Arthrology of the Vertebral Column (final exam) Flashcards
(181 cards)
1
Q
What are the four consistent features of synovial (diarthrosis) joints?
A
Articular or fibrous capsule
Synovial membrane
Articular cartilage
Synovial fluid
2
Q
Thickening of the fibrous capsule connective tissue will form the __?
A
Capsular ligament
3
Q
What generic accessory ligaments may accompany and support the capsular ligament?
A
Intracapsular and Extracapsular ligaments
4
Q
What are the common characteristics of type 1 articular receptors?
A
Located in the superficial layer of the fibrous capsule
Resemble Ruffini endings
Most numerous in cervical zygapophysis and they monitor the joint “at rest”
5
Q
What are the characteristics of type II articular receptors?
A
Located in deeper strata of the fibrous capsule,
Resemble Pacinian corpuscles,
Most numerous in the cervical spine and monitor the joint during normal range of motion
6
Q
What are the characteristics of type III articular receptors?
A
Present in collateral and intrinsic ligaments,
Resemble Golgi Tendon organs,
Not initially observed along the vertebral column and monitor extreme joint motion
7
Q
What is the function of type IV articular receptors?
A
Nociceptive, they monitor pain
8
Q
Type IVa articular receptors would be present in what location?
A
Fibrous capsule, Articular fat pads or adventitia of blood vessels
9
Q
Type IVb articular receptors would be present in what locations
A
Accessory ligaments in general, dense in the posterior longitudinal ligament of spine
10
Q
What are the three modifications of articular synovial membrane?
A
1) Synovial villi
2) Articular fat pads or Haversian glands
3) Synovial menisci and intra-articular discs
11
Q
What is the generic function of modifications of articular synovial membrane?
A
Aid in spreading synovial fluid
12
Q
What is the apparent function of synovial villi?
A
Increase the surface of synovial membrane available for secretion–absorption phenomena
13
Q
Articular fat pads are most numerous in what location along the vertebral column?
A
Lumbar zygapophysis
14
Q
Condensed fibrous connective tissue or fibrocartilage projections of the synovial membrane are called__.
A
Synovial menisci or Intra-articular discs
15
Q
Synovial menisci are a feature of what joint examples?
A
Femur-tibia articulation,
Cervical zygapophysis and lumbar zygapophysis
16
Q
What are the layers of the synovial membrane?
A
Outer fibrous layer and an inner (luminal) cellular layer AKA synovial lamina intima
17
Q
What are the specific functions of type A synovial cells?
A
Are phagocytic
18
Q
What is the specific function of Type B synovial cells?
A
Secrete proteinaceous substances and hyaluronic acid
19
Q
What is the common function of Type A and type B synovial cells?
A
Formation and absorption of synovial fluid
20
Q
What is the source of nutrition for articular cartilage?
A
Blood vessels in the synovial membrane, sinuses of the bone marrow cavity and from synovial fluid itself.
21
Q
What is unique about the surface of articular cartilage?
A
true perichondrium is absent
22
Q
Which collagen fiber type predominates in articular cartilage?
A
Type II
23
Q
What is the primary function of bound glycosaminoglycans in articular cartilage?
A
Form a network for water retention
24
Q
Cartilage is able to change shape due to compression, a characteristic known as ___?
A
Deformation
25
What is implied when cartilage is said to have elastic properties?
Cartilage can deform and returns to original volume rapidly, a time independent property
26
What is implied when cartilage is said to have viscoelastic properties?
Cartilage can deform but returns to original volume slowly, a time dependent property.
27
What is the function of articular cartilage?
Provide a wear-resistant, low-friction, easily lubricated surface for joint movement.
28
What are the properties of synovial fluid?
it is yellow-white, viscous, slightly alkaline and tastes salty
29
Synovial fluid consists of what specific chemical groups?
Fats, Salts, Albumins and hyaluronate
30
Which substance in synovial fluid was first thought to be responsible for its viscosity and lubricating behavior?
Hyaluronate
31
What substance of synovial fluid has been proposed to be responsible for its viscosity and lubricating behavior?
