Arthrology of the Vertebral Column Flashcards
(138 cards)
1
Q
What is the maximum number of common ligaments identified with a vertebral couple?
A
Eight
2
Q
What is the reason that nine common ligaments are identified but only eight will be attached at any specific vertebral couple?
A
The ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple
3
Q
What is the number of true intervertebral discs identified in the adult?
A
Twenty-three
4
Q
What is the organizational pattern for glycosaminoglycans in the lumbar nucleus pulposus?
A
They typically lack a binding site for hyaluronic acid and are thus non-aggregated
5
Q
What cell is associated with the nucleus pulposus until about age eleven?
A
Notochord cells
6
Q
Which type of collagen is dominant in the nucleus pulposus?
A
Collagen type II
7
Q
What is unusual about the cervical annulus fibrosus?
A
It lacks any lamellar or layered organization
8
Q
What is the appearance of the cervical annulus fibrosus?
A
A horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate processes; the posterior margin is thin
9
Q
What compensates for the thinness of the posterior part of the cervical annulus fibrosus?
A
Posterior longitudinal ligament
10
Q
What is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus?
A
They typically have a binding site for hyaluronic acid and dare thus aggregated
11
Q
What is the consequence of aggregated glycosaminoglycans in the lumbar annulus fibrosus?
A
The annulus fibrosus will retain water under deformation conditions
12
Q
Which type of collagen is dominant in the annulus fibrosus?
A
Collagen type I
13
Q
What is the organizational pattern for collagen fibers in the annulus fibrosus?
A
They are parallel with one another in a single lamellus and angled
14
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
15
Q
What is the average angle of collagen fibers with the annulus fibrosus?
A
They average 50 to 60 degrees
16
Q
What is the origin for the cells of the annulus fibrosus?
A
Sclerotomites
17
Q
What cell type is associated with the annulus fibrosus?
A
Fibroblast and fibrocyte
18
Q
What is the cartilage end plate derived from?
A
The epiphyseal plate
19
Q
What part of the vertebral body will the cartilage end plate cover?
A
The cancellous bone at the top or bottom of the vertebral body
20
Q
What is the principal type of collagen fiber within the cartilage end plate?
A
The type II collagen fiber
21
Q
What is the direction of collagen fibers within the cartilage end plate?
A
Collagen fibers are aligned anterior to posterior
22
Q
What is the earliest indicator of intervertebral disc pathology or degeneration?
A
Changes in the histology of the cartilage end plate
23
Q
What part of the intervertebral disc is innervated?
A
The outer lamellae of the annulus fibrosus
24
Q
What part of the cervical intervertebral disc is highly innervated?
A
The middle third of the annulus fibrosus
25
What are the types of receptor endings in the intervertebral disc?
Nociceptors and proprioceptors
26
What is the relationship between size of the intervertebral disc and receptor endings?
The larger the disc, the greater the variety of receptor endings
27
What nerve(s) have been shown to give off the sinus vertebral/sinu-vertebral/recurrent meningeal nerve?
The mixed spinal nerve, ventral primary ramus, dorsal primary ramus, gray ramus communicans, and white ramus communicans have all been implicated
28
The recurrent meningeal/sinu-vertebral/sinus vertebral nerve has typically been shown to originate from which source?
The gray ramus communicans
29
What part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?
The outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc
30
What forms the anterior neural plexus of the vertebral column?
Fibers from teh ventral primary ramus
31
What forms the lateral neural plexus of the vertebral column?
Fibers from the ventral primary ramus, fibers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray ramus communicans
32
What part of the intervertebral disc is innervated by fibers from the ventral primary ramus?
The outer lamellae of the annulus fibrosus at the anterior and lateral part of the intervertebral disc
33
What innervates the annluus fibrosus at the lateral part of the intervertebral disc?
Fibers from the ventral primary ramus, fibers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray ramus communicans
34
What part of the intervertebral disc is innervated by fibers from the white ramus communicans?
The outer lamellae fo teh annulus fibrosus at the lateral part of the intervertebral disc
35
What is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc?
The paradiscal ramus communicans
36
How does the intervertebral disc attach to the vertebral body?
Sharpey's fibers from the outer lamellae of the annulus fibrous are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies
37
In what regions of the vertebral column is the space formed between vertebral bodies by the intervertebral disc the greatest?
The cervical and lumbar regions
38
Which curve direction will be associated with the greatest space observed between vertebral bodies?
The lordotic or anterior curves
39
What part of the thoracic spine is most susceptible to herniation?
The segments below T8
40
What is the popular theory of intra-abdominal cavity pressure and intervertebral disc response to weight bearing?
Increasing the intra-abdominal cavity pressure will diminish the amount of resistance the intervertebral disc needs to generate by up to 50 %
41
What part of the somite will form the vertebral column?
The sclerotome
42
What structure is formed following migration of sclerotomes to surround the notochord?
The perichordal blastema
43
What is formed within the perichordal blastema between the sclerotomites?
The intrasclerotomal fissure or fissure of von Ebner
44
What does the intrasclerotomal fissure or fissure of on Ebner become?
