Articulations and vessels of the vertebral column

Question 1

primary curvature of the back

Answer 1

anterior concavity of the vertebral column

kyphodic curve

exists in fetal life throughout the column
persists in adult life in the thoracic and sacral areas

Question 2

secondary curves of spine

Answer 2

anterior convexity of the vertebral column

develops in response to lifting head and the assumption of the erect position

exists in cervical and lumbar areas

Question 3

lordosis

Answer 3

exaggerated secondary curve of the lumbar area

Question 4

kyphosis

Answer 4

exaggerated primary curve of the thoracic area

Question 5

scoliosis

Answer 5

lateral S shape any area of vertebral column

Question 6

zygopophysis (facet joints)

Answer 6

articulations between vertebral arches

true synovial joints

Question 7

3 major classifications of joints

Answer 7

membranous
cartilaginous
synovial

Question 8

what is a synovial joint?

Answer 8

articulating bones of a synovial joint are united by a joint capsule

the joint capsule has two parts:
outer fibrous layer
lined by a serous synovial membrane spanning and enclosing an articular cavity

the joint cavity contains synovial fluid

articular cartilage covers the articulating surfaces of the bones

PROVIDES FREE MOVEMENT

Question 9

articulations between vertebral bodies?

Answer 9

intervertebral discs

Question 10

annulus fibrosis

Answer 10

part of the intervertebral discs

outer fibrocartilaginous ring

consists of concentric lamellae (layers) of fibrocartilage*** Superstrength

the fibers of adjacent lamellae cross each other obliquely in opposite directions -> allows limited rotation b/w adjacent vertebrae

thinner posteriorly*** in cervical and lumbar regions which assists in maintaining secondary curves of these areas

Question 11

nucleus pulposus

Answer 11

the core of the IV disc

inner highly elastic , highly hydrated gelatinous mass

can be pushed around during movement
extension–> moved anteriorly
flexion–> moved posteriorly
sidebending–> moved to opposite side of the bending

Question 12

intervertebral discs attachments

Answer 12

attached above and below to the hyaline cartilage of vertebral bodies

attached anteriorly and posteriorly to longitudinal spinal ligaments

Question 13

function of IV

Answer 13

shock absorbers

during compression they bulge past the margins of the vertebral body

Question 14

posterior longitudinal ligament

Answer 14

n

Question 15

ruptured disc

Answer 15

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

Question 16

herniated disc

Answer 16

nucleus pluposus squeezes through the ruptured disc and may impinge/contact roots of spinal nerves

Question 17

posterolateral herniation versus a posterior herniation ?

Answer 17

posterolateral herniation pushes on spinal nerve

posterior herniation directly on spinal nerve right next to it AND on cauda equina –SO this is more of a problem

L4-L5
L5-S1 are the most common areas of herniation in the body

Question 18

if you have a posterolateral herniation of IV between LV4 and LV5 which nerve is impinged?

Answer 18

L5 b/c L4 has already left the vertebral column

Question 19

herniations that occur in the cervical region affect spinal nerves at …

Answer 19

the same level as the herniation

Question 20

herniations that occur in the lumbar region….

Answer 20

due to the angle at which the spinal nerves descend from the spinal cord relative to the herniated IV disk, affect the spinal nerve one or more segments lower

Question 21

anterior longitiudinal spinal ligament

Answer 21

location
-anterior surface of ALL vertebrae extending from the basilar portion of he occipital bone to the pelvic surface of the sacrum

• only ligament that prevents excessive extension
• composed of two layers

Question 22

two layers of anterior longitudinal spinal ligament

Answer 22

deep layer composed of short fibers which span contiguous vertebrae

-superficial layer composed of long fibers which span many vertebrae

Question 23

poster longitudinal spinal ligament

Answer 23

runs within the vertebral canal along the posterior aspect of the vertebral bodies

extends from the occipital bone to the sacrum

prevents excessive flexion

directs/prevents intervertebral disk herniation posterolaterally thereby affecting spinal nerves