Lubricin
32
What are the classifications of synovial joints (diarthrosis) based on the number of articulating surfaces?
Simple and compound synovial joints
33
What is complex synovial joint (diarthrosis)?
Within the simple joint or the compound joint,
| Articulating surfaces are separated by an articular disc (intra-articular disc) or meniscus
34
What morphological classification of synovial joints is classified as nonaxial?
Plane (diarthrosis arthrodial)
35
What morphological classifications of synovial joints would be classified as uniaxial?
Hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)
36
What morphological classifications of synovial joints would be classified as biaxial?
(diarthrosis) bicondylar
(Diarthrosis) condylar
(Diarthrosis) Ellipsoidal
(Diarthrosis sellar) Saddle
37
What is the pivot point in the proximal radio-ulnar joint?
In the proximal radio-ulnar joint,
The pivot point is the head of the radius which rotates within the osteo-ligamentous ring formed by the radial notch of the ulna and the annular ligament.
38
Identify the common ligaments of the vertebral column.
```
1)Anterior longitudinal ligament,
Intervertebral disc
Posterior longitudinal ligament
Ligamentum Flavum
Capsular ligament
Interspinous ligament
Ligamentum Nuchae
Supraspinous ligament
Intertransverse ligament
```
39
What is the maximum number of common ligaments identified with a vertebral couple?
8
40
What is the reason that nine common ligaments are identified but only eight will be attached at any specific vertebral couple?
the Ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple.
41
What is the number of true intervertebral discs identified in the adult?
23
42
In the adult, which vertebral levels will demonstrate a true intervertebral disc?
Those between C2 and S1 inclusive
43
What prevent of the vertebral column length is contributed by the intervertebral disc?
20-25%
44
What is the percent of intervertebral disc height contribution to cervical region, Thoracic region, and Lumbar region length?
Cervical 20-25%
Thoracic 20%
Lumbar 33%
45
What is the cervical nucleus pulposus composed of?
Fibrocartilage
46
What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?
Birth---- 88%
| Thirty years old----70%
47
What cell is associated with the nucleus pulposus until about age eleven?
notochord cells
48
What cells are associated with the mature nucleus pulposus?
Reticulocyte-fibroblast
| Chondroblast
49
Which type of collagen is dominant in the nucleus pulposus?
Type II
50
What is the organizational pattern for collagen fibers in the nucleus pulposus?
Irregularly oriented and randomly scattered
51
What is unusual about the cervical annulus fibrosus?
Lacks any lamellar or layered organization
52
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; the posterior margin is thin
53
What compensates for the thinness of the posterior part of the cervical annulus fibrosus?
Posterior longitudinal ligament
54
What is the organization of the lumbar annulus fibrosus?
has 12-24 concentric cylindrical lamellae
55
What is the water concentration in the lumbar annulus fibrosus at birth and after thirty?
Birth---- 78%
| Thirty--- 70%
56
Which type of collagen is dominant in the annulus fibrosus?
Type I
57
What is the organizational pattern for collagen fibers in the annulus fibrosus?
Parallel with one another in a single lamellus and angled
58
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
59
What is the average angle of collagen fibers within the annulus fibrosus?
Average 50 to 60 degrees
60
What is the thickest part of the cartilage end plate?
Around the periphery
61
What is the principal type of collagen fiber within the cartilage end plate?
Type II collagen fiber
62
What is the direction of collagen fibers within the cartilage end plate?
Collagen fibers are aligned anterior to posterior
63
What is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus?
Cartilaginous end plate
64
What are the types of receptor endings in the intervertebral disc?
Nociceptors and proprioceptors
65
What is the relationship between size of the intervertebral disc and receptor endings?
Larger the disc = Greater variety of receptor endings
66
What is the proposed function of receptor ending density in the anterior part of the intervertebral disc?
Provide feedback during extension
67
What innervates the annulus fibrosus at the posterior part of the intervertebral disc?
Recurrent meningeal or sinu-vertebral or sinus vertebral notch
68
What innervates the annulus fibrosus at the anterior part of the intervertebral disc?
