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

A

Magnitude, location, direction, etiology, structural scoliosis and non-structural scoliosis

3
Q

What does magnitude of scoliosis refer to?

A

The length and angle of the curve deviation on x-ray

4
Q

What is often used ot measure the magnitude of scoliosis?

A

The Cobb Method

5
Q

What does location of scoliosis infer?

A

The location on the vertebral segment forming the apex of the curve deviation

6
Q

What does the direction of scoliosis refer to?

A

The side the convexity of the curve will bend toward

7
Q

What does etiology of scoliosis mean?

A

The cause of the scoliosis

8
Q

what is structural scoliosis?

A

A more radical fom of scoliosis, it may worsen, associated with structural deformities of the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation

9
Q

What is non structural scoliosis?

A

A mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or intervertebral disc and lacks a fixed angle of trunk rotation.

10
Q

What are some of the classifications of scoliosis based on etiology?

A

Congential, neuromuscular, neurofibromatosis, nerve root irritation, idiopathic

11
Q

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

A

Ideopathic scoliosis

12
Q

What does idiopathic scoliosis infer?

A

The scoliosis is unique to the individual, it has no known cause, unknown etiology

13
Q

What is the incidence of idiopathic scoliosis in the population?

A

1%-4% of the population

14
Q

What is the age range for infantile idiopathic scoliosis?

A

From birth to 3 years old

15
Q

What is the age range for juvenile idopathic scoliosis?

A

From 3-10 years

16
Q

What is the age range for adolescent idiopathic scoliosis?

A

Over 10 years old

17
Q

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

A

left thoracic, male, less than 1% incidence

18
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

19
Q

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

A

Right thoracic or right thoracic and left lumbar, females, and 80% incidence

20
Q

What is the genetic factor associated with adolescent idiopathic scoliosis?

A

An autosomal dominant factor that runs in families

21
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

22
Q

What is/are the characteristic(s) of occipitalization of C1?

A

The atlas may be partially or completely fused to the occiput

23
Q

What is another way of implying occipitalization of C1?

A

atlas assimilation

24
Q

What is the incidence of occipialization of C1?

A

0.1% - 0.8%

25
Q

When do the centers of ossification for the odontoid process first appear?

A

During the last trimester in utero

26
Q

When do the bilateral ossification centers for the odontoid process fuse?

A

at or shortly after birth

27
Q

What joint is formed between the odontoid process ossification centers and the centrum of C2?

A

The subdental synchondrosis

28
Q

What is the classification of the joint formed between the C2 odontoid process and centrum?

A

Amphiarthrosis synchondrosis

29
Q

Ossification between the odontoid porcess and centrum joint of C2 first appears at what age?

A

4 Years old

30
Q

A joint between the odontoid process and centrum of C2 is last identified at what age?

A

7 Years old

31
Q

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?

A

Os odontoideum

32
Q

What is the name given to the joint between the odontoid process and centrum of C2 which is still evident beyond age 7?

A

Persistent subdental synchondrosis

33
Q

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

A

Tip of the dens synchondrosis

34
Q

at what age will the tip o fthe dens center of ossification appear?

A

Sometime in early adolescence

35
Q

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

A

Before age 12

36
Q

If the joint formed between the tip of the dens and odontoid process centers of ossification persists betyond age 12, what is the condition called?

A

Terminal ossicle

37
Q

What is basilar impression?

A

Peristence of the nonunion of the basilar and condylar parts of the chondrocranium such that the cartilage deforms due to the weight of the brain

38
Q

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

A

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

39
Q

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

A

No, they are typically asymptomatic

40
Q

What is the gender bias suggested in dorsalization of C7?

A

Female

41
Q

What alterations of C7 facet orientation may aaccompany dorsalization?

A

The superior articular facet of C7 may change from back, upward, and medial to that of a typical thoracic facet… back, upward, and lateral; the inferior articular facet is unchanged

42
Q

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

A

Up to 46%

43
Q

what T1 facet orientation changes may accompany cervicalization?

A

The superior articular facet may change from back, upward, and lateral to back, upward, and medial; the inferior articular facet is unchanged

44
Q

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

A

Up to 28% of the population

45
Q

What is the incidence of lumbar ribs in the population?

A

Over 7% of the population demonstrates lumbar ribs

46
Q

What L1 facet orientation changes may accompany dorsalization?

A

The superior articular facet may change from concave, back, upward, and medial to flat, back, upward, and lateral; the inferior articular facet is unchanged

47
Q

What is the gender bias associated with dorsalization of L1?

A

Males are two to three times more affected

48
Q

What T12 facet orientation changes may accompnay lumbarization?

A

The supieror articular facet may change from flat, back, upward, and lateral to concave, back, upward, and medial; the inferior articular facet is unchanged

49
Q

What T11 facet orientation changes may accompnay lumbarization?

A

The inferior articular facet may change from flat, foward, medial, and downward to convex, forward, lateral, and downward; the superior articular facet is unchanged

50
Q

What is the usual way fo identifying the number of cervicals, thoracics and lumbar verebrae during imaging studies

A

Identify the vertebrae with ribs - they will be thoracics; those higher are cervicals, those lower are lumbars

51
Q

What is characteristics of lumbarization of S1

A

The failure of synostosis between S1 and S2, squaring of the vertebral body of S1 and flaring of the sacral ala

52
Q

What is failure of synostosis between S1 and S2?

