Arthrology of the Vertebral Column Flashcards
(155 cards)
1
Q
What is the maximum number of common ligaments identified with a vertebral couple?
A
8
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
3
Q
Which common ligaments will attach to the vertebral body?
A
Anterior longitudinal ligament
Intervertebral disc
Posterior longitudinal ligament
4
Q
What common ligaments will attach to the vertebral arch?
A
Ligamentum flavum
5
Q
What is the number of true intervertebral discs identified in the adult?
A
23
6
Q
In the adult, which vertebral levels will demonstrate a true intervertebral disc?
A
C2-S1
7
Q
What is the intervertebral disc histologically composed of?
A
Cells
Collagen fibers
Hydrated proteoglycan gel
8
Q
What is the cervical nucleus pulposus composed of?
A
Fibrocartilage
9
Q
What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?
A
Birth = 88% 30 = 70%
10
Q
What is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?
A
Nucleus pulposus will lose water under deformation conditions
11
Q
What cell is associated with the nucleus pulposus until about age eleven?
A
Notochord cells
12
Q
What cells are associated with the mature nucleus pulposus?
A
Reticulocyte-fibroblast
Chondroblast
13
Q
Which type of collagen is dominant in the nucleus pulposus?
A
Collagen type II
14
Q
What general tissue location is described as having an abundance of collagen type II fibers?
A
Cartilage
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
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
17
Q
What compensates for the thinness of the posterior part of the cervical annulus fibrosus?
A
Posterior longitudinal ligament
18
Q
What is the organization of the lumbar annulus fibrosus?
A
Has 12-14 concentric cylindrical lamellae
19
Q
What is the water by concentration in the lumbar annulus fibrosus at birth and after thirty?
A
Birth = 78% 30% = 70%
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
21
Q
Which type of collagen is dominant in the annulus fibrosus?
A
Collagen type I
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
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
24
Q
What is the average angle of collagen fibers within the annulus fibrosus?
A
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
