Final exam flash cards
(454 cards)
1
Q
what motion is particularly associated with lumbar spondylolysis?
A
hyper-extension coupled with rotation
2
Q
what fills the space in a lumbar spondylolysis?
A
fibrocartilagenous material
3
Q
what name has been given to the material filling the space in a lumbar spondylolysis?
A
spondylolysis ligament
4
Q
what types of neural functions have been associated with the spondylolysis ligament?
A
nociception, neuromodulation and autonomic function
5
Q
what is the appearance of the lumbar vertebra upon oblique xray view?
A
a Scotty dog
6
Q
what is the appearance of a pars defect in a lumbar vertebra upon oblique xray view?
A
a collared Scotty dog
7
Q
what is the appearance of a spondylolysis in a lumbar vertebra upon oblique xray view?
A
a collared scotty dog
8
Q
in an oblique xray, 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
9
Q
what part of a lumbar vertebra forms the eye of a scotty dog?
A
the pedicle
10
Q
what part of a lumbar vertebra forms the ear of a Scotty dog?
A
the superior articular process
11
Q
what part of a lumbar vertebra forms the nose of a Scotty dog?
A
the transverse process
12
Q
what is the incidence of sacral spondylolysis in the general population?
A
it is rare
13
Q
what ethnic group is associated with a high incidence of sacral spondylolysis?
A
the native Alaskan (inuit) population
14
Q
is sacral spondylolysis the result of congential conditions, acquired conditions or an age related condition?
A
it seems to be aquired
15
Q
what activities are associated with sacral spondylolysis?
A
kayaking and harpooning
16
Q
what is the ethnic, gender, and locational bia associated with sacral spondylolysis?
A
the native alaskan male at the S1 level
17
Q
what is the definition of spondylolisthesis?
A
a vertebral slippage
18
Q
what vertebral condition results in spondylolisthesis?
A
bilateral spondylolysis
19
Q
what is the direction of spondylolisthesis?
A
anterior or forward displacement
20
Q
what is the posterior direction of vertebral slippage called?
A
retrospondylolisthesis or retrolisthesis
21
Q
identiy all names given to type 1 spondylolisthesis?
A
dysplastic spondylolisthesis, congenital spondylolisthesis
22
Q
what is the locational bias of type 1 spondylolisthesis?
A
L5 or upper sacral segments
23
Q
what is the location of the defect associated with type 1 spondylolisthesis?
A
more frequently the vertebral arch
24
Q
what additional conditions are linked to type 1 spondylolisthesis?
A
spina bifida occulta and nerve root compression of the S1 nerve
25
identify all the names given to type II spondylolisthesis?
isthmic spondylolisthesis
26
which subtype of type II spondylolisthesis is stressed in Spinal II?
lytic spondylolisthesis or stress fracture induced spondylolisthesis
27
what is the cause most frequently given for type II spondylolisthesis?
microfractures as the result of repetitive stress during hyperflexion and rotation
28
what is the age group typically associated with type II spondylolisthesis?
teenagers or young adults
29
will spondylolisthesis always result in type II spondylolisthesis?
no, particularly in cases of unilateral spondylolysis
30
what spinal canal dimensions are associated with type II spondylolisthesis?
isthmic spondylolisthesis demonstrates an increase in sagittal diameter of spinal canal
31
what is the gender bias and locational bias associated with type II spondylolisthesis?
isthmic spondylolisthesis is common in men at the L5/S1 level
32
what conditions are often associated with type III spondylolisthesis?
degenerative spondylolisthesis is often associated with osteoarthritis, intervertebral disc degeneration, ligament laxity and articular facet remodeling
33
what is the gender bias, locational bias, and spinal canal dimension changes often associated with type III spondylolisthesis?
degenerative spondylolisthesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal cord
34
identify all names given to type IV spondylolisthesis?
traumatic spondylolisthesis
35
what causes type IV spondylolisthesis?
fracture of the neural arch components
36
is there a gender, locational, or age bias associated with type IV spondylolisthesis?
no
37
identify all the names given to type V spondylolisthesis?
pathologic spondylolisthesis
38
what are the causes associated with type V spondylolisthesis?
bone diseases such as Paget disease or osteogenesis imperfecta
39
what determines the length of intervertebral foramen?
the width of the pedicle
40
what may extend the length of the intervertebral foramen?
the TVP, muscles or ligaments
41
what forms the superior boundary for the typical intervertebral foramen?
the inferior vertebral notch of the pedicle above
42
what is the average height of the intervertebral foramen?
about 13mm
43
what percent of total vertebral column length does "true" intervertebral foramina height from C2 to S1 equal?
About 40%
44
what percent of total vertebral column length does all intervertebral foramina height from occiput Co1 equal?
53%
45
what are the generic contents of the intervertebral foramen?
neural tissue, connective tissue, vascular tissue, lymphatic tissue
46
what is the percent of neural tissue in the IVF?
from 8 to 50%
47
what are the characteristics of the Artery of Adamkiewicz?
it is a left side, anterior medullary feeder artery, located in the T9/T10 IVF, and the primary vascular supply to the lumbar enlargement
48
what is the most likely region of the thoracic spine for herniation?
below T8
49
what will the Intervertebral veins drain into?
the external vertebral venous plexus or Batson's plexus
50
what is a unique histological feature of the veins of the vertebral column?
they appear to lack valves
51
what size of lymphatic vessels lie in the IVF?
medium sized lymphatics
52
what type of connective tissue will be present in the IVF?
adipose tissue and loose alveolar connective tissue
53
what is the relationship of cervical IVF height to nerve root size?
the height increases but the nerve root size stays about the same from cranial to caudal
54
what parts of the cervical vertebra will modify the IVF?
the lateral groove and uncinate processes
55
what is the relationship between aging and cervical spine nerve root characteristics?
the length of the nerve root increases as it descends fro its apparent origin on the spinal cord, but the cross-sectional area of the nerve root decreases
56
what are the specific attachment sites for a cervical spinal nerve?
the sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery
57
what contributes to the anterior boundary of the thoracic IVF?
the costocentral joint
58
what is the amount of contribution of the IVD to the height of the lumbar IVF?
about half
59
which are the largest spinal nerves?
