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General Anatomy > Vertebrae & Vertebral joints > Flashcards

Vertebrae & Vertebral joints Flashcards

1
Q

What are type of joints are zygapophyseal joints

A

Synovial joints

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2
Q

What are zygapophyseal joints inbetween

A

between superior and inferior articular processes of adjacent vertebrae, surrounded by thin loose articular cartilage

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3
Q

Function of zygapophyseal joints

A

Together with intervertebral disc transfer loads, guide and constrain motions in the spine
Protect the motion segment from anterior shear forces, excessive rotation and flexion
Permit gliding movement between articular processes
Shape and disposition of articular surfaces determine types of movement possible
Range of movement determined by size of IV disc relative to vertebral body

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4
Q

What is the innervation of zygapophyseal joint

A

articular branches that arise from medial branches of posterior rami of spinal nerves

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5
Q

What type of joint is a costotransverse joint

A

plane type synovial

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6
Q

What is the costotransverse joint between

A

between facet of tubercle of rib and transverse process of adjacent thoracic vertebrae
Ribs 11/12 do not articulate with their respective transverse processes of T11/T12

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7
Q

What movements does the costotransverse joint allow

A

gliding movements

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8
Q

What is the costovertebral joint between

A

Consists of costotransverse and ligaments

Between heads of ribs and bodies of thorarcic vertebrae

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9
Q

What movements do costovertebral joints allow

A

gliding movements

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10
Q

What type of joint is the atlanto-occipital joint

A

Synovial condyloid–> have thin, loose articular capsules

Pivot joint

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11
Q

What is the atlanto-occipital joint between

A

between superior articular surfaces of lateral masses of atlas and occipital condyles
hence contains a pair of condyles

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12
Q

What movement occurs at atlanto0occipital joint

A

‘Yes” movement of neck (nodding)= flexion/extension
Lateral flexion/conjunct rotation (rotation occurs with lateral flexion)
Also permits sideways tilting of head

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13
Q

What are the atlanto-occipital membranes

A

cranium and C1 connected by anterior and posterior atlanto-occipital membranes
They extend from posterior arches of C1 to anterior and posterior margins of foramen magnum
Membranes help prevent excessive movement of joints

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14
Q

What type of joint is the atlanto-axial joint

A

synovial joint

bicondylar joint

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15
Q

What vertebraes is the atlanto-axial joint between

A 
between C1 (atlas) and C2 (axis)
this joint contains 3 synovial joints, making it the most mobile joint in the spine
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16
Q

What are the 3 articulations of atlanto-axial joint

A

2 Lateral Joints (gliding joint)–> between inferior facets of lateral facets of lateral masses of C1 and superior facets of C2
1 median joint (pivot joint)–> between dens of C2 and anterior arch of the atlas

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17
Q

What is the orientation of the lateral atlanto-axial joint

A

concave in anterior-posterior direction (hence rotation)

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18
Q

What is the front and back articulation of the medial atlanto-axial joint

A

Posterior surface of atlas anterior arch and odontoid process (front)
Anterior surface of transverse ligament and odontoid process (back)

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19
Q

What movement does the atlanto-axial joint allow

A

rotation–> ‘no’ head movement

during movement C1 rotates on C2 as a unit

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20
Q

How does the rotational movement in atlanto-axial joint occur

A

Dens of C2 is axis or pivot that is held in a socket or collar
Socket/collar is formed anteriorly by anterior arch of atlas and posteriorly by transverse ligament of atlas

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21
Q

What is the transverse ligament of atlas

A

strong band extending between tubercles on medial aspects of lateral masses of C1 vertebraes

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22
Q

What is the intervertebral joint

A

Fibrocartilaginous joint–> symphyses

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23
Q

What does the intervertebral joint consist of

A

Secondary cartilaginous joints between vertebraes with IV disc in middle
Articulating surfaces of adjacent vertebrae are connected by IV discs and ligaments

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24
Q

What is the purpose of intervertebral joints

A

Designed for WB’ing and strength

IV discs provide strong attachments between the vertebral bodies

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25
Q

What type of joint is the lumbosacral joint

A

Not a joint–> has a disc inbetween and consists of Z joints

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26
Q

What movement does the lumbosacral joint allow

A

Flexion, extension, lateral flexion and rotation

Compressive, sheer, tensile force and bending and torsional movement

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27
Q

What is the vertebral arch made up of

A

pedicle and lamina

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28
Q

How is the cervical vertebrae different to a typical vertebrae

A

smaller in size as it bears less weight

smaller vertebral body

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29
Q

What are the components of a typical vertebrae

A

Body
Vertebral arch (pedicle and lamina)
Vertebral foramen (forms vertebral canal)
transverse process (2 on each side)
Articular processes and facets (zygapophyses)–> superior and inferior
Spinous process (posterior)
Typical vertebrae don’t have the presence of unicinate processes and dislocations are not always associated with spinal cord damage

