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Spinal Final > Arthrology of the Vertebral Column > Flashcards

Arthrology of the Vertebral Column Flashcards

1
Q

What is the maximum number of common ligaments identified with a vertebral couple?

A

eight

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2
Q

What is the reason that nine common ligaments are identified but only right will be attached at any specific vertebral couple?

A

the ligamentum nuchae and supraspinous ligament attach to the spinous tubercles, but only one of these will be identified at a single vertebral couple

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3
Q

What is the number of true intervertebral discs identified in the adult?

A

twenty-three

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4
Q

In the adult, which vertebral levels will demonstrate a true intervertebral disc?

A

those between C2 and S1 inclusive

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5
Q

What is the percent of intervertebral disc height contribution to the length of each region of the vertebral column?

A

cervical 22-25%…thoracic 20%…lumbar 33%

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6
Q

What are the names of central, peripheral, and horizontal zones of the intervertebral disc?

A

nucleus pulposus…central zone, annulus fibrosis…peripheral zone, cartilagenous end plate…horizontal zone

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7
Q

What is the cervical nucleus pulposus composed of?

A

fibrocartilage

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8
Q

What is the consequence of non-aggregated glycosaminoglycans in the lumbar nucleus pulposus?

A

the nucleus pulposus will loose water under deformation conditions

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9
Q

What cell is associated with nucleus pulposus until about age 11?

A

notochord cells

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10
Q

What type of collagen is dominate in the nucleus pulposus?

A

collagen type II

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11
Q

What is the organizational pattern for collagen fibers in the nucleus pulposus?

A

they are irregularly oriented and randomly scattered

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12
Q

What is the appearance of the cervical annulus fibrosus?

A

a horse-shoe with the anterior margin thick and the lateral margins tapering to the uncinate processes; the posterior margin is thin

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13
Q

What compensates for the thinness of the posterior part of the cervical annulus fibrosus?

A

posterior longitudinal ligament

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14
Q

What is the organization of the lumbar annulus fibrosus?

A

it has 12-14 concentric cylindrical lamellae

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15
Q

What is the water concentration in the lumbar annulus fibrosus at birth and after 30?

A

birth…78%; after 30…70%

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16
Q

What is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosus?

A

they typically have a binding sit for for hyaluronic acid and thus are aggregated

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17
Q

What type of collagen is dominant in the annulus fibrosus?

A

type I collagen

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18
Q

What is the organizational pattern for collagen fibers in the annulus fibrosus?

A

they are parallel with one another in a single lamellas and angled

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19
Q

What is the organization of collagen fibers between lamellae?

A

collagen fibers will be angled in the opposite direction such that a spiral - counter spiral organization is observed

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20
Q

What is the attachment site for collagen fibers within the annulus fibrosus?

A

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

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21
Q

What is the origin for the cells of the annulus fibrosus?

A

sclerotomites

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22
Q

What is the principal type of collagen fiber within the cartilage end plate?

A

the type two collagen fiber

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23
Q

What is the direction of collagen fibers within the cartilage end plate?

A

collagen fibers are aligned anterior to posterior

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24
Q

What is the attachment site for collagen fibers of the inner lamellae of the annulus fibrosus?

A

the cartilaginous end plate

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25
Q

What are the types of receptor endings in the intervertebral disc?

A

nociceptors and proprioceptors

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26
Q

What morphological classifications of receptor endings are present in the intervertebral disc?

A

free nerve endings, Pacinian corpuscles, Golgi tendon organs, Ruffini endings and Meissner’s corpuscles

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27
Q

What is the relationship between the size of the the intervertebral disc and receptor endings?

A

the larger the disc, the greater the variety of receptor endings

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28
Q

What part of the intervertebral disc is innervated by the recurrent meningeal/sinu-vertebral/sinus vertebral nerve?

A

the outer lamellae of the annulus fibrosis at the posterior part of the intervertebral disc

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29
Q

What forms the anterior neural plexus of the vertebral column?

