Osteology/Articulations Flashcards by Aloki M

What is the bony landmark for CV7?

Vertebral prominens

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What is the bony landmark for TV7?

Internal angle of scapula

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What is the bony landmark for LV4?

Iliac crest

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What is bipedalism? What can it cause?

Human beings walking on two legs -> major cause of low back pain

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What is a lateral curvature of the vertebral column?

Scoliosis

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What plane does scoliosis usually impact?

Coronal plane

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What is the most common form of scoliosis?

Idiopathic scoliosis -> right thoracic curve

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What is excessive thoracic curvature called? What is its nickname?

Kyphosis -> hunchback

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What is excessive lumbar curve called? What is its nickname?

Lordosis -> swayback

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What runs through the transverse foramen?

Vertebral artery -> heads to brain

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What exits through the intervertebral foramen?

Spinal nerves

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What type of scoliosis occurs with patients with cerebral palsy?

Myopathic scoliosis

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What is the scoliosis called when there are improperly formed vertebrae?

Congenital scoliosis

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What is short leg syndrome associated with?

Functional scoliosis

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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

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What does stenosis of the IV foramen cause?

Impingement of spinal nerves -> radiculopathy!

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What is the C1 vertebrae called?

Atlas

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What is the C2 vertebrae called?

Axis

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What connects the dens with the C1 (atlas)?

Transverse ligament of atlas

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What occurs if there is a rupture of the transverse ligament of the atlas?

Compression of the dens

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Transverse ligament of atlas is usually absent in…

Patients with Down Syndrome or certain connective tissue disorders -> Marfan’s syndrome

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Fracture of the dens

Causes avascular necrosis of dens, fragments can lacerate spinal cord

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What is the atlanto-occipital joint? What motion does it allow?

Synovial, condyloid -> shake your head yes!

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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!

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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