Unit 7 and 8 Intervertebral Foramen/ Curvatures of spinal coulmn(Exam 2)

Question 1

What are the characteristics of the artery of Adamkiewicz?

Answer 1

It is a left side, anterior medullary feeder artery, Located in the T9/T10 intervertebral foramen, and the primary vascular supply to the lumbar enlargement.

Question 2

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

Answer 2

Below T8

Question 3

What will the intervertebral veins drain into?

Answer 3

External vertebral venous plexus or Batson’s plexus

Question 4

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

Answer 4

They appear to lack of valves.

Question 5

What size lymphatic vessels lie in the intervertebral foramen?

Answer 5

Medium sized lymphatics

Question 6

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

Answer 6

Adipose tissue and loose areolar connective tissue

Question 7

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

Answer 7

Height increases, nerve root size stays the same from Cranial to Caudal

Question 8

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

Answer 8

The lateral groove and Uncinate process

Question 9

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

Answer 9

Length of the nerve root increases as it Descends from apparent origin on the spinal cord, but the cross-sectional area of the nerve root decrease.

Question 10

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

Answer 10

1) Sulcus for the ventral primary ramus on the costotransverse bar
2) Vertebral artery

Question 11

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

Answer 11

Costocentral joint

Question 12

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

Answer 12

About half

Question 13

Which are the largest spinal nerves?

Answer 13

L5 and S1 spinal nerves

Question 14

What increases the length of the intervertebral foramen at L5?

Answer 14

The lumbosacral tunnel

Question 15

What forms the lumbosacral tunnel?

Answer 15

1) Lumbosacral ligament

2) Transverse process of L5 sacral ala

Question 16

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

Answer 16

The far out Syndrome

Question 17

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

Answer 17

Intervertebral disc above the IVF is usually the source of damage.

Question 18

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

Answer 18

Completely osseous boundary exists

Question 19

What is more likely the cause of nerve irritation at the sacral IVF?

Answer 19

Tilt or position of the entire sacrum relative to the pelvis

Question 20

What is unique about the relationship of spinal nerve to intervertebral foramen at S5-Co1?

Answer 20

There are two nerves present, S5 nerve and Co1 nerve

Question 21

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

Answer 21

Tuberculosis, hemangiomas, osteoporosis

Question 22

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

Answer 22

Joint of Luschka—-Cervicals

Costocentral joint—-Thoracics

Question 23

What examples of osteophyte formation that influence the IVF?

Answer 23

Bony spurs—Accessory bone

Lamina—-Para-articular processes

Question 24

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

Answer 24

Obesity, Pregnancy, Heavy backpacks

Question 25

What is the recommended weight of a backpack compared to individual weight for the developing spine?

Answer 25

Backpack weight should not exceed 10% individual body weight

Question 26

What are the curvatures of the vertebral column?

Answer 26

Anterior, Posterior, Lateral

Question 27

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

Answer 27

Posterior

Question 28

Why is the posterior curve also called the primary curve?

Answer 28

It is the first curve to appear embryologically

Question 29

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

Answer 29

Thoracic or Dorsal curve | Pelvic or Sacrococcygeal curve

Question 30

What are the names given to curves that form during development to reverse the direction of regions along the vertebral column?

Answer 30

anterior curve, Secondary curve Compensatory curve

Question 31

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

Answer 31

Cervical curves | Lumbar curves

Question 32

What segmental levels form the cervical curve?

Answer 32

C2-T1

Question 33

What segmental levels form the lumbar curve?

Answer 33

T12-L5

Question 34

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

Answer 34

3rd fetal month

Question 35

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

Answer 35

Last trimester in utero

Question 36

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

Answer 36

W/in 1st year AFTER birth.

Question 37

What developmental events are indicated in the formation of the adult cervical curve?

Answer 37

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) Intervertebral disc height becomes greater anterior than posterior.

Question 38

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

Answer 38

3-4th month after birth

Question 39

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

Answer 39

Righting reflex

Question 40

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

Answer 40

Typically between C4 and C5

Question 41

What is the location for the cervical kyphosis?

Answer 41

Between occiput and C1.

Question 42

What is the name given to the primary cervical curve?

Answer 42

Cervical kyphosis

Question 43

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

Answer 43

Cervical curve--C2-T1 | Cervical Enlargement-- C3-T1

Question 44

What is the time of appearance of the lumbar curve?

