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Spinal Anatomy > Arthrology of the Vertebral Column > Flashcards

Arthrology of the Vertebral Column Flashcards

1
Q

What is the maximum number of common ligaments identified with a vertebral couple?

A

8

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2
Q

What is the reason the nine common ligaments are identified but only eight will be attached at any specific vertebral couple?

A

Ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple

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3
Q

Which common ligaments will attach to the vertebral body?

A

Anterior longitudinal ligament
Intervertebral disc
Posterior longitudinal ligament

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4
Q

What common ligaments will attach to the vertebral arch?

A

Ligamentum flavum

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5
Q

What is the number of true intervertebral discs identified in the adult?

A

23

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6
Q

In the adult, which vertebral levels will demonstrate a true intervertebral disc?

A

C2-S1

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7
Q

What is the intervertebral disc histologically composed of?

A

Cells
Collagen fibers
Hydrated proteoglycan gel

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8
Q

What is the cervical nucleus pulposus composed of?

A

Fibrocartilage

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9
Q

What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?

A 
Birth = 88%
30 = 70%
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10
Q

What is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?

A

Nucleus pulposus will lose water under deformation conditions

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11
Q

What cell is associated with the nucleus pulposus until about age eleven?

A

Notochord cells

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12
Q

What cells are associated with the mature nucleus pulposus?

A

Reticulocyte-fibroblast

Chondroblast

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13
Q

Which type of collagen is dominant in the nucleus pulposus?

A

Collagen type II

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14
Q

What general tissue location is described as having an abundance of collagen type II fibers?

A

Cartilage

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15
Q

What is the role of collagen type II fibers based on locations where it is dominant?

A

It appears to be related to tissues having a deformation - reformation ability

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16
Q

What is the appearance of the cervical annulus fibrosus?

A

Horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate processes
Posterior margin is thin

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17
Q

What compensates for the thinness of the posterior part of the cervical annulus fibrosus?

A

Posterior longitudinal ligament

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18
Q

What is the organization of the lumbar annulus fibrosus?

A

Has 12-14 concentric cylindrical lamellae

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19
Q

What is the water by concentration in the lumbar annulus fibrosus at birth and after thirty?

A 
Birth = 78%
30% = 70%
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20
Q

What is the organizational pattern for the glycosaminoglycans int he lumbar annulus fibrosus?

A

Typically have a binding site for hyaluronic acid and thus aggregated

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21
Q

Which type of collagen is dominant in the annulus fibrosus?

A

Collagen type I

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22
Q

What is the organizational pattern for collagen fibers in the annulus fibrosus?

A

Parallel with one another in a single lamellae and angled

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23
Q

What is the organization of collagen fibers between lamellae?

A

Collagen fibers will be angled in the opposite direction such that a spiral - counterspiral organization is observed

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24
Q

What is the average angle of collagen fibers within the annulus fibrosus?

A

Average 50 to 60 degrees

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25
Q

What is the origin for the cells of the annulus fibrosus?

A

Sclerotomites

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26
Q

What part of the vertebral body will the cartilage end plate cover?

A

Cancellous bone at the top or bottom of the vertebral body

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27
Q

What is the principal type of collagen fiber within the cartilage end plate?

A

Type II collagen fiber

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28
Q

What is the direction of collagen fibers within the cartilage end plate?

A

Collagen fibers are aligned anterior to posterior

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29
Q

What is the earliest indicator of intervertebral disc pathology or degeneration?

A

Changes in the histology of the cartilage end plate

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30
Q

What is the cartilage end plate derived from?

A

Epiphyseal plate

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31
Q

What is the thickest part of the cartilage end plate?

A

Around the periphery

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32
Q

What is the area of maximum metabolic activity in the intervertebral disc?

A

Transition zone

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33
Q

What are the types of receptor endings in the intervertebral disc?

A

Nociceptors

Proprioceptors

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34
Q

What is the relationship between size of the intervertebral disc and receptor endings?

A

Larger the disc, the greater the variety or receptor endings

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35
Q

The recurrent meningeal/sinu-vertebral/sinus vertebral nerve has typically been shown to originate from which source?

A

Gray ramus communicans

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36
Q

What part of the intervertebral discis innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?

A

Outer lamellae of the annulus fibrosus atthe posterior part of the intervertebral disc

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37
Q

What forms the anterior neural plexus of the vertebral column?

A

Fibers from the ventral primary ramus

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38
Q

What forms the lateral neural plexus of the vertebral column?

A

Fibers from the ventral primary ramus
Fibers from the white ramus communicans
Fibers from the paradiscal ramus communicans
Fibers from the gray ramus communicans

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39
Q

What is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc?

A

Paradiscal ramus communicans

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40
Q

What part of the intervertebral disc is innervated by fibers from the paradiscal ramus communicans?

