Exam III Flashcards
1
Q
Blood supply to individual vertebra is typically _______.
A
Segmental
2
Q
Once inside the intervertebral foramen, the vertebral artery splits into these three branches:
A
Anterior Branch (Prelaminar) Posterior Branch (Postcentral) Neural branch (neurospinal)
3
Q
What does the anterior branch supply blood to?
A
The posterior aspect of the vertebral bodies, and anterior aspect of the spinal cord and anterior ligaments inside the spinal canal
4
Q
What does the posterior branch supply blood to?
A
The posterior arch, posterior part of the spinal cord and ligaments in the posterior spinal canal
5
Q
What does the neural branch supply blood to?
A
The lateral aspects of the spinal cord, spinal nerve and nerve roots
6
Q
The 3 main arteries that go from the head/neck downward to supply the main portion of the spinal cord:
A
2 Posterior spinal arteries
1 Anterior spinal artery
7
Q
The 2 posterior arteries and 1 anterior spinal artery come off of the _______ arteries just before they unite to form the _______ artery
A
vertebral
basilar
8
Q
The anterior spinal artery comes from both _____ arteries, unites in front of the _____ ____, and runs caudally through the ______ _____ ____ of the cord.
A
vertebral
spinal cord
ventral median fissure
9
Q
A branch off the anterior spinal artery, found between T-9 and T-12
A
Great Radicular Artery of Adamkiewicz
10
Q
What does the great radicular artery of adamkiewicz supply blood to?
A
The inferior thoracic vertebrae, superior lumbar vertebrae, lumbarsacral enlargement of the spinal cord
11
Q
Anterior spinal artery also supplies blood to:
A
The lumbar segmental arteries, lateral sacral artery, and blood of the sacrum and coccyx
12
Q
The posterior spinal artery arises from the ______ ____, adjacent to the ______ ______. It supplies the ______ and ______ posterior columns of the spinal cord.
A
vertebral artery
medulla oblongata
grey
white
13
Q
The two major venous plexus (group of veins) that leave the vertebra:
A
Internal venous plexus
External venous plexus
14
Q
Where is the internal venous plexus located?
A
The inside of the spinal canal
15
Q
Where is the external venous plexus located?
A
Outside the vertebral column
16
Q
The internal venous plexua is also called the (2 different names)
A
Epidural venous plexus or the Batson’s Plexus
17
Q
Both the internal and external venous plexus have an _____ and a _______ part
A
anterior
posterior
18
Q
Vein inside the vertebral body. Part of the anterior internal venous plexus
A
Basivertebral Vein
19
Q
The opening in the basivertebral vein inside the vertebral body is called:
A
Hanh’s venous Cleft
20
Q
3 Classes/types of joints within the spinal column
A
Fibrous
Cartilaginous
Synovial
21
Q
Type of joint where 2 bones are connected by connective tissue of hyaline cartilage, with a lack of motion
A
Fibrous joints
22
Q
Type of joint formed when 2 bony surfaces are united by cartilage or a disc. Many SLIGHT motions
A
Cartilaginous joint
23
Q
Type of joint with an articular surface covered with articular cartilage, and connected by ligaments lined by a synovial membrane.
A
Synovial
24
Q
What type of joint is most common in the spine and body?
A
Synovial joints
25
Subclassification of the fibrous joints in the spine is called the ________ ______. Formed when 2 bones are united by an ___________ _______.
