Spinal Anatomy Final Flashcards
(357 cards)
1
Q
What is the radiological test for skeletal maturity?
A
The Risser sign, an indication of bone maturity in the iliac apophysis
2
Q
What does the magnitude of scoliosis refer to?
A
The length and angle of the curve deviation on x-ray
3
Q
What is often used to measure the magnitude of scoliosis?
A
The Cobb Method
4
Q
What does location of scoliosis infer?
A
The location on the vertebral segment forming the apex of the curve deviation
5
Q
What does direction of scoliosis refer to?
A
The side the convexity of the curve will bend toward
6
Q
What does etiology of scoliosis mean?
A
The cause of the scoliosis
7
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
8
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
Lacks a fixed angle of trunk rotation
9
Q
What are some of the classifications of scoliosis based on etiology?
A
Congenital, neuromuscular, neurofibromatosis, nerve root irritation, idiopathic
10
Q
What is the classification of scoliosis that is unique to the individual patient?
A
Idiopathic scoliosis
11
Q
What does idiopathic scoliosis infer?
A
The scoliosis is unique to the individual, it has no known cause, unknown etiology
12
Q
What is the incidence of idiopathic scoliosis in the population?
A
1% to 4% of the population
13
Q
What is the age range for infantile idiopathic scoliosis?
A
From birth to 3 years old
14
Q
What is the age range for juvenile idiopathic scoliosis?
A
From 3 years old to 10 years old
15
Q
What is the age range for adolescent idiopathic scoliosis?
A
Over 10 years old
16
Q
Identify the curve direction, location, gender bias and incidence of infantile idiopathic scoliosis
A
Left thoracic, male, less than 1% incidence
17
Q
Identify the curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis
A
Right thoracic, females over 6 years old, and 12% - 21% incidence
18
Q
Identify the curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis
A
Right thoracic or right thoracic and left lumbar, females, and 80% incidence
19
Q
What is the genetic factor associated with adolescent idiopathic scoliosis?
A
An autosomal dominant factor that runs in families
20
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
21
Q
What is/are the characteristic(s) of occipitalization of C1
A
The atlas may be partially or completely fused to the occiput
22
Q
What is another way of implying occipitalization of C1?
A
Atlas assimilation
23
Q
What is the incidence of occipitalization of C1?
A
0.1% to 0.8%
24
Q
When do the centers of ossification for the odontoid process first appear?
A
During the last trimester in utero
25
When do the bilateral ossification centers for the odontoid process fuse?
At or shortly after birth
26
What joint is formed between the odontoid process ossification centers and the centrum of C2?
The subdental synchondrosis
27
Ossification between the odontoid process and centrum joint of C2 first appears at what age?
4 years old
28
A joint between the odontoid process and centrum of C2 is last identified at what age?
7 years old
29
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
30
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
31
What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?
Tip of the dens synchondrosis
32
At what age will the tip of the dens center of ossification appear?
Sometime in early adolescence
33
At what age will the tip of the dens fuse with the odontoid process?
Before age 12
34
If the joint formed between the tip of the dens and odontoid process centers of ossification persists beyond age 12, what is the condition called?
Terminal ossicle
35
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
36
What is a basilar invagination?
The upper cervical spine appears to be invaginated into the skull on x-ray analysis
37
What is the incidence of rib-related changes following dorsalization of C7?
From .5 to 2.5 percent of the population
38
Do patients typically present with symptoms specific for dorsalization of C7?
No, they are typically asymptomatic
39
What is the gender bias suggested in dorsalization of C7?
Female
40
What alteration in C7 facet orientation may accompany dorsalization?
The superior articular facet of C7 may change from back, upward, and medial (BUM) to that of a typical thoracic facet...back, upward, and lateral (BUL); the inferior articular facet is unchanged
41
What percent of the population may demonstrate thoracic-like features at C7?
Up to 46%
42
What T1 facet orientation changes may accompany cervicalization?
The superior articular facet may change from back, upward, and lateral (BUL) to back, upward, and medal (BUM); the inferior articular facet is unchanged
43
What is the incidence of cervicalization of T1 in the population?
Up to 28% of the population
44
What is the incidence of lumbar ribs in the population?
Over 7% of the population demonstrates lumbar ribs
45
What L1 facet orientation changes may accompany dorsalization?
The superior articular facet may change from concave, back, upward, and medial to flat, back, upward, and lateral; the inferior articular facet is unchanged
46
What is the gender bias associated with dorsalization of L1?
Males are two to three times more affected
47
What T12 facet orientation changes may accompany dorsalization?
The superior articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged
48
What T11 facet orientation changes may accompany lumbarization?
The inferior articular facet may change from flat, forward, medial, and downward to convex, forward, lateral, and downward; the superior articular facet is unchanged
49
What is the usual way of identifying the number of cervicals, thoracics and lumbar vertebrae during imaging studies?
