Ligaments Flashcards
What was ossification of the anterior longitudinal ligament in the lumbar region identified as?
Forestier’s Disease
What is the function of the anterior longitudinal ligament?
It brakes or limits dorsi-flexion or hyperextension of the vertebral column
What is ossification of the anterior longitudinal ligament in the lumbar region now identified as?
Diffuse Idiopathic Skeletal Hyperostosis or DISH
What is the innermost layer of the posterior longitudinal ligament called?
The perivertebral ligament
What is the function of the posterior longitudinal ligament?
It brakes or limits flexion of the vertebral column
Where is ossification of the posterior longitudinal ligament most commonly identified?
The cervical spine with an 80% incidence
What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?
A loss of hand and finger dexterity
What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?
Faltering gait
What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?
It is greater in males over 50 and has a higher incidence in the Japanese
What is the acronym for ossification of the posterior longitudinal ligament?
OPLL
At one time, ossification of the posterior longitudinal ligament was an example of what condition?
Diffuse Idiopathic Skeletal Hyperostosis or DISH
In which region of the spine will the ligamentum flavum be paired?
The lumbar spine
What is the name given to the ligamentum flavum based on appearance and histology?
It is a yellow elastic ligament
What is now thought to be a major function of the ligamentum flavum?
It is an early prime factor in extension of the vertebral column
Where is ossification of the ligamentum flavum most commonly identified?
The thoracic spine or thoracolumbar transition zone
What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?
The cervical and lumbar regions
If the zygapophyseal capsular ligament is not significantly involved in restricting motion, what is its function?
It is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement
What is now thought to be a major function of the interspinalis ligament?
It is more likely a proprioceptive transducer for the spinal reflex
What are the names given to the superficial and deep layers of the ligamentum nuchae, respectively?
Funicular layer and lamellar layer
What are the attachment sites for the superficial layer of the ligamentum nuchae?
The external occipital protuberance, external occipital crest, and spinous tubercle of C7
What is the histological make-up of the human ligamentum nuchae?
It is a yellow elastic ligament, but has more collagen fibers than in quadrupeds
What is the primary yellow elastic or elastic ligament of the spine?
The ligamentum flavum
What is the classic function of the human ligamentum nuchae?
It brakes or limits flexion of the cervical spine
What is the termination level inferiorly for the supraspinous ligament according to current literature?
Primarily at L4 (73%); between L4 and L5 (5%)
Where is the supraspinous ligament said to be best developed?
In the lumbar spine
What is now thought to be a major function of the supraspinous ligament?
It is a proprioceptive transducer for the spinal reflex
What is the status of the cervical intertransverse ligament?
It is said to be paired with an anterior and a posterior intertransverse ligament present
What part of the intertransverse ligament in the lumbar spine covers the intervertebral foramen?
The ventral slip
What part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?
The dorsal slip
What are the attachment sites of the ponticulus posticus?
It is attached to the arcuate rim of the posterior arch of C1 and to the superior articular process of the lateral mass of C1
What other name may be used to identify a ponticulus posticus?
Kimmerle’s anomaly
What names are given to the opening formed by the ponticulus posticus?
Arcuate foramen or retroarticular canal
What amount of flexion-extension is accommodated by the atlanto-occipital joint?
About twenty-five degrees
What amount of axial rotation is accommodated by the atlanto-occipital joint?
About three to eight degrees one side axial rotation
What amount of lateral bending is accommodated by the atlanto-occipital joint?
About five degrees
Which motion is best accommodated by the atlanto-occipital joint?
Flexion-extension
What histological feature is present on the anterior surface of the transverse atlantal ligament?
Fibrocartilage at the surface of the ligament articulating with C2
What is the function of the transverse atlantal ligament?
It is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1
What is the ADI?
The Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
What is the ADI of children compared with that of adults?
About 4.5mm in children; a range of 2-3mm or about 2.5mm in adults
What ligament forms the medial, posterior boundary of the intervertebral foramen at C1/C2?
The posterior atlanto-axial ligament
What are the degrees of movement facilitated at the atlanto-axial joint?
About 20 degrees flexion-extension, 40 degrees one side axial rotation, and 5 degrees of lateral bending
The occiput C1-C2 joint complex accounts for what percent of all cervical axial rotation?
About 60%
What are the attachment sites for the apical ligament of the dens or apicodental ligament?
The anterior margin of the foramen magnum and the tip of the odontoid process of C2
What is the embryonic derivative of the apical ligament of the dens or the apicodental ligament?
The notochord
What ligament attaches to the posterolateral part of the odontoid process of C2 and to surfaces on the medial border of the occipital condyle or as far anterior as the anterolateral margin of the foramen magnum?
The alar ligament
What is the function of the alar ligament?
