IVD Flashcards
ivd constitutes % of entire height of spinal column
25%
how many ivds in spinal column
24
how many ivds in spine
23
the ivd is bigger anterior in what areas
cervical and lumbar spines
what are the components of the ivd
annulus fibrosus
nucleus pulposus
vertebral (cartilage) end plates
the nucleus pulposus is remnant of
notochord
annulus fibrosus made up of # concentric fibrocartilagenous rings/lamellae
12-20
outermost lamella run () degrees from the horizontal plane THE ODD NUMBER
30 degrees
most superficial lamellae attach directly to the vertebral bodies via
epiphyseal rings via sharpey’s fibers
what are the pain fibers
periosteum not sharpeys
annulus fibrosus is predominately what type of collagen
type 1 collagen (what u see in tendons) 50-60%
what is the load bearing structure of the ivd
annulus fibrosus
the nucleus pulposus is slightly () in the lumbar spine
posterior
the nucleus pulposus and annulus fibrosus is thickest in
cervical and lumbar spines
nucleus pulposus contains () collagen
type 2 collagen (seen in articular cartilage) 15-20%
the nucleus pulposus contains
proteoglycans and GAGS (glycoaminoglycans) 65%
what are GAGS
precurosors for proteoglycans, its hydrophilic
nucleus pulposus is % water
70-90%
at age () the water content decreases
50
what age does the sacrum fuse
25
older person jumps and hurts
facet problem
young person jumps and hurts
ivd problem
how many vertebral end plates are there
2 one superior and one inferior
cartilaginous plates cover all but the
peripheral rim of the ivd
the vertebral end plates attach to
the disc and the adjacent vertebral bodies
the vertebral end plates is important for
nutrition of the IVD
the vertebral end plate is very () allowing fluid to enter and exit
porous
is there vascular supply to the annulus fib and nuc pulp
no, avascular necrosis
how do ivds get blood
from arteries coming into vert bodies, blood gets shoved in IMBIBITION
what swell up when you have motion
proteoglycans
what decreases with age
imbibition
what part of annulus fibrosus gets sensory and vasomotor innervation
peripheral outer one third (so technically the 4 if you have 12)
why don’t realize have disc problem
cause u cant feel it unitl it gets out to the lat 1/3
what nerve innervates the posterior aspect of the annulus fibrosus
recurrent meningeal nerve
what nerve innervates the posterolateral annulus fibrosus
ventral primary rami
what innervates the anterior and lateral aspects of the annulus fibrosus
branches of gray communicating rami and sympathetic chain
whats the nerve supply to the nucleus pulposus
non existent
what do you see in xray
schmorl’s nodes
what xray can tell difference between protrusion and excursion
mri
where get ivd pathologies nad why
pll and all not cover posterolateral
cuada equine syndrome
pushes through but still contained by annulus fibrosus and starts pushing on cord
when nuc pulp push out first have () pain and then tweak to avoid () pain and when it hits nerve get () pain
scleretogenous, myetogenous, dermatogenous
protrusions are still
contained
lamens terms for hernia
slipped disc
when nucleus pulposus breaks through and not contained
extrusion/prolapse
what could happen if fragment break off and goes floating
sequestration
bulge
circumferential concentric phenomenon, could be creep normal
protrusion
nucleus pulposus has broken through some of the annulus fibrosis, but nucleus is still contained, encapsulated
extrusion (prolapse)
nucleus pulposus has broken through all the annulas fibrosis. NO LONGER ENCAPSULATED contained
sequestration
broken fragment of the nucleus dislodged in the canal
palliative
when you are consciously moving into a position to relieve the pain
antalgic
not aware that you are not standing properly (lean to left so say antalgic to left)
if protrusion is medial to nerve root to and the pain they lean to side of pain
relieves the pain
if lean opposite to side of pain and protrusion on medial side it would
increase the pain
if have a disc issue at l4 itll affect () nerve
l5
if you lean antalgic to the right and hurts on left and pain goes down lateral aspect of leg past knee to digit 4 and 5
l5 dermatome, l5 nerve so l4 disc hurt, so its ont LATERAL SIDE OF NERVE
if the protrusion is lateral the patient wil
lean away
most problems with disc usually happen in
lumbar
what % of annulus fibrosus is proteglycans
20%
poisson’s ration
when a tensile force is applied to a material that material will respond by deforming in length and compressing in width