L5 and S1 spinal nerves
60
what increases the length of the IVF at L5
the lumbosacral tunnel
61
what forms the lumbosacral tunnel?
the lumbosacral ligament, transverse process of L5 and sacral ala
62
what condition is the result of encroachment on the L5 spinal nerve?
the far out syndrome
63
what ligaments may contribute to the loss of size in the lumbar IVF?
the transforaminal ligament and the corporotransverse ligament
64
what is unusual about the sacral IVF compared to other IVF?
a completely osseous boundary exists
65
what is more likely the cause of nerve irritation at the sacral IVF?
the tilt or position of the entire sacrum relative to the pelvis
66
what is unique about the relationship of spinal nerve to IVF at S5-Co1?
there are two nerves present, S5 nerve and Co1 nerve
67
what are some examples of destructive lesions of vertebral body?
tuberculosis, hemangiomas, osteoporosis
68
what may reduce the impact of IVD loss of integrity on the IVF in cervical and thoracic spine?
the joint of Lushka in the cervicals, the costocentral joint in the thoracics
69
what are examples of osteophyte formation that influence the IVF?
the bony spurs of the vertebral body and para-articular processes on the lamina
70
what are examples of acquired alterations of the spinal curves identified in class?
obesity, pregnancy and the use of heavy backpacks
71
what is the recommended weight of a backpack compared to individual weight for the developing spine?
backpack weight should not exceed 10% individual body weight
72
what are the curvatures of the vertebral column?
anterior, posterior, and lateral
73
what is the direction of the primary curve of the vertebral column?
posterior
74
why is the posterior curve also called the primary curve?
it is the first curve to appear embryologically
75
what are the adult remnants of the primary curve along the vertebral column
the thoracic or dorsal curve and the pelvic or sacrococcygeal curve
76
what are the names given to curves that form during development to reverse the direction of regions along the vertebral column
anterior curve, secondary curve, compensatory curve
77
what are the names of the anterior curves, secondary curves, and compensatory curves?
cervical curve and lumbar curve
78
what segmental levels form the cervical curve
C2-T1
79
what segmental levels form the lumbar curve?
T12 to L5
80
what is the earliest time of appearance of the cervical curve?
the third fetal month
81
what is the traditional time of appearance of the cervical curve said to be?
during the last timester in utero
82
what is the time during which the "adult" cervical curve is said to appear
within the first year after birth
83
what development events are indicated in the formation of the adult cervical curve?
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 IVD height becomes greater anterior than posterior
84
at what age will the infant begin to hold the head erect?
usually between the third and fourth month after birth
85
what is the name given to the integration of visual and motor pathways associated with holding the head erect?
the righting reflex
86
what is the location for the apex of the cervical curve?
typically between C4 and C5
87
what is the location for the cervical kyphosis?
between occiput and C1
88
what is the name given to the primary cervical curve?
cervical kyphosis
89
what is the vertebral relationship between the cervical curve and the cervical enlargement?
cervical curve C2-T1; cervical enlargement C3-T1
90
what is the time of appearance of the lumbar curve?
between 12 to 18 months after birth
91
what infant activities are associated with the developmental of the lumbar curve?
crawling and walking
92
what developmental events are indicated in the formation of the adult lumbar curve?
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. IVD height will become greater anterior compared to posterior
4. walking in further promote muscle and IVD development
93
what its within the IVD to facilitate the lumbar curve development?
the nucleus pulposus of L4 will shift its position within the annulus fibrosis
94
which sense is a requirement for holding the head erect, standing, sitting, and walking?
vision
95
what is the gender bias associated with lumbar curve convexity?
females have a greater convexity of the lumbar curve
96
what is the vertebral relationship between the lumbar curve and the lumbar enlargement?
lumbar curve T12-L5; lumbar enlargement T9-T12
97
what is the formation of the lateral curve often correlated with?
faster development of the muscles on the side of handedness
98
what is the time of appearance of the lateral curves
they appear after 6 years old
99
what location of lateral curves are recognized?
cervical, thoracic or dorsal, and lumbar
100
which lateral curves are best developed
thoracic or dorsal, and lumbar
101
what is the relationship between curve direction and handedness?
a right handed person has a high probability for a right thoracic, left lumbar curve combination
102
what is the incidence of a right thoracic, left lumbar curve combination in the population
about 80% of the population demonstrates this
103
what does the suffix "osis" mean?
a condition
104
does osis infer a normal or an abnormal condition
neither, it is non-judgmental
105
what generic names identified abnormal curves of the vertebral column?
lordosis, kyphosis, scoliosis
106
what is the definition of lordosis
a forward bending condition
107
what is the definition of kyphosis
a humpback or hunchback condition
108
what is the definition of scoliosis
a warped or crooked condition
109
what is the direction of the curve deviation in lordosis?
to the anterior
110
what is the direction of the curve deviation in kyphosis
to the posterior
111
what is the direction of the curve devitation in scoliosis
to the side (it is a lateral curve deviation)
112
is there a locational bias for the classic definition of lordosis?
