XI. Arthrology of the Vertebral Column Flashcards
(207 cards)
1
Q
What is the Latin term for joint?
A
arthron
2
Q
What is the study of joints called?
A
arthrology
3
Q
What is the Latin term for a “tightly bonded together condition”?
A
syndesmosis
4
Q
What material was responsible for the “tightly bonded together condition” in the joint?
A
dense fibrous connective tissue, a ligament
5
Q
What is the study of ligaments called?
A
syndesmology
6
Q
What fibrous connective tissue classically fills the joint space of a syndesmosis?
A
interosseous ligament
7
Q
What protein fiber is the dense connective tissue primarily composed of?
A
collagen fibers which give it a whitish color
8
Q
Beside collagen, what other proteins are ligaments composed of?
A
elastin fibers which can give a yellowish tinge to the ligament
9
Q
What are the examples of the typical syndesmosis from the vertebral column?
A
most of the ligamentous joints of the vertebral column and the ligamentous sacro-iliac joints
10
Q
The ligamentous sacro-iliac joints (or most of the ligamentous joints of the vertebral column) are examples of which joint classification?
A
syndesmosis
11
Q
What is the synonym for amphiarthrosis joints?
A
cartilage joint
12
Q
Which classification of cartilage joint is the first to appear developmentally?
A
(amphiarthrosis) synchondrosis
13
Q
What is the classification of primary cartilage joints?
A
(amphiarthrosis) synchondrosis
14
Q
Which cartilage joint classification would be considered secondary?
A
(amphiarthrosis) symphysis
15
Q
What is the classification of a secondary cartilage joint?
A
(amphiarthrosis) symphysis
16
Q
Which cartilage joint classification is present along the adult vertebral column?
A
(amphiarthrosis) symphysis
17
Q
Which cartilage joint occurs between bones formed by endochondral ossification?
A
(amphiarthrosis) symphysis
18
Q
Which classification of cartilage joint is permanent in its longevity?
A
(amphiarthrosis) symphysis
19
Q
What type of cartilage is characteristic of the (amphiarthrosis) symphysis?
A
fibrocartilage or fibrous cartilage
20
Q
What type of cartilage is characteristic of a secondary cartilage joint?
A
fibrocartilage or fibrous cartilage
21
Q
Which classification of cartilage joint is secondary, permanent and composed of fibrous cartilage (fibrocartilage)?
A
(amphiarthrosis) symphysis
22
Q
Which cartilage joint has limited motion, lies in the median plane, and occurs between bones formed by endochondral ossification?
A
(amphiarthrosis) symphysis
23
Q
What are the characteristics of a (amphiarthrosis) symphysis?
A
limited motion, median plane location, support ligaments both anterior and posterior to the joint, more permanent in longevity than synchondrosis, and they occur between bones developing by endochondral ossification
24
Q
What is the classic example of a (amphiarthrosis) symphysis from the vertebral column?
A
intervertebral disc
25
What are the four consistent features of synovial (diarthrosis) joints?
articular or fibrous capsule, synovial membrane, articular cartilage, and synovial fluid
26
Thickening of the fibrous capsule connective tissue will form the ...
capsular ligament
27
What generic accessory ligaments may accompany and support the capsular ligament?
intracapsular and extracapsular ligaments
28
What are examples of intracapsular and extracapsular ligaments?
intracapsular ligaments: cruciate ligaments of the knee
| extracapsular ligaments: collateral ligaments of the knee
29
What is the generic function of ligaments?
stimulate reflex contraction of muscles around the joint
30
Type I articular receptors are morphologicallly identical to which sensory receptor ending?
Ruffini ending
31
Type I articular receptors would be most numerous in which joint of the vertebral column?
cervical zygapophysis
32
What is the function of the type I articular receptors?
they monitor the joint "at rest"
33
What are the common characteristics of type I articular receptors?
located in the superficial layer of the fibrous capsule, resemble Ruffini endings, most numerous in cervical zygapophyses and they monitor the joint "at rest"
34
Type II articular receptors are located in what part of the joint?
deeper strata of the fibrous capsule
35
Type II articular receptors morphologically resemble which type of sensory ending?