The perichordal disc
45
What structure forms following migration and subsequent mixing of the sclerotomites?
The vertebral blastema
46
What is the earliest indicator of the position of the adult intervertebral disc?
The intrasclerotomal fissure or fissure of von Ebner
47
What is the function of the anterior longitudinal ligament?
It brakes or limits dorsi-flexion or hyperextension of the vertebral column
48
What was ossification of the anterior longitudinal ligament in the lumbar region identified as?
Forestier's Disease
49
What is ossification of the anterior longitudinal ligament in the lumbar region now identified as?
Diffuse Idiopathic Skeletal Hyperostosis or DISH
50
What is the innermost layer of the posterior longitudinal ligament called?
The perivertebral ligament
51
What is the function of the posterior longitudinal ligament?
It brakes or limits flexion of the vertebral column
52
Where is ossification of the posterior longitudinal ligament most commonly identified?
The cervical spine with an 80% incidence
53
What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?
A loss of hand and finger dexterity
54
What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?
Faltering gait
55
What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?
It is greater in males over 50 and has a higher incidence in the Japanese
56
What is the acronym for ossification of the posterior longitudinal ligament?
OPLL
57
At one time ossification of the posterior longitudinal ligament was an example of what condition?
Diffuse Idiopathic Skeletal Hyperostosis or DISH
58
In which region of the spine will the ligamentum flavum be paired?
The lumbar spine
59
What is the name given to the ligamentum flavum based on appearance and histology?
It is a yellow elastic ligament
60
What is now thought to be a major function of the ligamentum flavum?
It is an early prime factor in extension of the vertebral column
61
Where is ossification of the ligamentum flavum most commonly identified?
The thoracic spine or thoracolumbar transition zone
62
What regions of the vertebral column demonstrate the greatest laxity of capsular ligament?
The cervical and lumbar regions
63
If the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its' function?
It is probably involved in proprioceptive feedback to the muscle stabilizing the vertebral couple during movement
64
What is now thought to be a major function of the interspinous ligament?
It is more likely a proprioceptive transducer for the spinal reflex
65
What are the names given to the superficial and deep layers of the ligamentum nuchae, respectively?
Funicular layer and lamellar layer
66
What are the attachment sites for the superficial layer of the ligamentum nuchae?
The external occipital protuberance, external occipital crest, and spinous tubercle of C7
67
What is the histological make-up of the human ligamentum nuchae?
It is a yellow elastic ligament, but has more collagen fibers than in quadrupeds
68
What is the primary yellow elastic or elastic ligament of the spine?
The ligamentum flavum
69
What is the classic function of the human ligamentum nuchae?
It brakes or limits flexion of the cervical spine
70
What is the termination level inferiorly for the supraspinous ligament according to current literature?
Primarily at L4 (73%); between L4 and L5(5%)
71
Where is the supraspinous ligament said to be best developed?
In the lumbar spine
72
What is now thought to be a major function fo the supraspinous ligament?
It is a proprioceptive transducer for the spinal reflex
73
What is the status of the cervical intertransverse ligament?
It is said to be paired with an anterior and a posterior intertransverse ligament present
74
What part of the intertranverse ligament in the lumbar spine covers the intervertebral foramen?
The ventral slip
75
What part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?
The dorsal slip
76
What are the attachment sites of the ponticulus posticus?
It is attached to the arcuate rim of the posterior arch of C1 and to the superior articular process of the lateral mass of C1
77
What other name may be used to identify a ponticulus posticus?
Kimmerle's anomaly
78
What names are given to the opening formed by the ponticulus posticus?
Arcuate foramen or retroarticular canal
79
What amount of flexion-extension is accommodated by the atlanto-occipital joint?
About twenty-five degrees
80
What amount of axial rotation is accommodated by the atlanto-occipital joint?
About three to eight degrees one side axial rotation
81
What amount of lateral bending is accommodated by the atlanto-occipital joint?
About five degrees
82
Which motion is best accommodated by the atlanto-occipital joint?
Flexion-extension
83
What histological feature is present on the anterior surface of the transverse atlantal ligament?
Fibrocartilage at the surface of the ligament articulating with C2
84
What is the function of the transverse atlantal ligament?
It is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1
85
What is the ADI?
The Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
86
What is the ADI of children compared with that of adults?
About 4.5mm in children; a range of 2-3mm or about 2.5mm in adults
87
What ligament forms the medial, posterior boundary of the interveretbral foramen at C1/C2?
The posterior atlanto-axial ligament
88
What are the degrees of movement facilitated at the atlanto-axial joint?
About 20 degrees flexion-extension, 40 degrees one side axial rotation, and 5 degrees of lateral bending
89
The occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation?
About 60%
90
What are the attachment sites for the apical ligament of the dens or apicodental ligament?
The anterior margin of the foramen magnum and the tip of the odontoid process of C2
91
What is teh embryonic derivative of the apical ligament of the dents or the apicodental ligament?
The notochord
92
What ligament attaches to the posterolateral part of the odontoid process of C2 and to surfaces on the medial border of the occipital condyle or as far anterior as the anterolateral margin of the foramen magnum?
