1
Q
Ossification of the ligamentum flavum at the attachment site on the lamina will be association with which classification of bone?
A
accessory bone
2
Q
Ossification within the length of the ligamentum flavum will be associated with which classification of bone?
A
heterotopic bone
3
Q
The greatest transverse diameter of the typical cervical vertebra occurs at?
A
C6
4
Q
The greatest frequency of osteophytes associated with the vertebral body occurs at which typical cervical vertebral couple?
A
C5/C6
5
Q
List, in order, the osseous parts of the typical cervical vertebra transverse process beginning at the vertebral body.
A
- costal element
- anterior tubercle
- costotransverse bar
- posterior tubercle
- true transverse process
6
Q
What muscles may attach to the posterior tubercle of a typical cervical vertebra?
A
- splenius cervicis
- iliocostalis cervicis
- longissimus cervicis
- levator scapula
- middle scalene
- posterior scalene
- rotators
- posterior intertransverse muscles
7
Q
What muscles will attach to the costotransverse bar?
A
- middle scalene
- posterior intertransverse muscles
8
Q
What is the orientation and angulation of a typical cervical transverse process?
A
- 60 degrees anterolaterally (midsagittal plane)
- 15 degrees inferiorly (horizontal plane)
9
Q
What is the name given to the modification of the anterior tubercle of the C6 transverse process?
A
the carotid tubercle
10
Q
What will occupy the typical cervical vertebra transverse foramen?
A
- vertebral artery
- vertebral venous plexus
- postganglionic sympathetic motor nerve fibers
11
Q
What is the classic angulation of typical cervical articular facets?
A
forty to forty-five degrees from the coronal plane
12
Q
What is the orientation of the typical cervical superior articular facet?
A
backward, upward, medial (BUM)
13
Q
What is the orientation of the typical cervical inferior articular facet?
A
forward, lateral, downward (FoLD)
14
Q
<p>What muscles will attach to typical cervical articular processes?</p>
A
<p>-longissimus capitis -longissimus cervicis -semispinalis capitis -semispinalis cervicis -multifidis -rotators</p>
15
Q
What modifications of the synovial joint are observed in the cervical spine?
A
meniscoidal folds
16
Q
The greatest range of flexion-extension among the typical cervical vertebrae occurs at which vertebral couple?
A
typically C5/C6
17
Q
What motions are coupled in the cervical spine?
A
lateral bending and axial rotation
18
Q
Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?
A
the C5/C6 vertebral couple
19
Q
What is the usual condition for the African-American typical cervical spinous process?
A
they are non-bifid
20
Q
What muscles may attach to the typical cervical spinous process?
A
- spinalis cervicis
- semispinalis cervicis
- semispinalis thoracis
- multifidis
- rotators
- interspinalis
21
Q
What joint classifications are observed on the anterior arch of C1?
A
- fibrous (amphiarthrosis) syndesmosis joint
- synovial (diarthrosis) trochoid joint
22
Q
What is the orientation of the superior articular facet of C1?
A
backward, upward, medial (BUM)
23
Q
What is the joint classification of the atlanto-occipital zygapophysis?
A
synovial (diarthrosis) ellipsoidal joint
24
Q
What are the morphological characteristics of the inferior articular facet of C1?
A
asymmetrical, slightly concave or flattened
25
What is the orientation of the inferior articular facet of C1?
backward, medial, downward (BMD)
26
What is the joint classification of the atlanto-axial zygapophysis?
synovial (diarthrosis) arthrodia joint
27
What muscles attach to the lateral mass of C1?
- levator scapula
- splenius cervicis
- rectus capitis anterior
28
What is the distance from the posterior tubercle of the posterior arch to the skin in each gender?
- males: about fifty millimeters
| - females: about thirty-seven millimeters
29
What attaches to the posterior tubercle of the posterior arch of C1?
- rectus capitis posterior minor muscle
| - ligamentum nuchae
30
Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?
accessory bone
31
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
32
Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?
an incomplete ponticulus posticus or a complete ponticulus posticus
33
What forms the types of ponticulus posticus?
ossification of the anterior free margin of the posterior atlanto-occipital ligament
34
What other name may be used to identity a ponticulus posticus?
Kimmerle's anomaly
35
What names are given to the opening formed by the ponticulus posticus?
arcuate foramen or retroarticular canal
36
Ponticulus posticus has observed in what ethnic populations?
all ethnic populations studied thus far
37
What is the general range of incidence of ponticulus posticus in the populations studied?