Answer 44

12-18 months after birth

Question 45

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

Answer 45

Crawling, Walking

Question 46

What developmental events are indicated in the formation of the adult lumbar curve?

Answer 46

1) Crawling will cause the abdomen to put tension on the lumbar region and pulls it forward. 2) Muscle development is promoted to compensate for the swayback of the lumbars 3) Intervertebral disc height will become greater anterior compared to posterior. 4) Walking will further promote muscle and intervertebral disc development.

Question 47

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

Answer 47

Nucleus pulposus of L4 will shift its position within the annulus fibrosis.

Question 48

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

Answer 48

Vision

Question 49

What is the gender bias associated with lumbar curve convexity?

Answer 49

Females have a greater convexity enlargement T9-T12

Question 50

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

Answer 50

Faster development of the muscles on the side of handedness

Question 51

What is the time of appearance of the lateral curves?

Answer 51

after age 6.

Question 52

What locations of lateral curves are recognized?

Answer 52

Cervical, Thoracic, Lumbar

Question 53

Which lateral curves are best developed?

Answer 53

Thoracic or dorsal, and lumbar

Question 54

What is the relationship between curve direction and handedness?

Answer 54

Right handed person has a high probability for a right thoracic, Left lumbar curve combination.

Question 55

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

Answer 55

about 80%

Question 56

What does the suffix "osis" mean?

Answer 56

a condition

Question 57

Does "osis" infer a normal or abnormal condition?

Answer 57

Neither, it is non-judgmental

Question 58

What generic names identified abnormal curves of the vertebral column?

Answer 58

Lordosis Kyphosis Scoliosis

Question 59

What is the definition of lordosis?

Answer 59

Forward bending condition

Question 60

What is the definition of kyphosis?

Answer 60

humpback or hunchback condition

Question 61

What is the definition of scoliosis?

Answer 61

warped or crooked condition

Question 62

What is the direction of the curve deviation in scoliosis?

Answer 62

To the side (it is a lateral curve deviation)

Question 63

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

Answer 63

No, There would be an increase in the anterior direction in the cervical spine, Decrease in the posterior direction in the thoracic spine Increases in the anterior direction in the lumbar spine Decrease in the posterior direction in the pelvic or sacrococcygeal region.

Question 64

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

Answer 64

No, There would be decrease in the anterior direction in the cervical spine, Increase in the posterior direction in the thoracic spine, Decrease in the anterior direction in the lumbar spine, Increase in the posterior direction in the pelvic or sacrococcygeal region

Question 65

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

Answer 65

Military neck Humpback or Hunchback Swayback

Question 66

What is military neck?

Answer 66

Decreased anterior curve in the cervical region, a straight neck.

Question 67

What is humpback or hunchback?

Answer 67

Increased posterior curve in the thoracic region

Question 68

What is swayback?

Answer 68

Increased anterior curve in the lumbar region

Question 69

What is classic classification of military neck?

Answer 69

Kyphosis

Question 70

What is classic classification of humpback or hunchback?

Answer 70

Kyphosis

Question 71

What is classic classification of swayback?

Answer 71

Lordosis

Question 72

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

Answer 72

Normal cervical and normal lumbar anterior curve

Question 73

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

Answer 73

Normal thoracic/dorsal and normal pelvic posterior curve.

Question 74

What prefixes are used to convey abnormality in curve patterns?

Answer 74

Hyper and Hypo

Question 75

What does the term hyperlordotic infer?

Answer 75

Increase in the anterior curve of the cervical and lumbar region

Question 76

What does the term hypolordotic infer?

Answer 76

a decrease in the anterior curve of the cervical and lumbar region.

Question 77

What does the term hyperkyphotic infer?

Answer 77

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

Question 78

What does the term hypokyphotic infer?

Answer 78

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

Question 79

What are the curve classifications for military neck?

Answer 79

Kyphosis or hypolordotic curve

Question 80

What are the curve classifications for humpback or hunchback?

Answer 80

Kyphosis or Hyperkyphotic curve

Question 81

What are the curve classifications for swayback?

Answer 81

Lordosis, or Hyperlordotic curve

Question 82

What is the more complete, accepted definition of scoliosis?

Answer 82

An abnormal lateral curve coupled with axial rotation

Question 83

What is the radiological test for skeletal maturity?