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
113
is there a locational bias for the classic definition of kyphosis?
no, there would be a decrease in the anterior direction in the cervical spine, and 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
114
what clinical abnormal curvatures of the vertebral column were stressed in class
military neck, humpback/hunchback, and swayback
115
what is military neck
a decreased anterior curve in the cervical region, a straight neck
116
what is humpback or hunchback
an increased posterior curve in the thoracic region
117
what is swayback
an increased anterior curve in the lumbar region
118
what is classic classification of military neck
kyphosis
119
what is classic classification of humpback or hunchback
a kyphosis
120
what is classic classification of swayback
lordosis
121
what does the use of the term lordotic try to imply
a normal cervical and normal lumbar anterior curve
122
what does the use of the term kyphotic try to imply
a normal thoracic or dorsal and normal pelvic or sacrococcygeal posterior curve
123
what prefixes are used to convey abnormality in curve patterns
hyper and hypo
124
what does the term hyperlordotic infer
an increase in the anerior curve of the cervical or lumbar region
125
what does the term hypolordotic infer
a decrease in the anterior curve of the cervical or lumbar region
126
what does the term hyperkyphotic infer
an increase in the posterior curve of the thoracic/dorasal or pelvic/sacrococcygeal region
127
what does the term hypokyphotic infer
a decrease in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region
128
what are the curve classifications for military neck
a kyphosis or hypolordotic curve
129
what are the curve classifications for humpback or hunchback
a kyphosis or hyperkyphotic curve
130
what are the curve classifications for swayback
a lordosis or hyperlordotic curve
131
what is the more complete, accepted definition of scoliosis
an abnormal lateral curve coupled with axial rotation
132
what is the radiological test for skeletal maturity
the Risser sign, an indication of bone maturity in the iliac apophysis
133
what are the classifications of scoliosis according to the scoliosis research society
magnitude, location, direction, etiology, structural scoliosis and nonstructural scoliosis
134
what does magnitude of scoliosis refer to?
the length and angle of the curve deviation on xray
135
what is often used to measure the magnitude of scoliosis
the cobb method
136
what does the location of scoliosis infer
the location of the vertebral segment forming the apex of the curve deviation
137
what does the direction of scoliosis refer to
the side the convexity of the curve will bend toward
138
what does etiology of scoliosis mean
the cause of the scoliosis
139
what is structural scoliosis
a more radical form of scoliosis, it may worsen, associated with structural deformities of the vertebra or IVD, frequently has a fixed angle of trunk rotation
140
what is nonstructural scoliosis?
a mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or IVD and lacks a fixed angle of trunk rotation
141
what is the classification of scoliosis that is unique to the individual patient?
idiopathic scoliosis
142
what does idiopathic scoliosis infer?
the scoliosis is unique to the individual, it has no known cause, unknown etiology
143
what is the incidence of idiopathic scoliosis in the population
1% to 4% of the population
144
based on age of onset, what are the types of idiopathic scoliosis
infantile, juvenile, and adolescent
145
waht is the age range for infantile idiopathic scoliosis
from birth to 3 years old
146
what is the age range for juvenile idiopathic scoliosis
from 3 years old to 10 years old
147
what is the age range for adolescent idiopathic scoliosis
over 10 years
148
identify curve direction, location, gender bias and incidence of infantile idiopathic scoliosis
left thoracic, male, less than 1% incidence
149
identify curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis
right thoracic, females over 6 years old, and 12% - 21% incidence
150
identify curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis
right thoracic or right thoracic and left lumbar, females, and 80% incidence
151
what is the genetic factor associated with adolescent idiopathic scoliosis
an autosomal dominant factor that runs in families
152
what is the relationship between curve deviation, incidence, and curve worsening?
the greater the deviation, the lower the incidence, and the more likely to worsen
153
what is the name given to segments that lie in the transition zones of the vertebral column
transition vertebrae
154
what are the transition zones of the vertebral column
occitiocervical, cervicothoracic, thoracolumbar, lumbosacral, and sacrococcygeal zones
155
how are specific segments within a transition zone identified
by adjacent region of the segment, process of transition, and specific segment (occipitalization of C1)
156
what doe the suffix "ization" refer to
in the process of becoming like
157
what are the possible transition zone - segmental combinations
cervicalization of occiput, occipitalization of C1, dorsalization of C7, cervicalization of T1, lumbarization of T12, dorsalization of L1, sacralization of L5, lumbarization of S1, coccygealization of S5, sacralization of Co1
158
what is/are the characteristic of cervicalization of occiput
an increase in occipital bone size, formation of new or larger lines on the occipital bone,
159
what is/are the characteristics of occipitalization of C1
the atlas may be partially or completely fused to the occiput
160
what is another way of implying occipitilization of C1
atlas assimilation
161
what is the incidence of occipitalization of C1
0.1 - 0.8%
162
when do the centers of ossification for the odontoid process first appear?
