Spinal Final Exam: Section XI cont. ALL,PLL, Lig. FLavum...etc

Question 1

What vertebral levels will the anterior longitudinal ligament attach to?

Answer 1

those b/w occiput and S3 inclusive are traditionally located

Question 2

What is the lowest extent of the anterior longitudinal ligament based on recent studies?

Answer 2

L3

Question 3

What is the function of the anterior longitudinal ligament?

Answer 3

it brakes or limits dorsi-flexion or hyperextension of the vertebral column

Question 4

What was ossification of the anterior longitudinal ligament in the lumbar region identified as?

Answer 4

Forestier’s Disease

Question 5

Anterior longitudinal ligament ossification in the lumbar region is now identified as_____?

Answer 5

Diffuse Idiopathic Skeletal Hyperostosis or DISH

Question 6

What vertebral levels will the posterior longitudinal ligament attach to?

Answer 6

those between C2 and S3 inclusive are traditionally indicated

Question 7

What is the function of the posterior longitudinal ligament?

Answer 7

it brakes or limits flexion of the vertebral column

Question 8

Where is the ossification of the posterior longitudinal ligament most commonly identified?

Answer 8

the cervical spine with an 80% incidence

Question 9

What is the clinical sign of posterior longitudinal ligament ossification in the cervical spine?

Answer 9

a loss of hand and finger dexterity

Question 10

What is the incidence of posterior longitudinal ligament ossification in the thoracic and lumbar spine?

Answer 10

about 10% of the thoracic and 10% at the lumbar spine

Question 11

What is the clinical sign of posterior longitudinal ligament ossification in the lumbar spine?

Answer 11

faltering gait

Question 12

What is the gender, age, and ethnic bias associated with ossification of the posterior longitudinal ligament?

Answer 12

it is greater in males over 50 and has a higher incidence in the Japanese

Question 13

What is the acronym for ossification of the posterior longitudinal ligament?

Answer 13

OPLL

Question 14

At one time ossification of the posterior longitudinal ligament was an example of what condition?

Answer 14

Diffuse Idiopathic Skeletal Hyperostosis or DISH

Question 15

What vertebral levels will the ligamentum flavum be attached to?

Answer 15

those between C2 and S1 inclusive are traditionally indicated

Question 16

What is the histology of the ligamentum flavum?

Answer 16

it is formed primarily with elastic fibers, which are yellow in appearance

Question 17

What is the name given to the ligamentum flavum based on appearance and histology?

Answer 17

it is a yellow elastic ligament

Question 18

What is the function of the ligamentum flavum?

Answer 18

it brakes or limits flexion of the vertebral column

Question 19

What is now thought to be major function of the ligamentum flavum?

Answer 19

it is an early prime factor in extension of the vertebral column

Question 20

Where is ossification of the ligamentum flavum most commonly identified?

Answer 20

the thoracic spine or thoracolumbar transition zone

Question 21

What is the acronym for ossification of the ligamentum flavum?

Answer 21

OLF

Question 22

What is the relationship between the capsular ligament and mobility?

Answer 22

the more lax/loose the capsular ligament is, the greater the motion of the joint

Question 23

What regions of the vertebral column demonstrate the greatest laxity of capsular ligaments?

Answer 23

the cervical and lumbar regions

Question 24

The capuslar ligament may blend with which other common ligament?

Answer 24

the ligamentum flavum

Question 25

What muscle will blend with the capsular ligament posteriorly?

Answer 25

the multifidis

Question 26

What is the pattern of innervation for the zygapophysis capsular ligament?

Answer 26

it is typically innervated by 3 spinal nerves

Question 27

If the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its' function?

Answer 27

it is probably involved in proprioceptive feedback to the muscle stabilizing the vertebral column during movement

Question 28

What vertebral levels will the interspinous ligament be attached to?

Answer 28

those between C2 and S1 inclusive are traditionally indicated

Question 29

What is the status of the human interspinous ligament compared with other common ligaments?

Answer 29

they are poorly developed as ligaments although collagen fibers are present

Question 30

What is the stats of the cervical interspinous ligament?

Answer 30

it is lacking, poorly developed, or simply considered the deep anterior part of the ligamentum nuchae

Question 31

What is the status of the thoracic interspinous ligament?

Answer 31

it is narrow and elongated reflecting the shape of the spinous process

Question 32

What is the status of the lumbar interspinous ligament?

Answer 32

it is broad and thick with three layers identified from anterior to posterior

Question 33

What is the classic function of the interspinous ligament?

Answer 33

it brakes or limits flexion of the vertebral column

Question 34

What is now thought to be a major function of the interspinous ligament?

Answer 34

it is more likely a proprioceptive transducer for the spinal reflex

Question 35

What is the name given to the superficial layer of the ligamentum nuchae?

Answer 35

the funicular layer or part

Question 36

What is the name given to the deep layer of the ligamentum nuchae?

Answer 36

the lamellar layer or part

Question 37

What are the attachment sites for the superficial layer of the ligamentum nuchae?

Answer 37

the external occipital protuberance, external occipital crest, and spinous tubercle of C7

Question 38

What are the attachment sites for the deep layer of the ligamentum nuchae?

Answer 38

the posterior tubercle of the posterior arch of C1, and spinous tubercles b/w C2 and C6 inclusive

Question 39

What is the histological make-up of the ligamentum nuchae in quadrupeds?

Answer 39

it is a yellow elastic ligament

Question 40

What is the histological make-up of the human ligamentum nuchae?

Answer 40

it is a yellow elastic ligament, but has more collagen fibers than in quadrupeds

Question 41

What is the primary yellow elastic or elastic ligament of the spine?

Answer 41

the ligamentum flavum

Question 42

What is the classic function of the human ligamentum nuchae?

Answer 42

it brakes or limits flexion of the cervical spine

Question 43

What will the supraspinous ligament by attached to?

Answer 43

the spinous tubercles along the vertebral column from C7 to sacrum

Question 44

What is the termination level inferiorly for the supraspinous ligament according to current literature?

Answer 44

primarily at L4 (73%); between L4 and L5 (5%)

Question 45

Where is the supraspinous ligament said to be best developed?

Answer 45

in the lumbar spine

Question 46

What is the classic function of the human supraspinous ligament?

Answer 46

it brakes or limits flexion of the spine

Question 47

What is now thought to be a major function of the supraspinous ligament?

Answer 47

it is a proprioceptive transducer for the spinal reflex

Question 48

What is the status of the cervical intertransverse ligament?

Answer 48

it is said to be paired with an anterior and a posterior intertransverse ligament present

Question 49

What is the status of the thoracic intertransverse ligament?

Answer 49

it is said to bled with muscles of the deep back; a separate ligament may not exist

Question 50

Where in the vertebral column is the intertransverse ligament best developed?

Answer 50

in the lumbar spine

Question 51

What part of the lumbar intertransverse ligament covers the intervertebral foramen?

Answer 51

the ventral slip

Question 52

What part of the intertransverse ligament in the lumbar spine divides the body wall into an anterior muscular compartment and a posterior muscular compartment?

Answer 52

the dorsal slip

Question 53

What is the classic function of the anterior atlanto-occipital ligament

Answer 53

it brakes or limits "extension" of the skull over the cervical spine

Question 54

What is the classic function of the posterior atlanto-occipital ligament?

Answer 54

it brakes or limits axial rotation, flexion, and perhaps lateral bending of the skull on atlas

Question 55

What amount of flexion - extension is accommodated by the atlanto-occipital joint?

Answer 55

about 25 degrees

Question 56

What amount of the axial rotation is accommodated by the atlanto-occipital joint?

Answer 56

about 3-8 degrees one side axial rotation

Question 57

What amount of lateral bending is accommodated by the atlanto-occipital joint?

Answer 57

about 5 degrees

Question 58

Which motion is best accommodated by the atlanto-occipital joint?

Answer 58

felxion - extension

Question 59

What is the function of the transverse atlantal ligament?

Answer 59

it is the primary stabilizer of the atlanto-axial joint restricting the distance of C2 from the anterior arch of C1

Question 60

What movements are facilitated at the median atlanto-axial joint?

Answer 60

flexion - extension, rotation, and telescoping (superior - inferior gliding)

Question 61

What is the ADI?

Answer 61

the Atlanto-Dental Interspace, a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint

Question 62

The ADI is observed between which surfaces?

Answer 62

the fovea dentis of C1 and the facet for fovea dentis of C2

Question 63

What is the ADI of children compared with that of adults?

Answer 63

about 4.5 mm in children; a range of 2-3 mm or about 2.5 mm in adults

Question 64

What are the characteristics of the capsular ligament of the lateral atlanto-axial joint?

Answer 64

it is lax or loose and demonstrates a meniscoidal fold within the joint cavity

Question 65

What are the attachment sites for the accessory atlanto-axial ligaments?

Answer 65

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

Question 66

What are the degrees of movement facilitated at the atlanto-axial joint?

Answer 66

about 20 degrees flexion - extension, 40 degrees one side axial rotation, and 5 degrees of lateral bending

Question 67

The occiput - C1 - C2 joint complex accounts for what percent of all cervical axial rotation?

Answer 67

about 60%

Question 68

Embryologically, what forms the apical ligament of the dens of the apicodental ligament?

Answer 68

the notochord

Question 69

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?

Answer 69

the alar ligament

Question 70

What is the function of the alar ligament?

Answer 70

together they function to resist axial rotation

Question 71

For the cervical spine below C2, what is the range of flexion - extension?

Answer 71

about 90 degrees or about 18 degrees per couple

Question 72

For the cervical spine below C2, what is the range of one side lateral bending?

Answer 72

about 50 degrees or about 10 degrees per couple

Question 73

For the cervical spine below C2, what is the range of one side axial rotation?

Answer 73

about 33 degrees or about 6 degrees per couple

Question 74

For the cervical spine below C2, what is the range of motion allowed for each type of joint motion identified?

Answer 74

- 90 degrees flexion-extension - 50 degrees one side lateral bending - 33 degrees one side axial rotation

Question 75

Based on the current literature what common ligaments are absent at the lumbosacral joint?

Answer 75

ligamentum nuchae, interspinous ligament, and supraspinous ligament

Question 76

Which ligaments replace the intertransverse ligament at the lumbosacral joint?

Answer 76

the iliolumbar ligament and lumbosacral ligament

Question 77

What are the attachment sites for the lumbosacral ligament?

Answer 77

the sacral ala and ventrolateral surface of sacrum attach to the transverse process of L5

Question 78

What are the attachment sites for the iliolumbar ligament?

Answer 78

the iliac crest is attached to the transverse process of L5

Question 79

What muscle is intimately attached to the superior iliolumbar ligament?

Answer 79

quadratus lumborum

Question 80

Which vertebral couple of the lumbar spine has the greatest range of motion?

Answer 80

L5/S1

Question 81

Which range of motion is greatest for all lumbar vertebral couples?

Answer 81

flexion - extension

Question 82

Which range of motion is least for L1 - L5 vertebral couples?

Answer 82

one side axial rotation

Question 83

Which range of motion is least for the L5/S1 vertebral couple?

Answer 83

one side lateral bending

Question 84

What are the attaching sites for the anterior sacrococcygeal ligament?

Answer 84

the vertebral bodies from about S3 to Co2 - Co3

Question 85

List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal column.

Answer 85

- the anterior atlanto-occipital ligament, - anterior atlanto-axial ligament, - anterior longitudinal ligament, and - the anterior sacrococcygeal ligament

Question 86

What are the attaching sites for the deep posterior sacrococcygeal ligament?

Answer 86

the vertebral bodies from about S3 to Co1

Question 87

List, in order, from cranial to caudal the ligaments forming the anterior boundary of the spinal canal.

Answer 87

the membrane tectoria, posterior longitudinal ligament, and the deep posterior sacrococcygeal ligament

Question 88

List, in order, from cranial to caudal the ligaments forming the posterior boundary of the spinal canal.

Answer 88

- the posterior atlanto-occipital ligament, - posterior atlanto-axial ligament, - ligamentum flavum, and - the superficial posterior sacrococcygeal ligament

Question 89

What forms the closure for the spinal canal inferiorly?

Answer 89

the fusion of the deep posterior sacrococcygeal ligament with the superficial posterior sacrococcygeal ligament

Question 90

What is the homolog of the intertransverse ligament at the sacrococcygeal joint?

Answer 90

the lateral sacrococcygeal ligament

Question 91

What are the attaching sites for the lateral sacrococcygeal ligament?

Answer 91

the inferior lateral margin of sacrum and the transverse process of Co1

Question 92

What is the homolog of the capsular ligament at the sacrococcygeal joint?

Answer 92

the intercornual ligament

Question 93

What does degenerative arthrosis mean?

Answer 93

a condition of defeneration of the joint, sometimes referred to as degenerative joint disease (DJD)

Question 94

What does ankylosis mean?

Answer 94

a condition of fibrous adhesion occurs within the joint

Question 95

What is the age and surface bias associated with degenerative arthrosis of the sacro-iliac joint?

Answer 95

age 40, the iliac auricular surface

Question 96

What is the age and gender bias associated with anklysosis of the sacro-iliac joint?

Answer 96

age 50 and male bias particularly in African American males

Question 97

What age and gender bias is associated with ossification of the anterior sacro-iliac ligament?

Answer 97

age 40 and male bias

Question 98

Which is the strongest of the sacro-iliac ligaments?

Answer 98

the interosseous sacro-iliac ligament

Question 99

What are the attachment sites of the interosseous sacroiliac ligament?

Answer 99

at the sacral tuberosity and the iliac sulcus

Question 100

What passes between the layers of the interosseous sacro-iliac ligament?

Answer 100

dorsal rami from the sacral spinal nerves

Question 101

What ligament blends with the lateral borderr of the long posterior sacro-iliac ligament?

Answer 101

the sacrotuberous ligament

Question 102

What is formed by the continuation of the sacrotuberous ligament along the ischial ramus?

Answer 102

the falciform process

Question 103

What separates the greater sciatic and lesser sciatic foramina?

Answer 103

the sacrospinous ligament

Question 104

What is the function of the sacrospinous and sacrotuberous ligaments?

Answer 104

the oppose the upward tilt of the sacral apex and resist the rotation of sacrum between the innominate bones