Spine

Autograft, Allograft

A comminuted anterior column fracture would imply the need of surgical ___ and ___.

Atlanto-occipital Ligament

Among the ligaments of the Occiput-C1-C2 Complex, which is the strongest? What is its function?

Between C1 and C2

Among the vertebrae, IV disc is absent...

4, Inferiorly, 2 Inches anterior to S2

Around ___ years, the center of gravity moves (superiorly, inferiorly) to the level ___.

Proprioception

Aside from limiting flexion, one important function of the supraspinous ligament is...

Avascular, Alymphatic, Aneural; Annulus Fibrosis (70%), Nucleus Pulposus (90%)

Describe the IV disc for ages 11 years and up. What are the two layers and their water content?

C: 45 degrees; flex, extend, laterally bend, rotate T: 60 degrees; flex, laterally bend, rotate L: 90 degrees; very limited

Describe the angle and possible movements of the articular facets of the three kinds of vertebrae.

- Anterior: weight-bearing (80%), flexibility, shock absorption, protection - Posterior: weight bearing (20%), articulation. stability, protection

Describe the distinct functions of the anterior and posterior elements of the spine.

3-6 Months Fetal Life: S4 Birth: L3 9-11 Years Old: L1-L2

Describe the progression of the spinal cord shortening.

C: bifid, sjort T: long L: short, broad

Describe the spinous processes of each kind of vertebrae.

Spongy Bone covered by Compact Bone

Describe the structure of the vertebral body.

Watershed - Aorta -> Subclavian -> Circle of Willis -> Anterior Spinal Artery - Descending Aorta -> Posterior Intercostal Compensation - Segmental/Radicular Feeding Arteries

Describe the watershed phenomenon of arterial supply and the compensation for it.

Radiculopthy, Myelopathy, Neuropathy

Elucidate the kinds of herniation based on nervous damage.

1. Protrusion - AF intact 2. Prolapse - AF thinning 3. Extrusion - AF ruptured 4. Sequestration - NP escapes

Elucidate the types of herniation based on morphology.

Iliocostalis, Longissimus, Spinalis

Enumerate the erector spinae muscles.

A. Superficial: Splenius capitis, Splenius cervicis, Erector spinae B. Deep: Semispinalis, Multifidus, Rotatores

Enumerate the spine muscles.

Multifidus, Semispinalis, Rotatores

Enumerate the transversospinalis muscles.

C7L2, T12K1, L5L2, S5K1, Cx4

How many bones are there in each kind of vertebrae. Indicate K for Kyphosis and L for Lordosis. Indicate 1 if primary and 2 if secondary curvature.

Tuberculosis - Pott's Disease

Infection and neoplasm of the spine is known as....

Alar Ligament

It connects sides of dens to tubercles on medial side of occipital condyle.

Pars Interarticularis

It connects the superior and inferior articulating facets.

Supraspinous Ligament

It is a cord-like ligament connecting the apices of spinous process from C7 to sacrum.

Herniation

It is caused by protrusion of the nucleus pulposus to the annulus fibrosus.

Posterior Longitudinal Ligament

It is the demarcation between anterior and posterior elements of the spine.

Spondylitis

It is the infection of the vertebrae.

Spondylosis

It is the instability of the vertebrae brought about by age.

Diarthrodial

It is the kind of joint found between facets.

Syndesmosis

It is the kind of joint found between lamina and ligamentum flavum.

Amphiarthrodial

It is the kind of joint found in IV discs.

Trochoid

It is the kind of joint found in the atlanto-axial joint.

Condyloid

It is the kind of joint found in the atlanto-occipital joint.

L5

It is the largest movable vertebra.

Ligamentum Flavum (Yellow Ligament)

It is the ligament between laminae of adjacent vertebrae.

Interspinous Ligament

It is the ligament between spinous processes.

T12-L1

It is the most common fracture (thoracolumbar).

T12

It is the most commonly fractured vertebra.

Transverse Atlantal Ligament

It securely fastens dens processes between C1 and C2.