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30
Q

Explain features of a typical cervical vertebrae

A 
typical cervical vertebrae C3-C6
Small rectangular body
large triangular vertebral foramen
short transverse processes
framen transversarium
Horizontal articular processes and facets
Bifid spinous process
31
Q

Explain features of C1

A 
Atlas
Cranium rests on, hence atlas
Doesn't have a spinous process or body
Has 2 lateral masses connected by anterior and posterior arches (where transverse process arises
Ring shaped bone
32
Q

Explain features of C2

A

Axis
tooth-like dens–> odontoid process which projects superiorly from body
Dens provide a pivot point around which the atlas turns and carries cranium
Has 2 large lateral, flat weight bearing surfaces= superior articular facets= on which atlas rotates
Articulates anteriorly with anterior arch of atlas and posteriorly with transverse ligament of atlas
Has a bifid spinous process that can be felt deep in the nuchal groove

33
Q

Explain features of C7

A

Prominent vertebrae
Long spinous process (hence called vertebrae prominens)
All other features correspond to that of typical vertebrae (particularly that of thoracic)

34
Q

What are the features of a typical thoracic vertebrae

A

Heart shaped vertebral body
Costal facets for articulation with respective head of rib
Circular small vertebral foramen
Land transverse processes with articulation facets
Vertical articular processes and facets
Long postero-inferior spinous process

35
Q

What is the function of thoracic vertebrae

A

Holds rib cage and protects the heart and lungs

36
Q

What are the joints specific to thoracic vertebrae

A

Costotransverse joint

Costvertebral joint

37
Q

Explain features of lumbar vertebrae

A

Located lower back
Large kidney shaped vertebral body(due to increase in the weight they support)
Triangular medium sized vertebral foramen (small foramen allows increase body size=can bear more weight)
Long transverse process
Vertical articular process and facets
Short thick spinous process
Posterior surface of base of each transverse process are small accessory process (provides attachment for medial intertransverse lumborum muscle)
Posterior surface of articular surfaces are mammillary processes–> attachment for multifidus and medial intertransverse musckes
Allows flexion, extension, not too much rotation

38
Q

Explain the sacral vertebrae

A

Located between hip bones
5 fused sacral vertebrae in adults
4 pairs of sacral foramina
Triangular shape results from the rapid decrease in the size of lateral masses of the sacral vertebrae during development
Base–>articulates with L5 at lumbosacral angle
Apex–> articulates with coccyx
Dorsal surface–> rough and convex
Pelvic surface–> smooth and concave
Sacral canal = continuation of vertebral canal
Anterior projecting edge of body of S1 vertebrae is sacral promontory

39
Q

What is the function of sacrum

A

Provides strength and stability to pelvis and transmits the weight of body to pelvic girdle/lower limbs
Inferior half of sacrum is not weight bearing

40
Q

Explain the coccyx

A

4 fused coccygeal vertebrae
May weight bear during sitting
Attachment point for glute max and coccygeal muscles

41
Q

What is the main role of cervical vertebrae

A

Movement of head and neck, as well as stabilising head onto neck

42
Q

What is the function of lumbar vertebrae

A

Supports weight of upper body
Largest vertebrae
Provides attachment for medial intertransverse lumborum muscle

43
Q

What is the function of zygapophyseal joints

A

Form the articular ‘pillars’ that act to provide structural stability to the vertebral column as a whole
Together with disc, bilateral facet joints transfer loads and guide and constrain motions in the spine

44
Q

Describe the zygapophyseal joints in the lumbar region

A

Lie in a sagittal plane
Articulating facets are 90 degrees to the transverse plane and 45 degrees to frontal plane
Superior facets face medially and inferior facets face laterally
Only flexion and extension
synovial joint between inferior and superior facets