Identify the vertebrae with ribs - they will be thoracics; those higher are cervicals, those lower are lumbars
50
What is characteristic of lumarization of S1?
The failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala
51
What is failure of synostosis between S1 and S2?
The segments do not completely fuse together
52
What is squaring of the vertebral body of S1?
The S1 vertebral body has similar anterior and posterior heights, hence a lack of wedging
53
What is flaring of the sacral ala?
The transverse process of the ala appears to elevate as though separating from the rest of the sacral ala
54
What articular facet changes accompany lumarization of S1?
none
55
What is characteristic of sacralization of L5?
L5 may be partially or completely fused to the sacrum
56
What is the incidence of sacralization of L5 in the population?
41% to 85%
57
Which segment demonstrates the greatest morphological variation along the spine?
L5
58
What articular facet changes accompany sacralization of L5?
none
59
What is the incidence of variation within the sacrococcygeal region in the population?
Up to 14%
60
What is characteristic of sacralization of Co1?
The premature fusion of Co1 to the sacrum
61
What is characteristic of coccygealization of S5?
The separation of S5 from sacrum and its' premature fusion to Co1
62
The trapezius is innervated by what nerve?
The spinal accessory nerve
63
What forms the spinal accessory nerve innervating the trapezius?
C1-C5 cord levels contribute to the spinal root of the spinal accessory nerve
64
The latissimus dorsi is innervated by what nerve?
The thoracodorsal nerve
65
What forms the thoracodorsal nerve innervating the latissimus dorsi?
Ventral rami from C6-C8
66
What forms the dorsal scapular nerve?
The ventral ramus of C5
67
What is the innervation of the splenius capitis?
Dorsal rami of middle cervical spinal nerves (C3-C5 cord levels)
68
Splenius cervicis will attach to what locations on the spine?
Lateral mass of C1 and posterior tubercle of transverse process on C1-C4
69
Which muscles are identified as erector spinae or sacrospinalis muscles?
Iliocostalis, Longissimus, Spinalis
70
What is the innervation of the iliocostalis lumborum?
Dorsal rami of lower thoracic and all lumber spinal nerves
71
What osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis?
none
72
What is the insertion for the iliocostalis thoracis?
Costal angles of the upper 6-7 ribs, transverse process of C7
73
What osseous parts of the vertebral column serve as an origin to the longissimus thoracis?
Accessory process and transverse processes of L1-L5, spinous processes of L3-L5 and median sacral crest S1-S3
74
What is the innervation of the longissimus cervicis?
Dorsal rami of C4-C8 and T1-T2 spinal nerves (C4-C8 and T1-T2 cord levels)
75
What osseous parts of the vertebral column serve as an origin to the spinalis thoracis?
Spinous processes of T11 & T12 - L1 & L2
76
Which muscles are identified as transversospinalis muscles?
Semispinalis, multifidis and rotators
77
How many vertebrae can be attached to a single segment by transversospinalis muscles?
As many as 9 vertebrae
78
What segment will represent the lowest attachment site for the semispinalis thoracis?
T12
79
What osseous parts of the vertebral column serve as an origin to the semispinalis cervicis?
Transverse tubercles of T1-T5 or T6 & articular processes of C4-C7
80
What osseous parts of the vertebral column serve as an origin to the semispinalis capitis?
Transverse tubercles of C7, T1-T6 or T7 & articular processes of C4-C6
81
The semispinalis capitis and spinalis capitis may fuse to form what muscle?
Biventer cervicis
82
What osseous parts of the vertebral column serve as an origin to the classic multifidis?
Articular process of C4-C7, transverse processes of T1-T12, mammillary processes of L1-L5 and the dorsal surface of S1-S4 or S5
83
Contraction of the classic multifidis will result in what movements of the vertebral column?
Lateral flexion & rotation of the spine,
Maintains the lumbar lordotic curve,
Prevents entrapment of zygapophyseal capsular ligament during movement
84
Contraction of multifidis cervicis will result in what movements?
Alters the zygapophyseal capsular ligament response to load distribution,
Determines the cervical spine response to injury as evidenced by neck pain,
Is a significant contributor to postural control of the head and neck
85
Contraction of multifidis lumborum will result in what movements?
Lateral flexion & rotation of the lumbar spine,
Maintains the lumbar lordotic curve,
Prevents entrapment of lumbar zygapophyseal capsular ligament during movement
86
Which muscles of the spine exhibit a reversal of the expected origin - insertion combination?
Iliocostalis lumborum pars lumborum, longissimus thoracic pars lumborum and multifidis lumborum
87
Rotator muscles are typically identified in what region of the spine?
The thoracic region
88
Which suboccipital muscle lacks an attachment to the skull?
Obliquus capitis inferior
89
Which nerve will innervate all suboccipital muscles?