Pacinian corpuscle
36
Type II articular receptors are most numerous in what region of the vertebral column?
cervical spine
37
What is the function of type II articular receptors?
they monitor the joint during normal range of motion
38
What are the characteristics of type II articular receptors?
located in deeper strata of the fibrous capsule, resemble Pacinian corpuscles, most numerous in the cervical spine and monitor the joint during normal range of motion
39
What is the location of type III articular receptors?
collateral and intrinsic ligaments of many joints, they were not thought to be present along vertebral column
40
Type III articular receptors are morphologically similar to what type of sensory ending?
Golgi tendon organs
41
What is the function of type III articular receptors?
they monitor the joint during extreme motion or beyond normal range or motion
42
What are the characteristics of type III articular receptors?
present in collateral and intrinsic ligaments, resemble Golgi tendon organs, not initially observed along the vertebral column and monitor extreme joint motion
43
What is the function of type IV articular receptors?
nociceptive, they monitor pain
44
Type IVa articular receptors would be present in what locations?
fibrous capsule, articular fat pads or adventitia of blood vessels
45
Type IVb articular receptors would be present in what locations?
accessory ligaments in general, dense in the posterior longitudinal ligament of the spine
46
Type IV articular receptors are absent in what part(s) of the synovial (diarthrosis) joint?
synovial membrane, articular cartilage, and synovial menisci or intra-articular discs
47
What are the three classifications of synovial membrane?
articular, vaginal, and bursal synovial membrane
48
What are the three modifications of articular synovial membrane?
synovial villi
articular fat pads or Haversian glands
synovial menisci and intra-articular discs
49
What is the generic function of modifications of articular synovial membrane?
aid in spreading synovial fluid
50
What is the name given to finger-like extensions of the synovial membrane?
synovial villi
51
What is the apparent function of synovial villi?
increase the surface of synovial membrane available for secretion - absorption phenomena
52
What role will aging have in synovial villi number?
synovial villi increase with age
53
What is another name for the articular fat pad?
Haversian gland
54
Where are the articular fat pads located?
in the fibrous layer of synovial membrane; they are absent from articular cartilage, synovial menisci and the intra-articular disc
55
Articular fat pads are most numerous in what location along the vertebral column?
lumbar zygapophyses
56
Condensed fibrous connective tissue or fibrocartilage projections of the synovial membrane are called...
synovial menisci or intra-articular discs
57
Intra-articular discs are a feature of what joints examples?
temporomandibular, sternoclavicular, acromioclavicular, and radio-ulnar joints
58
Synovial menisci are a feature of what joint examples?
femur-tibia articulation, cervical zygapophyses, and lumbar zygapophyses
59
What are the layers of the synovial membrane?
outer fibrous layer and an inner (lumenal) cellular layer AKA synovial lamina intima
60
What is the unique name of the inner or lumenal layer of the synovial membrane?
synovial lamina intima
61
What are the specific functions of type A synovial cells?
are phagocytic
62
What is the specific function of type B synovial cells?
secrete proteinaceous substances and hyaluronic acid
63
What is the common function of type A and type B synovial cells?
formation and absorption of synovial fluid
64
How does the articular cartilage thickness vary within the joint?
male (convex) surfaces on bone are thicker at the center of the articular region
female (concave) surfaces on bone are thicker at the periphery of the articular region
65
Where is the male articular surface thicker?
at the center of the articular region
66
Where is the female articular surface thicker?
at the periphery of the articular region
67
What is the source of nutrition for articular cartilage?
blood vessels in the synovial membrane, sinuses of the bone marrow cavity and from synovial fluid itself
68
What is unique about the surface of articular cartilage?
a true perichondrium is absent
69
What are the primary constituents of articular cartilage?
water, cells, collagen type II fibers, and a proteoglycan gel
70
Which collagen fiber type predominates in articular cartilage?
type II
71
What are proteoglycans composed of?
a core proteins and glycosaminoglycans
72
What are glycosaminosglycans?
relatively long, non-branched carbohydrates formed from repeating units of disaccharides
73
What examples of glycosaminoglycans are important in articular cartilage maintenance?
hyaluronic acid, chondroitin sulfates, and keratin sulfate
74
What is the architecture of the largest proteoglycans?