during the last trimester in utero
163
when do the bilateral ossification centers for the odontoid process fuse
at or shortly after birth
164
what joint forms between the odontoid process ossification centers and the centrum of C2
the subdental synchondrosis
165
what joint classification is present between the C2 odontoid process and centrum
amphiarthrosis synchondrosis
166
ossification between the odontoid process and centrum joint of C2 appears at what age
4 years old
167
a joint between the odontoid process and centrum of C2 is las identified at what age
7 years old
168
what is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 persists beyond age 7
os odontoideum
169
what is an os odontoideum
a persistence beyond age 7 of the joint formed between the centrum and odontoid process centers of ossification
170
what is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7
persistent subdental synchondrosis
171
what is the name given to the joint formd between the tip of the dens and the odontid process centers of ossifications
tip of the dens synchondrosis
172
what is the classification of the joint formed between the tip of the dens and odontoid process centers of ossifications
amphiarthrosis synchondrosis
173
at what age will the tip of the dens center ossification appear
sometime in early adolescence
174
based on the age of appearance, how is the tip of the dens center of ossification classified
secondary center of ossification
175
at what age will the tip of the dens fuse with odontoid process
before age 12
176
if the joint formed between the tip of dens and odontoid process centers of ossification persists beyond age 12 what is the condition called
terminal ossicle
177
what is a basilar impression
persistence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain
178
what is a basilar invagination
the upper cervical spine appears to be invaginated into the skull on xray analysis
179
what is the incidence of rib related changes following dorsalization of C7
from one half to two and one half percent of the population
180
do patients typically present with symptoms specific for dorsalization of C7
no, they are typically asymptomatic
181
what is the gender bias suggested in dorsaliztion of C7
female
182
what alteration in C7 facet orientation may accompany dorsalization
the superior articular face of C7 may change from back, upward, and medial to that of a typical thoracic facet... backupward and lateral; the inferior articular facet is unchaged
183
that alteration in C6 facet orientation may accompany dorsalization
c6 demonstrates a change in infereor articular facet orientation from forward lateral downward to forward medial and downward; the superior articular facet unchaged
184
what percent of the population may demonstrate thoracici like features at c7
up to 46%
185
what rib related changes may accompany cervicalization of t1
the first rib may decrease in mean relative length or become absent
186
what will result from fusion of a short rib to the t1 TVP
the transverse foramen
187
what t1 facet orientation changes may accompany cervicalization
the superior articular facet may change from BUL to BUM; the inferior articular facet is unchanged
188
what c7 facet orientation changes may accompany cervicalization
the inf. articular facet may change from FMD to FoLD; the superior articular facet is unchanged
189
what is the incidences of cervicalization of t1 in the population
up to 28% of the population
190
what rib related changes may accompany dorsalization of L1
elongated bones shaped like ribs may appear
191
what is the incidence of lumbar ribs in the population
over 7% of the population demonstrates lumbar ribs
192
what L1 facet orientation changes may accompany dorsalization
the sup articular facet may change from concave BUM to flat BUL; the inf articular facet is unchanged
193
what T12 facet orientation changes may accompany dorsalization
the inf art facet may change from convex FLD to flat FMD; the sup art facet is unchanged
194
what is the gender bia associated with dorsalization of L1
males are two to three times affected
195
what rib related changes may accompany lumbarization of T12
a significant shortening of the mean relative lengt of 113 mm of the 12th rib or it becomes absent
196
what t12 facet orientation changes may accompany lumbarization
the sup art facet may change from flat BUL to concave BUM; the inf art facet is unchaged
197
what t11 facet orientation changes may accompany lumbarization
the inf art facet may change from flat FMD to convex FLD; the sup art facet is unchagned
198
what is characteristic of lumbarization of S1
the failure of synostosis between S1 and S2, squaring the VB of S1 and flaring of the sacral ala
199
what unique characteristic s of lumbarization of S1 were stressed in class
squaring of the VB of S1 and flaring of the sacral ala
200
what is failure of synostosis between S1 and S2
the segments do not completely fuse together
201
what art facet changes accompany lumbarization of S1
none
202
what is characteristic of sacralization of L5
L5 may be partially or completely fused to the sacrum
203
what is the incidence of sacralization of L5 in the population
41 to 85%
204
which segment demonstrates the greatest mophological variation along the spine
L5
205
what articular facet changes accompany sacralization of L5
none
206
what is the incidence of variation within the sacrococcygeal region in the population
up to 14%
207
what is the characteristic of sacralization of Co1
the premature fusion of co1 to the sacrum
208
what is characteristic of coccygealization of S5
the separation of S5 from sacrum and its premature fusion to Co1
209
what forms the spinal accessory nerve innervation the trapezius
C1-C5 cord levels contribute to the spinal root of the spinal accessory nerve
210
what forms the thoracodorsal nerve innnervation the lat dorsi
ventral rami from c6-c8
211
what forms the dorsal scapular nerve
the ventral ramus of c5
212
An increase in the density of muscle spindles is most apparent in which suboccipital muscle
Obliquus capitis inferior
213
What is the result of communication between suboccipital muscle, visual centers and vestibular centers
Coordination of head and eye
| position
214
WHat is the proposed function of the suboccipital muscle group
Postural stabilizers of the Atlanto-occipital and Atlanto-axial joints
215
Which suboccipital muscles are known to attach to dura mater
Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior
216
Interspinalis is paired in which regions of the spine
Cervical and lumbar regions
217
BAsed on the density of muscle spindles what is the proposed function of the interspinalis
Acts as a proprioceptive transducer in conjunction with intertransversarii to coordinate the smooth movement of the spine and to maintain appropriate posture
218
Intertransversarii are paired in which regions of the spine
Cervical and lumbar regions
219
WHat are the names of the parts of the intertransversarii in the lumbar spine
Medial belly, ant. Lateral And posterior lateral belly
220
BAsed on the density of muscle spindles what is the proposed function of the intertransversarii
Acts as a proprioceptive transducer in conjunction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture
221
what are the four consistent features of synovial (diarthrosis) joints
articular or fibrous capsule, synovial membrane, articular cartilage and synovial fluid