Fibers form the ventral primary ramus
69
What innervates the annulus fibrosus at the lateral part of the intervertebral disc?
Fibers from: Ventral primary rami,
White ramus communicans
Gray ramus communicans
Paradiscal ramus communicans
70
What is the name given to the white ramus communicans which becomes embedded within the annulus fibrosus of the intervertebral disc?
Paradiscal ramus communicans
71
What is the popular theory of intra-abdominal cavity pressure and the intervertebral disc response to weight bearing?
Increase in abdominal pressure = diminishes resistance the intervertebral disc needs to generate by 50%
72
What part of the intervertebral disc will allow distribution of weight over a maximum surface area?
Nucleus pulposus
73
What vertebral levels will the anterior longitudinal ligament attach to?
Between occiput and S3
74
What is the lowest extent of the anterior longitudinal ligament based on recent studies?
L3
75
What is the function of the anterior longitudinal ligament?
Brakes or limits dorsi-flexion or hyperextension of the vertebral column
76
What was ossification of the anterior longitudinal ligament in the lumbar region identified as?
Forestier's disease
77
Anterior longitudinal ligament of ossification in the lumbar region is now identified as __?
DISH
Diffuse Idiopathic skeletal Hyperostosis
78
What vertebral levels will the posterior longitudinal ligament attach to?
Between C2 and S3
79
What is the innermost layer of the posterior longitudinal ligament called?
Perivertebral ligament
80
What is the function of the posterior longitudinal ligament?
brakes or limits flexion of the vertebral column
81
Where is ossification of the posterior longitudinal ligament most commonly identified?
Cervical spine with and 80% incidence
82
What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?
A loss of hand and finger dexterity
83
What is the incidence of the posterior longitudinal ligament ossification in the thoracic and lumbar spine?
About 10% at thoracic and Lumbar spine
84
What is the clinical sign of PLL ossification in the lumbar spine?
Faltering gait
85
What is the gender, age, and ethnic bias associated with ossification of the PLL?
Greater in Males >50
| Higher incidence in Japanese men
86
What is the acronym for ossification of the PLL?
OPLL
87
At one time ossification of the PLL was an example of what condition?
DISH
Diffuse Idiopathic Skeletal Hyperostosis
88
What vertebral levels will the ligamentum flavum be attached to?
C2-S1
89
What is the relationship of the ligamentum flavum to the vertebral foramen?
Forms the Posterior boundary of spinal canal
90
What is the histology of the ligamentum flavum?
Elastic fibers which are yellow
91
What is the function of the ligamentum flavum?
Brakes or limits flexion of the vertebral column
92
What is now thought to be a major function of the ligamentum flavum?
Early prime factor in extension of the vertebral column
93
Where is ossification of the ligamentum flavum most commonly identified?
Thoracic spine or Thoracolumbar transition zone
94
What is the acronym for ossification of the ligamentum flavum?
OLF
95
What is the relationship between the capsular ligament and mobility?
More lax/loose the capsular ligament = greater motion of joint
96
What regions of the column demonstrate the greatest laxity of capsular ligaments?
Cervical and lumbar regions
97
The capsular ligament may blend with which other common ligament?
Ligamentum Flavum
98
What muscle will blend with the capsular ligament posteriorly?
Multifidis
99
What vertebral levels will the interpsinous ligament be attached to?
C2-S1
100
What is the classic function of the interspinous ligament?
Brakes or limits flexion of the vertebral column
101
What is now thought to be a major function of the interspinous ligament?
Proprioceptive transducer for the spinal relfex
102
What will ligamentum nuchae be attached to?
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.
103
What is the name given to the superficial layer of the ligamentum nuchae?
Funicular layer
104
What is the name given to the deep layer of the ligamentum nuchae?
Lamellar layer
105
What are the attachment sites for the superficial layer of the ligamentum nuchae?
External occipital protuberance, external occipital crest, and spinous tubercle C7
106
What is the histological make-up of the human ligamentum nuchae in quadrupeds?
