Spinal Articulations Flashcards
primary curve
anterior concavity
thoracic and sacral regions
curvature of fetus?
primary curve
secondary curve?
anterior convexity
develops in response to lifting head and walking
lumbar and cervical regions
lordosis
exaggerated secondary curve
kyphosis
exaggerated primary curve
scoliosis
lateral S-shaped curve in any region of vertebral column
zygopophyseal joint type?
synovial joint
three major classifications of joints?
membranous, cartilagenous, synovial
what has cartilagenous joint?
intervertebral discs and pubic symphysis
two components of intervertebral disc?
annulus fibrosis
- cocentric lamellae
- each ring has 90 degree rotation
nucleus pulposus
- allows for movement
- hydrated gelatinous mass (more liquid)
annulus fibrosis
outer fibrocartilagenous ring of the intervertebral disc
nucleus pulposus
inner highly elastic, highly hydrated gelatinous
in center of the intervertebral disc
what happens to IV discs as you age?
decrease in thickness due to dehydration
shape of IV discs?
wedge shaped
- thicker anteriorly in cervical and lumbar
- assist with secondary curves
attachment of IV disc?
above and below - hyaline cartilage to vertebral bodies
anterior/posterior to longitudinal spinal ligaments
ruptured disc?
tear of annulus fibrosis
-leading to loss of integrity between contiguous vertebrae
herniated disc?
tear of annulus fibrosis where the nucleus pulposus squeezes through rupture
what happens during flexion and extension in the IV disc?
compression and elongation of the nucleus pulposus
anterior longitudinal ligament
nice and broad
posterior longitudinal ligament
serrated (on posterior of body)
what is more of a problem with bulging of IV discs?
more of a problem posteriorly
-will impinge on the spinal cord
rediculopathy?
pushing on a spinal root
how many cervical nerves?
8
how many thoracic nerves?
12
how many lumbar nerves
5
how many sacral nerves?
5
how many coccygeal nerves?
1 Co1
posterolateral herniation
push on the spinal nerve
posterior herniation
push on cord or cauda equina
L4-L5 herniation (posterolateral) will impinge what nerve?
LV5 spinal nerve
would see L5 rediculopathy
most common spaces of herniation?
LV4-5 to SV1
cervical and lumbar regions
anterior longitudinal spinal ligament layers?
deep layer with short fibers
-span contiguous vertebrae
superficial layer with long fibers
-span many vertebrae
function of anterior longitudinal spinal ligament?
prevents excessive extension
attachment of anterior longitudinal spinal ligaments?
anterior surface of all vertebrae
-extends from basilar portion of occipital bone to sacrum
posterior longitudinal spinal ligament attachments?
posterior surface of all vertebral bodies
-extends from occipital bone to sacrum
function of posterior lontigudinal spinal ligament?
prevents excessive flexion
posterior longitudinal spinal ligament layer?
deep layer with short fibers
superficial layer with long fibers
posterior longitudinal spinal ligament and herniations?
pushes it posterolaterally
-causes spinal nerve impingement
zygapophysis
facet joints of articulating surfaces between vertebrae
articulation of the cervical regions allow?
flexion, extension, rotation, and lateral flexion
articulation of thoracic regions allow?
rotation, lateral flexion
little flexion and almost no extension
articulations of the lumbar regions allow?
flexion, extension, sidebending
-very limited rotation
what limits the motion of the thoracic region?
presence of ribs
-also long thoracic spinous processes and thin IV discs
what do thoracic vertebrae limit?
the anterior and posterior translocation
*bc of vertical coronal articulation
where is the anterior longitudinal spinal ligament widest?
as you descend the spinal column
ligamentum flavum
from lamina to lamina
slightly yellow in color ELASTIC
attachment of ligamentum flavum?
internal surfaces of adjacent laminae from CV2 down
function of ligamentum flavum?
maintaining upright posture by limiting flexion
-aligns facet joints to return to normal posture
recoil memory
ability of ligamentum flavum to return to upright posture
what is the strong of the vertebral ligaments?
ligamentum flavum
interspinal ligament
attaches to adjacent spinous processe from tip to lamina
what changes in the interspinal ligaments as you go down?
most robust at lumbar level and insignificant in the thoracic and cervical regions
attachment of supraspinal ligament?
connects tips of spinous processe from CV7 to sacrum
two layers of supraspinal ligament?
deep - span adjacent spinous processes
superficial - spans several vertebrae
continuity of the supraspinal ligament?
continuous on deep surface with interspinal ligament
continuous above CV7 with nuchal ligament
nuchal ligament
upward extension of the supraspinal ligament
extends from CV7 spinous processes to external occipital protuberance
function of nuchal ligament?
intermuscular septum for posterior deep muscles of the neck
provides muscle attachment without limiting extension of the cervical column
boundaries of the intervertebral foramen?
superior - inferior vertebral notch
inferior - superior vertebral notch
anterior - posterior portion of vertebra above and IV disc
posterior - facet joint between two opposing vertebrae
contents of the IV foramen?
dorsal/ventral roots dorsal root ganglion spinal nerve spinal artery intervertebral vein
atlantooccipital joint?
synovial joint
between occipital condyles of skull and superior articular facets of CV1 (atlas)
action of atlantooccipital joint?
allows flexion and extension of neck
anterior atlantooccipital membrane?
between anterior margin of foramen magnum and anterior arch of atlas
posterior atlantooccipital membrane?
between posterior margin of foramen magnum and posterior arch of atlas
**has openings in lateral margins for passage of vertebral artery and suboccipital nerve (dorsal rami of C1)
suboccipital nerve?
dorsal rami of C1
where do the atlantooccipital membranes fuse?
laterally with the joint capsule of the atlanto-occipital joints
tectorial membrane?
covers dens and its associated ligaments
extends from anterior foramen magnum
-where it fuses with the dura
to body of CV2 - fuses with posterior longitudinal ligament
atlantoaxial joint?
lateral atlantoaxial articulation
median atlantoaxial articulation
lateral atlantoaxial articulation
gliding synovial joint between CV1 and CV2 articular processes
median atlantoaxial articulation
pivot synovial joint between dens of axis and anterior arch of atlas
what makes of the cruciform ligament?
transverse ligament of the atlas
superior crus
inferior crus
transverse ligament of the atlas?
attaches to internal surface of anterior arch of atlas forming a socket between itself and the anterior arch (socket contains dens)
superior crus?
passes from transverse ligament of atlas superiorly to attach to anterior edge of foramen magnum
inferior crus?
passes from transverse ligament of atlas inferiorly to attach to posterior body of axis
apical dental ligament?
weak ligament passes from apex of dens to the anterior edge of foramen magnum
**deep to superior crus
alar ligaments
bilateral ligaments that arise from the dens lateral to the apical ligament and attach to the the occipital condyles
**tearing increases rotation 30%
anterior atlantoaxial membrane?
anterior arch of atlas to anterior body of axis
-deep to the anterior longitudinal ligament
posterior atlantoaxial membrane?
posterior arch of atlas to lamina of axis
-continuous with ligamentum flavum
check ligaments?
limit rotation
spondylolysis
defect (usually developmental - can be trauma) in pars interarticularis
pars interarticularis?
neural arch between the superior and inferior articulating processes
spondylolisthesis
bilateral defect in pars interarticularis that results in the vertebral column slides forward
most common site of spondylolisthesis
LV5-SV1
spinal artery
arise from vessels that parallel the vertebral column
- vertebral artery
- ascending cervical artery
- posterior intercostal arteries
- lumbar arteries
- iliolumbar artery
- lateral sacral arteries
**enter the IV foramina and branch
branches of the spinal artery?
osseus - like branches above and below to form plexuses
neural branches - provide radicular branches that enter dural sac along spinal nerve
osseus branches
branch of spinal artery
-within the vertebral canal (epidural space)
posterior to posterior longitudinal ligament and anterior to the ligamentum flavum
neural branches
provide radicular branches that enter the dural sac
segmental medullary arteries
neural branches that course along roots and connect with the anterior/posterior spinal arteries
**allow flow because can get blood to multiple levels
radicular arteries
supply to roots only (don’t extend to the spinal arteries)
what is important during abdominal surgeries?
when clamping aorta important to ensure blood flow to the vertebral column
veins of vertebral column?
four venous plexuses
all four run entire length of spinal column
all four freely intercommunicate
NO valves
anterior external venous plexus
anterior surface of vertebral bodies
posterior external venous plexus
external surface of spinous, articular, and transverse processes
anterior internal venous plexus
in epidural space adjacent to posterior longitudinal spinal ligament
posterior internal venous plexus
in epidural space adjacent to lamina and ligamentum flavum
basivertebral veins
dran bodies of vertebrae to the anterior internal venous plexus
intervertebral veins
receive drainage from all four plexuses
-drain to vertebral, posterior intercostal, lumbar, and lateral sacral veins
Batson’s Plexus
venous circulation of vertebral column
changes in intra-thoracic and intra-abdominal pressure along with lack of valves can lead to changes in flow
**allows for the metastatic spread of cancer and spread of infection to the vertebral column
