Articulations and vessels of the vertebral column Flashcards Preview

MSK exam 1 AP > Articulations and vessels of the vertebral column > Flashcards

Flashcards in Articulations and vessels of the vertebral column Deck (67)
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1
Q

primary curvature of the back

A

anterior concavity of the vertebral column

kyphodic curve

exists in fetal life throughout the column
persists in adult life in the thoracic and sacral areas

2
Q

secondary curves of spine

A

anterior convexity of the vertebral column

develops in response to lifting head and the assumption of the erect position

exists in cervical and lumbar areas

3
Q

lordosis

A

exaggerated secondary curve of the lumbar area

4
Q

kyphosis

A

exaggerated primary curve of the thoracic area

5
Q

scoliosis

A

lateral S shape any area of vertebral column

6
Q

zygopophysis (facet joints)

A

articulations between vertebral arches

true synovial joints

7
Q

3 major classifications of joints

A

membranous
cartilaginous
synovial

8
Q

what is a synovial joint?

A

articulating bones of a synovial joint are united by a joint capsule

the joint capsule has two parts:
outer fibrous layer
lined by a serous synovial membrane spanning and enclosing an articular cavity

the joint cavity contains synovial fluid

articular cartilage covers the articulating surfaces of the bones

PROVIDES FREE MOVEMENT

9
Q

articulations between vertebral bodies?

A

intervertebral discs

10
Q

annulus fibrosis

A

part of the intervertebral discs

outer fibrocartilaginous ring

consists of concentric lamellae (layers) of fibrocartilage*** Superstrength

the fibers of adjacent lamellae cross each other obliquely in opposite directions -> allows limited rotation b/w adjacent vertebrae

thinner posteriorly*** in cervical and lumbar regions which assists in maintaining secondary curves of these areas

11
Q

nucleus pulposus

A

the core of the IV disc

inner highly elastic , highly hydrated gelatinous mass

can be pushed around during movement
extension–> moved anteriorly
flexion–> moved posteriorly
sidebending–> moved to opposite side of the bending

12
Q

intervertebral discs attachments

A

attached above and below to the hyaline cartilage of vertebral bodies

attached anteriorly and posteriorly to longitudinal spinal ligaments

13
Q

function of IV

A

shock absorbers

during compression they bulge past the margins of the vertebral body

14
Q

posterior longitudinal ligament

A

n

15
Q

ruptured disc

A

tear of annulus fibrosis leading to loss of integrity between contiguous vertebrae

16
Q

herniated disc

A

nucleus pluposus squeezes through the ruptured disc and may impinge/contact roots of spinal nerves

17
Q

posterolateral herniation versus a posterior herniation ?

A

posterolateral herniation pushes on spinal nerve

posterior herniation directly on spinal nerve right next to it AND on cauda equina –SO this is more of a problem

L4-L5
L5-S1 are the most common areas of herniation in the body

18
Q

if you have a posterolateral herniation of IV between LV4 and LV5 which nerve is impinged?

A

L5 b/c L4 has already left the vertebral column

19
Q

herniations that occur in the cervical region affect spinal nerves at …

A

the same level as the herniation

20
Q

herniations that occur in the lumbar region….

A

due to the angle at which the spinal nerves descend from the spinal cord relative to the herniated IV disk, affect the spinal nerve one or more segments lower

21
Q

anterior longitiudinal spinal ligament

A

location
-anterior surface of ALL vertebrae extending from the basilar portion of he occipital bone to the pelvic surface of the sacrum

  • only ligament that prevents excessive extension
  • composed of two layers
22
Q

two layers of anterior longitudinal spinal ligament

A

deep layer composed of short fibers which span contiguous vertebrae

-superficial layer composed of long fibers which span many vertebrae

23
Q

poster longitudinal spinal ligament

A

runs within the vertebral canal along the posterior aspect of the vertebral bodies

extends from the occipital bone to the sacrum

prevents excessive flexion

directs/prevents intervertebral disk herniation posterolaterally thereby affecting spinal nerves

