

A

C1 is BMD, C2-6 is FoLD, C7 is ForMeD

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136
Q

How many synovial joints are identified for each cervical vertebra?

A

1 : five, 2: 8, 3-6: 8, 7: 6

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137
Q

How many joints are identified at the vertebral body of each cervical vertebra?

A

1 : none, 2: 10, 3-6: 10, 7: 8

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138
Q

What features will allow discrimination between T2-4 and T5-8 segmental groups?

A

the vertebral body, transverse process, articular process and spinous process

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139
Q

What is the name given to the left side appearance of the vertebral body of T5-8?

A

the aortic impression

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140
Q

What part of the vertebral body is most influenced by the aorta at T5-8

A

the left side superior and inferior epiphyseal rims

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141
Q

What is the height pattern of the typical thoracic vertebral body?

A

the posterior height is greater than the anterior height by one to two mm

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142
Q

What is the principal cause of the posterior curve of the thoracic spine?

A

the vertebral body height differences

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143
Q

In terms of the anterior-posterior curves of the vertebral column, what direction will the thoracic spine face?

A

posterior

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144
Q

What is another way of naming a posterior curve pattern?

A

kyphotic curve

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145
Q

How many synovial joints are formed at the vertebral body of a typical thoracic?

A

four

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146
Q

How many symphysis joints are formed with the vertebral body of a typical thoracic?

A

two

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147
Q

How many joints are formed at the vertebral body of a typical thoracic?

A

typically ten (14 if the costocentral stellate/radiate ligaments are included)

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148
Q

How many costocentral joints are formed at the vertebral body of a typical thoracic?

A

four

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149
Q

Which of the demi-facets on the vertebral body of a typical thoracic is larger?

A

the superior costal demi-facet

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150
Q

What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?

A

the costocentral joint or ribs

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151
Q

What is the size relationship between the articulating surface of the head of the rib and the costal demi-facet surface?

A

the rib surface is greater than the costal demi-facet surface

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152
Q

which muscle(s) is attached to the vertebral body of T2-3

A

the longus colli

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153
Q

Which X-ray view is used to see into the intervertebral foramen of a typical thoracic?

A

lateral view

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154
Q

Which vertebral notch or incisure is said to be prominent?

A

the inferior vertebral notch or inferior vertebral incisure

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155
Q

What is overlap of the lamina called in the typical thoracic region?

A

shingling

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156
Q

In which polane will the size of the vertebral foramen of a typical thoracic be greatest?

A

the transverse plane, the vertebral transverse diameter

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157
Q

What is the distance between the transverse tubercles in the typical thoracic region?

A

from T2 each transverse diameter becomes shorter as the transverse processes angle more posterior

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158
Q

What is present on the transverse tubercle of a typical thoracic?

A

the transverse costal facet

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159
Q

What is the classification of the costotransverse joint?

A

synovial plane (diarthrosis arthrodia) joint

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160
Q

What are the osseous parts of the costotransverse joint?

A

the transverse costal facet and the articular surface of the tubercle of a rib

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161
Q

What ligaments support the costotransverse joint of a typical thoracic?

A

the superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

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162
Q

Which muscles may attach to the transverse process of a typical thoracic?

A

longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis thoracis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

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163
Q

How do the transverse diameters of the articular processes compare in the T2-4 region?

A

the superior articular process transverse diameter is greater than the inferior articular process transverse diameter for a given segment

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164
Q

How do the transverse diameters of the articular processes compare in the T5-8 region?

A

the superior articular process transverse diameter is the same as or equal to the inferior articular process transverse diameter for a given segment

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165
Q

What is the orientation of the superior articular facet of a typical thoracic?

A

BUL

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166
Q

What is the orientation of the inferior articular facet of a typical thoracic?

A

ForMeD

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167
Q

How many synovial joints are present at a typical thoracic?

A

ten

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168
Q

Identify the synovial joint surfaces present on a typical thoracic.

A

two superior costal demi-facets, two inferior costal demi-facets, two transverse costal facets, two superior articular facets, two inferior articular facets

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169
Q

What is the name given to the overlap of spinous processes in the thoracic region?

A

imbrication

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170
Q

Imbrication will be more pronounced for what region of the thoracics?

A

T5-8

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171
Q

Which thoracic has the longest spinous process?

A

T8

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172
Q

What is the angulation of the spinous process of T2-4

A

the undersurface of T2-4 spinous processes will angle up to 40 degrees from the horizontal plane

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173
Q

What is the angulation of the spinous process ot T5-8

A

the undersurface of T5-8 spinous processes will angle up to 60 degrees from the horizontal plane

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174
Q

What joint classification is associated with typical thoracic spinous process ligaments?

A

fibrous (amphiarthrosis) syndesmosis joint

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175
Q

Which muscles may attach to the spinous process of a typical thoracic?

A

trapezius, latissimus dorsi, rhomboid major, serratus posterior superior, splenius cervicis , splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis

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176
Q

What is the appearance of the superior surface of the vertebral body of T1?

A

it is somewhat cup-shaped with elevations at the posterior and lateral margin

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177
Q

What may the elevations on the vertebral body of T1 represent?

A

uncinated processes

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178
Q

What is the appearance of the inferior surface of the vertebral body of T1?

A

typically flat, lacking anterior and posterior lips characteristic of the cervicals

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179
Q

How many synovial joints are formed at the vertebral body of T1?

A

four normally

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180
Q

How many symphysis joints are formed with the vertebral body of T1?

A

two

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181
Q

How many syndesmosis joints are formed at the vertebral body of T1?

