CMED 116: The Back Pt. 1 (The Vertebrae)

Mammillary processes

(Blank) or small tubercles also occur on vertebra T12.

Traumatic spondylolysis of C2

A fracture in the pars intertarticularis, called a (blank), usually occurs as a result of hyperextension of the head on the neck.

L4

A horizontal line joining the highest points of the iliac crests passes through the tip of the (blank) spinous process and the L4-L5 IV disc. This is a useful landmark when performing a lumbar puncture to obtain a sample of CSF.

Hangman's fracture

Abrupt hyperextension of the head will lead to what type of fracture in the axis?

Fractures of the dens

Also common axis injuries (40-50%), which may result from a horizontal blow to the head or as a complication of osteopenia.

Thick

Although the cervical IV discs are thinner than those of inferior regions, they are relatively (blank) compared to the size of the vertebral bodies they connect.

Increases

An increased length of the presacral region of the vertebral column (blank) the strain on the inferior part of the lumbar region of the column owing to the increased leverage.

Males, females

An increased number of vertebrae occurs more often in (blank), and a reduced number occurs more frequently in (blank).

Articular processes

Are in apposition with corresponding processes of vertebrae adjacent (superior and inferior) to them, forming zygapophysial joints.

Vertebra prominens

Because of the prominent process of C7, it is called the?

Nuchal groove

C2 has a large bifid spinous process that can be felt deep in the (blank), the superficial vertical groove at the back of the neck.

Cervical enlargement of the spinal cord

C3-C7 have large vertebral foramina to accommodate the (blank) as a consequence of this region's role in the innervation of the upper limbs.

Whiplash injury

Combined hyperextension of the head and neck may result to?

Back

Comprises the posterior aspect of the trunk, inferior to the neck and superior to the buttocks.

Typical vertebra

Consists of a vertebral body, a vertebral arch, and seven processes.

T5-T8

Demonstrate all the features typical of thoracic vertebrae.

Lumbar spinal stenosis

Describes a narrow vertebral foramen in one or more lumbar vertebrae.

Childhood

During (blank), the individual sacral vertebrae are connected by hyaline cartilage and separated by IV discs.

Vertebral arch and posterior surface of the vertebral body

Form the walls of the vertebral foramen

Articular facet

Four articular processes (G. zygapophyses)—two superior and two inferior—also arise from the junctions of the pedicles and laminae, each bearing an (blank)

Vertebral arch

Fractures of the (blank) of the axis (vertebra C2) are one of the most common injuries of the cervical vertebrae.

Jefferson or burst fracture

Fracturing one or both of the anterior or posterior arches of C1. Does not necessarily result in spinal cord injury.

20

Fusion of the sacral vertebrae starts after age (blank); however, most of the IV discs remain unossified up to or beyond middle life.

L5

Generally, the articular processes bear weight only temporarily, as when one rises from the flexed position, and unilaterally when the cervical vertebrae are laterally flexed to their limit. However, the inferior articular processes of the (blank) vertebra bear weight even in the erect posture.

C7

Has the longest spinous process/

Anular epiphyses

In addition to serving as growth zones, the (blank) and their cartilaginous remnants provide some protection to the vertebral bodies and permit some diffusion of fluid between the IV disc and the blood vessels in the vertebral body.

72-75 cm

In adults, the vertebral column is (blank) long, of which approximately one quarter is formed by the IV discs that separate and bind the vertebrae together

Quadriplegia

In more severe injuries, the body of the C2 vertebra is displaced anteriorly with respect to the body of the C3 vertebra. With or without such subluxation (incomplete dislocation) of the axis, injury of the spinal cord and/or of the brainstem is likely, sometimes resulting in (blank)

Ribs

In the thoracic region, the costal elements separate from the developing vertebrae and elongate into (blank), and the transverse elements alone form the transverse processes.

T1

Is atypical of thoracic vertebrae in that it has a long, almost horizontal spinous process that may be nearly as prominent as that of the vertebra prominens.

Sacral triangle

Is formed by the lines joining the two posterior superior iliac spines and the superior part of the intergluteal (natal) cleft between the buttocks.