The dorsal ramus of C1, the suboccipital nerve
90
What is the origin of the obliquus capitis inferior?
C2 spinous process and lamina
91
An increase in the density of muscle spindles is most apparent in which suboccipital muscle?
Obliquus Capitis Inferior
92
What is the proposed function of the suboccipital muscle group?
Postural stabilizers of the atlanto-occipital and atlanto-axial joints
93
Which suboccipital muscles are known to attach to dura mater?
Rectus capitis posterior major, rectus capitis posterior minor & obliquus capitis inferior
94
Interspinalis is paired in which regions of the spine?
Cervical and lumbar regions
95
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
96
What is the origin of the longus colli?
Vertebral bodies of C5-C7, T1-T3 & anterior tubercles of transverse processes C3-C5
97
What is the origin of the rectus capitis anterior?
Lateral mass & costal element of the transverse process of C1
98
What will innervate the rectus capitis anterior?
Ventral rami of C1-C2 spinal nerves
99
What will innervate the rectus capitis lateralis?
Ventral rami of C1-C2 spinal nerves
100
What is the insertion of the anterior scalene?
Ridge and anterior scalene tubercle of the first rib
101
What is the insertion of the middle scalene?
Between the tubercle and groove for the subclavian artery on the first rib
102
What is the insertion of the posterior scalene?
Outer surface of second rib
103
What will innervate the posterior scalene?
Ventral rami of C6-C8 spinal nerves
104
The quadratus lumborum is implicated in the formation of which ligaments?
The iliolumbar ligament
105
What is the origin of the psoas major?
Vertebral bodies T12, L1-L5, S1 and transverse processes of L1-L5
106
What is the origin of the psoas minor?
Vertebral bodies T12, L1
107
What will innervate the psoas minor?
Ventral ramus of L1 spinal nerve
108
What is the maximum number of common ligaments identified with a vertebral couple?
8
109
What is the reason that 9 common ligaments are identified but only 8 will be attached at any specific vertebral couple?
The ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only 1 of these will be identified at a single vertebral couple
110
What is the number of true intervertebral discs identified in the adult?
23
111
In the adult, which vertebral levels will demonstrate a true intervertebral disc?
Those between C2 and S1 inclusive
112
What is the percent of intervertebral disc height contribution to the length of each region of the vertebral column?
Cervical: 22-25% Thoracic: 20% Lumbar: 33%
113
What are the names of the central, peripheral, and horizontal zones of the intervertebral disc?
Nucleus pulposus - central zone
Annulus fibrosus - peripheral zone
Cartilaginous end plate - horizontal zone
114
What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?
Birth - 88% Thirty - 70%
115
What is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?
The nucleus pulposus will loose water under deformation conditions
116
What cell is associated with the nucleus pulposus until about age 11?
Notochord cells
117
Which type of collagen is dominant in the nucleus pulposus?
Collagen type II
118
What is the organizational pattern for collagen fibers in the nucleus pulposus?
They are irregularly oriented and randomly scattered
119
What is the appearance of the cervical annulus fibrosus?
A horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate process; the posterior margin is thin
120
What compensates for the thinness of the posterior part of the cervical annulus fibrosus?
Posterior longitudinal ligament
121
What is the organization of the lumbar annulus fibrosus?
It has 12-14 concentric cylindrical lamellae
122
What is the water concentration in the lumbar annulus fibrosus at birth and after 30?
Birth - 78% Thirty - 70%
123
What is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus?
They typically have a binding site for hyaluronic acid ad are thus aggregated
124
Which type of collagen is dominant the annulus fibrosus?
Collagen type 1
125
What is the organizational pattern for collagen fibers in the annulus fibrosus?
They are parallel with one another in a single lamellus and angled
126
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
127
What is the attachment site for collagen fibers within the annulus fibrosus?
Collagen fibers of the outer lamellae will become Sharpey's fibers and penetrate the epiphyseal rims Collagen fibers of the inner lamellae will attach to the cartilaginous end plate
128
What is the origin for the cells of the annulus fibrosus?
Sclerotomites
129
What is the principal type of collagen fiber within the cartilage end plate?
The type II collagen fiber
130
What is the direction of collagen fibers within the cartilage end plate?
Collagen fibers are aligned anterior to posterior
131
What is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus?
The cartilaginous end plate
132
What are the types of receptor endings in the intervertebral disc?
Nociceptors and proprioceptors
133
What is the relationship between size of the intervertebral disc and receptor endings?
The larger the disc, the greater the variety of receptor endings
134
What part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?
The outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc
135
What forms the anterior neural plexus of the vertebral column?
Fibers from the ventral primary ramus
136
What forms the lateral neural plexus of the vertebral column?
Fibers from the ventral primary ramus,
Fibers from the white ramus communicans,
Fibers from the gray ramus communicans
Fibers from the paradiscal ramus communicans,
137
What is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc?
