Joints And Ligaments Unit Three Exam Flashcards
Arthrology is
Study of joints
Arthr means what
Joint
Itis means
Inflammation
Osis means
Pathological condition of
What are the three classes or types of joints within the spinal column
Fibrous, cartilaginous and synovial
What is the movement of a fibrous joint
Immovable
What is a fibrous joint
2 bones connected by a connective tissue or hyaline cartilage and a lack of motion
Synarthrosis is similar to
Fibrous joint
Movement of cartilaginous joints
Slightly movable
Cartilaginous joint AKA
Amphiarthrosis
What are cartilaginous joints
Formed when two bony surfaces are united by a cartilage or a disc
Movement of synovial joints
Freely movable
Aka of synovial joints
Diarthrosis
What are synovial joints
Articular surface covered with articular cartilage and connected by ligaments lined by a synovial membrane
What are the most typical joints in the spine and body
Synovial
What is the subclassification of the fibrous joint in the spine
Syndesmodial joint
What is a syndesmoidal joint
Formed when two bones are united by an interosseousligament
What are the two subclassifications of a cartilaginous joint
Synchondrosis and symphysis
What is a synchondrosis joint
A temporary joint where the cartilage later changes into bone itself
What is a symphysis joint
Two bony surfaces connected by a disc or fibrocartilage
What are the three subclassifications of a synovial joint
Trochoid, condyloid and arthrodial joint
Aka of trochoid joint
Pivot joint
What is a trochoid joint
Allows for rotation in one plane of motion
What is a condyloid joint
Allows for flexion and extension
AKA of arthrodial joint
Gliding, articulatio plana joint
What is an arthrodial joint
Allows for gliding motion
The Atlanto-occipital joint is what type of joint
Synovial, condyloid
The atlanto-axial joint is what type of joint
Synovial arthrodial and synovial trochoid
What type of joint is between the vertebral bodies C2 and S1
Cartilaginous symphysis
What type of joint is between zagapophyseal joints between C2 and S1
Synovial arthrodial, gliding, articulation plan
What type of joint is at the intersacral articulations
Cartilaginous synchondrosis (temporary)
What type of joint is at the sacro-coccygeal articulations
Cartilaginous symphysis (fibrocartilage) and fibrous syndesmodial (united by interosseous ligaments)
What type of joint is at intercoccygeal articulations
Cartilaginous synchondrosis
Common (cardinal) ligaments of the spine are grouped into how many groups
Three
Group one of the common (cardinal) ligaments of the spine are
Ligaments attached to the vertebral bodies
Group 2 of the common cardinal ligaments of the spine are
Ligaments attached to the spinous processes
Group three of the common cardinal ligaments of the spine
Ligaments attached to the lamina, articular process, transverse process
Where is the anterior longitudinal ligament
Covers anterior surface of the vertebral bodies and disc fro C2 to sacrum
Anterior longitudinal ligament is broader over
Vertebral bodies than disc
The anterior longitudinal ligament has three layers called
Deep, middle and superficial
Where is the most narrow and most wide on the anterior longitudinal ligament
Most narrow in C spine and widest in L spine
Function of anterior longitudinal ligament
Limit extension of the spine
Where do the fibers of the anterior longitudinal ligament fibers adhere to
Annulus fibrosus
How does the anterior longitudinal ligament attach to the vertebral body
Superiorly and inferiorly at the levels of the end plate
The anterior longitudinal ligament is continuous with what
Anterior atlanto-occipital membrane
The anterior longitudinal ligament superficial fibers span where
Several segments
Anterior longitudinal ligament deep fibers span
One segment
The posterior longitudinal ligament is where
Posterior aspect of body of C2 to sacrum
What is the most anterior ligament in spinal canal
Posterior longitudinal ligament
Where is the PLL the widest and narrow
Widest c spine and narrow L spine
How many layers in PLL
Three
PLL is widest where and narrow on the vertebral body and disc
Narrow over vertebral body and wide over disc
Describe appearance of PLL
Arm like projection, fan shaped, star shaped
Why is PLL loosely attached to center of vertebral bodies
Basivertebral vein
Function of PLL
Limits flexion of vertebral bodies
ALL and PLL are called what type of ligaments
Intercentral
Which is weaker ALL or PLL
PLL
How do the fibers look at the Disc of PLL
Fibers extend laterally which help contain herniated disc material
How is PLL attached to vertebra
