Spinal Anatomy II Exam II All review questions Set II
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?
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?
What articular facet changes accompany sacralization of L5?
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?
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?
What segmental levels form the lumbar curve?
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?
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?
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?
What is classic classification of humpback or hunchback?
What is classic classification of swayback?
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?