Back Arthrology

Question 1

Vertebral joints C1/C2 type

Answer 1

C1/C2: compound synovial joint (planar and trochoid)

Question 2

Intervertebral joints C3-S1 type

Answer 2

C3-S1: Symphysis

Question 3

S5/Co1 joint type

Answer 3

Symphysis

Question 4

Zygopophyseal joint

Answer 4

C1-S1: Planar synovial

Question 5

Anterior longitudinal ligament travels where, and explain its importance in fractures of vertebral column

Answer 5

Travels on anterior surface of vertebral bodies
If vertebral column fracture is expected, patient should be kept in hyperextension at all times. The pull of the anterior longitudinal L. will help realign fragments of bone and keep further injury from occurring (does not apply to cervical fractures due to hyperextension)

Question 6

Hyperextension or whiplash injury

Answer 6

Results in excessive stretching or tearing of anterior longitudinal ligament. Recoil effect can result in a hyperflexion injury as well

Question 7

Posterior longitudinal ligament

Answer 7

Travels on dorsal/posterior surface of vertebral bodies

Question 8

Ligamentum flavum

Answer 8

Yellow fibers which travel on the ventral surfaces of vertebral laminae

Question 9

Intertransverse ligaments- differences b/w cervical/thoracic/lumbar

Answer 9

Not well defined in cervical region, fibrous cords in thoracic region, thin membranes in lumbar region

Question 10

Supraspinous ligament

Answer 10

Travels on dorsal/posterior surface of spinous processes, continues as ligamentum nuchae in cervical region

Question 11

Annulus fibrosis of intervertebral discs

Answer 11

Tough fibrous outer region, overlapping lamellae of fibrocartilage

Question 12

Nucleus pulposus of intervertebral discs

Answer 12

Soft gelatinous inner portion

Question 13

Herniation

Answer 13

Herniation of the nucleus pulposus through the annulus fibrosis.
Typically occurs posterolaterally where the annulus fibrosis receives no support from anterior/posterior longitudinal ligaments.
The resultant bulge compresses spinal nerve roots, cauda equina and spinal nerves in the vertebral canal and intervertebral foramina, respectively.
Most common at L4/5 and L5/S1, where discs are larger and more mobile

Question 14

Second number rule

Answer 14

For 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/herniation at C5/6 will affect spinal nerve 6 because of the numbering system of cervical nerves (C1 nerve comes out above C1, C2 comes out below C1)
Ex. L4/5 prolapse will affect nerve 5, because lumbar spinal nerves exit the vertebral canal superior to the intervertebral disc

Question 15

Atlantooccipital joint- type of joint and components

Answer 15

Condyloid synovial joint b/w atlas and basilar occipital bone
Anterior atlantooccipital membrane (from ant. arch of atlas to basilar occipital bone)
Tectorial membrane (from posterior surface of body of axis to anterior internal margin of foramen magnum of occipital bone)
Posterior atlantooccipital membrane (from anterior surface of posterior arch of atlas to posterior internal margin of foramen magnum of occipital bone)

Question 16

Median atlantoaxial joint type and location

Answer 16

Trochoid synovial

Between anterior facet of dens of the axis and the articular facet for the dens on the atlas

Question 17

Cruciate ligament

Answer 17

Part of median atlantoaxial joint
Superior longitudinal band-from occipital bone to transverse ligament
Transverse ligament-around odontoid process, from tubercle of transverse L. to contralateral tubercle of transverse L.
Inferior longitudinal band-from C2 to transverse L.

Question 18

Which 3 ligaments are part of median atlantoaxial joint

Answer 18

Cruciate ligament
Alar ligament
Apical ligament

Question 19

Alar ligament

Answer 19

From odontoid process of the axis to the lateral margins of the foramen magnum of the occipital bone

Question 20

Apical ligament of the dens

Answer 20

Extends from apex of dens to the anterior internal margin of the foramen magnum

Question 21

Lateral atlantoaxial joint type and location

Answer 21

Planar synovial joint b/w superior and inferior articulating processes of the atlas and axis

Question 22

Uncoverterbral joint (of Luschka)

Answer 22

Joint b/w the uncinate process of the inferior vertebra and beveled inferior surface of the superior vertebra

Question 23

Lumbosacral joint type

Answer 23

Compound joint- symphysis and planar synovial

Question 24

Ligaments of lumbosacral joint include

Answer 24

Anterior/posterior longitudinal
Ligamentum flavum
Iliolumbar 
Lumbosacral
(notably absent are the interspinous, intertransverse and supraspinous ligaments)

Question 25

Anterior longitudinal ligament

Answer 25

Travels on ventral surface of the vertebral bodies, onto the ventral surface of sacrum

Question 26

Posterior longitudinal ligament

Answer 26

Travels on dorsal surface of the vertebral bodies onto anterior wall of sacral canal

Question 27

Iliolumbar and lumbosacral ligament

Answer 27

Iliolumbar- Travels from L5 transverse process to the iliac crest
Lumbosacral- Travels from L5 transverse process and body to the sacral ala