Vertebral Column Part 2 Flashcards
Articulations between the bodies of the vertebra
-Formed by the Intervertebral Discs
Cartilaginous Joints
Gliding joints that form the facet joints
Synovial Joints
Special Joint found between C1 and C2.
-Pivot Joint
-Right/Left rotation of the head on the neck
Atlanto axial Joint
Special joint between the Skull and C1
-Condyloid Joint (really acts like a hinge joint)
-Skull rocks forward and backwards on C1
-Articulation occurs with condyles of the skull on either side of the foramen magnum
Atlanto Occipital Joint
Formed by the Annulus Fibrosus and the Nucleus Pulposus.
-Annulus Fibrosus: Fibrocartilaginous covering that sits between each flexible vertebra. Has usually about 6 rings of fibrous tissue
-Found in between almost all flexible vertebra
-Fluid based - can dehydrate with age and lose height
-Has a liquid portion in the center called the Nucleus Pulposus (forms the center)
Intervertebral Disc
A long, fibrous ligament that runs down the posterior portion of the vertebra, crossing the intervertebral discs posteriorly
-Runs within the spinal canal, posteriorly to the discs/bodies
-Broadest portion is in the neck/upper portion of the back
-Weakest in Lumbar Spine
-Has lateral extensions that cover the lower portion of the discs, providing some protection.
-Begins in part of the skull called the Clivus, passes through foramen magnum, and streams down into upper portion of the neck.
-Gets thinner the further down you go.
Posterior Longitudinal Ligament (PLL)
A long ligament running anterior to the vertebral discs/bodies, all the way down the entire spinal column
-Runs anteriorly to the discs/bodies
-Broadest/strongest in the lower back, and narrows up to the neck.
Anterior Longitudinal Ligament (ALL)
Occurs when the Annulus Fibrosus has broken down, and some of the Nucleus Pulposus is squirting out
-Puts pressure on other structures
-Nucleus is out laterally, medial side is crushed by spinal cord dura mater, and between these two is a compressed nerve root that causes dysfunction
-Pt will try to shift pressure off of nucleus by leaning to the opposite side
Disc Herniation
A thin ligament that helps to stabilize the joints of the neural arch.
-Covers just the tips of the spinous processes.
-Runs all the way up to the cervical spine, where it changes its name
-Runs from C7 down to the end of the spinal cord
Supraspinous Ligament
A big and broad ligament of the neck.
-Continuation of the Supraspinous Ligament
-Stabilization and muscle attachment (Trapezius; Splenius Capitis m.)
-The higher up the neck you get, the thicker and stronger it gets.
-Starts at C7 and attaches to the back of the head
Ligamentum Nuchae
Segmental Ligaments that interconnect spinous processes
-Found between spinous processes, all the way up and down the spinal column
Interspinous Ligaments
Ligaments found between transverse processes.
-Segmental ligaments interconnecting the transverse processes
-Found up and down the entire spinal column
Intertransverse Ligaments
An elastic-like ligament found between the Lamina. Interconnects the lamina of the vertebral column.
-Connects the whole width of the space between the Lamina, all the way around
-Have to pass through this with spinal anesthesia, and it offers resistance
-Vertebra can contract together, making it hard to get through the interlaminar space there. Can calcify with aging.
-Provides spring to the spinal column, good for walking/sports/etc. Cushions the vertebra.
Ligamentum Flava
Lumbar herniations typically go in which direction?
Posterior-Lateral (due to thin PLL in this area)
1) Skin (no resistance)
2) Supraspinous Ligament (a little resistance)
3) Ligamentum Flavum (Lots of resistance) - will feel a pop after passing through
Stopping here is Epidural
If you keep going, will pop through dura mater and enter subarachnoid space for intrathecal injections. Can pull back on syringe and see if CSF is present to know you’re in the subarachnoid space.
-Hit Bone: gone too far. Pull back.
Spinal Anesthesia
