Arthrology of the Vertebral Column

Question 1

The ligamentous sacro-iliac joints (or most of the ligamentous joints of the vertebral column) are examples of which joint classification?

Answer 1

syndesmosis

Question 2

What are the four consistent features of synovial (diarthrosis) joints?

Answer 2

articular or fibrous capsule, synovial membrane, articular cartilage and synovial fluid

Question 3

Type 1 articular receptors are located in what part of the joint?

Answer 3

superficial layer of the fibrous capsule

Question 4

What is the function of the type 1 articular receptor?

Answer 4

They monitor the joint “at rest”

Question 5

Type II articular receptors are located in what part of the joint?

Answer 5

deeper strata of the fibrous capsule

Question 6

What is the function of type II articular receptors?

Answer 6

they monitor the joint during normal range of motion

Question 7

What is the location of type III articular receptors?

Answer 7

collateral or intrinsic ligaments of many joints, they were not thought to be present along vertebral column

Question 8

what is the function of type III articular receptors?

Answer 8

they monitor the joint during extreme motion or beyond normal range of motion

Question 9

What is the function of type IV articular receptors

Answer 9

nociceptive, they monitor pain

Question 10

Type IVb articular receptors would be present in what locations?

Answer 10

accessory ligaments in general, dense in the posterior longitudinal ligament of the spine

Question 11

What are the three modifications of articular synovial membrane?

Answer 11

1 synovial villi, 2 articular fat pads or Haversian glands, 3 synovial menisci and intra-articular discs

Question 12

Articular fat pads are most numerous in what location along the vertebral column?

Answer 12

lumbar zygapophyses

Question 13

What are the specific functions of type A synovial cells?

Answer 13

are phagocytic

Question 14

What is the specific function of type B synovial cells?

Answer 14

secrete proteinaceous substances and hyaluronic acid

Question 15

Which collagen fiber type predominates in articular cartilage?

Answer 15

type II

Question 16

What are proteoglycans composed of?

Answer 16

a core protein and glycosaminoglycans

Question 17

Cartilage is able to change shape due to compression, a characteristic known as:

Answer 17

deformation

Question 18

What is implied when cartilage is said to have elastic properties?

Answer 18

cartilage can deform and returns to original volume rapidly, a time independent property

Question 19

What is implied when cartilage is said to have viscoelastic properties?

Answer 19

cartilage can deform but returns to original volume slowly, a time dependent property

Question 20

What are the properties of synovial fluid?

Answer 20

it is yellow-white, viscous, slightly alkaline, and tastes salty

Question 21

Synovial fluid consists of what specific chemical groups?

Answer 21

fats, salts, albumins and hyaluronate

Question 22

Which substance in synovial fluid was first thought to be responsible for its viscosity and lubricating behavior?

Answer 22

hyaluronate

Question 23

What is complex synovial joint (diarthrosis)?

Answer 23

within the simple or the compound joint, the articulating surfaces are separated by an articular disc (intra-articular disc) or meniscus

Question 24

What morphological classification of synovial joints is classified as non axial?

Answer 24

plane (diarthrosis arthrodial)

Question 25

What morphological classifications of synovial joints would be classified as uniaxial?

Answer 25

hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)

Question 26

What morphological classifications of synovial joints would be classified as biaxial?

Answer 26

(diarthrosis) bicondylar, (diarthrosis) condylar, (diarthrosis) ellipsoidal, and saddle (diarthrosis sellar)

Question 27

Which vertebrae will have common ligaments?

Answer 27

segments C2 to L5

Question 28

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

Answer 28

eight

Question 29

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

Answer 29

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

Question 30

What common ligaments will attach to the vertebral arch?

Answer 30

the ligamentous flavum

Question 31

What is the cervical nucleus pulposus composed of?

Answer 31

fibrocartilage

Question 32

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

Answer 32

the nucleus pulposus will lose water under deformation conditions

Question 33

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

Answer 33

notochord cells

Question 34

Which type of collagen is dominant in the nucleus pulposus?

Answer 34

collagen type II

Question 35

What is unusual about the cervical annulus fibrous?

Answer 35

it lacks any lamellar or layered organization

Question 36

What is the appearance of the cervical annulus fibrosus?

Answer 36

a horse-shoe with the anterior margin think and the lateral margins tapering to the uncinate processes; the posterior margin is thin

Question 37

What is the organization of the lumbar annulus fibrosus?

Answer 37

it has 12-14 concentric cylindrical lamellae

Question 38

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

Answer 38

birth...78%; thirty...70%

Question 39

What is the consequence of aggregated glycosaminoglycans in the lumbar annulus fibrosus?

Answer 39

the annulus fibrosus will retain water under deformation conditions

Question 40

Which type of collagen is dominant in the annulus fibrosus?

Answer 40

collagen type 1

Question 41

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

Answer 41

they are parallel with one another in a single lamellus and angled

Question 42

What is the organization of collagen fibers between lamellae?

Answer 42

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

Question 43

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

Answer 43

they average 50 to 60 degrees

Question 44

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

Answer 44

collagen fibers are aligned anterior to posterior

Question 45

What cell type is associated with the cartilage end plate?

Answer 45

chondrocytes

Question 46

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

Answer 46

changes in the histology of the cartilage end plate

Question 47

What part of the intervertebral disc is innervated?

Answer 47

the outer lamellae of the annulus fibrosus

Question 48

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

Answer 48

nociceptors and proprioceptors

Question 49

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

Answer 49

the larger the disc, the greater the variety of receptor endings

Question 50

What is the proposed function of receptor ending density in the anterior part of the intervertebral disc?

