Exam III Flashcards

1
Q

Blood supply to individual vertebra is typically _______.

A

Segmental

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2
Q

Once inside the intervertebral foramen, the vertebral artery splits into these three branches:

A
Anterior Branch (Prelaminar)
Posterior Branch (Postcentral)
Neural branch (neurospinal)
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3
Q

What does the anterior branch supply blood to?

A

The posterior aspect of the vertebral bodies, and anterior aspect of the spinal cord and anterior ligaments inside the spinal canal

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4
Q

What does the posterior branch supply blood to?

A

The posterior arch, posterior part of the spinal cord and ligaments in the posterior spinal canal

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5
Q

What does the neural branch supply blood to?

A

The lateral aspects of the spinal cord, spinal nerve and nerve roots

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6
Q

The 3 main arteries that go from the head/neck downward to supply the main portion of the spinal cord:

A

2 Posterior spinal arteries

1 Anterior spinal artery

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7
Q

The 2 posterior arteries and 1 anterior spinal artery come off of the _______ arteries just before they unite to form the _______ artery

A

vertebral

basilar

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8
Q

The anterior spinal artery comes from both _____ arteries, unites in front of the _____ ____, and runs caudally through the ______ _____ ____ of the cord.

A

vertebral
spinal cord
ventral median fissure

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9
Q

A branch off the anterior spinal artery, found between T-9 and T-12

A

Great Radicular Artery of Adamkiewicz

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10
Q

What does the great radicular artery of adamkiewicz supply blood to?

A

The inferior thoracic vertebrae, superior lumbar vertebrae, lumbarsacral enlargement of the spinal cord

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11
Q

Anterior spinal artery also supplies blood to:

A

The lumbar segmental arteries, lateral sacral artery, and blood of the sacrum and coccyx

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12
Q

The posterior spinal artery arises from the ______ ____, adjacent to the ______ ______. It supplies the ______ and ______ posterior columns of the spinal cord.

A

vertebral artery
medulla oblongata
grey
white

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13
Q

The two major venous plexus (group of veins) that leave the vertebra:

A

Internal venous plexus

External venous plexus

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14
Q

Where is the internal venous plexus located?

A

The inside of the spinal canal

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15
Q

Where is the external venous plexus located?

A

Outside the vertebral column

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16
Q

The internal venous plexua is also called the (2 different names)

A

Epidural venous plexus or the Batson’s Plexus

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17
Q

Both the internal and external venous plexus have an _____ and a _______ part

A

anterior

posterior

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18
Q

Vein inside the vertebral body. Part of the anterior internal venous plexus

A

Basivertebral Vein

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19
Q

The opening in the basivertebral vein inside the vertebral body is called:

A

Hanh’s venous Cleft

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20
Q

3 Classes/types of joints within the spinal column

A

Fibrous
Cartilaginous
Synovial

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21
Q

Type of joint where 2 bones are connected by connective tissue of hyaline cartilage, with a lack of motion

A

Fibrous joints

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22
Q

Type of joint formed when 2 bony surfaces are united by cartilage or a disc. Many SLIGHT motions

A

Cartilaginous joint

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23
Q

Type of joint with an articular surface covered with articular cartilage, and connected by ligaments lined by a synovial membrane.

A

Synovial

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24
Q

What type of joint is most common in the spine and body?

A

Synovial joints

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25
Q

Subclassification of the fibrous joints in the spine is called the ________ ______. Formed when 2 bones are united by an ___________ _______.

A

Sydesmodial joint

Interosseous ligaments

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26
Q

2 subclassifications of cartilaginous joints

A

Synchondrosis

Symphysis

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27
Q

Subclassification of cartilaginous joints. A temporary joint where the cartilage later changes into bone itself (Ex- epiphisial plates)

A

Synchondrosis

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28
Q

Subclassification of cartilaginous joints: 1 bony surfaces connected by a disc or fibrocartilage. (Ex- Pubic symphasis)

A

Symphysis

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29
Q

3 subclassifications of synovial joints

A

Trochoid/Pivot Joints
Condyloid Joints
Arthrodial/Gliding/Articulatio Plana joints

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30
Q

Subclassification synovial joint. Allows for gliding motion. (Ex- facet joints)

A

Arthrodial/Gliding/articulatio plana joints

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31
Q

Subclassification of synovial joint. Allows for rotation. Uniaxial motion. (Ex- C1-C2)

A

Trochoid/Pivot joints

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32
Q

Subclassification of synovial joints. Allows for flextion and extension. All motions except for axial rotation (Ex- C1-Occiput)

