Articulations and vessels of the vertebral column Flashcards Preview

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

primary curvature of the back

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

secondary curves of spine

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

lordosis

exaggerated secondary curve of the lumbar area

4

kyphosis

exaggerated primary curve of the thoracic area

5

scoliosis

lateral S shape any area of vertebral column

6

zygopophysis (facet joints)

articulations between vertebral arches

true synovial joints

7

3 major classifications of joints

membranous
cartilaginous
synovial

8

what is a synovial joint?

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

articulations between vertebral bodies?

intervertebral discs

10

annulus fibrosis

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

nucleus pulposus

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

intervertebral discs attachments

attached above and below to the hyaline cartilage of vertebral bodies

attached anteriorly and posteriorly to longitudinal spinal ligaments

13

function of IV

shock absorbers

during compression they bulge past the margins of the vertebral body

14

posterior longitudinal ligament

n

15

ruptured disc

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

16

herniated disc

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

17

posterolateral herniation versus a posterior herniation ?

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

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

L5 b/c L4 has already left the vertebral column

19

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

the same level as the herniation

20

herniations that occur in the lumbar region....

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

anterior longitiudinal spinal ligament

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

two layers of anterior longitudinal spinal ligament

deep layer composed of short fibers which span contiguous vertebrae

-superficial layer composed of long fibers which span many vertebrae

23

poster longitudinal spinal ligament

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

zygopophyseal joints in the cervical region and the movement they allow

oblique in coronal plane

allow for flexion, extension, rotation and lateral flexion

25

zygopophyseal joints in the thoracic region and the movement they allow

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

zygophoyseal joints in the lumbar region and the movement they allow

vertically in the sagittal plane

NO ROTATION

YES FOR FLEXION AND EXTENSION

SIDE BENDING

27

ligamentum flavum general info


yellow- due to high percentage of elastic fibers

unites internal surface of adjacent laminae from CV2 downward


covering the zygopophyseal joint

28

function of the ligamentum flavum

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

interspinal ligament

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

5 ligaments to consider in spinal column

anterior and posterior longitudinal spinal ligament

ligamentum flavum
interspinal ligament
supraspinal ligament
nuchal ligament

31

supraspinal ligament

connects tips of spinous processes from CV7 to sacrum

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

32

what is the supraspinal ligament continuous with at the deep surface

and above CV7

on deep surface continuous with interspinous ligament

above CV7 continuous with nuchal ligament

33

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

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

34

nuchal ligament

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

superior and inferior border of the intervertebral foramina

superior --> inferior vertebral notch of vertebra above

inferior--> superior vertebral notch of vertebra below

36

anterior and posterior borders of the intervertebral foramina

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

posterior--> facet joint b/w 2 opposing vertebrae

37

osteoarthritis

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

Contents of the intervertebral foramina (4)

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

39

the intervertebral foramina has depth ....

the width of the pedicle

40

atlantooccipital joint

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

accessory ligaments of the atlantooccipital joint

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

what does the posterior atlantooccipital membrane have an opening for?

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

43

atlantoaxial joint (2 different types of articulations)

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

where is the location of the dens/atlas articulation

anterior arch of atlas

45

what type of movement does the medial atlantoaxial articulation provide

"NO" action (rotation)

46

accessory ligaments of the atlantoaxial joint

transverse ligament of the atlas*** most important

superior crus

inferior crus

these form the CRUCIFORM LIGAMENT of the atlas

47

transverse ligament of the atlas

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

48

superior crus and inferior crus

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

apical dental ligament

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

50

alar ligaments

bilateral ligament

arise from dens and attach to the occipital condyles

51

what happens if you tear the alar ligament

increase rotation of the skull by approximately 30 degrees

example--> owl has very lax alar ligament

52

tectorial membrane

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

anterior antantoaxial membrane

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

posterior atlantoaxial membranes

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

continuous with the ligamentum flavum

55

spondyloysis

elongated pars interarticularis

UNILATERAL

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

56

spondylolisthesis

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

important note*** on vasculature...

All spinal nerve roots have what?

associated radicular or segmental medullary arteries

most roots have radicular arteries

both types of arteries run along the roots

58

radicular arteries

end before reaching anterior or posterior spinal arteries

59

segmental medullary arteries

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

60

spinal arteries arise from what?

arise from vessels which parallel the vertebral column

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

61

spinal arteries?

anterior spinal artery

paired posterior spinal artery

connected to segmental medullary arteries but NOT radicular arteries

62

4 things i need to know about veins

Four venous plexuses drain the vertebral column

all four run the entire length

all four freely intercommunicate

they do NOT posses valves

63

Plexuses

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

venous flow (2 types)

Basivertebral

Intervertebral

65

Basivertebral venous flow

drain the bodies of the vertebrae to the anterior internal plexus

66

intervertebral veins

receive drainage from ALL 4 venous plexuses

drain to
-vertebral
-posterior intercostal
-lumbar
-lateral sacral veins

67

Batson's plexus

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)