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vertebral column > Lecture 1- development of vertebral column > Flashcards

Lecture 1- development of vertebral column Flashcards

1
Q

how many vertebrae in the adult?

A

33

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2
Q

how many presacral?

A

24

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3
Q

how many sacral/ coccygeal?

A

9

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4
Q

How many cervical, thoracic and lumbar?

A

7, 12,5

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5
Q

how many sacral and coccygeal?

A

5, 4

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6
Q

Curved segments act like what?

A

independent springs conferring flexibility and resilience to the structure as a whole

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7
Q

what vertebrae are primary curvatures?

A

Thoracic, sacral/ coccygeal

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8
Q

what vertebrae are secondary curvatures?

A

cervical and lumbar

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9
Q

are primary curvatures convex anteriorly or concave anteriorly?

A

concave

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10
Q

are secondary curvatures convex anteriorly or concave anteriorly?

A

convex

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11
Q

in a fetus what shape is the vertebral column?

A

‘C’

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12
Q

when are the thoracic and sacrococcygeal primary curvatures established?

A

in fetal development

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13
Q

when are the cervical and lumbar secondary curvatures developed?

A

during infancy

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14
Q

when specifically is the secondary curvature developed in the cervical region?

A

2-3 months

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15
Q

when specifically is the secondary curvature developed in the lumbar region?

A

6-8 months

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16
Q

primary curves are maintained through what?

A

through shape of vertebrae

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17
Q

secondary curvatures arise from what?

A

from a modification in shape of the intervertebral disc

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18
Q

degeneration of the discs in the elderly results in what?

A

a return to a more pronounced primary curvature

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19
Q

what is kyphosis?

A

hunchback deformity

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20
Q

what is lordosis?

A

sway back deformity, forward pelvic tilt

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21
Q

what can lordosis occur from?

A

pregnancy

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22
Q

what is scoliosis?

A 
lateral deviation of greater than 10'
often accompanied by a rational defect
congenital
idiopathic
secondary to primary condition
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23
Q

adult vertebral body is derived from what?

A

the juvenile centrum plus a small portion of the neural arch

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24
Q

the adult vertebral body equates to more than what?

A

the juvenile centrum

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25
Q

ossification is initiated where?

A

dorsal to the notochord

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26
Q

what kind of ossification is the centra?

A

true endochondral

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27
Q

when does the centra first appear?

A

in lower thoracic and upper lumbar regions (T10- L1) between 9-10 fetal weeks

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28
Q

what kind of progression is the ossification of the centra?

A
  • bidirectional progression
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29
Q

when does ossification of the centra reach L5 and C2?

A

L5 by 3rd month and C2 by end of 4th fetal month

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30
Q

Notochord cells contain what?

A

angiogenic inhibiting factor which delays vascular penetration into this region

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31
Q

vertebral centra from first trimester display what?

A

an axial avascular area around the notochord region

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32
Q

what does the axial avascular area around the notochord region result in?

A

a ring- shaped area of ossification

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33
Q

morphology and development of juvenile centrum is heavily influenced by what?

A

profuse vascular supply

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34
Q

each centre is supplied by what?

A

paired nutrient arteries and an accompanying venous network

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35
Q

Where do the neural arches commence?

A

on the inner surface of the hemi-arch

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36
Q

what comes first?

A

intramembranous followed by endochondral

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37
Q

where do the neural arches first appear?

A

in the lower cervical and upper thoracic regions in 2nd fetal month

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38
Q

the neural arches spread where?

A

spread upwards and downwards

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39
Q

Ossification of the neural arches initiated by what?

A

in response to gasp reflex- muscle contraction

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40
Q

by the 3rd fetal month what happens in relation to the neural arches?

A

a second group of centres appear in the lower thoracic and upper lumbar regions

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41
Q

in relation to the 3rd fetal month of the neural arches where do they spread?

A

upwards and downwards

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42
Q

ossification of the neural arches in the 3rd fetal month is initiated by what?

A

in response to lower limb movement- muscles contraction

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43
Q

during the first year the neural arches commence fusion where?

A

posteriorly at the spinous process

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44
Q

Where does fusion of the neural arches occur initially and where does it progress?

A

in the lower thoracic and upper lumbar regions in the latter part of the first year and progresses in a systematic cranial and caudal direction

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45
Q

cervical arches may not fuse till when?

A

beginning of 2nd year

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46
Q

lower lumbar arches may not fuse until when?

A

the end of the 5th year

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47
Q

in an individual <6years what could occur in relation to the neural arches?

A

non-fusion of the arches should be expected

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48
Q

fusion between the neural arches and the centra occurs where?

A

ventral to the pedicles at the neurocentral junction

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49
Q

when does ossification of the neural arches and centra occur?

A

between 2-5 years

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50
Q

adult vertebral bodies formed from what?

A

centrum and ‘boutons’ of pedicles

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51
Q

head of costal process only ever articulates with what?

