back soft arthyrology

Question 1

what is the anterior longitudinal ligament, where does it run and why is it significant?

Answer 1

ligament that runs longitudinally along the front of vertebral body

Widens as it descends, maintains stability

Limits extension and supports annulus fibrosus

In a “whiplash” injury (hyperextension) the stretching or even tearing of the anterior longitudinal ligament can occur.

Question 2

what ligament is involved with whiplash? what should you do if that happens?

Answer 2

anterior longitudinal ligament

Importance due to its possible splinting action that should be used when a fracture to the vertebral column is suspected.

Keep patient in hyperextension at all times, the pull of the anterior longitudinal ligament will help realign fragments of bone and keep further injury to the spinal cord from happening

Question 3

What is the posterior longitudinal ligament, where does it run and why is it significant?

Answer 3

• runs longitudinally along the posterior of the ventral body
• narrows as it descends
• interconnects vertebral bodies and intervertebral disks
• supports annulus fibrosis and vertebral bodies posteriorly
• limits flexion

Question 4

what is the ligamentum flavum, whats so significant about it?

Answer 4

• lines the anterior portion of the vertebral laminae

- connects laminae of adjacent vertebrae, maintains upright posture

Question 5

Ligamentum Nuchae, whats so significant about it and what does it do?

Answer 5

• septum between muscles on two sides of posterior aspect of neck
• formed by thickened supraspinous ligaments
• attached to posterior tubercle of atlas and spinous processes of other cervical vertebrae

Question 6

what are the interspinous ligaments?

Answer 6

travels between adjacent spinous processes

Question 7

what are the intertransverse ligaments?

Answer 7

not well defined in C-region, fibrous cords in the T- region, thin membranes in the L-region

Question 8

what is the supraspinous ligament?

Answer 8

travels on the dorsal surface of the vertebral spinous processes, continues as the ligamentum nuchae in the C-region

Question 9

what is the intervertebral disc, what is its 2 parts?

Answer 9

lies between 2 vertebrae , allows for movement

Annulus fibrosis- tough fibrous outer region, overlapping lamellar of fibrocartilage

Gooey center: nucleus pulposis - soft gelatinous inner portion

Question 10

where does herniation of the vertebral disc happen and what happens?

Answer 10

Herniation of nucleus pulposus through the annulus fibrosis is a common cause of low back and lower limb pain.

Herniation typically occurs posterolaterally where the annulus fibrosis receives no support from the anterior and posterior longitudinal ligaments.

The result is a bulge and compression of the spinal nerve roots, the cauda equina, and spinal nerve in the vertebral canal and intervertebral foramina, respectively.

Most common at L4/5 and L5/S1 where discs are much larger and more mobile

Question 11

what is the joint of luschka?

Answer 11

in between uncinate process and superior vertebra

Question 12

where is the atlantoaxial joint, what does it do?

Answer 12

synovial joint

• between atlas and axis
• involved in rotation of atlas and head

Median part: between anterior facet of dens of axis and articular facet of dens of atlas

Lateral part: planar synovial joint , between superior and inferior articulating process of atlas and axis

Question 13

what are the ligaments that make up atlantoaxial joint?

Answer 13

Cruciate L
Alar L
Apical L

median part of joint

Question 14

what is the Uncovertebral joint (of Luschka) ?

Answer 14

Intervertebral joint between inferior vertebra and superior vertebra

Question 15

what are intervertebral joint?

Answer 15

C3 - S1
Symphysis

S5/Co1
Symphysis

Question 16

what are
Zygapophyseal
joints?

Answer 16

(planar synovial)

C1-S1

Question 17

what are the ligamentous structures involved in a whiplash injury?

Answer 17

Hyperextension, excessive stretching, tearing of anterior longitudinal L

Question 18

what can recoil cause during whiplash?

Answer 18

hyperflexion

Question 19

what can happen to nerve during vertebral disc hernia?

Answer 19

Nerves increase in size from superior to inferior, but foramina decrease in size=susceptibility of L5 roots to become impinged if herniation occurs

Question 20

what is the second number rule for the cervical and lumbar regions

Answer 20

Vertebral level where prolapse occurs affects spinal nerve with second number designation
Ex: C5/C6 will affect nerve 6, which exits at C5/C6

Question 21

what is the second number rule for the lumbar region?

Answer 21

Affects nerve level inferior

Ex: prolapse at L4/L5 affects nerve that exits at L5/S1

Question 22

where is the lumbosacral joint and related articulations?

Answer 22

L5/S1

Anterior and Posterior Longitudinal L
Ligamentum Flavum
Interspinous, Intertransverse L
Supraspinous L
Iliolumbar L
Intervertebral disc

Question 23

the importance of the Anterior Longitudinal L. and it’s role in vertebral fractures
?

Answer 23

Facet jumping, hyperextension followed by hyperflexion causing dislocation of the vertebral arches of cervical spine

Rupture of anterior longitudinal ligament and adj annulus fibrosus of the c2 and c3 iv disc

=separation of cranium, c1, and dens/body of c2 from rest of axial skeleton and spinal cord severely severed