The paradiscal ramus communicans
138
What part of the intervertebral disc is innervated by fibers from the paradiscal ramus communicans?
The outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc
139
How does the intervertebral disc attach to the vertebral body?
Sharpey's fibers from the outer lamellae of the annulus fibrosus are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies
140
Based on histology, what is the classification of the intervertebral disc?
A cartilaginous (amphiarthrosis) symphysis
141
What are the divisions of the embryonic somite?
The sclerotome, myotome, and dermatome
142
What structure is formed following migration of sclerotomes to surround the notochord?
The perichordal blastema
143
What is formed within the perichordal blastema between the sclerotomites?
The intrasclerotomal fissure or fissure of von Ebner
144
What does the intrasclerotomal fissure or fissure of von Ebner become?
The perichordal disc
145
What will the dense sclerotomite become?
The upper part of the vertebral segment forming below
146
What structure forms following migration and subsequent mixing of the sclerotomites?
The vertebral blastema
147
What part of the intervertebral disc will the notochord form?
The nucleus pulposus
148
What part of the intervertebral disc will the perichordal disc form?
The annulus fibrosus
149
What is the earliest indicator of the position of the adult intervertebral disc?
The intrasclerotomal fissure or fissure of von Ebner
150
What vertebral levels will the anterior longitudinal ligament attach to?
Those between occiput and S3 inclusive are traditionally indicated
151
What is the lowest extent of the anterior longitudinal ligament based on recent studies?
L3
152
What is believed to form the anterior longitudinal ligament in the lumbar spine?
The tendon of the crura of the diaphragm
153
What innervates the anterior longitudinal ligament?
The anterior neural plexus formed by fibers from the ventral primary ramus and sympathetic postganglionic fibers from the paravertebral ganglia
154
What is the function of the anterior longitudinal ligament?
It brakes or limits dorsiflexion or hyperextension of the vertebral column
155
What was ossification of the anterior longitudinal ligament in the lumbar region identified as?
Forestier's Disease
156
What is ossification of the anterior longitudinal ligament in the lumbar region now identified as?
Diffuse Idiopathic Skeletal Hyperostosis or DISH
157
Newer research suggests what regional variation in the posterior longitudinal ligaments?
Prominent in the cervicals, occasional in the thoracics, rare in the lumbars
158
What is the relationship of the posterior longitudinal ligament to the vertebral foramen?
It forms the anterior boundary of the spinal canal
159
What is the innermost layer of the posterior longitudinal ligament called?
The perivertebral ligament
160
What is the function of the posterior longitudinal ligament?
It brakes or limits flexion of the vertebral column
161
Where is ossification of the posterior longitudinal ligament most commonly identified?
The cervical spine with an 80% incidence
162
What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?
A loss of hand and finger dexterity
163
What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?
Faltering gait
164
What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?
It is greater in males over 50 and has a higher incidence in the Japanese
165
What is the name given to the ligamentum flavum based on appearance and histology?
It is a yellow elastic ligament
166
What fibers are most ligaments made up of?
Collagen type I fibers with are whitish in appearance
167
Where is ossification of the ligamentum flavum most commonly identified?
The thoracic spine or thoracolumbar transition zone
168
What is the relationship between the capsular ligament and mobility?
The more lax/loose the capsular ligament is, the greater the motion of the joint
169
What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?
The cervical and lumbar regions
170
What layers are present in the capsular ligament?
A superficial layer of collagen fibers and a deep layer of elastic fibers
171
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
172
What is now thought to be a major function of the interspinous ligament?
It is more likely a proprioceptive transducer for the spinal reflex
173
What is the name given to the superficial layer of the ligamentum nuchae?
The funicular layer or part
174
What is the name given to the deep layer of the ligamentum nuchae?
The lamellar layer or part
175
What are the attachment sites for the superficial layer of the ligamentum nuchae?
The external occipital protuberance, the external occipital crest, and spinous tubercle of C7
176
What is the histological make-up of the human ligamentum nuchae?
It is a yellow elastic ligament, but has more collagen fibers than in quadrupeds
177
What is the classic function of the human ligamentum nuchae?
It brakes or limits flexion of the cervical spine
178
What is the termination level inferiorly for the supraspinous ligament according to current literature?
Primarily at L4 (73%); between L4 and L5 (5%)
179
What is now thought to be a major function of the supraspinous ligament?
It is a proprioceptive transducer for the spinal reflex
180
What amount of flexion-extension is accommodated by the atlanto-occipital joint?
About 25 degrees
181
What amount of axial rotation is accommodated by the atlanto-occipital joint?
About 3-8 degrees one side axial rotation
182
What amount of lateral bending is accommodated by the atlanto-occipital joint?
About 5 degrees
183
What motion is best accommodated by the atlanto-occipital joint?
