The coccyx made up of ___ fused vertebrae. They are also known as what?
4, AKA: vertebral segments
1. How many ossification centers are there per vertebra?
2a) When does primary ossification start? b) Finish?
1. There are 8 in total: 3 primary and 5 secondary.
2a) In the 1st four weeks of pregnancy. b) Usually by age 10
1. Where are the primary ossification centres?
2.Where are the secondary ossification centres?
1. Body and pedicle/laminae
2. Transverse and spinous processes, and the upper and lower "crust" of the body.
What is meant by spina bifida?
2. There are 2 types. Spina Bifida _____ and ____.
1. A "spinal column split". It's the failure of 2 parts of the vertebrae to fuse.
2. Occulta and Cystica
What is Spina Bifida Occulta?
1. Occulta = hidden
When there is a defect in the vertebral arch (failure of full fusion). Clinically patient is asymptomatic and it is usually an incidental finding.
2. Gap is made into spinal canal, but nothing protrudes in or out of canal.
What are the 2 types of Spina Bifida Cystic?
Mennigocoela and Menningomyolocoela
Menningo = Menniges
Coela = Cyst
Myelo = Nervous tissue
Composed of menninges and CSF
Composed of nervous tissue, menninges, & CSF. *** Presence of nervous tissue in the cyst & it can be seen externally.
Will have paralysis from the waste down.
After surgery, will still produce excess CSF that has nowhere to drain. So px must come in for drainage w/in a few months.
What are the total number of vertebrae that the typical spine composed of?
5C + 12T + 5L + 5S + 4Co = 33
What is meant by lumbarization of the S1 segment?
When a free sacral vertebra looks like a lumbar vertebra (i.e. 6L + 4S). There is NO possibility of having 6 lumbar vertebrae, so it should be:
5C + 12T + 5L + + 1 free sacral + 4S + 4Co = 33
What is meant by sacralization of L5?
When L5 has fused with the sacrum. In this case there would be 10 sacral foramina. 4L + 5L added to 5S.
It looks like this: 5C + 12T + 4L + 5S + 4Co = 33
The typical number of vertebrae is ____? However, it could also be ____ depending on what?
33, but it could be 32 or 34 due to + or - of 1 segment of the coccyx.
1. Where do the tubercle and the head of the rib attach on the spine?
2. What does a typical rib look like, in terms of its attachments?
3. On which vertebrae are there facets on the TPs?
1. Tubercle attaches to transverse process and head attaches to the body
2. It has a facet on the upper and lower part of the body where the head of the rib attaches. Ribs T2 - T9 are like this.
3. Facets are present on T1-T10, but NOT present on T11-T12. ***This is standard but could change if there is an anomoly.
1. What is a demi facet?
2. What are the atypical vertebrae in terms of rib connection and what do they look like?
1. Where 1 vertebra connects 1/2 of the rib.
2. T1: Has one full facet for the 1st rib and one demi facet for the head of rib 2. TP has a full facet for rib 1.
T10: Has one demi facet for the head of rib 10 on the superior margin of the vertebral body. TP may/may not have a facet for rib 10. It's varibale.
T11 & T12: Have one full facet each for attachment of ribs 11 and 12. They usually lack facets on the TPs.
What are five functions of the vertebral column?
1. Protects spinal cord & spinal nerves.
2. Supports the weight of the body.
3. Rigid/flexible axis for the body.
4. Pivot for the head
5. Posture and locomotion
1. Spinal column is made of what 5 components? How many vertebra per component?
2. How many vertebra altogether?
3. How many bones altogether?
Cervical (7), Thoracic (12), Lumbar (5), Sacral (5), and Coccygeal (4)
2. 33 are commonly found
3. 26 bones (24 vertebra + sacrum and coccyx)
1. What are the two types of curves and the categories within them?
2. How do the primary curves develop? Secondary?
1. Primary Curves: Thoracic kyphosis and sacral kyphosis. Secondary Curves: Cervical lordosis and lumbar lordosis
2. In the womb (after ~2 months) and for a period of time following birth, a baby's spine is shaped like the letter C. This is a primary curve, which is Kyphotic. During the time the baby is learning to lift his head and eventually sit & walk, muscles develop. As muscular strength and ability is gained, the baby's activity will shift body weight to the spine. Gradually secondary curves develop in the cervical and lumbar regions; Lordotic curves. These curves will continue to develop until growing stops.