Coccyx

Is the remnant of the skeleton of the embryonic tail-like caudal eminence, which is present in human embryos from the end of the 4th week until the beginning of the 8th week.

Auricular surface

It is the site of the synovial part of the sacroiliac joint between the sacrum and ilium. During life, the (blank) is covered with hyaline cartilage.

Thorax and sacrum

Lumbar vertebrae are in the lower back between the (blank) and (blank).

Vertebral end plates

Most of the superior and inferior surfaces of the vertebral body are covered with discs of hyaline cartilage which are also called

30

Of the 9 inferior vertebrae, the 5 sacral vertebrae are fused in adults to form the sacrum, and after approximately age (blank), the 4 coccygeal vertebrae fuse to form the coccyx.

Rami

On the pelvic and posterior surfaces of the sacrum between its vertebral components are typically four pairs of sacral foramina for the exit of the posterior and anterior (blank) of the spinal nerves

Intertransversarii muscles

On the posterior surface of the base of each transverse process of the lumbar vertebrae is a small accessory process, which provides an attachment for the (blank)

Multifidus

On the posterior surface of the superior articular processes are small tubercles, the mammillary processes, of the lumbar vertebrae which give attachment to both the (blank) and intertransversarii muscles of the back

Median spinous process

One (blank) projects posteriorly from the vertebral arch at the junction of the laminae.

Two perichondral centers

One in each half of the neural arch

Basivertebral veins

One or more large foramina in the posterior surface of the vertebral body accommodate (blank) that drain the marrow.

Horizontal trabeculae

Osteoporosis especially affects the (blank) of the trabecular bone of the vertebral body.

Bodies

Osteoporosis usually affects which part of the vertebrae?

Osteopenia

Pathological loss of bone mass.

Spinous and transverse processes

Provide attachment for deep back muscles and serve as levers, facilitating the muscles that fix or change the position of the vertebrae.

Thoracic kyphosis

Radiographs in later stages of osteoporosis may reveal vertebral collapse (compression fractures) and increased (blank).

S5

Sacral vertebrae with no spinous process.

Puberty

Secondary ossification centers develop during (blank) in each typical vertebra.

25 superior

Significant motion occurs only between the (blank) vertebrae.

Transverse ligament

Spinal cord injury is more likely, however, with a jefferson or burst fracture if the (blank) has also been ruptured.

T12

Subject to transitional stresses that cause it to be the most commonly fractured vertebra.

Spinal cord

Surgical laminectomy is often performed to relieve pressure on the (blank) or nerve roots caused by a tumor, herniated IV disc, or bony hypertrophy (excess growth).

Demifacet

T1 also has a complete costal facet on the superior edge of its body for the 1st rib and a (blank) on its inferior edge that contributes to the articular surface for the 2nd rib.

Pedicles

The (blank) are short, stout cylindrical processes that project posteriorly from the vertebral body to meet two broad, flat plates of bone, called laminae, which unite in the midline.

Lateral sacral crests

The (blank) are the tips of the transverse processes of the fused sacral vertebrae

Trabecular bone

The (blank) is a meshwork of mostly tall vertical trabeculae intersecting with short, horizontal trabeculae.

Lumbrosacral angle

The (blank) occurs at the junction of the long axes of the lumbar region of the vertebral column and the sacrum.

Inferior half

The (blank) of the sacrum is not weight-bearing; therefore, its bulk is diminished considerably.

Dorsal surface

The (blank) of the sacrum is rough, convex, and marked by five prominent longitudinal ridges

Pelvic surface

The (blank) of the sacrum is smooth and concave.

L2 spinous process

The (blank) provides an estimate of the position of the inferior end of the spinal cord.

Intermediate sacral crest

The (blank) represent the fused articular processes.

Sacral hiatus

The (blank) results from the absence of the laminae and spinous process of S5 and sometimes S4.

Pelvic, dorsal

The (blank) sacral foramina are larger than the (blank) ones

Sacral cornua

The (blank), representing the inferior articular processes of S5 vertebra, project inferiorly on each side of the sacral hiatus and are a helpful guide to its location.

