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Spinal Final > Arthrology of the Vertebral Column > Flashcards

Arthrology of the Vertebral Column Flashcards

1
Q

What is the latin term for joint?

A

arthron

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2
Q

What fibrous connective tissue classically fills the joint space in a syndesmosis?

A

interosseous ligament

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3
Q

What protein fiber is the dense connective tissue primarily composed of?

A

collagen fibers which give it a whitish color

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4
Q

Besides collagen, what other proteins are ligaments composed of?

A

elastin fibers which can give a yellowish tinge to the ligament

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5
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

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6
Q

What are the characteristics of type I articular receptors?

A

located in the superficial layer of the fibrous capsule, resemble Ruffini endings, most numerous in cervical zygapophyses and they monitor the joint “at rest”

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7
Q

What are the characteristics of type II articular receptors?

A

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

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8
Q

What are the characteristics of type III articular receptors?

A

present in collateral and intrinsic ligaments, resemble golgi tendon organs, not initially observed along the vertebral column and monitor extreme joint 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 IVa articular receptors would be present in what locations?

A

fibrous capsule, articular fat pads, or adventitia of blood vessels

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11
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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12
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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13
Q

What is the generic function of modifications of articular synovial membrane?

A

aid in spreading synovial fluid

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14
Q

What is the apparent function of synovial villi?

A

increase the surface of synovial membrane available for secretion - absorption phenomena

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15
Q

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

A

lumbar zygapophyses

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16
Q

Condensed fibrous connective tissue or fibrocartillage projections of the synovial membrane are called ______

A

synovial menisci or intra-articular discs

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17
Q

Synovial menisci are a feature of what joint examples?

A

femur-tibia articulation, cervical zygapophyses, and lumbar zygapophyses

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18
Q

What are the layers of the synovial membrane?

A

outer fibrous layer and an inner (lumenal) cellular layer AKA synovial lamina intima

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19
Q

What are the specific functions of type A synovial cells?

A

are phagocytic

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20
Q

What is the specific function of type B synovial cells?

A

secrete proteinaceous substances and hyaluronic acid

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21
Q

What is the common function of type A and Type B synovial cells?

A

formation and absorption of synovial fluid

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22
Q

What is the source of nutrition for articular cartilage?

A

blood vessels in the synovial membrane, sinuses of the bone marrow cavity, and from synovial fluid itself

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23
Q

What is unique about the surface of articular cartilage?

A

a true perichondrium is absent

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24
Q

Which collagen fiber type predominates in articular cartilage?

A

type II

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25
Q

What is the primary function of bound glycosaminoglycans?

A

form a network for water retention

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26
Q

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

A

deformation

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27
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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28
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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29
Q

What is the function of articular cartilage?

A

to provide a wear-resistant, low friction, easily lubricated surface for joint movement

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30
Q

What are the properties of synovial fluid?

A

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

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31
Q

Synovial fluids consists of what specific chemical groups?

A

fats, salts, albumins, and hyaluronate

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32
Q

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

A

hyaluronate

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33
Q

What substance of synovial fluid has been proposed to be responsible for its viscocity and lubricating behavior?

A

lubricin

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34
Q

What are the classifications of synovial joints (diarthroses) based on the number of articulating surfaces?

A

simple and compound synovial joints

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35
Q

What is a complex synovial joint (diarthrosis)?

A

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

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36
Q

What morphological classification of synovial joints is classified as nonaxial?

A

plane (diarthrosis arthrodia)

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37
Q

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

A

hinge (diarthrosis ginglymus) and pivot (diarthrosis trochoid)

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38
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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39
Q

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

A

ball and socket (diarthrosis enarthrosis), (diarthrosis spheroidal), (diarthrosis cotyloid) are all classifications given to the same type of joint

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40
Q

Diarthrosis ginglymus joints are commonly called ________ joints based on action.

A

synovial hinge

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41
Q

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

A

eight

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42
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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43
Q

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

A

twenty-three

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44
Q

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

A

those between C2 and S1 inclusively

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45
Q

What percent of the vertebral column length is contributed by the intervertebral disc?

A

twenty to twenty-five percent

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46
Q

What is the percent of intervertebral disc height contribution to cervical region length?

