Back & Vertebral Column - Joints and Ligaments

Question 1

structure of the anterior longitudinal ligament?

Answer 1

strong, wide, but a thin and flat sheet

Question 2

location of the anterior longitudinal ligament?

Answer 2

from base of occipital bone to sacrum

Question 3

structure of the posterior longitudinal ligament?

Answer 3

narrow and thin - extends laterally at IVDs

Question 4

location of the posterior longitudinal ligament?

Answer 4

along posterior aspect of vertebral bodies form C2 to sacrum

Question 5

why is the ligamentum flavum yellow?

Answer 5

small & composed of 80% elastin and 20% collagen - high elastin content gives it a yellow colour

connect lamina of adjacent vertebrae

Question 6

structure & location of the interspinous ligaments?

Answer 6

thin and weak

between adjacent spinous processes

Question 7

structure & location of the supraspinous ligaments?

Answer 7

strong fibrous cord - tougher and thicker than interspinous ligaments

runs through posterior tips of spinous processes from C7-sacrum

Question 8

why does the supraspinous ligament only run from C7 downwards?

Answer 8

nuchal ligament is above - attaches to the occipital bone and continues until C7

Question 9

structure & location of the intertransverse ligaments?

Answer 9

thin ligaments - connect adjacent transverse processes

Question 10

function of anterior longitudinal ligament

Answer 10

prevents hyperextension - increases tension as spine extends
joins anterior vertebral bodies & IVDs

Question 11

function of posterior longitudinal ligament

Answer 11

prevents hyperflexion & posterior disc prolapses

Question 12

functions of ligamentum flavum (3)

Answer 12

1. prevents hyperflexion
2. accommodates flexing movements (due to elastic nature)
3. forms posterior wall of vertebral canal & protects spinal cord

Question 13

function of interspinous ligaments

Answer 13

stabilising structure for adjacent spinous processes (less helpful with preventing hyperflexion)

Question 14

functions of supraspinous ligaments (2)

Answer 14

prevents hyperflexion
supports posterior aspect of VC

Question 15

function of intertransverse ligaments

Answer 15

limits lateral flexion - i.e. left IT ligament prevents excessive right side lateral flexion

Question 16

list the cruciform ligaments

Answer 16

transverse ligament of atlas
superior & inferior longitudinal bands (2)
alar ligaments (2)

Question 17

what ligament is a superior continuation of the supraspinous ligament?

Answer 17

nuchal ligament

Question 18

location of nuchal ligament - superior & inferior attachments?

Answer 18

superior attachment to external occipital protuberance of the occipital bone

inferior attachments of spinous processes of C1-7

Question 19

location of transverse ligament of atlas - attachments?

Answer 19

lateral masses of C1 to posterior aspect of dens on C2

Question 20

describe the attachments/ locations of the superior & inferior longitudinal bands

Answer 20

superior & inferior bands originate from the transverse ligament

superior band = from transverse ligament to occipital bone

inferior band = from transverse ligament to inferior C2 body

Question 21

describe the attachments/ locations of the alar ligaments

Answer 21

either side of dens - extend superolaterally to occipital bone

Question 22

function of the ligamentum nuchae?

Answer 22

prevents neck hyperflexion - tension increases as the head bends forwards

Question 23

function of the transverse ligament of atlas?

Answer 23

prevents posterior displacement of dens into spinal canal - could otherwise damage the spinal cord

Question 24

function of the superior & inferior longitudinal bands?

Answer 24

works with transverse ligament to stabilise dens

Question 25

functions of the alar ligaments? (2)

Answer 25

prevents posterior displacement & stabilises dens
prevents excessive rotation of the cervical spine

Question 26

what cervical spine ligaments prevent posterior displacement & help stabilise the dens (3)

Answer 26

transverse ligament of atlas
superior & inferior longitudinal bands
alar ligaments

Question 27

what vertebral column ligaments prevent hyperflexion? (4)

Answer 27

1. posterior longitudinal ligament
2. ligamentum flavum
3. supraspinous ligaments
4. intertransverse ligaments - prevent contralateral flexion

Question 28

the intervertebral joint consists of two main components that connect vertebrae & allow for movement. what are they?

Answer 28

1. zygapophyseal joints
2. intervertebral discs

Question 29

zygapophyseal joints - articulations? what type of joint are they?

Answer 29

articulation between inferior articular facet of vertebra below & superior articular facet of vertebra below

synovial plane type - allows for gliding movements between vertebrae

Question 30

how do the properties of the joint capsules that surround zygapophyseal joint differ from cervical, thoracic and lumbar regions?

Answer 30

cervical - thinner & looser joint capsules = more flexibility and movement

thoracic - joints are more vertical to limit excessive movement

lumbar - thicker and tighter joint capsule, more horizontal joints, restricts excessive movement

Question 31

why do the thoracic region of zygapophyseal joints try and limit movement?

Answer 31

limit movement with more vertically orientated joints due to articulation with the ribs

Question 32

what type of joint is the intervertebral joint?

Answer 32

secondary cartilaginous/ symphyses - fibrocartilaginous joint

Question 33

what do intervertebral discs do as part of the intervertebral joint?

Answer 33

unite vertebral bodies of adjacent vertebrae

Question 34

describe the structure of the intervertebral disc

Answer 34

outer anulus fibrosus layer - tough fibrocartilaginous layer of concentric rings

consists of:
- outer zone = dense, more fibrous
- inner zone = transition zone with the characteristics of the nucleus pulposus & anulus fibrosus (less dense & concentric rings than AF, high water content and proteoglycans like NP)

inner nucleus pulposus layer - soft, gelatinous, hydrated

Question 35

functions of the inner nucleus pulposus of IVD?

Answer 35

1. shock absorption - reduces stress on the spine
2. load distribution - distributes mechanical load across VC, prevents fractures and stress peaks
3. small movements possible at each vertebral level translate into large movements & flexibility across spinal cord

Question 36

what are the two layers of the intervertebral disc?

Answer 36

outer annulus fibrosus
inner nucleus pulposus

Question 37

what factors affect the movements possible at different vertebral regions?

Answer 37

1. facet joint articulation
2. rib articulations - thoracic vertebrae have limited movement
3. ligaments & joint capsule properties
4. soft tissue resistance - muscle, skin, fat prevent movement

Question 38

which vertebral region isn’t capable of flexion and extension? why?

Answer 38

thoracic vertebrae - due to rib articulation

Question 39

which vertebral region isn’t capable of rotation? why?

Answer 39

lumbar vertebrae - 90 degree posterior orientation of superior articular facets prevent this, cause interlocking