a backbone of hyaluronic acid to which core proteins are are bound, chondroitin sulfates and keratin sulfates are then bound to the core protein
75
What is the primary function of bound glycosaminoglycans in articular cartilage?
form a network water retention
76
Cartilage is able to change shape due to compression, a characteristic known as...
deformation
77
What is implied when cartilage is said to have elastic properties?
cartilage can deform and returns to original volume rapidly, a time independent property
78
What is implied when cartilage is said to have viscoelastic properties?
cartilage can deform but returns to original volume slowly, a time dependent property
79
What is the function of articular cartilage?
to provide a wear-resistant, low-friction, easily lubricated surface for joint movement
80
What are the properties of synovial fluid?
it is yellow-white, viscous, slightly alkaline and tastes salty
81
Synovila fluid consists of what specific chemical groups?
fats, salts, albumins, and hyaluronate
82
Which substance in synovial fluid was first thought to be responsible for its viscosity and lubricating behavior?
lubricin
83
What cells are often observed in synovial fluid?
white blood cells and a few other types of connective tissue cells
84
What is the function of synovial fluid?
provides a nutritive source for articular cartilage and supply the lubricant for the cartilage surface
85
What are the three broad methods of joint classification?
1) number of articulating surfaces or bones in the joint
2) degree(s) of freedom and/or types of motion accommodated in the joint
3) surface appearance of the bony surfaces or shape of the joint cavity
86
What are the classifications of synovial joints (diarthroses) based on the number of articulating surfaces?
simple and compound synovial joints
87
What is a simple synovial joint (diarthrosis)?
only one pair of articulating surfaces are observed
88
What is a compound synovial joint (diarthrosis)?
more than two articulating surfaces are present in the same synovial joint
89
What is a complex synovial joint (diarthrosis)?
within the simple joint or the compound joint, the articulating surfaces are separated by an articular disc (intra-articular disc) meniscus
90
What are the classifications of synovial joints (diarthroses) based on type of movement?
nonaxial, uniaxial, biaxial and multiaxial synovial joints
91
What movements are accommodated by nonaxial synovial joints?
translational movement, a plane or gliding movement
92
What morphological classification of synovial joints is classified as nonaxial?
plane (diarthrosis arthrodial)
93
What movements are accommodated by uniaxial synovial joints?
a single combination of movements relative to a single axis:
flexion-extension or medial rotation-lateral rotation
94
What morphological classifications of synovial joints would be classified as uniaxial?
hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)
95
What movements are accommodated by biaxial synovial joints?
movement in two independent planes at right angles to each other:
flexion-extension combined with abduction - adduction
96
What morphological classifications of synovial joints would be classified as biaxial?
(diarthrosis) bicondylar, (diarthrosis) condylar, (diarthrosis) ellipsoidal, and saddle (diarthrosis sellar)
97
What movements are accommodated by multiaxial synovial joints?
combinations of motion including flexion - extension, abduction - adduction, medial rotation - lateral rotation, circumduction, and even translation
98
What morphological classification of synovial joints would be classified as multiaxial?
ball and socket (diarthrosis enarthrosis), (diarthrosis spheroidal), (diarthrosis cotyloid) are all classifications given to the same type of joint
99
What are examples of synovial plane (diarthrosis arthrodial) joints?
most zygapophyses of the vertebral column
intercarpal, carpometacarpal, and intermetacarpal joints of the hand
intercuneiform, tarsometatarsal, and intermetatarsal joints of the foot
100
What are examples of synovial hinge (diarthrosis ginglymus) joints?
humero-ulnar joint of the elbow and interphalangeal joints of the fingers and toes; temporomandibular joint
101
Diarthrosis ginglymus joints are commonly called .... joints based on action.
synovial hinge
102
Synovial hinge (diarthrosis ginglymus) joints are characterized by strong extracapsular ligaments called .... ligaments.
collateral
103
Diarthrosis trochoid joints are commonly called .... joints based on action.
synovial pivot
104
What are the examples of synovial pivot (diarthrosis trochoid) joints?
median atlanto-axial joint and proximal radio-ulnar joint
105
What is the shared morphological characteristic of diarthrosis trochoid joints?
an osseous pivot point and an osteo-ligamentous ring
106
What is the pivot point in the median atlanto-axial joint?