A

typically four are identified (as many as eight if the rib articulation is included)

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182
Q

How many joints are formed at the vertebral body of T1/

A

typically ten (fourteen if the rib ligaments are included)

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183
Q

How many costocentral joints are formed at the vertebral body of T1?

A

four

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184
Q

What synovial joint surfaces are present on the T1 vertebral body?

A

the right and left superior costal facet

the right and left inferior costal demi-facet

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185
Q

What is the rib - vertebral body combination at the intervertebral foramen for the eighth cervical nerve?

A

the superior costal facet of T1 will joint with the articular surface of the head of the first rib

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186
Q

What ligament supports the costocentral joint of the first rib?

A

the costocentral stellate/radiate ligament

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187
Q

What ligaments support the costocentral joint of the second rib?

A

the costocentral stellate/radiate ligament and the costocentral interarticular or intra-articular ligament

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188
Q

Which muscle(s) is attached to the vertebral body of T1?

A

the longus colli

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189
Q

What ligaments support the costotransverse joint of T1?

A

the inferior costotransverse and lateral costotransverse ligaments

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190
Q

What ligament is absent at the costotransverse joint of T1?

A

the superior costotransverse ligament

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191
Q

Which costotransverse joint will the superior costotransverse ligament of T1 support?

A

the second rib costotransverse joint

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192
Q

What muscles attach to the transverse process of T1?

A

longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversearii, levator costarum brevis

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193
Q

Which specific transversospinalis muscle is absent from T1?

A

semispinalis thoracis

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194
Q

What is the orientation of the superior articular facet of T1?

A

BUL

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195
Q

What is the orientation of the inferior articular facet of T1?

A

ForMeD

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196
Q

What is the classification of the articular facet joint?

A

synovial plane (diarthrosis arthrodial)

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197
Q

How many synovial joints are present at T1?

A

ten

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198
Q

Which vertebrae have been identified as forming the vertebral prominence?

A

C6,C7,T1

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199
Q

What is the gender bias associated with T1 as the vertebral prominence?

A

males (9%) are more likely than females (6%) to demonstrate T1 as the vertebral prominence

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200
Q

What muscles attach to the spinous process of T1?

A

the trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, interspinalis

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201
Q

Which synovial joint surfaces may be absent from the vertebral body of T9?

A

inferior costal demi-facets

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202
Q

Which muscles attach to the transverse process of T9?

A

the longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

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203
Q

Which is the last thoracic vertebra to have an inferior costal demi-facet?

A

T9

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204
Q

What muscles attach to the spinous process of T9?

A

the trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis

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205
Q

Which muscles are conspicuously absent at the T9 spinous process?

A

spinalis and semispinalis

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206
Q

How many synovial joints are formed at the vertebral body of T10?

A

two

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207
Q

How many symphysis joints are formed with the vertebral body of T10?

A

two

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208
Q

How many syndesmosis joints are formed at the vertebral body of T10?

A

typically four are identified (as many as eight if the costocentral stellate/radiate ligaments are included)

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209
Q

How many joints are typically formed at the vertebral body of T10?

A

typically eight (twelve if the costocentral stellate/radiate ligaments are included)

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210
Q

Which synovial joint surface is absent from the vertebral body of T10?

A

inferior costal demi-facets

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211
Q

Para-articular processes are more commonly observed on which segment of the spine?

A

T10

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212
Q

What muscles attach to the transverse process of T10?

A

longissimus thoracis, semispinalis thoracis, multifidis, rotator longus and rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

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213
Q

What is the orientation of the spinous process of T10?

A

posterior and slightly inferior, it will shorten and become more horizontal

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214
Q

A dimpling or depression of the skin in the thoracic region is often characteristic of the location of which segment?

A

T10

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215
Q

What muscles attach to the spinous process of T10?

A

the trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis

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216
Q

What name is given to T11?

A

the anticlinal vertebra

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217
Q

How many synovial joints are formed at the vertebral body of T11?

A

two

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218
Q

How many symphysis joints are formed with the vertebral body of T11?

A

two

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219
Q

How many joints are typically formed at the vertebral body of T11?

A

typically eight (twelve if the costocentral stellate/radiate ligaments are included

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220
Q

What part of the transverse process is absent present on T11?

A

the transverse costal facet

221
Q

Which vertebra is the last segment to demonstrate a transverse costal facet?

A

T10

222
Q

What ligaments form the costotransverse joint of T11?

A

the superior costotransverse, and slightly developed inferior costotransverse and lateral costotransverse ligaments

223
Q

Which costotransverse joint will the superior costotransverse ligament at the transverse process of T11 support?

A

the twelfth rib costotransverse joint

224
Q

What muscles attach to the transverse process of T11?

A

longissimus thoracis
semispinalis thoracis, multifidis, rotator longus and rotator brevis
intertransversarii and levator costarum brevis

225
Q

Which levator costarum muscle is absent at T11?

A

levator costarum longus

226
Q

Which segment is the last to demonstrate an attachment for the levator costarum longus?

A

T10

227
Q

What is the orientation of the superior articular facets of T11?

A

BUL

228
Q

What is the orientation of the inferior articular facets of T11?

A

ForMeD

229
Q

How many synovial joints are typically present at T11?

A

six

230
Q

What muscles attach to the spinous process of T11?

A

trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis

231
Q

At which segments of the thoracic spine will the spinalis muscle not attach?

A

T9,T10

232
Q

Which erector spinae muscle uniquely attaches to the spinous process of T11?

A

iliocostalis lumborum

233
Q

How many synovial joints are formed at the vertebral body of T12?

A

two

234
Q

How many symphysis joints are formed with the vertebral body of T12?

A

two

235
Q

How many syndesmosis joints are formed at the vertebral body of T12?

