Vertebral column : viva questions and answers

 

Vertebral column 

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Definition:

The vertebral column, also known as the backbone or spine, is part of the axial skeleton which is formed by  a segmented series of bone: vertebrae separated by intervertebral discs

The vertebral column houses the spinal canal, a cavity that encloses and protects the spinal cord.

Number of vertebra form vertebral column: 33

Cervical vertebra : 7 , Thoracic vertebra : 12 , Lumbar vertebra : 5. Sacral vertebra: 5 , Coccygeal vertebra : 4

Function of vertebral column :

1.       It gives support to the trunk

2.       Provides articulation with ribs and pelvic bones

3.       Lodge and protects spinal cord

4.       Support and transmits body weight

Provides attachments of muscles and ligaments

Extension of the vertebral column:   From the skull to the apex of the coccyx

Content of vertebral canal:

From skull to lower border of the 1^st lumbar vertebra contain spinal cord , spinal meninges  and blood vessels

Below the lower border of 1^st lumbar vertebra : corda equina and filum terminalis (pia mater of meninges

What is corda equine ?

It is the bundle of nerve roots of lower lumbar, sacral and coccygeal spinal nerve  

Regions of vertebral column: it has four regions

Cervical region /Thoracic region/Lumbar region/Sacral region

Curvature of vertebra:

There are two types of curvature present in vertebral column  

Primary curvature: the concavity  of curvature is directed forward.  Primary curvature is present in thoracic and sacral region

 Secondary curvature : the convexity of curvature is directed forward. Secondary curvature is present in cervical and lumbar region

parts of vertebra 

Body and arch

Vertebral arches:

are formed by two pedicle, two lamina,

two superior articular process,

two inferior articular process,

 two transverse process and one spinal process 

Vertebral body :

It has six surfaces anterior , posterior , superior , inferior and two lateral surfaces .

two adjacent vertebral body is separated by intervertebral disc.

Intervertebral foramen : when two vertebrae articulate with each other the inferior vertebral notch of the vertebra above together with the superior vertebral notch of the vertebra below form intervertebral foramen

It is situated below the pedicle

Content : trunk of spinal nerve & vessels  

Intervertebral disc :

It is formed by fibrocartilage. It forms secondary cartilaginous joint which limited movement

Parts : it has outer annulus fibrosus & inner nucleus pulposus

 Number:

There are 23 discs in the human spine:

6 in the cervical region (neck),

12 in the thoracic region (middle back),

5 in the lumbar region (lower back).

Function of intervertebral disc:

·         The intervertebral disc functions to separate the vertebrae from each other

It acts as  shock-absorber

 

Difference between cervical, thoracic and lumbar vertebra

Topic	Cervical	Thoracic	Lumbar
body	1. Smallest of all vertebra 2.Transverse measurement is greater than anterior posterior measurement 3.Superior surface is concave	1.Body is heart shaped 2.Anterior posterior measurement is greater than the transverse measurement 3. body bears costal facet	1.Body is big size and kidney shaped 2. Transverse measurement is greater than anterior posterior measurement 3. body is thick in front than behind
Transverse process	1.It is pierce by foramen transversarium 2.It has anterior and posterior root which is connected by costo-transverse bar	1. Big size face laterally and backwards  2. Each process bears a facet which articulate with numerically corresponding tubercle of rib	1. Thin and elongated 2. An accessory process is present at its posterior inferior process
Spinous process	Short , bifid and horizontal	It is directed downward and backward It is end with tubercle	It is quadrangular in shape and lies horizontally
Laminae	Long and narrow	Short , broad & thick	Short , strong and broad
Pedicle	Project laterally and backwards	Project directly backwards	Short and strong and project from postero-lateral aspect of the body
Superior articular process	Faces upwards and backwards	Faces upward, backward & laterally	Concave process face backward and medially
Inferior articular process	Faces downwards and forwards	Faces forwards, medially and downwards	Convex process faces forward and laterally
Vertebral foramen	Triangular in shape Large in proportion to the size of the body	Circular in shape Size is smaller	Triangular in shape Larger than thoracic vertebral but smaller than cervical vertebra
Special feature	Foramen transversarium	Costal facet present on  the body	Massive body Mamillary process is present at the posterior border of superior articular process

 

 

 

 

 

 

Summary of ossification of whole skeleton of body

 

Summary of ossification of whole skeleton of body

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 Membranous ossification:

Ex: head and neck: parietal bone, frontal bone, maxilla, zygomatic,

Sup extre: clavicle

Cartilaginous ossification: all vertebrae, all ribs, sternum, scapula, all bones of upper limb except clavicle, all bones of lower limb

Membrano-cartilaginous ossification:

Occipital: membranous ossification area above the highest nuchal line, rest of the parts arises from cartilaginous ossification 

Sphenoid: membranous ossification above the lateral part of greater wing and pterygoid process except the hamulus, rest of the part arises from cartilage,

Temporal: membranous ossification – squamous part and tympanic part, rest of the parts arises from cartilage,

 Mandible: cartilaginous ossification anterior part of body and part of ramus above mandibular foramen, rest of the body arises from membranous ossification

Name of bone	Primary ossification center	Secondary ossification center
Clavicle	Two	One for sternal end
Humerus	One for shaft	Three for upper end – head , greater & lesser tubercle Four for lower end – lateral & medial epicondyle, capitulum, trochlear
Radius	One primary ossification center for shaft	One for upper end One for lower end
Ulna	One primary ossification center for shaft	One for upper end One for lower end
Carpal bone	One primary ossification center which appear after birth	No secondary ossification centre
Metacarpal bone	One primary ossification center for shaft	One 2nd ossification centre :  base of  1st metacarpal bones is ossified from 2nd ossification center Heads of  2-5 metacarpal bone are ossified from 2nd ossification center
Phalanges	One primary ossification center for shaft and head	One 2nd ossification center for base  of each phalanx

 

Lower limb

Name of bone	Primary ossification center	Secondary ossification center
Hip bone	Three – ilium, ischium, pubis	5 secondary ossification center
Femur	One for shaft	Three for upper end – head , greater & lesser trochanter One for lower end
Tibia	One primary ossification center for shaft	One for upper end One for lower end
Fibula	One primary ossification center for shaft	One for upper end One for lower end
Tarsal bone (except calcaneus)	One primary ossification center	No secondary ossification centre
Calcaneus	One primary ossification center	One secondary ossification centre
Metatarsal bone	One primary ossification center for shaft	One 2nd ossification centre :  base of  1st metatarsal bones is ossified from 2nd ossification center Heads of  2-5 metatarsal bone are ossified from 2nd ossification center
Phalanges	One primary ossification center for shaft and head	One 2nd ossification center for base  of each phalanx

 

Articulated skeleton of hand : viva questions

 

Articulated skeleton of hand

Anatomical points

Carpal bones lies above

Concavity of articulated skeleton of hand directed forward

1^st metacarpal bone short and shout lies laterally

Identification of carpal bone : proximal, scaphoid, lunate, triquetral and pisiform and distal row: trapezoid , trapezium capitates hamete

Which carpal bone is largest : capitates

Scaphoid : boat shape

Lunate : half moon shape  

Morphological types of carpal bone : all bones are short bone except pisiform  

Why carpal bones are  known as short bone?

they have six surfaces, Carpal bones ossify from one primary ossification centre

but no secondary ossification centre

Usually primary ossification center develops before birth

 but primary ossification center of carpal bone develops after birth.

Each year of life one carpal bone develops Ex: 1 years age children has one carpal bone ,

 three years old contain three carpal bones and 7 years old contain 7 carpal bones

Pisiform is a sesamoid bone:  form within the tendon of flexor carpi ulnaris,

Mention some features of sesamoid bone 

Morphological type of metacarpal and phalanges bones: miniature long bone

Why do you mean by  miniature long bone : because they have one epiphysis (only one secondary ossification center)  and one primary ossification center for shaft

 1^st metacarpal bone has one primary ossification center for shaft and one 2^nd ossification centre (epiphyses) for base

2^nd to 5^th metacarpal bones, each  has one primary ossification center for shaft and one epiphysis ( 2^nd ossification centre ) for head  (metacarpal)

Attachment of flexor retinaculum : (which form carpal tunnel)

·         Laterally : tubercle of scaphoid, crest of trapezius

·         Medially: pisiform, tip of hook of hamate

q. What are the structures passage through  the carpal tunnel :

Ten structures pass through the carpal tunnel, most of them flexor tendons (not the muscles themselves):

·         flexor digitorum profundus (four tendons)

·         flexor digitorum superficialis (four tendons)

·         flexor pollicis longus (one tendon)

1.      What are the structures passage above the carpal tunnel or flexor retinaculum

The ulnar artery and ulnar nerve, and the cutaneous branches of the median and ulnar nerves, pass on top of the flexor retinaculum.