24
Q

zygopophyseal joints in the cervical region and the movement they allow

A

oblique in coronal plane

allow for flexion, extension, rotation and lateral flexion

25
Q

zygopophyseal joints in the thoracic region and the movement they allow

A

sit vertically in the coronal plane

MOSTLY FOR ROTATION and LATERAL FLEXION

thoracic region needs to be stable and ribs need to move in the thoracic region

can flex fairly well, but LIMIT EXTENSION

limit anterior and posterior translation

26
Q

zygophoyseal joints in the lumbar region and the movement they allow

A

vertically in the sagittal plane

NO ROTATION

YES FOR FLEXION AND EXTENSION

SIDE BENDING

27
Q

ligamentum flavum general info

A

yellow- due to high percentage of elastic fibers

unites internal surface of adjacent laminae from CV2 downward

covering the zygopophyseal joint

28
Q

function of the ligamentum flavum

A

maintains upright posture by limiting FLEXION of the vertebral column

ALSO returns vertebral column to its normal posture by aligning facet joints (recoil memory)

STRONGEST of the 4 ligaments located posteriorly to the vertebral bodies

29
Q

interspinal ligament

A

unites adjacent spinous processes from tip to laminae

most robust in lumbar region
insignificant in cervical and thoracic areas due to the respective distance b/w contiguous spinous processes

30
Q

5 ligaments to consider in spinal column

A

anterior and posterior longitudinal spinal ligament

ligamentum flavum
interspinal ligament
supraspinal ligament
nuchal ligament

31
Q

supraspinal ligament

A

connects tips of spinous processes from CV7 to sacrum

composed of TWO laminae
deep-span adjacent spinous proces.
superficial- spans several vertebrae

32
Q

what is the supraspinal ligament continuous with at the deep surface

and above CV7

A

on deep surface continuous with interspinous ligament

above CV7 continuous with nuchal ligament

33
Q

when you go into flexion what happens to the zygopophyseal joints>

A

they separate and spread out a bit so ligamentum flavum prevents this

34
Q

nuchal ligament

A

median sheet like upward extension of the supraspinal ligament

extends from CV7 spinous process to external occipital protuberance

intermuscular septum for posterior deep muscles of the neck

site of MUSCULAR ATTACHMENT without limiting extension of the cervical column

35
Q

superior and inferior border of the intervertebral foramina

A

superior –> inferior vertebral notch of vertebra above

inferior–> superior vertebral notch of vertebra below

36
Q

anterior and posterior borders of the intervertebral foramina

A

anterior–> posterior part of vert. above and intervertebral disk

posterior–> facet joint b/w 2 opposing vertebrae

37
Q

osteoarthritis

A

can cause inflammation and bulging into the spinal nerve area…. OUCHY

this is relevant to the discussion on the intervertebral foramen and why you don’t want to impinge upon it

38
Q

Contents of the intervertebral foramina (4)

A

dorsal and ventral roots
dorsal root ganglion
spinal nerve
spinal artery and intervertebral vein

39
Q

the intervertebral foramina has depth ….

A

the width of the pedicle

40
Q

atlantooccipital joint

A

plane synovial joint b/w occipital condyles of skull and superior articulating facets of CV1 atlas

loose joint promotes between skull and atlas in “YES” range==> flexion and extension

41
Q

accessory ligaments of the atlantooccipital joint

A

Anterior atlanto-occipital membrane
-b/w anterior arch of the atlas and anterior margin pf foramen magnum

Posterior atlanto-occipital membrane
-posterior margin of both atlas and foramen magnum

42
Q

what does the posterior atlantooccipital membrane have an opening for?