A

cervical .. 22-25%

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47
Q

What is the percent of intervertebral disc height contribution to thoracic region length?

A

thoracic.. 20%

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48
Q

What is the percent of intervertebral disc height contribution to lumbar region length?

A

lumbar.. 33%

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49
Q

What is the cervical nucleus pulposus composed of?

A

fibrocartilage

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50
Q

What is the water concentration in the lumbar nucleus pulposus at birth and after thirty?

A

birth… 88%; thirty…70%

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51
Q

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

A

notochord cells

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52
Q

What cells are associated with the mature nucleus pulposus?

A

reticulocyte-fibroblast and chondroblast

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53
Q

Which type of collagen is dominant in the nucleus pulposus?

A

collagen type II

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54
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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55
Q

What is unusual about the cervical annulus fibrosus?

A

it lacks any lamellar or layered organization

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56
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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57
Q

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

A

posterior longitudinal-ligament

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58
Q

What is the organization of the lumbar annulus fibrosus?

A

it has 12-14 concentric cylindrical lamellae

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59
Q

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

A

birth… 78%; thirty…70%

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60
Q

Which type of collagen is dominant in the annulus fibrosus?

A

collagen type I

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61
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

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62
Q

What is the organization of collagen fibers between lemellae?

A

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

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63
Q

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

A

they average 50 to 60 degrees

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64
Q

What is the thickest part of the cartilage end plate?

A

around the periphery

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65
Q

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

A

the type II collagen fiber

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66
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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67
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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68
Q

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

A

nociceptors and proprioceptors

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69
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

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70
Q

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

A

they provide feedback during extension

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71
Q

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

A

the recurrent meningeal/sinu-vertebral/sinus vertebral nerve

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72
Q

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

A

fibers from the ventral primary ramus

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73
Q

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

A

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

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74
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

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75
Q

What is the popular theory of intra-abdominal cavity pressure and intervertebral disc response to weight bearing?

A

increasing the intra-abdominal cavity pressure will diminish the amount of resistance the intervertebral disc needs to generate by up to 50%

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76
Q

What part of the intervertebral disc will allow distribution of weight over a maximum surface area?

A

the nucleus pulposus

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77
Q

What vertebral levels will the anterior longitudinal ligament attach to?

A

those between occiput and S3 inclusive are traditionally indicated

78
Q

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

A

L3

79
Q

What is the function of the anterior longitudinal ligament?

A

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

80
Q

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

A

Forestier’s Disease

81
Q

Anterior longitudinal ligament ossification in the lumbar region is now identified as ______?

A

Diffuse Idiopathic Skeletal Hyperostosis or DISH

82
Q

What vertebral levels will the posterior longitudinal ligament attach to?

A

those between C2 and S3 inclusive are traditionally indicated

83
Q

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

A

the perivertebral ligament

84
Q

What is the function of the posterior longitudinal ligament?

A

it brakes or limits flexion of the vertebral column

85
Q

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

A

the cervical spine with an 80% incidence

86
Q

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

A

a loss of hand and finger dexterity

87
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

88
Q

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

A

faltering gait

89
Q

What is 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

90
Q

What is the acronym for ossification of the posterior longitudinal ligament?

A

OPLL

91
Q

At one time ossification of the posterior longitudinal ligament was an example of what condition?

A

Diffuse Idiopathis Skeletal Hyperostosis or DISH

92
Q

What vertebral levels will the ligamentum flavum be attached to?

A

those between C2 and S1 inclusively are traditionally indicated

93
Q

What is the relationship of the ligamentum flavum to the vertebral foramen?

A

it forms the posterior boundary of the spinal canal

94
Q

What is the histology of the ligamentum flavum?

A

it is formed primarily with elastic fibers, which are yellow in appearance

95
Q

What is the function of the ligamentum flavum?

A

it brakes or limits flexion of the vertebral column

96
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

97
Q

Where is ossification of the ligamentum flavum most commonly identified?

A

the thoracic spine or thoracolumbar transition zone

98
Q

What is the acronym for ossification of the ligamentum flavum?

A

OLF

99
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

100
Q

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

A

the cervical and lumbar regions

101
Q

The capsular ligament will blend with which other common ligament?

