Articulations and Vessels of the Vertebral Column

Question 1

What primary curve is present during birth?

Answer 1

anterior concavity of the vertebral column (“kyphotic)

Question 2

What curves arise in response to lifting the head and assuming an erect posture?

Answer 2

secondary lordotic curves of the cervical and lumbar regions

Question 3

Describe some abnormal curves.

Answer 3

lordosis - exaggerated secondary curve of the lumbar area
kyphosis - exaggerated primary curve of the thoracic area
scoliosis - lateral “S” shaped curve occurring in any region of the vertebral column

Question 4

What are intervertebral disks made of?

Answer 4

annulus fibrosis - outer fibrocartilaginous rings whose fibers are perpendicular to each other for added strength

nucleus pulposus - inner highly elastic, highly hydrated gelatinous-like mass in center of intervertebral disk

Question 5

What is the difference between ruptured and herniated disc?

Answer 5

ruptured - tear of annulus fibrosis leading to loss of integrity between contiguous vertebrae

herniated - where nucleus pulposus squeezes through tear, possibly coming in contact with spinal nerves.

Question 6

What ligament of the spinal cord is the only one involved in preventing excess extension located on the anterior surface of all vertebrae (sacrum basilar portion to occipital bone)?

Answer 6

anterior longitudinal spinal ligament

Question 7

What ligament of the spinal cord prevents excessive flexion and is located on the posterior surface w/in the vertebral foramen of all bodies extending from the occipital bone to the sacrum?

Answer 7

posterior longitudinal spinal ligament

Question 8

Where are the zygapophysial joints located?

Answer 8

synovial joint between the superior and inferior articulating processes. orientation differences dictates movement allowed in spinal column region.
cervical - flex, extend, rotate, and lateral flexion
thoracic - rotation and lateral flexion (little to no flex/extend)
lumbar - flex, extend, side bend (limited rotation)

Question 9

What are the 4 ligaments of the vertebral arch and where are they?

Answer 9

ligamentum flavum - unites internal surface of adjacent laminae from CV2 down ward

interspinal ligament - unit adjacent spinous processes from tip to laminae

supraspinal ligament - connects tips of spinous processes from CV7 to sacrum

ligamentum nuchae (nuchal ligament) - median sheet-like extension of the supraspinal ligament which extends from CV7 spinous process to external occipital protuberance

Question 10

What are the boundaries of the intervertebral foramina?

Answer 10

the inferior vertebral notch of vertebra above and the superior vertebral notch of the vertebra below

Question 11

What does the intervertebral foramina contain?

Answer 11

• dorsal and ventral roots
• dorsal root ganglion
• spinal nerve
• spinal a. and intervertebral v.

Question 12

What allows the ‘yes’ motion?

Answer 12

atlantooccipital joint - gliding synovial joint between the occipital condyles of the skull and the superior articulate facets of CV1 (atlas)

Question 13

What are the accessory ligaments of the atlantooccipital joint?

Answer 13

anterior atlantooccipital membrane - between anterior margin of foramen magnum and anterior arch of atlas

posterior atlantooccipital membrane - between posterior margin of foramen magnum and posterior arch of atlas; has openings in lateral margins for passage of vertebral artery and suboccipital nerve

Question 14

What allows the ‘no’ motion?

Answer 14

atlantoaxial joint - gliding type pivot joint between CV1 and CV2 articular processes

Question 15

What are the main ligaments of the atlantoaxial joint?

Answer 15

cruciform ligament of the atlas

• transverse ligament: attaches to internal surface of anterior arch of the atlas to forma socket between itself and the anterior arch to hold the dens in place
• superior crus: passes from the transverse ligament superiorly to anterior edge of the foramen magnum
• inferior crus: passes from the transverse ligament inferiorly to attach to posterior surface of the body of the axis

Question 16

What accessory ligaments limit how far you can rotate your head?

Answer 16

alar ligaments - strong bilateral ligaments which arise from the dens lateral to apical and attach to the occipital condyles. tearing increase rotation by 30 degrees

Question 17

What are the accessory ligaments of the atlantoaxial joint?

Answer 17

apical dental ligament - from apex of dens to anterior edge of foramen magnum deep to superior crus

alar ligaments - lateral to apical dental ligament and prevent excessive rotation

tectorial membrane - cover dens and associated ligaments, from anterior edge of foramen magnum to body CV@ to fuse with posterior longitudinal spinal ligament

anterior atlantoaxial membrane - from anterior arch of the atlas to the anterior body of the axis, underneath the anterior longitudinal spinal ligament

posterior atlantoaxial membrane - from posterior arch of the atlasto the lamina of the axis; continuous with ligamentum flavum

Question 18

spondylolysis

Answer 18

condition (usually developmental but can be trauma) where the pars interarticularis of the neural arch between superior and inferior articulating processes breaks. (spondylolisthesis is where both sides break) LV5 on SV1

Question 19

What vessels provide the main supply of blood to the spinal column?

Answer 19

spinal arteries - arise from vessels that parallel the vertebral column and enter through the intervertebral foramen. divide into:

• osseous branches: anastomose with like branches to form plexuses w/in the vertebral canal posterior to PLSL and anterior or ligamentum flavum
• neural branches: provide radicular branches which enter the dural sac along the spinal nerves. course along dorsal roots to ramify anterior and posterior spinal arteries on the surface of the spinal cord.

Question 20

What are the four main points to remember about the veins that drain the spinal column?

Answer 20

1. 4 venous plexuses that drain column
2. run the entire length of column
3. intercommunicate
4. no valves

Question 21

What are the 4 plexuses that drain the spinal column?

Answer 21

anterior external venous plexus - anterior surface of bodies

posterior external venous plexus - external surface of spinous, articular and transverse processes.

anterior internal venous plexus - in epidural space adjacent to posterior longitudinal spinal ligament

posterior internal venous plexus - in epidural space adjacent to laminae and ligamenta flava

Question 22

What drains the vertebral bodies?

Answer 22

basivertebral veins - drains into anterior internal plexus

Question 23

What veins drain all 4 venous plexuses?

Answer 23

intervertebral veins - drains into vertebral, posterior intercostal, lumbar and lateral sacral veins

Question 24

What is Batson’s plexus?

Answer 24

vertebral vascular plexus which, due to its lack of valves, receives blood from pelvic, abdominal, thoracic and cranial cavities.