A

Condyloid joints

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33
Q

Common articulations between C-2 and S-1, between the vertebral bodies

A

Cartilaginous symphysis

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34
Q

Common articulations between C-2 and S-1, between zagapophyseal joints

A

Synovial arthrodial, gliding, articulation plan

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35
Q

Atlanto-occipital articulations

A

Synovial——-condyloid

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36
Q

Articulations of atlanto-axial

A

Synovial——arthrodial

Synovial——trochoid

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37
Q

Intersacral articulations

A

Cartilaginous—synchondrosis

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38
Q

Sacro-coccygeal articulations

A

Cartilaginous symphysis (fibrocartilage)

Fibrous—-syndesmodial

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39
Q

Intercoccygeal articulations

A

Cartilaginous—-synchondrosis

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40
Q

Common cardinal ligaments of the spine have ____ blood supply, and _____ stretch

A

Some

Prevent

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41
Q

Group 1 of the common cardinal ligaments attach to:

A

The vertebral bodies

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42
Q

Group 2 of the common cardinal ligaments attach to:

A

The spinous processes

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43
Q

Group 3 of the common cardinal ligaments attach to:

A

Lamina, articulations processes, and transverse processes

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44
Q

Common/cardinal ligaments changes name at ____ to _______ ______ _______

A

C2

Anterior longitudinal ligament (ALL)

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45
Q

Anterior longitudinal ligament covers the _____ surface of vertebral _____ and ______ from ____ to _____. The attachment is _____(weak/strong)

A

Anterior

Bodies and
Disc

C-2 to
Sacrum

Strong

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46
Q

3 layers of anterior longitudinal ligament:

A

Deep, middle, and superficial

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47
Q

Where is the anterior Longitudinal ligament most narrow? Widest?

A

Most narrow in cervical, widest in lumbar

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48
Q

What this the function of the anterior longitudinal ligament?

A

To limit extension of the spine.

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49
Q

The anterior longitudinal ligament attaches to each vertebral body _____ and ______ at the levels of the ____ ____

A

Superiorly and inferiorly

End plates

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50
Q

What is the anterior longitudinal ligament continuous with?

A

Anterior Atlanto-occipital membrane

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51
Q

Ligament working opposite to anterior longitudinal ligament

A

Posterior longitudinal ligament (PLL)

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52
Q

Posterior longitudinal ligament is the most ______ (anterior/posterior) ligament in the spinal canal.

A

Anterior

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53
Q

Where is the posterior longitudinal ligament widest? Most narrow?

A

Widest in cervical and over discs,

Most narrow in lumbar and over vertebral bodies

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54
Q

Posterior longitudinal ligament is ______ attached to the center of vertebral bodies. This is due to the ______ ____.

A

Loosely

Basivertebral vein

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55
Q

What is the function of the posterior longitudinal ligament?

A

Limits flexion of the vertebral bodies.

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56
Q

The anterior and posterior longitudinal ligaments are also called the _________ ligaments

A

Intercentral ligaments

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57
Q

Between ALL and PLL, which ligament is weaker?

A

PLL

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58
Q

What is the PLL continuous to?

A

Tectoral membrane (inferior)

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59
Q

Why are the intervertebral discs called ligaments?

A

They separate vertebral bodies and hold the bodies together.

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60
Q

How many total discs?

A

23- none between occiput and C-1 or C-1-2

61
Q

What ligament is continuous from the tip of the spinous process of C-7 though S-1? Has 3 layers

A

Supraspinous ligament

62
Q

What ligament is formed by the superior extension of the supraspinous and interspinous ligaments? Attaches to SP of all cervical vertebrae. Broad, triangular in shape

A

Ligamentum nuchae

63
Q

The supraspinous ligament is a very _______ (weak/strong) band connecting the tips of contiguous spinous processes.

A

Weak

64
Q

Where does the ligamentum nuchae run?

A

between occiput and C7 SP

65
Q

Combination of the supraspinous and interspinous ligaments come together in the _______ spine.

A

Cervical

66
Q

A series of ligaments that run between the SP of each motor unit. From C2/3 to L5/S1. Poorly developed in cervical spine

A

Interspinous Ligament (ISL)

67
Q

Where does the ISL attach to? Anteriorly and posteriorly

A

Anteriorly to ligamentum flavum

Posterior to supraspinous ligament

68
Q

The ISL connects:

A

Spinous processes of adjacent vertebrae

69
Q

In the cervical spine, the ISL becomes part of the _______ _____.

A

Ligamentum nuchae

70
Q

Where does the supraspinous ligament run?

A

Between the tips of the adjacent spines

71
Q

Which ligament runs between adjacent TVP?

A

Intertransverse

72
Q

Which ligament connects the lamina of adjacent vertebrae? Extends to the facet joint capsule.

A

Ligamentum Flavum

73
Q

Which ligament covers the posterior lateral part of the Z-Joints?