The alar ligament
93
What is the function of the alar ligament?
Together they function to resist axial rotation
94
What are the attachment sites for the superficial layer of the membrana tectoria or tectorial membrane?
The posterior part of the inferior epiphyseal rim and vertebral body of C2 to the capsular ligament of the atlanto-occipital joint and cranial dura of the posterior cranial fossa
95
What lies in front of the deep layer of the membrana tectoria or tectorial membrane?
The cruciate ligament
96
For the cervical spine below C2, what is the range of motion allowed for each type of joint motion identified?
90 degrees flexion-extension, 50 degrees one side lateral bending and 33 degrees one side axial rotation
97
What are the locations for cotosvertebral joints on the vertebra?
The costocentral joint at the vertebral body and the costotransverse joint at the transverse process
98
Costocentral radiate or stellate ligaments will attach the head of the rib to what structures?
Both vertebral bodies of the costocentral joint and the intervertebral disc for ribs 1-9
99
An intra-articular ligament will be identified with which ribs?
Ribs 2-9
100
Which vertebrae will have a synovial plane (diarthrosis arthrodia) costotransverse joint?
Typically T1-T10
101
At what rib will the superior costotransverse ligament be absent?
The first rib
102
What ligaments will attach to the neck of the twelfth rib?
The superior costotransverse ligament from T11 and the lumbocostal ligament from L1
103
What unique ligament is present at the twelfth rib?
The superior costotransverse ligament from T11 and the lumbocostal ligament from L1
104
What unique ligament is present at the twelfth rib?
The lumbocostal ligament
105
Which ribs will have an attachment for the inferior costotransverse ligament?
Rib 1 to rib 11
106
At what rib will the inferior costotransverse ligament be absent?
The twelfth rib
107
What is the name of the space between the transverse process and the neck of the rib?
The costotransverse foramen
108
Which ligament "fills" the costotransverse foramen?
The inferior costotransverse ligament
109
At what rib will the lateral costotransverse ligament be absent?
The twelfth rib
110
Which vertebral couples of the thoracic spine have the greatest motion?
T11/T12 and T12/L1
111
Which range of motion is greatest for lower thoracic vertebral couples?
Flexion-extension
112
Which range of motion is least for lower thoracic vertebral couples?
One side axial rotation
113
Based on current literature, what common ligaments are absent at the lumbosacral joint?
Ligamentum nuchae, interspinous ligament, and supraspinous ligament
114
Which ligaments replace the intertransverse ligament at the lumbosacral ligament?
The iliolumbar ligament and lumbosacral ligament
115
What are the attachment sites for the lumbosacral ligament?
The sacral ala and ventrolateral surface of sacrum attach to the transverse process of L5
116
What muscle is intimately attached to the superior iliolumbar ligament?
Quadratus lumborum
117
Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions?
The superior iliolumbar ligament
118
Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?
The inferior iliolumbar ligament
119
Which vertebral couple of the lumbar spine has the greatest range of motion?
L5/S1
120
Which range of motion is greatest for all lumbar vertebral couples?
Flexion-extension
121
Which range of motion is least for L1-L5 vertebral couples?
One side axial rotation
122
Which range of motion is least for the L5/S1 vertebral couple?
One side lateral bending
123
What ligament represents the continuation of the anterior longitudinal ligament at the sacrococcygeal joint?
The anterior sacrococcygeal ligament
124
What ligament represent the continuation of the posterior longitudinal ligament at the sacrococcygeal joint?
The deep posterior sacrococcygeal ligament
125
What ligament represents the homolog of the ligamentum flavum at the sacrococcygeal joint?
The superficial posterior sacrococcygeal liagment
126
What is the homolog of the intertransverse ligament at the sacrococcygeal joint?
The lateral sacrococcygeal ligament
127
What is the auricular surface of sacrum composed of?
True articular cartilage, a modification of hyaline cartilage
128
What is the auricular surface of the ilium composed of?
Articular cartilage, interspersed with fibrocartilage
129
Which gender is biased with greater unevenness of the auricular surface of the sacro-iliac joint?
Males
130
What forms the accessory sacro-iliac joint?
The sacral tuberosity and the iliac sulcus
131
What does ankylosis mean?
A condition of fibrous adhesion occurs within the joint
132
What is the age and gender bias associated with ankylosis of the sacro-iliac joint?
Age 50 and male bias particularly in African American males
133
What is the age and gender bias associated with ossification of the anterior sacro-iliac ligament?
Age 40 and male bias
134
Which is the strongest of the sacro-iliac ligament?
The interosseous sacro-iliac ligament
135
What passes between the layers of the interosseous sacro-iliac ligament?
Dorsal rami from the sacral spinal nerves
136
What is formed by the continuation of the sacrotuberous ligament along the ischial ramus?
The falciform process
137
What separates the greater sciatic and lesser sciatic foramina?
The sacrospionous ligament
138
What is the function of the sacro-ischial ligaments?
They oppose the upward tilt of the sacral apex and resist the rotation of sacrum between the innominate bones
