Exam 2 - Regions in Spinal Column Flashcards by Rya Bryan

What are the 3 regions of the occiput?

Squamous portion
Lateral/condylar (2)
Basilar portion

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Posterior part and most of the base of the cranium is formed by what

Occipital bone

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What pass through foramen magnum?

Medulla oblongata
Vertebral arteries
Spinal arteries

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Where the glossopharyngeal, vagus, and accessory cranial nerve exit the skull

Jugular foramen

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The portion that connects to the sphenoid bone and is an area for attachment of many ligaments and muscles

Basilar portion

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First _____ of flexion/extension of head and neck takes place here before any other vertebra move

50%

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What are the 4 nuchal lines?

Median
Inferior
Superior
Highest

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The largest part of the occiput that is posterior to the foramen magnum

Squamous portion

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A typical cervical vertebra has _______ shaped bodies

Rectangular/oval

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A typical cervical vertebra has _______ SP

Bifid

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How many cervical lips does a typical cervical vertebra have?

3 - 2 superior lateral & 1 anterior inferior lip

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in the typical cervical vertebra, the TP are _______ to the AP

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__________ ________ are ascension of the vertebral artery

Transverse foramen

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What is a Costco-transverse lamella?

Groove on superior surface of the TVP for exit of the spinal nerve - typical cervical vertebra

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A typical cervical vertebra has a ________ neural foramen

Triangular

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Which cervical are typical

3,4,5,6

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Peculiar cervical vertebra are..

1,2,7

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What is the purpose of the uncinate processes?

Prevent lateral slipping of vertebra above

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When does the uncinate process develop?

Between 9 and 10

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A typical cervical has ___ true articulations and ___ pseudo ones

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Bony elevations on the superior lateral margins of the cervical vertebrae are called what?

Uncinate processes

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Uncinate processes articulate with the inferior lateral aspect of the vertebra above to form what?

Uncovertebral joint
AKA
Joints of Luschka
AKA
Luschkal Joint

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What is the defining characteristics of the atlas

Lacks a body, pedicles, Laminae, spinous

Has anterior arch, posterior arch, and lateral masses, and TVPs

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What is developed from the hypochondral arch that typically unites both halves of vertebral bodies

Anterior Arch

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Primary center of ossification for the atlas

Anterior arch

Anterior arch fuses to lateral masses when?

Between 6 and 8

Most anterior part of the atlas

Anterior tubercle

Groove for articulation of dens on the anterior tubercle that forms a pivotal joint for rotation of C1 and C2

Fovea Dentalis

50% of rotation of the head and neck takes place in the ______ before any other vertebra moves

Anterior tubercle of anterior arch of C1

Entrance of vertebral artery and exit for 1st pair of spinal nerves

Superior Vertebral Notch (Sulcus Arteriae Vertebralis)

Exit of 2nd pair of spinal nerves

Inferior vertebral notch

Anterior inferior surface of posterior arch

Inferior vertebral notch

Lateral masses of C-1 have _____ and _____ facets

Superior | Inferior

Superior facet of C1 faces...

Superior and medial

Inferior facet of C1 faces...

Flat and inferior

Where are the longest TVP in the cervical spine?

