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Spinal Anatomy II Exam II All review questions Set II

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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
What T12 facet orientation changes may accompany lumbarization?
the superior articular facet may change from flat, back, upward and lateral to
concave, back, upward and medial; the inferior articular facet is unchanged
What T11 facet orientation changes may accompany lumbarization?
the inferior articular facet may change from flat, forward, medial and downward to
convex, forward, lateral and downward; the superior articular facet is unchanged
What is characteristic of lumbarization of S1?
the failure of synostosis between S1 and S2. squaring of the vertebral body of S1 and
flaring of the sacral ala
What is failure of synostosis between Sl and S2?
the segments do not completely fuse together
What is squaring of the vertebral body of S1?
the S1 vertebral body has similar anterior and posterior heights, hence a lack of wedging
What is flaring of the sacral ala?
the transverse process of the ala appears to elevate as though separating from the rest
of the sacral ala
What articular facet changes accompany lumbarization of S1?
none
What is characteristic of sacralization of L5?
L5 may be partially or completely fused to the sacrum
What is the incidence of sacralization of L5 in the population?
41% to 85%
Which segment demonstrates the greatest morphological variation along the spine?
L5
What articular facet changes accompany sacralization of L5?
none
What is the incidence of variation within the sacrococcygeal region in the population?
up to 14%
What is characteristic of sacralization of Co1?
the premature fusion of C01 to the sacrum
What is characteristic of coccygealization of S5?
the separation of S5 from sacrum and its' premature fusion to C01
How are curvatures of the vertebral column identified?
according to the direction the convexity of the curve faces
What is the direction of the primary curve of the vertebral column?
posterior
What embryonic event causes the direction of the posterior curve of the vertebral column?
the embryonic disc will undergo flexion in a cranial to caudal direction
Why is the posterior curve also called the primary curve?
it is the first curve to appear embryologically
What segmental levels form the cervical curve?
C2-T1
What segmental levels form the lumbar curve?
T12-L5
What is the earliest time of appearance of the cervical curve?
the third fetal month
What is the traditional time of appearance of the cervical curve said to be?
during the last trimester in utero
What is the time during which the "adult" cervical curve is said to appear?
within the first year after birth
What developmental events are indicated in the formation of the adult cervical curve?
centers for vision and equilibrium will appear in the brain
musculature attaching the skull, cervical region and upper thorax together develops the head is held upright the intervertebral disc height becomes greater anterior than posterior
At what age will the infant begin to hold the head erect?
usually between the third and fourth month after birth
What is the name given to the integration of visual and motor pathways associated with holding the head erect?
the righting reflex
What is the location for the apex of the cervical curve?
typically between C4 and C5
What is the location for the cervical kyphosis?
between occiput and C1
What is the name given to the primary cervical curve?
cervical kyphosis
What is the vertebral relationship between the cervical curve and the cervical enlargement?
cervical curve C2-T1; cervical enlargement C3-T1
What is the time of appearance of the lumbar curve?
between 12 and 18 months after birth
What infant activities are associated with the developmental of the lumbar curve?
crawling and walking
What developmental events are indicated in the formation of the adult lumbar curve?
crawling will cause the abdomen to put tension on the lumbar region and pulls it forward
muscle development is promoted to compensate for the swayback of the lumbars intervertebral disc height will become greater anterior compared to posterior walking will further promote muscle and intervertebral disc development
What happens within the intervertebral disc to facilitate the lumbar curve development?
the nucleus pulposus of L4 will shift its position within the annulus fibrosis
Which sense is a requirement for holding the head erect, standing, sitting and walking?
vision
What is the gender bias associated with lumbar curve convexity?
females have a greater convexity of the lumbar curve
What is the vertebral relationship between the lumbar curve and the lumbar enlargement?
lumbar curve T12- L5; lumbar enlargement T9-T12
What is the formation of the lateral curve often correlated with?
faster development of the muscles on the side of handedness
What is the time of appearance of the lateral curves?
they appear after 6 years old
What is the relationship between curve direction and handedness?
