back soft arthyrology Flashcards
what is the anterior longitudinal ligament, where does it run and why is it significant?
ligament that runs longitudinally along the front of vertebral body
Widens as it descends, maintains stability
Limits extension and supports annulus fibrosus
In a “whiplash” injury (hyperextension) the stretching or even tearing of the anterior longitudinal ligament can occur.
what ligament is involved with whiplash? what should you do if that happens?
anterior longitudinal ligament
Importance due to its possible splinting action that should be used when a fracture to the vertebral column is suspected.
Keep patient in hyperextension at all times, the pull of the anterior longitudinal ligament will help realign fragments of bone and keep further injury to the spinal cord from happening
What is the posterior longitudinal ligament, where does it run and why is it significant?
- runs longitudinally along the posterior of the ventral body
- narrows as it descends
- interconnects vertebral bodies and intervertebral disks
- supports annulus fibrosis and vertebral bodies posteriorly
- limits flexion
what is the ligamentum flavum, whats so significant about it?
- lines the anterior portion of the vertebral laminae
- connects laminae of adjacent vertebrae, maintains upright posture
Ligamentum Nuchae, whats so significant about it and what does it do?
- septum between muscles on two sides of posterior aspect of neck
- formed by thickened supraspinous ligaments
- attached to posterior tubercle of atlas and spinous processes of other cervical vertebrae
what are the interspinous ligaments?
travels between adjacent spinous processes
what are the intertransverse ligaments?
not well defined in C-region, fibrous cords in the T- region, thin membranes in the L-region
what is the supraspinous ligament?
travels on the dorsal surface of the vertebral spinous processes, continues as the ligamentum nuchae in the C-region
what is the intervertebral disc, what is its 2 parts?
lies between 2 vertebrae , allows for movement
Annulus fibrosis- tough fibrous outer region, overlapping lamellar of fibrocartilage
Gooey center: nucleus pulposis - soft gelatinous inner portion
where does herniation of the vertebral disc happen and what happens?
Herniation of nucleus pulposus through the annulus fibrosis is a common cause of low back and lower limb pain.
Herniation typically occurs posterolaterally where the annulus fibrosis receives no support from the anterior and posterior longitudinal ligaments.
The result is a bulge and compression of the spinal nerve roots, the cauda equina, and spinal nerve in the vertebral canal and intervertebral foramina, respectively.
Most common at L4/5 and L5/S1 where discs are much larger and more mobile
what is the joint of luschka?
in between uncinate process and superior vertebra
where is the atlantoaxial joint, what does it do?
synovial joint
- between atlas and axis
- involved in rotation of atlas and head
Median part: between anterior facet of dens of axis and articular facet of dens of atlas
Lateral part: planar synovial joint , between superior and inferior articulating process of atlas and axis
what are the ligaments that make up atlantoaxial joint?
Cruciate L
Alar L
Apical L
median part of joint
what is the Uncovertebral joint (of Luschka) ?
Intervertebral joint between inferior vertebra and superior vertebra
what are intervertebral joint?
C3 - S1
Symphysis
S5/Co1
Symphysis
what are
Zygapophyseal
joints?
(planar synovial)
C1-S1
what are the ligamentous structures involved in a whiplash injury?
Hyperextension, excessive stretching, tearing of anterior longitudinal L
what can recoil cause during whiplash?
hyperflexion
what can happen to nerve during vertebral disc hernia?
Nerves increase in size from superior to inferior, but foramina decrease in size=susceptibility of L5 roots to become impinged if herniation occurs
what is the second number rule for the cervical and lumbar regions
Vertebral level where prolapse occurs affects spinal nerve with second number designation
Ex: C5/C6 will affect nerve 6, which exits at C5/C6
what is the second number rule for the lumbar region?
Affects nerve level inferior
Ex: prolapse at L4/L5 affects nerve that exits at L5/S1
where is the lumbosacral joint and related articulations?
L5/S1
Anterior and Posterior Longitudinal L Ligamentum Flavum Interspinous, Intertransverse L Supraspinous L Iliolumbar L Intervertebral disc
the importance of the Anterior Longitudinal L. and it’s role in vertebral fractures
?
Facet jumping, hyperextension followed by hyperflexion causing dislocation of the vertebral arches of cervical spine
Rupture of anterior longitudinal ligament and adj annulus fibrosus of the c2 and c3 iv disc
=separation of cranium, c1, and dens/body of c2 from rest of axial skeleton and spinal cord severely severed