A

four are typically identified (as many as six if the costocentral stellate/radiate ligaments are included)

236
Q

How many joints are typically formed at the vertebral body of T12?

A

typically eight (ten if the costocentral stellate/radiate ligaments are included)

237
Q

Which muscle(s) is attached to the vertebral body of T12?

A

psoas major and psoas minor

238
Q

What is present at the transverse process region of T12?

A

three tubercles of variable size

239
Q

Which tubercle on T12 represents the transverse process?

A

the lateral tubercle

240
Q

Which tubercle on T12 represents the mammillary process of the lumbars?

A

the superior tubercle

241
Q

Which tubercle on T12 represents the accessory process of the lumbars?

A

the inferior tubercle

242
Q

What ligaments form the costotransverse joint of the twelfth rib?

A

the superior costotransverse ligament from T11 and the lumbocostal ligament from L1

243
Q

Which costotransverse ligament(s) are attached at T12?

A

none; the capsular, superior, inferior and lateral costotransverse ligaments lack an attachment to T12

244
Q

What muscles attach to the transverse process region of T12?

A

the longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and intertransversarii

245
Q

Which segment is the last to demonstrate a levator costarum brevis attachment?

A

T11

246
Q

Which segment is the alst to demonstrate a levator costarum longus attachment?

A

T10

247
Q

What is the orientation of the superior articular facets of T12?

A

BUL

248
Q

What is the orientation of the inferior articular facets of T12?

A

FoLD

249
Q

What is the curvature of the inferior articular facets of T12?

A

they are significantly convex

250
Q

How many synovial joints are typically present on T12?

A

six

251
Q

Identify the synovial joint surfaces typically present on T12?

A

two superior costal facets, two superior articular facets, two inferior articular facets

252
Q

What muscles attach to the spinous process of T12?

A

the trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, mulfifidis, rotator longus, rotator brevis and interspinalis

253
Q

Which erector spinae muscle is unique in its attachment to the T12 spinous process?

A

iliocostalis lumborum

254
Q

Which muscles attaching to the spinous process of T12 are not included in any muscle layer of the true back?

A

interspinalis

255
Q

Which muscle(s) attach to the vertebral body of thoracic vertebrae?

A

longus colli, psoas major and minor

256
Q

Which thoracic is first to demonstrate the attachment of the levator costarum brevis?

A

T1

257
Q

Which thoracic is last to demonstrate the attachment of the levator costarum brevis?

A

T11

258
Q

What is the generic shape of the typical lumbar vertebral body from the cranial view?

A

reniform or kidney-shaped

259
Q

What accounts for the direction of the lumbar curve?

A

the vertebral body and intervertebral disc have a greater anterior height than posterior height

260
Q

What is the effect of aging on the vertebral body of a lumbar vertebra?

A

decrease in height, increase in circumference

261
Q

How many synovial joint surfaces are present at the typical lumbar vertebral body

A

none

262
Q

How many joint surfaces are present on the vertebral body of a typical lumbar?

A

6

263
Q

How many synovial joint surfaces are present on the vertebral body of a typical lumbar?

A

none

264
Q

How many cartilaginous (amphiarthrosis) symphysis joint surfaces are on a typical lumbar vertebral body?

A

two

265
Q

How many fibrous (amphiarthrosis) syndesmosis joint surfaces are on a typical lumbar vertebral body?

A

four

266
Q

What joint classifications will be observed at the vertebral body of a typical lumbar?

A

cartilaginous (amphiarthrosis) symphysis joint and fibrous (amphiarthrosis) syndesmosis joint

267
Q

What muscles may attach to a typical lumbar vertebral body?

A

psoas major and psoas minor

268
Q

Psoas minor will only attach to the vertebral body of which segments?

A

T12,L1

269
Q

What is the name given to ligaments that attach to the vertebral body to articular process?

A

transforaminal ligaments

270
Q

What are the attachment sites of the superior transforaminal ligament at the L1 -L2 intervertebral foramen?

A

L1 vertebral body and the inferior articular process of L1

271
Q

What are the attachment sites of the middle transforaminal ligament at the L1-L2 intervertebral foramen?

A

intervertebral disc and the inferior articular process of L1

272
Q

What are the attachment sites of the inferior transforaminal ligament at the L1 - L2 intervertebral foramen?

A

L2 vertebral body and the superior articular process of L2

273
Q

What ligaments attach the vertebral body to the transverse process?

A

corporotransverse ligaments

274
Q

What corporotransverse ligaments are identified?

A

superior corporotransverse and inferior corporotransverse ligaments

275
Q

What are the attachment sites of the superior corporotransverse ligaments at the L1 - L2 intervertebral foramen?

A

L1 vertebral body and L1 - L2 intervertebral disc to the transverse process of L2

276
Q

What are the attachment sites of the inferior corporotransverse ligaments at the L1-L2 intervertebral foramen?

A

L2 vertebral body and L2 - L3 intervertebral disc to the transverse process of L2

277
Q

What are the types of Hofmann ligaments?

A

Anterior, posterior, lateral and proximal root sleeve ligaments

278
Q

Hofmann ligaments are identified in which regions along the vertebral column?

A

cervical - upper thoracic region and lumbar region

279
Q

Cervical - upper thoracic Hofmann ligaments will attach what structures together?

A

dura mater to segments above

280
Q

What is the highest level known to demonstrate Hofmann ligaments?

A

C6

281
Q

What is the proposed function of the cervical - upper thoracic Hofmann ligaments?

A

resist caudal movement of the dural sac; resist gravitational forces on the dura and cord

282
Q

Lumbar Hofmann ligaments will attach what structures together?