Yellow elastic ligament
107
What is the primary yellow elastic or elastic ligament of the spine?
Ligamentum flavum
108
What is the histological make-up of the ligamentum nuchae?
Yellow elastic ligament, but has more collagen fibers than in quadrupeds.
109
What is the classic function of the human ligamentum nuchae?
It brakes/limits flexion of the cervical spine
110
What will the supraspinous ligament be attached to?
Spinous tubercles along the vertebral column form C7 to sacrum.
111
What is the termination level inferiorly for the supraspinous ligament according to current literature?
Primarily at L4 (73%); between L4 and L5 (5%)
112
Where is the supraspinous ligament said to be best developed?
Lumbar spine
113
What is the classic function of the human supraspinous ligament?
Brakes or limits flexion of the spine
114
What is now thought to be a major function of the supraspinous ligament?
Proprioceptive transducer for spinal reflex
115
What will the intertransverse ligament be attached to?
C1-L5 Transvers processes to transverse tubercles
116
What is the status of the cervical intertransverse ligament?
Paired with an anterior and a posterior intertransverse ligament.
117
What is the status of the lumbar intertransverse ligament?
Well developed with two parts identified, ventral slip and a dorsal slip
118
What part of the lumbar intertransverse ligament covers the intervertebral foramen?
Ventral slip
119
What part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?
Dorsal slip
120
What are the characteristics of the capsular ligament of the atlanto-occipital joint?
Said to be loose, thin, and composed of collagen fibers
121
What other joint space does the atlanto-occipital joint communicate with?
Posterior bursa of the median atlanto-axial joint
122
What is the median thickening of the anterior atlanto-occipital ligament called?
Anterior longitudinal ligament
123
What is the classic function of the anterior atlanto-occipital ligament?
Brakes or limits "Extension" of the skull over the cervical spine
124
Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?
Incomplete Ponticulus Posticus or a complete Ponticulus Posticus
125
What other name may be used to identify a Ponticulus Posticus?
Kimmerles's anomaly
126
What names are given to the opening formed by the Ponticulus Posticus?
Arcuate foramen or Retroarticular canal
127
What is the classic function of the posterior atlanto-occipital ligament?
Brakes or limits axial rotation, flexion, and perhaps lateral bending of the skull on atlas
128
What amount of flexion - extension is accommodated by the atlanto-occipital?
about 25 degrees
129
What amount of axial rotation is accommodated by the atlanto-occipital joint?
About 3-8 degrees one side axial rotation
130
What amount of lateral bending is accommodated by the atlanto-occipital joint?
5 degrees
131
Which motion is best accommodated by the atlanto-occipital joint?
Flexion- extension
132
Which atlanto-axial joint is identified as a synovial pivot (diarthrosis trochoid)?
Median atlanto-axial joint
133
What are the names given to the synovial joint spaces of the median atlanto-axial joint?
Anterior bursa and the posterior bursa
134
What are the joint surfaces of the median atlanto-axial joint at the anterior bursa?
Fovea dentis of C1 and the facet for fovea dentis of C2
135
What ligament is formed by the transverse atlantal ligament and is perpendicular extension?
Cruciate ligament or cruciform ligament
136
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.
137
What is the ADI?
Atlanto-dental interspace, radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint.
138
What is the ADI of children compared with that of adults?
Children: 4.5mm
Adult: 2-3mm
139
What are the characteristics of the capsular ligament of the lateral atlanto-axial joint?
Lax or loose and demonstrates a meniscoidal fold within the joint cavity
140
What are the degrees of movement facilitated at the atlanto-axial joint?
About 20 degrees flexion - extension
40 degrees one side axial rotation,
5 degrees of lateral bending
141
The occiput-C1-C2 joint complex account for what percent of all cervical axial rotation?
About 60%
142
What name is given to the occipital - C2 region of the spine?
Craniovertebral junction
143
Embryologically, what forms the apical ligament of the dens or the apicodental ligament?
notochord
144
What is the function of the apical ligament of the dens or the apicodental ligament?
It has no known function
145
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?
alar ligament
146
What is the function of the alar ligament?
