Facet joints

Question 1

describe the structure of facet joints

Answer 1

planar synovial joints
2 per vertebra
connect posterior arches

Question 2

describe the structural contents of facet joints

Answer 2

superior and inferior processes
articular cartilage
synovial membrane
synovial folds
fibrous capsule

Question 3

describe the orientations related to cervical facet joints

Answer 3

45 degrees from horizontal plane
superior articular facets orientated posteromedially

Question 4

describe the ROMs of cervical facet joints

Answer 4

flex/ext = 8-17
lat bending = 4-11
axial rotation = 8-12

Question 5

describe the orientations of thoracic facet joints

Answer 5

60 degrees from horizontal plane
superior articular facets orientated posterolaterally

Question 6

describe the ROM at thoracic facet joints

Answer 6

flex/ext 1-4
lat bending = 6-9
axial rotation = 2-9

Question 7

describe the orientations of lumbar facet joints

Answer 7

variable - from 20-90
from sagittal orientated facing medial to coronally orientated facing posterior

Question 8

describe the ROM at lumbar facet joints

Answer 8

flex/ext = 12-20
lateral bending = 3-8
axial rotation = 2-5

Question 9

what is the purpose of articular cartilage at the facet joints

Answer 9

smooth movement, force resistance

Question 10

what forms the anterior fibrous capsule

Answer 10

ligamentum flavum

Question 11

describe the synovium

Answer 11

soft and periarticular membrane
attaches to articular cartilage
lines fibrous capsule
found at base of synovial folds

Question 12

what are synovial folds

Answer 12

intra-articular protrusions from synovial membrane

Question 13

what is the function of synovial folds

Answer 13

protect articular cartilage by smoothing movements and wider load distribution

Question 14

describe the 3 types of synovial folds

Answer 14

adipose tissue pads
fibro-adipose meniscoids
connective tissue rims

Question 15

where are synovial folds found

Answer 15

articular areas with lack of cartilaginous cover
extra protection from compressive and shear loads

Question 16

describe the sensory innervation to facet joints

Answer 16

medial branch of dorsal rami
from own level and superior level

Question 17

describe the branches of the medial branch nerve

Answer 17

free nerve endings
complex-unencapsulated nerve endings
encapsulated nerve endings

Question 18

describe the blood supply to the facet joints

Answer 18

posterior branch of posterior intercostal artery - in thoracic region

Question 19

what percentage of low back pain does facet joint pain account for

Answer 19

15-45% (Manchikanti et al, 2008)

Question 20

what other facet joint injury stats were presented

Answer 20

54-60% of chronic neck pain
48% of chronic mid-back pain
both Manchikanti et al, 2008

Question 21

describe the mechanisms of facet joint injury

Answer 21

degeneration - most common
inflammatory conditions
trauma
genetics
infection

Question 22

what spinal levels has the highest prevalence of degeneration from Eubank et al.

Answer 22

L4-L5

Question 23

when is facet joint pain exacerbated

Answer 23

extension
rotation
direct palpation

Question 24

how specific is MRI for facet joint degeneration

Answer 24

> 90%

Question 25

what success rate does medial branch nerve block carry

Answer 25

80% Conger et al.

Question 26

what longer lasting treatment option for facet joint pain exists before surgery

Answer 26

radiofrequency ablation

Question 27

define whiplash

Answer 27

acceleration-deceleration mechanism of energy transfer to the neck

Question 28

describe the 7 stages of whiplash injury

Answer 28

trunk and shoulders forward lower c spine forced extension S curve of C spine SCM activation head extends head accelerates forwards neck forced into flexion

Question 29

when ligaments are typically injured in whiplash

Answer 29

Cervical ALL and nuchal ligament