1%-41%
38
What are the osseous parts of the transverse process of C1?
- costal element
- posterior tubercle
- true transverse process
39
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
- intertransversarii muscles
40
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
41
What are the connections between suboccipital muscles and the spinal dura called?
myodural bridges
42
What are the lateral bridges of atlas connected to?
- the lateral mass
| - the transverse process of atlas
43
What opening is identified when a complete lateral bridge is formed?
the retrotransverse foramen
44
What are the possible contents of the retrotransverse foramen?
- the vertebral artery
- a branch from the suboccipital nerve
- veins communicating with the venous sinuses of the neck
45
What is the gender variation for measurements of the transverse diameter of C1?
- males: 78 millimeters
| - females: 72 millimeters
46
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
47
What names are given to C2?
axis or epistropheus
48
What joint surfaces are present on the odontoid process of C2?
- facet for fovea dentis
- groove for transverse atlantal ligament
- attachment sites for the alar ligaments
- attachment site for the apical-dental ligament
49
How many joint surfaces are present on the odontoid process of C2?
five
50
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
51
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
52
What joint classifications are present at the vertebral body of C2?
- fibrous (amphiarthrosis) syndesmosis joint
- synovial (diarthrosis) trochoid joint
- modified synovial (diarthrosis) sellar
- cartilaginous (amphiarthrosis) symphysis joint
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?
the posterior longitudinal ligament
55
What attaches to the lamina of C2?
- obliquus capitis inferior muscle
- posterior atlanto-axial ligament
- ligamentum flavum
56
What muscle attaches to the lamina of C2?
obliquus capitis inferior
57
What is the appearance of the superior articular facets of C2?
they are asymmetrical and slightly convex
58
What is the facet orientation of the superior articular facet of C2?
backward, upward, and lateral (BUL)
59
What is the orientation of the inferior articular facets of C2?
forward, lateral, and down (FoLD)
60
What muscle attaches to the articular processes of C2?
longissimus cervicis
61
What osseous parts of the typical cervical transverse process are present at C2?
- costal element
- posterior tubercle
- true transverse process
62
What is the gender variation for the transverse diameter of C2?
- males: fifty-seven millimeters
| - females: about fifty millimeters
63
What muscles attach to the transverse process at C2?
- levator scapulae
- middle scalene
- splenius cervicis
- longissismus cervicis
- intertransversarii
64
What muscles attach to the spinous process of C2?
- rectus capitis posterior major
- obliquus capitis inferior
- spinalis cervicis
- semispinalis cervicis
- multifidus
- rotators
- interspinalis muscles
65
What names may be given to C7?
vertebra prominens and vertebral prominence
66
What is the name given to the topographical elevation observed at the base of the neck?
vertebral prominence
67
What name is given only to C7?
vertebra prominens
68
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
69
How many joint surfaces are present at the vertebral body of C7?
eight
70
What joint classifications are observed at the vertebral body of C7?
- fibrous (amphiarthrosis) syndesmosis joint
- cartilaginous (amphiarthrosis) symphysis joint
- modified synovial (diarthrosis) sellar joint
71
How many synovial joint surfaces are observed at the vertebral body of C7?
two
72
What muscle(s) attaches to the vertebral body of C7?
longus colli muscle
73
What are the osseous parts of the transverse process of C7?
- costal element
- anterior tubercle
- costotransverse bar
- posterior tubercle
- true transverse process
74
What features are typically present in the transverse foramen of C7?
- vertebral venous plexus
| - postganglionic sympathetic motor nerve fibers
75
What muscles attach to the transverse process of C7?
- middle scalene
- iliocostalis thoracis
- longissimus cervicis
- semispinalis capitis
- rotators
- intertransversarii
- levator costarum brevis
76
What is the angulation of the articular facet at C7?
more vertical at about 63 degrees
77
What is the orientation of the superior articular facet of C7?
backward, upward, medial (BUM)
78
What is the orientation of the inferior articular facet of C7?
forward, medial, downward (ForMeD)
79
What muscles will attach to the articular process of C7?
- longissimus cervicis
- longissimus capitis
- semispinalis cervicis
- multifidis
80
What are the features of the spinous process of C7?
long, horizontal, nonbifid
81
What muscles attach to the spinous process of C7?
