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Spinal Final Exam > Arthrology of the Vertebral Column > Flashcards

Arthrology of the Vertebral Column Flashcards

1
Q

The ligamentous sacro-iliac joints (or most of the ligamentous joints of the vertebral column) are examples of which joint classification?

A

syndesmosis

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2
Q

What are the four consistent features of synovial (diarthrosis) joints?

A

articular or fibrous capsule, synovial membrane, articular cartilage and synovial fluid

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3
Q

Type 1 articular receptors are located in what part of the joint?

A

superficial layer of the fibrous capsule

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4
Q

What is the function of the type 1 articular receptor?

A

They monitor the joint “at rest”

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5
Q

Type II articular receptors are located in what part of the joint?

A

deeper strata of the fibrous capsule

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6
Q

What is the function of type II articular receptors?

A

they monitor the joint during normal range of motion

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7
Q

What is the location of type III articular receptors?

A

collateral or intrinsic ligaments of many joints, they were not thought to be present along vertebral column

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8
Q

what is the function of type III articular receptors?

A

they monitor the joint during extreme motion or beyond normal range of motion

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9
Q

What is the function of type IV articular receptors

A

nociceptive, they monitor pain

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10
Q

Type IVb articular receptors would be present in what locations?

A

accessory ligaments in general, dense in the posterior longitudinal ligament of the spine

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11
Q

What are the three modifications of articular synovial membrane?

A

1 synovial villi, 2 articular fat pads or Haversian glands, 3 synovial menisci and intra-articular discs

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12
Q

Articular fat pads are most numerous in what location along the vertebral column?

A

lumbar zygapophyses

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13
Q

What are the specific functions of type A synovial cells?

A

are phagocytic

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14
Q

What is the specific function of type B synovial cells?

A

secrete proteinaceous substances and hyaluronic acid

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15
Q

Which collagen fiber type predominates in articular cartilage?

A

type II

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16
Q

What are proteoglycans composed of?

A

a core protein and glycosaminoglycans

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17
Q

Cartilage is able to change shape due to compression, a characteristic known as:

A

deformation

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18
Q

What is implied when cartilage is said to have elastic properties?

A

cartilage can deform and returns to original volume rapidly, a time independent property

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19
Q

What is implied when cartilage is said to have viscoelastic properties?

A

cartilage can deform but returns to original volume slowly, a time dependent property

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20
Q

What are the properties of synovial fluid?

A

it is yellow-white, viscous, slightly alkaline, and tastes salty

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21
Q

Synovial fluid consists of what specific chemical groups?

A

fats, salts, albumins and hyaluronate

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22
Q

Which substance in synovial fluid was first thought to be responsible for its viscosity and lubricating behavior?

A

hyaluronate

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23
Q

What is complex synovial joint (diarthrosis)?

A

within the simple or the compound joint, the articulating surfaces are separated by an articular disc (intra-articular disc) or meniscus

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24
Q

What morphological classification of synovial joints is classified as non axial?

A

plane (diarthrosis arthrodial)

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25
Q

What morphological classifications of synovial joints would be classified as uniaxial?

A

hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)

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26
Q

What morphological classifications of synovial joints would be classified as biaxial?

A

(diarthrosis) bicondylar, (diarthrosis) condylar, (diarthrosis) ellipsoidal, and saddle (diarthrosis sellar)

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27
Q

Which vertebrae will have common ligaments?

A

segments C2 to L5

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28
Q

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

A

eight

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29
Q

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

A

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

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30
Q

What common ligaments will attach to the vertebral arch?

A

the ligamentous flavum

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31
Q

What is the cervical nucleus pulposus composed of?

A

fibrocartilage

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32
Q

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

A

the nucleus pulposus will lose water under deformation conditions

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33
Q

What cell is associated with the nucleus pulposus until about age eleven?

A

notochord cells

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34
Q

Which type of collagen is dominant in the nucleus pulposus?

A

collagen type II

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35
Q

What is unusual about the cervical annulus fibrous?

A

it lacks any lamellar or layered organization

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36
Q

What is the appearance of the cervical annulus fibrosus?

A

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

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37
Q

What is the organization of the lumbar annulus fibrosus?

A

it has 12-14 concentric cylindrical lamellae

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38
Q

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

A

birth…78%; thirty…70%

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39
Q

What is the consequence of aggregated glycosaminoglycans in the lumbar annulus fibrosus?

A

the annulus fibrosus will retain water under deformation conditions

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40
Q

Which type of collagen is dominant in the annulus fibrosus?

A

collagen type 1

41
Q

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

A

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

42
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

43
Q

What is the average angle of collagen fibers within the annulus fibrosus?