Sydesmodial joint
| Interosseous ligaments
26
2 subclassifications of cartilaginous joints
Synchondrosis
| Symphysis
27
Subclassification of cartilaginous joints. A temporary joint where the cartilage later changes into bone itself (Ex- epiphisial plates)
Synchondrosis
28
Subclassification of cartilaginous joints: 1 bony surfaces connected by a disc or fibrocartilage. (Ex- Pubic symphasis)
Symphysis
29
3 subclassifications of synovial joints
Trochoid/Pivot Joints
Condyloid Joints
Arthrodial/Gliding/Articulatio Plana joints
30
Subclassification synovial joint. Allows for gliding motion. (Ex- facet joints)
Arthrodial/Gliding/articulatio plana joints
31
Subclassification of synovial joint. Allows for rotation. Uniaxial motion. (Ex- C1-C2)
Trochoid/Pivot joints
32
Subclassification of synovial joints. Allows for flextion and extension. All motions except for axial rotation (Ex- C1-Occiput)
Condyloid joints
33
Common articulations between C-2 and S-1, between the vertebral bodies
Cartilaginous symphysis
34
Common articulations between C-2 and S-1, between zagapophyseal joints
Synovial arthrodial, gliding, articulation plan
35
Atlanto-occipital articulations
Synovial——-condyloid
36
Articulations of atlanto-axial
Synovial——arthrodial
| Synovial——trochoid
37
Intersacral articulations
Cartilaginous—synchondrosis
38
Sacro-coccygeal articulations
Cartilaginous symphysis (fibrocartilage)
Fibrous—-syndesmodial
39
Intercoccygeal articulations
Cartilaginous—-synchondrosis
40
Common cardinal ligaments of the spine have ____ blood supply, and _____ stretch
Some
Prevent
41
Group 1 of the common cardinal ligaments attach to:
The vertebral bodies
42
Group 2 of the common cardinal ligaments attach to:
The spinous processes
43
Group 3 of the common cardinal ligaments attach to:
Lamina, articulations processes, and transverse processes
44
Common/cardinal ligaments changes name at ____ to _______ ______ _______
C2
Anterior longitudinal ligament (ALL)
45
Anterior longitudinal ligament covers the _____ surface of vertebral _____ and ______ from ____ to _____. The attachment is _____(weak/strong)
Anterior
Bodies and
Disc
C-2 to
Sacrum
Strong
46
3 layers of anterior longitudinal ligament:
Deep, middle, and superficial
47
Where is the anterior Longitudinal ligament most narrow? Widest?
Most narrow in cervical, widest in lumbar
48
What this the function of the anterior longitudinal ligament?
To limit extension of the spine.
49
The anterior longitudinal ligament attaches to each vertebral body _____ and ______ at the levels of the ____ ____
Superiorly and inferiorly
End plates
50
What is the anterior longitudinal ligament continuous with?
Anterior Atlanto-occipital membrane
51
Ligament working opposite to anterior longitudinal ligament
Posterior longitudinal ligament (PLL)
52
Posterior longitudinal ligament is the most ______ (anterior/posterior) ligament in the spinal canal.
Anterior
53
Where is the posterior longitudinal ligament widest? Most narrow?
Widest in cervical and over discs,
| Most narrow in lumbar and over vertebral bodies
54
Posterior longitudinal ligament is ______ attached to the center of vertebral bodies. This is due to the ______ ____.
Loosely
Basivertebral vein
55
What is the function of the posterior longitudinal ligament?
Limits flexion of the vertebral bodies.
56
The anterior and posterior longitudinal ligaments are also called the _________ ligaments
Intercentral ligaments
57
Between ALL and PLL, which ligament is weaker?
PLL
58
What is the PLL continuous to?
Tectoral membrane (inferior)
59
Why are the intervertebral discs called ligaments?
They separate vertebral bodies and hold the bodies together.
60
How many total discs?
23- none between occiput and C-1 or C-1-2
61
What ligament is continuous from the tip of the spinous process of C-7 though S-1? Has 3 layers
Supraspinous ligament
62
What ligament is formed by the superior extension of the supraspinous and interspinous ligaments? Attaches to SP of all cervical vertebrae. Broad, triangular in shape
Ligamentum nuchae
63
The supraspinous ligament is a very _______ (weak/strong) band connecting the tips of contiguous spinous processes.
Weak
64
Where does the ligamentum nuchae run?
between occiput and C7 SP
65
Combination of the supraspinous and interspinous ligaments come together in the _______ spine.
Cervical
66
A series of ligaments that run between the SP of each motor unit. From C2/3 to L5/S1. Poorly developed in cervical spine
Interspinous Ligament (ISL)
67
Where does the ISL attach to? Anteriorly and posteriorly
Anteriorly to ligamentum flavum
| Posterior to supraspinous ligament
68
The ISL connects:
Spinous processes of adjacent vertebrae
69
In the cervical spine, the ISL becomes part of the _______ _____.
Ligamentum nuchae
70
Where does the supraspinous ligament run?
Between the tips of the adjacent spines
71
Which ligament runs between adjacent TVP?
Intertransverse
72
Which ligament connects the lamina of adjacent vertebrae? Extends to the facet joint capsule.