- trapezius
- rhomboid major
- serratus posterior superior
- splenius capitis
- spinalis capitis
- spinalis cervicis
- semispinalis thoracis
- multifidis
- rotators
- interspinalis
82
What ligaments attach to the spinous process of C7?
ligamentum nuchae and interspinous ligaments
83
The vertebral artery on which side is typically larger?
left vertebral artery
84
What is the gender bias regarding size of the vertebral artery?
men have larger vertebral arteries than women
85
What is the name of the physical exam used to determine vertebral artery patency?
the vertebrobasilar artery insufficiency test
86
Which side artery is tested during the course of the vertebrobasilar artery insufficiency exam?
the ipsilateral artery on the side of rotation
87
What are the symptoms of failure of the vertebral artery to compensate during the vertebrobasilar artery insufficiency exam?
dizziness, vertigo, nausea are common complaints
88
Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?
C6
89
At what location will the vertebral artery form its first compensatory loop?
the atlanto-axial interspace
90
At what location will the vertebral artery form its second compensatory loop?
the atlanto-occipital interspace
91
At what segments will the vertebral artery be firmly attached to the transverse foramen?
both C1 and C2
92
What is the purpose of the vetebral artery loops between C2, C1, and occiput?
the increased length will accomodate the greater rotation at these locations
93
What happens to the vertebral artery as it enters the vertebral foramen of C1?
the adventitia of the artery blends with the dura mater and the arachnoid mater; as a result the artery lies in the subarachnoid space
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 are the superior articular facet orientations for the cervical vertebrae?
- C1: BUM
- C2: BUL
- C3-C7: BUM
96
What are the inferior articular facet orientations for the cervical vertebrae?
- C1: BMD
- C2-C6: FoLD
- C7: ForMeD
97
How many synovial joints are identified for each cervical vertebrae?
- C1 = 5
- C2 = 8
- C3-C6 = 8
- C7 = 6
98
How many joints are identified at the vertebral body of each cervical vertebra?
- C1 = none
- C2 = 10
- C3-6 = 10
- C7 = 8
99
What features will allow discrimination between T2-T4 and T5-T8 segmental groups?
the vertebral body, transverse process, articular process and spinous process
100
What is the height pattern of the typical thoracic vertebral body?
the posterior height is greater than the anterior height by one to two millimeters
101
What is another way of naming a posterior curve pattern?
a kyphotic curve
102
What joint classifications are identified at the vertebral body of a typical thoracic?
- fibrous (amphiarthrosis) syndesmosis joint
- cartilaginous (amphiarthrosis) symphysis joint
- synovial (diarthrosis) arthrodia joint
103
How many synovial joints are formed at the vertebral body of a typical thoracic?
four
104
How many symphysis joints are formed with the vertebral body of a typical thoracic?
two
105
How many joints are formed at the vertebral body of a typical thoracic?
typically ten; fourteen if the costocentral stellate/radiate ligaments are included
106
What ligaments support the costocentral joint?
the costocentral stellate/radiate ligaments and the costocentral interarticular or intra-articular ligament
107
What is the size relationship between the articulating surface of the head/capitulum of the rib and the costal demi-facet surface?
the rib surface is greater than the costal demi-facet surface
108
Which X-ray view is used to see into the intervertebral foramen of a typical thoracis?
the lateral view
109
What is the nerve-vertebral body relationship at the typical thoracic intervertebral foramen?
in the intervertebral foramen, the number of the nerve is the same as the number of the upper thoracic in the vertebral couple
110
What is the rib-vertebral body relationship at the typical thoracic intervertebral foramen?
in the intervertebral foramen, the number of the rib is the same as the number of the lower thoracic in the vertebral couple
111
What ligaments support the costotransverse joint of a typical thoracic?
the superior costotransverse, inferior costotransverse, and lateral costotransverse ligaments
112
What ligaments attach to the transverse process of a typical thoracic?
- intertransverse
- capsular costotransverse
- superior costotransverse
- inferior costotransverse
- lateral costotransverse
113
How do the transverse diameters of the articular processes compare in the T2-T4 region?
the superior articular process transverse diameter is greater than the inferior articular process transverse diameter for a given segment
114
What is the orientation of the superior articular facet of a typical thoracic?
backward, upward and lateral (BUL)
115
What is the orientation of the inferior articular facet of a typical thoracic?
forward, downward and medial (ForMeD)
116
How many synovial joints are present at a typical thoracic?
ten
117
How many synovial joint surfaces for ribs are present on a typical thoracic?
six
118
What is the angulation of the spinous process in the typical thoracic region?