A

The segments do not completely fuse together

53
Q

What is squaring of the vertebral body of S1?

A

The S1 vertebral bdy has similar anterior and posterior heights, hence a lack of wedging

54
Q

what isf laring of the sacral ala?

A

The transverse process of the ala appears to elevate as though separating from the rest of the sacral ala

55
Q

What articular facet changes accompnay lumbarization of S1

A

None

56
Q

What is characteristic of sacralization of L5

A

L5 may be partially of completey fused to the sacrum

57
Q

What is the inidence of sacralization of L5 in the population

A

41% - 85%

58
Q

Which segment demonstrates the greatest morphological variation along the spine

A

L5

59
Q

What articular facet changes accompnay saralization of L5

A

None

60
Q

What is the incidence fo variation within the sacroccoygeal region in the population

A

Up to 14%

61
Q

What is characteristic of sacralization of Co1

A

The premature fusion of Co1 to the sacrum

62
Q

What is characteristic of coccygealization of S5

A

The separation of S5 from sacruma nd its premature fusion to Co1

63
Q

The trapezius is innervated by what nerve?

A

The spinal accessory nerve

64
Q

What forms the spinal accessory nerve innervating the trapezius

A

C1-C5 cord levels contribute to the spinal root of the spinal accessory nerve

65
Q

The latissimus dorsi is innervated by what nerve

A

The thoracodorsal nerve

66
Q

what forms the thoracodorsal nerve innervating the latissimus dorsi

A

Ventral rami from C6-C8

67
Q

What forms the dorsal scapular nerve

A

The ventral rami of C8

68
Q

What is the innervation of the splenius capitis

A

Dorsal rami of middle cervical spinal nerves (C3-C5 cord levels)

69
Q

Splenius cervicis will arrach to what locations on the spine

A

Lateral mass of C1 & posterior tubercle of transverse process on C1-C4

70
Q

Which muscles are identified as erector spinae or sacrospinalis muscles

A

Iliocostalis, longissimus, spinalis

71
Q

What is the innervation of the iliocostalis lumborum

A

Dorsal rami of lower thoracic and all lumbar spinal nerves

72
Q

What osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis

A

None

73
Q

What is the insertion for the iliocostalis thoracis

A

Costal angles of the upper 6-7 ribs, thransverse process o C7

74
Q

What osseous parts of the vertebral column serve as an origin to the longissimus thoracis

A

Accessory process & transverse processes of L1-L5, spinous processes of L3-L5 and median sacral crest S1-S3

75
Q

What is the innervation of the longissimus cervicis

A

Dorsal rami of C4-C8 and T1-T2 spinal nerves (C4-C8 & T1-T2 cord levels)

76
Q

What osseous parts of the vertebral column serve as an origin to the spinalis thoracis

A

Spinous processes of T11 & T12-L1 & L2

77
Q

Which muscles are identified as transversospinalis muslces

A

Semispinalis, multifid, and rotators

78
Q

How many vertebrae can be attached to a single segment by transversospinalis muslces

A

As many as nine vertebrae

79
Q

What segment will represent the lowest attachment site for the semispinalis thoracis

A

T12

80
Q

What osseous parts of the vertebral column serve as an origin to the semispinalis cervicis

A

Transverse tubercles of T1-T5 or T6 & articular processes of C4-C7

81
Q

What osseous parts of the vertebral column serve as an origin to the semispinalis capitis

A

Transverse tubercles of C7, T1-T6 or T7 & articular processes of C4-C6

82
Q

The semispinalis ccapitis and spinalis capitis may fuse to form what muscle

A

Biventer cervicis

83
Q

What osseous parts of the vertebral column serve as an origin to the classic multifidis

A

Articular process of C4-C7, transverse processes of T1-T12, mammillary processes of L1-L5 and the dorsal surface of S1-S4 or S5

84
Q

Contraction of the classic multifidis will result in what movemnets of the vertebral column

A

Lateral flexion & rotation of the spine, maintains the lumbar lordotic curve and prevents entrapment of zygapophyseal capsular ligament during movement

85
Q

Contraction of multifidis cervicis will result in what movements

A

Alters the zygapophyseal capsular ligament response to load distribution determines the cervical spine response to injury as evidenced by neck pain and is a significant contributor to postural conrol of the head and neck

86
Q

contraction of multifidis lumborum will result in what movements

A

lateral flexion & rotation of the lumbar spine, maintains the lumbar lordotic curve and prevents entrapment of lumbar zygapophyseal capsular ligament during movemnt

87
Q

which muscles of the spine exhibit a reversal of the expected origin - insertion combination

A

iliocostalis lumborum pars lumborum, longissimus thoracic pars lumborum and multifidis lumborum