Causes of ADI abnormality

Trauma Down’s Syndrome Inflammatory Arthritis

C2 AKA

Axis | Epistropheus

Distinguishing characteristics of C2

``` Odontoid Process (dens) No superior lateral lips ```

What are the 5 articulations of C1?

2 with occiput | 3 with C2

Atlas-Dens Interval should be....

Less than 5mm in children | Less than 3mm in adults

Which cervical has the shortest TVP

Which cervical has the largest SP?

What are the articulations of C2?

3 with atlas | 3 with C3

What are the two ligaments of C2

Alar ligament | Apical dental ligament

Which cervical is the first palpable spinous below the EOP?

2 or more motions occurring at the same time

Coupling motion

Spinous process will move to ______ side when cervical spine is laterally flexed

Opposite

The vertebral body will move to the _______ side when the cervical spine is laterally flexed

Same

The spinous process will move to the _______ side when the lumbar spine is laterally flexed

Same

The vertebral body will move to the ______ side when the lumbar spine is laterally flexed

Opposite

The coupling motion of the cervical spine occurs where?

From cervical spine to T6,7,8

The first artery off the subclavian artery

Vertebral artery

Which artery supplies the posterior 1/3 of the bran?

Vertebral artery

Which arteries supply the anterior 2/3 of the brain?

Carotid arteries

Which artery comes off the aorta?

Subclavian artery

The vertebral artery ascends through the tansversarii of the first ____ vertebrae

What does it mean that the vertebral artery is fixed to adjacent structures?

It cannot slide inside the transverse foramen and will elongate then the cervical spine is rotated

The vertebral artery will elongate when the cervical spine is bent at what degree?

30-45%

Part 1 of the vertebral artery

Subclavian artery through TVP of C6

Part 2 of the vertebral artery

From C6 through C2

Part 3 of vertebral artery

C2 to C1 Moves laterally and passes through TVP of C1 Turns medially and goes through sulcus arterii vertebrialis

Part 4 of vertebral artery

Through posterior Atlanta-occipital ligament, into spinal canal then joins with fellow on opposite side to form the basilar artery

Last and largest branch of vertebral artery

PICA | Posterior inferior cerebellar artery

Basilar artery travels upward and branched into a right and left ___________

Posterior cerebral artery

The posterior cerebral artery branches and forms the _______________

Posterior communicating artery

The anterior cerebral artery unites with the _______

Anterior communicating artery

Where is the circles of Willis?

under the brain

What does the circle of Willis supply?

The base of the brain

Most common area of stroked or vascular accidents?

Circle of Willis

2 divisions of strokes

Ischemic | Hemorrhagic

Blood supple to a portion of the brain is blocked

Ischemic

Loss of blood flow due to bleeding

Hemorrhagic

90% of strokes are...

Ischemic

The type of stroke that is associated with manipulation

Ischemic

Least mobile region of the spine

Thoracic

Basic movement in the thoracic spine is _______

Rotation

There is some _______ but no _______ in the thoracic spine

Flexion | Extension

Typical thoracic vertebrae:

T2-8

Most of the thoracic vertebrae have an _______ shaped neural foramen

Oval

TVP of thoracic vertebrae are oriented...

45 degrees posterolateral

12 articulations of typical thoracic vertebra

4: Articular processes 4: Demi-facets on bodies with head of ribs 2: ribs at TVP 2: vertebral body above and below via disc

Which is the longest thoracic spinous?

Which is the shortest thoracic spinous

T11

Which thoracic vertebra are peculiar

T1, T9, T10, T11, T12

T1 characteristics

2nd transitional spinal segment Body more rectangular Rudimentary uncinate processes

T1 Characteristics

1 pair full costal facets superior 1 Park demifacets inferior 12 articulations

T9 characteristics

1 pair demi-facets on superior No inferior demi-facets 10 articulations

T10 characteristics

Only 1 pair of full costal facets-superior NO costal facets on inferior 10 articulations

T11 characteristics

NO fovea costalis transversalis on TVP 1 pair full facets 8 articulations

T12 characteristics

No fovea costalis transversalis on TVP 1 pair full facets on body 3rd transitional segment in spine Mammillary processes, accessory processes, 1 pair of interlocking articular process on inferior

Pectus carinatum

Sternum sticks outward

Ribs too short to bend backward so pushes sternum outward

Pectus carinatum

Pectus excavatum

Sternum is depressed inward

Ribs are too long and push sternum more inward

Pectus excavatum

Typical lumbar vertebra

L1-4

Typical lumbar vertebra bodies are ______ shaped

Kidney

SP of typical lumbar are..

Club-like

TVP of typical lumbar vertebra are ____ and _________

Thin | Blade like

TVPs of typical lumbar vertebra are _______ to articular process but _______ to IVF

Anterior | Posterior

Mammillary process of typical lumbar are on the _______ _________ ________ aspect of superior articular process

Posterior Superior Lateral

SAP of typical lumbar are convex or concave?

Concave

SAP of typical lumbar are located on inside or outside?

Outside

IAP of typical lumbar are convex or concave?

Convex

IAP of typical lumbar are on inside or outside?

Inside

Laminae of typical lumbar is _____ and _____

Broad | Short

Shape of neural foramen is _______ on typical lumbar vertebra

Triangular

Pedicles of typical lumbar have _______ inferior pedicle notch

Deep

Pedicles of typical lumbar vertebra have a ______ superior pedicle notch

Shallow

body of typical lumbars show a progressive _____ in mass

Increase

Pedicles of typical lumbar are ______ and ______ than thoracic

Longer | Wider

TVP of lumbar are _____ than in thoracic region

Smaller

SP of lumbar vertebra are _______ shaped

Square

Which lumbar is peculiar?

L5 has a _______ shaped body

Wedge

SP of L5 tips _______

Upward

TVP of L5 arises from the _______ and not the lamina/pedicle junction

Body

4th transitional segment of the spine

Flexion of lumbar spine only

60 degrees

Flexion of lumbar spine with aid of pelvis

105 degrees

Extension of the lumbars:

25 degrees

The first 15 degrees of lumbar extension are from the ______

Pelvis

Last 10 degrees of extension of the lumbar spine are from

Lumbar spine alone

Degree of lateral flexion in the lumbars:

25 degrees

Degree of rotation in the lumbars:

45 degrees

A break in the pars interarticularis without anterior slippage

Spondylolysis

Break in the pars interarticularis with anterior slippage

Spondylolisthesis

Anterolisthesis

Anterior slippage

Retrolisthesis

Posterior slippage

Spondylos 70-75% of the time occurs as ______ slips anterior on ______

L5 | S1

25% of spondylos occur as _____ slips anterior on _____

L4 | L5

Generally accepted cause of spondylolysis

Repeated strains | -damage lower spine over time, usually at L5

Stress fractures are associated with spondylo.....

Spondylolysis

What are the 5 types of spondylolisthesis?