in the median atlanto-axial joint, the pivot point is the dens or odontoid process of C2 which is stationary while the osteo-ligamentous ring formed by the radial notch of the ulna and the annular ligament
107
What is a common name for the diarthrosis sellar joint?
synovial saddle joint
108
What are examples of synovial saddle (diarthorsis sellar) joints?
carpometacarpal joint of the thumb, talocrural joint of the ankle and the calcaneocuboid joint of the foot
109
What is an example of a modified synovial saddle/diarthrosis sellar joint?
the joint of Luschka in the cervical spine
110
What are examples of diarthrosis condylar or diarthrosis bicondylar joints?
temporomandibular joint and femur-tibia joint of the knee
111
What are examples of diarthrosis ellipsoidal joints?
radiocarpal joint of the wrist, metacarpo-phalangeal joints of the hand, metatarsal-phalangeal joints of the foot and the atlanto-occipital joint of the vertebral column
112
Which synovial joint classifications are now often interchanged in textbooks?
ellipsoidal and condylar synovial joints
113
What is the common name for diarthrosis enarthrosis, diarthrosis cotyloid, diarthrosis spheroidal joints?
ball and socket joints
114
What are examples of diarthrosis enarthrosis joints?
femur-acetabulum of the innominate articulation at the hip and the humerus-glenoid cavity of the scapula articulation at the shoulder
115
What are examples of diarthrosis cotyloid joints?
femur-acetabulum of the innominate articulation at the hip and the humerus-glenoid cavity of the scapula articulation at the shoulder
116
What are examples of diarthrosis spheroidal joints?
femur-acetabulum of the innominate articulation at the hip and the humerus-glenoid cavity of the scapula articulation at the shoulder
117
What are the common ligaments of the vertebral column?
those ligaments commonly found between vertebral couples from C2/C3 to L4/L5
118
Which vertebrae will have common ligaments?
segements C2 to L5 inclusive
119
Identify the common ligaments of the vertebral column.
the 9 common ligaments are the anterior longitudinal ligament, intervertebral disc, posterior longitudinal ligament, ligamentum flavum, capsular ligament, interspinous ligament, ligamentum nuchae, supraspinous ligament, and intertransverse ligament
120
What is the maximum number of common ligaments identified with a vertebral couple?
eight
121
What is the reason that nine common ligaments are identified bu only eight will be attached at any specific vertebral couple?
the ligamentum nuchae and supraspinous ligaments attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple
122
Which common ligaments will attach to the vertebral body?
the anterior longitudinal ligament, intervertebral disc and posterior longitudinal ligament
123
What common ligament/s will attach to the vertebral arch?
the ligamentum flavum
124
Which common ligaments will attach to the apophyseal regions of a vertebra?
the capsular ligament, interspinous ligament, supraspinous ligament, ligamentum nuchae, and intertransverse ligament
125
Which common ligament/s will attach to the lamina?
the ligamentum flavum
126
Which common ligament/s will attach to the articular apophysis?
the capsular ligament
127
Which common ligaments will attach to the spinous apophysis?
the interspinous ligament, supraspinous ligament and ligamentum nuchae
128
Which common ligament/s will attach to the transverse apophysis?
the intertransverse ligament
129
What is the classification of the intervertebral disc?
cartilaginous (amphiarthrosis) symphysis
130
In the fetus, which vertebral levels will demonstrate intervertebral discs?
those between C2 and Co1 inclusive
131
What is the number of true intervertebral discs indentified in the adult?
twenty-three
132
In the adult, which vertebral levels will demonstrate a true intervertebral disc?
those between C2 and S1 inclusive
133
What percent of the vertebral column length is contributed by the intervertebral disc?
twenty to twenty-five percent
134
What is the length of the intervertebral disc contribution to the vertebral column length?
about seven inches
135
What is the percent of the intervertebral disc height contribution to the length of each region of the vertebral column?
cervical: 22-25%
thoracic: 20%
lumbar: 33%
136
What is the percent of intervertebral disc height contribution to cervical region length?
cervical: 22-25%
137
What is the percent of intervertebral disc height contribution to thoracic region length?
thoracic: 20%
138
What is the percent of intervertebral disc height contribution of the lumbar region?
lumbar: 33%
139
What is the intervertebral disc histologically composed of?