Synovial zygapophysial joints

The 25 cervical, thoracic, lumbar, and first sacral vertebrae also articulate at (blank), which facilitate and control the vertebral column's flexibility.

Long axis of the lumbar region

The L5 body is markedly taller anteriorly; therefore, it is largely responsible for the lumbosacral angle between the (blank) of the vertebral column and that of the sacrum.

Subarachnoid space

The S2 spinous process lies at the middle of a line drawn between the posterior superior iliac spines, indicated by the skin dimples. This level indicates the inferior extent of the (blank).

Transverse and costal elements

The ala and auricular surfaces of the sacrum are formed by the fusion of the (blank) and (blank).

Cervical muscles

The anterior and posterior tubercles of the cervical vertebrae provide attachment for a laterally placed group of (blank) (levator scapulae and scalenes).

Sacral promontory

The anterior projecting edge of the body of the S1 vertebra is the (blank), an important obstetrical landmark.

C6

The anterior tubercles of vertebra (blank) are called carotid tubercles because the common carotid arteries may be compressed here, in the groove between the tubercle and body, to control bleeding from these vessels.

Adjacent vertebrae

The articular processes also assist in keeping (blank) aligned, particularly preventing one vertebra from slipping anteriorly on the vertebra below.

Greatest degree of rotation

The articular processes of the thoracic vertebrae extend vertically with paired, nearly coronally oriented articular facets that define an arc centered in the IV disc. This arc permits rotation and some lateral flexion of the vertebral column. In fact, the (blank) is permitted here.

Superior articular facets

The axis has two large, flat bearing surfaces, the (blank), on which the atlas rotates.

Males

The body of the S1 vertebra is usually larger in (blank).

Median sacral crest

The central ridge, the (blank), represents the fused rudimentary spinous processes of the superior three or four sacral vertebra.

Neck injuries

The cervical vertebrae, "stacked like coins," can be dislocated in (blank) with less force than is required to fracture them.

Sacral hiatus and sacral cornua

The clinically important features of the dorsal surface of the sacrum are the inverted U-shaped (blank) and the (blank).

Sitting

The coccyx does not participate with the other vertebrae in support of the body weight when standing; however, when (blank) it may flex anteriorly somewhat, indicating that it is receiving some weight.

Anococcygeal ligament

The coccyx provides attachments for parts of the gluteus maximus and coccygeus muscles and the (blank), the median fibrous band of the pubococcygeus muscles.

Transverse ligament of the atlas

The dens is held in position against the posterior aspect of the anterior arch of the atlas by the (blank). It prevents posterior (horizontal) displacement of the dens and anterior displacement of the atlas.

Pivot

The dens lies anterior to the spinal cord and serves as the (blank) about which the rotation of the head occurs.

Odontoid process

The distinguishing feature of C2 is the blunt tooth-like dens, also called the (blank), which projects superiorly from its body.

Uncinate process

The elevated superolateral margin of the cervical vertebrae.

Epiphysial growth plates

The hyaline anular epiphyses, to which the IV discs attach, are sometimes referred to as (blank) and form the zone from which the vertebral body grows in height.

Occipital condyles

The kidney-shaped, concave superior articular surfaces of the lateral masses of C1 articulate with two large cranial protuberances, the (blank), at the sides of the foramen magnum.

Foramen transversarium

The most distinctive feature of each cervical vertebra is the oval (blank) in the transverse process.

C1 nerve

The posterior arch of C1, which corresponds to the lamina of a typical vertebra, has a wide groove for the vertebral artery on its superior surface. The (blank) also runs in this groove.

Cauda equina

The sacral canal is the continuation of the vertebral canal in the sacrum which contains the bundle of spinal nerve roots arising inferior to the L1 vertebra, known as the (blank), that descend past the termination of the spinal cord.

Low back sprains

The sacral triangle outlining the sacrum is a common area of pain resulting from (blank).

Female, male

The sacrum is often wider in proportion to length in the (blank) than in the (blank).

130-160 degrees

The sacrum is tilted so that it articulates with the L5 vertebra at the lumbosacral angle which varies from (blank).