A

fibers from the ventral primary ramus

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30
Q

What forms the lateral neural plexus of the vertebral column?

A

fibers from the ventral primary rams, fibers from the white ramus communicans, fibers from the paradiscal ramus communicans, fibers from the gray ramus communicans

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31
Q

What is the name given to the white ramus communicanswhich becomes embedded within the annulus fibrosus of the intervertebral disc?

A

the paradiscal ramus communicans

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32
Q

What part of the intervertebral disc is innervated by fibers from the paradiscal ramus communicans?

A

the outer lamellae of the annulus fibrosus at the lateral part of the intervertebral disc

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33
Q

How does the intervertebral disc attach to the vertebral body?

A

Sharpey’s fibers from the outer lamellae of the annulus fibrosus are firmly embedded into the epiphyseal rims of the adjacent vertebral bodies

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34
Q

Based on histology, what is the classification of the intervertebral disc?

A

a cartilaginous (amphiarthrosis) symphysis

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35
Q

What are the divisions of the embryonic somite?

A

the sclerotome, myotome, and dermatome

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36
Q

What structure is formed following migration of the sclerotomes to surround the notochord?

A

the perichordal blastema

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37
Q

What is formed within the perichordal blastema between the sclerotomites?

A

the intrasclerotomal fissure or fissure of von Ebner

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38
Q

What does the sclerotomal fissure or fissure of von Ebner become?

A

the perichordal disc

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39
Q

What will the dense sclerotomite become?

A

the upper part of the vertebral segment forming below

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40
Q

What structure forms following the migration and subsequent missing of the sclerotomites?

A

the vertebral blastema

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41
Q

What part of the intervertebral disc will the notochord form?

A

the nucleus pulposus

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42
Q

What part of the intervertebral disc will the perichordal disc form?

A

the annulus fibrosus

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43
Q

What is the earliest indicator of the position of the adult intervertebral disc?

A

the intrasclerotomal fissure or fissure of von Ebner

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44
Q

What vertebral levels will the anterior longitudinal ligament attach to?

A

those between occiput and S3 inclusive are traditionally indicated

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45
Q

What is the lowest extent of the anterior longitudinal ligament based on recent studies?

A

L3

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46
Q

What is believed to form the anterior longitudinal ligament in the lumbar spine?

A

the tendon of the crura of the diaphragm

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47
Q

What innervates the anterior longitudinal ligament?

A

the anterior neural plexus formed by the fibers from the ventral primary ramus and the sympathetic postganglionic fibers from the paravertebral ganglia

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48
Q

What is the function of the anterior longitudinal ligament?

A

it brake or limits dorsi-flexionof hyperextension of the vertebral column

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49
Q

What was the ossification of the anterior longitudinal ligament in the lumbar region identified as?

A

Forestier’s Disease

50
Q

What is ossification of the anterior longitudinal ligament in the lumbar region now identified as?

A

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

51
Q

Newer research suggests what regional variation in the posterior longitudinal ligament ?

A

prominent in the cervicals, occasional in the thoracics, rare in the lumbars

52
Q

What is the relationship of the posterior longitudinal ligament to the vertebral foramen?

A

it forms the anterior boundary of the spinal canal

53
Q

What is the innermost layer of the posterior longitudinal ligament called?

A

the perivertebral ligament

54
Q

What is the function of the posterior longitudinal ligament?

A

it breaks or limits flexion of the vertebral column

55
Q

Where is ossification of the posterior longitudinal ligament most commonly identified?

A

the cervical spine with an 80% increase

56
Q

What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?

A

a loss of hand and finger dexterity

57
Q

What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?

A

faltering gait

58
Q

What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?

A

it is greatest in males over 50 and has a higher incidence in the Japanese

59
Q

What is the name given to the ligamentum flavum based on appearance and histology?