Flexion-extension
184
What is the function of the transverse atlantal ligament?
It is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1
185
What movements are facilitated at the median atlanto-axial joint?
Flexion-extension, rotation, and telescoping (superior-inferior gliding)
186
\*\*\*What is the ADI?
The Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
187
\*\*\*What is the ADI of children compared with that of adults?
About 4.5 mm in children; a range of 2-3 mm or about 2.5 mm in adults
188
What are the degrees of movement facilitated at the atlanto-axial joint?
About 20 degrees flexion-extension,
40 degrees one side axial rotation,
5 degrees of lateral bending
189
The occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation?
About 60%
190
What is the embryonic derivative of the apical ligament of the dens or the apicodental ligament?
The notochord
191
What is the function of the alar ligament?
Together they function to resist axial rotation
192
What forms the cranial continuation of the posterior longitudinal ligament?
The membrana tectoria or tectorial membrane
193
List, in order, the ligaments in a midsagittal plane from the dura mater at the level of the medulla oblongata to the anterior bursa of the median atlanto-axial joint.
The membrana tectoria or tectorial membrane
The cruciate ligament
The capsular ligament of the posterior bursa of the median atlanto-axial joint
The apical ligament of the dens or the apicodental ligament
194
For the cervical spine below C2, what is the range of flexion-extension?
About 90 degrees or about 18 degrees per couple
195
For the cervical spine below C2, what is the range of one side lateral bending?
About 50 degrees or about 10 degrees per couple
196
For the cervical spine below C2, what is the range of one side axial rotation?
About 33 degrees or about 6 degrees per couple
197
What are the locations for the costovertebral joints on the vertebra?
The costocentral joint at the vertebral body and the costotransverse joint at the transverse process
198
At what rib will the superior costotransverse ligament be absent?
The 1st rib
199
What ligaments will attach to the neck of the 12th rib?
The superior costotransverse ligament from T11 and the lumbocostal ligament from L1
200
What are the attachment sites for the inferior costotransverse ligament?
The neck of the rib and the transverse process of the vertebra at the level
201
At what rib will the inferior costotransverse ligament be absent?
The 12th rib
202
What is the name of the space between the transverse process and the neck of the rib?
The costotransverse foramen
203
Which ligament 'fills' the costotransverse foramen?
The inferior costotransverse ligament
204
What are the attachment sites for the lateral costotransverse ligament?
The non-articular surface of the tubercle of the rib and the transverse tubercle of the transverse process of the vertebra at that level
205
Which vertebra will lack an attachment for the lateral costotransverse ligament?
T12
206
Which vertebral couples of the thoracic spine have the greatest motion?
T11/T12 and T12/L1
207
Which range of motion is the greatest for lower thoracic vertebral couples?
Flexion-extension
208
Which range of motion is least for lower thoracic vertebral couples?
One side axial rotation
209
Which ligaments replace the intertransverse ligament at the lumbosacral joint?
The iliolumbar ligament and lumbosacral ligament
210
What muscle is intimately attached to the superior iliolumbar ligament?
Quadratus lumborum
211
Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions?
The superior iliolumbar ligament
212
Which ligament from the iliolumbar ligament complex will attach to the sacral ala?
The inferior iliolumbar ligament
213
Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?
The inferior iliolumbar ligament
214
What are the attachment sites for the accessory iliolumbar ligament?
The transverse process of L4 and the iliac crest
215
Which vertebral couple of the lumbar spine has the greatest range of motion?
L5/S1
216
Which range of motion is greatest for all lumbar vertebral couples?
Flexion-extension
217
Which range of motion is least for L1-L5 vertebral couples?
One side axial rotation
218
Which range of motion is least for the L5/S1 vertebral couple?
One side lateral bending
219
List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.
The membrana tectoria, posterior longitudinal ligament and the deep posterior sacrococcygeal ligament
220
List, in order, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal.
The posterior atlanto-occipital ligament, posterior atlanto-axial ligament, ligamentum flavum and the superficial posterior sacrococcygeal ligament
221
What is the auricular surface of the ilium composed of?
Articular cartilage, interspersed with fibrocartilage
222
What does ankylosis mean?
A condition of fibrous adhesion occurs within the joint
223
What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint?
Age 40, the iliac auricular surface
224
What is the age and gender bias associated with ankylosis of the sacro-iliac joint?
Age 50 and male bias particularly in African American males
225
What passes between the layers of the interosseous sacroiliac ligament?
Dorsal rami from the sacral spinal nerves
226
What separates the manubrium sterni and corpus sterni?
The manubriosternal symphysis
227
What vertebral levels corresponds to the position of the corpus sterni?
T5-T9
228
How many sternabrae for the corpus sterni?
4 sternabrae
229
What surface feature on the corpus sterni identifies the location of the synchondroses?
