Arthrology of the Vertebral Column Flashcards Preview

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Flashcards in Arthrology of the Vertebral Column Deck (155):
1

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

8

2

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

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

3

Which common ligaments will attach to the vertebral body?

Anterior longitudinal ligament
Intervertebral disc
Posterior longitudinal ligament

4

What common ligaments will attach to the vertebral arch?

Ligamentum flavum

5

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

23

6

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

C2-S1

7

What is the intervertebral disc histologically composed of?

Cells
Collagen fibers
Hydrated proteoglycan gel

8

What is the cervical nucleus pulposus composed of?

Fibrocartilage

9

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

Birth = 88%
30 = 70%

10

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

Nucleus pulposus will lose water under deformation conditions

11

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

Notochord cells

12

What cells are associated with the mature nucleus pulposus?

Reticulocyte-fibroblast
Chondroblast

13

Which type of collagen is dominant in the nucleus pulposus?

Collagen type II

14

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

Cartilage

15

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

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

16

What is the appearance of the cervical annulus fibrosus?

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

17

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

Posterior longitudinal ligament

18

What is the organization of the lumbar annulus fibrosus?

Has 12-14 concentric cylindrical lamellae

19

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

Birth = 78%
30% = 70%

20

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

Typically have a binding site for hyaluronic acid and thus aggregated

21

Which type of collagen is dominant in the annulus fibrosus?

Collagen type I

22

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

Parallel with one another in a single lamellae and angled

23

What is the organization of collagen fibers between lamellae?

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

24

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

Average 50 to 60 degrees

25

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

Sclerotomites

26

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

Cancellous bone at the top or bottom of the vertebral body

27

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

Type II collagen fiber

28

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

Collagen fibers are aligned anterior to posterior

29

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

Changes in the histology of the cartilage end plate

30

What is the cartilage end plate derived from?

Epiphyseal plate

31

What is the thickest part of the cartilage end plate?

Around the periphery

32

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

Transition zone

33

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

Nociceptors
Proprioceptors

34

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

Larger the disc, the greater the variety or receptor endings

35

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

Gray ramus communicans

36

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

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

37

What forms the anterior neural plexus of the vertebral column?

Fibers from the ventral primary ramus

38

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

39

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

Paradiscal ramus communicans

40

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

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

41

What is formed within the perichordal blastema between the sclerotomites?

Intrasclerotomal fissure or fissure of von Ebner

42

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

Perichordal disc

43

What will the dense sclerotomite become?

Upper part of the vertebral segment forming below

44

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

Hourglass shaped along its lateral margins

45

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

Perivertebral ligament

46

What innervated the posterior longitudinal ligament?

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

47

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

Cervical spine with an 80% incidence

48

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

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

49

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

Yellow elastic ligament

50

What fibers are most ligaments made of?

Collagen type I fibers which are whitish in appearance

51

What is the function of the ligamentum flavum?

Brakes or limits flexion of the vertebral column

52

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

Early prime factor in extension of vertebral column

53

Where is ossification of the ligamentum flavum most commonly identified?

Thoracic spine or thoracolumbar transition zone

54

What is the relationship between the capsular ligament and mobility?

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

55

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

Cervical
Lumbar

56

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

Poorly developed as ligaments although collagen fibers are present

57

What is the status of the cervical interspinous ligament?

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

58

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

More likely a proprioceptive transducer for the spinal reflex

59

What are the layers of the ligamentum nuchae?

Superficial layer
Deep layer

60

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

Funicular layer or part

61

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

Lamellar layer or part

62

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

EOP
External occipital crest
SPinous tubercle of C7

63

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

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

64

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

Primarily at L4 (73%)
Between L4 and L5 (5%)

65

Where is the supraspinous ligament said to be developed?

Lumbar spine

66

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

Proprioceptive transducer for the spinal reflex

67

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

Lumbar spine

68

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

Ventral slip

69

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

Dorsal slip

70

What is the classification of the atlanto-occipital joint?

Synovial (diarthrosis) ellipsoidal

71

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

Posterior bursa of the median atlanto-axial joint

72

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

Anterior longitudinal ligament

73

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

Accessory bone

74

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

Kimmerle's anomaly

75

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

25 degrees

76

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

3-8 degrees one side axial rotation

77

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

5 degrees

78

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

Flexion-extension

79

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

Median atlanto-axial joint

80

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

Lateral atlanto-axial joint

81

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

Anterior bursa
Posterior bursa

82

What part of the vertical crus ligament may be absent?