A

Articular capsule/capsular ligament

74
Q

What are 3 basic parts of the articular capsule?

A

Basic, middle and inner

75
Q

Which layer of the articular capsule has synovial fluid with Haluronic acid?

A

Inner layer

76
Q

Which layer of the articular capsule is rich in nerve supply, low in blood supply?

A

Outer layer

77
Q

Which layer of the articular capsule is highly vascularized with no nerves?

A

Middle layer

78
Q

The articular capsule is stressed the most in _______.

A

Rotation

79
Q

What type of joints are the Z joints?

A

Gliding

80
Q

The ligamentum flava forms the ______ boundary of the IVF. Is highly ______. Helps restrict _______. Is thicker in the _____ region

A

Posterior

Elastic

Hyper flexion

Lumbar

81
Q

What is the ligamentum flavum continuous with?

A

Posterior Atlanta-occipital membrane

82
Q

The ligamentum flavum supports the anterior aspect of the _______ _____.

A

Z- joint

83
Q

When is the intertransverse ligament stressed the most?

A

In contralateral bending or lateral flexion .

84
Q

Narrowing of disc space results in:

A

Stress on facet joint

85
Q

6 Ligaments of the Atlanto-occipital articulation

A

2 articular capsules

1 anterior atlant-occipital ligament

1 posterior Atlanto-occipital ligament

2 Lateral Atlano-occipital ligaments

86
Q

3 synovial joints of the Atlanto-axial articulation

A

2 lateral Atlanto-axial joints

1 Median Atlanto-axial joint

87
Q

How many total ligaments in the Atlanto-axial articulation?

A

7

88
Q

50% of rotation comes from:

A

Atlantoaxial joint

89
Q

7 ligaments of atlantoaxial articulations

TEST Q**

A

2 articular capsules

2 accessory ligaments

1 anterior atlantoaxial ligament

1 posterior atlantoaxial ligament

1 transverse ligament of the atlas

90
Q

6 ligaments of the occipital axial complex

A

1 membrane tectoria

2 alar ligaments

1 apical ligament

1 crucial ligament

1 ligamentum nuchae

91
Q

Superior extension of posterior longitudinal ligament

A

Membrana tectoria, AKA Tectorial Membrane, occipito-axial ligament

92
Q

Where does the membrana tectoria attach?

A

from the posterior aspect of body of C-2 to anterior rim of foramen magnum of occiput

93
Q

Function of the membrana tectoria

A

Holds other ligaments in. Limits flexion and extension of the atlas on the occiput .

94
Q

Where are the alar ligaments (AKA Check Ligaments, or Odontoid ligaments) located?

A

Extend from posterior lateral aspect of the odontoid process to the medial surface of occipital condyles.

95
Q

What is the function of the Alar Ligaments?

A

Limits or checks contralateral axial roration and flexion whiplash)

96
Q

Damage of the Alar Ligaments will allow for _____ rotation and _____ flexion of __________ ______

A

increased
lateral
atlanto-occipital articulation

97
Q

What type of injuries are primarily responsible for chronic whiplash symptoms, especially post-traumatic headaches

A

Injured Alar Ligaments.

98
Q

Upper cervical ligaments:

A

Occipitoaxial ligament
Apical ligament
Alar ligaments

99
Q

1 inch long V shaped ligament. Extends from anterior wall of foramen magnum, where it is the widest, to the superior terminal aspect of dens of C-2. Remnant of the embryonic notochord

A

Apical ligament

100
Q

Apical ligament’s tit

TEST QUESTION

A

20 degrees anterior

101
Q

Ligament attached to the transverse ligament. Function is to hold transverse ligament in place

A

Cruciate ligaments

102
Q

2 parts of the cruciate ligament

A

1- Superior crus

2- Inferior crus

103
Q

Crus anterior tip of foramen magnum

A

Superior crus

104
Q

Crus posterior aspect of C2 body

A

Inferior crus

105
Q

Ligaments attached to the lumbo-sacral articulation

A

Lumbosacral ligament

Iliolumbar ligament

106
Q

Lumbosacral articulations are the same as the thoracic and lumbar ligaments, except there is no _______ _____

A

Intertransverse ligament

107
Q

Ligament from TVP L-5 to sacral Alae and promontory

A

Lumbosacral ligament

108
Q

Ligament from TVP L5 to crest of ilium anterior to sacro-iliac joint.