a right handed person has a high probability for a right thoracic, left lumbar curve
combination
What is the incidence of a right thoracic, left lumbar curve combination in the population?
about 80% of the population
Does "osis" infer a normal or an abnormal condition?
neither, it is non-judgmental
What clinical examples of abnormal curves along the vertebral column were stressed in class?
military neck, humpback or hunchback and swayback
What is military neck?
a decreased anterior curve in the cervical region, a straight neck
What is humpback or hunchback?
an increased posterior curve in the thoracic region
What is swayback?
an increased anterior curve in the lumbar region
What is classic classification of military neck?
a kyphosis
What is classic classification of humpback or hunchback?
a kyphosis
What is classic classification of swayback?
a lordosis
What does the use of the term lordotic try to imply?
a normal cervical and normal lumbar anterior curve
What does the use of the term kyphotic try to imply?
a normal thoracic or dorsal curve and a normal pelvic or sacrococcygeal posterior curve
What prefixes are used to convey abnormality in curve patterns?
hyper and hypo
What does the term hyperlordotic infer?
an increase in the anterior curve of the cervical or lumbar region
What does the term hypolordotic infer?
a decrease in the anterior curve of the cervical or lumbar region
What does the term hyperkyphotic infer?
an increase in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region
What does the term hypokyphotic infer?
a decrease in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region
What are the curve classifications for military neck?
a kyphosis or hypolordotic curve
What are the curve classifications for humpback or hunchback?
a kyphosis or hyperkyphotic curve
What are the curve classifications for swayback?
a lordosis or hyperlordotic curve
What is the more complete, accepted definition of scoliosis?
an abnormal lateral curve coupled with axial rotation
What is the relationship between degrees of lateral curve deviation, axial rotation, and care?
curves with 10 - 20 degrees of lateral deviation and a fixed angle of trunk rotation
have scoliosis curves with 20 - 30 degrees of lateral deviation and a fixed angle of trunk rotation of
5 degrees require attention curves with 30-50 degrees of lateral deviation and a fixed angle of trunk rotation of
7 degrees require intervention as they have a 60% chance to worsen curves with greater thi;1O50 degrees of lateral deviation have a 90% chance to worsen
What is the radiological test for skeletal maturity?
he Risser sign, an indication of bone maturity in the iliac apophysis
What are the classifications of scoliosis according to the Scoliosis Research Society?
magnitude, location, direction, etiology and structural/non-structural
What does magnitude of scoliosis refer to?
the length and angle of the curve deviation on x-ray
What is often used to measure the magnitude of scoliosis?
the Cobb Method
What does location of scoliosis infer?
the location on the vertebral segment forming the apex of the curve deviation
What does direction of scoliosis refer to?
he sid~ the convexity of the curve will bend toward
What is nonstructural scoliosis?
a mild form of scoliosis, unlikely to worsen, not associated with structural deformities of
the vertebra or intervertebral disc and lacks a fixed angle of trunk rotation
What is structural scoliosis?
a more radical form of scoliosis, it may worsen, associated with structural deformities of
the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation
What are some of the classifications of scoliosis based on etiology?
congenital, neuromuscular, neurofibromatosis, nerve root irritation, idiopathic
Which classification of scoliosis is unique to the individual patient?
idiopathic scoliosis
What does idiopathic scoliosis infer?
the scoliosis is unique to the individual, it has no known cause, unknown etiology
What is the incidence of idiopathic scoliosis in the population?
1% to 4% of the population
Based on age of onset, what are the types of idiopathic scoliosis?
infantile, juvenile and adolescent
What is the age range for infantile idiopathic scoliosis?
from birth to 3 years old
What is the age range for juvenile idiopathic scoliosis?
from 3 years old to 10 years old
What is the age range for adolescent idiopathic scoliosis?
over 10 years old
Identify the curve direction, location, gender bias and incidence of infantile idiopathic scoliosis.
left thoracic, male, less than 1% incidence
Identify the curve direction, location, gender bias and incidence of juvenile idiopathic scoliosis.
right thoracic, females over 6 years old, 12% - 21% incidence
dentify the curve direction, location, gender bias and incidence of adolescent idiopathic scoliosis.
right thoracic or right thoracic and left lumbar, females, 80% incidence
What is the genetic factor associated with adolescent idiopathic scoliosis?
an autosomal dominant factor that runs in families
hat is the relationship between curve deviation, incidence, and curve worsening?
the greater the deviation, the lower the incidence and the more likely to worsen
What does the word "splenius" mean?