Answer 50

they provide feedback during extension

Question 51

What innervates the annulus fibrosus at the posterior part of the intervertebral disc?

Answer 51

the recurrent meningeal/sinu-vertebral/sinus vertebral nerve

Question 52

What forms the posterior neural plexus of the vertebral column?

Answer 52

the sinu-vertebral nerve (sinus vertebral nerve, recurrent meningeal nerve)

Question 53

What forms the anterior neural plexus of the vertebral column?

Answer 53

fibers from the ventral primary ramus

Question 54

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

Answer 54

the paradiscal ramus communicans

Question 55

How does the intervertebral disc attach to the vertebral body?

Answer 55

sharpey's fibers from the outer lamellae of the annulus fibrosus are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies

Question 56

In what regions of the vertebral column is the space formed between vertebral bodies by the intervertebral disc the greatest?

Answer 56

the cervical and lumbar regions

Question 57

which curve direction will be associated with the greatest space observed between vertebral bodies?

Answer 57

the lordotic or anterior curves

Question 58

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

Answer 58

perichordal disc

Question 59

What part of the intervertebral disc will the perichordal disc form?

Answer 59

the annulus fibrosus

Question 60

What part of the intervertebral disc will the notochord form?

Answer 60

the nucleus pulposus

Question 61

What is the earliest indicator of the position of the adult intervertebral disc?

Answer 61

the intrasclerotomal fissure or fissure of von Ebner

Question 62

changes in the histology or appearance of the cartilaginous end plate will precede what conditions?

Answer 62

degenerative disc diseases

Question 63

What vertebral levels will the anterior longitudinal ligament attach to?

Answer 63

those between occiput and S3 inclusive traditionally indicated

Question 64

What is the lowest extent of the anterior longitudinal ligament based on recent studies?

Answer 64

L3

Question 65

What is the function of the anterior longitudinal ligament?

Answer 65

it brakes or limits dorsi-flexion or hyperextension of the vertebral column

Question 66

What was ossification of the anterior longitudinal ligament in the lumbar region identified as?

Answer 66

Forestier's disease

Question 67

What vertebral levels will the posterior longitudinal ligament attach to?

Answer 67

those between C2 and S3 inclusive are traditionally indicated

Question 68

Newer research suggests what regional variation in the posterior longitudinal ligament?

Answer 68

prominent in the cervicals, occasional in the thoracics, rare in the lumbars

Question 69

What is the relationship of the posterior longitudinal ligament to the vertebral foramen?

Answer 69

it forms the anterior boundary of the spinal canal

Question 70

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

Answer 70

the perivertebral ligament

Question 71

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

Answer 71

the cervical spine with an 80% incidence

Question 72

What is the clinical sign of the posterior longitudinal ligament ossification in the cervical spine?

Answer 72

a loss of hand and finger dexterity

Question 73

What is the incidence of posterior longitudinal ligament ossification in the thoracic and lumbar spine?

Answer 73

about 10% at the thoracic and 10% at the lumbar spine

Question 74

What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?

Answer 74

faltering gait

Question 75

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

Answer 75

it is greater in males over 50 and has a higher incidence in the japanese

Question 76

What is the acronym for ossification of the PLL?

Answer 76

OPLL

Question 77

At one time ossification of the PLL was an example of what condition?

Answer 77

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Question 78

What are the specific bony attaching sites for the ligamentum flavum?

Answer 78

the laminae

Question 79

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

Answer 79

it is a yellow elastic ligament

Question 80

What fibers are most ligaments made up of?

Answer 80

collagen type 1 fibers which are whitish in appearance

Question 81

What is the color of most ligaments in the body?

Answer 81

they are whitish

Question 82

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

Answer 82

it is an early prime factor in extension of the vertebral column

Question 83

Where is ossification of the ligamentum flavum most commonly identified?

Answer 83

the thoracic spine or thoracolumbar transition zone

Question 84

What is the relationship between the capsular ligament and mobility?

Answer 84

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

Question 85

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

Answer 85

the cervical and lumbar regions

Question 86

What muscle will blend with the capsular ligament posteriorly?

Answer 86

the multifidis

Question 87

What is the status of the lumbar interspinous ligament?

Answer 87

it is broad and thick with three layers identified from anterior to posterior

Question 88

What is the classic function of the interspinous ligament?

Answer 88

it is more likely a proprioceptive transducer for the spinal reflex

Question 89

What will the ligamentum nuchae be attached to?

Answer 89

the external occipital protuberance, external occipital crest, the posterior tubercle of the posterior arch of C1, and spinous tubercles between C2 and C7 inclusive are traditionally indicated

Question 90

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

Answer 90

the funicular layer or part

Question 91

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

Answer 91

the lamellar layer or part

Question 92

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

Answer 92

the external occipital protuberance, external occipital crest, and spinous tubercle of C7

Question 93

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

Answer 93

it is a yellow elastic ligament

Question 94

What is the primary yellow elastic or elastic ligament of the spine?

Answer 94

the ligamentum flavum

Question 95

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

Answer 95

primarily at L4 (73%); between L4 and L5 (5%)

Question 96

Where is the supraspinous ligament said to be best developed?

Answer 96

in the lumbar spine

Question 97

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

Answer 97

it is a proprioceptive transducer for spinal reflex

Question 98

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

Answer 98

in the lumbar spine