Spinal Exam 2: Section VII. Intervertebral Foramen

Question 1

What determines the length of the intervertebral foramen?

Answer 1

the width of the pedicle

Question 2

What may extend the length of the intervertebral foramen?

Answer 2

the transverse process, muscles or ligaments

Question 3

What forms the superior boundary for the typical intervertebral foramen?

Answer 3

the inferior vertebral notch of the pedicle above

Question 4

What is the average height of the intervertebral foramen?

Answer 4

about 13 mm

Question 5

What percent of total vertebral column length does “true” intervertebral foramina height from C2-S1 equal?

Answer 5

40%

Question 6

What percent of totoal vertebral column length does all intervertebral foramina height from occiput Co1 equal?

Answer 6

53%

Question 7

What are the generic contents of the intervertebral foramen?

Answer 7

neural tissue, connective tissue, vascular tissue, lymphatic tissue

Question 8

What is the percent of neural tissue in the intervertebral foramen?

Answer 8

from 8 to 50 percent

Question 9

Which branches of the spinal artery may occupy the intervertebral foramen?

Answer 9

the osseous arteries, 
anterior spinal canal artery, 
posterior spinal canal artery, 
anterior medullary feeder artery, and 
posterior medullary feeder artery

Question 10

What is the name of the largest medullary feeder artery?

Answer 10

the artery of Adamkiewicz or the arteria radicalis magna anterior

Question 11

What are the characteristics of the Artery of Adamkiewicz?

Answer 11

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

Question 12

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

Answer 12

below T8

Question 13

What will the intervertebral veins drain into?

Answer 13

the external vertebral venous plexus or Batson’s plexus

Question 14

Which venous vessels of the vertebra will drain into the segmental veins?

Answer 14

the external vertebral venous plexus of Batson’s plexus

Question 15

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

Answer 15

they appear to lack valves

Question 16

What size lymphatic vessels lie in the intervertebral foramina?

Answer 16

medium sized lymphatics

Question 17

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

Answer 17

adipose tissue and loose anterior areolar connective tissue

Question 18

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

Answer 18

the lateral groove and uncinate process

Question 19

What happens to cervical nerve roots between their origin form the spinal cord and exit from the intervertebral foramen?

Answer 19

they descend along the spinal cord

Question 20

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

Answer 20

the length of the nerve root increases as it descends form its apparent origin on the spinal cord, but the cross-sectional area of the nerve root decreases

Question 21

What is the relationship between aging and cervical spine intervertebral foramen size?

Answer 21

the cross-sectional area diminishes after age 50

Question 22

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

Answer 22

the sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery

Question 23

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

Answer 23

the costocentral joint

Question 24

What is the relationship of lumbar nerve root size to intervertebral foramen size about L4?

Answer 24

the nerve root size will account for less than 22% of the available size

Question 25

What is the relationship of lumbar nerve root size to intervertebral foramen size below L4?

Answer 25

the nerve root size will account for up to 30% of the available size

Question 26

Which are the largest spinal nerves?

Answer 26

L5 and S1 spinal nerves

Question 27

What increases the length of the intervertebral foramen at L5?

Answer 27

the lumbosacral tunnel

Question 28

What forms the lumbosacral tunnel?

Answer 28

the lumbosacral ligament, transverse process of L5, and sacral ala

Question 29

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

Answer 29

the far out syndrome

Question 30

What ligaments may contribute to the loss of size in the lumbar intervertebral foramen?

Answer 30

the transformational ligament and the corporotransverse ligament

Question 31

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

Answer 31

the intervertebral disc above the intervertebral foramen is usually the source of damage

Question 32

What is unusual baout the sacral intervertebral foramen compared to other intervertebral foramina?

Answer 32

a completely osseous boundary exists

Question 33

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

Answer 33

the tilt or position of the entire sacrum relative to the pelvis

Question 34

What is the relationship of lumbar nerve root size to intervertebral foramen size above L4?

Answer 34

the nerve root size will account for less than 22% of the available size

Question 35

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

Answer 35

there are two nerves present, S5 nerve and Co1 nerve

Question 36

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

Answer 36

tuberculosis, hemangiomas, osteoporosis

Question 37

What are examples of osteophyte formation that influence the intervertebral foramen?

Answer 37

the body spurs of the vertebral body and para-articular processes on the lamina

Question 38

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

Answer 38

obesity, pregnancy, and the use of heavy backpacks

Question 39

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

Answer 39

backpack weight should not exceed 10% individual body weight