Spinal Final Exam: Section XI cont. ALL,PLL, Lig. FLavum...etc Flashcards
What vertebral levels will the anterior longitudinal ligament attach to?
those b/w occiput and S3 inclusive are traditionally located
What is the lowest extent of the anterior longitudinal ligament based on recent studies?
L3
What is the function of the anterior longitudinal ligament?
it brakes or limits dorsi-flexion or hyperextension of the vertebral column
What was ossification of the anterior longitudinal ligament in the lumbar region identified as?
Forestier’s Disease
Anterior longitudinal ligament ossification in the lumbar region is now identified as_____?
Diffuse Idiopathic Skeletal Hyperostosis or DISH
What vertebral levels will the posterior longitudinal ligament attach to?
those between C2 and S3 inclusive are traditionally indicated
What is the function of the posterior longitudinal ligament?
it brakes or limits flexion of the vertebral column
Where is the 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 incidence of posterior longitudinal ligament ossification in the thoracic and lumbar spine?
about 10% of the thoracic and 10% at the lumbar spine
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
What vertebral levels will the ligamentum flavum be attached to?
those between C2 and S1 inclusive are traditionally indicated
What is the histology of the ligamentum flavum?
it is formed primarily with elastic fibers, which are yellow in appearance
What is the name given to the ligamentum flavum based on appearance and histology?
it is a yellow elastic ligament
What is the function of the ligamentum flavum?
it brakes or limits flexion of the vertebral column
What is now thought to be 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 is the acronym for ossification of the ligamentum flavum?
OLF
What is the relationship between the capsular ligament and mobility?
the more lax/loose the capsular ligament is, the greater the motion of the joint
What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?
the cervical and lumbar regions
The capuslar ligament may blend with which other common ligament?
the ligamentum flavum
What muscle will blend with the capsular ligament posteriorly?
the multifidis
What is the pattern of innervation for the zygapophysis capsular ligament?
it is typically innervated by 3 spinal nerves
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 muscle stabilizing the vertebral column during movement
What vertebral levels will the interspinous ligament be attached to?
those between C2 and S1 inclusive are traditionally indicated
What is the status of the human interspinous ligament compared with other common ligaments?
they are poorly developed as ligaments although collagen fibers are present
What is the stats of the cervical interspinous ligament?
it is lacking, poorly developed, or simply considered the deep anterior part of the ligamentum nuchae
What is the status of the thoracic interspinous ligament?
it is narrow and elongated reflecting the shape of the spinous process
What is the status of the lumbar interspinous ligament?
it is broad and thick with three layers identified from anterior to posterior
What is the classic function of the interspinous ligament?
it brakes or limits flexion of the vertebral column
What is now thought to be a major function of the interspinous ligament?
it is more likely a proprioceptive transducer for the spinal reflex
What is the name given to the superficial layer of the ligamentum nuchae?
the funicular layer or part
What is the name given to the deep layer of the ligamentum nuchae?
the lamellar layer or part
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 are the attachment sites for the deep layer of the ligamentum nuchae?
the posterior tubercle of the posterior arch of C1, and spinous tubercles b/w C2 and C6 inclusive
What is the histological make-up of the ligamentum nuchae in quadrupeds?
it is a yellow elastic ligament
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 will the supraspinous ligament by attached to?
the spinous tubercles along the vertebral column from C7 to sacrum
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 the classic function of the human supraspinous ligament?
it brakes or limits flexion of the 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 is the status of the thoracic intertransverse ligament?
it is said to bled with muscles of the deep back; a separate ligament may not exist
Where in the vertebral column is the intertransverse ligament best developed?
in the lumbar spine
What part of the lumbar intertransverse ligament 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 is the classic function of the anterior atlanto-occipital ligament
it brakes or limits “extension” of the skull over the cervical spine
What is the classic function of the posterior atlanto-occipital ligament?
it brakes or limits axial rotation, flexion, and perhaps lateral bending of the skull on atlas
What amount of flexion - extension is accommodated by the atlanto-occipital joint?
about 25 degrees
What amount of the axial rotation is accommodated by the atlanto-occipital joint?
about 3-8 degrees one side axial rotation
What amount of lateral bending is accommodated by the atlanto-occipital joint?
about 5 degrees
Which motion is best accommodated by the atlanto-occipital joint?
felxion - extension
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 movements are facilitated at the median atlanto-axial joint?
flexion - extension, rotation, and telescoping (superior - inferior gliding)
What is the ADI?
the Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
The ADI is observed between which surfaces?
the fovea dentis of C1 and the facet for fovea dentis of C2
What is the ADI of children compared with that of adults?
about 4.5 mm in children; a range of 2-3 mm or about 2.5 mm in adults
What are the characteristics of the capsular ligament of the lateral atlanto-axial joint?
it is lax or loose and demonstrates a meniscoidal fold within the joint cavity
What are the attachment sites for the accessory atlanto-axial ligaments?
the base of the odontoid process and vertebral body of axis to the tubercle for the transverse atlantal ligament on the lateral mass of C1;
a superior continuation may attach on the occipital bone just behind that of the alar 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%
Embryologically, what forms the apical ligament of the dens of 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
For the cervical spine below C2, what is the range of flexion - extension?
about 90 degrees or about 18 degrees per couple
For the cervical spine below C2, what is the range of one side lateral bending?
about 50 degrees or about 10 degrees per couple
For the cervical spine below C2, what is the range of one side axial rotation?
about 33 degrees or about 6 degrees per couple
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
- 33 degrees one side axial rotation
Based on the 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 are the attachment sites for the iliolumbar ligament?
the iliac crest is attached to the transverse process of L5
What muscle is intimately attached to the superior iliolumbar ligament?
quadratus lumborum
Which vertebral couple of the lumbar spine has the greatest range of motion?
L5/S1
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 are the attaching sites for the anterior sacrococcygeal ligament?
the vertebral bodies from about S3 to Co2 - Co3
List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal column.
- the anterior atlanto-occipital ligament,
- anterior atlanto-axial ligament,
- anterior longitudinal ligament, and
- the anterior sacrococcygeal ligament
What are the attaching sites for the deep posterior sacrococcygeal ligament?
the vertebral bodies from about S3 to Co1
List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.
the membrane tectoria, posterior longitudinal ligament, and the deep posterior sacrococcygeal ligament
List, in order, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal.
- the posterior atlanto-occipital ligament,
- posterior atlanto-axial ligament,
- ligamentum flavum, and
- the superficial posterior sacrococcygeal ligament
What forms the closure for the spinal canal inferiorly?
the fusion of the deep posterior sacrococcygeal ligament with the superficial posterior sacrococcygeal ligament
What is the homolog of the intertransverse ligament at the sacrococcygeal joint?
the lateral sacrococcygeal ligament
What are the attaching sites for the lateral sacrococcygeal ligament?
the inferior lateral margin of sacrum and the transverse process of Co1
What is the homolog of the capsular ligament at the sacrococcygeal joint?
the intercornual ligament
What does degenerative arthrosis mean?
a condition of defeneration of the joint, sometimes referred to as degenerative joint disease (DJD)
What does ankylosis mean?
a condition of fibrous adhesion occurs within the joint
What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint?
age 40, the iliac auricular surface
What is the age and gender bias associated with anklysosis of the sacro-iliac joint?
age 50 and male bias particularly in African American males
What age and gender bias is associated with ossification of the anterior sacro-iliac ligament?
age 40 and male bias
Which is the strongest of the sacro-iliac ligaments?
the interosseous sacro-iliac ligament
What are the attachment sites of the interosseous sacroiliac ligament?
at the sacral tuberosity and the iliac sulcus
What passes between the layers of the interosseous sacro-iliac ligament?
dorsal rami from the sacral spinal nerves
What ligament blends with the lateral borderr of the long posterior sacro-iliac ligament?
the sacrotuberous ligament
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 sacrospinous and sacrotuberous ligaments?
the oppose the upward tilt of the sacral apex and resist the rotation of sacrum between the innominate bones