cells, collagen fibers, and a hydrated proteoglycan gel
140
What are the names of the central, peripheral, and horizontal zones of the intervertebral disc?
nucleus puposus - central zone
annulus fibrosus - peripheral zone
cartilaginous end plate - horizontal zone
141
What is the name of the growth zone of the intervertebral disc?
transition zone
142
What maintains the height of the cervical intervertebral disc?
the uncinate processes
143
What is the effect of aging on the intervertebral disc nucleus pulposus?
it becomes more fibrous as water and proteoglycan concentrations diminish
144
What are the names of the glycosaminoglycans of the intervertebral disc?
keratin sulfate, hyaluronic acid, chondroitin-4-sulfate, condroitin-6-sulfate
145
What is the contribution of the nucleus pulposus to intervertebral disc cross-section area?
about forty percent
146
What is the cervical nucleus pulposus composed of?
fibrocartilage
147
What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?
birth: 88%
thirty: 70%
148
What is the organizational pattern for glycosaminoglycans in the lumbar nucleus puplosus?
they typically lack a binding site for hyaluronic acid and are thus non-aggregated
149
What is the consequences of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?
the nucleus pulposus will lose water under deformation conditions
150
What cell is associated with the nucleus pulposus until about age eleven?
notochord cells
151
What cells are associated with the mature nucleus pulposus?
reticulocyte-fibroblast and chondroblast
152
Which type of collage is dominant in the nucleus pulposus?
collage type II
153
What is the organizational pattern for collagen fibers in the nucleus pulposus?
they are irregularly oriented and randomly scattered
154
What general tissue location is described as having an abundance of collagen type II fibers?
cartilage
155
What is the role of collagen type II fibers based on locations where it is dominant?
it appears to be related to tissues having a deformation - reformation ability
156
What is unusual about the cervical annulus fibrosus?
it lacks any lamellar or layered organization
157
What is the appearance of the cervical annulus fibrous?
a horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate processes; the posterior margin is thin
158
What compensates for the thinness of the posterior part of the cervical annulus fibrosus?
posterior longitudinal ligament
159
What is the organization of the lumbar annulus fibrosus?
it has 12-14 concentric cylindrical lamellae
160
What is the reason the anterior margin of the lumbar intervertebral disc is less susceptible to rupture, herniation, prolapse, or protrusion?
the anterior margin of each lamellus is thick and the anterior longitudinal ligament is also better developed than the posterior lamellae or posterior longitudinal ligament
161
Why is the posterior part of the lumbar annulus fibrosus more susceptible to rupture, herniation, prolapse, or protrusion?
the posterior margin of each lamellus is thin and the posterior longitudinal ligament is also less developed
162
What is the mechanism for growth of the lumbar annulus fibrosus?
the outside of the lumbar annulus fibrosus adds new lamellae by appositional growth
163
What is the water concentration in the lumbar annulus fibrosus at birth and after thirty?
birth: 78%
thirty: 70%
164
What is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus?
they typically have a binding site for hyaluronic acid and are thus aggregated
165
What is the consequence of aggregated glycosaminoglycans in the lumbar annulus fibrosus?
the annulus fibrosus will retain water under deformation conditions
166
Which type of collagen is dominant in the annulus fibrosus?
collagen type I
167
What is the organizational pattern for collagen fibers in the annulus fibrosus?
they are parallel with one another in a single lamellus and angled
168
What is the organization of collagen fibers between lamellae?
collagen fibers will be angled in the opposite direction such that a spiral - counterspiral organization is observed
169
What is the average angle of collagen fibers within the annulus fibrosus?
they average 50 to 60 degrees
170
What is the difference in the angle of collagen fibers within the inner lamellae and outer lamellae of the annulus fibrosus?
the outer lamellae collagen fibers are more vertical; the inner lamellae collagen fibers are more horizontal
171
What is the attachment site for collagen fibers within the annulus fibrosus?
collagen fibers of the outer lamellae will become Sharpey's fibers and penetrate the epiphyseal rims; collagen fibers of the inner lamellae will attach to the cartilaginous end plate
172
What is the origin for the cells of the annulus fibrosus?
sclerotomites
173
What cell type is associated with the annulus fibrosus?