Question 24

zygopophyseal joints in the cervical region and the movement they allow

Answer 24

oblique in coronal plane

allow for flexion, extension, rotation and lateral flexion

Question 25

zygopophyseal joints in the thoracic region and the movement they allow

Answer 25

sit vertically in the coronal plane MOSTLY FOR ROTATION and LATERAL FLEXION thoracic region needs to be stable and ribs need to move in the thoracic region can flex fairly well, but LIMIT EXTENSION limit anterior and posterior translation

Question 26

zygophoyseal joints in the lumbar region and the movement they allow

Answer 26

vertically in the sagittal plane NO ROTATION YES FOR FLEXION AND EXTENSION SIDE BENDING

Question 27

ligamentum flavum general info

Answer 27

yellow- due to high percentage of elastic fibers unites internal surface of adjacent laminae from CV2 downward covering the zygopophyseal joint

Question 28

function of the ligamentum flavum

Answer 28

maintains upright posture by limiting FLEXION of the vertebral column ALSO returns vertebral column to its normal posture by aligning facet joints (recoil memory) STRONGEST of the 4 ligaments located posteriorly to the vertebral bodies

Question 29

interspinal ligament

Answer 29

unites adjacent spinous processes from tip to laminae most robust in lumbar region insignificant in cervical and thoracic areas due to the respective distance b/w contiguous spinous processes

Question 30

5 ligaments to consider in spinal column

Answer 30

anterior and posterior longitudinal spinal ligament ligamentum flavum interspinal ligament supraspinal ligament nuchal ligament

Question 31

supraspinal ligament

Answer 31

connects tips of spinous processes from CV7 to sacrum composed of TWO laminae deep-span adjacent spinous proces. superficial- spans several vertebrae

Question 32

what is the supraspinal ligament continuous with at the deep surface and above CV7

Answer 32

on deep surface continuous with interspinous ligament above CV7 continuous with nuchal ligament

Question 33

when you go into flexion what happens to the zygopophyseal joints>

Answer 33

they separate and spread out a bit so ligamentum flavum prevents this

Question 34

nuchal ligament

Answer 34

median sheet like upward extension of the supraspinal ligament extends from CV7 spinous process to external occipital protuberance intermuscular septum for posterior deep muscles of the neck site of MUSCULAR ATTACHMENT without limiting extension of the cervical column

Question 35

superior and inferior border of the intervertebral foramina

Answer 35

superior --> inferior vertebral notch of vertebra above inferior--> superior vertebral notch of vertebra below

Question 36

anterior and posterior borders of the intervertebral foramina

Answer 36

anterior--> posterior part of vert. above and intervertebral disk posterior--> facet joint b/w 2 opposing vertebrae

Question 37

osteoarthritis

Answer 37

can cause inflammation and bulging into the spinal nerve area.... OUCHY this is relevant to the discussion on the intervertebral foramen and why you don't want to impinge upon it

Question 38

Contents of the intervertebral foramina (4)

Answer 38

dorsal and ventral roots dorsal root ganglion spinal nerve spinal artery and intervertebral vein

Question 39

the intervertebral foramina has depth ....

Answer 39

the width of the pedicle

Question 40

atlantooccipital joint

Answer 40

plane synovial joint b/w occipital condyles of skull and superior articulating facets of CV1 atlas loose joint promotes between skull and atlas in "YES" range==> flexion and extension

Question 41

accessory ligaments of the atlantooccipital joint

Answer 41

Anterior atlanto-occipital membrane -b/w anterior arch of the atlas and anterior margin pf foramen magnum Posterior atlanto-occipital membrane -posterior margin of both atlas and foramen magnum

Question 42

what does the posterior atlantooccipital membrane have an opening for?