A

dura mater to lower segmental levels

283
Q

What is the proposed function of the lumbar Hofmann ligaments?

A

resist cranial movement of the dural sac during flexion

284
Q

What is the proposed function of the proximal root sleeve ligament?

A

resist displacement of the peripheral nerve system in the intervertebral foramen

285
Q

What osseous conditions of lumbar vertebrae facilitate a spinal tap in this region?

A

overlap of the laminae, shingling, diminishes; overlap of spinous processes, imbrication, diminishes

286
Q

What part of the central nerve system is present in the lumbar spine?

A

the conus medullaris is typically present in the vertebral foramen of L1

287
Q

What part of the peripheral nerve system is present in the lumbar spine?

A

the cauda equine is typically present in the vertebral foramina of L2-L4

288
Q

Beginning with the L1 transverse process, what is the generic direction and relative length of each succeeding lumbar transverse process/

A

each transverse process is directed straight lateral and increases in length from L1-L3; L4 then begins to decrease in length

289
Q

What is the name of the elevation near the origin of the lumbar transverse process?

A

accessory process

290
Q

Congenital elongation of the lumbar accessory process results in what feature?

A

styloid process

291
Q

A styloid process occurs with what frequency and as a result of what condition?

A

7% occurrence as a result of congenital elongation of the lumbar accessory process

292
Q

What bony part of a cervical transverse process is lacking at the lumbar transverse process?

A

the costotransverse bar

293
Q

What ligament(s) will attach to the lumbar accessory process?

A

mammillo-accessory ligament

294
Q

What parts of a vertebra are attached via the mammillo-accessory ligament

A

the mammillary process and accessory process of the same segment

295
Q

What was believed to be entrapped by the mammillo-accessory ligament?

A

the medial branch of the dorsal ramus of a lumbar spinal nerve

296
Q

What muscle(s) attach to the lumbar accessory process?

A

longissimus thoracis and intertransversarii

297
Q

What ligament attaches the twelfth rib to the transverse process of L1?

A

the lumbocostal ligament

298
Q

What muscles may attach to the transverse process of a typical lumbar vertebra?

A

psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus and intertransversarii

299
Q

What ligaments attach to the transverse process of a typical lumbar vertebra?

A

the lumbocostal, mammillo-accessory and intertransverse ligaments

300
Q

What are the posterior elements of the vertebra?

A

zygapophysis, lamina and spinous process

301
Q

What are the anterior elements of the vertebra?

A

vertebral body and pedicle

302
Q

What is characteristic of the L1-L4 articular processes?

A

the transverse diameter (distance between) superior articular processes of an L1-L4 segment will be greater than the transverse diameter (distance between) the inferior articular processes of that same segment

303
Q

What is the orientation of the typical lumbar superior articular fact?

A

BUM; Concave

304
Q

What is the orientation of the typical lumbar inferior articular facet

A

FoLD; Convex

305
Q

What is the name given to the projection on the lumbar superior articular process?

A

mammillary process

306
Q

What is the position of the lumbar zygapophysis in children?

A

the zygapophysis lies in the coronal plane

307
Q

What is the position of the lumbar zygapophysis in adults?

A

the zygapophysis lies in the sagittal plane for L1/L2, L2/L3 and L3/L4; the zygapophysis lies in the coronal plane for L4/L5 and L5/S1

308
Q

What names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane and the other zygapophysis lies in the sagittal plane?

A

joint asymmetry or joint tropism

309
Q

What is the name(s) of the condition in which the typical lumbar spinous process increases in length due to the aging process?

A

Baastrup’s syndrome or “kissing spines”

310
Q

What is Baastrup’s syndrome?

A

elongation of the lumbar spinous process as a result of aging

311
Q

What muscles will attach to the typical lumbar spinous process?

A

latissimus dorsi, serratus posterior inferior, iliocostalis lumboroum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis

312
Q

What is the appearance of the fifth lumbar vertebral body from the lateral view?

A

anterior height is greater than posterior height by several millimeters; it appears to form a wedge on a lateral X-ray view

313
Q

How many synovial joint surfaces are present at the fifth lumbar vertebral body?

A

none

314
Q

How many fibrous (amphiarthrosis) syndesmosis joint surfaces are present on the L5 vertebral body?

A

four

315
Q

How many joint surfaces are present on the vertebral body of the fifth lumbar?

A

six

316
Q

What characteristic of the L1-L4 pedicle may be used to differentiate it from the L5 segment? Be specific and complete as the difference(s) on a segment from each group.

A

On cranial view, the lateral surface of the pedicle is apparent on a L1-L4 segment. At L5 the transverse process originates from the vertebral body, pedicle and lamina-pedicle region

317
Q

How does the size of the vertebral foramen differ along the spine?

A

cervicals have the greatest size, lumbars next, thoracics are smallest

318
Q

What is the generic direction and length of the fifth lumbar transverse process?

A

it is directed straight lateral and is the shortest of all lumbar transverse processes

319
Q

What accounts for the shortness of the L5 transverse process?

A

the hip-innominate bones diminish the available space in the transverse plane

320
Q

What muscle(s) attach to the fifth lumbar accessory process?

A

longissimus thoracis

321
Q

What muscles may attach to the transverse process of the fifth thoracic vertebra?

A

psoas major, quadratus lumborum, longissimus thoracis, rotator brevis, rotator longus and intertransversarii

322
Q

What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?

A

lumbosacral, iliolumbar and mammillo-accessory ligaments

323
Q

What is the reported angulation and X-ray appearance of the fifth lumbar articular facets?

A

they lie in the vertical plane and are coronal facets

324
Q

What is the orientation of the fifth lumbar superior articular facet?

