Vertebral column

Question 1

Primary Spinal Curvature

Answer 1

Present at birth

1. Thoracic kyphosis
2. Sacral kyphosis

Question 2

Secondary Spinal Curvature

Answer 2

After birth

1. Cervical lordosis - when holding head up
2. Lumbar lordosis - when first walking

Question 3

Intervertebral disc function

Answer 3

1. link adjacent vertebral bodies
2. limit rotation
3. inc. strength
4. transmit loads
5. absorb shock

Question 4

Annulus fibrosis

Answer 4

1. alternating fibers
2. Limits rotation
3. inc. strength
4. around edges of IVD
5. thinner posteriorly

Question 5

Nucleus pulposus

Answer 5

1. core of IVD
2. inc. flexibility
3. inc. resilience
4. avascular
5. remnant of notochord

Question 6

Atlanto-occipital joint

Answer 6

sup. articular facets of C1 and occipital condyles
1. No IVD
2. primary fxn: flexion
3. some extension, lateral flexion, and rotation

Question 7

Atlanto-axial joint

Answer 7

C1 and C2 (dens process)

1. primary fxn: rotation

Question 8

Uncovertebral joints

Answer 8

1. uncinate processes of C3-C7 and superior adjacent body
2. common sire of bone spurs (osteophytes)
3. saddle-like structures
4. may compress nerves/arteries

Question 9

zygapophyseal joints

Answer 9

1. articular facets determine ROM
2. Cervical: sloped/horizontal
   A. promotes flexion/extension, some lateral flexion
   B. limits rotation
   C. Most mobile region
3. Thoracic: vertical
   A. promotes rotation
   B. limits flexion/extension
4. Lumbar: wrapped (facets cup each other)
   a. promotes flexion/extension
   b. limits rotation

Question 10

Vertebral column development

Answer 10

Week 3: paraxial mesodern -> somitomeres
Week 4: surround notochord -> somites
End week 4: scleratome -> mesenchyme
a. scleratome: cranial = loose, caudal = dense

Question 11

Adult vs. Embryp vertebrae components

Answer 11

1. body > centrum
2. arch < neural arch
3. body = centrum + part neural arch
4. arch = part neural arch

Question 12

Resegmentation of scleratomes

Answer 12

centrum from caudal part of superior scleratome + cranial prtion of inferior adjacent scleratome
a. remaining mesenchyme -> IVD

Question 13

Rib development

Answer 13

costal processes (elements) on all vert,

a. should only elongate on thoracic
b. common defects
1. extra ribs: C7 and L1
2. sacrilization of L5
3. lumbarization of S1

Question 14

Mermaid syndrome

Answer 14

defect in caudal scleratome migration

Question 15

Klippel-Feil syndrome

Answer 15

1. 2+ cervical vertebrae fused
2. short neck, dec. mobility, low hairline
3. associated w/ cervical dystonia, facial asymmetry, high scapula, spinal stenosis and compression

Question 16

Spina Bifida

Answer 16

1. Occulta: asymptomatic, tuft of hair on outside
2. Cystica: neurological defects
   a. meningocele: meningeal cyst
   b. meningemyelocele: involves spinal cord
   c. myeloschisis and rachischesis: spinal cord exposed

Question 17

Vertebral body osteoporosis

Answer 17

Metabolic bone disease

1. Detected routine radio graphic studies
2. Bone atrophy -> inc risk fractures

Question 18

Lumbar spinal stenosis

Answer 18

Narrowing of vertebral foramen

Question 19

IVD herniation (slipped disc)

Answer 19

Protrusion of nucleus purposes into or thru anulus fibrosus

Question 20

DISH (diffuse idiopathic skeletal hypersotosis)

Answer 20

Vertebral ligaments calcified

1. Usually ant. Longitudinal lig. -> spinal fusion
2. “Melted candle wax” appearance

Question 21

Spondylolisthesis

Answer 21

Vertebral body slips forward

1. Lumbar
2. Related to stress fracture

Question 22

Spondylitis

Answer 22

Vertebrae joint and IVD inflammation

Question 23

Ankylosing spondylitis

Answer 23

Inflammation of all vertebral joints and IVD degeneration

1. “Bamboo spine” - anulus fibrosus ossify -> syndesmophytes, spinal fusion, and spinal straightening

Question 24

Spondylosis

Answer 24

Degenerative vertebral arthritis

Question 25

Hemivertebrae

Answer 25

Right/left chondrification that center vertebrae doesn’t dev. 1. Unilateral wedge-shaped hemivertebrae

Question 26

Block vertebrae

Answer 26

Non-segmentation of adjacent scleratomes -> vertebral fusion 1. Kyphotic deformity 2. Kipper-feil syndrome 3. Blocking/stretching nerve root

Question 27

Excess thoracic kyphosis

Answer 27

1. Humpback or Dowager’s hump | 2. Association w/ osteoporosis

Question 28

Excess lumbar lordosis

Answer 28

Hollow/sway back

Question 29

Scoliosis

Answer 29

Excess lateral curvature

Question 30

Accessory ribs

Answer 30

Extra ribs, usually on C7 or L1

Question 31

Sacrilization of L5

Answer 31

L5 fuses w/ S1