A

the ligamentum flavum

102
Q

What muscle will blend with the capsular ligament posteriorly?

A

the multifidis

103
Q

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

A

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

104
Q

What verebral levels will the interspinous ligament be attached to?

A

those between C2 and S1 inclusive are traditionally indicated

105
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

106
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

107
Q

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

A

the funicular layer or part

108
Q

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

A

the lamellar layer or part

109
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

110
Q

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

A

it is a yellow elastic ligament

111
Q

What is the histological make-up of the human ligamentum nuchae?

A

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

112
Q

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

A

the ligamentum flavum

113
Q

What is the classic function of the human ligamentum nuchae?

A

it brakes or limits flexion of the cervical spine

114
Q

What will the supraspinous ligament be attached to?

A

the spinous tubercles along the vertebral column from C7 to sacrum

115
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%)

116
Q

Where is the supraspinous ligament said to be best developed?

A

in the lumbar spine

117
Q

What is the classic function of the human supraspinous ligament?

A

it brakes or limits flexion of the spine

118
Q

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

A

it is a proprioceptive transducer for the spinal reflex

119
Q

What will the intertransverse ligament be attached to?

A

the transverse tubercles and transverse processes of adjacent vertebrae along the vertebral column from C1 to L5

120
Q

What is the status of the cervical intertransverse ligament?

A

it is said to be paired with an anterior and a posterior intertransverse ligament present

121
Q

What is the status of the lumbar intertransverse ligament?

A

it is well developed with two parts identified, a ventral slip and a dorsal slip

122
Q

What part of the lumbar intertransverse ligament covers the intervertebral foramen?

A

the ventral slip

123
Q

What part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?

A

the dorsal slip

124
Q

What are the characteristics of the capsular ligament of the atlanto-occipital joint?

A

it is said to be loose, thin, and composed of collagen fibers

125
Q

What other joint space does the atlanto-occipital joint communicate with?

A

the posterior bursa of the medial atlanto-axial joint

126
Q

What is the median thickening of the anterior atlanto-occipital ligament called?

A

the anterior longitudinal ligament

127
Q

What is the classic function of the anterior atlanto-occipital ligament?

A

it brakes or limits “extension” of the skull over the cervical spine

128
Q

Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?

A

an incomplete ponticulus ponticus or a complete ponticulus ponticus

129
Q

What other name may be used to identify a ponticulus posticus?

A

Kimmerle’s anomaly

130
Q

What names are given to the opening formed by the ponticulus posticus?

A

arcuate foramen or retroarticular canal

131
Q

What is the classic function of the posterior atlanto-occipital ligament?

A

it brakes or limits axial rotation, flexion, and perhaps lateral bending of the skull on atlas

132
Q

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

A

about twenty-five degrees

133
Q

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

A

about three to eight degrees one side axial rotation

134
Q

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

A

about five degrees

135
Q

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

A

flexion - extension

136
Q

Which atlanto-axial joint is identified as a synovial pivot (diarthrosis trochoid)?

A

the median atlanto-axial joint

137
Q

What are the names given to the synovial joint spaces of the medial atlanto-axial joint?

A

the anterior bursa and the posterior bursa

138
Q

What are the joint surfaces of the median atlanto-axial joint at the anterior bursa?

A

the fovea dentis of C1 and the facet for the fovea dentis of C2

139
Q

What are the joint surfaces of the median atlanto-axial joint at the posterior bursa?

A

the groove for the transverse atlantal ligament of C2 and the transverse atlantal ligament

140
Q

What ligament is formed by the transverse atlantal ligament and its perpendicular extension?

A

the cruciate ligament or cruciform ligament

141
Q

What is the function of the transverse atlantal ligament?

A

it is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1

142
Q

What is the ADI?

A

the Atlanto-Dental interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint

143
Q

What is the ADI of children compared with that of an adult?

A

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

144
Q

What are the characteristics of the capsular ligament of the lateral atlanto-axial joint?

A

it is lax or loose and demonstrates a meniscoidal fold within the joint cavity

145
Q

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

A

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

146
Q

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

A

about 60%

147
Q

What is the name given to the occipital-C2 region of the spine?