A

they average 50 to 60 degrees

44
Q

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

A

collagen fibers are aligned anterior to posterior

45
Q

What cell type is associated with the cartilage end plate?

A

chondrocytes

46
Q

What is the earliest indicator of intervertebral disc pathology or degeneration?

A

changes in the histology of the cartilage end plate

47
Q

What part of the intervertebral disc is innervated?

A

the outer lamellae of the annulus fibrosus

48
Q

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

A

nociceptors and proprioceptors

49
Q

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

A

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

50
Q

What is the proposed function of receptor ending density in the anterior part of the intervertebral disc?

A

they provide feedback during extension

51
Q

What innervates the annulus fibrosus at the posterior part of the intervertebral disc?

A

the recurrent meningeal/sinu-vertebral/sinus vertebral nerve

52
Q

What forms the posterior neural plexus of the vertebral column?

A

the sinu-vertebral nerve (sinus vertebral nerve, recurrent meningeal nerve)

53
Q

What forms the anterior neural plexus of the vertebral column?

A

fibers from the ventral primary ramus

54
Q

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

A

the paradiscal ramus communicans

55
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

56
Q

In what regions of the vertebral column is the space formed between vertebral bodies by the intervertebral disc the greatest?

A

the cervical and lumbar regions

57
Q

which curve direction will be associated with the greatest space observed between vertebral bodies?

A

the lordotic or anterior curves

58
Q

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

A

perichordal disc

59
Q

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

A

the annulus fibrosus

60
Q

What part of the intervertebral disc will the notochord form?

A

the nucleus pulposus

61
Q

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

A

the intrasclerotomal fissure or fissure of von Ebner

62
Q

changes in the histology or appearance of the cartilaginous end plate will precede what conditions?

A

degenerative disc diseases

63
Q

What vertebral levels will the anterior longitudinal ligament attach to?

A

those between occiput and S3 inclusive traditionally indicated

64
Q

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

A

L3

65
Q

What is the function of the anterior longitudinal ligament?

A

it brakes or limits dorsi-flexion or hyperextension of the vertebral column

66
Q

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

A

Forestier’s disease

67
Q

What vertebral levels will the posterior longitudinal ligament attach to?

A

those between C2 and S3 inclusive are traditionally indicated

68
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

69
Q

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

A

it forms the anterior boundary of the spinal canal

70
Q

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

A

the perivertebral ligament

71
Q

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

A

the cervical spine with an 80% incidence

72
Q

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

A

a loss of hand and finger dexterity

73
Q

What is the incidence of posterior longitudinal ligament ossification in the thoracic and lumbar spine?

A

about 10% at the thoracic and 10% at the lumbar spine

74
Q

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

A

faltering gait

75
Q

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

A

it is greater in males over 50 and has a higher incidence in the japanese

76
Q

What is the acronym for ossification of the PLL?

A

OPLL

77
Q

At one time ossification of the PLL was an example of what condition?

A

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

78
Q

What are the specific bony attaching sites for the ligamentum flavum?

A

the laminae

79
Q

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

A

it is a yellow elastic ligament

80
Q

What fibers are most ligaments made up of?

A

collagen type 1 fibers which are whitish in appearance

81
Q

What is the color of most ligaments in the body?

A

they are whitish

82
Q

What is now thought to be a major function of the ligamentum flavum?

A

it is an early prime factor in extension of the vertebral column

83
Q

Where is ossification of the ligamentum flavum most commonly identified?

A

the thoracic spine or thoracolumbar transition zone

84
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

85
Q

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

A

the cervical and lumbar regions

86
Q

What muscle will blend with the capsular ligament posteriorly?

A

the multifidis

87
Q

What is the status of the lumbar interspinous ligament?

A

it is broad and thick with three layers identified from anterior to posterior

88
Q

What is the classic function of the interspinous ligament?

A

it is more likely a proprioceptive transducer for the spinal reflex

89
Q

What will the ligamentum nuchae be attached to?

A

the external occipital protuberance, external occipital crest, the posterior tubercle of the posterior arch of C1, and spinous tubercles between C2 and C7 inclusive are traditionally indicated

90
Q

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

A

the funicular layer or part

91
Q

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

A

the lamellar layer or part

92
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

93
Q

What is the histological make-up of the ligamentum nuchae in quadrupeds?

A

it is a yellow elastic ligament

94
Q

What is the primary yellow elastic or elastic ligament of the spine?

A

the ligamentum flavum

95
Q

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

A

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

96
Q

Where is the supraspinous ligament said to be best developed?

A

in the lumbar spine

97
Q

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

A

it is a proprioceptive transducer for spinal reflex

98
Q

Where in the vertebral column is the intertransverse ligament best developed?

A

in the lumbar spine

Spinal Final Exam (5 decks)

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