Answer 83

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

Question 84

What are the classifications of scoliosis according to the scoliosis research society?

Answer 84

1) Magnitude 2) Location 3) Direction 4) etiology 5) Structural scoliosis 6) non-structural scoliosis

Question 85

What does magnitude of scoliosis refer to?

Answer 85

Length and angle of the curve deviation on xray.

Question 86

What is often used to measure the magnitude of scoliosis?

Answer 86

Cobb method

Question 87

What does location of scoliosis infer?

Answer 87

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

Question 88

What does direction of scoliosis refer to?

Answer 88

side the convexity of the curve will bend toward

Question 89

What does etiology of scoliosis mean?

Answer 89

the cause of scoliosis

Question 90

What is structural scoliosis?

Answer 90

More radical form of scoliosis, May worsen and associated with structural deformities of the vertebra or intervertebral disc, Frequently has a fixed angle of trunk rotation

Question 91

What is nonstructural scoliosis?

Answer 91

Mild form, unlikely to worsen, no structural deformities of the vertebra or intervertebral disc, lacks a fixed angle of trunk rotation

Question 92

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

Answer 92

idiopathic scoliosis

Question 93

What does idiopathic scoliosis infer?

Answer 93

scoliosis is unique to the individual, has no known cause or etiology.

Question 94

What is the incidence of the idiopathic scoliosis in the population?

Answer 94

1-4%

Question 95

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

Answer 95

Infantile, Juvenile, and adolescent

Question 96

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

Answer 96

Left thoracic Male Less than 1% incidence

Question 97

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

Answer 97

Right thoracic Females over 6 12-21% incidence

Question 98

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

Answer 98

Right thoracic, or Right thoracic and Left Lumbar Females 80% incidence

Question 99

What is the name given to the joint formed between the tip of the dens and the odontoid process centers of ossification?

Answer 99

Tip of the dens synchondrosis

Question 100

At what age will the tip of the dens center of ossification appear?

Answer 100

Sometime in early adolescence

Question 101

Based on the age of appearance, how is the tip of the dens center of ossification classified?

Answer 101

Secondary center of ossification

Question 102

At what age will the tip of the dens fuse with the odontoid process?

Answer 102

Before age 12

Question 103

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?

Answer 103

terminal ossicle

Question 104

What is a basilar impression?

Answer 104

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.

Question 105

What is a basilar invagination?

Answer 105

Upper cervical spine appears to be invaginated into the skull on xray analysis

Question 106

What is/are the characteristic(s) of dorsalization of C7?

Answer 106

The addition of a rib and changes in superior articular facet orientation are typical.

Question 107

What is the incidence of rib-related changes following dorsalization of C7?

Answer 107

From one-half to two and one-half percent of the population

Question 108

Do patients typically present with symptoms specific for dorsalization of C7?

Answer 108

No, They are Asymptomatic

Question 109

What is the gender bias suggested in dorsalization of C7?

Answer 109

Female

Question 110

What alteration in C7 facet orientation may accompany dorsalization?

Answer 110

Superior articular facet changes from BUM-->BUL | inferior articular facet is unchanged

Question 111

what alteration in C6 facet orientation may accompany dorsalization?

Answer 111

Inferior articular facet changes from FoLD--> ForMeD | Superior articular facet unchanged

Question 112

What percent of the population may demonstrate thoracic-like features at C7?

Answer 112

up to 46%

Question 113

What rib-related changes may accompany cervicalization of T1?

Answer 113

First rib may decrease in mean relative length or become absent

Question 114

What will result from fusion of a short rib to the T1 transverse process?

Answer 114

transverse foramen

Question 115

What T1 facet orientation changes may accompany cervicalization?

Answer 115

Superior articular facet may change BUL-->BUM | Inferior articular facet is unchanged

Question 116

What C7 facet orientation changes may accompany cervicalization?

Answer 116

Inferior articular facet may change ForMeD--> FoLD Superior articular facet unchanged

Question 117

What is the incidence of cervicalization of T1 in the population?

Answer 117

up to 28%

Question 118

What rib-related changes may accompany dorsalization of L1?

Answer 118

elongated bones shaped like ribs may appear

Question 119

What is the incidence of lumbar ribs in the population?

Answer 119

over 7% of population demonstrates lumbar ribes

Question 120

What is the gender bias associated with dorsalization of L1?

Answer 120

Male, 2-3x more