Osteology of Spine and Articulations Flashcards
(107 cards)
1
Q
How many vertebrae are there? Divisions?
A
33
7 cervical, 12 thoracic, 5 lumbar, 5 sacral(fused) and 4 coccygeal(usually fused)
2
Q
How consistent are sacral fusion patterns
A
vary in 5 % population
3
Q
Differentiate between sacralization and lumbarization
A
sacralization- fusion of L5 with sacrum
lumbarization- lack of fusion of S1 with sacrum
4
Q
what is the general size patterns of vertebrae
A
get larger as descent spine because of weight bearing
5
Q
Describe composition of the body of the vertebrae
A
cancellous (spongy) bone. thing layer around of compact (cortical) bone
6
Q
Compression fractures are usually due to
A
demineralization of the cancellous bone in vertebral body
7
Q
What type of cartilage covers body of vertebrae
A
hyaline cartilage
8
Q
What are the posterolateral processes that project from the vertebral body
A
pedicles
9
Q
Structures found on pedicles
A
superior and inferior vertebral notches
10
Q
What structures form vertebral foramina
A
when the superior and inferior notches of adjacent vertebrae come together
11
Q
What passes through spinal foramina
A
spinal nerves and vessels
12
Q
What is the continuation of the pedicles posteromedially to complete vertebral arch
A
Laminae
13
Q
Name all of the articular processes
A
2 superior and 2 inferior located between the pedicel and lamina– articular facets
14
Q
What makes up a spinal process
A
fusion of two laminae
15
Q
What are the characteristics of the vertebral bodies of Cervical vertebrae
A
the body is small and shaped laterally
16
Q
Describe the transverse process on cervical vertebrae
A
Arise from pedicle and articulating processes. Directed anterolateral
Form costotransverse foramen (transverse cervical foramen)
17
Q
What travels through the costotransverse foramen
A
vertebral artery, vein and sympathetic nervous plexus
18
Q
What parts of cervical vertebrae provide sites for attachment of neck and superficial back muscles
A
the anterior and posterior tubercles formed by termination of the costal and transverse processes
19
Q
Why is the connection between the costal and transverse processes (Cervical) grooved
A
superior surface for passage of spinal nerve
20
Q
Describe articular facets of Cervical vertebrae
A
posterior to transverse process
flat and oval shaped and oriented OBLIQUELY in coronal plane
Superior facets directed up and back
Inferior facets directed down and forward
21
Q
What do the spinal processes look like on cervical vertebrae
A
short, bifid* and downward projecting
22
Q
Describe vertebral arch of cervical vertebrae
A
triangularly shaped
23
Q
Describe the C1 vertebra
A
Atlas. No body. Anterior arch and posterior arch with lateral masses
24
Q
Anterior arch of C1 vs posterior
A
Anterior- tubercle and is the facet for dens of CV2
Posterior- tubercle and is the sulcus for vertebral artery
25
Describe the lateral masses on C1
Superior and Inferior articulating facets And transverse process
superior- articulate with occipital condyles
inferior- articulate with sup articulating on C2
Transverse process are attachments sites for head rotating muscles
26
Why does C1 have such a large vertebral foramen
space for caudal medulla
27
Describe C2 vertebra
Axis. has the dens (odontoid process)
dens has smooth articulating facet which receives anterior arch
Sup articular facets articulate with C1
Spinous process is thick and bifid
28
What is special about C7
Cervical prominens. Transition between C and T vertebrae
| very long horizontal spinous pocess
29
What runs through the transverse foramina of C7
ONLY vertebral vein (if have the foramina- many times is not there)
30
Describe the vertebral body of thoracic vertebrae
Heart-shaped, intermediate size
| 2 costal facets per side
31
Which Thoracic Vertebra have a complete facet(not just half)
T1 T10 T11 T12
32
Describe T articulating processes
thing and flat- VERTICALLY in coronal plane
superior facets face posterior superior and lateral
inferior facets face anterior, inferior and medial
33
Describe T transverse processes
Thick, strong and long
directed posterolateral
facet on anterior surface for articulation with costal tubercle
34
Describe characteristic of T laminae
overlapping like roofing shingles
35
Describe spinous processes of T vertebrae
Overlap one another and directed inferiorly*
36
Which level of vertebra is the vertebral foramen the most narrow in diameter
Thoracic
37
Describe body of Lumbar vertebrae
largest because of weight bearing
38
Why are the pedicles closer in L vertebrae
stronger, less torque
39
Describe transverse processes of L vertebrae
anterior to articulating processes. direct laterally
40
Describe articulating processes of L vertebrae
VERTICALLY in SAGITTAL plane
superior- face medially and posteriorly
inferior- face laterally and anteriorly
41
Describe laminae of L vertebrae
short- non overlapping.