A

Outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc

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41
Q

What is formed within the perichordal blastema between the sclerotomites?

A

Intrasclerotomal fissure or fissure of von Ebner

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42
Q

What does the intrasclerotomal fissure or fissure of von Ebner become?

A

Perichordal disc

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43
Q

What will the dense sclerotomite become?

A

Upper part of the vertebral segment forming below

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44
Q

What is the appearance of the posterior longitudinal ligament in the lumbar spine?

A

Hourglass shaped along its lateral margins

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45
Q

What is the innermost layer of the posterior longitudinal ligament called?

A

Perivertebral ligament

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46
Q

What innervated the posterior longitudinal ligament?

A

Posterior neural plexus formed by fibers from the recurrent meningeal nerve/sinus vertebral nerve/sinu-vertebral nerve

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47
Q

Where is ossification of the posterior longitudinal ligament most commonly identified?

A

Cervical spine with an 80% incidence

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48
Q

What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?

A

Greater in males over 50 and has higher incidence in the Japanese

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49
Q

What is the name given to the ligamentum flavum based on appearance and histology?

A

Yellow elastic ligament

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50
Q

What fibers are most ligaments made of?

A

Collagen type I fibers which are whitish in appearance

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51
Q

What is the function of the ligamentum flavum?

A

Brakes or limits flexion of the vertebral column

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52
Q

What is now thought to be a major function of the ligamentum flavum?

A

Early prime factor in extension of vertebral column

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53
Q

Where is ossification of the ligamentum flavum most commonly identified?

A

Thoracic spine or thoracolumbar transition zone

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54
Q

What is the relationship between the capsular ligament and mobility?

A

The more lax/loose the capsular ligament is, the greater the motion of the joint

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55
Q

What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?

A

Cervical

Lumbar

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56
Q

What is the status of the human interspinous ligament compared with other common ligaments?

A

Poorly developed as ligaments although collagen fibers are present

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57
Q

What is the status of the cervical interspinous ligament?

A

Lacking
Poorly developed
Considered the deep anterior part of the ligamentum nuchae

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58
Q

What is now thought to be the major function of the interspinous ligaments?

A

More likely a proprioceptive transducer for the spinal reflex

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59
Q

What are the layers of the ligamentum nuchae?

A

Superficial layer

Deep layer

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60
Q

What is the name given to the superficial layer of the ligamentum nuchae?

A

Funicular layer or part

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61
Q

What is the name given to the deep layer of the ligamentum nuchae?

A

Lamellar layer or part

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62
Q

What are the attachment sites for the superficial layer of the ligamentum nuchae?

A

EOP
External occipital crest
SPinous tubercle of C7

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63
Q

What is the histological make-up of the ligamentum nuchae?

A

Yellow elastic ligament, but has more collagen fibers than in quadrupeds

64
Q

What is the termination level inferiorly for the supraspinous ligament according to current literature?

A

Primarily at L4 (73%)

Between L4 and L5 (5%)

65
Q

Where is the supraspinous ligament said to be developed?

A

Lumbar spine

66
Q

What is now thought to be a major function of the suprapsinous ligament?

A

Proprioceptive transducer for the spinal reflex

67
Q

Where in the vertebral column is the intertransverse ligament best developed?

A

Lumbar spine

68
Q

What part of the intertransverse ligament in the lumbar spine covers the intervertebral foramen?

A

Ventral slip

69
Q

What part of the intertransvere ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?

A

Dorsal slip

70
Q

What is the classification of the atlanto-occipital joint?

A

Synovial (diarthrosis) ellipsoidal

71
Q

What other joint space does the atlanto-occipital joint communicate with?

A

Posterior bursa of the median atlanto-axial joint

72
Q

What is the median thickening of the anterior atlanto-occipital ligament called?

A

Anterior longitudinal ligament

73
Q

Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?

A

Accessory bone

74
Q

What other name may be used to identify a ponticulus posticus?

A

Kimmerle’s anomaly

75
Q

What amount of flexion-extension is accommodated by the atlanto-occipital joint?

A

25 degrees

76
Q

What amount of axial rotation is accommodated by the atlanto-occipital joint?

A

3-8 degrees one side axial rotation

77
Q

What amount of lateral bending is accommodated by the atlanto-ocipital joint?

A

5 degrees

78
Q

Which motion is best accommodated by the atlanto-occipital joint?

A

Flexion-extension

79
Q

Which atlanto-axial joint is identified as synovial pivot (diarthrosis trochoid)?

A

Median atlanto-axial joint

80
Q

Which atlanto-axial joint is identified as a synovial plane (diarthrosis arthrodia)?

A

Lateral atlanto-axial joint

81
Q

What are the names given to the synovial joint spaces of the median atlanto-axial joint?

