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0

What will influence spinal kinematics?

Geometry of articular facets, mechanical properties of connective tissue, mechanical properties of muscle

1

What should be carefully considered when applying research results to a population?

The condition of the subject material (fresh cadaver, fixed cadaver, living subject)

The age of the population studied

The method of measurment (X-ray, goniometer, MRI, CT, etc)

2

The greatest range of flexion-extension among the typical cervical vertebrae occurs at which vertebral couple?

Typically C5/C6

3

What motions are coupled in the cervical spine?

Lateral bending and axial rotation

4

Ranges of coupled motion among the typical cervical vertebrae will be similar for what cervical vertebral couples?

The C2/C3, C3/C4, C4/C5 vertebral couples

5

Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?

The C5/C6 vertebral couple

6

What is the usual condition for the Caucasian typical cervical spinous process?

They are bifid

7

What is the usual condition for the African-American typical cervical spinous process?

They are non-bifid

8

What is the osseous modification at the distal end of the spinous process?

The spinous tubercle

9

What muscles may attach the typical cervical spinous process?

The spinalis cervicis, semispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

10

What ligaments will attach to the typical cervical spinous process?

The interspinous ligament and ligamentum nuchae

11

What will form the unique anterior boundary of a typical cervical intervertebral foramen?

The uncinate process of the segment below and lateral groove of the segment above forms the joint of Luschka

12

What forms the unique anterior boundary of the intervertebral foramen for the C4 spinal nerve?

The lateral groove of C3 and the uncinate process of C4 forming the joint of Luschka

13

What muscle attaches to the anterior arch of C1?

Longus colli

14

What ligaments will attach to the anterior arch of C1?

The anterior longitudinal, anterior atlanto-occibital and anterior atlanto-axial ligaments

15

What is observed on the back of the anterior arch of C1?

The fovea dentis

16

WHat joint classificationis are observed on the anterior arch of C1?

Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint

17

What is the morphology of the superior articular facet of C1?

They are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces

18

What is the orientation of the superior articular facet of C1?

Backward, upward, medial (BUM)

19

What is the joint classification of the atlanto-occipital zygapophysis?

Synovial (diarthrosis) ellipsoidal joint

20

What are the morphological characteristics of the inferior articular facet of C1?

Asymmetrical, slightly concave or flattened

21

What is the orientation of the inferior articlar facet of C1?

Backward, medial, downward (BMD)

22

What is the joint classification of the atlanto-axial zygapophysis?

Synovial (diarthrosis) arthrodia joint

23

What muscles attach to the lateral mass of C1?

Levator scapula, splenius cervicis and rectus capitis anterior

24

What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?

Males: about fifty milimeters; Females: about thirty-seven millimeters

25

What attaches to the posterior tubercle of the posterior arch of C1?

Rects capitis posterior minor muscle and ligamentum nuchae

26

What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital ligament was observed?

About age 7 years old

27

What other name may be used to identify a ponticulus posticus?

Kimmerle's anomaly

28

What names are given to the opening formed y the ponticulus posticus?

Arcuate foramen or retroarticular canal

29

What is the gender bias now associated with ponticulus posticus?

Female

30

What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?

The incidence of a complete ponticulus posticus is about fifteen percent; the incidence of an incomplete ponticulus posticus is as high as forty-one percent.

31

What muscles attach to the transverse process of C1?

Rectus capitis anterior, rectus capitis lateralis, middle scalene, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles.

32

What suboccipital muscles are known to have fascial projections attaching to the spinal dura?

Rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior

33

What are the connections between suboccipital muscles and the spinal dura called?

Myodural bridges

34

What opening is identified when a complete lateral bridge is formed?

The retrotransverse foramen

35

What are the possible contents of the retrotransverse foramen?

The vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous sinuses of the neck

36

What is the gender variation for measurements of the transverse diameter of C1?

Males: 78 millimeters and Females: 72 millimeters

37

What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?

A little over 30 millimeters for both males and females

38

What joint classifications are observed at C1?

Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) ellipsoidal joint, synovial (diarthrosis) trochoid joint and synovial (diarthrosis) arthroida joint.

39

How many synovial surfaces are observed at C1?