- the undersurface of T2-T4 spinous process will angle up to forty degrees from the horizontal plane
- the undersurface of T5-T8 spinous process will angle up to sixty degrees from the horizontal plane
119
What joint classifications are present at every typical thoracic vertebra?
- fibrous (amphiarthrosis) syndesmosis joint
- cartilaginous (amphiarthrosis) symphysis joint
- synovial (diarthrosis) arthrodia joint
120
How many synovial joints are formed at the vertebral body of T1?
four normally
121
How many symphysis joints are formed with the vertebral body of T1?
two
122
How many joints are formed at the vertebral body of T1?
typically ten; fourteen if the rib ligaments are included
123
How many synovial joints are present at T1?
ten
124
Identify the synovial joint surfaces present at T1.
- two superior costal facets
- two inferior costal demi-facets
- two transverse costal facets
- two superior articular facets
- two inferior articular facets
125
How many joints are typically formed at the vertebral body of T9?
typically ten; fourteen if the costocentral stellate/radiate ligaments are included
126
How does the superior costal demi-facet of T9 compare in size with those of T2-T8?
it is larger
127
How many joints are typically formed at the vertebral body of T10?
typically eight; twelve is the costocentral stellate/radiate ligaments are included
128
Which synovial joint surface is absent from the vertebral body of T10?
inferior costal demi-facets
129
Para-articular processes are more commonly observed on which segment?
T10
130
What muscles attach to the transverse process of T10?
- longissimus thoracis
- semispinalis thoracis
- multifidis
- rotator longus and brevis
- intertransversarii
- levator costarum longus
- levator costarum brevis
131
How many synovial joints are typically present at T10?
eight
132
A dimpling or depression of the skin in the thoracic region is often characteristic of the location of which segment?
T10
133
What muscles attach to the spinous process of T10?
- trapezius
- latissimus dorsi
- multifidis
- rotator longus
- rotator brevis
- interspinalis
134
What is the name given to T11?
the anticlinal vertebra
135
What is the outline of the vertebral body of T11 in superior view?
kidney-shaped or reniform
136
How many synovial joints are formed at the vertebral body of T11?
two
137
How many joints are typically formed at the vertebral body of T11?
typically eight; twelve if the costocentral stellate/radiate ligaments are included
138
Which synovial joint surface is absent from the vertebral body of T11?
inferior costal demi-facets
139
How does the superior costal facet of T11 compare in size with those of T10?
it is larger, below the superior epiphyseal rim, and is completely circular
140
Which ligament of the costocentral joint is absent for the eleventh rib?
the costocentral interarticular or intra-articular ligament
141
What ligaments form the costotransverse joint of T11?
- superior costotransverse
- slightly developed inferior costotransverse
- lateral costotransverse
142
How many synovial joints are typically present at T11?
six
143
Identify the synovial joint surfaces typically present on T11.
- two superior costal facets
- two superior articular facets
- two inferior articular facets
144
Which muscle(s) is attached to the vertebral body of T12?
psoas major and psoas minor
145
Which tubercle on T12 represents the transverse process?
the lateral tubercle
146
Which tubercle on T12 represents the mammillary process on the lumbars?
the superior tubercle
147
Which tubercle on T12 represents the accessory process of the lumbars?
the inferior tubercle
148
What joint surface of the typical thoracic transverse process is absent on T12?
the transverse costal facet
149
What ligaments form the costotransverse joint for the twelth rib?
- the superior costotransverse ligament from T11
| - lumbocostal ligament from L1
150
What muscles attach to the transverse process region of T12?
- longissimus thoracis
- semispinalis thoracis
- multifidis
- rotator longus
- rotator brevis
- intertransversarii
151
What is the orientation of the superior articular facets of T12?
they face backward, upward and lateral (BUL)
152
What is the orientation of the inferior articular facets of T12?
they face forward, downward and lateral (FoLD)
153
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
154
What accounts for the direction of the lumbar curve?
the vertebral body and the intervertebral disc have a greater anterior height than posterior height
155
What muscles may attach to a typical lumbar vertebral body?
psoas major and psoas minor
156
What is the name given to ligaments which attach the vertebral body to articular process?
transforaminal ligaments
157
What ligaments attach the vertebral body to the transverse process?
corporotransverse ligaments
158
Cervical-upper thoracic Hofmann ligaments will attach what structures together?
dura mater to the segments above
159
What is the highest level known to demonstrate Hofmann ligaments?
