MSK_MT1_TBL5 (Vertebral Column, Ligaments& Joints) Flashcards
Vertebral column
Central, longitudinal bony pillar of the body.
-
SUPPORTS the:
1. skull
2. pectoral girdle
3. upper limbs
4. thoracic cage - Protects the spinal chord
pelvic girdle
transmits body weight → lower limbs
33 vertebrae of the Vetebral Column
Cervical : C1 - C7
Thoracic: T1 - T12
Lumbar: L1 - L5
Saccral: S1 - S5 (fused to form the sacrum)
Coccygeal: Cx1 - Cx4 (lower 3 commonly fused)
typical vertebra is made of … (2)
- A rounded body anteriorly
- Vertebral arch posteriorly
vertebral arch consists of
- pair of pedicles: sides of the arch
- pair of flattened laminae: complete the arch posteriorly.
vertebral foramen
space enclosed by vertebral arch + vertebral body
What are the 7 structures that the vertebral arch gives rise to?
1x spinous process
2x transverse proccess
2x superior articular process
2x inferior articular process
spinous & transverse processes serve as
LEVERS: attachments of muscles* and *ligaments
articular processes
- vertically arranged (2x Superior + 2x Inferior)
- facets are covered with HYALINE cartilage
zygapophyseal joints
each vertebra = total of four synovial joints
- The TWO superior articular of bottom vertebra
+ TWO inferior articular of the top vertabra
superior & inferior vertebral notches
- the notches of the pedicles
intervertebral foramen
- the SPACE BETWEEN one superior notch of one vertebra + inferior notch of another vertebra
- spinal nerves and blood vessels pass through the foramen
Atypical Vertebrae – Atlas (C1)
NO vertebral body OR spinous process
-
anterior and posterior arches: a lateral mass on both sides of the articular surface
- posterior arch : vertebral artery passes ONLY
- atlanto-occipital joints: anterior C1 surface + occipital condyles skull
- atlantoaxial joints: inferior C1 surface + C2
transverse foramina
passages for the vertebral artery and vein
Atypical Vertebrae – Axis (C2)
has a tooth-like odontoid process (dens) that projects upward (into C1) from the superior surface of the body.
Cervical Vertebrae (C3-C7)
(C7) = vertebra prominens = it has the longest spinous process.
T2-T8
superior costal facet
inferior costal facet
tranverse costal facet
- sites where the ribs articulate with the body
- demifacets: 1 rib = 2 thoracic vertebrae
T1
full costal facet (NOT a superior demifacet like the others)
- to connect it to C7
T11 and T12
each have full costal facets on the pedicles
ribs 11 and 12 articulate only with one vertebra.
Mamillary Process
located ONLY in Lumbar
site of muscle attachment
Lumbar Vertebral body
Massive; kidney shaped
Lumbar Vertebral foramen
Triangular
larger > thoracic vertebrae
smaller < cervical vertebrae
Lumbar Transverse processes
Long and slender
accessory process on posterior surface
Lumbar Articular processes
-
Nearly vertical facets
- superior facets = medially
- inferior facets = laterally
- mammillary process on posterior surface
Lumbar Spinous processes
Short and sturdy; thick, broad, and hatchet shaped
Regional Characteristics of Vertebrae
sacrum
five fused vertebrae
wedge-shaped
concave anteriorly
Sacrum Base and Apex
base = articulates with the fifth lumbar vertebra
apex = articulates with the coccyx
sacroiliac joints
sacrum articulates with the two iliac bones
sacral promontory
first sacral vertebra bulges forward into the pelvic inlet
in females, obstetric importance =measuring the size of the pelvis.
cauda equina
anterior and posterior roots of the sacral and coccygeal nerves
sacralization of the L5 vertebra
fifth lumbar vertebra incorporated into the sacrum region
= painfull friction against the illiac crest (Bertolotti’s syndrome)
anterior and posterior sacral foramina
passage of the anterior and posterior rami of the upper four sacral nerves.
Lumbarization of the S1 vertebra
coccyx
four vertebrae fused together to form a triangular bone
“tail bone”
primary curvatures
- thoracic
- sacrococcygeal
retain their initial prenatal anterior concavities
secondary curvatures
- cervical
- lumbar
curves form postnatally
posterior concavities
fetal vertebral column
“fetal position” = one continuous anterior concavity
lumbar curve
cervical and lumbar curves = anterior concave
b/c of pregnancy, lumbar curve is more pronounced in adult females
Normal Terminology of Lordosis/Kyphosis
- Cervical lordosis
- Thoracic kyphosis
- Lumbar lordosis
- Sacral kyphosis
senile kyphosis
Associated with Age
- osteoporosis OR degeneration of the intervertebral discs
- OR notable weakening of the intrinsic back muscles = kyphosis.
Adolescent kyphosis
In adolescents with poor muscle, long hours of study at low desk
= less severe, gently curved upper thoracic region.
Lumbar lordosis
caused by an increase in the weight of the abdominal contents, as with the gravid uterus.
OR
postural compensation for a thoracic kyphosis
External Markers of the Vertebral Column and Sacrum
- S2 = back dimples
- median sacral crest = (inferior to L5) sacral triangle and intergluetal cleft
- sacral hiatus = start of the intergluetal cleft
atlanto-occipital joints
Vertebra C1 (the atlas) + base of the skull
atlantoaxial joints
Vertebra C1 (the atlas) + vertebra C2 (the axis)
condyles of the skull
where the atlanto-occipital synovial joints formed in the base of skull
Anterior atlanto-occipital membrane
Ligament
connects the anterior arch of the atlas→ skull.
Posterior atlanto-occipital membrane
Ligament
connects the posterior arch of the atlas→ skull.
Median atlantoaxial joint
between odontoid/dens of C2 + anterior arch of the C1
(2x lateral atlantoaxial joints + 1 Median atlantoaxial joint)
Apical ligament
connects the apex of the odontoid→ skull
Connecting the axis to the base of the cranium are the apical ligament of dens
Alar ligaments
lie on each side of the apical ligament and connect the odontoid process to the occipital condyles
Scoliosis
a lateral deviation : commonly found in the thoracic region.
malrotation
strong association with the adolescent growth spurt.
Adam’s Forward Bend Test
Test for Scoliosis at the rotational component
observing the patient from the back while he or she bends forward
Jefferson’s fracture
- ring of the atlas to be disrupted = lateral masses to be displaced laterally
- caused by excessive vertical force applied from above
- ex) diving
Nontraumatic compression fractures
- osteoporosis
- tuberculous spondylitis
- Pott’s disease
DISEASED vertebral body may break down and collapse under the weight of the upper body
Hangman’s Fracture
-
Fractures of the odontoid process (Dens) = result from falls or blows on the head
- rupture of the transverse ligament = spinal injury
- ex) car crash = caused by overextension of neck (whiplash)
“Teardrop” Fracture
abrupt neck extension causes the anterior longitudinal ligament to tear = a triangular-shaped fragment (tear drop)
Spondylolysis
- bilateral defect (fracture or separation) in posterior arch of the spine
- between pars interarticularis between the zygapophyseal (facet) joints
- L5/L4
- a fatigue fracture due to acute overload
- present in athletes
spondylolisthesis
body of a lower vertebra (usually L5) slips forward to compensate for the break of spondolysis
