Back Arthology

Question 1

What is whiplash?

Answer 1

Hyperextension
Excessive stretching and tearing of anterior longitudinal L.
Sometimes recoil which causes hyperflexion
anterior longitudinal L. can help realign

Question 2

Why is the anterior longitudinal L. important?

Answer 2

Because of its possible splinting action that should be used whenever fracture of the vertebral column is expected (except cervical fractures due to hyperextension)

Fracture of vertebral column= keep patient hyperextended at all times so that the anterior longitudinal L.can realign fragments of bone and prevent further injury

Question 3

How does herniation of the Nucleus Pulposus through the Annulus Fibrosis occur?

Answer 3

pulpous goes through annulus

Occurs posterolaterally where the Annulus Fibrosis receives no support from the Anterior and Posterior Longitudinal Ls.
The bulge compresses spinal nerve roots, the cauda equina and spinal nerves in the bertebral canal and intervetebral foramina

Most common at L4/5 and L5/S1 where discs are larger and more mobile

Question 4

What is the second number rule in terms of the cervical and lumbar regions?

Answer 4

For the cervical and lumbar regions, the vertebral level at which the prolapse occurs will affect the spinal nerve with the second number designation

Ex. A prolapse at C5/6 will
affect spinal nerve 6 (which exits the column at C5/6).

Question 5

What is the reasoning behind the second number rule?

Answer 5

In the Cervical Region this is because the
numbering system of Spinal Nerves in the Cervical Region (C1 Spinal Nerve coming out above C1 Vertebra and C2 Spinal Nerve coming out below C1 vertebra, resulting in 8 Cervical Spinal Nerves).

However a prolapse at L4/5 will affect spinal nerve 5 (which exits at L5/S1). This is because lumbar spinal nerves exit the Vertebral Canal superior to the Intervertebral Disc, therefore herniation will not affect the nerve exiting at that level, but will affect the nerve one level inferior

Question 6

What is the Uncovertebral Joint (of Luschka)?

Answer 6

At the Cervical Intervertebral Joint the joint between the Uncinate Process of the inferior Vertebra and beveled inferior surface of the superior Vertebra

Unclear whether this joint should be classified as Synovial

Question 7

What is the vertebral joint at C1/C2 aka atlas and axis?

Answer 7

Compound synovial joint: planar and trochoid

Question 8

What is the vertebral joint that is C3-S1 aka normal vertebral joints ?

Answer 8

intervertebral joint + zygapophyseal

compound: symphysis and planar synovial

Question 9

What is the joint at S5/Co1?

Answer 9

Symphysis

Question 10

What is the joint that is C1-S1?

Answer 10

Sypopophyseal: Planar synovial joint

Question 11

Where is the Anterior Longitudinal L.?

Answer 11

travels on the anterior surface of the vertebral bodies onto the Ventral surface of the Sacrum,

Question 12

Where is the Posterior Longitudinal L?

Answer 12

travels on the dorsal surface of the vertebral

bodies onto the Ventral surface of the Sacrum

Question 13

What is the Ligamentum Flavum? Where are they?

Answer 13

pale yellow fibers which travel on the ventral

surfaces of Vertebral Laminae onto the posterior wall of the Sacral Canal

Question 14

Where is the Interspinous L?

Answer 14

travels between adjacent Spinous Processes

Question 15

Where is the Intertransverse L?

Answer 15

Not well defined in the Cervical Region, fibrous cords in the Thoracic Region, thin membranes in the Lumbar Region

Question 16

Where is the Supraspinous L.?

Answer 16

travels on the dorsal surface of the Vertebral Spinous Processes, continues as the Ligamentum Nuchae in the Cervical Region

Question 17

What makes up the Intervertebral Discs?

Answer 17

Annulus Fibrosis= tough fibrous outer region, overlapping lamellae of Fibrocartilage)

Nucleus Pulposus= soft gelatinous inner portion

Question 18

Where is the Atlantooccipital Joint? What is it made of?

Answer 18

Condyloid Synovial Joint; between the Atlas and Basilar Occipital B.
- throchoid and planar synovial

Anterior Atlantooccipital Membrane (from the Anterior Arch of the Atlas to the basilar Occipital B.)

Tectorial Membrane (from the posterior surface of the Body of the Axis to the anterior internal margin of the Foramen Magnum on the Occipital B.)

Posterior Atlantooccipital Membrane= from ligamental falvum (from the anterior surface of the Posterior Arch of the Atlas to the posterior internal margin of the Foramen Magnum of the Occipital B.)

Question 19

What is the Median Atlantoxial Joint? What are the ligament it is composed of?

Answer 19

Trochoid Synovial Joint; between the anterior facet of the Dens of the Axis and the articular facet for the dens on the Atlas

Cruciate L.

• Superior Longitudinal Band (from the Occipital B. to the Transverse L.)
• Transverse L. of the Atlas= starts on atals goes arounds dens then back on atlas (around Odontoid Process, from Tubercle of the Transverse L. to contralateral Tubercle of the Transverse L.)
• Inferior Longitudinal Band (from C2 to Transverse L.)

Alar L.= from the Odontoid Process of the Axis to the lateral margins of the Foramen Magnum of the Occipital B.

Apical L.= extends from the apex of the Dens to the anterior internal margin of the Foramen Magnum
- behind superior longitudinal

Question 20

What is the Lateral Atlantoaxial Joint? Where is it?

Answer 20

Planar Synovial Joint

Between Superior and Inferior Articulating processes of the Atlas and Axis

Question 21

What is the Lumbosacral Joint? What does it contain?

Answer 21

Compound joint: symphysis and planar synovial between L5 and Sacrum

Anterior Longitudinal L.
Posterior Longitudinal L. 
Ligamentum Flaveum 
Iliolumbar L. 
Intervertebral discs

Question 22

What is the Iliolumbar L.?

Answer 22

Travels from the L5 Transverse Processes to the Iliac Crest

Question 23

What is the Lumbosacral L?

Answer 23

travels from L5 Transverse Process and Body

to the Sacral Ala

Question 24

What makes up the Vertebral Joints?

Answer 24

Anterior Longitudinal L.
Posterior Longitudinal L.
Ligamentum Flavum
Interspinous L.
Intertransverse L.
Supraspinous L.
Intervertebral Discs

Question 25

What does the anterior longitudinal L. become?

Answer 25

Anterior atlantooccipital membrane

Question 26

What does the posterior longitudinal L. become?

Answer 26

Tectorial membrane

Question 27

What does the ligamentum Flavum become?

Answer 27

Posterior atlantooccipital membrane

Question 28

What does the supraspinous L become?

Answer 28

nuchal ligament