A

vertebral artery and suboccipital nerve (dorsal ramus of spinal nerve C1)

43
Q

atlantoaxial joint (2 different types of articulations)

A

lateral articulations–> gliding type synovial joint b/w CV1 and CV2 articular processes

median articulations–> pivot type joint b/w dens of the axis and the anterior arch of the atlas

44
Q

where is the location of the dens/atlas articulation

A

anterior arch of atlas

45
Q

what type of movement does the medial atlantoaxial articulation provide

A

“NO” action (rotation)

46
Q

accessory ligaments of the atlantoaxial joint

A

transverse ligament of the atlas*** most important

superior crus

inferior crus

these form the CRUCIFORM LIGAMENT of the atlas

47
Q

transverse ligament of the atlas

A

attaches to the internal surfaces of the anterior arch of the atlas forming a socket b/w itself and the anterior arch

48
Q

superior crus and inferior crus

A

superior–> pass from transverse ligament superiorly to attach to the anterior edge of foramen magnum

inferior–> passes from the transverse ligament inferiorly to attach to the posterior surface of the body of the axis

49
Q

apical dental ligament

A

weak ligament which passes from the apex of the dens to the anterior edge of foramen magnum deep to the superior crus

50
Q

alar ligaments

A

bilateral ligament

arise from dens and attach to the occipital condyles

51
Q

what happens if you tear the alar ligament

A

increase rotation of the skull by approximately 30 degrees

example–> owl has very lax alar ligament

52
Q

tectorial membrane

A

covers the dens and associated ligaments

extends from the anterior edge of foramen magnum to the body of CV2 where it fuses with the posterior longitudinal spinal ligament

53
Q

anterior antantoaxial membrane

A

anterior–> from the anterior arch of the atlas to the anterior body of the axis

is overlain by the superior most extension of the anterior longitudinal ligament

54
Q

posterior atlantoaxial membranes

A

from the posterior arch of the atlas to the lamina of the axis

continuous with the ligamentum flavum

55
Q

spondyloysis

A

elongated pars interarticularis

UNILATERAL

usually from development BUT can be trauma induced (fracture–> heal—> elongate)

56
Q

spondylolisthesis

A

BILATERAL fracture or problem of the pars interarticularis

the affected vertebra, as well as the entire spinal column above slips foward on the vertebrae below

MOST COMMON AT LV5 and SV1 b/c of weight bearing area

this causes stretching to nerve roots

57
Q

important note*** on vasculature…

All spinal nerve roots have what?

A

associated radicular or segmental medullary arteries

most roots have radicular arteries

both types of arteries run along the roots

58
Q

radicular arteries

A

end before reaching anterior or posterior spinal arteries

59
Q

segmental medullary arteries

A

continue on from roots to supply a segment of the anterior or posterior spinal arteries

60
Q

spinal arteries arise from what?

A

arise from vessels which parallel the vertebral column

ie:
verterbral artery
ascending cervical artery
posterior intercostal artery 
lumbar artery 
lateral sacra artery
61
Q

spinal arteries?

A

anterior spinal artery

paired posterior spinal artery

connected to segmental medullary arteries but NOT radicular arteries

62
Q

4 things i need to know about veins

A

Four venous plexuses drain the vertebral column

all four run the entire length

all four freely intercommunicate

they do NOT posses valves

63
Q

Plexuses

A

Anterior and posterior external venous plexuses
-either on vertebral body or external surfaces of the transverse, spinous or articular processes

Anterior and posterior internal venous plexuses
-in epidural space

64
Q

venous flow (2 types)

A

Basivertebral

Intervertebral

65
Q

Basivertebral venous flow

A

drain the bodies of the vertebrae to the anterior internal plexus

66
Q

intervertebral veins

A

receive drainage from ALL 4 venous plexuses

drain to

  • vertebral
  • posterior intercostal
  • lumbar
  • lateral sacral veins
67
Q

Batson’s plexus

A

NO VALVES

so….. receives blood from abdominal, pelvic, thoracic, and cranial cavities

so changes in intra-abdominal pressures are accompanied by changes of flow within these plexuses

RESPONSIBLE FOR METASTATIC SPREAD OF CANCER (prostate and breast)