A

it is a yellow elastic ligament

60
Q

What fibers are most ligaments made up of?

A

collagen type I fibers which are whitish in appearance

61
Q

Where is ossification of the ligamentum flavum most commonly identified?

A

the thoracic spine or thoracolumbar transition zone

62
Q

What is the relationship between the capsular ligament and mobility?

A

the more lax/loose the capsular ligament is, the greater the motion of the joint

63
Q

What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?

A

the cervical and lumbar regions

64
Q

What layers are present in the capsular ligament?

A

a superficial layer of collagen fibers and a deep layer of elastic fibers

65
Q

If the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its’ function?

A

it is probably involved in propioceptive feedback to the muscles stabilizing the vertebral couple during movement

66
Q

What is now thought to be a major function of the interspinous ligament?

A

it is more likely a proprioceptive transducer for the spinal reflex

67
Q

What is the name given to the superficial layer of ligamentum nuchae?

A

the funicular layer or part

68
Q

What is the name given to the deep layer of ligamentum nuchae?

A

the lamellar layer or part

69
Q

What are the attachment sites for the superficial layer of the ligamentum nuchae?

A

the external occipital protuberance, external occipital crest, and spinous tubercle of C7

70
Q

What is the histological makeup of the human ligamentum nuchae?

A

it is a yellow elastic ligament, but has more collagen fibers than quadrupeds

71
Q

What is the classic function of the human ligament nuchae?

A

it brakes or limits flexion of the cervical spine

72
Q

What is the termination level inferiorly for the supraspinous ligament accoring to current literature?

A

primarily at L4 (73%); between L4 and L5 (5%)

73
Q

What is now thought to be a major function of the supraspinous ligament?

A

it is a proprioceptive transducer for the spinal reflex

74
Q

What amount of flexion’extension is accommodated by the atlanto-occipital joint?

A

about twenty-fiver degrees

75
Q

What amount of axial rotation is accommodated by the atlanto-occipital joint?

A

about three to eight degrees one side axial rotation

76
Q

What amount of lateral bending is accommodated by the atlanto-occipital joint?

A

about 5 degrees

77
Q

Which motion is best accommodated by the atlanto-occipital joint?

A

flexion-extension

78
Q

What is the function of the transverse atlantal ligament?

A

it is the primary stabilizer of the antlanto-axil joint restricting the distance of C2 from the anterior arch of C!1

79
Q

What movements are facilitated at the median atlanto-axial joint?

A

flexion-extension, rotation, telescoping (superior-inferior gliding)

80
Q

What is the ADI?

A

the Atlanto-Dental Interspace, a radiographic dstance between the surfaces of the anterior bursa of the median antlanto-axial joint

81
Q

What is the ADI of children compared with that of adults?

A

about 4.5mm in children ; a range of 2-3mm in adults or about 2.5mm in adults

82
Q

What are the degrees of movement facilitated at the atlanto-axial joint?

A

about 20 degrees flexion-extension, 40 degrees one side axial roation, and 5 degrees of lateral bending

83
Q

The occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation?

A

about 60%

84
Q

What is the embryonic derivative of the apical ligament of the dens or the apicodental ligament?

A

the notochord

85
Q

What is the function of the alar ligament?

A

together they function to resist axial rotation

86
Q

What forms the cranial continuation of the posterior longitudinal ligament?

A

the membrana tectoria or tectorial membrane

87
Q

List in order, the ligaments in a midsagital plane from the dura mater at the level of the medulla oblongata to the anterior bursa of the median antlanto-axial joint.

A

the membrana tectoria or tectorial membrane
the cruciate ligament
the capsular ligament of the posterior bursa of the median atlanto-axial joint
the apical ligament of the dens or apicodental ligament

88
Q

For the cervical spine below C2, what is the range of flexion-extension?

A

about 90 degrees or about 18 degrees per couple

89
Q

For the cervical spine below C2, what is the range of one side lateral bending?