88
Q

rotator muscles are typically identified in what region of the spine

A

the thoracic region

89
Q

which suboccipital muslce lacks an attachment to the skull

A

obliquus capitis inferior

90
Q

which nerve will innervate all suboccipital muscles

A

dorsal ramus of C1, the suboccipital nerve

91
Q

what is the origin of the obliquus capitis inferior

A

C2 spinous process and lamina

92
Q

an increase in the density of muslce spindles is most apparent in which suboccipital muscle

A

obliquus capitis inferior

93
Q

what is the proposed function of the suboccipital muscle group

A

postural stabilizers of the atlanto-occipital and atlanto-axial joints

94
Q

which suboccipital muscles are known to attach to dura mater

A

rectus capitis posterior major/minor

obliquus capitis inferior

95
Q

interspinalis is paired in which regions of the spine

A

cervical and lumbar regions

96
Q

based on the density of muscle spindles what is the proposed function of the interspinalis

A

acts as a proprioceptive transducer in conjunction with intertransversarii to coordinate the smooth movement of the spine and to maintian appropriate posture

97
Q

which of the cervical intertransversarii is innervated by dorsal rami of cervical spine nerves

A

posterior medial belly, cervical intertransversarii

98
Q

what is the origin of the medial belly of the lumbar intertransversarii

A

accessory process of transverse process L1-L4

mammillary process of superior articular process L1-L4

99
Q

which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves

A

intertransversarii

100
Q

based on the density of muscle spindles what is the proposed function of the intertransversarii

A

acts as a proprioceptive transducer in conjuction with interspinalis to coordinate the smooth movement of the spine and to maintain appropriate posture

101
Q

what is the origin of the longus colli

A

vertebral bodies of C5-C6, T1-T3

anterior tubercles of transverse processes C3-C5

102
Q

what will innervate the rectus capitis anterior

A

ventral rami C1-C2 spinal nerves

103
Q

what will innervate the rectus capitis lateralis

A

ventral rami of C1-C2 spinal nerves

104
Q

what is the insertion of the anterior scalene

A

ridge and anterior scalene tubercle of first rib

105
Q

what is the insertion of the middle scalene

A

between the tubercle and groove for the subclavian artery on the first rib

106
Q

what is the insertion of the posterior scalene

A

outer surface of second rib

107
Q

what will innervate the posterior scalene

A

the ventral rami of C6-C8 spinal nerves

108
Q

the quadratus lumborum is implicated in the formation of which ligament

A

the iliolumbar ligament

109
Q

what is the origin of the psoas major

A

vertebral bodies T12, L1-L5, S1 and trasnverse processes of L1-L5

110
Q

what is the origin of psoas minor

A

vertebral bodies of T12, L1

111
Q

what will innervate the psoas minor

A

the ventral ramus of L1 spinal nerve

112
Q

what is the maximum number of common ligaments identified with a vertebral couple

A

eight

113
Q

what is the reason that nine common ligaments are identified but only eight will be attached at any specific vertebral couple

A

the ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple

114
Q

what is the number of true intervertebral discs identified in the adult

A

23

115
Q

in the adult, which vertebral levels will demonstrate a true intervertebral disc

A

those between C2 and S1 inclusive

116
Q

what is the percent of intervertebral disc heigh contribution to the length of each region of the vertebral column

A

cervical 22-25%
thoracic 20%
lumbar 33%

117
Q

what are the names of the central, peripheral, and horizontal zones of the intervertebral disc

A

nucleus pulposus-central
annulus fibrosus-peripheral
cartilaginous end plate-horizontal

118
Q

what is the water concentration in the lumbar nucleus pulposus at birth and after thirty

A

birth 88%

thirty 70%

119
Q

what is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus

A

nucleus pulposus will lose water under deformation conditions

120
Q

what cell is associated with he nucleus pulposus until about age eleven

A

notochord cells

121
Q

which type of collagen is dominant in the nucelus pulposus

A

collagen type II

122
Q

what is the organizational pattern for collagen fibers in the nucleus pulposus

A

they are irregularly oriented and randomly scattered

123
Q

what is the appearance of the cervical annulus fibrosus

A

a horse-shoe with the anterior margin thick and lateral margins tapering to the uncinate processes; the posterior margin is thing

124
Q

what compensates for the thinness of the posterior part of the cervical annulus fibrosus

A

posterior longitudinal ligament

125
Q

what is the organization of the lumbar annulus fibrosus

A

is has 12-14 concentric cylindrical lamellae

126
Q

what is the water concentration in the lumbar annulus fibrosus at birth and after thirty

A

birth - 78%

thirty - 70%

127
Q

what is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus

A

they typically have a binding site for hyaluronic acid and are thus aggregated

128
Q

which type of collagen is dominant in the annulus fibrosus

A

collagen type I

129
Q

what is the organizational patter for collagen fibers in the annulus fibrosus

A

they are parallel with one another in a single lamellus and angled

130
Q

what is the organization of collagen fibers between lamellae

A

collagen fibers will be angled in the opposite direction such that a spiral - counterspiral organization is observed