A

BUM; typically concave

325
Q

What is the orientation of the fifth lumbar inferior articular facet?

A

FoLD; significant convexity

326
Q

What muscle(s) will attach to the mammillary process?

A

multifidis and intertransversarii

327
Q

What names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane and the other zygapophysis lies in the sagittal plane?

A

joint asymmetry or joint tropism

328
Q

What is the name(s) of the condition in which the L5 spinous process increases in length due to the aging process?

A

Baastrup’s syndrome or “kissing spines”

329
Q

What is Knife Clasp Syndrome?

A

The congenital condition in which the L5 spinous process is elongated, the sacrum exhibits spina bifida and dorsiflexion produces pain

330
Q

What muscles will attach to the fifth lumbar spinous process?

A

latissimus dorsi, iliocostalis lumborum, longissimus thoracis, multifidis, rotator longus, rotator brevis and interspinalis

331
Q

How many synovial joints are maximally observed at each lumbar vertebra?

A

L1-L5 = four each

332
Q

How many joints are traditionally observed at each lumbar vertebral body?

A

L1-L5 = six each

333
Q

What muscle(s) may attach to the first sacral vertebral body?

A

psoas major

334
Q

How many joint surfaces are present on the vertebral body of the first sacral segment?

A

fivef

335
Q

What is the origin of the sacral ala?

A

On base view, the S1 transverse process and costal element appear to originate from the vertebral body and possibly the pedicle to form the sacral ala.

336
Q

What part of the sacral ala is derived from the costal element?

A

the anterior two-thirds

337
Q

What forms the median sacral crest?

A

fused spinous processes and their spinous tubercles

338
Q

What muscles may attach to the median sacral crest?

A

latissimus dorsi, iliocostalis lumborum, longissimus thoracis

339
Q

What forms the intermediate sacral crest?

A

fused articular processes and their facets

340
Q

What features may be identified along the intermediate sacral crest?

A

the mammillary process of S1 and the sacral cornu of S5

341
Q

What does the sacral cornu represent?

A

the inferior articular process and facet of S5

342
Q

What forms the lateral sacral crest?

A

the fused transverse processes and transverse tubercles from S1 to S5

343
Q

What features may be identified along the lateral sacral crest:

A

S1 transverse tubercle, sacral tuberosity of S2, transverse tubercles of S3-S5

344
Q

What is the name of the joint formed by the sacral tuberosity?

A

the accessory sacro-iliac joint

345
Q

What feature is associated with the transverse tubercle of s5?

A

the inferior and lateral (inferolateral) sacral angle

346
Q

What muscles may attach to the lateral sacral crest?

A

multifidis, iliocostalis lumborum

347
Q

What muscle is said to attach to the dorsal surface of sacrum?

A

iliacus

348
Q

What feature is identified on the lateral surface of S1 - S3?

A

auricular surface

349
Q

What is the sacral promontory?

A

the bulging anterior surface of the superior epiphyseal rim of S1

350
Q

What forms the posterior boundary for the fifth sacral spinal nerve intervertebral foramen?

A

sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament and intercornual ligament

351
Q

What forms the anterior boundary for the fifth sacral spinal nerve intervertebral foramen?

A

vertebral body S5, vertebral body Co1, deep posterior sacrococcygeal ligament and intervertebral disc

352
Q

What is the homolog for the posterior longitudinal ligament at S5?

A

deep posterior sacrococcygeal ligament

353
Q

What is the homolog for the anterior longitudinal ligament at S5?

A

anterior sacrococcygeal ligament

354
Q

What is the homolog for the ligamentum flavum at S5?

A

superficial posteror sacrococcygeal ligament

355
Q

What forms the inferior boundary for the spinal canal?

A

the union of the superficial posterior and deep posterior sacrococcygeal ligaments

356
Q

What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments at Co1?

A

the posterior sacrococcygeal ligament

357
Q

What ligament is a homolog of the intertransverse ligament at S5?

A

lateral sacrococcygeal ligament

358
Q

What ligament divides the sciatic foramen into the greater and lesser sciatic foramnina?

A

sacrospinous ligament

359
Q

Which ligament has a broad attachment along the lateral margin of sacrum and coccyx and then attaches to the ischial tuberosity?

A

sacrotuberous ligament

360
Q

Which ligament represents a thickening of the fibrous capsule of the sacro-iliac joint?

A

anterior sacro-iliac ligament

361
Q

Which ligament is the strongest of the sacro-iliac ligaments and is penetrated by dorsal rami of the sacral spinal nerves?

A

interosseous sacro-iliac ligament

362
Q

Which ligament will attach the intermediate sacral crest of S1, lateral sacral crest of S2 to the posterior superior iliac spine?

A

short posterior sacro-iliac ligament

363
Q

Which ligament attaches the lateral sacral crest of S3 and S4 to the posterior superior iliac spine?

A

long posterior sacro-iliac ligament

364
Q

What is the homolog for the inferior articular process and facet of Co1?

A

coccygeal cornu

365
Q

What is the homolog for the capsular ligament at S5?

A

intercornual ligament

366
Q

What is the number of coccygeal somites?

A

ten

367
Q

What is the typical number of segments that unite to form the adult coccyx?

A

4 segments

368
Q

When is ossification of coccyx completed?

A

about age 30

369
Q

What bony features are present on the coccyx?

A

all segments are represented by a “vertebral body; Co1 has a coccygeal cornu and transverse process”

370
Q

What is the homolog of the superior articular process and facet on Co1?

A

coccygeal cornu

371
Q

What is the direction of fusion of coccygeal segments?