Ligamentum Flavum
73
Which ligament covers the posterior lateral part of the Z-Joints?
Articular capsule/capsular ligament
74
What are 3 basic parts of the articular capsule?
Basic, middle and inner
75
Which layer of the articular capsule has synovial fluid with Haluronic acid?
Inner layer
76
Which layer of the articular capsule is rich in nerve supply, low in blood supply?
Outer layer
77
Which layer of the articular capsule is highly vascularized with no nerves?
Middle layer
78
The articular capsule is stressed the most in _______.
Rotation
79
What type of joints are the Z joints?
Gliding
80
The ligamentum flava forms the ______ boundary of the IVF. Is highly ______. Helps restrict _______. Is thicker in the _____ region
Posterior
Elastic
Hyper flexion
Lumbar
81
What is the ligamentum flavum continuous with?
Posterior Atlanta-occipital membrane
82
The ligamentum flavum supports the anterior aspect of the _______ _____.
Z- joint
83
When is the intertransverse ligament stressed the most?
In contralateral bending or lateral flexion .
84
Narrowing of disc space results in:
Stress on facet joint
85
6 Ligaments of the Atlanto-occipital articulation
2 articular capsules
1 anterior atlant-occipital ligament
1 posterior Atlanto-occipital ligament
2 Lateral Atlano-occipital ligaments
86
3 synovial joints of the Atlanto-axial articulation
2 lateral Atlanto-axial joints
1 Median Atlanto-axial joint
87
How many total ligaments in the Atlanto-axial articulation?
7
88
50% of rotation comes from:
Atlantoaxial joint
89
7 ligaments of atlantoaxial articulations
***TEST Q*****
2 articular capsules
2 accessory ligaments
1 anterior atlantoaxial ligament
1 posterior atlantoaxial ligament
1 transverse ligament of the atlas
90
6 ligaments of the occipital axial complex
1 membrane tectoria
2 alar ligaments
1 apical ligament
1 crucial ligament
1 ligamentum nuchae
91
Superior extension of posterior longitudinal ligament
Membrana tectoria, AKA Tectorial Membrane, occipito-axial ligament
92
Where does the membrana tectoria attach?
from the posterior aspect of body of C-2 to anterior rim of foramen magnum of occiput
93
Function of the membrana tectoria
Holds other ligaments in. Limits flexion and extension of the atlas on the occiput .
94
Where are the alar ligaments (AKA Check Ligaments, or Odontoid ligaments) located?
Extend from posterior lateral aspect of the odontoid process to the medial surface of occipital condyles.
95
What is the function of the Alar Ligaments?
Limits or checks contralateral axial roration and flexion whiplash)
96
Damage of the Alar Ligaments will allow for _____ rotation and _____ flexion of __________ ______
increased
lateral
atlanto-occipital articulation
97
What type of injuries are primarily responsible for chronic whiplash symptoms, especially post-traumatic headaches
Injured Alar Ligaments.
98
Upper cervical ligaments:
Occipitoaxial ligament
Apical ligament
Alar ligaments
99
1 inch long V shaped ligament. Extends from anterior wall of foramen magnum, where it is the widest, to the superior terminal aspect of dens of C-2. Remnant of the embryonic notochord
Apical ligament
100
Apical ligament's tit
**TEST QUESTION**
20 degrees anterior
101
Ligament attached to the transverse ligament. Function is to hold transverse ligament in place
Cruciate ligaments
102
2 parts of the cruciate ligament
1- Superior crus
| 2- Inferior crus
103
Crus anterior tip of foramen magnum
Superior crus
104
Crus posterior aspect of C2 body
Inferior crus
105
Ligaments attached to the lumbo-sacral articulation
Lumbosacral ligament
| Iliolumbar ligament
106
Lumbosacral articulations are the same as the thoracic and lumbar ligaments, except there is no _______ _____
Intertransverse ligament
107
Ligament from TVP L-5 to sacral Alae and promontory
Lumbosacral ligament
108
Ligament from TVP L5 to crest of ilium anterior to sacro-iliac joint.