| facilitate lumbar puncture because when flexed can get needle through
42
What is the pars interarticularis
area of lamina between superior and inferior articulating processes
43
What does the erector spinae mm attach to on L vertebrae
spinous processes
mammillary processes
accessory mammillary processes
44
Describe vertebral foramen in L vertebrae
triangular shaped with apex directed posteriorly
45
What is the superior surface of the sacrum
Promontory- anteriorly facing
46
What are the lateral surfaces of sacrum
Alae- fused costal and transverse processes of SV1
47
What is the auricular surface of the sacrum
anterolateral surface of the alas- articulate with ilium
48
Describe ventral surface of sacrum
concave and smooth
| pierced by 4 paris of sacral foramina
49
What runs through ventral sacral foramina
ventral primary rami of sacral spinal nerves
50
Describe dorsal surface of sacrum
convex and rough. Four pairs of dorsal sacral foramina. Median sacral crest
Sacral hiatus
51
What runs through the dorsal sacral foramina
dorsal primary rami of sacral spinal nerves
52
What makes up the median sacral crest
fusion of sacral spinous processes
53
Where is the site for epidural anesthetic injection
sacral hiatus
54
What creates the sacral hiatus
failure of S5 fusion, sometimes S4 too
55
What makes up the intermediate sacral crest
fused articular processes
56
What are the sacral cornua
tubercles of inferior articulating processes of S5
57
What makes up the lateral sacral crest, site for what?
fused transverse processes,
| site for attachment of sacroiliac, sacrotuberous and sacrospinous ligaments
58
What makes up the coccyx
4 fused segments- bodies only
| coccygeal horns are posterior tubercles which articulate with sacral horns from S5 vertebral foramen
59
What are the normal curvatures
Primary- anterior concavity of the vertebral column
| Secondary- anterior convexity of the vertebral column (Cervical and Lumbar when we can walk)
60
Abnormal curvatures and describe each
Lordosis- exaggerated secondary curve of lumbar
Kyphosis- exaggerated primary curve of thoracic
Scoliosis- lateral S shape in any region
61
What are the components of an intervertebral disc
Annulus fibrosis and Nucleus Pulposis
62
How much of the length of the spine is attributed to intervertebral discs and does this change?
1/4
| decrease in thickness as age increases due to dehydration
63
What is the shape of intervertebral discs
wedge shaped. thicker anteriorly in cervical and lumbar to maintain secondary curves
64
What is a ruptured disc
tear of the annulus fibrosis leading to loss of integrity between contiguous vertebrae
65
What is a herniated disc
nueclue pulposus squeezes through the ruptured disc and may contact roots of spinal nerves.
66
Differences in herniated discs based on the level they occur
In Cervical regions- affect spinal nerves at same level
| In Lumbar regions- affect spinal nerves one or more levels lower
67
What is the ligament that runs on the anterior surface of all vertebrae
anterior longitudinal ligament
68
Layers of anterior long lig
deep layer- short fibers that span contiguous vertebrae
| superficial layer- long fibers that span many vertebrae
69
What ligament prevents excessive extension
anterior long spinal lig
70
Where is the post long lig and its function
located on post surface of all vertebral bodies- same fibers as anterior log.
Prevents excessive flexion
*directs intervertebral dis herniation posterolaterally
71
Zygapophysis
facet joints. synovial joint
72
Describe motion limits of zygapophysis regarding to the segment
Cervical- flexion, extension, rotation, lateral flexion
Thoracic- rotation, lateral flexion(little flexion no extension)
Lumbar- flexion, extension, side bending, very limited rotation
73
Why is the zygapophysis in the thoracic region more restricted?
presence of ribs, long thoracic spinal processes and thin intervertebral discs
74
What is the ligamentum flava
unites internal surfact of adjacent laminae from C2 downward.
Maintains upright posture by LIMITING flexion and ALIGNS facet joints
75
Why is the ligamentum flava yellow
high in elastic fibers
76
What is the strongest ligament posterior to vertebral bodies
ligamentum flava
77
Describe the Interspinal ligament
Unites adjacent processes from tip to laminae
| most robust at lumbar levels.