Function to resist axial rotation
147
Which ligament lies behind the alar ligaments?
Cruciate ligament, specifically the superior crus ligament
148
What are the layers of the membrane tectoria or tectorial membrane?
superficial layer and deep layer identified
149
The superficial layer of the membrane tectoria or tectorial membrane lies in front of what structure?
dura mater of the medulla oblongata and the spinal cord
150
What is the function of the membrane tectoria or tectorial membrane?
Resists flexion and extension of the skull on the upper cervical spine
151
For the cervical spine below C2, what is the range of flexion - extension?
about 90 degrees or about 18 degrees per couple
152
For the cervical spine below C2, what is the range of one side lateral bending?
About 50 degrees or about 10 degrees per couple
153
For the cervical spine below C2, what is the range of one side axial rotation?
33 degrees or about 6 degrees per couple
154
Which ligaments replace the intertransverse ligament at the lumbosacral joint?
Iliolumbar ligament and lumbosacral ligament
155
What are the attachment sites for the lumbosacral ligament?
Sacral ala and ventrolateral surface of sacrum attach tot he transverse process of L5
156
What are the attachment sites for the iliolumbar ligament?
Iliac crest is attached to the transverse process of L5
157
What muscle is intimately attached to the superior iliolumbar ligament?
quadratus lumborum
158
Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical descriptions?
Superior iliolumbar ligament
159
Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?
inferior iliolumbar ligament
160
Which vertebral couple of the lumbar spine has the greatest range of motion?
L5/S1
161
Which range of motion is greatest for all lumbar vertebral couples?
Flexion- extension
162
Which range of motion is least for L1 - L5 vertebral couples?
One side axial rotation
163
Which range of motion is least for the L5/S1 vertebral couple?
One side lateral bending
164
List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal?
1) Membrana tectoria
2) PLL
3) Deep posterior sacrococcygeal ligament
165
List, in order, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal?
1) Posterior atlanto-occipital ligament
2) Posterior atlanto-axial ligament
3) Ligamentum flavum
4) Superficial posterior sacrococcygeal ligament
166
List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal column?
1) Anterior atlanto-occipital ligaments
2) Anterior atlanto-axial ligament
3) Anterior longitudinal ligament
4) Anterior sacrococcygeal ligament
167
What is the auricular surface of sacrum composed of?
true articular cartilage
| Modification of hyaline cartilage
168
What is the auricular surface of the ilium composed of?
Articular cartilage interspersed with fibrocartilage.
169
What is the superficial appearance of the auricular surfaces of the sacro-iliac joint?
Sacrum develops a sacral groove
| Ilium develops an iliac edge
170
Which gender has greater unevenness of the auricular surface of the sacro-iliac joint?
Males
171
What pathological or age-related modifications of the sacro-iliac joint may occur?
1) Degenerative arthrosis
| 2) Ankylosis
172
What does ankyloses mean?
condition of fibrous adhesion occurs within the joint
173
What is the age and surface bias associated with degenerative arthrosis of sacro-iliac joint?
age: 40
surface: iliac auricular surface
174
What is the age and gender bias associated with ankyloses of the sacro-iliac joint?
Age: 50
Gender: Males, African American
175
What age and gender bias is associated with ossification of the anterior sacro-iliac ligament?
Age: 40
Gender: Male
176
Which is the strongest of the sacro-iliac ligaments?
interosseous sacro-iliac lig.
177
What are the attachment sites of the interosseous sacro-iliac ligament?
1) Sacral tuberosity
| 2) Iliac sulcus
178
What passes between the layers of the interosseous sacro-iliac ligament?
Dorsal rami from the sacral spinal nerves
179
What is formed by the continuation of the sacrotuberous ligament along the ischial ramus?
Falciform process
180
What separates the greater sciatic and lesser sciatic foramina?
Sacrospinous ligament
181
What is the function of the sacrospinous and sacrotuberous ligaments?
1) Oppose upward tilt of the sacral apex
| 2) Resist the rotation of sacrum between innominate bones.