Five

40

What names are given to C2?

Axis or Epistropheus

41

What unique vertebral body modificatiion is characteristic of C2?

The Dens or Odontoid process

42

What joint surfaces are present on the odontoid process of C2?

Facet for fovea dentis, groove for transverse atlantal ligament, attachment site for the alar ligaments, attachment site for the apical-dental ligament

43

How many joint surfaces are present at the odontoid process of C2?

Five

44

Which joint classifications are represented at the odontoid process of C2?

Fibrous (amphiarthrosis) syndesmosis joint and synovial (diarthrosis) trochoid joint

45

What is the name given to the odontoid process when the facet for the fovea dentis lies above the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed posterior?

Lordotic Dens

46

What is the name given to the odontoid process when the facet for the fovea dentis lies below the groove for the transverse atlantal ligament and the attachment sites for the apical-dental and alar ligaments appear to be directed anterior?

Kyphotic dens

47

How many joints are formed by the inferior part of the vertebral body of C2?

Five

48

What joint classifications are present at the inferior part of the vertebral body of C2?

Fibrous (amphiarthrosis) syndesmosis joint, modified synovial (diarthrosis) sellar joint and cartilaginous (amphiarthrosis) symphysis joint.

49

How many joint surfaces are present at the vertebral body of C2?

Ten

50

What joint classifications are present at the vertebral body of C2?

Fibrous (amphiarthrosis) syndesmosis joint, synovial (diarthrosis) trochoid joint, modified synovial (diarthrosis) sellar and cartilaginous (amphiarthrosis) symphysis joint

51

What ligaments will attach posteriorly, to the inferior epiphyseal rim of C2?

Membrana tectoria and posterior longitudinal ligament

52

What ligament will represent the cranial continuation of the posterior longitudinal ligament?

Membrana tectoria

53

What ligament forms the anterior boundary for the spinal canal above C2?

Membrana tectoria

54

What ligament forms the anterior boundary for the spinal canal below C2?

Posterior longitudinal ligament

55

What lies on the upper surface of the pedicle of C2?

The superior articular process

56

What is the location of the superior vertebral notch of C2?

On the lamina-pedicle junction

57

What attaches to the lamina of C2?

Obliquus capitis inferior muscle, posterior atlanto-axial ligament, ligamentum flavum.

58

What is the appearance of the superior articular facets of C2?

They are asymmetrical and slightly convex

59

What is the facet orientation of the superior articular facet of C2?

Backward, Upward, and Lateral (BUL)

60

What is the orientation of the inferior articular facets of C2?

Forward, lateral and down (FoLD)

61

What is the classification of the zygapophyseal joints of C2?

Synovial (diarthrosis) arthrodia joint

62

What muscle attaches to the articular process of C2?

Lognissimus cervicis

63

What osseous parts of the typical cervical transverse process are absent at C2?

Anterior tubercle and costotransverse bar

64

What will be observed inthe transverse foramen at C2?

Vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

65

What is the gender variation for the transverse diameter of C2?

Males: fifty-seven millimeters and Females: about fifty millimeters

66

What muscles attach to the transverse process at C2?

Levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii

67

What is the characteristic appearance of the C2 spinous process in humans?

Bifid

68

What muscles attach to the spinous process of C2?

Rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators and interspinalis muscles

69

What names may be given to C7?

Vertebra prominens and vertebral prominence

70

What is the name given to the topographical elevation observed at the base of the neck?

Vertebral prominence

71

What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?

C6 is more common in females and T1 is more common in males

72

How many joint surfaces are present at the vertebral body of C7?

Eight

73

What joint classifications are observed at the vertebral body of C7?

Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint, and modified synovial (diarthrosis) sellar joint.

74

How many synovial joint surfaces are observed at the vertebral body of C7?

Two

75

What are the osseous parts of the tranverse process of C7?

Costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process

76

What features are typically present in the transverse foramen of C7?

Vertebral venous plexus, postganglionic sympathetic motor fibers

77

What muscles attach to the transverse process of C7?

Middle scalene, iliocostalis thoracics, longissimus cervicis, semispinalis capitis, rotators, intertransversarii and levator costarum brevis

78

What is the orientation of the superior articular facet of C7?