``` Isthmic Degenerative Traumatic Pathological Dysplastic ```

Most common type of spondylolisthesis

Isthmic

Type of spondylolisthesis that causes fatigue or stress fracture of the pars of L5

Isthmic

Where can you find a Scotty Dog?

Oblique x-ray

Primarily posterior joint degeneration is what type of spondylolisthesis

Degenerative

Most common form of spondylolisthesis below the age of 50

Isthmic

Most common form of spondylolisthesis above the age of 50

Degenerative

No fracture or pars defect, this is caused by time (type of spondylolisthesis)

Degenerative

L5 slips on S1

Isthmic spondylolisthesis

L4 slips on L5

Degenerative

Most common spondylolisthesis in female over 40

Degenerative

Acute fracture anywhere in the posterior arch except at the pars interarticularis

Traumatic spondylolisthesis

Found secondary to pathology (type of spondylolisthesis)

Pathological

Rare congenital malformation in with L5 may not have inferior articular processes to articulate with S1 (causes anterior slide)

Dysplastic spondylolisthesis

Spondylolisthesis and spondylolysis are both _________ conditions

Acquired

Incidents of spondylolisthesis _________ with age

Increase

Congenital spondylolisthesis AKA

Dysplastic

Spondylolysis means what?

Breaking the vertebrae

95% of spondylolysis occur at which vertebrae?

Spindylolysis are generally ________ in nature (bilateral or unilateral)

Bilateral

Isthmic spondylolisthesis is most often found between the ages of _____ and _____ in athletes

9 | 13

The majority of spondylos occur asymptomatically by the age of _____ and become symptomatic by age _____

12 | 13

As many as ____% of young athletes with lumbar pain for over 3 months have either spondylolisthesis and spondylolysis