Superior and inferior margins and to the annular fibers of the intervertebral disc
PLL is an INFERIOR continuation of
Tectorial membrane
How do the PLL superficial fibers span
Several segments
If PLL ossified, where does this occur
C region
Why is the intervertebral disc called a ligament
Separate vertebral bodies and hold vertebrae bodies together
The intervertebral disc extend between
C2/3 through L5/S1
How many total intervertebral disc
23
Where are there no intervertebral disc
Between occiput and C1 or C1/C2
Intervertebral disc is named or numbered according to
Vertebra that sits on top of them
The supraspinous ligament is one continuous ligament from
The tip of the spinous process of C7 through S1
How many layers does the supraspinous ligament have
Three
Ligamentum nuchae AKA
Nuchal ligament
The ligament nuchae is formed by
The superior extension of the supraspinous and interspinous ligaments
The ligamentum nuchae extends from
EOP and superior nuchal line of Occiput to tip of SP of C7
What does the ligamentum nuchae look like
Broad, triangular in shape
The ligamentum nuchae attaches to SP of what part of spine
All Cervical vertebrae
The interspinous ligament is a series of ligaments that run between
The SP of each motor unit from C2/3 to L5/S1
Where is the interspinous ligament poorly developed
C spine
The interspinous ligament anteriorly attaches to
Ligamentum flavum
Interspinous ligament posteriorly attaches to
Supraspinous ligament
The interspinous ligament connects each
Adjacent spinous process
In the C spine the interspinous ligament becomes part of the
Ligamentum nuchae that extends cranial to insert into occiput
The supraspinous ligament is an inferior continuation of
The nuchal ligament
The intertransverse ligaments run between
Adjacent transverse processes
The ligamentum flavum ligaments connect what
The laminae of adjacent vertebrae
The cervical region ligaments supraspinous and interspinous ligaments greatly thicken to form
The strong ligamentum nuchae
A articular capsule is what type of ligament
Capsular ligament
The articular capsule covers
The posterior lateral part of the Z joints
What are the three basic parts of the articular capsule
The outer, middle and inner layer
The outer layer of the articular capsule is made of
Dense fibroelastic CT and made up of collagen fibers that is rich in nerve supply but poor in blood supply
Since the outer layer of the articular layer is poor in blood supply how is the healing
Slow healing and a lot of pain due to increased nerve supply
The middle layer of the articular capsule consists of
Adipose tissue that is highly vascularized but no nerves
The inner layer of the articular capsule consists of
Synovial membrane and has synovial fluid (synovium) with haluronic acid
The articular capsule is stressed the most in what motion
Rotation
Facet joints also called
Zagapophyseal joints
How are facet joints formed
Articular processes of adjacent vertebrae with inferior articular process articulates with superior articular processes below
Facet joints are what type of joint
Synovial gliding
Ligamentum flavum is what color
Yellow
Where is the ligamentum flavum
From inside lamina above to posterior outside lamina below and extends from C2 to S1
Where is ligamentum flavum thickest and thinnest
Thinnest in C spine and thickest in lumbar
How does the ligamentum flavum cover the z joints
In front, on the anterior and medial side of the joints
What is the most posterior ligament in the spinal canal
Ligamentum flavum
The ligamentum flavum is made up of
80% elastic fibers and 20% collagen
Function of elastic fibers in ligamentum flavum
Prevent it from folding up on itself in spinal canal
What forms the posterior boundary of the IVF
Ligamentum flavum
Ligamentum flavum helps to restrict what
Hyper flexion
How are the elastic fibers oriented in the ligamentum flavum
Oriented vertically and extend from the anterior inferior surface of the lamina above to the superior posterior surface of the lamina below
The ligamentum flavum is continuous with
Posterior Atlanto-occipital membrane
Ligamentum flavum supports the anterior aspect of what joint
Z joint
Intertransverse ligament connects what
Adjacent TVPs
Where is the intertransverse ligament not well defined
In C spine
The intertransverse ligament may connect posterior to
Articular capsules or anterior to vertebral bodies
What is now believed to be an anterior portion of the intertransverse ligament
Transforaminal ligament
The intertransverse ligament is stressed the most in
Contralateral lateral bending or lateral flexion
What results in stress on facet joint