A

Anterior bursa

Posterior bursa

82
Q

What part of the vertical crus ligament may be absent?

A

Inferior crus ligament

83
Q

What is the function of the transverse atlantal ligament?

A

Primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1

84
Q

What is the ADI?

A

Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint

85
Q

What is the ADI of children compared with that of adults?

A

4.5mm in children

2-3mm or 2.5mm in adults

86
Q

What are the attachment sites for the accessory atlanto-axial ligament?

A

Base of the odontoid process and vertebral body of axis of the tubercle for the transverse atlantal ligament on the lateral mass of C1; superior continuation may attach on the occipital bone just behind that of the alar ligament

87
Q

What is the homolog of the posterior atlanto-axial ligament?

A

Ligamentum flavum

88
Q

What are the degrees of movement facilitated at the atlanto-axial joint?

A

20 degrees flexion-extension
40 degrees one side axial rotation
5 degrees of lateral bending

89
Q

The occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation?

A

60%

90
Q

What ligaments are present at the occipito-axial joint?

A

Apical ligament of the dens/ apicodental ligament
Alar ligament
Membrania tectoria/ tectorial membrane

91
Q

What is the embryonic derivative of the apical ligament of the dens or the apicodental ligament?

A

Notochord

92
Q

What is the function of the alar ligament?

A

Together they function to resist axial rotation

93
Q

What forms the cranial continuation of the posterior longitudinal ligament?

A

Membrana tectoria or tectorial membrane

94
Q

What are the attachment sites for the superficial layer of the membrana tectoria or tectorial membrane?

A

Posterior part of the inferior epiphyseal rim
Vertebral body of C2 to the capsular ligament of the atlanto-occipital joint
Cranial dura of the posterior cranial fossa

95
Q

What are the attachment sites for the deep layer of the membrana tectoria or tectorial membrane?

A

Posterior part of the inferior epiphyseal rim
Vertebral body of C2 to the periosteum behind the cruciate ligament attachment site on the anterior rim of the formaen magnum

96
Q

For the cervical spine belowC2, what is the range of flexion-extension?

A

90 degrees or 18 degrees per couple

97
Q

For the cervical spine below C2, what is the range of one side lateral bending?

A

50 degrees or 10 degrees per couple

98
Q

For the cervical spine below C2, what is the range of one side axial rotation?

A

33 degrees or 6 degrees per couple

99
Q

What are the locations for costovertebral joints on the vertebra?

A

Costocentral joint at the vertebral body

Costotranseverse joint at the transverse process

100
Q

Which costocentral ligament forms part of the anterior boundary of the intervertebral foramen?

A

Costocentral capsular ligament

101
Q

The costocentral radiate/stellate ligament is identified with which joint classification?

A

Fibrous (amphiarthrosis) syndesmosis

102
Q

An intra-articular ligament will be identified with which ribs?

A

2-9

103
Q

What are the attaching surfaces of the intra-articular ligament?

A

Intra-articular crest of the head of the rib

Intervertebral disc

104
Q

Which verterbrae will have a synovial plane (diarthrosis arthrodia) costotransverse joint?

A

T1-T10

105
Q

What are the accessory ligaments of the costotransverse joint?

A

Superior costotransverse ligament
Inferior costotransverse ligament
Lateral costotransverse ligament

106
Q

At what rib will the superior costotransverse ligament be absent?

A

1st rib

107
Q

What ligaments will attach to the neck of the 12th rib?

A

Superior costotransverse ligament from T11

Lumbosacral ligament from L1

108
Q

What are the attachment sites for the lumbocostal ligament?

A

Neck of 12th rib

Transverse process of L1

109
Q

What is the function of the superior costotransverse ligament?

A

Limitation of lateral bending or maintaining lateral stability

110
Q

What are the attachment sites for the inferior costotransverse ligament?

A

Neck of the rib

Transverse process of the vertebra at that level

111
Q

Which vertebrae will have an attachment for the inferior costotransverse ligament?

A

T1-T11

112
Q

At what rib will the inferior costotransverse ligament be absent?

A

12th rib

113
Q

What is the name of the space between the transverse process and the neck of the rib?

A

Costotransverse foramen

114
Q

Which ligament “fills” the costotransverse foramen?

A

Inferior costotransverse ligament

115
Q

What are the attachment sites for the lateral costotransverse ligament?

A

Non-articular surface of the tubercle of the rib

Transverse tubercle of the transverse process of the vertebra at that level

116
Q

Which vertebrae will have an attachment for the lateral costotransverse ligament?

A

T1-T11

117
Q

Which vertebra will lack an attachment for the lateral costotransverse ligament?

