Anthrology & Syndesmology Of The Spine

Question 1

Define anthrology.

Answer 1

The study of joints and articulations

Question 2

Define syndesmology.

Answer 2

The study of ligaments

Question 3

How would we classify a joint that has little to no movement? Give an example.

Answer 3

Synarthrosis. Ex. Bones of the skull at their fusion

Question 4

How would we classify a joint that has a wide range of movement? Give an example.

Answer 4

Diarthrosis. Ex. Glenohumeral joint

Question 5

How do we classify a joint that moves slight amounts? Give an example.

Answer 5

Amphiarthrosis. ex. IVDs

Question 6

What is a fibrous joint? Give an example.

Answer 6

Articulating surfaces connected by fibrous tissue. Ex. Teeth

Question 7

What is a synovial joint? Give an example.

Answer 7

Articulating surfaces covered by cartilage, but NOT directly connected.
Ex. Z joints

Question 8

What are the features of a synovial joint?

Answer 8

Synovial cavity, joint capsule, and extracapsular ligaments. Often lined w/ hyaline cartilage.

Question 9

What is a cartilaginous joint? Give an example.

Answer 9

Articulating surfaces connected by cartilage. Ex. Pubic symphysis. Central body joints.

Question 10

How would we classify the movement of a central joint (inter body joint)?

Answer 10

Amphiarthrosis.

Question 11

Where would we find a central joint?

Answer 11

Between adjacent vertebral bodies and IVD. “Inter body joint”.

Question 12

How would we classify the connective tissue of a central joint (inter body joint)?

Answer 12

Cartilaginous joint.

Question 13

How would we classify the movement of a zygapophyseal joint?

Answer 13

Diathrosis.

Question 14

How would we classify the connective tissue of a zygapophyseal joint?

Answer 14

Synovial joint.

Question 15

Where would we find a zygapophyseal joint?

Answer 15

Between the superior articular process of the inferior vertebrae, and the inferior articular process of the superior vertebrae.

Question 16

Where are the atypical central joints?

Answer 16

CO-C1, C1-C2, sacral segments, coccygeal segments.

Question 17

What do we call the “central joint” of CO-C1?

Answer 17

Atlanto-occipital joint.

Question 18

What do we call the “central joint” of C1-C2?

Answer 18

Atlanto-axial joint.

Question 19

Why don’t we find central joints in the sacrum or coccyx?

Answer 19

The joints are fused in both structures, in most people. In others, rudimentary discs may be present but they are not true central joints.

Question 20

What kind of connective tissue makes up the IVDs?

Answer 20

Fibrocartilage. Sometimes hyaline.

Question 21

How many IVDs do we have in the spinal column?

Answer 21

23 total - 6C, 12T, 5L

Question 22

How do we name an IVD?

Answer 22

Include the vertebrae they separate. Ex. C4-C5 IVD

Question 23

Describe the relative shape of the IVDs.

Answer 23

Thickest in L, thinnest in T.

Thicker anteriorly in lumbar and cervical regions, helps to form lordotic curves.

Question 24

What are the two anatomical features of an IVD?

Answer 24

Nucleus pulposus (inner) and anulus fibrosus (outer).

Question 25

Describe the structural features of the anulus fibrosus.

Answer 25

Outer concentric fibrocartilaginous rings. “Basket weave” for strength.

Question 26

What is the function of the anulus fibrosus?

Answer 26

Functions as a ligament to bind vertebral bodies. Retains nucleus pulposus.

Question 27

Which structure is most similar to that of an embryonic notochord?

Answer 27

Nucleus pulposus of the IVDs.

Question 28

What is in the nucleus pulposus?

Answer 28

Collagen in mucopolysaccharide base.

Question 29

Explain the hydrophilic nature of the nucleus pulposus.

Answer 29

Imbibes water while laying down due to hydrophilic tendencies. When standing and sitting, the force of gravity disperses the water, causing the IVD to shrink. With age the nucleus pulposus becomes dehydrated and fibrous, accounting for height loss up to 25%

Question 30

What is a vertebral end plate?

Answer 30

Interface of bone and fibrocartilage adjacent to upper and lower surfaces of successive vertebral bodies. Collagen fibers are continuous between the anulus fibrosis and the VEPs

Question 31

T/F The VEP is thickest peripherally.

Answer 31

False - ~3mm thick centrally, 1mm thick peripherally.

Question 32

What is the purpose of the VEPs?

Answer 32

Porous to allow transport of water and nutrients from vertebral bodies to IVDs. Allows waste to exit

Question 33

Where does the IVD adhere to?

Answer 33

Anular epiphysis on the upper and lower surfaces of the adjacent vertebral bodies. Rough inner portion of the vertebral bodies. Also, ALL, PLL, radiate ligament of head of rib, intra-articular lig.

Question 34

What are the functions of the IVD?

Answer 34

Absorbs forces. Shape contributes to L & C curves (lordotic) Binds and limits motion at one segment. Resists forces - shear, compression, torsion.

Question 35

What is the innervation of the anulus fibrosus?

Answer 35

N: Branches of ventral primary rami

Question 36

What is the blood supply for the anulus fibrosus?

Answer 36

BS: Spinal branches, sparsely. Drained by internal and external vertebral plexuses.

Question 37

What is the innervation for the nucleus pulposus?

Answer 37

Lacks direct innervation (cannot feel pain in this region)

Question 38

What is the blood supply for the nucleus pulposus?

Answer 38

Lacks direct blood supply.

Question 39

Describe disc degeneration as a pathology of IVDs.

Answer 39

Small tears in the anulus fibrosus. Over time, all discs degenerate. Can be sped up, making it pathological. Causes: trauma, genetics, repetitive stress. Common at L5-S1

Question 40

Describe disc herniation as a pathology of IVDs.

Answer 40

Nucleus pulposus herniates from within the anulus fibrosis, reaching the periphery. Usually occurs posterolaterally, due to reinforcement by PLL. Also known as “slipped disc”

Question 41

Describe disc protrusion as a pathology of IVDs.

Answer 41

Nucleus pulposus protrudes from within the anulus fibrosis, but the anulus fibrosis is still intact. Can compress the spinal nerves. Usually occurs posterolaterally, due to reinforcement by PLL. Also known as “bulging disc”

Question 42

Describe the symptoms of a herniation of C6-C7.

Answer 42

Sensory and motor deficits - abnormal sensations - loss of voluntary movement Sometimes asymptomatic.

Question 43

Describe Schmorl’s nodes as a pathology of IVDs.

Answer 43

Pockets of nucleus pulposus that were forced into the vertebral body by the VEP. Usually incidental in finding, show up as dark, round spots in vertebral bodies in X-rays. Unsure if they are linked to pain.

Question 44

Define paresis.

Answer 44

Slight/incomplete loss of voluntary muscle movement. | Not strictly neurological.

Question 45

Define paralysis.

Answer 45

Complete loss of voluntary muscle movement

Question 46

Define paresthesia .

Answer 46

Abnormal sensations in the body, resulting from some neuropathy.

Question 47

What are the 3 Ps of neuropathy?

Answer 47

Paresis, paralysis, and paresthesia.