131
Q

what is the attachment site for collagen fibers within the annulus fibrosus

A

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

132
Q

what is the origin for the cells of the annulus fibrosus

A

sclerotomites

133
Q

what is the principal type of collagen fiber within the cartilage end plate

A

type II collagen fibers

134
Q

what is the direction of collagen fibers within the cartilage end plate

A

collagen fibers are aligned anterior to posterior

135
Q

what is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus

A

cartilaginous end plate

136
Q

what are the types of receptor endings in the intervertebral disc

A

nociceptors and proprioceptors

137
Q

what is the relationship between size of the intervertebral disc and receptor endings

A

the larger the disc, the greater the variety of receptor endings

138
Q

what part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve

A

the outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc

139
Q

what forms the anterior neural plexus of the vertebral column

A

fibers from the ventral primary ramus

140
Q

what forms the lateral neural plexus of the vertebral column

A

fibers from the ventral primary ramus, fivers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray rumus communicans

141
Q

what is the name given to teh white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc

A

the paradiscal ramus communicans

142
Q

what part of the intervertebral disc is innervated by fibers from the paradiscal ramus communicans

A

the outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc

143
Q

how does the intervertebral disc attach to the vertebral body

A

sharpeys fibers from the outer lamellae of the annulus fibrosus are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies

144
Q

based on the histology, what is the classification of the intervertebral disc

A

a cartilaginous (amphiarthorsis) symphysis

145
Q

what are the divisions of the embryonic somite

A

the sclerotome, myotome, and dermatome

146
Q

what structure is formed following migration of sclerotomes to surround the notochord

A

the perichordal blastema

147
Q

what does the intrasclerotomal fissure or fissure of von ebner become

A

periochodral disc

148
Q

what will the dense sclerotomite become

A

the upper part of the vertebral segment forming below

149
Q

what structure forms following migration and subsequent mixing of the sclerotomites

A

the vertebral blastema

150
Q

what part of the intervertebral disc will the notochord form

A

the nucleus pulposus

151
Q

what part of the intervertebral disc will the perichordal disc form

A

the annulus fibrosus

152
Q

what is the earliest indicator of the position of the adult intervertbral disc

A

the intrasclerotomal fissure or fissure of von ebner

153
Q

what vertebral levels will the anterior longitudinal ligament attach to

A

those between occiput and S3 inclusive are traditionally indicated

154
Q

what is the lowest extent of the anterior longitudinal ligament based on recent studies

A

L3

155
Q

what is believed to form the anterior longitudinal ligament in the lumbar spine

A

the tendon of the crura of the diaphragm

156
Q

what innervates the anterior longitudinal ligament

A

the anterior neural plexus formed by fibers from the ventral primary ramus and sympathetic postganglionic fibers from teh paravertebral ganglia

157
Q

what is the function of the anterior longitudinal ligament

A

it brakes or limits dorsi-flexion or hyperextension of the vertebral column

158
Q

what was ossification of the anterior longitudinal ligament in the lumbar region identified as

A

forestier’s disease

159
Q

what is ossification of the anterior longitudinal ligament in the lumbar region now identified as

A

diffuse idiopathic skeletal hyperostosis or DISH

160
Q

newer research suggest what regional variation in the posterior longitudinal ligament

A

prominent in the cervicals, occasional in the thoracics, rare in the lumbars

161
Q

what is the relationship of the posterior longitudinal ligament to the vertebral foramen

A

it forms the anterior boundary of the spinal canal

162
Q

what is the innermost layer of the posterior longitudinal ligament called

A

perivertebral ligament

163
Q

what is the function of the posterior longitudinal ligament

A

it brakes of limits flexion of the vertebral column

164
Q

where is ossification of the posterior longitudinal ligament most commonly identified

A

the cervical spine with an 80% incidence

165
Q

what is the clinical sign of posterior longitudinal ligament ossification in the cervical spine

A

a loss of hand and finger dexterity

166
Q

what is the clinical sign of posterior longitudinal ligament ossification of the posterior longitudinal ligament

A

faltering gait

167
Q

what is teh gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament

A

greater in males
over 50
japanese

168
Q

what is the name given to the ligamentum flavum based on appearance and histology

A

yellow elastic ligament

169
Q

what fibers are most ligaments made of

A

collagen type 1 fibers which are whitish in appearanche

170
Q

where is ossification of the ligamentum flavum most commonly identified

A

the thoracic spine of thoracolumbar transition zone

171
Q

what is the relationship between the capsular ligament and mobility

A

the more lax the capsular ligament is, the greater teh motion of the joint

172
Q

what regions of the vertebral column demonstrate the greatest laxity of capsular ligaments

A

the cervical and lumbar regions

173
Q

what layers are present in the capsular ligament

A

a superficial layer of collagen fibers and a deep layer of elastic fibers

174
Q

if the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its function

A

it is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement

175
Q

what is now thought to be a major function of the interspinous ligament

A

it is more likely a proprioceptive transducer for the spinal reflex

176
Q

what is the name given to the superficial layer of the ligamentum nuchae

A

funicular layer or part

177
Q

what is the name given to the deep layer of the ligamentum nuchae

A

the lamellar layer or part

178
Q

what are the attachment sites for the superficial layer of the ligamentum nuchae

A

the external occipital protuberance, external occipital crest, and spinous tubercle of C7

