Osteology/Articulations Flashcards
What is the bony landmark for CV7?
Vertebral prominens
What is the bony landmark for TV7?
Internal angle of scapula
What is the bony landmark for LV4?
Iliac crest
What is bipedalism? What can it cause?
Human beings walking on two legs -> major cause of low back pain
What is a lateral curvature of the vertebral column?
Scoliosis
What plane does scoliosis usually impact?
Coronal plane
What is the most common form of scoliosis?
Idiopathic scoliosis -> right thoracic curve
What is excessive thoracic curvature called? What is its nickname?
Kyphosis -> hunchback
What is excessive lumbar curve called? What is its nickname?
Lordosis -> swayback
What runs through the transverse foramen?
Vertebral artery -> heads to brain
What exits through the intervertebral foramen?
Spinal nerves
What type of scoliosis occurs with patients with cerebral palsy?
Myopathic scoliosis
What is the scoliosis called when there are improperly formed vertebrae?
Congenital scoliosis
What is short leg syndrome associated with?
Functional scoliosis
What are unco-vertebral joints? What commonly occurs here?
Known as joints of Luschka; occur between the uncal processes of C3-C7
- Common sites of osteophyte formation -> stenosis of intervertebral foramen
What does stenosis of the IV foramen cause?
Impingement of spinal nerves -> radiculopathy!
What is the C1 vertebrae called?
Atlas
What is the C2 vertebrae called?
Axis
What connects the dens with the C1 (atlas)?
Transverse ligament of atlas
What occurs if there is a rupture of the transverse ligament of the atlas?
Compression of the dens
Transverse ligament of atlas is usually absent in…
Patients with Down Syndrome or certain connective tissue disorders -> Marfan’s syndrome
Fracture of the dens
Causes avascular necrosis of dens, fragments can lacerate spinal cord
What is the atlanto-occipital joint? What motion does it allow?
Synovial, condyloid -> shake your head yes!
What is the atlanto-axial articulation? What motion does it allow?
2 synovial plane/gliding joints, one synovial plane/pivot joint -> shake your head no!
What are zygapophyseal joints? What are they innervated by?
Synovial, plane/gliding joints -> innervated by DORSAL rami
What are intervertebral discs? What do they include? What are they innervated by?
Secondary cartilaginous joints, include annulus fibrosis, nucleus pulposus, and vertebral end plates, innervated by recurrent VENTRAL rami
What is Hangman’s Fracture?
Mechanism: violent hyperextension that breaks the pars interarticularis of the axis bilaterally
What is ligamentum flavum?
Connects the internal surface of laminae of vertebrae
Prevents hyperflexion
Interspinous ligaments
Attach obliquely to the adjacent spinous process, cannot limit movement greatly!
What is the supraspinous ligament?
Affords minimal resistance to hyperflexion
What is Jefferson fracture?
“Burst” fracture from trauma directed through the skull and occipital condyles onto the atlas, bursting the arch; usually does NOT injure the spinal cord
What is anterior longitudinal ligament?
Resists vertical separation of vertebral bodies during extension
WIDE
What is posterior longitudinal ligament?
Resists posterior separation of vertebral bodies during flexion, also helps prevent posterior protrusion of intervertebral discs
What ligament checks hyperextension of vertebral column?
Anterior longitudinal ligament
What is impacted by whiplash injury?
Anterior longitudinal ligament
What is the iliolumbar ligament?
Transverse processes L5 - ilium
Prevents forward sliding, twisting, and lateral flexion of L5
What is the sacroiliac joint?
Strong ligaments, transfer weight to pelvis
What is spinal stenosis?
Narrowing of vertebral canal
What can spinal stenosis be caused by?
Protruding intervertebral discs, meningioma, bony changes (aging), hypertrophy of ligaments (PLL, ligamentum flavum), degeneration of zygapophyseal joints
Chief symptoms of spinal stenosis
Bilateral extremity pain/numbness, weakness, incontinence; can be relieved by surgical laminectomy
Facet joint orientation -> cervical
Allow wide ROM, flexion, extension, rotation, bending
Facet joint orientation -> thoracic vertebrae
Limited ROM, rotation, disc thin to body
Facet joint orientation -> lumbar vertebrae
Joint PREVENTS rotation, mainly flexion/extension
What is the main function of IV discs
Transfer compressive forces to bodies above and below
What is creep (related to IV discs)?
Sustained loads on IV discs will lead to a loss in height due to mainly fluid loss. AF collagen also deforms leading to some height loss
PAPPA BECAME SHORT
What is restored during sleep?
Water will be reabsorbed to restore disc height
Anatomy preventing disc herniation of nucleus pulposus
Annulus fibrosus, PLL
Most common disc herniation?
Postero-lateral is the most common
Regional occurrence of disc herniation?
95 % are LV4-5 or LV5-SV1
5% are CV5-6, CV6-7, or CV7-T1
Central herinations compress
Spinal cord! (LL weakness, incontinence) or cauda equina
What are Schmorl’s Nodes?
Fractured vertebral endplate, protrusion of NP in the vertical plane, inflames affected vertebra
What is the Scotty dog?
Eye - pedicle
Ear - superior articular process
First leg - inferior articular process
Nose - transverse processes
Neck - pars intercularis
What is pars interarticularis fracture?
Spondylolysis: defect present, unilateral
Spondylolisthesis: translation/discolation of vertebra
Structures most likely damaged in hyperflexion injury?
Supraspinuos, interspinous ligament, ligamentum flavum
Provocative tests for disc herniation
Upper limb: Spurling’s test
Lower limb: straight leg test
Defective portion of vertebra with spondylolisthesis in lumbar area?
Pars interarticularis, lamina
Defective portion of vertebra of spondylolisthesis in cervical area?
Pedicle
Ligament which limits skull rotation?
Alar ligament
What is ankylosing spondylitis?
Inflammation of vertebral joints and ligaments, especially in sacroliliac and lumbar regions
What occurs in ankylosing spondylitis?
Ossification of annulus fibrosis -> bamboo spine
Rupture of alar ligaments - what is it, what happens?
Alar ligaments are CHECK ligaments, rupture will lead to increased ROM on contralateral rotation, but decreased skull base
HVLA is contraindicated in patients with…
Rheumatoid arthritis
What can cervical dislocations cause injury to?
Spinal cord
What is osteoporosis? What is it caused by?
Ca++ deficiency, characterized of bone density, common in seniors
Signs/symptoms: thoracic/lumbar back pain, dysfunction in deep back muscles, fractures in vertebral bodies, kyphosis increase, lordosis decrease, SHORTEN height
What are the primary curves?
Thoracic and sacral
What are the secondary curves?
Cervical and lumbar