222
thickening of the fibrous capsul connective tissue will form the ___
capsular ligament
223
what generic accessory ligaments may accompany and support the capsular ligament
intracapsular and extracapsular ligaments
224
what are common characteristics of type 1 articular receptors
located in the superficial layer of the fibrous capsule, resemble ruffini endings, most numerous in cervical zygapophyses and they monitor the joint "at rest"
225
what are the characteristics of type 2 articular receptors
located in deeper strata of the fibrous capsule, resemble pacinian corpuscles, most numerous in the cervical spine and monitor the joint during normal range of motion
226
what are the characteristics of type 3 articular receptors
present in collateral and intrinsic ligaments, resemble Golgi tendon organs, not initially observed along the vertebral column and monitor extreme joint motion
227
what is the function of type IV articular receptors
nociceptive, they monitor pain
228
type IVa articular receptors would be present in what locations
fibrous capsule, articular fat pads or adventitia of blood vessels
229
type IVb articular receptors are absent in what part of the synovial (diarthrosis) joint
accessory ligaments in general, dense in the posterior longitudinal ligament of the spine
230
what are the three modifications of articular synovial mebrane
1. synovial villi
2. articular fat pads or haversian glands
3synovial menisci and intra articular discs
231
what is the generic function of modifications of articular synovial membrane
aid in spreading synovial fluid
232
articular fat pads are most numerous in what location along the vertebral column
lumbar zygapophyses
233
condensed fibrous connective tissue or fibrocartilage projections of the synovial membrane are called
synovial menisci or intra articular discs
234
synovial menisci are a feature of what joint examples
femur-tibia articulation, cervical zygapophyses and lumbar zyga's
235
what are the specific functions of type A synovial cells
are phagocytic
236
what is the specific function of type B synovial cells
secrete proteinaceous substances and hyaluronic acid
237
what is the common function of type A and type B synovial cells
formation and absorption of synovial fluid
238
what is the source of nutrition for articular cartilage
blood vessels in the synovial membrane, sinuses of the bone marrow cavity and synovial fluid itself
239
what are the primary constituents of articular cartilage
water, cells, collagen type II fibers and a proteoglycan gel
240
what is the primary function of bound gag's in articular cartilage
form a network for water retention
241
what is implied when cartilage is said to have elastic properties
cartilage can deform and returns to original volume rapidly, a time independent property
242
what is implied when cartilage is said to have viscoelastic properties
cartilage can deform but returns to original volume slowly, a time dependent property
243
what is the function of articular cartilage
to provide a wear resistant, low friction, easily lubricated surface for joint movement
244
what are the properties of synovial fluid
it is yellow white, viscous, slightly alkaline and tastes salty
245
synovial fluid consists of what specific chemical groups
fats, salts, albumins, hyaluronate
246
which substance in synovial fluid was first thougt to be responsible for its viscosity and lubricating behavior
hyaluronate
247
what substance of synovial fluid has been proposed to be responsible for its viscosity and lubricating behavior
lubricin
248
what are the classifications of synovial joints (diarthroses) based on the number of articulating surfaces
simple and compound synovial joints
249
what is a complex synovial joint (diarthrosis)
within the simple joint or the compound joint, the articulating surfaces surfaces are separated by an articular disc (intra articular disc) or meniscus
250
identify the common ligaments of the vertebral column
the 9 column ligaments are the ALL, IVD, PLL, ligamentum flavum, capsular ligament, interspinous ligament, ligamentum nuchae, supraspinous ligament and intertransverse ligament
251
what is the maximum number of common ligamnets identified with vertebral couple
8
252
what is the reason that nine common ligaments are identifiied but only eight will be attached at any specific vertebral couple
the ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral column
253
what is the number of true IVD identified in the adult
23
254
in the adult which vertebral levels will demonstrate a true IVD
those between C2 and S1 inclusive
255
what percent of the vertebral column length is contributed by the IVD
20-25%
256
what is the length of the IVD constribution to the vertebral column length
about 7 inches
257
what is the percent of IVD height contribution to the length of each region of the vertebral column
cervical...22-25%, thoracic...20%, lumbar...33%
258
what is the cervical nucleus pulposus composed of
fibrocartilage
259
what is the water concentration in the lumbar nucleus pulposus at birth and after thirty
birth...88%, thirty...70%
260
what cell is associated with the nucleus pulpos usuntil about age 11
notochord cells
261
what cells are associated with mature nucleus pulposus
reticulocyte-fibrocblast and chondroblast
262
which type of collagen is dominant in the nucleus pulposus
collagen type II
263
what is the organizational pattern for collagen fibers in the nucleus pulposus
they are irregularly oriented and randomly scattered
264
what is unusual about the cervical annulus fibrosus
it lacks any lamellar or layered organization
265
what is the appearance of the cervical annulus fibrosus
a horse shoe with the anterior margin thick and lateral margins tapering to the uncinate processes, the posterior margin is thin
266
what compensates for the thinness of the posterior part of the cervical annulus fibrosus
PLL
267
what is the organization of the lumbar annulus fibrosus
it has 12-14 concentric cylindrical lamellae
268
what is the water concentration in the lumbar annulus fibrosus at birth and after thirty
birth = 78%, thirty = 70%
269
which type of collagen is dominant in the anulus fibrosus
collagen type I
270
what is the organizational pattern for collagen fibers in the annulus fibrosus
they are parallel with one another in a single lamellus and angled
271
what is the organization of collagen fibers between lamellae
collagen fibers will be angled in the opposite direction such that a spiral/counter-spiral organization is observed
272
what is the average angle of collagen fibers within the annulus fibrosus
they average 50 to 60 degrees
273
what is the thickest part of the cartilage end plate
around the periphery
274
what is the principle type of collagen fiber within the cartilage endplate
the type II collagen fiber
275
what is the direction of collagen fibers within the cartilage end plate
collagen fibers are aligned anterior to posterior
276
what is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus
the cartilaginous end plate
277
what part of the IVD is innervated
the outer lamellae of the annulus fibrosus
278
what are the types of receptor endings in the IVD
nociceptors and proprioceptors
279
what is the relationship between size of the IVD and receptor endings
the larger the disc, the greater the variety of receptor endings
280
what is the proposed function of receptor ending density in the anterior part of the IVD