Backward, Upward, Medial (BUM)

79

What is the orientation of the inferior articular facet of C7?

Forward, medial, downward (ForMeD)

80

What muscles will attach to the articular process of C7?

Longissimus cervicis, longissimus capitis, semispinalis cervicis and multifidis

81

What are the features of the spinous process of C7?

Long, horizontal, nonbifid

82

What muscles attach to the spinous process of C7?

Trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalisis thoracis, multifidis, rotators, and interspinalis

83

WHat ligaments attach to the spinous process of C7?

Ligamentum nuchae and interspinous ligaments

84

The vertebral artery on which side is typically larger?

Left vertebral artery

85

WHat is the gender bias regarding size of the vertebral artery?

Men have larger vertebral arteries than women

86

What is the name of the physical exam used to determine vertebral artery patency?

The vertebrobasilar artery insufficiency test

87

Which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?

The ipsilateral artery on the side of rotation

88

What are the symptoms of failure o the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?

Dizziness, vertigo, nausea are common complaints

89

Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?

C6

90

At what location will the vertebral artery form its first compensatory loop?

The atlanto-axial interspace

91

At what location will the vertebral artery form its second compensatory loop?

The atlanto-occipital interspace

92

At what segments will the vertebral artery be firmly attached to the transverse foramen?

Both C1 and C2?

93

What is the purpose of the vertebral artery loops between C2, C1, and occiput?

The increased length will accommodate the greater rotation at these locations

94

What happens to the vertebral artery after it enters the subarachnoid space at C1?

The vertebral artery ascends along the medulla oblongata to the pontine-medullary junction where the right and left arteries unite to form the basilar artery.

95

What artery is formed by the union of the right and left vertebral arteries?

The basilar artery

96

Which Suboccipital muscles attach to C1?

Rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior

97

Which suboccipital muscles attach to C2?

Rectus capitis posterior major, obiquus capitis inferior

98

What forms the boundaries for the exit of the C1 nerve from the spinal canal?

Occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament.

99

What forms the boundaries for the exit of the C2 nerve from the spinal canal?

Inferior articular process of C1, superior articular process of C2, capsular ligament, inferior vertebral notch of C1, superior vertebral notch of C2, posterior arch of C1, lamina of C2, posterior atlanto-axial ligament.

100

What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?

The vertebral bodies, intervertebral disc, posterior longitudinal ligament, uncinate process, lateral groove

101

What forms the anterior boundary for the C8 nerve exit from the spinal canal?

The vertebral bodies of C7 and T1, intervertebral disc, posterior longitudinal ligament, capsular ligament of the costocentral joint, superior costal facet of T1 and articular surface of the first rib.

102

What are the superior articular facet orientations for the cervical vertebrae?

C1 is backward, upward, medial (BUM),

C2 is backward, upward, lateral (BUL)

C3-C7 is backward, upward, medial (BUM)

103

What are the inferior articular facet orientations for the cervical vertebrae?

C1 is backward, downward, medial (BMD),

C2-C6 is forward, downward, lateral (FoLD)

C7 is forward, downward, lateral

****Check page 27 number 15 and 16 I think the C7 is wrong

104

How many synovial joints are identified for each cervical vertebra?

C1 = 5

C2 = 8

C3-C6 = 8

C7 = 6

105

How many joints are identified at the vertebral body of each cervical vertebra?

C1 = none

C2 = 10

C3-C6 = 10

C7 = 8

106

What features will allow discrimination between T2-T4 and T5-T8 segmental groups?

The vertebral body, transverse process, articular process and spinous process

107

What is the outline of the vertebral body of a typical thoracic from superior view?

Triangular

108

On cranial view, what is the outline of the vertebral body for the T2-T4 group?

The vertebral body will have bilaterally convex sides

109

On cranial view, what is the outline of the vertebral body for the T5-T8 group?

The left side of the vertebral body will be flattened, the right side convex

110

What is the aortic impression?

The flattening of the superior and inferior epiphyseal rims on the left side of the vertebral body of T5-8 which give the vertebral body a less scalloped or less indented appearance on that side.

111

What is the principal cause of the posterior curve of the thoracic spine?