A

from caudal to cranial, the last segments to fuse together are Co1 and Co2

372
Q

What is the major motion and range of motion for coccyx?

A

flexion - extension, 5-20 degrees

373
Q

How many coccygeal nerves are present in the fetus?

A

typically 5 pairs of coccygeal nerves are present

374
Q

How many coccygeal nerves are present in the adult?

A

typically only one pair of coccygeal nerves remain in the adult

375
Q

What forms the coccygeal nerve plexus?

A

S4, S5 and Co1 nerves

376
Q

What is the ganglion impar?

A

a midline sympathetic ganglion

377
Q

What is the location of the ganglion impar?

A

anywhere from the sacrococcygeal joint to the upper third of coccyx

378
Q

What is the coccygeal glomus or coccygeal body?

A

an enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx

379
Q

What innervates the coccygeal glomus or coccygeal body?

A

both sympathetic and parasympathetic fibers are identified

380
Q

What muscles attach to the coccyx?

A

ishiococcygeus and levator ani

381
Q

What ligaments form the posterior boundary for the Co1 spinal nerve intervertebral foramen?

A

superficial posterior sacrococcygeal ligament and intercornual ligament

382
Q

What ligaments form the anterior boundary for the Co1 spinal nerve intervertebral foramen?

A

deep posterior sacrococcygeal ligament and intervertebral disc

383
Q

What is the superior articular facet orientation of C1?

A

BUM concave

384
Q

What is the inferior articular facet orientation of C1?

A

BMD

385
Q

What is the superior/inferior articular facet orientation of C2?

A

BUL/FoLD

386
Q

What is the superior/inferior articular facet orientation of C3-6?

A

BUM/FoLD

387
Q

What is the superior.inferior articular facet orientation of C7?

A

BUM/ForMeD

388
Q

What is the superior/inferior articular facet orientation of T1-11?

A

BUL/ForMeD

389
Q

What is the superior/inferior articular facet orientation of T12?

A

BUL/FoLD convex

390
Q

What is the superior/inferior articular facet orientation of L1-L5?

A

BUM concave/FoLD convex

391
Q

What is the superior articular facet orientation of S1?

A

BUM concave

392
Q

What is the definition of spondylosis?

A

a vertebral condition

393
Q

What is the definition of spondylolysis?

A

a vertebral separation or vertebral cleavage

394
Q

What is the definition of spondylolisthesis

A

a vertebral slippage

395
Q

What is the current limited definition of spondylosis?

A

a vertebral condition that is acquired or age-related

396
Q

What are some of the causes of spondylolysis?

A

congenital, acquired during development, the result of aging, or the result of trauma

397
Q

What is the location of spondylolysis that will be stressed in Spinal?

A

a separation along the pars interarticularis (defect in the pars interarticularis or pars defect)

398
Q

What specific parts of a vertebra are separated as a result of a pars defect?

A

the vertebral body, pedicle, and articular process (the intervertebral disc is also indicated when looking at a vertebral couple)

399
Q

What is the incidence of spondylolysis in the general population?

A

a range of 2.6% to 10%

400
Q

What is the incidence of spondylolysis in the native Alaskan population?

A

52.6%

401
Q

What is the geographic or ethnic bias for a higher incidence of spondylolysis?

A

the native Alaskan (Inuit) population

402
Q

What characteristics are associated with cervical spondylolysis?

A

rare, congenital, gender biased toward men, most common at C6 and linked to spondylolisthesis and spina bifida

403
Q

Lumbar spondylolysis has not been reported in what groups of individuals?

A

fetuses, newborns, rarely in children under five years old, patients who have never walked and in non-erect species

404
Q

Lumbar spondylolysis only been reported in what types of species?

A

those species that walk erect; humans

405
Q

Lumbar spondylolysis is associated with what characteristics?

A

familial association, spina bifida occulta, racial/ethnic disparities, gender and locational bias, youthful incidence and activities requiring repetitive stress on the spine

406
Q

What is the gender bias and locational bias associated with lumbar spondylolysis?

A

men at L5/S1; women at L4/L5

407
Q

What is the age range typically associated with lumbar spondylolysis?

A

10-20 years old

408
Q

What activities are particularly stressful at the pars interarticularis of lumbar vertebrae?

A

gymnastics, dance, soccer

409
Q

What motion(s) is particularly associated with lumbar spondylolysis?

A

hyperextension coupled with rotation

410
Q

What fills the space in a lumbar spondylolysis?

A

fibrocartilagenous material

411
Q

What name has been given to the material filling the space in a lumbar spondylolysis?

A

spondylolysis ligament

412
Q

What types fo neural function(s) have been associated with the psondylolysis ligament?

A

nociception, neuromodulation and autonomoic function

413
Q

What is the appearance of the lumbar vertebra upon oblique x-ray view?

A

a Scotty dog

414
Q

What is the appearance of a pars defect in a lumbar veretbra upon oblique x-ray view

A

a collared Scotty dog

415
Q

What is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view?

A

a collared Scotty dog

416
Q

In an oblique X-ray, spondylolysis below the superior articular process of a lumbar pars interarticularis is associated with what part of the Scotty dog?

A

the neck of the Scotty dog

417
Q

What part of a lumbar vertebra forms the eye of a Scotty dog?

A

the pedicle

418
Q

What part of a lumbar vertebra forms the ear of a Scotty dog?

A

the superior articular process

419
Q

What part of a lumbar vertebra forms the nose of a Scotty dog?

A

the transverse process

420
Q

What is the incidence of a sacral spondylolysis in the general population?

A

it’s rare

421
Q

What ethnic group is associated with a high incidence of a sacral spondylolysis?