Iliolumbar ligament
109
6 ligaments of intersacral articulations
4 Fibrocartilages
1 Anterior intersacral ligament
1 Posterior Intersacral Ligament
110
Ligament present between segments until segments fuse and it ossifies
Fibrocartilage ligaments
111
Ligament analogous to ALL. Present till segments fuse then ossify
Anterior intersacral ligament
112
Ligament analogous to PLL. Present till segments fuse then ossify
Posterior intersacral ligament
113
8 Ligaments of the sacro-coccygeal articulation
1- Intervertebral fibrocartilage
1- Anterior sacrococcygeal ligament
1- Deep posterior sacrococcygeal ligament
1- Superficial posterior sacrococcygeal ligament
2- Lateral sacrococcygeal ligaments
2- Intercornual ligaments
114
Ligament that is a thin fibrous extension of ALL
Anterior sacrococcygeal ligament
115
Ligament extension of PLL. From sacral hiatus to 1st coccygeal
Deep posterior sacrococcygeal ligament
116
Ligament on top of sacral hiatus. Forms roof over top. Longer than deep posterior sacococcygeal ligament
Superficial posterior sacrococcygeal ligament
117
Ligaments from inferior angle of sacrum to coccygeal alae. Analogous to intertransverse
Lateral Sacrococcygeal ligaments
118
Ligaments from sacral coruna to coccygeal cornua. Analogous to articular capsules
Intercornual ligaments
119
5 intercoccygeal ligaments
3 intersegmental fibrocartilages
1 anterior coccygeal ligament
1 posterior coccygeal ligament
120
4 cartilaginous synchondrodial joints.
Intersegmental fibrocartilages
121
Fibrocartilage present in coccyx ossify around age:
25-30
122
Fibrous extension of ALL, then ossifies
Anterior coccygeal ligament
123
Fibrous extension of PLL then ossifies
Posterior coccygeal ligament.
124
7 Ligaments of the sacro-iliac joint
```
1 articular capsule
1 anterior sacroiliac ligament
1 interosseous sacroiliac ligament
1 short posterior sacroiliac ligament
1 long posterior sacroiliac ligament
1 sacrotuberous ligament
1 sacrospinous ligament
```
125
Ligament from the anterior surface of sacrum (S2,3,4) to spine of ischium:
Sacrospinous ligament
126
What is whiplash?
Both a torn ligament (sprain) and torn muscle (strain)
127
Women are 40% _____ likely to be injured from a car crash, likely due to their _____ ____.
More
Smaller size
128
Men’s injuries are likely to be _____ severe
More
129
Tolerance to impact DECREASES over the age of:
40
130
The most common source of chronic neck pain after whiplash is the:
Cervical facet joint
131
How soon can symptoms of whiplash occur?
Immediately after the accident, within 12-24 hours, a few days, a few weeks, or even a few months
132
Whiplash victims are 10x more likely to develop ______
Spondylosis (osteoarthritis)
133
Signs and symptoms associated with slower recovery rate after whiplash
Neck pain upon palpation
Pain or numbness radiating from neck to arms
Headaches
134
Symptoms of whiplash, not including pain
Visual disturbances, dizziness, weakness, fatigue, poor concentration, difficulty sleeping, poor memory and depression
135
Type of pain: Deep, burning, gnawing, strapping or dull pain
Nerve pain
136
Type of pain: cramping or pulling pain, dulll achy, superficial
Muscle pain
137
Type of pain: sharp, deep boring
Fracture (bone) joint pain
138
Type of pain: throbbing
Vascular (pain when heart beats)
139
Type of pain: Stabbing, lighting like or shooting pain
Nerve root pain
140
4 phases of healing
1- Acute inflammatory phase
2- Tissue repair phase
3- rehabilitative/remodeling phase
4- maintenance/wellness phase
141
How long does acute inflammatory phase last?
48-72 hours
142
How long does the tissue repair phase last?
Lasts from 48 hours -12 weeks
143
How long does rehabilitative/remodeeling phase last?
Up to 1 year
144
How long does maintenance/wellness phase last?
A lifetime
145
Signs/symptoms of acute phase
Pain, swelling, head, redness, loss of function
146
There are ___ discs. __ cervical , ___ thoracic, ___ lumbar
23,
6 cervical
12 thoracic
5 lumber
147
IVD (intervertebral disc) is attached to:
```
Vertebral bodies
ALL
PLL
Intra-articular
Ligaments
Ribs 2-9
```
148
Function of the disc is to maintain the ____ ___ between vertebrae, aids in ______ of the spine, and acts to properly ______ ______ _____.
Changeable space
Flexibility
Assimilate compressive loads