78
Describe the Supraspinal ligament
Connects tips of spinous procceses from C7 to sacrum
| continuous with interspinous lig
79
What are the two layers of supraspinal ligament
deep- span adjacent spinous process
| superficial- span several vertebrae
80
What is the Ligamentum Nuchae
Nuchal lig.
median sheet like upward extension of the supra spinal ligament
extends from C7 to external occiptal protuberance
acts ans intermuscular septum
Provides muscular attachment without limiting extension of cervical column
81
What are the boundaries of the intervertebral foramina
Superior- inferior vertebral notch of vertebra
Inferior- Superior vertebral notch of vertebra
Anterior- Posterior portion of vertebra above intervertebral disc
Posterior- facet joint between 2 opposing vertebrae
82
How deep is the intervertebral foramen
width of pedicle
83
What runs within the intervertebral foramen
Dorsal and ventral roots
Dorsal root Ganglion
Spinal Nerve
Spinal a and intervertebral vein
84
What type of joint is the Atlantoocciptal joint
gliding, or plane synovial joint between occipital condyles of skull and superior articulating facets (C1) atlas
85
What movement does atlantoocciptal joint permit
Yes movement. flexion and extension
86
What are the accessory ligaments of the atlantoocciptal joint
Anterior membrane- between ant margin of foramen magnum and anterior arch of atlas
Posterior membrane- between post margin of foramen magnum and post arch of atlas
87
What runs through the openings in the posterior atlantooccipital membrane
lateral passage for vertebral arteries and suboccipital nerve (dorsal ramus C1)
88
Where do the Ant and Post membranes of atlanto-occipital joint fuse
laterally
89
What is the atlantoaxial joint: type and function
gliding synovial between atlas and axis
| No movement- rotation because pivot at the dens on axis
90
What are the ligaments of Atlantoaxial joint
Transverse lig of atlas- attaches to internal surface of anterior arch of C1 forming socket
Sueprior crus- from transverse log superiorly to attach to ant edge of foramen magnum
Inferior crus- transverse lig inferiorly to attach to post surface of axis body
91
What is the collective name for the ligament of the atlantoaxial joint
Cruciform ligament of the atlas
92
What are the accessory ligaments for C1/C2
Apical dental lig(deep to superior crus)
Alar ligaments- arise from dens laterally to attach to occipital condyles(rotation restriction)
Tectorial membrane- covers dens and assoc ligaments
Anterior atlantoaxial membrane and Posterior
93
What does the tectorial ligament fuse with
anteriorly fuses with dura mater, inferiorly to C2 to the posterior longitudinal ligament
94
Describe anterior and posterial atlantoaxial membranes
anterior- from ant arch of atlas to ant body of axis
| Posterior- posterior arch of atlas to lamina of axis- continuous with ligamentum flava
95
What is an injury seen with C1/C2 joint
fractures of dens. dislocation super rare because of extensive ligaments
96
Spondylosis
usually developmental defect in pars interarticularis
97
Spondylolisthesis
bilateral spondylosis. Entire column affected as it slide forward on vertebra below. Most commonly seen at L5 on S1
98
What is the arterial supply in column
Spinal arteries:
| vertebral a, ascending cervical a, posterior intercostal aa, lumbar aa, iliolumbar a, lateral sacral a
99
What are the divisions of spinal arteries
Osseous and neural branches
100
Describe osseous branches of spinal aa
anastomose with like branches above, below and opposite to form plexi within vertebral canal(epidural) posterior to the post long ligament and ant to ligamentum flava
101
Describe the neural branches of spinal aa
Provide RADICULAR branches which enter dural sac along spinal nerve. (course along dorsal and ventral roots)
102
What is a precaution in heart surgery because of spinal aa
Special procedures to supply this blood when aorta is clamped
103
4 General considerations of Veins in vertebral column
1) Four venous plexi drain vertebral column
2) All four run the entire length
3) all four freely intercommunicate
4) They do NOT have valves
104
What are the four plexuses
Anterior external- ant surface vertebral bodies
Posterior external- external surface of spinous, articular and transverse processes
Anterior internal- In epidural space adjacent to posterior long spinal ligament
Posterior internal- in epidural space adjacent to laminae and ligament flava
105
Describe two components of venous flow in column
Basivertebral vv- drain bodies to anterior internal plexus
Intervertebral vv- drain all 4 venous plexuses
these drain into vertebral, posterior intercostal, lumbar and lateral sacral vv
106
What is particular about the vertebral vascular plexus due to its no valves
receives blood from pelvic, abdominal, thoracic and cranial cavities. Changes in intra-thoracic and intra-abdominal Pressures also have changes in venous flow
107
Why is this no valve system important clinically
metastatic spread of cancer cells(prostate and breast)
| also spread of infectious disease to vertebral column