A

boutons and never with the centrum

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52
Q

where does neurocentral fusion occur?

A

first in lumbar region, followed by cervical segment, with thoracic vertebrae being last to fuse

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53
Q

where does atlas C1 ossify from?

A

three primary centres

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54
Q

At birth what represents atlas C1?

A
  • two bony masses
  • display larger concave articular facets anteriorly on upper surface
  • display smaller flatter articular facets on their lower surface
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55
Q

morphology atlas C1 remains what?

A

unchanged throughout the first year after birth

56
Q

what happens to atlas C1 in the first or second year?

A
  • ossification commences in the anterior arch

- either as single, paired, multifocal nodules or from ossification bars that extend directly from lateral masses

57
Q

posterior arch of atlas C1 usually fuses when

A

4-5 years

58
Q

what percentage of adults still have an unfused atlas?

A

1%

59
Q

anterior neurocentral junction closes when?

A

5-6 years

60
Q

line of union between anterior arch and lateral masses passes where?

A

across the anterior portions of the superior articular facet

61
Q

endochondral growth occurs where?

A

at all junctions prior to fusion allowing an overall integrates expansion of the vertebral canal as the 3 ossified units grow away from one another

62
Q

adults size atlas is reached when?

A

by 4-6 years

63
Q

early limitation on size of vertebral canal is a clear indication of what?

A
  • precocious maturation of the CNS
64
Q

The axis C2 ossifies from what?

A

5 primary centres of ossification

  • one for each half of the neural arch
  • one for the true centrum of the axis
  • one for each half of the body of the dense
65
Q

centres for the neural arches in the axis C2 appear when?

A

before the centra ~ 7-8 fetal weeks

66
Q

The true centrum of the axis commences ossification when?

A

from a single centre between 4-5 months intra-uterine life, around the same time two laterally places ossification centres appear in the odontoid process

67
Q

these laterally placed ossification centres do what?

A

they rapidly coalesce so that the intradental synchondrosis fuses by birth and forms forked appearance of juvenile dens

68
Q

In relation to the axis C2 when does the posterior synchondrosis between neural arches fuse?

A

between 3-4 years

69
Q

in the axis C2 the dens fuses where and when?

A

laterally to the neural arches at the dentoneural synchondrosis ~3-4 years

70
Q

the fusion line of the axis C2 passes where?

A

across superior articular facet, so that medial 1/3 of facet is formed by dens and lateral 2/3 by the neural arch

71
Q

In relation to the axis C2 the inferior articular facet forms from what?

A

entirely from neural arch

72
Q

in relation to the axis C2 the fusion halts increase what?

A

in dimension of the vertebral canal

73
Q

in relation to the axis C2, complete of what occurs between 3 and 4 years?

A

fusion of the foramen transversarium is complete when?

74
Q

in relation to the axis C2, what fuses between weeks 4-6?

A

the dentocentral junction and the paired neurocentral junctions

75
Q

all lines of fusion of the axis disappear when?

A

9-10 years

76
Q

what line of fusion may still be present in relation to the axis C2?

A

small horizontal cervice may remain in region of posterior dentocentral junction

77
Q

In relation to the axis what occurs at 2 years?

A

a small ossific nodule, the ossiculum terminales, appears in the cartliage plug that fills the apical cleft

78
Q

Os terminale fuses when?

A

with dens at ~12 years

79
Q

in relation to the axis C2, what are the 5 secondary centres?

A
  • 2 flake-like epiphyses for the bifid transverse processes
  • 2 plate- like epiphyses for the bifid spinous process
  • inferior annular ring (only inferior in C2)
80
Q

when would the 5 secondary centres of the axis C2 become 6?

A
  • is os terminale is considered to be epiphyseal
81
Q

recognisable secondary centre of ossification occurs with relation to what?

A

to the inferior annular ring

82
Q

what infills the interdental groove?

A

a small tongue of bone progresses up the posterior surface of the dens

83
Q

how do the typical cervical vertebrae develop?

A

in accordance with the general ossification pattern of any typical vertebra

84
Q

what is a typical cervical vertebrae formed from?

A

3 centres

85
Q

when is a typical cervical vertebrae recognisable from?

A

mid- fetal life

86
Q

all cervical laminae unite where and when?

A

posteriorly within the 2nd year

87
Q

when is neurocentral fusion complete within the cervical vertebrae?

A

3-4 years

88
Q

once neurocentral fusion takes place in the cervical vertebrae what happens?

A

synovial uncovertebral joints of luschka form on the sloping and elevated articular sides of the neural element of the vertebral body

89
Q

in relation to the cervical vertebrae when does single bony element close?

A

by 4 years

90
Q

what is luschka?

A

one cervical vertebrae can articulate with the other

91
Q

what are the 6 secondary centres in cervical vertebrae?