The vertebral body height differences

112

How many synovial joints are formed at the vertebral body of a typical thoracic?

Four

113

How many symphysis joints are formed with the vertebral body of a typical thoracic?

Two

114

How many syndesmosis joints are formed at the vertebral body of a typical thoracic?

Typically four are identified; as many as eight if the costocentral stellate/radiate ligaments are included

115

What is the name given to the joint formed between the vertebral body an rib?

Costocentral joint

116

How many costocentral joints are formed at the vertebral body of a typical thoracic?

Four

117

What synovial joint surfaces are present on the vertebral body of a typical thoracic?

The right and left superior and the right and left inferior costal demi-facets

118

What feature will provide assistance in maintaining the stability of the intervertebral foramen in the typical thoracics?

The costocentral joint or ribs

119

What is the position and direction of the pedicle from the typical thoracic vertebral body?

The pedicle arises from the upper third of the vertebral body and projects posterior and slightly laterally

120

What is the angulation of the pedicle in the typical thoracic region?

Ten to fifteen degrees posterolateral from the sagittal plane

121

What is overlap of the lamina called in the typical thoracic region?

Shingling

122

What is the direction of the transverse process in the typical thoracis?

The transverse process projects more posterior with each inferior vertebra

123

What is the distance between the transverse tubercle in the typical thoracic region?

From T2 each transverse diameter becomes shorter as the transverse process angle more posteriorly

124

What is present on the transverse tubercle of a typical thoracic?

The transverse costal facet

125

What is the rib-transverse process relationship for the typical thoracics?

The number of the rib is the same as the number of the vertebra whose transverse process is being studied; fifth rib with T5 transverse process

126

What is the classification of the costotransverse joint?

Synovial (dyarthrosis) arthrodia joint

127

What are the osseous parts of the costotransverse joint?

The transverse costal facet and the articular surface of the tubercle of a rib

128

What ligaments support the costotransverse joint of a typical thoracic?

The superior costotransverse, inferior costotransverse and lateral costotransverse ligaments.

129

The superior costotransverse ligament of rib five will attach to which segmental body feature?

The transverse process of T4

130

The superior costotransverse ligament of the transverse process of T4 will attach to which rib?

The fifth rib

131

The inferior costotransverse ligament of rib five will attach to which segmental bony feature?

The transverse process of T5

132

The inferior costotransverse ligament of the transverse process of T5 will attach to which rib?

The fifth rib

133

What ligaments attach to the transverse process of a typical thoracic?

Intertransverse, capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments

134

Which joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments?

Fibrous (amphiarthrosis) syndesmosis joint

135

Which muscles may attach to the transverse process of a typical thoracic?

The longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis thoracis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis.

136

How can you distinguish between a T2-T4 from a T5 - T8 segment using the articular process?

T2-T4: width between the superior articular processes is greater than width between the inferior ones of that vertebra

T5-T8: Width between superior articular processes is equal to or the same as the width between the inferior ones of that vertebra

137

What is the angulation of the articular facet of a typical thoracic?

About ten to twenty degrees from the coronal plane; sixty degrees from the horizontal plane

138

What is the orientation of the superior articular facet of a typical thoracic?

They face backward, upward and lateral (BUL)

139

What is the orientation of the inferior articular facet of a typical thoracic?

They face forward, downward, and medial (ForMeD)

140

What is the joint classification of the articular facet joint?

Synovial (diarthrosis) arthrodia joint

141

How many synovial joints are present at a typical thoracic?

Ten

142

What is the angulation of the spinous process in the typical thoracic region?

The undersurface of T2-T4 spinous processes will angle up to forty degrees from the horizontal plane

The undersurface of T5-T8 spinous processes will angle up to 60 degrees from the horizontal plane

143

Which muscles may attach to the spinous process of a typical thoracic?

The trapezius, latissimus dorsi, rhomboid major, serratus posterior superior, splenus cervics, splenius capitis, spinalis thoracis, spinalis cervicis, spinalis capitis, semispinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis

144

What joint classifications are present at every typical thoracic vertebra?