Greek for bandage
What part of the vertebra forms the osseous origin for the splenius?
spinous process
Splenius capitis will attach to what locations on the skull?
mastoid process of temporal bone, superior nuchal line of the occipital bone
Contraction of splenius capitis will result in what movements?
lateral flexion of head. rotation of face to the side; bilaterally they extend the head
What is the innervation of the splenius capitis?
dorsal rami of middle cervical spinal nerves (C3-C5 cord levels)
Splenius cervicis will attach to what locations on the spine?
lateral mass of C1 & posterior tubercle of transverse process on C1-C4
Contraction of splenius cervicis will result in what movements?
lateral flexion & rotation of neck; bilaterally they extend the neck
What is the innervation of the splenius cervicis?
dorsal rami of lower cervical spinal nerves (C5-C7 cord levels)
Which muscles represent the fourth layer of the true back?
the erector spinae or sacrospinalis muscles
What osseous parts of the vertebral column serve as an origin to the iliocostalis lumborum?
spinous processes of T11-L5, median sacral crest, lateral sacral crest
What is the insertion for the iliocostalis lumborum?
costal angles of the lower 6-9 ribs (rib6-rib 12 or rib 3-rib 12)
Contraction of iliocostalis lumborum will result in what movements?
extension, lateral flexion & rotation of lumbar spine; lateral pelvic movement
What is the innervation of the iliocostalis lumborum?
dorsal rami of lower thoracic and all lumbar spinal nerves
What muscles are identified as subdivisions within the iliocostalis muscles?
iliocostalis lumborum pars lumborum & iliocostalis lumborum pars thoracis
42. What is the insertion for the iliocostalis lumborum pars lumborum?
iliac crest of the innominate bone
What osseous parts of the vertebral column serve as an origin to the iliocostalis lumborum pars thoracis?
posterior superior iliac spine (PSIS) & iliac crest of the innominate bone
What is the insertion for the iliocostalis lumborum pars thoracis?
costal angles of the lower 8-9 ribs (rib 3 or 4-rib 12)
What osseous parts of the vertebral column serve as an origin to the iliocostalis thoracis?
none
What is the origin for the iliocostalis thoracis?
costal angles of the lower 6-7 ribs (rib 5'or 6-rib 12)
What is the insertion for the iliocostalis thoracis?
costal angles of the upper 6-7 ribs, transverse process of C7
What osseous part of the vertebral column serves as an insertion for the iliocostalis thoracis?
transverse process of C7
Which subdivision of the iliocostalis primarily originates & inserts on ribs?
iliocostalis thoracis
What is the innervation of the iliocostalis thoracis?
dorsal rami of upper 6 thoracic spinal nerves (T1-T6 cord levels)
What osseous parts of the vertebral column serve as an origin to the iliocostalis cervicis?
none
What is the origin for the iliocostalis cervicis?
costal angles of the upper 3-6 ribs (ribs 1-3 or ribs 1-6)
What is the insertion for the iliocostalis cervicis?
posterior tubercle of transverse process of C(3) 4-C6
Contraction of iliocostalis cervicis will result in what movements?
extension, lateral flexion & rotation of the lower cervical spine
What is the innervation of the iliocostalis cervicis?
dorsal rami of T1, T2 spinal nerves, sometimes c8 spinal nerve (C8, T1, T2 cord levels)
What muscles are classically identified as longissimus muscles?
longissimus thoracis, longissimus cervicis and longissimus capitis
What osseous parts of the vertebral column serve as an origin to the longissimus thoracis?
accessory process & transverse processes of L1-L5, spinous processes of L3-L5 and
median sacral crest S1-S3
What innervates the rotator brevis attaching to C2?
the dorsal ramus of C2 is believed to do so
What innervates the rotator longus attaching to C2?