1. What is scoliosis?
2. What is hyperlordosis? Hypolordosis?
3. What is hyperkyphosis?
1. Curvature sideways in the spine where (typically) the thoracolumbar spine is effected. Is always a pathology, except in puberty in women.
2. HYPER: Accentuated belly forward. HYPO: Full bending forward.
3. HYPER: Hunchback. HYPO: Very straight.
What makes up a typical vertebrae? (9 parts)
Body, pedicles, laminae, intervertebral foramen, spinous process, transverse process, superior and inferior articular processes, facets, and the superior and inferior vertebral notch.
1. What are the typical and atypical cervical vertebrae?
2. What are 5 characteristics of a typical cervicle vertebrae?
1. TYP: C3-C6. ATYP: C1 (Atlas), C2 (Dens axis), and C7.
2. Split bifid spinous process, transverse process foramina, Ant & Post tubercles on the TPs, Lg. vertebral foramen, uncinate (uncle) processes on the upper body, and articular column
1. Why do cervical vertebrae exhibit several different directions of movement?
2. What is characteristic of C7?
1. Articular processes and postion of articular facets are closest to the transverse anatomical plane. They therefore exhibit flexion, extension, lateral flexion, and rotation. ***They are the most mobile vertebrae.
2. Longest spinous process which is easily palpated on the posterior surface of the neck.
What is the atlas composed of? (6 things)
1. Ant & Post arch
2. Ant & Post tubercles on the TP
3. Lateral masses
4. Sup articular surfaces (condyles) that make a joint with the occipital bone,
5. Articular surface for dens axis on the anterior arch
6. The groove for the vertebral artery.
1. What are the major characteristics of the axis (C2)?
1. Dens axis (odontoid process/epistropheus)
2. Two facets: 1. on the anterior surface which is for joint between the dens and the anterior arch of atlas and the other one which is located on the posterior surface of dens axis. 2. For the transverse ligament of the atlas.
1. How many contact points does the axis have with the atlas?
2. What are the two facets on the dens axis for?
2. To make a joint with the atlas???
What is unique about thoracic vertebrae? (4)
1. Larger vertebral body
2. Long, pointed spinous process
3. Cylindrical vertebral foramen
4. They make contact with the ribs and have facets on both the lateral surface of the vertebral body and the transverse process
Why is mvt of thoracic vertebrae mostly rotation and to some extent flexion/extension?
B.c the position and orientation of facets on the sup & inf articular processes are closest to the frontal plane.
1. Which thoracic vertebrae are typical and atypical? Why?
2. What is unique about T11 and T12 unrelated to rib attachment?
1. TYP: T2-T9 b/c they all have sup & inf demi facets. ATYP: T1, T10-T12
2. Their spinous processes are short and rectangular (closer to the shape of spinous processes of lumbar vertebrae).
What characterizes lumbar vertebrae?
Do not differ much from the description of typical vertebrae. They have the largest vertebral bodies and short, rectangular, and horizontally oriented spinous processes.
2. They have 2 additional processes called accessory and mammillary processes
Position and orientation of facets on articular processes of the lumbar vertebrae approximate the _________ plane. Principle movement is ________, some ________ is permitted, but no _________.
saggital. flexion and extension, some lateral flexion is permitted, but no rotation.
1. Which lumbar vertebrae is atypical and why?
2. Why is this important?
3. What is the TP on the lumbar spine referred to ?
1. TYP: L1-L4. ATYP: L5
L5 has a wedge-shaped body, which is thicker anteriorly than posteriorly.
2. B.c it accommodates the transition between perpendicularly arranged lumbar spine vs nearly horizontal position of the sacrum.
3. Costal process
What five structures appear on the pelvic surface of the sacrum?
1. Transverse lines
2. Sacral pelvic foramina/structures passing through
3. Base of the sacrum
What 7 structures appear on the dorsal surface of the sacrum?