Fibrous (amphiarthrosis) syndesmosis joint, cartilaginous (amphiarthrosis) symphysis joint and synovial (diarthrosis) arthrodia joint.

145

What ligaments attach to the transverse process of T1?

Intertransverse, capsular costotransverse, superior costotransverse, Inferior costotransverse and lateral costotransverse

146

What joint classification is associated with the intertransverse, superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments?

Fibrous (amphiarthrosis) syndesmosis joint

147

What muscles attach to the transverse process of T1?

The longissimus thoracis, longissimus cervicis, longissimus capitis, semispinalis cervicis, semispinalis capitis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum brevis

148

Which muscles attach to the transverse process of T9?

Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

149

How many synovial joints are typically present at T9?

Ten

150

Which rib related facet may be absent on T9?

The inferior costal demi-facet

151

Which muscles attach to the spinous process of T9?

The trapezius, latissimus dorsi, multifidis, rotator longus, rotator brevis and interspinalis

152

How many joints are typically formed at the vertebral body of T10?

Typically eight: twelve if the costocentral stellate/radiate ligaments are included

153

Which synovial joint surface is absent from the vertebral body of T10?

Inferior costal demi-facets.

154

What feature is very commonly observed on the lamina at T10?

Para-articular processes

155

What ligaments support the costotransverse joint of T10?

The superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments

156

What muscles attach to the transverse process of T10?

Longissimus thoracis, semispinals thoracis, multifidis, rotator longus and rotator brevis, intertransversarii, levator costarum longus and levator costarum brevis

157

How many synovial joints are typically present at T10?

Eight

158

What is the topographical indication of the spinous process of T10?

The skin often dimples or is depressed

159

What muscles attach to the spinous process of T10?

Trapezius, Latissimus dorsi, multifidis, rotator longus, rotator brevis, and interspinalis

160

What is the name given to T11?

The anticlinal vertebra

161

What joint classifications are identified at the vertebral body of T11?

Fibrous (amphiarthrosis) syndesmosis joint, cartilagenous (amphiarthrosis) symphysis joint and synovial (diarthroisis) arthrodia joint

162

What ligaments form the costotransverse joint of T11?

The superior costotransverse, and slightly developed inferior costotransvere and lateral costotransverse ligaments

163

What is the orientation of the transverse costal facets for T11

There are no transverse costal facets on T11

164

What muscles attach to the transverse process of T11?

Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii and levaor costarum brevis

165

Which levator costarum muscle is absent at T11?

Levator costarum longus

166

What muscles attach to the spinous process of T11?

Trapezius, latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, and interspinalis.

167

At which segments of the thoracic spine will the spinalis muscle not attach?

T9, T10

168

What does the superior tubercle of T12 represent?

The mammillary process of lumbar vertebrae

169

What does the inferior tubercle of T12 represent?

The accessory process of lumbar vertebrae

170

What ligaments form the costotransverse joint of the twelfth rib?

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

171

Which costotransverse ligament(s) lack an attachment to T12?

Capsular costotransverse, superior costotransverse, inferior costotransverse and lateral costotransverse ligaments

172

What muscles attach to the transverse process of T12?

Longissimus thoracis, semispinalis thoracis, multifidis, rotator longus, rotator brevis, intertransversarii

173

What muscles attach to the spinous process of T12?

Trapezius, Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, spinalis thoracis, multifidis, rotator longus, rotator brevis, interspinalis

174

Which erector spinae muscle is unique in its attachment to the T12 spinous process?

Iliocostalis lumborum

175

How many synovial joints are maximally observed at each thoracic vertebra?

T1-T9 = 10

T10 = 8

T11-T12 = 6

176

What is the superior articular facet orientation at each thoracic vertebra?

BUL

177

What is the generic shape of the typical lumbar vertebral body from the cranial view?

Reniform or kidney - shaped

178

What accounts for the direction of the lumbar curve?

The vertebral body and intervertebral disc have a greater anterior height than posterior height

179

What is the effect of aging on the vertebral body of a lumbar vertebra?

Decrease in height, increase in circumference

180

How many joint surfaces are present on the vertebral body of a typical lumbar?

Six

181

What muscles may attach to a typical lumbar vertebral body?