they provide feedback during extension
281
what innervates the annulus fibrosus at the posterior part of the IVD
the recurrent meningeal/sinu-vertebral/sinus vertebral nerve
282
what innervates the annulus fibrosus at the anterior part of the IVD
the fibers from the ventral primary ramus
283
what is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the IVD
the paradiscal ramus communicans
284
what vertebral levels will the ALL attach to
those between occiput and S3 inclusive are traditionally indicated
285
what is the lowest extent of the ALL based on recent studies
L3
286
what is the function of the ALL
it brakes or limits dorsi-flexion or hyperextension of the vertebral column
287
what was ossification of the ALL in the lumbar region identified as
Forestier's disease
288
ALL ossification in the lumbar region is now identified as
diffuse idiopathic skeletal hyperstosis or DISH
289
what is the function of the ligamentum flavum
it brakes or limits flexion of the vertebral column
290
what is now thought to be a major function of the ligamentum flavum
it is an early prime factor in extension of the vertebral column
291
where is ossification of the ligamentum flavum most commonly identified
the thoracic spine or thoracolumbar transition zone
292
what is the acronym for ossification of the ligamentum flavum
OLF
293
what is the relationship between the capsular ligamnet and mobility
the more lax/loose the capsular ligament is, the greater the motion of the joint
294
what regions of vertebral column demonstrate the greatest laxity of capsular ligaments
the cervical and lumbar regions
295
the capsular ligament may blend with which other common ligament
the ligamentum flavum
296
what muscle will blend with the capuslar ligament posteriorly
the multifidis
297
if the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its function
it is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement
298
what vertebral levels will the interspinous ligament be attached to
those between C2 and S1 inclusive are traditionally indicated
299
what is now thought to be a major function of the interspinous ligament
it is more likely a proprioceptive transducer for the spinal reflex
300
what will the ligamentum nuchae be attached to
the EOP, EOC, posterior tubercle of the posterior arch of C1, and spinous tubercles between C2 and C7 inclusive are traditionally indicated
301
what is the name given to the superficial layer of the ligamentum nuchae
the funicular layer or part
302
what is the name given to the deep layer of the ligamentum nuchae
the lamellar layer or part
303
what are the attachment sites for the superficial layer of the ligamentum nuchae
the EOP, EOC, and spinous tubercle of C7
304
what is the histological makeup of the ligamentum nuchae in quadrupeds
it is a yellow elastic ligament
305
what is the histological makeup of the human ligamentum nuchae
it is a yellow elastic ligament, but has more collagen fibers than in quadrupeds
306
what is the primary yellow elastic or elastic ligament of the spine
the ligamentum flavum
307
what is the classic function of the human ligamentum nuchae
it brakes or limits flextion of the cervical spine
308
what will the supraspinous ligament be attached to
the spinous tubercles along the vertebral column from C7 to sacrum
309
what is the termination level inferiorly for the supraspinous ligament according to current literature
primrily at L4 (73%); between L4 and L5 (5%)j
310
where is the supraspinous ligament said to be best developed
in the lumbar spine
311
what is now thought to be a major function of the supraspinous ligament
it is a proprioceptive transducer for the spinal reflex
312
what will the intertransverse ligament be attached to
the transverse tubercles and TVP of adjacent vertebra along the vertebral column from C1 toL5
313
what is the status of the cervical intertransverse ligament
it is said to be paried with an anterior and posterior intertransverse ligament present
314
what is the status of the lumbar intertransverse ligament
it is well developed with two parts identified, a ventral slip and dorsal slip
315
what part of the lumbar intertransverse ligament covers the intervertebral foramen
the ventral slip
316
what part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment
the dorsal slip
317
what are the characteristics of the capsular ligament of the antlanto-occipital ligament
it is said to be loose, thin, and composed of collagen fibers
318
what other joint space does the atlanto occipital joint communicate with
the posterior bursa of the median atlanto axial joint
319
what is the median thickening of the anterior atlanto occipital ligament called
the ALL
320
which ribs are classified as typical ribs, true ribs, costa verae, and vertebrosternal ribs in the typical adult skeleton?
ribs 3-7
321
which ribs are classified as atypical ribs, true ribs, costa verae and vertebrosternal ribs in the typical adult skeleton
ribs 1 and 2
322
which ribs are classified as typical ribs, false ribs, costa spuriae, and vertebrochoncal ribs in the typical adult skeleton
ribs 8 and 9
323
which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebrochoncal ribs in the typical adult skeleton
rib 10
324
which ribs are classified as atypical ribs, false ribs, costa spuriae and vertebral ribs in the typical adult skeleton
ribs 11 and 12
325
what joint classification is now given to the joint between the sternum, clavicle, and first rib
synovial saddle (diarthrosis sellar) joint
326
what ribs will participate in the sternocostal or sternochondral joint
rib 1 to 7
327
what is the classic classification of the first sternocostal or sternochondral joint
cartilaginous (amphiarthrosis) synchondrosis
328
what is the newer suggested classification of the first sternocostal or sternochondral joint
cartilaginous (amphiarthrosis) symphysis
329
what is the classification of the second - seventh sternocostal or sternochondral joint
synovial plane (diathrosis arthrodia)
330
what is the classification of the sixth through the ninth interchondral joints
synovial plane (diathrosis arthrodia)
331
what is the classification of the fifth - sixth or ninth - tenth interchondral joints
fibrous (amphiarthrosis) syndesmosis
332
which costal cartilages fail to form a joint at their sternal end
the eleventh and 12th costal cartilages
333
what is the name given to the segments of the sternum
sternabrae (for sternal bodies)
334
how many primary centers of ossification appear in the manubrium
1-3 centers have been identified
335
how many primary centers of ossifications appear in the corpus sterni
typically 6
336
in what part of the sternum will a secondary center of ossification appear
the xiphoid process
337
when does the xiphoid process first demonstrate a center of ossification
sometime during or after 3 years old
338
in what part of the rib will primary centers of ossification appear
the body (corpus, shaft)
339
in what parts of the rib will secondary centers of ossifications appear
the head, articular surface of the tubercle and the non articular surface of the tubercle
340
which ribs will demonstrate primary centers of ossification for the body (corpus or shaft)
all ribs; ribs 1-12
341
which ribs will demonstrate secondary centers of ossification
ribs 1-10
342
which ribs lack secondary centers of ossifications
ribs 11-12
343