2.      What is carpal tunnel syndrome?

3.                                    Attachment of FD superficialis :four tendon of FDS inserted  two side of base of middle phalages (medial four digit)

4.      Attachment of FD Profundus : 1^st four tendon of FDP passage through the tendon of FDS and then it inserted to base of the distal phalages for medial four digit

Identify the joints of articulated skeleton of hand and their types:

 

Joint	Type
1st carpometacarpal joint	Saddle variety of synovial joint
2nd to 5th carpometacarpal joint	Ellipsoid variety of synovial joint
Intercarpal joint	Plane variety of synovial joint
Interphalangeal joint	Hinge variety of synovial joint
Metacarpophalangeal joint	Condylar variety of synovial joint
Inter metacarpal joint	Plane variety of synovial joint

 Movement of 2^nd to 5^th metacarpophalangeal joint :

Adduction of fingers : palmar interossei

Abduction of fingers : dorsal interossei

Flexion : interossei and lumbricals

Extension : extensor digitorum, extension indicis, extensor digiti minimi 

Articulated skeleton of foot : viva examination

 

Articulated skeleton of foot

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1.       Ana points:

·         1^st metatarsal is shortest and thickest and lies medially

·         Tarsal bones are lies posteriorly

·         Phalanges lie anteriorly

·         Superior surface of talus is directed upwards

 

2.       Morphological type : tarsal: short bone metatarsal and phalanges : miniature short bone (why call miniature short bone : because it has one epiphysis)

3.       Parts of metatarsal and phalanges bone : base,  shaft and head

4.       1^st metatarsal and all phalanges : epiphysis present at the base

5.       2^nd to 5^th metatarsal : epiphysis present at the head

6.       Ossification  of Articulated skeleton of foot: intra cartilaginous ossification

7.         Identify tarsal bone

8.       Show attachment of following muscles with origin, action and nerve supply :

 tibialis ant and pos , peroneus longus and brevis, FHL,FDL,tendoachilis- how it is formed

1.       Show groove for FHL, peroneus longus

 

2.       Ligament :  deltoid and spring lig : show attachment on bones

 1.       Which tarsal bone devoid of muscular attachment: talus  

2.       Joints  of articulated sk of foot–( articular surfaces, type, movement and muscle producing the movement)

Ankle joint	Type: hinge variety of synovial joint Innervation: sural, tibial, saphenous, deep peroneal  nerves Muscles: tibialis anterior (dorsiflexion), gastrocnemius (plantar flexion)
Inferior (distal) tibial joint	Type : syndesmosis variety of fibrous joint  Muscles: no muscles act on this joint
Talocalcaneal joint or subtalar joint	Type : plane type of synovial joint Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); peroneus  longus, peroneus  tertius, peroneus  brevis (eversion)
Talocalcaneonavicular joint	Type: ball and socket type of synovial joint Muscles:  tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); peroneus  longus, peroneus  tertius, peroneus  brevis (eversion)
Naviculocuneiform joint	Type : compound joint Muscles: peroneus  longus,  peroneus  brevis (eversion) , tibialis anterior and posterior (gliding, rotation)
Calcaneocuboid joint	Type : saddle type of synovial joint Muscles: tibialis anterior, tibialis posterior, gastrocnemius, soleus (inversion); peroneus  longus, peroneus  tertius, peroneus  brevis (eversion)
Cuboideonavicular joint	Type : syndesmosis variety of fibrous joint Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Intercuneiform and cuneocuboid joints	Muscles: Muscles: fibularis longus and brevis, tibialis anterior and posterior (gliding, rotation)
Tarsometatarsal joint	Type : plane variety of synovial joint Muscles: short and long extensors of the toe (flexion, extension);  tibialis anterior, fibularis longus (abduction, rotation)
Intermetatarsal	Plane variety of synovial joint
Metatarsophalangeal	Type : ellipsoid variety of synovial joint Muscles:  flexor digitorum brevis, lumbricales, interossei (flexion);  flexor hallucis longus and brevis (extension);  abductor hallucis, plantar interossei (abduction); adductor hallucis, dorsal interossei, abductor digiti minimi (adduction)
Interphalangeal joints	Type : hinge variety of synovial joint Muscles: flexor digitorum longus and brevis (flexion);  extensor digitorum longus and brevis (extension)

 

1.       Subtalar jt , very important ( muscles producing movement )

2.       Related questions :

3.       What is arch?

4.       How medial and lateral  longitudinal arches are formed ?

5.       How anterior and posterior  transverse arches are formed ?

6.       Factors maintaining the arches of foot