Psoas major and Psoas minor

182

What is the name given to ligaments which attach the vertebral body to articular process?

Transforaminal ligaments

183

WHat are the types of transforaminal ligaments?

Superior transforaminal, middle transforaminal ligaments and inferior transforaminal ligaments

184

What ligaments attach the vertebral body to the transverse process?

Corpotransverse ligaments

185

What corpotransverse ligaments are identified?

Superior corpotransverse and inferior corpotransverse ligaments

186

Cervical - upper thoracic Hofmann ligaments will attach what structures together?

Dura mater to segments above

187

What is the proposed function of the cervical - upper thoracic Hofmann ligaments?

Resist caudal movment of the dural sac; resist gravitational forces on the dura and cord

188

Lumbar Hofmann ligaments will attach what structures together

Dura mater to lower segmental levels

189

WHat is the proposed function of the lumbar Hofmann ligaments?

Resist cranial movment of the dural sac during flexion

190

Congenital elongation of the lumbar acessory process results in what feature?

Styloid process

191

WHat parts of vertebra are attached via the mammillo-accessory ligament?

The mammilllary process and accessory process of the same segment

192

WHat was believed to be entrapped by the mammillo-accessory ligament?

The medial branch of the dorsal ramus of a lumbar spinal nerve

193

What muscle(s) attach to the lumbar accessory process?

Longisimus thoracis and intertransversarii

194

What is the position of the lumbar zygapophysis in adults?

The sygapophysis lies in the sagittal plane for L1/L2, L2/L3 and L3/L4

The zygapophysis lies in the coronal plane for L4/L5 and L5/S1

195

What names are given to the condition in which the right zygapophysis of a vertebral couple lies in a plane or position different from the left zygapophysis?

Joint asymmetry or joint tropism

196

What muscles will attach to the typical lumbar spinous process?

Latissimus dorsi, serratus posterior inferior, iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidis, rotator longus, rotator brevis and interspinalis.

197

What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?

Lumbosacral, iliolumbar and mammillo-accessory ligaments

198

What are the posterior elements of the vertebra?

Zygapophysis, lamina and spinous process

199

What are the anterior elements of the vertebra?

Vertebral body and pedicle

200

What is the orientation of the fifth lumbar superior articular facet?

Backward, upward, medial (BUM); typically concave

201

What is the orientation of the fifth lumbar inferior articular facet?

Forward, lateral, downward (FoLD); significant onvexity

202

What is the name(s) of the condition in which the L5 spinous process increases in length due to the aging process?

Baastrup's syndrome or "kissing spines"

203

What is Knife Clasp syndrome?

The congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida and dorsiflexion produces pain

204

What is the superior articular facet orientation at each lumbar vertebra?

L1-L5 = backward, upward, medial (BUM)

205

What is the inferior articular facet orientation at each lumbar vertebra?

L1-L5 = forward, downward, lateral (FoLD)

206

What is the incidence of spondylolysis in the general population?

A range of 2.6% to 10%

207

Lumbar spondylolysis has not been reported in what groups of individuals?

Fetuses, newborns, rarely in children under five years old, patients who have never walked and in non-erect species

208

What does lumbar spondylolysis appear to be related to?

The uniquely human upright stance or erect posture

209

What is the gender bias typically associated with lumbar spondylolysis?

Men at L5/S1; women at L4/L5

210

WHat is the age range typically associated with lumbar spondylolysis?

10-20 year olds

211

What motion(s) is particularly associated with lumbar spondylolysis?

Hyperextension coupled with rotation

212

What fills the space in a lumbar spondylolysis?

Fibrocartilagenous material

213

What name has been given to the material filling the space in a lumbar spondylolysis?

Spondylolysis ligament

214

What types of neural function(s) have been assocated with the spondylolysis ligament?

Nociception, neuromodulation and autonomic function

215

What is the appearance of a spondylolysis in a lumbar vertebra upon oblique x-ray view?

A collared Scotty dog

216

What part of a lumbar vertebra forms the neck of a Scotty dog?

The pars interarticularis below the superior articular process

217

What part of a lumbar vertebra forms the eye of a Scotty dog?

The pedicle

218

What part of a lumbar vertebra forms the ear of a Scotty dog?