A

the native Alaskan (Inuit) population

422
Q

Is sacral spondylolysis the result of a congenital conditions, acquired conditions or an age-related conditions?

A

it seem to be acquired

423
Q

What activities are associated with sacral spondylolysis?

A

kayaking and harpooning

424
Q

What is the ethnic, gender, and locational bias associated with sacral spondylolysis?

A

the native Alaskan (Inuit) male at the S1 level

425
Q

What is the direction of spondylolisthesis?

A

anterior or forward displacement

426
Q

What is the posterior direction of a vertebral slippage called?

A

retrospondylolisthesis or retrolisthesis

427
Q

Identify all names given to type I spondylolisthesis?

A

dysplastic spondylolisthesis, congenital spondylolisthesis

428
Q

What is the locational bias of type I spondylolisthesis?

A

L5 or upper sacral segments

429
Q

What is the location of the defect associated with type I spondylolisthesis?

A

more frequently the vertebral arch

430
Q

What additional conditions are linked to type I spondylolisthesis?

A

spina bifida occulta and nerve root compression of the S1 nerve

431
Q

Identify all names given to type II spondylolisthesis?

A

isthmic spondylolisthesis

432
Q

Which subtype of type II spondylolisthesis is stressed in spinal?

A

lytic spondylolisthesis or stress fracture induced spondylolisthesis

433
Q

What is the cause most frequently given for type II spondylolisthesis

A

micofractures as a result of repetitive stress during hyperflexion and rotation

434
Q

What is the age group typically associated with type II spondylolisthesis?

A

teenagers or young adults

435
Q

Will spondylolysis always result in type II spondylolisthesis?

A

no, particularly in cases of unilateral spondylolysis

436
Q

What spinal canal dimensions are associated with type II spondylolisthesis?

A

isthmic spondylolisthesis demonstrates an increase in sagittal diameter of the spinal canal

437
Q

What is the gender bias and locational bias associated with type II spondylolisthesis?

A

isthmic spondylolisthesis is common in men at the L5/S1 level

438
Q

What conditions are often associated with type III spondylolisthesis?

A

degenerative spondylolisthesis is often associated with osteoarthritis, intervertebral disc degeneration, ligament laxity and articular facet remodeling

439
Q

What is the gender bias, locational bias, and spinal canal dimension changes often associated with type III spondylolisthesis?

A

degenerative spondylolisthesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal canal

440
Q

Identify all names given to type IV spondylolisthesis?

A

traumatic spondylolisthesis

441
Q

What causes type IV spondylolisthesis?

A

fracture of the neural arch components

442
Q

Is there a gender, locational, or age bias associated with type IV spondylolisthesis?

A

no

443
Q

Identify all names given to type V spondylolisthesis?

A

pathologic spondyloisthesis

444
Q

What are the cause(s) associated with type V spondylolisthesis?

A

bone diseases such as Paget disease or osteogenesis imperfecta

445
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

446
Q

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

A

below T8

447
Q

What will the intervertebral veins drain into?

A

the external vertebral venous plexus or Batson’s plexus

448
Q

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

A

they appear to lack valves

449
Q

What size lymphatic vessels lie in the intervertebral foramen?

A

medium sized lymphatics

450
Q

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

A

adipose tissue and loose areolar connective tissue

451
Q

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

A

the height increases but the nerve root size stays about the same from cranial to caudal

452
Q

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

A

the lateral groove and uncinated process

453
Q

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

A

the length of the nerve root increases as it descends from its apparent origin on the spinal cord, but the cross-sectional area of the nerve root decreases

454
Q

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

A

the sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery

455
Q

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

A

the costocentral joint

456
Q

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

A

about half

457
Q

Which are the largest spinal nerves?

A

L5 and S1 spinal nerves

458
Q

What increases the length of the intervertebral foramen at L5?

A

the lumbosacral tunnel

459
Q

What forms the lumbosacral tunnel?

A

the lumbosacral ligament, transverse process of L5 and sacral ala

460
Q

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

A

the far out syndrome

461
Q

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

A

the intervertebral disc above the intervertebral foramen is usually the source of damage

462
Q

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

A

a completely osseous boundary exists

463
Q

What is the relationship of lumbar nerve root size to intervertebral foramen size above L4?

A

the nerve root size will account for less than 22% of the available size

464
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

465
Q

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

A

tuberculosis, hemanglomas, osteoporosis

466
Q

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

A

the joint of Luschka in the cervicals, the costocentral joint in the thoracics

467
Q

What are examples of osteophyte formation that influence the intervertebral foramen?

A

the nomy spurs of the vertebral body and para-articular processes on the lamina

468
Q

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

A

obesity, pregnancy and the use of heavy backpacks

469
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

470
Q

What are the curvatures of the vertebral column?

A

anterior, posterior, and lateral

471
Q

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

A

posterior

472
Q

Why is the posterior curve also called the primary curve?

A

it is the first curve to appear embryologically

473
Q

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

A

the thoracic or dorsal curve and the pelvic or sacrococcygeal curve

474
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

475
Q

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

A

cervical curve and lumbar curve

476
Q

What segmental levels form the cervical curve?

A

C2-T1

477
Q

What segmental levels form the lumbar curve?

A

T12 to L5

478
Q

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

A

the third fetal month

479
Q

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

A

during the last trimester in utero

480
Q

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

A

within the first year after birth

481
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. the intervertebral disc height becomes greater anterior than posterior
482
Q

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

A

usually between the third and fourth month after birth

483
Q

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

A

the righting reflex

484
Q

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

A

typically between C4 and C5

485
Q

What is the location for the cervical kyphosis?

A

between occiput and C1

486
Q

What is the name given to the primary cervical curve?