A

T12

118
Q

Which vertebral couples of the thoracic spine have the greatest motion?

A

T11/T12

T12/L1

119
Q

Which range of motion is greatest for lower thoracic vertebral couples?

A

Flexion-extension

120
Q

Which range of motion is least for lower thoracic vertebral couples?

A

One side axial rotation

121
Q

Based on current literature what common ligaments are absent at the lumbosacral joint?

A

Ligamentum nuchae
Interspinous ligament
Supraspinous ligament

122
Q

Which ligaments replace the intertransverse ligament at the lumbosacral joint?

A

Iliolumbar ligament

Lumbosacral ligament

123
Q

Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions?

A

Superior iliolumbar ligament

124
Q

Which ligament from the iliolumbar ligament complex will attach to the sacral ala?

A

Inferior iliolumbar ligament

125
Q

Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of the classical descriptions?

A

Inferior iliolumbar ligament

126
Q

What are the attachment sites for the accessory iliolumbar ligament?

A

Transverse process of L4

Iliac crest

127
Q

Which vertebral couple of the lumbar spine has the greatest range of motion?

A

L5/S1

128
Q

Which rang of motion is greatest for all lumbar vertebral couples?

A

Flexion-extension

129
Q

Which range of motion is least for L1-L5 vertebral couples?

A

One side axial rotation

130
Q

Which range of motion is least for the L5/S1 vertebral couple?

A

One side lateral bending

131
Q

List in order from cranial to caudal the ligaments forming the anterior boundary of the spinal column.

A

Anterior atlanto-occipital ligament
Anterior atlanto-axial ligament
Anterior longitudinal ligament
Anterior sacrococcygeal ligament

132
Q

List in order from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.

A

Membrana tectoria
Posterior longitudinal ligament
Deep posterior sacrococcygeal ligament

133
Q

List in order from cranial to caudal the ligaments forming the posterior boundary of the spinal canal.

A

Posterior atlanto-occipital ligament
Posterior atlanto-axial ligament
Ligamentum flavum
Superficial posterior sacrococcygeal ligament

134
Q

What forms the closure for the spinal canal inferiorly?

A

Fusion of the deep posterior sacrococcygeal ligament with the superficial posterior sacrococcygeal ligament

135
Q

What is the homolog of the intertransverse ligament in the sacrococcygeal joint?

A

Lateral sacrococcygeal ligament

136
Q

What is the homolog of the capsular ligament at the sacrococcygeal joint?

A

Intercornual ligament

137
Q

What does the sacral cornu represent?

A

Inferior articular process and facet of S5

138
Q

What is the auricular surface of the ilium composed of?

A

Articular cartilage interspersed with fibrocartilage

139
Q

What is the superficial appearance of the auricular surfaces of the sacro-iliac joint by age 15?

A

Sacrum develops a sacral groove while the ilium develops an iliac ridge

140
Q

Which gender is biased with greater unevenness of the auricular surface of the sacro-iliac joint?

A

Males

141
Q

What forms the accessory sacro-iliac joint?

A

Sacral tuberosity and iliac sulcus

142
Q

What pathological or age-related modifications of the sacro-iliac joint may occur?

A

Degenerative arthrosis and ankylosis

143
Q

What does degenerative arthrosis mean?

A

Condition of degeneration of the joint, sometimes referred to as degenerative joint disease (DJD)

144
Q

What does ankylosis mean?

A

Condition of fibrous adhesion occurring in a joint

145
Q

What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint?

A

Age 40, the iliac auricular surface

146
Q

What is the age and gender boas associated with ankylosis of the sacro-iliac joint?

A

Age 50, male bias particularly in black males

147
Q

What movements at the sacro-iliac joint are described as forward nodding and backward nodding?

A

Nutation and counternutation

148
Q

What is the age and gender bias associated with ossification of the anterior sacro-iliac ligament?

A

Age 40, male bias

149
Q

Which is the strongest of the sacro-iliac ligaments?

A

Interosseous sacro-iliac ligament

150
Q

What are the attachment sites of the interosseous sacro-iliac ligament?

A

Sacral tuberosity

Iliac sulcus

151
Q

What is the relationship between the capsular and interosseous sacroiliac ligaments?

A

Interosseous sacro-iliac ligament replaces the capsular ligament posteriorly

152
Q

What passes between the layers of the interosseous sacro-iliac ligament?

A

Dorsal rami from the sacral spinal nerves

153
Q

What ligament blends with the lateral border of the long posterior sacro-ilaic ligament?

A

Sacrotuberous ligament

154
Q

What forms the falciform process?

A

Continuation of the sacrotuberous ligament along the ischial ramus

155
Q

What separates the greater sciatic and lesser sciatic foramina?

A

Sacrospinous ligament

Spinal Anatomy (19 decks)

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