The superior articular process

219

What part of a lumbar vertebra forms the nose of a Scotty dog?

The transverse process

220

What characteristics are associated with cervical spondylolysis?

Rare, congenital, gender biased toward men, most common at C6 and linked to spondylolisthesis and spina bifida

221

What characteristics are associated with sacral spondylolysis?

Rare in general population, within typical percents in the native Alaskan (Inuit) population, seems to be acquired, gender biased toward men, most common at S1 and linked to activities such as kayaking and harpooning

222

What is the posterior direction of vertebral slippage called?

Retrospondylolisthesis or retrolisthesis

223

What are the types/classifications of spondylolisthesis?

Type I: spondylolisthesis (dysplastic spondy, congenital spondy)

Type II Isthmic spondy

Type III Degenerative spondy

Type IV Traumatic Spondy

Type V Pathologic Spondy

224

What is the locational bias of type I spondylolisthesis?

L5 or upper sacral segments

225

Which subtype of Type II spondylolisthesis is stressed in Spinal II?

Lytic spondylolisthesis or stress fracture induced spondylolisthesis

226

What gender bias, locational bias, and spinal canal dimensions are associated with type II spondylolisthesis?

Isthmic spondylolisthesis is common in men, located at L5/S1 level and demonstrates an increase in sagittal diameter of the spinal canal

227

What is the gender bas, locational bias, and spinal canal dimension changes often associated with type III spondylolisthesis?

Degenerative spondylolisthesis is more common in women, particularly at L4/L5, and demonstrates no change in sagittal diameter of the spinal canal

228

What causes type IV spondylolisthesis?

Fracture of the neural arch components

229

What are the cause(s) associated with type V spondylolisthesis?

Bone diseases such as Paget disease or osteogenesis imperfecta

230

How many joint surfaces are present on the vertebral body of the first sacral segment?

Five

231

What joint classifications will be observed at the first sacral vertebral body?

Cartilaginous (amphiarthrosis) symphysis, fibrous (amphiarthrosis) syndesmosis

232

What muscle(s) may attach to the first sacral vertebral body?

Psoas major

233

What is the position of the sacral zygapophysis in adults?

The zygapophysis lies in the coronal plane for L5/S1

234

What is the orientation of the first sacral superior articular facet?

Backward, upward, medial (BUM); typically concave

235

What is the size relationship between ventral and dorsal sacral foramina?

Ventral sacral foramina are larger

236

What part of the sacral ala continues along the ventral surface of sacrum to about S4?

The costal element

237

What is the name of the region of bone lateral to the vertebrl body of S5?

True transverse process

238

An imaginary line drawn from the superior articular process of S1 to the sacral cornu will form what feature?

Intermediate sacral crest

239

What features may be identified along the intermediate sacral crest?

The mammillary process of S1 and the sacral cornu of S5

240

What is the name of the inferior opening of the sacral spinal canal?

The sacral hiatus

241

What features may be identified along the lateral sacral crest:

S1 transverse tubercle, sacral tuberosity of S2, transverse tubercles of S3,S4 and S5

242

What is the name of the joint formed by the sacral tuberosity?

The accessory sacro-iliac joint

243

What feature is associated with the transverse tubercle of S5?

The inferior and lateral (inferolateral) sacral angle

244

What classification of joint is formed by the auricular surface of sacrum?

Synovial (diarthrosis) arthrodia joint

245

What feature does the anterior surface of the superior epiphyseal rim of S1 form?

The sacral promontory

246

How many synovial joints are typically present at sacrum?

Four

247

What forms the posterior boundary for the fifth sacral spinal nerve intervertebral foramen?

Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament and intercornual ligament

248

What is the homolog for the posterior longitudinal ligament at S5?

Deep posterior sacrococcygeal ligament

249

What is the homolog for the anterior longitudinal ligament at S5?

Anterior sacrococcygeal ligament

250

What is the homolog for the ligamentum flavum at S5?

Superficial posterior sacrococcygeal ligament

251

What is the homolog for the capsular ligament at S5?

Intercornual ligment

252

What is the number of coccygeal somites?

Ten

253

What is the typical number of segments which unite to form the adult coccyx?