Narrowing of disc space
Facet joints have the most stress in what motion
Rotation
Facet joints have the highest pressure combined with
Extension with compression
What are the six ligaments of the Atlanto-occipital articulation
2 articular capsules, anterior Atlanto-occipital ligament, posterior atlanto-occipital ligament, 2 lateral atlanto-occipital ligaments
What is the articular capsules of the C1 and occiput
Surrounds the articulation of the condyles and superior articular facet of lateral mass of c1
Anterior atlanto-occipital ligament also known as
Membrane due to broad size
The anterior atlanto-occipital ligament is analogous to
Anterior longitudinal ligament
Aka of posterior atlanto-occipital ligament
Posterior oblique ligament
When posterior atlanto-occipital ligament calcifies it is called what
Ponticus posticus
Posterior atlanto-occipital ligament is analogous to
Ligamentum flavum
The lateral atlanto-occipital ligaments extend from
Jugular process of occiput to lateral mass and TVP of atlas
Lateral atlanto-occipital ligaments reinforces what
The articular capsule laterally
How many total ligaments of the atlanto-axial articulation
7
What are the three synovial joints in the atlanto-axial articulation
2 lateral atlanto-axial joints and 1 median atlanto-axial joint
The 2 lateral atlanto-axial joints are
Articular capsules
Where is the median atlanto-axial joint
Between the dens and fovea dentalis
Describe the median atlanto-axial joint
Weak, loose synovial joint
What is the posterior synovial joint that is larger and is between the transverse ligament of the atlas
Bursa and is considered 1 joint with 2 synovial capsules
What is the plane of ROM of the atlantoaxial joint
In the transverse plane of motion
Dens of C2 acts as what for the rotation of C1
Pivot joint
The articulating surfaces of C1 and C2 form the zygapophyseal joints and allow for
Flexion/extension, side bending, and rational movements
What are the 7 ligaments of C1/C2 articulation
2 articular capsules, 2 accessory ligaments, 1 anterior atlantoaxial ligament, 1 posterior atlantoaxial ligament, 1 transverse ligament of the atlas
Where are the 2 accessory ligaments of the atlantoaxial articulation
Posterior medial aspect of body of C2 just below the dens to the medial aspect of the lateral masses of the atlas
Where is the anterior atlantoaxial ligament
From anterior to inferior aspect of anterior arch of the atlas to anterior aspect of the vertebral body of axis
The anterior atlantoaxial ligament is analogous to
The anterior longitudinal ligament
Where is the posterior atlantoaxial ligament
From inferior aspect of posterior arch of C1 to posterior superior aspect of laminae of C2
The posterior atlantoaxial ligament is analogous to
Ligamentum flavum
Where is the transverse ligament
From one median tubercle of lateral mass of atlas to other one
Where is the transverse ligament widest
At dens
Function of transverse ligament
Allows for rotation of C1 and holds atlas in place when other ligaments fail
What is the most important ligament of the upper cervical complex ( occiput, C1 and C2)
Transverse ligament
What ligament may be absent in Down syndrome patients
Transverse ligament
What are the 6 ligaments in the occipitalaxial complex
1 membrane tectoria, 2 alar ligaments, 1 apical ligament, 1 cruciate ligament, 1 ligamentum nuchae
What type of joint is the occipital axial complex
A fibrous syndesmoidial joint with no bony articulations (connected by interossesous ligament)
Membrana tectoria AKA
Tectorial membrane and occipito-axial ligament
Membrana tectoria is a superior extension of
Posterior longitudinal ligament
Where is membrana tectoria
Attaches from posterior aspect of body of C2 to anterior rim of foramen magnum
Function of membrana tectoria
Hold other ligaments in and limits flexion and extension of atlas on the occiput
Alar ligaments AKA
Check ligaments and odontoid ligaments
Where are the alar ligaments
Extend from posterior lateral aspect of the odontoid process to the medial surface of occipital condyles
Function of alar ligaments
Limits or check contralateral axial rotation of the skull and atlantoaxial joint
Alar ligaments are must vulnerable to
Tearing in combined axial rotation and flexion
If damage occurs to alar ligaments what occurs
Allow for increased rotation and lateral flexion of atlanto-occipital articulation
Injured alar ligaments are primarily responsible for
Chronic whiplash symptoms especially post traumatic headaches
Aka of apical ligament
Apical dental ligament and suspensory ligament
Where is the apical ligament