Together they function to resist axial rotation
What are the attachment sites for the superficial layer of the membrana tectoria or tectorial membrane?
The posterior part of the inferior epiphyseal rim and vertebral body of C2 to the capsular ligament of the atlanto-occipital joint and cranial dura of the posterior cranial fossa
What lies in front of the deep layer of the membrana tectoria or tectorial membrane?
The cruciate ligament
For the cervical spine below C2, what is the range of motion allowed for each type of joint motion identified?
90 degrees flexion-extension, 50 degrees one side lateral bending, and 33 degrees one side axial rotation
What are the locations for costovertebral joints on the vertebra?
The costocentral joint at the vertebral body and the costotransverse joint at the transverse process
Costocentral radiate or stellate ligaments will attach the head of the rib to what structures?
Both vertebral bodies of the costocentral joint and the intervertebral disc for ribs 1-9
An intra-articular ligament will be identified with which ribs?
Ribs 2-9
Which vertebrae will have a synovial plane (diarthrosis arthrodia) costotransverse joint?
Typically T1-T10
At what rib will the superior costotransverse ligament be absent?
The first rib
What ligaments will attach to the neck of the twelfth rib?
The superior costotransverse ligament from T11 and the lumbocostal ligament from L1
What unique ligament is present at the twelfth rib?
The lumbocostal ligament
Which ribs will have an attachment for the inferior costotransverse ligament?
Rib 1-rib11
At what rib will the inferior costotransverse ligament be absent?
The twelfth rib
What is the name of the space between the transverse process and the neck of the rib?
The costotransverse foramen
Which ligament “fills” the costotransverse foramen?
The inferior costotransverse ligament
At what rib will the lateral costotransverse ligament be absent?
The twelfth rib
Which vertebral couples of the thoracic spine have the greatest motion?
T11/T12 and T12/L1
Which range of motion is greatest for lower thoracic vertebral couples?
Flexion-extension
Which range of motion is least for lower thoracic vertebral couples?
One side axial rotation
Based on current literature, what common ligaments are absent at the lumbosacral joint?
Ligamentum nuchae, interspinous ligament, and supraspinous ligament
Which ligaments replace the intertransverse ligament at the lumbosacral joint?
The iliolumbar ligament and lumbosacral ligament
What are the attachment sites for the lumbosacral ligament?
The sacral ala and ventrolateral surface of sacrum attach to the transverse process of L5
What muscle is intimately attached to the superior iliolumbar ligament?
Quadratus lumborum
Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of the classical descriptions?
The superior iliolumbar ligament
Which ligament from the iliolumbar ligament complex represents the lumbosacral ligament of classical descriptions?
The inferior iliolumbar ligament
What is the joint classification given to each ligament of the iliolumbar ligament complex?
Fibrous (amphiarthrosis) syndesmosis
Which range of motion is greatest for all lumbar vertebral couples?
Flexion-extension
Which range of motion is least for L1-L5 vertebral couples?
One side axial rotation
Which range of motion is least for the L5/S1 vertebral couple?
One side lateral bending
What ligament represents the continuation of the anterior longitudinal ligament at the sacrococcygeal joint?
The anterior sacrococcygeal ligament
What ligament represents the continuation of the posterior longitudinal ligament at the sacrococcygeal joint?
The deep posterior sacrococcygeal ligament
What ligament represents the homolog of the ligamentum flavum at the sacrococcygeal joint?
The superficial posterior sacrococcygeal ligament
What is the homolog of the intertransverse ligament at the sacrococcygeal joint?
The lateral sacrococcygeal ligament
What is the auricular surface of sacrum composed of?
True articular cartilage, a modification of hyaline cartilage
What is the auricular surface of the ilium composed of?
Articular cartilage, interspersed with fibrocartilage
Which gender is biased with greater unevenness of thee auricular surface of the sacroiliac joint?
Males
What forms the accessory sacroiliac joint?
The sacral tuberosity and the iliac sulcus
What does ankylosis mean?
A condition of fibrous adhesion occurs within the joint
What is the age and gender bias associated with ankylosis of the sacroiliac joint?
Age 50 and male bias particularly in African American males
What is the age and gender bias associated with ossification of the anterior sacroiliac ligament?
Age 40 and male bias
Which is the strongest of the sacroiliac ligaments?
The interosseous sacroiliac ligament
What passes between the layers of the interosseous sacroiliac ligament?
Dorsal rami from the sacral spinal nerves
What is formed by the continuation of the sacrotuberous ligament along the ischial ramus?
The falciform process
What separates the greater sciatic and lesser sciatic foramina?
The sacrospinous ligament
What is the function of the sacroischial ligaments?
They oppose the upward tilt of the sacral apex and resist the rotation of sacrum between the innominate bones