what part of the skull is derived from endochondral ossification
chondrocranium
344
which skull bones are ossified by both endochondral and intrammbranous ossification
mandible, sphenoid, temporal, and occipital bones
345
whcih bone of the appendicular skeleton is formed by endochondal and intramembranous classification
the clavicle
346
how many bones form the skull
28 including the auditory ossicles
347
exluding the auditory ossicles how many bones form the skull
22
348
what is the cranium
the skull minus the mandible
349
how many bones form the cranium
27 bones
350
what is the calvaria
the skullcap
351
what is the neurocranium
the part of the skull that surrounds the brain
352
how many bones form the neurocranium
8 bones
353
what bones form the neurocranium
frontal, parietal, occipital, temporal, sphenoi, and ethmoid
354
what is the facial skeleton
the bones that support the face
355
what is the facial skeleton
the bones that support the face
356
how many bones form the facial skeleton
14 bones
357
what bones form the facial skeleton
mandible, vomer, nasal, maxilla, lacrimal, inf. nasal concha, palatine, and zygomatic
358
what is another name for the facial skeleton
the viscerocranium
359
what are the four subclassifications of synarthrosis joints based on latin groupings
suture, gomphosis, schindylesis and syndesmosis
360
what are the characteristics of sutura vera (true sutures)
sutures demonstrating interlocking of the adjacent bone surfaces; typically formed by intramembranous ossification
361
what are the characteristics of sutura notha (false suture)
sutures lacking interlocking of adjacent bone surfaces; typically formed by endochondral ossification
362
what is the classification of a joint with a "nail like condition
gomphosis
363
what is the classification of a joint with a "fissure-like" condition
schindylesis
364
what is the anterior fontanelle
the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with both parietal bones
365
what is the posterior fontanelle
the diamond shaped remnant of developing membrane bone at the intersection of the occipital bone with both parietal bones
366
what is the name given to the indentation of bone between the nasal and frontal bones
nasion
367
what is the name given to the outline of the nasal cavity at the front of the skull
piriform aperature
368
what is the name given to the alveolar jugum of the canine tooth in the maxilla
canine eminence
369
what forms a bullet like chin
a large mental protuberance
370
what forms an indented chin
well developed bilateral mental tubercles and slight mental protuberance
371
what is the tip of the EOP called
the inion
372
what is the name of the linear elevation lateral to the EOP
superior nuchal line
373
what points on the skull are used to measure the skull size
the nasion, vertex, inion, and gnathion
374
what points on the skull measure cranial vault capacity
nasion, vertex, and inion
375
what is the appearance of the suture intersections over the hard palate called
the cruciate/cruciform suture
376
what is the posterior boundary of the anterior cranial fossa
a line drawn along the lesser wing of sphenoid , anterior clinoid processes, and sphenoidal jugum
377
what passes through the cribriform plate
fila olfactoria of cranial nerve 1, the olfactory nerve
378
an emissary vein leaves the anterior cranial fossa via what opening
foramen cecum
379
what is the post boundary of the middle cranial fossa
superior border of petrous part of tympanic bone, posterior clinoid processes and dorsum sella of sphenoid bone
380
what bony feature is prominent in the median plane of the middle cranial fossa
sella turcica
381
what cranial nerves exit the skull via middle crania fossa ostia
CN 2-6
382
what are the contents of the optic canal
the optic nerve and ophthalmic artery
383
what are the contents of the superior orbital fissure
ophthalmic veins, oculomotor nerve, trochlear nerve, ophthalmic division of trigeminal nerve, and abducent nerve
384
which single opening will allow the exit of the greatest number of cranial nerves
the sup orbital fissure
385
what is unique about the ophthalmic artery and veins
they will not share the same opening, the artery is in the optic canal, and veins are in sup orbital fissure
386
what are contents of foramen ovale
mandibular division trigeminal nerve (Vc) and lesser petrosal branch of the glossopharyngeal nerve
387
the maxillary division of the trigeminal nerve exits the middle cranial fossa via what opening
the foramen rotundum
388
what opening allws a branch of cranial nerve Vc to enter the mid cranial fossa from the infratemporal region
the foramen spinosum
389
which vessel is located within the foramen spinosum
middle meiningeal artery
390
what forms the roof of the post cranial fossa
the tentorium cerebeli
391
what part of the cerebrum occupies the post cranial fossa
none, the tentorium cerebelli separates the cerebrum into space above the post cranial fossa
392
what part of the CNS occupies the post ranial foss
the cerebellum, pons, and medulla oblongata
393
what bony feature is prominent in the median plane of the post cranial fossa
the clivus or basilar part of the occipital bone
394
which cranial nerve exit post cranial fossa ostia
CN VII-XII
395
what are the contents of the internal acoustic meatus
CN VII and VIII, the nervus intermedius/nerve of Wrisberg/sensory root of VII and motor root of VII, the vestibular and cochlear roots of VIII and internal auditory/internal labyrinth artery and vein
396
what are the contents of the jugular foramen
the jugular bulb, inf. petrsal sinus, the tympanic body/tympanic glomus or jugular body/jugular glomus, CN IX-XI
397
what is the jugular bulb
venous expansion between the sigmoid dural venous sinus and internal jugular vein
398
what is the function of the jugular body/jugular glomus
a chemoreceptive organ that monitors hypoxia, hypercapnia, and increases the hydrogen ion
399
what can the five layers of the scalp spell
skin, connective tissue, aponeurosis, loose connective tissue, periorsteum....SCALP
400
what are the principal sources of blood to the scalp
internal carotid and external carotid artery branches
401
what veins drain the scalp
superficial temporal, post. auricular, occipital, and ophthalmic veins
402
which divisions of the trigeminal nerve receive sensory info from the scalp
all 3; ophthalmic, maxillary, and mandibular`
403
what is the third layer of the scalp associated with
muscular component of the scalp
404
what muscle are specifically associated with the scalp
frontalis and occipitalis bellies of the epicranius
405
the bellies of the epicranius are connected by what
galea aponeurotica
406
what specific nerves provid motor control to the scalp
facial nerve; post. auricular and temporal branches
407
what is unusual about the muscles of the face
they don't act as lever muscles, no origin or instertion on bone
408
which muscle lack any attachement to bone
orbicularis oris, proceris, risorius
409
what type of motor fibers to skeletal muscle are given off by facial nerve
branchial efferent (BE)
410
what openings are located at the sup. wall of the orbit
optic canal
411
what are the contents of optic canal
optic nerve and ophthalmic artery
412
what is the name given to the medial wall of the orbit
lamina papyracea
413
what features may be observed on medial wall of orbit
lacrimal groove, fossa for lacrimal sac, ant. ethmoid foramen and post.