A

the craniovertebral junction

148
Q

Embryologically, what forms the apical ligament of the dens or the apicodental ligament?

A

the notochord

149
Q

What is the function of the apical ligament of the dens or the apicaldental ligament?

A

it has no known function

150
Q

What ligament attaches to the posterolateral part of the odontoid process of C2 and to surfaces on the medial border of the occipital condyle or as far anterior as the anterolateral margin of the foramen magnum?

A

the alar ligament

151
Q

What is the function of the alar ligament?

A

together they function to resist axial rotation

152
Q

Which ligament lies behind the alar ligaments?

A

the cruciate ligament, specifically the superior crus ligament

153
Q

what are the layers of the membrana tectoria or tectorial membrane?

A

a superficial and a deep layer are identified

154
Q

The superficial layer of the membrana tectoria or tectorial membrane lies in front of what structure?

A

the dura mater of the medulla oblongata and the spinal cord

155
Q

What is the function of the membrana tectoria or tectorial membrane?

A

it resists flexion and extension of the skull on the upper cervical spine

156
Q

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

A

about 90 degrees or about 18 degrees per couple

157
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

158
Q

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

A

about 33 degrees or about 6 degrees per couple

159
Q

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

A

T12

160
Q

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

A

T11/T12 and T12/L1

161
Q

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

A

flexion-extension

162
Q

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

A

one side axial rotation

163
Q

Which ligaments replace the intertransverse ligament at the lumbosacral joint?

A

the iliolumbar ligament and lumbosacral ligament

164
Q

What are the attachment sites for the lumbosacral ligament?

A

the sacral ala and ventrolateral surface of sacrum attach to the transverse process of L5

165
Q

What are the attachment sites for the iliolumbar ligament?

A

the iliac crest is attached to the transverse process of L5

166
Q

What muscle is intimately attached to the superior iliolumbar ligament?

A

quadratus lumborum

167
Q

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

A

the superior iliolumbar ligament

168
Q

Which of the current ligaments from the iliolumbar ligament complex represents the lumbosacral ligament of classic description?

A

the inferior iliolumbar ligament

169
Q

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

A

L5/S1

170
Q

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

A

flexion-extension

171
Q

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

A

one side axial rotation

172
Q

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

A

one side lateral bending

173
Q

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

A

the anterior atlanto-occipital ligament, anterior atlanto-axial ligament, anterior longitudinal ligament, and the anterior sacrococcygeal ligament

174
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 deep posterior sacrococcygeal ligament

175
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

176
Q

What is the auricular surface of sacrum composed of?

A

true articular cartilage, a modification of hyaline cartilage

177
Q

What is the auricular surface of the ilium composed of?

A

articular cartilage, interspersed with fibrocartilage

178
Q

What is the superficial appearance of the auricular surfaces of the sacro-iliac joint by age 15?

A

the sacrum develops a sacral groove while the ilium develops an iliac ridge

179
Q

Which gender has greater unevenness of the auricular surface of the sacro-iliac joint?

A

males

180
Q

What pathological or age-related modifications of the sacroiliac joint may occur?

A

degenerative arthrosis and ankylosis

181
Q

What does ankylosis mean?

A

a condition of fibrous adhesion occurs within the joint

182
Q

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

A

age 40, the iliac auricular surface

183
Q

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

A

age 50 and male bias particularly in African American males

184
Q

What age and gender bias is associated with ossification of the anterior sacro-iliac ligament?

A

age 40 and male bias

185
Q

Which is the strongest of the sacro-iliac ligaments?

A

the interosseous sacro-iliac ligament

186
Q

What are the attachment sites of the interosseous sacroiliac ligament?

A

at the sacral tuberosity and the iliac sulcus

187
Q

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

A

dorsal rami from the sacral spinal nerves

188
Q

What is formed by the continuation of the sacrotuberous ligament along the ischial ramus?

A

the falciform process

189
Q

What separates the greater sciatic and lesser sciatic foramina?

A

the sacrospinous ligament

190
Q

What is the function of the ssacrospinous and sacrotuberous ligaments?

A

they oppose the upward tilt of the sacral apex and resist the rotation of sacrum between the innominate bones

Spinal Final (6 decks)

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