Module 1: Unit 5

Question 1

When forces exceed tensile strength, failure occurs in the ligament. This is referred to as a:

A. Avulsion fracture
B. Sprain
C. Strain
D. BG fracture

Answer 1

B Sprain

Ligament = sprain
Strain involves MUSCULAR injury

Question 2

Why do ligament injuries take longer to recover? And do they regain 100% integrity?

Answer 2

Poor blood supply to the ligaments leads to long recovery times (6-9 months)

No, they do not regain 100% integrity

Question 3

What ligament connects bone to bone?

A. Skeletal ligament
B. Yellow fibers
C. Visceral ligament
D. Spinal ligament

Answer 3

A

Question 4

What is the name of the ligament that has bone to bone closely packed collagen fibers (white color) and ligaments with more stretch (yellow fibers)?

Answer 4

Skeletal ligaments

Question 5

Name some characteristics of spinal ligaments.

Answer 5

• Allows smooth motion within physiologic range
• Protect cord by limiting motion of joints
• Play a minor role in stabilization (muscles are the primary spinal stabilizers)

Question 6

Name the three ligaments that run the length of the spine.

Answer 6

Anterior longitudinal ligament (ALL)
Posterior longitudinal ligament (PLL)
Ligament flavum

Question 7

Which ligament runs from anterior VB of C2 to Sacrum, and is the thickest in the thoracic spine?

A. ALL
B. PLL
C. Superficial ligament
D. Inferior ligament

Answer 7

ALL,

Connects at mid-portion of each VB

Question 8

What ligament helps prevent excessive extension of the spine?

Answer 8

ALL

Question 9

Name the three general layers of the ALL:

Answer 9

Superficial: 3-4 vertebral segments
Intermediate: 2-3 segments
Deep: 2 segments

*Decrease deeper the layer the less vertebral segments expand

Question 10

What ligament extends from the posterior body of C2 to the sacrum, is inside the spinal canal, and attaches to intervertebral disc and margins of VB’s?

Answer 10

PLL

Question 11

What motion does the PLL inhibit?

Answer 11

Hyperflexion

Question 12

What ligament extends from C2 to the sacrum, blends laterally with articular capsules, connects laminae and resists excessive flexion?

Answer 12

Ligamentum Flavum

*Note: facet joint and ligamentum flavum are closely connected

Question 13

What ligament increases thickness from verticals to sacrum, and provides posterior boundary for central canal?

Answer 13

Ligament Flavum

*Note: Fibers thicken with aging (this may lead to stenosis)

Question 14

What ligament begins at C7-Sacrum connecting apices of SPs? What is above this ligament? Lastly, what action does this limit?

Answer 14

Supraspinous ligament

Above C7 is the Nuchal ligament

Hyperflexion

Question 15

What ligament sits between the SPs? What movement does this ligament limit?

Answer 15

Interspinous ligament

Flexion

Question 16

What ligament takes place from C1-L5, and limits lateral flexion and rotation?

Answer 16

Intertransverse Ligament

Question 17

Describe the articular capsules location. Are the fibers perpendicular or parallel to facet joints?

Answer 17

Located from C1/2 through L5/S1. Fibers are perpendicular to facet joints. Attach just outside the margins of the facet joints.

*Note: Articular capsules is thinner/looser in C/S and more taut in T/S, L/S

Question 18

Name and describe the upper cervical ligaments.

Answer 18

Tectorial membrane - Basilar aspect of occipital to posterior body of C2 (inside the spinal canal

Transverse ligament of atlas - aka cruciate/cruciform ligament. Lies deep/anterior to tectorial membrane.

Alar ligaments (wings) - aka check ligaments. Attach the dens of C2 to the occipital condyles. (LEFT AND RIGHT PAIR)

Apical ligament of dens - from apex of dens to anterior part in of foramen magnum. Between alar ligaments. *Not a significant stabilizer.

Posterior Atlanta-occipital ligament -

Posterior atlanto-axial ligament - From upper border, posterior arch of C1 to posterior margin of foramen magnum

Lateral atlanto-occipital ligament - Jugular process of occipital, to TP of C1.A

Anterior atlanto-occipital ligament - Anterior margin of foramen magnum to upper border of anterior arch of C1.

Nuchal ligament - Connects EOP (external occipital protuberance), C1 posterior tubercle, C2-C7 SP’s.

Question 19

Which of the following ligaments prevent lateral flexion?

A. Intertransverse
B. Interspinous
C. Ligamentum flavum
D. ALL

Answer 19

A

Question 20

Which of the following ligaments transitions into the tectorial membrane?

A. Cruciate ligment
B. Apical ligament
C. Posterior longitudinal
D. Anterior longitudinal

Answer 20

C

Question 21

True or false: Ligaments have pool vascular supply, which may lead to less than 100% recovery following a sprain

Answer 21

True

Question 22

Which of the following ligaments attach the dens to the sides of the foramen magnum?

A. Lateral Atlanta-occipital
B. Alar
C. Apcial
D. Transverse

Answer 22

B

Question 23

Which of the following ligaments extends from C7 to the sacrum?

A. Interspinous
B. ALL
C. PLL
D. Supraspinous

Answer 23

D

Question 24

Diffuse idiopathic skeletal hyperostosis involves ossification of which of the following ligaments?

A. Sacrotuberous
B. PLL
C. ALL
D. Sacrospinous

Answer 24

C

Question 25

Study Slide 95 on locations of ligaments in relation to one another.**

Question 26

Name the three ligaments bands: describe them. *Cross*

Answer 26

Transverse band - Attaches to medial tubercle of the lateral mass. Articular capsule between transverse ligament and dens Superior band - Attaches to anterior foramen magnum Inferior band - Attaches to the body of C2; may be absent

Question 27

What inflammatory conditions would would alert a chiropractor with not doing treatment on a patient?

Answer 27

Rheumatoid arthritis and psoriatic arthritis - disease can have spinal involvement, especially in cervical, which can lead to Atlanta-axial instability and a chiro could make worse.