Transverse lines
230
What articular sites for the costal cartilage of ribs will be identified on the corpus sterni?
Costal notches II-VII
231
What feature of the corpus sterni is present in 4-7% of the population?
A sternal foramen
232
What causes the appearance of the sternal foramen?
Failure of the ossification centers of the sternum to fuse together normally
233
What attaches to the scalene tubercle of the first rib?
The anterior scalene muscle
234
Which groove on the body (corpus or shaft) of the first rib is close to the vertebral end?
The groove for the subclavian artery and the first thoracic nerve
235
Which groove on the body (corpus or shaft) of the first rib is close to the sternal end?
The groove for the subclavian vein
236
What specifically will attach to the crest of the neck of the second rib?
The superior costotransverse ligament from the transverse process of T1
237
What specifically attaches to the back of the neck of the second rib?
The inferior costotransverse ligament from the transverse process of T2
238
What unique feature is present on the body (corpus or shaft) of the second rib?
The tuberosity for the serratus anterior
239
Which ribs are classified as typical ribs, true ribs, costa verae, and vertebrosternal ribs in the adult skeleton ?
Ribs 3-7
240
Which ribs are classified as atypical ribs, true ribs, costa verae, and vertebrosternal ribs in the adult skeleton ?
Ribs 1 and 2
241
Which ribs are classified as typical ribs, false ribs, costa spuriae, and vertebrochondral ribs in the adult skeleton ?
Ribs 8 and 9
242
Which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebrochondral ribs in the adult skeleton ?
Rib 10
243
Which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebral ribs in the adult skeleton ?
Ribs 11 and 12
244
What is the classification of the 1st sternocostal or sternochondral joint?
Cartilaginous (amphiarthrosis) synchondrosis
245
What is the classification of the 2nd-7th sternocostal or sternochondral joint?
Synovial plane (diarthrosis arthrodia)
246
Which of the sternocostal or sternochondral ligaments is unique to the 2nd sternocostal or sternochondral joint?
The intra-articular ligament
247
What is the classification of the 6th-9th interchondral joints?
Synovial plane (diarthrosis arthrodia)
248
What is the classification of the 5th-6th or 9th-10th interchondral joints?
Fibrous (amphiarthrosis) syndesmosis
249
Which costal cartilages fail to form a joint at their sternal end?
The eleventh and twelfth costal cartilages
250
How many primary centers of ossification appear in the manubrium?
1-3 centers have been identified
251
How many primary centers of ossification appear in the corpus sterni?
Typically 6
252
In what part of the sternum will a secondary center of ossification appear?
The xiphoid process
253
In what part of the rib will primary centers of ossification appear?
The body (corpus,shaft)
254
In what parts of the rib will secondary centers of ossification appear?
The head, articular surface of the tubercle and the non-articular surface of the tubercle
255
Which ribs will demonstrate secondary centers of ossification?
Ribs 1-10
256
Which ribs lack secondary centers of ossification?
Ribs 11 and 12
257
Which ribs demonstrate three secondary centers of ossification?
Ribs 2-9
258
Which ribs have only two secondary centers of ossification?
Ribs 1 and 10
259
What are the four subclassifications of synarthrosis joints based on Latin groupings?
Suture, gomphosis, schindylesis and syndesmosis
260
What were the five types of suture based on Latin groupings?
Serrate, denticulate, limbous, squamous and harmonia
261
What are the characteristics of sutura vera (true sutures)?
Sutures demonstrating interlocking of the adjacent bone surfaces; typically formed by intramembranous ossification
262
What are the characteristics of sutura notha (false sutures)?
Sutures lacking interlocking of adjacent bone surfaces; typically formed by endochondral ossification
263
Which sutures demonstrate non-interlock, but will overlap at their edges?
Squamous sutures
264
What were the classification of sutura notha (false sutures) based on Latin groupings?
Squamous and harmonia
265
What are the typical examples of the plane suture or harmonia suture?
Cruciate suture made up of the intermaxillary, interpalatine and palato-maxillary sutures
266
What are the examples of the schindylesis type of suture?
Sphenoid-ethmoid-vomer articulation, the palatine-maxilla-vomer articulation
267
What are the examples of the gomphosis joint?
Maxilla-root of tooth; Mandible-root of tooth
268
What are the five views of the skull called?
Norma verticalis, norma frontalis, norma occipitalis, normal lateralis, norma basalis
269
What is the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with both parietal bones?
The anterior fontanelle
270
What is the diamond shaped remnant of developing membrane bone at the intersection of the occipital bone with both parietal bones?
The posterior fontanelle
271
What is the glabella?
The elevation of bone over the frontal sinus between the orbits
272
What is the name given to the outline of the nasal cavity at the front of the skull?
Piriform aperture
273
What is the name given to the alveolar jugum of the canine tooth in the maxilla?