1. Dorsal sacral foramina + structures passing through,
2. Median, intermediate & lateral sacral crests,
3. Sacral canal
4. Sacral hiatus
5. Sacral cornua,
6. Auricular surface (for sacro-illiac joint)
7. Sacral tuberosity (attchmt of ligaments that reinforce the sacro-illiac joint)
1. What is the structure of the coccyx?
2. What is coccydynia or coccygodinia?
1. Composed of 4 coccygeal segments (occasionally 3 or 5) and coccygeal cornua
2. Pain in the coccyx or tailbone area, usually brought on by falling or sitting too abruptly and childbirth.
1. What are synostoses?
2. What makes up the intervertebral disc? For what joint?
1. Fusion of normally separate bones.
2. Nucleus pulposos (soft, attracts water) and the Annulus fibrosus (layered structure, hard). Joint = Anterior intervertebral joint.
1. How many intervertebral discs are there? Where not?
2. What are the two functions of intervertebral discs?
1. Twenty-three. Not btwn the occipital bone/atlas AND atlas/axis
2. Resistance to compression and connection between the bodies
What type of joint is the anterior intervertebral joint?
Amphiarthroidal and secondary cartilaginous joints
What is a disc herniation? Where does it usually happen?
1. When the content of one space/cavity finds its way out of its enclosure. Eg. When the nucleus pulposus foes into the Intervertebral foramen and/or the annulus fibrosis. It usually happens in the posterior lateral direction.
17)What are some relevant parts of the occipital bone?
?????????????basilar portion, squama, foramen magnum, condyles of the occipital bone, external occipital protuberance, superior and inferior nuchal lines????????????
1. What can happen if the suboccipital triangle squishes in?
2. How is flexion of the spinal column achieved without muscles that attach anteriorly?
1. Vertebro Basalar Syndrome: Basal artery is compressed over long period of time and the brain is effected, specifically the centre for vision. Blurred vision may be a sign of stroke. Rotating the head when this is already happening might compress the artery further and someone could have a stroke. Impact on cerebellum → balance.
1. What is torticollis and how can it be repaired?
AKA Wry neck. Muscles become shortened during fetal development causing the neck to tilt to one side. Can also happen b/c of careless handling during labour (i.e. with forceps). Minor surgery would put an incision the muscle to allow it to stretch and grow over life.
Cervical lordosis is the result of ________
A baby's ability to hold its head up
Which vertebrae have the most limited movement (type and range) and why?
Thoracic vertebrae b/c the sup & inf AP are flat in the frontal plane making them upright.
Name the joints that connect each section of the spine.
1. Cranial cervical junction
2. Cervical thoracic junction
3. Thoracolumbar junction
4. Lumbar sacral junction
What is the direction of the Spinotransverse group?
Inferior medial to superior lateral.
From the spinous process to the transverse process.
What is the direction of the Sacrospinalis group?
Inferior medial to superior lateral.
From the sacrum, etc. to the spinous process.
What is the direction of the Transversospinalis group?
Inferior lateral to superior medial.
From the transverse process to the spinous process.
Explain where all the muscles lie in the suboccipital triangle.
Why might a person be taller in the morning?
B/c of the ↑ water content of the nucleus fibrosus. It is very soft and it regenerates over night. So in the am, it hasn't had a lot of pressure on it yet.
What are 3 types of disc herniation and treatment?
Protrusion, prolaps, & extrusion.
Explain protrusion and treatment.
A slow and gradual bulging out of the nucleus pulposus (NP) into the anulus fibrosos(AF)/Int foramen distorting the shape of the disc. Milder and most common form. Treatment is sleeping in 90/90 position. It will regress back over time.
Explain prolaps and treatment.
Annulus fibrosus begins to open and the nucleus pulposus goes into the spinal canal. This causes perm. dmg and requires surgery that involves scooping the NP & pushing it back into the AF. Problems occur b/c with a small amount of NF to support the body, the disc will eventually wear down and vertebrae will ossify.
When the entire nucleus pulposus is pushed into the intervertebral foramen. An even further development is when a disc is sequestered into the intervertebral foramen. Sequestration occurs when the NP pushes through via the posterior longitudinal ligament. In this case the PLL is torn or ripped and it moves (is sequestered) to a different part of the spine.
What is squama?
2 layers of compound bone with a layer of spongy bone in btwn. Any bone in the head will have squama.