45
Q

Function of intervertebral discs

A

Permit movement between adjacent vertebrae
Serve as shock absorbers between each vertebrae as they are resilient to deformability
Keep vertebrae separated
Protect nerves that run down middle of spine
Designed for WB’ing and strength
IV discs provide strong attachments between the vertebral bodies
Articulating surfaces of adjacent vertebrae are connected by IV discs and ligaments
No IV disc between C1 and C2
Vary in thickness in different regions–> thickness is relative to size of bodies they connect to in cervical and lumbar regions

46
Q

What is the IV disc made up of

A

Annulus fibrosis and nucleus pulposus

47
Q

Describe the function and structure of annulus fibrosis

A

Outer fibrous part of IV disc
Composed of concentric lamellae of fibrocartilage forming circumference of IV disc
Annuli inserts into smooth, rounded epiphyseal rims on articular surfaces of vertebral bodies formed by fuses annular epiphyses
Fibres forming each lamellae run obliquely (at 90 degrees) from one vertebrae to another
This arrangement allows some movement between adjacent vertebrae, while providing strong bond between them
Lamellae of annulus fibrosis are thinner and less numerous posteriorly than enteriorly/laterally, hence nucleus pulposus is more posteriorly placed

48
Q

Describe the function and structure of nucleus pulposus

A

central core of IV disc
At birth, more cartilaginous than fibrous
Primarily liquid (water)
Semifluid–> hence responsible for much of the flexibility and resilience of IV discs and vertebral column
Avascular–> hence blood vessels don’t transverse in IV discs
Because avascular, recieves nourishment by diffusion from blood vessels at the periphery of annulus fibrosus and vertebral body

49
Q

What is the vertebral enplate

A

Plate of cartilage that acts as a barrier between the disc and vertebral body
Cover the superior and inferior aspects of annulus fibrosis and nucleus pulposus

50
Q

Biochemical properties of IV disc

A

Fibrocartilaginous materal
As the spine recieves pressure, the gel (nucleus pulposus) moves inside the annulus fibrosus and redistributes itself to absorb the impact of pressure

51
Q

Cellular properties of IV disc

A

Annulus fibrosis consists of several layers (laminae) of fibrocartilage made up of both type I and type II collagen (type I is concentrated towards the edge of the ring where it provides greater strength as stiff laminae can withstand compressive forces
Nucleus pulposus consists of large vaculoted notochord cells, small chondrocyte-like cells, collagen fibrils and aggregan (a proteoglycan that aggregates by binding to hyaluronan. Attached to each aggrecan molecule are glycosaminoglycan (GAG) chains of chondroitin sulphate and keratan sulphate
Nucleus pulposus is gel-like mass composed of water and proteoglycans held by randomly arranged fibres of collagen

52
Q

What are the biomechanical age changes of IV disc

A

Decreased IVD height
Decreased foramen size–> hence affects spinal nerve = increased potential nerve damage
Osteophytes
Decreased density of vertebrae–> OP= increased risk of vertebral #’s

53
Q

What are the biochemical age changes of IVD

A

Decreased elastin and proteoglycans–> decreased elastic fibres in AF
Increased collagen–> type I decreases, type II increases
Hence decreased hydrophilic ability
Increased collagen
Type II collagen increases in annulus fibrosis
Change in proteoglycans and collagen changes micro-biomechanics, which changes overall biomechanics of spine (changing pressure on Lx spine structural components and hence changing the mmt patterns)
smoking is highly associated with accerlerating these changes

54
Q

What is an IVD herniation

A

Also called spinal disc herniation/slipped disc
tear of the outer fibrous ring (annulus fibrosis) allows nucleus pulposus (soft central portion) to buldge out beyond the damaged outer rings
Upper 2 cervical vertebrae (C1,C2), sacrum and coccyx have no IVD hence exclude the risk of disc herniation there

55
Q

Where is IVD most common

A

lumbar and cervical disc herniations are most common (more common in lumbar than cervical)
Tears are most frequent postero-lateral because of the absence of the anterior/posterior longitudinal ligament (this is also where the annulus fibrosis is thinest)

56
Q

What level in Cx is IVD herniation common and what symptoms result from it

A

Most often at the level C5-C6 or C6-C7

causes referred pain to the head, face, neck, arms, shoulders and chest (also low back sometimes)

57
Q

What level in Lx is IVD herniation common and what symptoms result from it

A

Typically L4-L5 or L5-S1
Causes lower back pain and possibly leg pain as well (due to nerves from lumbar plexus innervating leg)
Referred to as sciatica
More common in this location in people above 55

