L3 - MSK Back Arthrology Flashcards
Where are Zygapophysial Joints located?
What type of joint are they?
Plane synovial joints.
Between Superior and Inferior Articular facets from C2-L5
What occurs during Whiplash?
What ligament is affected?
What can also happen?
What is it a common result of?
- Hyperextension
- excessive stretching and even tearing of the Anterior Longitudinal L.
- A recoil effect can often result in Hyperflexion injury as well
- Common injury in automobile accidents
Travels on the anterior surface of the vertebral bodies
Ligament
Anterior Longitudinal L.
Vertebral Joints C1/C2 Classification
Compound Synovial Joint (Planer and Trochoid)
Travels on the dorsal surface of the vertebral bodies
Ligament
Posterior Longitudinal L.
Travel on the ventral surfaces of Vertebral Laminae
Pale yellow fibers
Ligament
Ligamentum Flavum
Ligament
Travels between adjacent Spinous Processes
Interspinous L.
Ligaments that are placed between the transverse processes of the spine.
Not well defined in the Cervical Region
Fibrous cords in the Thoracic Region
Thin membranes in the Lumbar Region
Intertransverse L.
Ligament:
Travels on the dorsal surface of the Vertebral Spinous Processes
Continues as the Ligamentum Nuchae in the Cervical Region
Supraspinous L.
Tough fibrous outer region of Intervertebral Discs,
overlapping lamellae of Fibrocartilage
Annulus Fibrosis
Soft gelatinous inner portion of Intervertebral Discs
Nucleus Pulposus
What is the importance of the Anterior Longitudinal L. when a fracture of the vertebral column is suspected?
The Anterior Longitudinal L. is important due to its possible splinting action.
It should be used whenever fracture of the vertebral column is suspected (except cervical fractures due to hyperextension).
When a fracture of the vertebral column occurs, the patient should be kept in hyperextension at all times.
The pull of the Anterior Longitudinal L. will help realign fragments of bone and keep further injury to the spinal cord from occurring.
What is Disc Herniation?
What does it commonly cause?
What direction does it typically occur? Why?
What does it compress? Where?
Where is it most common? Why?
Herniation of the Nucleus Pulposus through the Annulus Fibrosis
It 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 Ls.
The Resultant bulge, and compress Spinal Nerve Roots, the Cauda Equina and Spinal Nerves in the Vertebral Canal and Intervertebral Foramina respectively.
Herniation is most common at L4/5 and L5/S1, where the Discs are much larger and therefore more mobile.
Second Number Rule:
For the cervical and lumbar regions, the vertebral level at which the prolapse (herniation) occurs will affect the spinal nerve with the second number designation.
Example:
–> A prolapse at C5/6 will affect spinal nerve 6 (which exits the column at C5/6).
In the Cervical Region this is because the numbering system of Spinal Nerves in the Cervical Region (8 nerves, only 7 vertebrae: C1 Spinal Nerve comes out above C1 Vertebra and C2 Spinal Nerve comes out below C1 vertebra, resulting in 8 Cervical Spinal Nerves).
–> A prolapse at L4/5 will affect spinal nerve 5 (which exits at L5/S1).
This is because lumbar spinal nerves exit the Vertebral Canal superior to the Intervertebral Disc, therefore herniation will not affect the nerve exiting at that level, but will affect the nerve one level inferior.
What is the Condyloid Synovial Joint between the Atlas and Basilar Occipital B. called?
What are the 3 Membranes present?
Atlantooccipital Joint
- Anterior Atlantooccipital Membrane
- Tectorial Membrane
- Posterior Atlantooccipital Membrane
What membrane runs from the Anterior Arch of the Atlas (C1) to the basilar Occipital B.?
Anterior Atlantooccipital Membrane
What membrane runs from the posterior surface of the Body of the Axis (C2) to the anterior internal margin of the Foramen Magnum on the Occipital B.?
Tectorial Membrane
from the anterior surface of the Posterior Arch of the Atlas to the posterior internal margin of the Foramen Magnum of the Occipital B.
Posterior Atlantooccipital Membrane
Trochoid Synovial Joint
between the anterior facet of the Dens of the Axis and the articular facet for the dens on the Atlas
Median Atlantoaxial Joint
What runs from the Occipital B. to the Transverse L. on the atlas (C1)?
Superior Longitudinal Band
of the
Cruciate L.
3 Parts of Cruciate L. on atlas (C1)
- Superior Longitudinal Band
- Transverse L. of the Atlas
- Inferior Longitudinal Band
- This ligament group holds the atlas and axis together in place (particulary the transverse L, which holds the Dens of Axis inside the Fovea for the Dens on Atlas)
- Secures the Atlantooccipital joint
What ligament goes around Odontoid Process (Dens), from one Tubercle of the Transverse L. to the other Tubercle of the Transverse L. of the atlas (C1)?
Part of Cruciate L.
Transverse L. of Atlas
Holds the Dens in place!
From C2 to Transverse L.
Part of Cruciate L.
Inferior Longitudinal Band
From the Odontoid Process of the Axis to the lateral margins of the Foramen Magnum of the Occipital B.
Alar L.
Extends from the apex of the Dens to the anterior internal margin of the Foramen Magnum
Apical L. of the Dens
Planar Synovial Joint
Between Superior and Inferior Articulating processes of the Atlas and Axis
Lateral Atlantoaxial Joint
Classification of Joint
Significance?
HN: At the Cervical Intervertebral Joint the joint between the Uncinate Process of the inferior Vertebra and beveled inferior surface of the superior Vertebra is described as an Uncovertebral Joint (of Luschka). It is unclear whether this joint should be classified as Synovial.
Compound Joint (Symphysis and Planar Synovial, between L5 and the Sacrum)
Lumbosacral Joint
Travels on the ventral surface of the vertebral bodies, onto the Ventral Surface of the Sacrum
Anterior Longitudinal L.
of Lumbosacral Joint
Travels on the dorsal surface of the vertebral bodies, onto the anterior wall of the Sacral Canal
Posterior Longitudinal L.
Travel on the ventral surfaces of vertebral laminae, onto the posterior wall of the Sacral Canal
Pale yellow fibers
Ligamentum Flavum
3 absent Ligaments of Lumbosacral Joint
Interspinous L. (absent)
Intertransverse L. (absent)
Supraspinous L. (absent)
Travels from the L5 Transverse Processes to the Iliac Crest
Iliolumbar L.
Travels from L5 Transverse Process and Body to the Sacral Ala
Lumbosacral L.