Pelvic girdle

The sacrum provides strength and stability to the pelvis and transmits the weight of the body to the (blank)

Coccygeal cornua

The short transverse processes of the coccyx are connected to the sacrum, and its rudimentary articular processes form (blank), which articulate with the sacral cornua.

T4

The size of the vertebral bodies increases as the column descends, most markedly from (blank) inferiorly, as each bears progressively greater body weight.

Red bone marrow

The spaces between the trabeculae are occupied by (blank) that is among the most actively hematopoietic tissues of the mature individual.

Centrum

The superior and inferior epiphyses usually unite with the (blank), the primary ossification center for the central mass of the vertebral body, early in adult life (at approximately age 25).

Intervertebral foramina

The superior and inferior vertebral notches of adjacent vertebrae and the IV discs connecting them form (blank)

Thoracic outlet syndrome

The supernumerary rib (cervical rib) or a fibrous connection extending from its tip to the first thoracic rib may elevate and place pressure on structures that emerge from the superior thoracic aperture, notably the subclavian artery or inferior trunk of the brachial plexus, and may cause (blank)

Laminectomy

The surgical excision of one or more spinous processes and the adjacent supporting vertebral laminae in a particular region of the vertebral column. Removal of most of the vertebral arch by transecting the pedicles.

Anterior, posterior

The transverse processes of cervical vertebrae end laterally in two projections: an (blank) tubercle and a (blank) tubercle.

Widest

The transverse processes of the atlas arise from the lateral masses, causing them to be more laterally placed than those of the inferior vertebrae. This feature makes the atlas the (blank) of the cervical vertebrae.

Atypical

The two superior-most cervical vertebrae are (blank)

Larger

The vertebrae gradually become (blank) as the vertebral column descends to the sacrum and then become progressively smaller toward the apex of the coccyx.

Sacro-iliac joint

The vertebrae reach maximum size immediately superior to the sacrum, which transfers the weight to the pelvic girdle at the (blank)

Two

The vertebral arch is posterior to the vertebral body and consists of (blank) pedicles and laminae.

Small accessory veins

The vertebral arteries and their accompanying veins pass through the transverse foramina, except those in C7, which transmit only (blank).

Compact bone

The vertebral body consists of vascular, trabecular (spongy, cancellous) bone enclosed by a thin external layer of (blank).

Supports body weight

The vertebral body is the more massive, roughly cylindrical, anterior part of the bone that gives strength to the vertebral column and (blank)

Cranium, coccyx

The vertebral column extends from the (blank) to the apex of the (blank).

33 vertebrae

The vertebral column in an adult typically consists of?

Locomotion

The vertebral column plays an important role in posture and (blank)

Pelvis

The vertebral column supports the weight of the body superior to the level of the (blank).

Transverse processes

Two (blank) project posterolaterally from the junctions of the pedicles and laminae.

Endochondral centrum and two perichondral centers

Typically, vertebrae begin to ossify toward the end of the embryonic period (8th week), with three primary ossification centers developing in each cartilaginous vertebra which are the?

Pars interarticularis

Usually the fractur occurs in the bony column formed by the superior and inferior articular processes of the axis called the?

Vertebra L5

Vertebra (blank), distinguished by its massive body and transverse processes, is the largest of all movable vertebrae and carries the weight of the whole upper body.

Body and spinous process

Vertebra C1, also called the atlas, is unique in that it has neither a (blank) nor a (blank).

Strongest

Vertebra C2, also called the axis, is the (blank) of the cervical vertebrae.

C3-C7

Vertebrae (blank) are typical cervical vertebrae.

Cervical vertebrae

Vertebrae having foramina in their transverse processes.

Postmenopausal females

Vertebral body osteoporosis occurs in all vertebrae but is most common in thoracic vertebrae and is an especially common finding in (blank)

Epiphysial rim

When growth ceases early in the adult period, the epiphyses usually unite with the vertebral body. This union results in the characteristic smooth raised margin, the (blank), around the edges of the superior and inferior surfaces of the body of the adult vertebra.

Endochondral centrum

Will eventually constitute most of the body of the vertebra.