58
Q

What are the causes of IVD herniation

A

wear and tear of the spine (backs carry and distribute a lot of our weight and IVD absorb a lot of shock which over time can cause them to become worn out)
Wear and tear causes annulus fibrosis to weaken allowing nucleus pulposus to push through creating a budging or herniated disc
Injury–> sudden jerking movement can put too much pressure on the disc and cause it to herniate (or by lifting incorrectly/something heavy)
Conbination of degeneration and injury–> weakened IVD makes it more prone to herniation from small trauma

59
Q

What are some predisposing factors of IVD herniation

A

Age (disc herniation most commonly caused as a result of deterioration through age–> hence older age increases risk); smoking accelerate this deteriorating process
Lifestyle (exercise–> strength of core and back muscles–> the stronger your muscles are the more likely they are able to withstand pressure and prevent protrusions
Overuse–> disc degeneration

60
Q

What is a herniated nucleus pulposus (HNP)

A

Localized displacement of nucleus, cartilage, fragmented apophyseal bone or frangmented annular tissue beyond IVD space
Essentially herniation of disc as a result of nucleus pulposus protruding put of the annulus fibrosis
It is traumatic acute and chronic lumbar (sometimes cervical)

61
Q

What are the subcategories of HNP

A

Protrusion (NP protrudes into AF but external disc capsule still intact)
Extrusion (NP breaks through AF and disrupts external capsule)
Sequestration (some NP separates from the disc into surrounding space)

62
Q

What is Degenerative disc disease (DDD)

A 
Degenerative annular tears
loss of disc height
nuclear degradation
Usual cause of non-traumatic cervical
Older age is usually the cause of this
Not actually a herniation, just the degenerative changes
63
Q

What are some symptoms of DDD

A

Pain in lower back, butt or upper thighs
pain not always present, comes and goes
Feels worse when you sit and better when walking/moving (bending/lifting/twisting makes it worse too)
Can lead to numbness and tingling in arms/legs (thinning IVD= decreased space b/w adjacent vertebral discs= possible compression of spinal nerves b/w vertebrae)

64
Q

What is Internal disc disruption (IDD)

A

Annular frissuring without external disc deformation
Annular fissuring–> when the fibres that make up the annulus fibrosis either break or separate (tears within AF)
A subgroup of discogenic pain= pain originating from a damaged vertebral disc
Get a deep-seated, burning, lacinating pain in the back
Sensation of a weak, unstable back

65
Q

What the age related changes to trabecule in vertebral bodies

A

Increasing age= decreased density in Lx vertebrae causing trabecula size and pattern changes
Vertical trabeculae (struts) absorbed, remaining ones become thicker
Horizontal trabeculae (beams) absorbed and not replaced
therefore characteristic ageing of vert. bodies=horizontal trabecula loss
Loss greatest is central body, therefore decreased central body load bearing capacity; therefore increased wt bearing by cortical bone
No support of underlying bone, causing end plates micro #’s

66
Q

What is folic acid and where is it found

A

Works with B complex group vitamins, especially B12
It is found in many foods but also easily lost from the body via urine and bile
No endogenous folic acid production
Converted folate is absorbed in proximal jejunum
Found in leafy green vegies, peanuts, bananas and avocado

67
Q

What do we need folic acid for

A

Cell division (hence low folate=incomplete spinal fusion)
RBC (hence low folate=anemias)
Metabolism of proteins and sugars
Trasmission of genetic code to offspirngs
Too much folic acid is toxic

68
Q

What are some examples of inhibitors of folate absorption

A

Excess alcohol
Some medication
Crohns disease
Kidney dialysis

69
Q

What is spina bifida

A

Congenital abnormalities (common and most serious)
Condition in which the bones in vertebral column do not fully cover the spinal cord, ealving it exposed
Cause by incomplete fusing of the embryonic neural tube
As a result, a sac forms on the foetus back as the membranes and spinal cord are pushed out
The sac may be covered with meninges or membrane

70
Q

What causes spina bifida

A

Low intake of folic acid before and during pregnancy can cause it

71
Q

Treatment options for spina bifida

A

Physical therapy
Surgery
Assistive devices

72
Q

What is miningocele

A

A type of spina bifida

Meninges or portective membranes push through the opening in vertebrae

73
Q

What is myelomeningcocele

A

Most severe form of spina bifida

spinal cord is exposed causing partial/complete paralysis of body below the opening

General Anatomy (13 decks)

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