A
  • 2x transverse processes
  • 2x spinous process
  • 1x superior annular ring
  • 1x inferior annular ring
92
Q

when do the secondary centres in cervical vertebrae appear?

A

beginning of puberty

93
Q

when do the secondary centres in cervical vertebrae begin fusing?

A

end of puberty (18y+)

94
Q

when do the secondary centres in cervical vertebrae completely fuse?

A

by 24 years old

95
Q

thoracic vertebrae develop in accordance with what?

A

with general ossification pattern for a typical vertebrae

96
Q

in relation to the thoracic vertebrae when do the primary centres appear?

A

present by end of third intra- uterine month

97
Q

how are the thoracic vertebrae identifiable?

A

by the 4th intra- uterine month

98
Q

lumbar vertebrae develop in accordance with what?

A

general ossification pattern for a typical vertebrae

99
Q

in relation to the lumbar vertebrae when do the primary centres appear?

A

present by end of third- intra-uterine month

100
Q

how are the lumbar vertebrae identifiable?

A

by the 4th intra-uterine month

101
Q

What is present in the thoracic and lumbar secondary ossification?

A 
annular ring
transverse process
spinous process
thoracic: sometimes on costal surface
lumbar: sometimes on mamillary processes
102
Q

how many centres does the sacrum have?

A

21 separate centres

103
Q

each sacral vertebrae is represented by what?

A

typical 3 primary centres

104
Q

what are the primary centres of the sacrum?

A

1x centrum

2x neural arches

105
Q

S1 -3 incorporate what, which form what?

A

paired lateral elements, form the ventral aspect of the alae and are site of SI artic

106
Q

what is the sacrum ossification pattern?

A

3rd iu month= S1 and S2 centra
4th iu month= S3 and S4 centra, S1-S3 neural arches
5th iu month= S5 centra, S4-S5 neural arches
6th iu month= S1-S3 paired costal elements
Birth = all centres represented although may only be small ossific nodule

107
Q

in relation to sacral fusion when do the neural arches unite?

A

with lateral elements between 2-5 yrs

108
Q

What do the lateral elements of sacral fusion then fuse with?

A

the centrum between 2-6 yrs

109
Q

when do all the primary centres of the sacral vertebrae fuse?

A

6yrs except post. at spinous processes

110
Q

when do the posterior spinous processes fuse?

A

7-15 yrs

111
Q

individual sacral vertebrae remain separate until when?

A

puberty when late elements commence fusion

112
Q

are secondary centres in relation to the sacral vertebrae consistent?

A

no, numbers vary between individuals

113
Q

how many secondary constant centres are there in the sacral vertebrae?

A

14

  • 10x annular rings
  • 2x auricular epiphyses
  • 2x lateral margin epiphyses
114
Q

what are the multiple small variable elements in relation to secondary centres of the sacral vertebrae?

A

flake- like epiphyses

  • spinous process
  • median sacral crest
  • lateral sacral crest
  • between sacral vertebrae
115
Q

what happens around 12 years old to the fusion of the secondary centres of the sacral vertebrae?

A
  • lateral elements are fusing the annular epiphyses commence fusion in a caudocranial direction
116
Q

in relation to the sacral vertebrae spaces an be identified between bodies what age?

A

<20 years

117
Q

if space only between S1 and S2 what age?

A

<27 years

118
Q

complete union not observed until when?

A

25+ years

119
Q

epiphysis for SI joint?

A

several ossific nodules which coalesce
appears 15-16 yrs, fuse by 18 yrs
lateral margin epiphysis follows same pattern

120
Q

fusion in the sacral vertebrae goes from where to where?

A

caudal to cranial

121
Q

ossification occurs from where to where in relation to sacral vertebrae?

A

cranial to caudal

122
Q

sacro-iliac joint forms when?

A

2nd iu month

123
Q

sacro-iliac joint completed when?

A

7th iu month

124
Q

the sacro-iliac joint at birth it is said to be what?

A

straight and parallel to vertebral column reflecting quadripedal form

125
Q

what assists with growth of the sacro-iliac joint?

A

mechanical forces associated with growth

126
Q

what causes the sacro-iliac joint to curve?

A

bipedalism cause the joint to curve caudodorsally into adult morphology

127
Q

surface area of sacro-iliac joint increases when?

A

substantially throughout development in line with important developmental milestones

128
Q

sacro-iliac joint is what?

A

non- weight bearing and demonstrates no secual dimporphism

129
Q

each coccygeal vertebrae forms from what?

A

a single separate centre

130
Q

Co1 forms from what?

A

multiple

131
Q

Co1 appears when?

A

between late fetal period and first year of life

132
Q

Co2 appears when?

A

3-6 yrs

133
Q

Co3 appears when?

A

10 yrs

134
Q

Co4 appears when?

A

puberty

135
Q

when are the coocygeal vertebrae recognisable?

A

puberty

vertebral column (10 decks)

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