179
Q

what is the histological make-up of the human ligamentum nuchae

A

it is a yellow elastic ligament, but has more collagen fibers than in quadrupeds

180
Q

what is the classic function of the human ligamentum nuchae

A

it brakes or limits flexion of the cervical spine

181
Q

what is the termination level inferiorly for the supraspinous ligament according to current literature

A

primarly at L4 (73%)

between L4-L5 (5%)

182
Q

what is now thought to be a major function of the supraspinous ligament

A

it is a proprioceptive transducer for the spinal reflex

183
Q

what amount of flexion-extension is accommodated by the atlanto-occipital joint

A

about 25 degrees

184
Q

what amount of axial rotation is accommodated by the atlanto-occipital joint

A

about 3-8 degrees one side axial rotation

185
Q

what amount of lateral bending is accommodated by the atlanto-occipital joint

A

about 5 degrees

186
Q

which motion is best accommodated by the atlanto-occipital joint

A

flexion-extension

187
Q

what is the function of the transverse atlantal ligament

A

it is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1

188
Q

what movements are facilitated at the median atlano-axial joint

A

flexion-extension, rotation, and telescoping (superior/inferior gliding)

189
Q

what is ADI

A

atlanto-dental interspace, a radiographif distance between the surfaces of the anterior bursa of the median atlanto-axial joint

190
Q

what is the ADI of children compared to adults

A

children - 4.5 mm

adults - 2-3 mm or about 2.5 mm

191
Q

what are the degrees of movement facilitated at the atlanto-axial joint

A

about 20 degrees flexion-extension, 40 degrees one side axial rotation, and 5 degrees of lateral bending

192
Q

the occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation

A

about 60%

193
Q

what is the embryonic derivative of the apical ligament of the dents or the apicodental ligament

A

the notochord

194
Q

what is the function of the alar ligament

A

together they function to resist axial rotation

195
Q

what forms the cranial continuation of the posterior longitudinal ligament

A

the membrana tectoria or tectorial membrane

196
Q

list in order the ligaments in a midsagittal plane from the dura mater tat the level of the medulla oblongata to the anterior bursa of the median atlanto-axial joint

A

memrbana tectoria
cruciate ligament
capsular ligament of posterior bursa of median atlanto-axial joint
apical ligament of the dens or apicodental ligament

197
Q

for the cervical spine below C2, what is the range of flexion-extension

A

~90 degrees or about 18 degrees per couple

198
Q

for the cervical spine below C2, what is the range of one side lateral bending

A

~50 degrees or about 10 degrees per couple

199
Q

for the cervical spine below C2, what is the range of one side axial rotatioin

A

~33 degrees or about 6 degrees per couple

200
Q

what are the locations for costovertebral joints on the vertebra

A

costocentral joint at the vertebral body

costotransverse joint at the transverse process

201
Q

at what rib will the superior costotransverse ligament be absent

A

first rib

202
Q

what ligaments will attach to the neck of the 12th rib

A

the superior costotransverse ligament from T11 and the lumbocostal ligament from L1

203
Q

what are the attachment sites for the inferior costotransverse ligament

A

neck of the rib and transverse process of the vertebra at that level

204
Q

at what rib will the inferior costotransverse ligament be absent

A

12th rib

205
Q

what is the name of the space between the transverse process and the neck of the rib

A

costotransverse foramen

206
Q

which ligament “fills” the costotransverse foramen

A

inferior costotransverse ligament

207
Q

what are the attachment sites for the lateral costotransverse ligament

A

non-articular surface of tubercle of rib

transverse tubercle of transverse process of vertebra at that level

208
Q

which vertebra will lack an attachment for the lateral costotransverse ligament

A

T12

209
Q

which vertebral couples of the thoracic spine have the greatest motion

A

T11/T12 and T12/L1

210
Q

which range of motion is greatest for lower thoracic vertebral couples

A

flexion-extension

211
Q

which range of motion is least for lower thoracic vertebral couples

A

one side axial rotation

212
Q

which ligaments replace the intertransverse ligament at the lumbosacral joint

A

iliolumbar ligament and lumbosacral ligament

213
Q

what muscle is intimately attached to the superior iliolumbar ligament

A

quadratus lumborum

214
Q

which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions

A

superior iliolumbar ligament

215
Q

which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions

A

inferior iliolumbar ligament

216
Q

which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions

A

inferior iliolumbar ligament

217
Q

what are the attachment sites for the accessory iliolumbar ligament

A

transverse process of L4 and the iliac crest

218
Q

which vertebral couple of the lumbar spine has the greatest range of motion

A

L5/S1

219
Q

which range of motion is greatest for all lumbar vertebral couples

A

flexion-extension

220
Q

which range of motion is least for L1-L5 vertebral couples

A

one side axial rotation

221
Q

whihc range of motion is least for the L5/S1 vertebral couple

A

one side lateral bending

222
Q

list in order from cranial to caudal the ligaments forming the anterior boundary of the spinal canal

A

membrana tectoria
posterior longitudinal ligament
deep posterior sacrococcygeal ligament

223
Q

list in order from cranial to caudal the ligaments forming the posterior boundary of the spinal canal