4 Segments

254

When is ossification of coccyx completed?

About age 30

255

What bony features are present on the coccyx?

All segments are represented by a "vertebral body; Co1 has a coccygeal cornu and transverse process

256

What is the direction of fusion of coccygeal segments?

From caudal to cranial, the last segments to fuse together are Co1 and Co2

257

What is the direction of the coccygeal curve?

Posterior, kyphotic

258

What is the major motion and range of motion for coccyx?

Flexion-extension, 5-20 degrees

259

What is the ganglion impar?

A midline sympathetic ganglion

260

What is the coccygeal glomus or coccygeal body?

An enlarged encapsulated arteriovenous anastomosis located near the last segment of coccyx

261

What forms the inferior boundary for the spinal canal?

The union of the superficial posterior and deep posterior sacrococcygeal ligaments

262

What ligament is formed by the union of the superficial posterior sacrococcygeal and the deep posterior sacrococcygeal ligaments at Co1?

The posterior sacrococcygeal ligament

263

What forms the posterior boundary for the first coccygeal spinal nerve intervertebral foramen?

Sacral cornu, coccygeal cornu, superficial posterior sacrococcygeal ligament, intercornual ligament

264

WHat forms the anterior boundary for the first coccygeal spinal nerve intervertebral foramen?

Vertebral body of S5, vertebral body of Co1, deep posterior sacrococcygeal ligament, intervertebral disc

265

Superior articular facets of which vertebrae will be orientated backward, upward, and medial?

C1, C3-C7, L1-L5, S1

266

Superior articular facets of which vertebrae are riented back up medial and concave?

C1, L1-L5, S1

267

Inferior articular facets of which segments will be orientated backward medial and downward?

C1

268

Superior articular facets of which segments will be orientated backward, upward, and lateral?

C2, T1-T12"

269

Inferior articular facets of which segments will be orientated forward, lateral, and downward?

C2-C6, T12, L1-L5

270

Inferior articular facets of which segments are orientated forward, lateral, downward and convex?

T12, L1-L5

271

Inferior articular facets of which segments will be orientated forward, medial, and downward?

C7, T1-T11

272

What is/are the characteristic(s) of cervicalization of occiput?

An increase in occipital bone size, formation of new or larger lines, on the occipital bone

273

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

The atlas may be partially or completely fused to the occiput

274

What is another way of implying occipitalization of C1?

Atlas assimilation

275

WHat is the incidence of occipitalization of C1?

0.1% to 0.8%

276

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

During the last trimester in utero

277

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

At or shortly after birth

278

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

The subdental synchondrosis

279

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

Amphiarthrosis synchondrosis

280

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

7 years old

281

WHat is the name given to the condition in which the joint formed between the odontoid process and centrum of C2 persists beyond age 7?

Os odontoideum

282

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

Persistent subdental synchondrosis

283

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

Tip of the dens synchondrosis

284

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

Sometime in early adolescence

285

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

Terminal ossicle

286

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

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

287

What is the gender bias suggested in dorsalization of C7?

Female

288

What alteration in C7 facet orientation may accompany dorsalization?

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.

289

What alteration in C6 facet orientation may accompany dorsalization?

C6 demonstrates a change in inferior articular facet orientation from forward, lateral, and downward to forward, medial, and downward; the superior articular facet is unchanged

290

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

Up to 46%

291

What T1 facet orientation changes may accompany cervicalization?

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

292

What C7 facet orientation changes may accompany cervicalization?

The inferior articualr facet may change from FMD to FLD; the superior articular facet is unchanged

293

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

up to 28% of the population

294

What rib-related changes may accompany lumbarization of T12?

A significant shortening of the mean relative length of 113 mm of the twelfth rib or it becomes absent

295

What T12 facet orientation changes may accompany lumbarization?

Superior articular facet may change from flat, BUL to concave BUM; inferior unchanged

296

What is the characteristic of lumbarization of S1?

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

297

What is the characteristic of sacralization of L5?

L5 may be partially or completely fused to the sacrum

298

Which segment demonstrates the greatest morphological variation along the spine?

L5

299

What is the incidence of variation within the sacrococcygeal region in the population?

Up to 14%