Back Arthrology Flashcards
Vertebral joints C1/C2 type
C1/C2: compound synovial joint (planar and trochoid)
Intervertebral joints C3-S1 type
C3-S1: Symphysis
S5/Co1 joint type
Symphysis
Zygopophyseal joint
C1-S1: Planar synovial
Anterior longitudinal ligament travels where, and explain its importance in fractures of vertebral column
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)
Hyperextension or whiplash injury
Results in excessive stretching or tearing of anterior longitudinal ligament. Recoil effect can result in a hyperflexion injury as well
Posterior longitudinal ligament
Travels on dorsal/posterior surface of vertebral bodies
Ligamentum flavum
Yellow fibers which travel on the ventral surfaces of vertebral laminae
Intertransverse ligaments- differences b/w cervical/thoracic/lumbar
Not well defined in cervical region, fibrous cords in thoracic region, thin membranes in lumbar region
Supraspinous ligament
Travels on dorsal/posterior surface of spinous processes, continues as ligamentum nuchae in cervical region
Annulus fibrosis of intervertebral discs
Tough fibrous outer region, overlapping lamellae of fibrocartilage
Nucleus pulposus of intervertebral discs
Soft gelatinous inner portion
Herniation
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
Second number rule
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
Atlantooccipital joint- type of joint and components
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)
Median atlantoaxial joint type and location
Trochoid synovial
Between anterior facet of dens of the axis and the articular facet for the dens on the atlas
Cruciate ligament
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.
Which 3 ligaments are part of median atlantoaxial joint
Cruciate ligament
Alar ligament
Apical ligament
Alar ligament
From odontoid process of the axis to the lateral margins of the foramen magnum of the occipital bone
Apical ligament of the dens
Extends from apex of dens to the anterior internal margin of the foramen magnum
Lateral atlantoaxial joint type and location
Planar synovial joint b/w superior and inferior articulating processes of the atlas and axis
Uncoverterbral joint (of Luschka)
Joint b/w the uncinate process of the inferior vertebra and beveled inferior surface of the superior vertebra
Lumbosacral joint type
Compound joint- symphysis and planar synovial
Ligaments of lumbosacral joint include
Anterior/posterior longitudinal Ligamentum flavum Iliolumbar Lumbosacral (notably absent are the interspinous, intertransverse and supraspinous ligaments)
Anterior longitudinal ligament
Travels on ventral surface of the vertebral bodies, onto the ventral surface of sacrum
Posterior longitudinal ligament
Travels on dorsal surface of the vertebral bodies onto anterior wall of sacral canal
Iliolumbar and lumbosacral ligament
Iliolumbar- Travels from L5 transverse process to the iliac crest
Lumbosacral- Travels from L5 transverse process and body to the sacral ala