C6
160
What is the proposed function of the cervical-upper thoracic Hofmann ligaments?
resist caudal movement of the dural sac; resist gravitational forces on the dura and cord
161
Lumbar Hofmann ligaments will attach what structures together?
dura mater to the lower segmental levels
162
What is the proposed function of the lumbar Hofmann ligaments?
resist cranial movement of the dural sac during flexion
163
Congenital elongation of the lumbar accessory process results in what feature?
styloid process
164
What muscle(s) attach to the lumbar accessory process?
- longissimus thoracis
| - intertransversarii
165
What osseous components are attached via the lumbocostal ligament?
the transverse process of L1 and neck/collum of the twelfth rib
166
What muscles may attach to the transverse process of a typical lumbar vertebra?
- psoas major
- quadratus lumborum
- longissimus thoracis
- rotators brevis
- rotator longus
- intertransversarii
167
What ligaments attach to the transverse process of a typical lumbar vertebra?
- lumbocostal
- mammillo-accessory
- intertransverse
168
What are the anterior elements of the vertebra?
vertebral body and pedicle
169
What is the orientation of the typical lumbar superior articular facet?
- backward, upward, medial (BUM)
| - concave
170
What is the orientation of the typical lumbar inferior articular facet?
- forward, lateral, downward (FoLD)
| - significant convexity
171
What muscle(s) will attach to the mammillary process?
- multifidis
| - intertransversarii
172
What was believed to be entrapped by the mammillo-accessory ligament?
the medial branch of the dorsal ramus of a lumbar spinal nerve
173
What is the position of the lumbar zygapophysis in children?
the zygapophysis lies in the coronal plane
174
What is the position of the lumbar zygapophysis in adults?
- the zygapophysis 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
175
What names are given to the condition in which one zygapophysis of a vertebral couple lies in the coronal plane or position and the other zygapophysis lies in the sagittal plane or position?
joint asymmetry or joint tropism
176
What is the name(s) of the condition in which the typical lumbar spinous process increases in length due to the aging process?
Baastrup's syndrome or "kissing spines"
177
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
- interspinalis
178
What is the appearance of the fifth lumbar vertebral body from the lateral view?
anterior height is greater than posterior height by a several millimeters; it appears to form a wedge on a lateral X-ray view
179
What muscles may attach to the transverse process of the fifth lumbar vertebra?
- psoas major
- quadratus lumborum
- longissimus thoracis
- rotator brevis
- rotator longus
- intertransversarii
180
What ligaments traditionally attach to the transverse process of the fifth lumbar vertebra?
- lumbosacral
- iliolumbar
- mammillo-accessory
181
What are the posterior elements of the L5 vertebra?
- zygapophysis
- lamina
- spinous process
182
What is the reported angulation and X-ray appearance of the fifth lumbar articular facets?
they lie in the vertical plane and are coronal facets
183
What is the orientation of the fifth lumbar superior articular facet?
- backward, upward, medial (BUM)
| - typically concave
184
What is the orientation of the fifth lumbar inferior articular facet?
forward, lateral, downward (FoLD)
| -significant convexity
185
What is Baastrup's syndrome?
elongation of the lumbar spinous process as a result of aging
-also called "kissing spines"
186
What is the name given to the congenital condition in which the fifth lumbar spinous process is elongated, the sacrum exhibits spina bifida, and dorsiflexion produces pain?
Knife Clasp Syndrome
187
What is the appearance of the lumbar vertebra upon oblique X-ray view?
a Scotty dog
188
What is the appearance of a pars defect in a lumbar vertebra upon oblique X-ray view?
a collared Scotty dog
189
What is the appearance of a spondylolysis in a lumbar vertebra upon oblique X-ray view?
a collared Scotty dog
190
In an oblique X-ray, spondylolysis below the superior articular process of a lumbar pars interarticularis is associated with what part of the Scotty dog?
the neck of the Scotty dog
191
What part of a lumbar vertebra forms the eye of a Scotty dog?
the pedicle
192
What part of a lumbar vertebra forms the ear of a Scotty dog?
the superior articular process
193
What part of a lumbar vertebra forms the nose of a Scotty dog?
the transverse process