Occipitodental Ligament

It secures the dens process to the occiput.

Acute, Obtuse

Males have (acute, obtuse) angled pelvis while females have (acute, obtuse) angled pelvis.

Posterior Rami of Spinal Nerves

Muscles associated with the spine are generally innervated by...

Atlanto-occipital, Atlanto-axial

Nodding involves the ___ joint while saying no and shaking the head involves the ___ joint.

2400, 6000, 8000

One functional unit can withstand ___ newtons. Vertebral bodies break at ___ newtons. Endplates break at ___ newtons.

Stretching the head, quadruped crawling

Postnatal lordosis is caused by ___. Infancy lordosis is caused by ___.

3-6 years

Synostosis occurs at which age?

Pedicle, 2nd Fetal Month

The first to ossify is what part of the vertebra? When?

Extend

The general action of spine muscles is to...

Prevent hyperflexion

The general function of posterior spine ligaments is...

Spinal and Dorsal Root Ganglia

The intervertebral foramen serves as the passageway of...

Posterior Longitudinal Ligament

The ligament with the most pain receptors is...

Vertebra Prominens, C7

The longest spinous process is called ___ and can be found at the ___.

Motion

The main function of cervical vertebrae is (motion, protection).

Mamillary processs of lower 2-3 vertebrae

The multifidus muscle inserts...

Cervical, Spinal A.

The prominent transverse foramen are found in ___ vertebrae for the passageway of ___.

Relaxin

The pubic symphysis opens 2-4 inches during delivery through the hormone ___.

1st

The spine is what class of lever?

Hyaline Cartilage

The superior and inferior surfaces of the vertebra are covered with...

Nuchal

The supraspinous ligament merges superiorly with the ___ ligament.

Vertebral Artery

The transverse foramen serves as the passageway of...

Mamillary Process and Accessory Process

The transverse processes of lumbar vertebrae have...

Decreases, Thicker

The vertebral body (increases, decreases) superiorly. The laminae goes (thicker, thinner) inferiorly.

36

The vertebral body is ossified at ___ weeks.

Interspinous Ligament

The weakest ligament of the spine is...

C1, C2

The widest cervical vertebra is ___. The strongest cervical vertebra is ___.

Intervertebral Foramen

These are indentations formed by superior and inferior vertebral notches of adjacent vertebrae.

Multifidus and Rotatores

These muscles are responsible for the fine steering movements of the spine.

Lateral Masses

These structures in C1 allow bearing the weight of the cranium.

Costal Facets

These structures in thoracic vertebrae allow articulation with ribs.

Multifidus

They are the spinal analogs of rotator cuff muscles.

Sacral Promontory

This is an important obstetrical landmark in the sacrum.

Posterolateral

This kind of herniation based on location is more common.

Posterior Longitudinal Ligament

This ligament prevents protrusion of IV disc.

Synsacrum

This term describes the five fused sacral bones,

Iliolumbar, Superior Pubic, Arcuate Pubic, Sacrospinous, Sacrotuberous

What are the five ligaments of the pelvis?

Maintain Stability of IV Disc Prevent hyperextension

What are the functions of the anterior longitudinal ligament?

Vertebra

What is the anatomical unit of the spine?

Vertebra + IV Disc

What is the functional unit of the spine?

ISL, FC, LF, PLL, ALL

What is the order, from first to last, of ligaments that will break?

Elastin

What protein is abundant in ligamentum flavum?

Between T10-L2, Lower Limb Paralysis

Where can the artery of adamkiewicz be found? Damage to this can cause what condition?

Lumbar

Which curvature is more recent, cervical or lumbar?

IV disc absorb water under low pressure when sleeping.

Why are we taller when we wake up from sleeping.

Interspinous Ligament, Intertransverse Ligament

___ connects adjoining spinous processes. ___ connects adjacent transverse processes.

Lumbar

___ has the largest intervertebral foramen.

Anterior Longitudinal Ligament

___ is the strongest ligament of the vertebrae that covers about ___ of the diameter of vertebrae.