V shaped ligament extends from anterior wall of foramen magnum to superior terminal aspect of dens
What is the degree of anterior tilt of apical ligament
20
What is the remnant of the embryonic notochord
Apical ligament
Cruciate ligament AKA
Cruciform ligament
What are the two parts of the cruciate ligament
Superior and inferior
Where is the superior cruciate ligament
transverse ligament to anterior tip of foramen magnum
Inferior cruciate ligament is located
From transverse ligament to posterior aspect of C2 body
Function of cruciate ligament
Hold transverse ligament in place
What is the ligamentum nuchae
Union of the supraspinous and interspinous ligaments in the upper cervical region
What are the ligaments in the lumbosacral articulation
Same as the thoracic and lumbar spine but no intertransverse ligament
The intertransverse ligament is replaced by what in the lumbosacral articulation
Lumbosacral ligament and iliolumbar ligament
Where is the lumbosacral ligament
From TVP L5 to sacral alae and promontory
Where is the iliolumbar ligament
From TVP L5 to crest of ilium anterior to sacroiliac joint
Function of lumbosacral ligament and iliolumbar ligament
Stabilize the area
The function of the sacrotuberous ligament
Restricts flexion in the pelvis
How many ligaments in the intersacral articulations
6
What are the six intersacral articulations
4 fibrocartilages (discs), anterior intersacral ligament, posterior intersacral ligament
Where is the fibrocartilage ligament of the intersacral ligament
Present between segments until segments fuse and ligaments become ossified
Anterior intersacral ligament is analogous to
ALL
The posterior intersacral ligament is analogous to
PLL
The anterior and posterior intersacral ligament are present till when
Segments fuse then ossify
What are the 8 ligaments of the sacrococcygeal articulation
Intervertebral fibrocartilage, anterior sacrococcygeal ligament, deep posterior sacrococcygeal ligament, superficial posterior sacrococcygeal ligament, 2 lateral sacrococcygeal ligaments, 2 intercornual ligaments
Is the intervertebral fibrocartilage a disc in the sacrococcygeal articulation
No due to no nucleus present
The anterior sacrococcygeal ligament is a thin fibrous extension of
ALL
The deep posterior sacrococcygeal ligament is an extension of
PLL
Where is the deep posterior sacrococcygeal ligament
From sacral hiatus to 1st coccygeal segment
Where is the superficial posterior sacrococcygeal ligament
On top of sacral hiatus, forms roof over top
Where is the lateral sacrococcygeal ligaments
From inferior angle of sacrum to coccygeal alae
Lateral sacrococcygeal ligament is analogous to
Intertransverse ligament
What is the intercornual ligament
From sacral cornua to coccygeal cornua
Intercornual ligament is analogous to
Articular capsules
What are the five inter-coccygeal ligaments
Intersegmental fibrocartilages, anterior coccygeal ligament and posterior coccygeal ligament
When segments fuse in the coccyx what happens to the ligaments
They are not longer ligaments
The intersegmental fibrocartilages in the intercoccygeal ligaments are what type of joints
4 cartilaginous synchondrodial joint
The fibrocartilages in the intercoccygeal ligaments are present till
Age 25 to 30
The anterior coccygeal ligament is an extension of
ALL
The posterior coccygeal ligament is an extension of
PLL
What are the 7 ligaments of the SI joint
Articular capsule, anterior sacroiliac ligament, interosseous sacroiliac ligament, short posterior sacroiliac ligament, long posterior sacroiliac ligament, sacrotuberous ligament, sacrospinous ligament
Where are the articular capsules located on the SI joint
Located on the anterior surface of the SI joint
Where is the anterior sacroiliac ligament
Covers the articular capsule on the anterior side
Function of anterior sacroiliac ligament
Limits external rotation of the front of the SI joint
Where is the interosseous sacroiliac ligament
Posterior side of the SI joint
Function of the interosseous sacroiliac joint
Connects the upper 3 segments of the sacrum to the ilium, limits external rotation (flaring) of ilium
Where is the short posterior SI ligament
From S1 and S2 tubercles to posterior medial part of iliac crest and runs horizontally
Where is the long posterior SI ligament
From PSIS and tubercles of S3 and S4. Runs vertically and blends into sacrotuberous ligament
Where is the sacrotuberous ligament
Inferior and lateral from posterior inferior part of sacrum to ischial tuberosity of ilium
Where is sacrospinous ligament
From anterior surface of sacrum (S2-S4) to spine of ischium