Answer 42

vertebral artery and suboccipital nerve (dorsal ramus of spinal nerve C1)

Question 43

atlantoaxial joint (2 different types of articulations)

Answer 43

lateral articulations--> gliding type synovial joint b/w CV1 and CV2 articular processes median articulations--> pivot type joint b/w dens of the axis and the anterior arch of the atlas

Question 44

where is the location of the dens/atlas articulation

Answer 44

anterior arch of atlas

Question 45

what type of movement does the medial atlantoaxial articulation provide

Answer 45

"NO" action (rotation)

Question 46

accessory ligaments of the atlantoaxial joint

Answer 46

transverse ligament of the atlas*** most important superior crus inferior crus these form the CRUCIFORM LIGAMENT of the atlas

Question 47

transverse ligament of the atlas

Answer 47

attaches to the internal surfaces of the anterior arch of the atlas forming a socket b/w itself and the anterior arch

Question 48

superior crus and inferior crus

Answer 48

superior--> pass from transverse ligament superiorly to attach to the anterior edge of foramen magnum inferior--> passes from the transverse ligament inferiorly to attach to the posterior surface of the body of the axis

Question 49

apical dental ligament

Answer 49

weak ligament which passes from the apex of the dens to the anterior edge of foramen magnum deep to the superior crus

Question 50

alar ligaments

Answer 50

bilateral ligament arise from dens and attach to the occipital condyles

Question 51

what happens if you tear the alar ligament

Answer 51

increase rotation of the skull by approximately 30 degrees example--> owl has very lax alar ligament

Question 52

tectorial membrane

Answer 52

covers the dens and associated ligaments extends from the anterior edge of foramen magnum to the body of CV2 where it fuses with the posterior longitudinal spinal ligament

Question 53

anterior antantoaxial membrane

Answer 53

anterior--> from the anterior arch of the atlas to the anterior body of the axis is overlain by the superior most extension of the anterior longitudinal ligament

Question 54

posterior atlantoaxial membranes

Answer 54

from the posterior arch of the atlas to the lamina of the axis continuous with the ligamentum flavum

Question 55

spondyloysis

Answer 55

elongated pars interarticularis UNILATERAL usually from development BUT can be trauma induced (fracture--> heal---> elongate)

Question 56

spondylolisthesis

Answer 56

BILATERAL fracture or problem of the pars interarticularis the affected vertebra, as well as the entire spinal column above slips foward on the vertebrae below MOST COMMON AT LV5 and SV1 b/c of weight bearing area this causes stretching to nerve roots

Question 57

important note*** on vasculature... All spinal nerve roots have what?

Answer 57

associated radicular or segmental medullary arteries most roots have radicular arteries both types of arteries run along the roots

Question 58

radicular arteries

Answer 58

end before reaching anterior or posterior spinal arteries

Question 59

segmental medullary arteries

Answer 59

continue on from roots to supply a segment of the anterior or posterior spinal arteries

Question 60

spinal arteries arise from what?

Answer 60

arise from vessels which parallel the vertebral column ``` ie: verterbral artery ascending cervical artery posterior intercostal artery lumbar artery lateral sacra artery ```

Question 61

spinal arteries?

Answer 61

anterior spinal artery paired posterior spinal artery connected to segmental medullary arteries but NOT radicular arteries

Question 62

4 things i need to know about veins

Answer 62

Four venous plexuses drain the vertebral column all four run the entire length all four freely intercommunicate they do NOT posses valves

Question 63

Plexuses

Answer 63

Anterior and posterior external venous plexuses -either on vertebral body or external surfaces of the transverse, spinous or articular processes Anterior and posterior internal venous plexuses -in epidural space

Question 64

venous flow (2 types)

Answer 64

Basivertebral Intervertebral

Question 65

Basivertebral venous flow

Answer 65

drain the bodies of the vertebrae to the anterior internal plexus

Question 66

intervertebral veins

Answer 66

receive drainage from ALL 4 venous plexuses drain to - vertebral - posterior intercostal - lumbar - lateral sacral veins

Question 67

Batson's plexus

Answer 67

NO VALVES so..... receives blood from abdominal, pelvic, thoracic, and cranial cavities so changes in intra-abdominal pressures are accompanied by changes of flow within these plexuses RESPONSIBLE FOR METASTATIC SPREAD OF CANCER (prostate and breast)