Canine eminence
274
What forms a bullet-like chin?
A large mental protuberance
275
What forms an indented chin?
Well developed bilateral mental tubercles and a slight mental protuberance
276
What bones form the pterion?
Parietal, temporal, sphenoid and frontal bones
277
What points on the skull are used to measure the skull size?
The nasion, vertex, inion and gnathion
278
What points on the skull are used to measure cranial vault capacity?
The nasion, vertex and inion
279
The olfactory nerve exits the cranial vault via what opening?
Cribriform plate of the ethmoid bone
280
What are the contents of the optic canal?
The optic nerve and ophthalmic artery
281
What are the contents of the superior orbital fissure?
Ophthalmic veins,
Ophthalmic division of the trigeminal nerve,
Oculomotor nerve,
Trochlear nerve,
Abducent nerve
282
What are the contents of the foramen rotundum?
The maxillary division of the trigeminal nerve (cranial nerve Vb)
283
What are the contents of the foramen ovale?
The mandibular division of the trigeminal nerve (Vc) and the lesser petrosal branch of the glossopharyngeal nerve
284
What are the contents of the foramen spinosum?
The nervus spinosus from the mandibular division of the trigeminal nerve and the middle meningeal artery
285
What are the contents of the internal acoustic meatus?
Cranial nerves VII (facial nerve) and VIII (vestibulocochlear/auditory nerve),
The nervus intermedius/nerve of Wrisberg/sensory root of VII and the motor root of VII,
The vestibular and cochlear roots of VIII,
The internal auditory/internal labyrinthine artery and vein
286
What are the contents of the jugular foramen?
The jugular bulb,
The inferior petrosal sinus,
The tympanic body/tympanic glomus or jugular body/jugular glomus,
Cranial nerves IX (glossopharyngeal), X (vagus) and XI (spinal accessory)
287
What can the five layers of the scalp spell?
Skin, connective tissue, aponeurosis, loose connective tissue, periosteum...SCALP
288
What are the principal sources of blood to the scalp?
Internal carotid and external carotid artery branches
289
Which divisions of the trigeminal nerve receive sensory information from the scalp?
All 3 divisions: ophthalmic nerve, maxillary nerve, & mandibular nerve
290
Which ventral rami branches supply the scalp?
Greater auricular and lesser occipital nerves
291
Which dorsal ramus nerve branch (name and cord level of origin) supplies the scalp?
Greater occipital nerve - C2, C3 communicating ramus
292
What forms the roof of the posterior cranial fossa?
The tentorium cerebelli
293
What part of the cerebrum occupies the posterior cranial fossa?
None; the tentorium cerebelli separates the cerebrum into a space above the posterior cranial fossa
294
What part of the central nerve system occupies the posterior cranial fossa?
The cerebellum, pons, and medulla oblongata
295
Which muscles lack any attachment to bone?
Orbicularis oris, procerus & risorius
296
What type of motor fibers to skeletal muscle are given off by the facial nerve?
Branchial efferent (BE)
297
Most of the seventh cranial nerve will exit the skull via what opening?
The stylomastoid foramen
298
The optic canal is located along which wall of the orbit?
Superior wall of the orbit
299
What are the contents of the optic canal?
Optic nerve & ophthalmic artery
300
What are the openings located along the medial wall of the orbit?
Anterior ethmoid & posterior ethmoid foramina
301
What is the name given to the medial wall of the orbit?
Lamina papyracea
302
The superior orbital fissure is located along which wall of the orbit?
Lateral wall of the orbit
303
What are the contents of the superior orbital fissure?
Oculomotor nerve
Trochlear nerve
Abducent/abducens nerve
Ophthalmic division of the trigeminal cranial nerve
Ophthalmic veins
304
What opening(s) are located along the inferior wall of the orbit?
Inferior orbital fissure
305
What is contained in the inferior orbital fissure?
Maxillary division of trigeminal nerve
306
What are the names given to the modified sebaceous gland in the tarsus of the eyelid?
Tarsal or Meibomian gland
307
What specific pathways are identified with Visceral Efferent (VE) innervation?
Sympathetic and parasympathetic motor pathways
308
How many neurons are involved in the Visceral Efferent pathways from CNS to target cell?
2 motor neurons
309
What is the location for the second neuron in the Visceral Efferent (VE) pathway?
Typically a ganglion
310
Which cranial nerves are involved in the Visceral Efferent (VE) parasympathetic pathway to the lacrimal gland?
Facial and trigeminal (maxillary and ophthalmic divisions/branches)
311
What is the origin for the sympathetic pathway to the lacrimal gland?
Lateral horn/intermediolateral cell column T1,T2
312
What is the target of the preganglionic sympathetic visceral efferent (VE) fiber in the pathway to the lacrimal gland?