414
what opening are located along the lateral wall of orbit
sup. orbital fissure
415
what are contents of sup. orbital fissure
oculomotor, trochlear and abducaent
| CN ophthalmic division trigeminal CN and ophthalmic veins
416
what openings are located along the inf. wall of orbit
inf. orbital fissure
417
what is contained in inf. orbital fissure
maxillary division of trigeminal nerve
418
identify the openings found along each wall of the orbit
superior: optic canal,
medial: ant./post. ethmoid foramina,
lateral: sup. orbital fissure,
inferior: inf. orbital fissure
419
what are the layers of the eyelid
skin, orbicularis oculi muscle, tarsal plate/tarsus and palpebral conjunctiva
420
what are the names given to the modified sebaceous gland in the tarsus of the eyelid
tarsal or Meibomian gland
421
what is the function of the Meibomian gland
produces thick, hydrophobic substance that prevents tears from overflowing onto cheeks along the eyelid
422
what is the name of the gland located at base of the eyelash
ciliary gland
423
what are names give to the modified sebaceous glands of palpebra
tarsal or Meibomian gland or ciliary gland
424
wht is the name given to the elevation at the medial canthus
lacrimal caruncle
425
what is the name given to the opening of the lacrimal papilla
lacrimal punctum
426
parasympathetic stimulation of blood vessels in the lacrimal gland will result in what events?
vasodilation, increased availability of water to secretory units, thinner or more watery product in lumen
427
sympathetic fibers synapse in which ganglion in the pathway to the lacrimal gland
the superior cervical ganglion
428
sympathetic stimulation of the lacrimal gland will result in what events
vasoconstriction of blood vessels, limited availability of water to secretory units, more viscous or thicker product formed in glandular lumen
429
what are the names of layers of the eyeball
fibrous tunic, uveal tract and retina
430
what are the parts of the fibrous tunic of eyeball
cornea and sclera
431
what are the parts of the uveal tract of the eyeball
iris, ciliary body, choroid and pupil
432
what muscles are present in the iris
scphincter pupillae and dilator pupillae
433
what is the innervation of sphincter pupillae
oculomotor nerve, parasymp. pathway
434
what iss the innervation of ciliaris muscle
oculomotor nerve, parasymp. pathway
435
what is innervation of dilator pupillae
internal carotid artery plexus, symp. path
436
what are chambers of the eyeball in front of the lens
anterior chamber and posterior chamber
437
what separates the ant. from post. chamber in eyball
the iris
438
what is contained in the ant. chamber of eyeball
aqueous humor
439
what is the primary cause of glaucoma
excess aqueous humor in the chambers in front of the eyeball
440
what is the name given to the chamber behind the lens
the vitreous chamber
441
what fills the vitreous chamber
vitreous body
442
what are the functions of the vitrous body
maintain retinal curvature, allow light distortion from lens to retina
443
what are the common characteristics in origin and insertion of all rectus extraocular muscles
they all originate from common annular tendon in the orbit they all insert into the sclera in front of the coronal equator
444
what is the common characteristic regarding the instertion of both oblique extraocular eye muscles
both insert onto sclera on the lateral margin of eyeball behind the coronal equator
445
what are the two unique features of the fourth cranial nerve
it is the only cranial nerve with apparent origin from the brains dorsal surface; it is the only cranial efferent nerve to decussate within the midbrain from its nucleus
446
intrinsic muscles of the eyeball are innervated by which visceral efferent pathways
ciliaris and sphincter pupillae are innervated by parasympathetics, dilator pupillae is innervated by sympathetics
447
the auricule transmits sensory innervation via which specific cranial nerve branches
auriculotemporal nerve (mandibular division, trigeminal)posterior auricular cutaneous nerve (facial) auricular nerve (vagus)
448
what part of the external acoustic meatus is protected by cartilage
lateral one third
449
what pat of the external acoustic meatus is protected by bone
medial two thirds
450
what is the cerumen
the product of ceruminous glands form the bulk of the earwax
451
skin lining the external acoustic meatus contains what modified sebaceous gland
ceruminous glands
452
what vein is formed within the parotid gland
retromandibular vein
453
what branche of the facial nerve penetrates parotid gland, but is not given off within it
the chorda tympani nerve
454
what forms the boundary of the infratemporal region
ramus of the mandible