fibroblast and fibrocyte
174
What is the cartilage end plate derived from?
the epiphyseal plate
175
What is the thickest part of the cartilage end plate?
around the periphery
176
What is the thinnest part of the cartilage end plate?
the central part, over the nucleus pulposus
177
What part of the vertebral body will the cartilage end plate cover?
the cancellous bone at the top or bottom of the vertebral body
178
What part of the vertebral body upper and lower surfaces will the cartilage end plate not cover?
the epiphyseal rim
179
What is the principal type of collagen fiber within the cartilage end plate?
the type II collagen fiber
180
What is the direction of collagen fibers within the cartilage end plate?
collagen fibers are aligned anterior and posterior
181
What is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus?
the cartilaginous end plate
182
What cell type is associated with the cartilage end plate?
chondrocytes
183
What is the earliest indicator of intervertebral disc pathology or degeneration?
changes in the histology of the cartilage end plate
184
What part of the intervertebral disc is the "growth plate"?
the transition zone
185
What is the area of maximum metabolic activity in the intervertebral disc?
the transition zone
186
What part of the intervertebral disc will exhibit constant remodeling?
the transition zone
187
What part of the intervertebral disc is innervated?
the outer lamellae of the annulus fibrosus
188
What part of the cervical intervertebral disc is highly innervated?
the middle third of the annulus fibrosus
189
What are the types of receptor endings in the intervertebral disc?
nociceptors and proprioceptors
190
What morphological classifications of receptor ending density in the anterior part of the intervertebral disc?
free nerve endings, Pacinian corpuscles, Golgi tendon organs, Ruffini endings and Meissner's corpuscles have been identified
191
What is the relationship between size of the intervertebral disc and receptor endings?
the larger the disc, the greater the variety of receptor endings
192
What is the proposed function of receptor ending density in the anterior part of the intervertebral disc?
they provide feedback during extension
193
Other than receptor endings, what type of innervation is present in the intervertebral disc?
vasomotor postganglionic sympathetic nerve fibers to blood vessels
194
What are the sources of innervation of the intervertebral disc?
the sinu-vertebral nerve (sinus vertebral nerve, recurrent meningeal nerve), fibers from the ventral primary ramus, fibers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray ramus communicans
195
What nerve(s) have been shown to give off the sinus vertebral/sinu-vertebral/recurrent meningeal nerve?
the mixed spinal nerve, ventral primary ramus, dorsal primary ramus, gray ramus communicans and white ramus communicans have all been implicated
196
The reccurent meningeal/sinu-vertebral/sinus vertebral nerve has typically been shown to originate from which source?
the gray ramus communicans
197
What part of the intervertebral disc is innervated by the reccurent meningeal/sinu-vertebral/sinus vertebral nerve?
the outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc
198
What is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?
the outer lamellae of the annulus fibrosus at the posterior part of the intervertebral disc, the posterior longitudinal ligament and dura mater plus vessels and connective tissue of the epidural space
199
What innervates the annulus fibrosus at the posterior part of the intervertebral disc?
the recurrent meningeal/sinu-vertebral/sinus vertebral nerve
200
What forms the posterior neural plexus of the vertebral column?
the sinu-vertebral nerve (sinus vertebral nerve, recurrent meningeal nerve)
201
What forms the anterior neural plexus of the vertebral column?
fibers from the ventral primary ramus
202
What forms the lateral neural plexus of the vertebral column?
fibers from the ventral primary ramus, fibers from the white ramus communicans, fibers fromt he paradiscal ramus communicans, fibers from the gray ramus communicans
203
What neural plexus(es) is formed, in part, by fibers from the ventral primary ramus?
the lateral and anterior neural plexuses of the vertebral column
204
What innervates the annulus fibrosus at the anterior part of the intervertebral disc?
fibers from the ventral primary ramus
205
What part of the intervertebral disc is innervated by fibers from the ventral primary ramus?
the outer lamellae of the annulus fibrosus at the anterior and lateral part of the intervertebral disc
206
What neural plexus is formed, in part, by fibers from the white ramus communicans?
the lateral neural plexus of the vertebral column
207
What innervates the annulus fibrosus at the lateral part of the intervertebral disc?
fibers from the ventral primary ramus, fibers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray ramus communicans