Inferior crus ligament

83

What is the function of the transverse atlantal ligament?

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

84

What is the ADI?

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

85

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

4.5mm in children
2-3mm or 2.5mm in adults

86

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

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

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

Ligamentum flavum

88

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

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

89

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

60%

90

What ligaments are present at the occipito-axial joint?

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

91

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

Notochord

92

What is the function of the alar ligament?

Together they function to resist axial rotation

93

What forms the cranial continuation of the posterior longitudinal ligament?

Membrana tectoria or tectorial membrane

94

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

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

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

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

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

90 degrees or 18 degrees per couple

97

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

50 degrees or 10 degrees per couple

98

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

33 degrees or 6 degrees per couple

99

What are the locations for costovertebral joints on the vertebra?

Costocentral joint at the vertebral body
Costotranseverse joint at the transverse process

100

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

Costocentral capsular ligament

101

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

Fibrous (amphiarthrosis) syndesmosis

102

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

2-9

103

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

Intra-articular crest of the head of the rib
Intervertebral disc

104

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

T1-T10

105

What are the accessory ligaments of the costotransverse joint?

Superior costotransverse ligament
Inferior costotransverse ligament
Lateral costotransverse ligament

106

At what rib will the superior costotransverse ligament be absent?

1st rib

107

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

Superior costotransverse ligament from T11
Lumbosacral ligament from L1

108

What are the attachment sites for the lumbocostal ligament?

Neck of 12th rib
Transverse process of L1

109

What is the function of the superior costotransverse ligament?

Limitation of lateral bending or maintaining lateral stability

110

What are the attachment sites for the inferior costotransverse ligament?

Neck of the rib
Transverse process of the vertebra at that level

111

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

T1-T11

112

At what rib will the inferior costotransverse ligament be absent?

12th rib

113

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

Costotransverse foramen

114

Which ligament "fills" the costotransverse foramen?

Inferior costotransverse ligament

115

What are the attachment sites for the lateral costotransverse ligament?

Non-articular surface of the tubercle of the rib
Transverse tubercle of the transverse process of the vertebra at that level

116

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

T1-T11

117

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

T12

118

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

T11/T12
T12/L1

119

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

Flexion-extension

120

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

One side axial rotation

121

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

Ligamentum nuchae
Interspinous ligament
Supraspinous ligament

122

Which ligaments replace the intertransverse ligament at the lumbosacral joint?

Iliolumbar ligament
Lumbosacral ligament

123

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

Superior iliolumbar ligament

124

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

Inferior iliolumbar ligament

125

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

Inferior iliolumbar ligament

126

What are the attachment sites for the accessory iliolumbar ligament?

Transverse process of L4
Iliac crest

127

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

L5/S1

128

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

Flexion-extension

129

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

One side axial rotation

130

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

One side lateral bending

131

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

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

132

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

Membrana tectoria
Posterior longitudinal ligament
Deep posterior sacrococcygeal ligament

133

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

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

134

What forms the closure for the spinal canal inferiorly?

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

135

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

Lateral sacrococcygeal ligament

136

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

Intercornual ligament

137

What does the sacral cornu represent?

Inferior articular process and facet of S5

138

What is the auricular surface of the ilium composed of?

Articular cartilage interspersed with fibrocartilage

139

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

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

140

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

Males

141

What forms the accessory sacro-iliac joint?

Sacral tuberosity and iliac sulcus

142

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

Degenerative arthrosis and ankylosis

143

What does degenerative arthrosis mean?

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

144

What does ankylosis mean?

Condition of fibrous adhesion occurring in a joint

145

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

Age 40, the iliac auricular surface

146

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

Age 50, male bias particularly in black males

147

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

Nutation and counternutation

148

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

Age 40, male bias

149

Which is the strongest of the sacro-iliac ligaments?

Interosseous sacro-iliac ligament

150

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

Sacral tuberosity
Iliac sulcus

151

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

Interosseous sacro-iliac ligament replaces the capsular ligament posteriorly

152

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

Dorsal rami from the sacral spinal nerves

153

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

Sacrotuberous ligament

154

What forms the falciform process?

Continuation of the sacrotuberous ligament along the ischial ramus

155

What separates the greater sciatic and lesser sciatic foramina?

Sacrospinous ligament