Signs and symptoms of spondylolisthesis

1. Low back pain (chronic) 2. Tight hamstrings (hyperlordosis) 3. Loss of flexibility

Typical x-ray views for the lumbar spine

``` A-P lumbar Lateral lumbar (not often) ```

if you suspect a spondylo, what type of x-ray view do you want?

A-P lumbar Lateral lumbar & obliques

2 ways to measure (or grade) the amount or degree of slippage using lateral lumbar x-ray

Ullman’s Line | Meyerding classification

Type of classification that uses posterior aspect of the vertebral bodies to measure slippage

Meyerding classification

Grade 1 meyerding classification

0-25%

Grade 2 Meyerding classification

25-50%

Grade 3 Meyerding classification

50-75%

Grade 4 Meyerding classification

75-100%

Grade 5 Meyerding classification

Vertebra has slipped totally off the segment below and anterior Called spondyloptosis

75% of flexion of the lumbar spine is at ________

L5/S1

Least segmental motion in the lumbar spine is _______

Rotation

Greatest amount of overall motion in the lumbar spine is at _______

L4-5

Greatest amount of lateral bending in the lumbar spine occurs at _____

L3-4

Least amount of lateral bending in the lumbar spine is ______

L5/S1

What is the most common anomaly of the spine?

Trophies

“Last lumbar assumes the characteristics of the sacrum” what does this describe?

Sacralization

“1st sacral segment assumes characteristics of the lumbar” what does this describe?

Lumbarization

What are the 3 types of Baastrup’s disease?

Trophism Sacralization Lumbarization

51% of disc herniation occur at ______

L4/5

49% of disc herniation occur at _______

L5/S1

More mobility = ________ stability

Less

Elongated spinous process of L5 (with lordosis) and a spina bifida at S1 is referred to as what?

Knife clasp syndrome

In ________, joints are faced different and only move with great stress.

Tropism

A pathological stimulation of new bone formation at the attachments of the longitudinal ligaments

Spondylosis

What are the 2 types of spondylosis?

Syndesmophyte | Spondylophyte

Vertical spurs - calcification of the longitudinal ligaments What type of spondylosis does this describe

Spondesmophyte

Horizontal spurs off the vertebra - may end up with fusion | What type of spondylosis does this describe?

Spondylophyte

What is a spur found on the bone called?

Osteophyte

What are the 3 types of fusion?

Arthrodesis Ankylosis Synostosis

Surgical fusion

Arthrodesis

Pathological fusion

Ankylosis

Congenital fusion

Synostosis

Base of the sacrum is body of ______

Sacral Alae AKA

Lateral sacral masses

Superior articular process of the sacrum articulates with what?

Last lumbar segment

Facets in the sacrum face more ______ than ______

Coronally than sagittally

Women sacrum is _______(short or tall), _______ (thin or wide), and _______ curved

Shorter Wider More curved

Sacral vertebrae connects the spine to the pelvic girdle at the _______________

Sacroiliac joint

Sacral promontory is on the _____ surface of the sacrum

How many pair of anterior pelvis sacral foramen are there?

What is the articular surface on the lateral surface of the sacrum?

SI joint

Lateral sacral crest is analogous to _____

TVP

The only normally occurring spina bifida in vertebral column is what?

Sacral hiatus

What is the last pair of articular processes?

Sacral cornua

Male sacrum is more _____ than the females (narrow or wide)

Narrow

Male sacrum is ________ than females (short or long)

Longer

Male sacrum is oriented more ________

Vertically

Female sacrum is oriented more _________

Horizontally

Male lumbosacral angle is _________

Decreased

Female lumbosacral angle _________

Increased

Female anterior surface of the sacrum is more or less curved

What is a females Q-angle?

18 degrees

What is a males Q-angle?

13 degrees

Coccyx is formed by ___ segments fused together

Each segment of the coccyx develop as what?

Primary center of ossification

Coccyx will develop every ____ to ____ years

1-5

Segments of the coccyx are completely fused between ages _____ and ____

25 - 30

Normal lumbar spine is about _____ degrees from sacrum

Nerve supply for SI joint is from

SI and S2 segments

Sacroiliac joint moves about _____ degrees

Articular capsule on anterior surface of sacrum

Sacroiliac joint

What 5 typed of joints are in the pelvic ring?

``` Syphysis pubis (1) SI joints (2) Coxal joint (2) Anterior LS joint (1) Lumbosacral zagapophyseal joints (2) ```

Total number of joints in the pelvic ring?

Pelvic girdle is more flexible in _____

Females

Forward movement of the sacral base with relationship to the ilium

Nutation

Sacral base moves posterior in relation to the ilium

Counter nutation

When the ilium comes tougher is posterior and widens in front, what type of motion is it?

Nutation

When the ilium opens in the back and comes together in the front, what type of motion is it?

Counter nutation

What three types of movement are associated with the SI joint

Rotatory Nutation Counter nutation

By the _____ generation of life, degeneration begins and mobility decreases

4th

By the _____ decade, total fibrous degeneration occurs and movement is changed

8th

_______ are more susceptible to SI joint issues than ______

Females | Males

3 joints of uncinate processes

Joints of Von Luschka Unco-vertebral joint Co-vertebral joint

False or pseudo joint is called

Joint of Von Luschka AKA Luschka Joint

Transverse ridges of the sacrum are analogous to ______

Discs

Sacrospinous ligament seperates _______________ and _____________

Greater sciatic notch and foramen | Lesser sciatic notch and foramen

Who has larger lordosis, males or females?

Females

Atlas can move _______ left or right just from the C1/C2

40-45

2/5th the body ring is part of the ______ arch of C1

Posterior

Most posterior part of C1 | Is analogous to SP

Posterior tubercle

Entrance of vertebral artery and exit of 1st pair spinal nerves through

Sulcus arteriae vertebraialis

Ponticus posticus AKA

Posterior Atlanto-occipital ligament

Calcification of the sulcus arteriae vertebrialis

Ponticus posticus

Exit of 2nd pair of spinal nerves

Inferior vertebral notch

Exam 2 - Regions in Spinal Column Flashcards

(241 cards)