A

cervical kyphosis

487
Q

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

A

cervical curve C2-T1; cervical enlargement C3-T1

488
Q

What is the time of appearance of the lumbar curve?

A

between 12 and 18 months after birth

489
Q

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

A

crawling and walking

490
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
491
Q

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

A

the nucleus pulposus of L4 will shift its position within the annulus fibrosis

492
Q

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

A

vision

493
Q

What is the gender bias associated with lumbar curve convexity?

A

females have a greater convexity of the lumbar curve

494
Q

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

A

lumbar curve T12-L5; lumbar enlargement T9-T12

495
Q

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

A

faster development of the muscles on the side of handedness

496
Q

What is the time of appearance of the lateral curves?

A

they appear after 6 years old

497
Q

What locations of lateral curves are recognized?

A

cervical, thoracic or dorsal, and lumbar

498
Q

Which lateral curves are best developed?

A

thoracic or dorsal, and lumbar

499
Q

qWhat is the relationship between curve direction and handedness?

A

a right-handed person has a high probability for a right thoracic, left lumbar curve combination

500
Q

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

A

about 80% of the population demonstrates this

501
Q

What does the suffix -osis mean

A

a condition

502
Q

Does -osis infer a normal or an abnormal condition

A

neither, it is non-judgmental

503
Q

What generic names identified abnormal curves of the vertebral column?

A

lordosis, kyphosis, scoliosis

504
Q

What is the definition of lordosis?

A

a forward bending condition

505
Q

What is the definition of kyphosis?

A

a humpback or hunchback condition

506
Q

What is the definition of scoliosis?

A

a warped or crooked condition

507
Q

What is the direction of the curve deviation in scoliosis?

A

to the side (it is a lateral curve deviation)

508
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, a decrease in the posterior direction in the thoracic spine, an increase in the anterior direction in the lumbar spine and a decrease in the posterior direction in the pelvic or sacrococcygeal region

509
Q

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

A

no, there would be a decrease in the anterior direction in the cervical spine, an increase in the posterior direction in the thoracic spine, a decrease in the anterior direction in the lumbar spine and an increase in the posterior direction in the pelvic or sacrococcygeal region

510
Q

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

A

military neck, humpback or hunchback, and swayback

511
Q

What is military neck?

A

a decreased anterior curve in the cervical region, a straight neck

512
Q

What is humpback or hunchback?

A

an increased posterior curve in the thoracic region

513
Q

What is swayback?

A

an increased anterior curve in the lumbar region

514
Q

What is classic classification of military neck?

A

a kyphosis

515
Q

What is a classic classification of humpback or hunch back?

A

a kyphosis

516
Q

What is a classic classification of swayback?

A

lordosis

517
Q

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

A

a normal cervical and normal lumbar anterior curve

518
Q

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

A

a normal thoracic or dorsal and normal pelvic or sacrococcygeal posterior curve

519
Q

What prefixes are used to convey abnormality in curve patterns?

A

hyper or hypo

520
Q

What does the term hyperlordotic infer?

A

an increase in the anterior curve of the cervical or lumbar region

521
Q

What does the term hypolordotic infer?

A

a decrease in the anterior curve of the cervical or lumbar region

522
Q

What does the term hyperkyphotic infer?

A

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

523
Q

What does the term hypokyphotic infer?

A

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

524
Q

What are the curve classifications for military neck?

A

a kyphosis or hypolordotic curve

525
Q

What are the curve classifications for humpback or humchback?

A

a kyphosis or hyperkyphotic curve

526
Q

What are the curve classifications for swayback?

A

a lordosis or hyperlordotic curve

527
Q

What is the more complete, accepted definition of scoliosis?

A

an abnormal lateral curve coupled with axial rotation

528
Q

What is the radiological test for skeletal maturity?

A

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

529
Q

What are the classifications of scoliosis according to the Scoliosis Research Society?

A

magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis

530
Q

What does magnitude of scoliosis refer to?

A

the length and angle of the curve deviation on x-ray

531
Q

What is often used to measure the magnitude of scoliosis?

A

the Cobb Method

532
Q

What does location of scoliosis infer?

A

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

533
Q

What does direction of scoliosis refer to?

A

the side the convexity of the curve will bend toward

534
Q

What does etiology of scoliosis mean?

A

the cause of the scoliosis

535
Q

What is structural scoliosis?

A

a more radical form of scoliosis, it may worsen, associated with structural deformities of the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation

536
Q

What is nonstructural scoliosis?

A

a mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or intervertebral disc and lacks a fixed angle of trunk rotation

537
Q

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

A

idiopathic scoliosis

538
Q

What does idiopathic scoliosis infer?

A

the scoliosis is unique to the individual, it has no known cause, unkown etiology

539
Q

What is the incidence of idiopathic scoliosis in the population?

A

1%-4% of the population

540
Q

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

A

infantile, juvenile, and adolescent

541
Q

What is the age range for infantile idiopathic scoliosis?

A

from birth to 3

542
Q

What is the age range for juvenile idiopathic scoliosis?

A

from 3 to 10

543
Q

What is the age range for adolescent idiopathic scoliosis?

A

over 10

544
Q

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

A

left thoracic, male, less than 1%

545
Q

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

A

right thoracic, females over 6 and 125 to 21% incidence

546
Q

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

A

right thoracic or right thoracic and left lumbar, females, and 80% incidence

547
Q

What is the genetic factor associated with adolescent idiopathic scoliosis?

A

an autosomal dominant factor that runs in families

548
Q

What is the relationship between curve deviation, incidence, and curve worsening?

A

the greater the deviation, the lower the incidence, and the more likely to worsen

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