A

about 50 degrees or about 10 degrees per couple

90
Q

For the cervical spine below C2, what is the range of one side axial rotation?

A

about 3 degrees or about 6 degrees per couple

91
Q

What are the locations of the costovertebral joints on the vertebra?

A

the costocentral joint at the vertebral body and the costotransverse joint at the transverse process

92
Q

At what rib will the superior costotransverse ligament be absent?

A

the first rib

93
Q

What ligaments will attach to the neck of the twelfth rib?

A

the superior costotransverse ligament from T11 and the lumbocostal ligament from L1

94
Q

What are the attachment sites for the inferior costotransverse ligaments?

A

the neck of the rib and the transverse process of the vertebra at that level

95
Q

At what rib will the inferior costotransverse ligament be absent?

A

T12

96
Q

What is the name given to the space between the transverse process and the neck of the rib?

A

the costotransverse foramen

97
Q

What ligament fills the costotransverse foramen?

A

the inferior costotransverse ligament

98
Q

What are the attachment sites for the lateral costotransverse ligament?

A

the non-articular surface of the tubercle of the rib and the transverse tubercle of the transverse process of the vertebra at that level

99
Q

Which vertebra will lack an attachment for the lateral costotransverse ligament?

A

T12

100
Q

Which vertebral couples of the thoracic spine have the greatest motion?

A

T11/T12 and T12/L1

101
Q

Which range of motion is greatest for lower thoracic vertebral couples?

A

flexion-extension

102
Q

Which range of motion is least for lower thoracic vertebral couples?

A

one side axial rotation

103
Q

Which ligaments replace the intertransverse ligament at the lumbosacral joint?

A

the iliolumbar ligament and lumbosacral ligament

104
Q

What muscle is intimately attached to the superior iliolumbar ligament?

A

quadratus lumborum

105
Q

Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament in the classical description?

A

the superior iliolumbar ligament

106
Q

Which ligament from the iliolumbar ligament complex will attach to the sacral ala?

A

the inferior iliolumbar ligament

107
Q

Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?

A

the inferior iliolumbar ligament

108
Q

What are the attachment sites of the for the accessory iliolumbar ligament?

A

the transverse process of L4 and the iliac crest

109
Q

Which vertebral couple of the lumbar spine has the greatest range of motion?

A

L5/S1

110
Q

Which range of motion is greatest for all lumbar vertebral couples?

A

flexion-extension

111
Q

What range of motion is least for L1-L5 vertebral couples?

A

one side axial rotation

112
Q

What range of motion is least for the L5/S1 vertebral couple?

A

one side lateral bending

113
Q

List in order from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.

A

the membrana tectoria, posterior longitudinal ligament and the deeo posterior sacrococcygeal ligament

114
Q

What ligament represents the homolog of the ligamentum flavum at the sacrococcygeal joint?

A

the superficial posterior sacrococcygeal ligament

115
Q

list in order from cranial to caudal the ligaments forming the posterior boundary of the spinal canal?

A

the posterior atlanto-occipital ligament, posterior atlanto-axial ligament, ligamentum flavum and the superficial posterior sacrococcygeal ligament

116
Q

What is the articular surface of the ilium composed of?

A

articular cartilage, interspersed with fibrocartilage

117
Q

What does ankylosis mean?

A

a condition of fibrous adhesion occurs within the joint

118
Q

What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint

A

age 40, the iliac auricular surface

119
Q

What is the age an gender bias associated with ankylosis of the sacro-iliac joint?

A

age 50 and male bias particularly in African American males

120
Q

What is the relationship between the capsular and interosseus sarcoiliac ligaments?

A

the interosseus sacro-iliac ligament replaces the capsular ligament posteriorly

121
Q

What passes between the layers of the interosseus sacro-iliac ligament?

A

dorsal rami from the sacral spinal nerves

Spinal Final (8 decks)

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