A

posterior atlanto-occipital ligament
posterior atlanto-axial ligament
ligamentum flavum
superficial posterior sacrococcygeal ligament

224
Q

what is the auricular surface of the ilium composed of

A

articular cartilage, interspersed with fibrocartilage

225
Q

what does ankylosis mean

A

a condition of fibrous adhesion occurs within the joint

226
Q

what is the age and surface bias associated with degenerative arthrosis of the sacroiliac joint

A

age 40

iliac auricular surface

227
Q

what is the age and gender bias associated with ankylosis of the sacroiliac joint

A

age 50
male bias
particularly in african american males

228
Q

what is the relationship between the capsular and interosseous sacroiliac ligaments

A

interosseous sacroiliac ligament replaces the capsular ligament posteriorly

229
Q

what passes between the layers of the interosseous sacroiliac ligament

A

dorsal rami from the sacral spinal nerves

230
Q

what separates the manubrium sterni and corpus sterni

A

manubriosternal symphysis

231
Q

what vertebral levels correspond to the position of the corpus sterni

A

T5-T9

232
Q

how many sternabrae for the corpus sterni

A

4 sternabrae

233
Q

what surface feature on the corpus sterni identifies the location of the synchondroses

A

transverse lines

234
Q

what articular sites for the costal cartilage of ribs will be identified on the corpus sterni

A

costal notches II-VII

235
Q

what feature of the corpus sterni is present 4-7% of the population

A

sternal foramen

236
Q

what causes the appearance of the sternal foramen

A

failure of the ossification centers of the sternum to fuse together normally

237
Q

what attaches to the scalene tubercle of the first rib

A

anterior scalene msucle

238
Q

which groove on the body of the first rib is close to the vertebral end

A

groove for the subclavian artery and first thoracic nerve

239
Q

which groove on the body of teh first rib is close to the sternal end

A

groove for subclavian vein

240
Q

what specifically will attach to the crest of the neck of the second rib

A

superior costotransverse ligament from the transverse process of T1

241
Q

what specifically attaches to teh back of the neck of teh second rib

A

inferior costotransverse ligament from teh transverse process of T2

242
Q

what unique feature is present on teh body of the second rib

A

tuberosity for the serratus anterior

243
Q

which ribs are classified as typical ribs, true ribs, costa verae, and vertebrosternal ribs in the typical adult skeleton

A

ribs 3-7

244
Q

which ribs are classified as atypical ribs, true ribs, costa verae, and vertebrosternal ribs in the typical adult skeleton

A

ribs 1-2

245
Q

which ribs are classified as typical ribs, false ribs, costa spuriae, and vertebrochodral ribs in the typical adult skeleton

A

ribs 8 & 9

246
Q

which ribs are classified as atypical ribs, false ribs, costa spuriae, and vertebrochondral ribs in the typical adult skeleton

A

rib 10

247
Q

which ribs are classified as a typical ribs, false ribs, costa spuriae, and vertebral ribs in the typical adult skeleton

A

ribs 11 and 12

248
Q

what is the classification of the first sternocostal or sternochondral joint

A

cartilaginous (amphiarthorsis) synchodrosis

249
Q

what is the classification of the 2nd-7th sternocostal or sternochondral joint

A

synovial plane (diarthorsis arthordia)

250
Q

which of teh sternocostal or sternochondral ligaments is unique to the second sternocostal or sternochondral joints

A

intra-articular ligament

251
Q

what is the classification of the 6th-9th interchondral joints

A

synovial plane (diarthorsis arthrodia)

252
Q

what is the classification of the 5th-6th or 9th-10th interchondral joint

A

fibrous (amphiarthrosis) syndesmosis

253
Q

which costal cartilages fail to form a joint at their sternal end

A

11th and 12th costal cartilages

254
Q

how many primary centers of ossification appear in the manubrium

A

1-3 centers have been identified

255
Q

how many primary centers of ossification appear in the corpus sterni

A

typically 6

256
Q

in what part of the sternum will a secondary center of ossification appear

A

xiphoid process

257
Q

in what part of the rib will primary centers of ossification appear

A

the body

258
Q

in what parts of the rib will secondary centers of ossification appear

A

the head
articular surface of the tubercle
non articular surface of the tubercle

259
Q

which ribs will demonstrate secondary centers of ossification

A

ribs 1-10

260
Q

which ribs lack secondary centers of ossification

A

ribs 11-12

261
Q

which ribs demonstrate three secondary centers of ossification

A

ribs 2-9

262
Q

which ribs have only two secondary centers of ossification

A

ribs 1 and 10

263
Q

what are the four subclassifications of synarthrosis joints based on latin grouping

A

suture
comphosis
schindylesis
syndesmosis

264
Q

what were the five types of suture based on latin grouping

A
serrate
denticulate
limbous
squamous
harmonia
265
Q

what are the characteristics of sutura vera (true sutures)

A

sutures demonstrating interlocking of adjacent bone surfaces; typically formed by intermembranous ossification

266
Q

what are the characteristics of sutura notha (false sutures)

A

sutures lacking interlockign of adjacent bone surfaces; typically formed by endochondral ossification

267
Q

which sutures demonstrate non-interlock, but will overlap at their edges

A

squamous sutures

268
Q

what were the classifications of suture notha based on latin groupings

A

squamous and harmonia

269
Q

what are the typical examples of the plane suture or harmonia suture

A

cruciate suture made up of the:

intermaxially, interpalatine and palato-maxillary suture

270
Q

what are the examples of the schindylesis type of suture

A

sphenioid, ethmoid, vomer articulation

palatine, maxilla, vomer articulation

271
Q

what are the examples of teh gomphosis joint

A

maxilla - root of tooth

mandible - root of tooth

272
Q

what are the five views of skull called

A
norma verticalis
norma frontalis
norma occipitalis
norma lateralis
norma basalis
273
Q

what is the diamond shaped remnant of developing membrane bone at the intersection of the frontal bone with boht paretal bones

A

anterior fontanelle

274
Q

what is the diamond shaped remnant of developing membrane bone at the intersection of the occipital bone with both parietal bones

A

posterior fontanelle

275
Q

what is the glabella

A

elevation of bone over frontal sinus between orbits

276
Q

what is the name given to the outline of the nasal cavity at the front of the skull

A

piriform aperture

277
Q

what is the name given to the alveolar jugum at the canine tooth in the maxialla

A

canine eminence

278
Q

what forms a bullet-like chin

A

large mental protuberance

279
Q

what forms an indented chin

A

well developed bilateral mental tubercles and a slight mental protuberance

280
Q

what bones form the pterion

A

patietal
sphenoid
temporal
frontal

281
Q

what points on the skull are used to measure the skull size

A

nasion
vertex
inion
gnathion

282
Q

what points on the skull are used to measure cranial vault capacity

A

nasion
vertex
inion

283
Q

the olfactory nerve exits the cranial vault via what opening

A

cribriform plate of ethmoid bone

284
Q

what are the contents of the optic canal

A

optic nerve and ophthalmic artery

285
Q

what are the contents of the superior orbital fissure

A
ophthalmic veins
oculomotor nerve
trochlear nerve
ophthalmic division of the trigeminal nerve
abducent nerve
286
Q

what are the contents of the foramen rotundum

A

maxillary division of the trigeminal nerve (cranial nerve Vb)

287
Q

what are the contents of the foramen ovale

A

mandibular division of the trigeminal nerve (Vc)

lesser petrosal branch of glossopharyngeal nerve

288
Q

what are the contents of the foramen spinosum

A

nervus spinosus from the mandibular division of the trigeminal nerve and middle meningeal artery

289
Q

what forms the roof of the posterior cranial fossa

A

tentorium cerebelli

290
Q

what part of the central nerve system occupies the posterior cranial fossa

A

cerrebellum
pons
medulla oblongata

291
Q

what part of the cerebrum occupies the posterior cranial fossa

A

none; tentorium cerebelli separates the cerebrum into a space above the posterior cranial fossa

292
Q

what are the contents of the internal acoustic meatus

A

cranial nerves VII and VIII
nervus intermedius/nerve of wrisberg/sensory root of VII
motor root of VII
vestibular and cochlear roots of VIII
internal auditory/internal labyrinthine artery and vein

293
Q

what are the contents of the jugular foramen

A

jugular bulb
inferiro petrosal sinus
tympanic body/tympanic glomus or jugular body/jugular glomus
cranial nerves IX, X, XI

294
Q

what can the five layers of scalp spell

A
Skin
Connective tissue
Aponeurosis
Loose connective tissue
Periosteum
295
Q

what are the principal sources of blood to the scalp

A

internal carotid and external carotid artery branches

296
Q

which divisions of the trigeminal nerve receive sensory info from scalp

A

all 3 divisions:
ophthalmic nerve
maxillary nerve
mandibular nerve

297
Q

which ventral rami branhces supply the scalp

A

greater auricular and lesser occipital nerves

298
Q

which dorsal ramus nerve branch supplies scalp

A

greater occipital nerve - C2, C3 communicating ramus

299
Q

which muscles lack any attachment to bone

A

orbicularis oris
procerus
risorius

300
Q

what type of motor fivers to skeletal muscle are given off by the facial nerve

A

branchial efferent (BE)

301
Q

most of the seventh cranial nerve will exit the skull via what opening

A

stylomastoid foramen

302
Q

the optic canal is located along which wall of the orbit

A

superior wall of orbit

303
Q

what are the contents of the optic canal

A

optic nerve & ophthalmic arter

304
Q

what are the openings located along the medial wall of the orbit

A

anterior ethmoid & posterior ethmoid formina

305
Q

what is the name given to the medial wall of the orbit

A

lamina papyracea

306
Q

the superior orbital fissure is located along which wall of the orbit

A

lateral wall of the orbit

307
Q

what are the contents of the superior orbital fissure

A
oculomotor nerve
trochlear nerve
abducent nerve
ophthalmic division of trigeminal nerve
ophthalmic veins
308
Q

what openings are located along inferior wall of orbit

A

inferior orbital fissure

309
Q

what is contained in inferior orbital fissure

A

maxillary division of trigeminal nerve

310
Q

what are the names given to teh modified sebaceous gland in tarsus of eyelid

A

tarsal or meibomian gland

311
Q

what specific pathways are identified with visceral efferent (VE) innervation

A

sympathetic and parasympathetic motor pathways

312
Q

how many neurons are involved in the visceral efferent pathways from CNS to target cell