A

Iliolumbar ligament

109
Q

6 ligaments of intersacral articulations

A

4 Fibrocartilages
1 Anterior intersacral ligament
1 Posterior Intersacral Ligament

110
Q

Ligament present between segments until segments fuse and it ossifies

A

Fibrocartilage ligaments

111
Q

Ligament analogous to ALL. Present till segments fuse then ossify

A

Anterior intersacral ligament

112
Q

Ligament analogous to PLL. Present till segments fuse then ossify

A

Posterior intersacral ligament

113
Q

8 Ligaments of the sacro-coccygeal articulation

A

1- Intervertebral fibrocartilage
1- Anterior sacrococcygeal ligament
1- Deep posterior sacrococcygeal ligament
1- Superficial posterior sacrococcygeal ligament
2- Lateral sacrococcygeal ligaments
2- Intercornual ligaments

114
Q

Ligament that is a thin fibrous extension of ALL

A

Anterior sacrococcygeal ligament

115
Q

Ligament extension of PLL. From sacral hiatus to 1st coccygeal

A

Deep posterior sacrococcygeal ligament

116
Q

Ligament on top of sacral hiatus. Forms roof over top. Longer than deep posterior sacococcygeal ligament

A

Superficial posterior sacrococcygeal ligament

117
Q

Ligaments from inferior angle of sacrum to coccygeal alae. Analogous to intertransverse

A

Lateral Sacrococcygeal ligaments

118
Q

Ligaments from sacral coruna to coccygeal cornua. Analogous to articular capsules

A

Intercornual ligaments

119
Q

5 intercoccygeal ligaments

A

3 intersegmental fibrocartilages
1 anterior coccygeal ligament
1 posterior coccygeal ligament

120
Q

4 cartilaginous synchondrodial joints.

A

Intersegmental fibrocartilages

121
Q

Fibrocartilage present in coccyx ossify around age:

A

25-30

122
Q

Fibrous extension of ALL, then ossifies

A

Anterior coccygeal ligament

123
Q

Fibrous extension of PLL then ossifies

A

Posterior coccygeal ligament.

124
Q

7 Ligaments of the sacro-iliac joint

A
1 articular capsule
1 anterior sacroiliac ligament
1 interosseous sacroiliac ligament
1 short posterior sacroiliac ligament
1 long posterior sacroiliac ligament
1 sacrotuberous ligament
1 sacrospinous ligament
125
Q

Ligament from the anterior surface of sacrum (S2,3,4) to spine of ischium:

A

Sacrospinous ligament

126
Q

What is whiplash?

A

Both a torn ligament (sprain) and torn muscle (strain)

127
Q

Women are 40% _____ likely to be injured from a car crash, likely due to their _____ ____.

A

More

Smaller size

128
Q

Men’s injuries are likely to be _____ severe

A

More

129
Q

Tolerance to impact DECREASES over the age of:

A

40

130
Q

The most common source of chronic neck pain after whiplash is the:

A

Cervical facet joint

131
Q

How soon can symptoms of whiplash occur?

A

Immediately after the accident, within 12-24 hours, a few days, a few weeks, or even a few months

132
Q

Whiplash victims are 10x more likely to develop ______

A

Spondylosis (osteoarthritis)

133
Q

Signs and symptoms associated with slower recovery rate after whiplash

A

Neck pain upon palpation

Pain or numbness radiating from neck to arms

Headaches

134
Q

Symptoms of whiplash, not including pain

A

Visual disturbances, dizziness, weakness, fatigue, poor concentration, difficulty sleeping, poor memory and depression

135
Q

Type of pain: Deep, burning, gnawing, strapping or dull pain

A

Nerve pain

136
Q

Type of pain: cramping or pulling pain, dulll achy, superficial

A

Muscle pain

137
Q

Type of pain: sharp, deep boring

A

Fracture (bone) joint pain

138
Q

Type of pain: throbbing

A

Vascular (pain when heart beats)

139
Q

Type of pain: Stabbing, lighting like or shooting pain

A

Nerve root pain

140
Q

4 phases of healing

A

1- Acute inflammatory phase
2- Tissue repair phase
3- rehabilitative/remodeling phase
4- maintenance/wellness phase

141
Q

How long does acute inflammatory phase last?

A

48-72 hours

142
Q

How long does the tissue repair phase last?

A

Lasts from 48 hours -12 weeks

143
Q

How long does rehabilitative/remodeeling phase last?

A

Up to 1 year

144
Q

How long does maintenance/wellness phase last?

A

A lifetime

145
Q

Signs/symptoms of acute phase

A

Pain, swelling, head, redness, loss of function

146
Q

There are ___ discs. __ cervical , ___ thoracic, ___ lumbar

A

23,
6 cervical
12 thoracic
5 lumber

147
Q

IVD (intervertebral disc) is attached to:

A
Vertebral bodies
ALL
PLL
Intra-articular
Ligaments
Ribs 2-9
148
Q

Function of the disc is to maintain the ____ ___ between vertebrae, aids in ______ of the spine, and acts to properly ______ ______ _____.

A

Changeable space

Flexibility

Assimilate compressive loads