the dorsal ramus of C2is believed to do so
What muscles are included in the suboccipital muscle group?
rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior
and obliquus capitis superior
Which suboccipital muscle lacks an attachment to the skull?
obliquus capitis inferior
Which nerve will innervate all suboccipital muscles?
the dorsal ramus of C1, the suboccipital nerve
What is the origin of the rectus capitis posterior major?
the spinous tubercle of C2
What is the insertion of the rectus capitis posterior minor?
inferior nuchal line laterally
Contraction of rectus capitis posterior major will result in what movements?
turns the face to the side, bilaterally acts to extend the head
What is the origin of the rectus capitis posterior minor?
the posterior tubercle of the posterior arch of C1
What is the insertion of the rectus capitis posterior minor?
inferior nuchal line medially
What is the origin of the obliquus capitis inferior?
C2 spinous process and lamina
What is the insertion of the obliquus capitis inferior?
transverse process of C1
Contraction of obliquus capitis inferior will result in what movement?
turns the face to the side
What is the origin of the obliquus capitis superior?
the posterior tubercle of the transverse process of C1
What is the insertion of the obliquus capitis superior?
between superior nuchal line & inferior nuchal line
Contraction of obliquus capitis superior will result in what movements?
lateral flexion/lateral bending of the head, bilaterally acts to extend the head
An increase in the density of muscle spindles is most apparent in which suboccipital muscle?
obliquus capitis inferior
Suboccipital muscle feedback relays to what 9dditionallocations in the brain?
extraocular nuclei of origin, primary visual cortex and vestibular nuclei
What is the result of communication between suboccipital muscles, visual centers and vestibular centers?
coordination of head and eye position
What is the proposed function of the suboccipital muscle group?
postural stabilizers of the atlanto.occipital and atlanto-axial joints
Which suboccipital muscle is known to attach to dura mater?
rectus capitis posterior minor
At what segmental levels of the spine will the interspinalis muscle be present?
C2-T3 and T11-L4 or L5
InterspinaliS is paired in which regions of the spine?
cervical and lumbar
At what locations will interspinalis be absent along the spine?
T3-T4 to T10-T11
What are the attachment sites for the interspinalis muscle?
spinous tubercle & spinous process of adjacent vertebrae
Contraction of interspinalis is traditionally said to result in what movement?
weak approximation of the spinous processes or extension of the spine
Based on the density of muscle spindles what is the proposed function of the interspinalis?
Based on the density of muscle spindles what is the proposed function of the interspinalis?
Intertransversarii are paired in which region(s) of the spine?
cervical and lumbar regions
Intertransversarii are unpaired in which region(s) of the spine?
thoracic
In which region of the spine are intertransversarii best developed?
cervical
What are the names of the parts of the intertransversarii in the cervical spine?
anterior belly, posterior lateral belly, posterior medial belly
Which of the cervical intertransversarii is innervated by dorsal rami of cervical spinal nerves?
posterior medial belly, cervical intertransversarii
. What are the names of the parts of the intertransversarii in the lumbar spine?
medial belly, anterior lateral belly, posterior lateral belly
Which muscle group is innervated by both dorsal rami and ventral rami of spinal nerves?
intertransversarii
Contraction of intertransversarii is traditionally said to result in what movement?
weak approximation of transverse processes or lateral flexion (bending) of the spine
Based on the density of muscle spindles what is the proposed function of the
intertransversarii?
acts as a proprioceptive transducer in conjunction with interspinalis to coordinate
the smooth movement of the spine and to maintain appropriate posture
What is the origin of the longus colli?
vertebral bodies of C5- T3 & anterior tubercles of transverse processes C3-C5
What is the insertion of the longus colli?
anterior tubercle of the anterior arch C1, vertebral bodies of C2-C4, &
anterior tubercles of transverse processes C5-C6
What will innervate the longus colli?
ventral rami of C2-C6 or C7 spinal nerves
Which muscle is said to form the iliolumbar ligament?
quadratus lumborum
The quadratus lumborum is implicated in the formation of which ligament?
the iliolumbar ligament