A

2 motor neurons

313
Q

what is the location for the second neuron in the visceral efferent (VE) pathway

A

typically a ganglion

314
Q

which cranial nerves are involved in visceral efferent parasympathetic pathway to the lacrimal gland

A

facial and trigeminal (maxillary and ophthalmic divisions/branches)

315
Q

what is the origin for the sympathetic pathway to the lacrimal gland

A

lateral horn/intermediolateral cell column T1, T2

316
Q

what is the target of preganglionic sympathetic visceral efferent fiber in the pathway to the lacrimal gland

A

VE fiber ascends to the superior cervical ganglion to synapse

317
Q

sympathetic stimulation of the lacrimal gland will result in what events

A

vasoconstriction of blood vessels
limited availability of water to secretory units
more viscous or thicker product formed in glandular lumen

318
Q

parasympathetic stimulation of targets in the lacrimal gland will result in what events

A

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

319
Q

what are the names of the layers of the eyeball

A

fibrous tunic
uveal tract
retina

320
Q

what are the parts of the fibrous tunic

A

cornea

sclera

321
Q

what are the parts of the uveal tract of the eyeball

A

iris
ciliary body
choroid
pupil

322
Q

what muscles are present in iris

A

sphincter pupillae

dilator pupillae

323
Q

what is the innervation of the sphincter pupillae

A

oculomotor nerve

parasympathetic pathway

324
Q

what is the innervation of ciliaris muscle

A

oculomotor nerve

parasympathetic pathway

325
Q

what is the function of the rod cell

A

provide vision in dim light conditions

326
Q

what is the function of the cone cell

A

provide vision in bright light conditions and mediate color vision

327
Q

what ist he most numerous photoreceptor cell

A

rod cell

328
Q

what forms the optic nerve

A

axons of ganglion cells

329
Q

what occurs at the optic chiasma

A

part of the optic nerve decussates

330
Q

what is the location of the anterior chamber of the eyball

A

between cornea and iris

331
Q

what is the location of posterior chamber of eyeball

A

between iris and lens

332
Q

what is contained in anterior chamber

A

aqueous humor

333
Q

what is contained in the posterior chamber of eyeball

A

aqueous humor

334
Q

what is the name given to the chamber behind the lens

A

vitreous chamber

335
Q

what fills the vitreous chamber

A

vitreous body

336
Q

what are the common characteristics in origin and insertion of all rectus extraocular muscles

A

all originate from a common annular tendon in orbit

all insert into sclera in front of coronal equator of eyeball

337
Q

what is the common characteristic regarding insertion of both oblique extraocular muscles

A

both insert onto sclera on lateral margin of eyeball behind coronal equator

338
Q

what is the common characteristic concerning the insertion of the superior and inferior rectus extra ocular muscles

A

insert onto sclera of eyeball in front of coronal equator

displaced slightly mediall

339
Q

what is the embryonic origin of extraocular muscles of extrinsic muscles of eyeball

A

skeletal muscle is derived from somites hence somatic efferent

340
Q

which nerves will innervate specific extrinsic/extraocular muscles

A

oculomotor- sup rec, med rec, inf rec, inf obl
trochlear- sup obl
abducens- lat rec

341
Q

which of the cranial nuclei of termination contain primary afferent neurons

A

mesencephalic nucleus of trigeminal nerve

342
Q

what is the location of synapse for preganglionic parasympathetic efferent fibers of the third cranial nerve (oculomotor)

A

ciliary ganglion

343
Q

what is unique about the vascular supply of the retina

A

single vessel supplies it

344
Q

what vessel supplies the inner tunic of the eyeball

A

central artery of the retina

345
Q

what is the name given to the ‘goats beard’ of the auricle

A

tragus

346
Q

what is the name of the palpable posterior projection of the eminentia concha of the auricle

A

ponticulus

347
Q

what cranial nerve will innervate the muscles of the auricl

A

facial nerve

348
Q

sensory innervation of the auricle is derived from which nerves

A

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)

349
Q

the lateral third of the external acoustic meatis is protected by __________________.

A

cartilage

350
Q

the medial part of the external acoustic meatus is protected by ______________________.

A

the temporal bone

351
Q

skin lining the external acoustic meatus contains what modified sebaceous glands

A

ceruminous glands

352
Q

what is cerumen

A

product of ceruminous glands forming the bulk of ear wax

353
Q

what is the superior boundary of the parotid region

A

zygomatic arch

temporomandibular joint

354
Q

what vein is formed within the parotid gland

A

retromandibular gland

355
Q

within the parotid gland what does the facial nerve form

A

facial nerve plexus

356
Q

what are the branches of the facial nerve plexus

A
temporal
zygomatic
buccal
marginal mandibular
cervical branches
357
Q

what branch of the facial nerve penetrates the parotid gland, but is not given off within it

A

the chorda tympani nerve