The VE fiber ascends to the superior cervical ganglion to synapse
313
\*\*\*\*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
314
\*\*\*\*Parasympathetic stimulation of targets in the lacrimal gland will result in what events?
Vasodilation of blood vessels,
Increased availability of water to secretory units,
Thinner or more watery product in lumen;
Constriction of myoepithelial cells leading to release of product from secretory lumen into duct system
315
What are the names of layers of the eyeball?
Fibrous tunic, uveal tract and retina
316
What are the parts of fibrous tunic of the eyeball?
Cornea and sclera
317
What are the parts of the uveal tract of the eyeball?
Iris, ciliary body, choroid & pupil
318
What muscles are present in the iris?
Sphincter pupillae and dilator pupillae
319
What is the innervation of the sphincter pupillae?
Oculomotor nerve, parasympathetic pathway
320
What is the innervation of the ciliaris muscle?
Oculomotor nerve, parasympathetic pathway
321
What is the function of the rod cell?
Provide vision in dim light conditions
322
What is the function of the cone cell?
Provide vision in bright light conditions and mediate color vision
323
What is the most numerous photoreceptor cell?
Rod cell
324
What forms the optic nerve?
Axons of ganglion cells
325
What occurs at the optic chiasma?
Part of the optic nerve decussates
326
What is the location of the anterior chamber of the eyeball?
Between the cornea and iris
327
What is the location of the posterior chamber of the eyeball?
Between the iris and lens
328
What is contained in the anterior chamber of the eyeball?
Aqueous humor
329
What is contained in the posterior chamber of the eyeball?
Aqueous humor
330
What is the name given to the chamber behind the lens?
Vitreous chamber
331
What fills the vitreous chamber?
Vitreous body
332
What are the common characteristics in origin and insertion of all rectus extraocular muscles?
They all originate from a common annular tendon in the orbit
They all insert in the sclera in front of the coronal equator of the eyeball
333
What is the common characteristic regarding the insertion of both oblique extraocular muscles?
Both insert onto sclera on the lateral margin of the eyeball behind the coronal equator
334
What is the common characteristic concerning the insertion of the superior and inferior rectus muscles?
They insert onto the sclera of the eyeball in front of the coronal equator and are displaced slightly medially
335
What is the embryonic origin of the extraocular muscles or extrinsic muscles of the eyeball?
The skeletal muscle is derived from the somites hence somatic efferent (SE)
336
Which nerves will innervate specific extrinsic/extraocular muscles?
Oculomotor - superior rectus, medial rectus, inferior rectus, inferior oblique
Trochlear - superior oblique
Abducens/Abducent - lateral rectus
337
Which of the cranial nuclei of termination contain primary afferent neurons?
Mesencephalic nucleus of the trigeminal nerve
338
What is the location of synapse for preganglionic parasympathetic efferent fibers of the third cranial nerve?
Ciliary ganglion
339
What is unique about the vascular supply of the retina?
A single vessel supplies it
340
What vessel supplies the inner tunic of the eyeball?
Central artery of the retina
341
What is the name given to the "goat's beard" of the auricle?
Tragus
342
What is the name of the palpable posterior projection of the eminentia concha of the auricle?
Ponticulus
343
Which cranial nerve will innervate the muscles of the auricle?
The facial nerve
344
Sensory innervation of the auricle is derived from which nerves?
Greater auricular (ventral rami C2,C3)
Lesser occipital nerve (ventral rami C2, possibly C3)
Auriculotemporal nerve (mandibular division, trigeminal)
Posterior auricular cutaneous nerve (facial)
Auricular nerve (vagus)
345
The lateral third of the external acoustic meatus is protected by \_\_\_\_?
Cartilage
346
The medial third of the external acoustic meatus is protected by \_\_\_\_?
The temporal bone
347
Skin lining the external acoustic meatus contains what modified sebaceous glands?
Ceruminous glands
348
What is cerumen?
The product of ceruminous glands forming the bulk of ear wax
349
What are the characteristics of the parotid gland?
It is lobulated, yellowish, encapsulated and an exocrine gland
350
What vein is formed within the parotid gland?
The retromandibular vein
351
Within the parotid gland what does the facial nerve form?
The facial nerve plexus
352
What are the branches of the facial nerve plexus?
Temporal, zygomatic, buccal, marginal mandibular, and cervical branches
353
What branch of the facial nerve penetrates the parotid gland, but is not given off within it?
The chorda tympani nerve
354
Which of the cervical intertransversarii is innervated by dorsal rami of cervical spinal nerve?
Posterior medial belly, cervical intertransversarii
355
What is the origin of the medial belly of the lumbar intertransversarii?
Accessory process of transverse proccess L1-L4
Mammillary process of superior articular process L1-L4
356
Which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves?
Intertransversarii
357
Based on the density of muscle spindles what is the proposed function of the intertransversarii?
Acts as a proprioceptive transducer in conjuction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture
