Spinal Lecture 4 Flashcards
where does the anterior longitudinal ligament extend from?
anterior surface of vertebral bodies
can you stress the anterior longitudinal ligament?
No, taugt extension, can’t in reality stress it
what aspects of the anterior longitudinal ligament are broader, thinner?
broader caudally and thinner cranially
at about the level of C2 what is the anterior longitudinal ligament replaced by?
it is replaced by the anterior atlantooccipital membrane (different type of tissue)
the anterior longitudinal ligament is thicker and narrower in the _spine than in the _ and _ spine
thicker and narrower in the T-spine than in the c and l-spine
the anterior longitudinal ligament extends to the front of the ___
sacrum
the longitudinal fibres of the anterior longitudinal ligament attach to what?
IVD
hyaline cartilage
anterior aspect of vertebral bodies
the anterior longitudinal ligament fibres blend with what?
subadjacent periosteum, perichondrium and periphery of the annulus fibrosis
describe the anterior longitudinal ligament superficial layer
longest, extend over 3 of 4 vertebrae (thinnest, weakest)
How many vertebrae does the anterior longitudinal ligament intermediate layer run between?
between two or three vertebrae
describe the anterior longitudinal ligament deep layer
one body to next (strongest)
where does the posterior longitudinal ligament lay?
lies in the vertebral canal on the posterior surface of the vertebral bodies
what is the posterior longitudinal ligament continuous with at about C1-C2?
membrane tectoria
what does the posterior longitudinal ligament attach to?
IVD, hyaline cartilage and vertebral bodies
in the lumbar spine and lower thoracis spine the posterior longitudinal ligment is ___, narrow over ___ and broad over ___
in lumbar spine and lower thoracic spine it is DENTICULATE, narrow over VERTEBRAL BODIES and broad over DISCS
what is the posterior longitudinal ligament fused with and how does this reinforce the disc
fused with nulus fibrosis of the IVD therfore reinforces disc posteriorly
when is the posterior longitduinal ligament taut?
in flexion
T/F the posterior longitudinal ligament is affected by anything in the vertebral canal i.e. meningitis, disc herniation
TRUE
describe the superficial layer of the posterior longitudinal ligament
longest, extend over 3 of 4 vertebrae
describe the intermediate layer of the posterior longitudinal ligament
between two or three vertebrae
describe the deep layer of the posterior longitudinal ligament
extends between adjacent vertebrae
where is the ligamentum flavum found and what does it lie posterior to?
inside vertebral canal posterior to spinal cord
what does the ligamentum flavum connect in the vertebral canal?
connects lamina to lamina
what tissue properties does the ligamentum flavum have and what does this allow for?
yellow elastic tissue like the ligamentum nuchae to allow for mobility and recoil
what does the ligamentum flavum restrict and what does it provide rebound tension for?
restricts flexion and lends rebound tension to go back into extension
do the fibres of the ligamentum flavum run parallel or perpendicular?
almost perpendicular fibres
what two points does the ligamentum flavum run between?
descend from inferior surface of one lamina to the superior surface of next lower lamina
where is the ligamentum flavum thin, thick and thickest?
thin -broad and long in the neck
thicker - in the thoracic spine
thickest -in the lumbar spine
what is the most superficial ligament in the spine?
surpraspinous ligament
what points does the supraspinous ligament run between
from spinous process to spinous process - C7 to sacrum (becomes ligamentum nuchae above C7)
what level may the supraspinous ligament cease at?
L5
what portion of the spine has a thicker and broader supraspinous ligament
L-spine
what does the supraspinous ligament intimately blend with
neighbouring fascia
what does the supraspinous ligament provide attachment for
muscle, fascia and aponeurotic attachment
how many segments does the superficial fibres of the supraspinous ligament extend over
3 to 4 segments
how many segments does the intermediate fibres of the supraspinous ligament span between?
two to threee segments
how many segments does the deep fibres of the supraspinous ligament span between
one segment
what movement stresses the surpraspinous ligament
flexion
what ligament fills the gap between SPs
interspinous ligament
is the interspinous ligament thick or thin?
thin, almost membranous
the __ ligament connects adjoining spine from root to apex of each
interspinous ligament
what does the interspinous ligament meet with anteriorly and posteriorly
meet ligamentum flavum anteriorly and supraspinous ligament posteriorly
where is the interspinous ligament narrow and where is it broad
-narrow and elongated in the thoracic spine -broader and thicker in the lumbar spine
where is the interspinous ligament poorly developed and what is it replaced by in this area
poorly developed in the cervical spine where its replaced by and interspinous muscle
When is the interspinous ligament taut?
in flexion
what points does the intertransverse ligament travel between
between transverse processes, superior part of one below to inferior part of one above
in which area does the intertransverse ligament have few, irregular fibres and what is it replaced by in this area
in C-spine and it is largely replaced by the intertransverse muscle
in which area does the cords of the intertransverse ligament blend with surrounding muscles
t-spine
in which area is the intertransverse ligament thin and membranous
l-spine
Whn running the psoas in contracting causing ____ and ____. If there is disfunction in the area (such as anterior longitudinal ligament not doing it’s job) the Psoas then needs to stabilize the spine too. This is not it’s intended job and now is sucepitble to ___.
Side bending and rotation. Injury
What is a negative consequence of the ligamentum flavum becoming ossified?
Spinal stenosis. Not much you can do to fix but you can correct everything around it and get the patient mobile and moving as much as possible.
Anterior Longitudinal Ligament
A1:
A2:
Fibre Direction:
Stress:
Function:
Relationships:
Anterior Longitudinal Ligament
A1: Front of Sacrum - Anterior surface of vertebral bodies, IVD, hyaline cartilage
A2: C2 (replaced by atlantooccipital membrane) - Anterior surface of vertebral bodies, IVD, hyaline cartilage
Fibres blend with subadjacent periosteum, perichondrium and peripher of the annulus fibrosis
3 layers: Superficial (3 to 4 vertebrae - weakest), intermediate (2 or 3 vertebrae), deep (one body to next - strongest)
Fibre Direction: Vertical (superior / inferior)
Stress: Taught in extension but can’t in reality stress it
Function: Resists extension, prevents anterior translation, force attenuation by transmitting force through the entire spine.
Relationships:
Continuous with anteromedial aspect of SIJ at the sacrum
Lateral borders of the ALL merge with attachment sites for Psoas - implication is a tight psoas can put stress on the anterior longitudinal ligament and thus the vertebrae. Vice versa if there is no movement or disfunction is present in the lumbar spine it can impact the psoas
Crura shares attachemnt - R. side L1-L3 L. side L1-L2. Every time you breath the crura is pulling on L1-L3
Posterior Longitudinal Ligament
A1:
A2:
Fibre Direction:
Stress:
Function:
Relationships:
Posterior Longitudinal Ligament
A1: C1/C2 (replaced by membrane tectorium) - posterior surface of vertebral bodies, IVD, hyaline cartilage
A2: Sacrum - posterior surface of vertebral bodies, IVD, hyaline cartilage
3 layers: superficial (3 to 4 vertebrae), intermediate (2 to 3 vertebrae), deep (extends to adjacent vertebrae)
Fibre Direction: vertical (superior / inferior)
Stress: Taut in flexion
Function: resist posterior translation, flexion
Relationships:
Affected by anything in the vertebral canal such as meningitis or disc herniation
Strongest attachments to outer layer of annulus fibrosis weakest attachments to vertebral bodies
Attachment for the dura
Ligamentum Flavum:
A1:
A2:
Fibre Direction:
Stress:
Function:
Relationships:
Ligamentum Flavum
A1: Inferior aspect of one lamina (inside vertebral canal posterior to spinal cord)
A2: Superior aspect of another (inside vertebral canal posterior to spinal cord)
Fibre Direction: Vertical (perpendicular fibres)
Stress: Side bend? Flexion?
Function: restrics flexion and lends rebound tension to go back into extension
Force attenuation - transmitted between supraspinous, interspinous as well as up and down the spine
Helps to protect the contents of the vertebral foramen by helping to form the roof over top
Relationships:
Lateral fibres attach to facet joint capsule
Medial fibres fuse with interspinous ligament
Made up of 80% elastin (yellow - unique to this ligament)
If buckes as it comes into neutral or extension it could push into the vertebral foramen and you could be in trouble - it merges with the interspinous ligament which pulls it back out disallowing it to buckle
Supraspinous Ligament
A1:
A2:
Fibre Direction:
Stress:
Function:
Relationships:
Supraspinous Ligament
A1: C7 (replaced by ligamentum nuchae) - Spinous process
A2: Sacrum (may cease at L5) - Spinous process
Superficial fibres (3 to 4 segments), intemediate (2 to 3), deep (segment to segment)
Fibre Direction: Vertical (superior / inferior)
Stress: Flexion
Function:
Relationships:
Most superficial ligament in the spine
Thicker in L-spine
Binds to the interspinous ligament
Blends with neighbouring fascia - thus act as force transducer - transmitting force develpoed in the extremities and torso into the lumbar vertebral column
Area for muscle, fascia and aponerutoic attachment
Interspinous Ligament
A1:
A2:
Fibre Direction:
Stress:
Function:
Relationships:
Interspinous Ligament
A1: Root of one spine
A2: Apex of another spine
Fibre Direction: Vertical - fan shaped allowing the ligament to expand without rupture
Stress: Flexion
Function: Resist flexion, force dispersal
Relationships:
Meet ligamentum flavum anteriorly
Meet supraspinous ligament posteriorly
- Thus dispersed force between the two
The fibres run mostly anterior posterior to act as an anchor, transmitting the AP pull of the TLF, into which is attached the supraspinous ligament and ligamentum flavum, not allowing the later to buckle
Intertransverse Ligament
A1:
A2:
Fibre Direction:
Stress:
Function:
Relationships:
Intertransverse Ligament
A1: Superior part of one TP
A2: Inferior part of another TP
Fibre Direction: Vertical
Stress: ?
Function: Prevents side bending a rotation (a little)
Relationships:
Replaced with intertransverse muscle in the c-spine
