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46 Cards in this Set
- Front
- Back
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How many vertebrae are in the human spine? How many intervertebral discs?
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-33
-23 |
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What composes the spinal segment?
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-lower half of upper vertebrae
-inferior facets -intervertebral disc -superior facets -upper half of lower vertebrae |
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What is responsible for shock absorption in the spine?
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-vertebral bodies, NOT the disc.
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What are the functions of the intervertebral disc?
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-bind vertebral bodies
-permit segment movement -transmit loads across the segment |
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What are the 5 zones of the disc according to Paris?
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-neurovascular capsule
-fibrous outer annulus -inner less fibrous annulus -nucleus pulposus -cartilaginous end plate |
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What nerves innervate intervertebral discs?
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-sinuvertebral n.
-branches of gray ramus communicans -posterior primary rami -anterior primary rami |
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What are the functions of the annulus fibrosus?
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-contain nucleus
-stabilization -permission of movement -minimal shock absorption |
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How does the annulus fibrosus provide stabilization?
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-layers bind to cartilaginous end plates, vertebral rim, and vertebral bodies
-taut on convexity with compression on concavity -rotation limited by appropriate fibers |
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What composes the nucleus pulposus?
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-network of collagen
-reticular fiber mesh -mucoprotein gel rich in polysaccharides -water |
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What are the functions of the nucleus pulposus?
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-imbibition
-nutrition -transmission of force -equalization of stress -movement |
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Describe the nutrient cycle of the nucleus pulposus.
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-mucoid protein and osmotic properties attract nutrients across the cartilaginous end plate, while at rest
-during weight bearing activity, fluids are forced out to the annulus and vertebral bodies |
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How does the nucleus allow movement?
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-ball bearing action
-provides rocking action |
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What is the effect of age on nucleus pulposus and its permission of movement?
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-dehydrates with age
-permits increased motion and contributes to segment instability |
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What are the functions of cartilaginous end plates?
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-protect bone end
-transmit weight -permit fluid exchange for the disc nutrient cycle |
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What are Sharpey's Fibers?
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-outermost lamellae which blend with the vertebral periosteum and the posterior longitudinal ligament
-attach cartilaginous end plate to vertebral body |
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Describe the blood supply of the intervertebral disc.
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-blood vessels disappear after 8 yo
-avascular for during adult life -outermost annulus contains only remaining vasculature |
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What effect on vascularity does disc degeneration have?
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-degeneration has been reported to stimulate ingrowth of blood supply to the disc from their cartilaginous end plates
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What tissues types comprise the facet capsule?
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-white fibrous tissue
-yellow elastic tissue |
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What elements prevent the capsule from being nipped?
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-elastic tissue of facet capsule
-ligamentum flavum -multifidus |
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What are the functions of the facet joint menisci?
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-provide greater stability via joint congruence
-help distribute the load over greater articular area |
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What is the blood supply of the facet joints?
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-periarticular plexus
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What are the principal functions of the facet joints?
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-permit motion
-guide motion -limit motion |
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What are joints of Von Lushka?
What motion do they assist? |
-lateral interbody articulations of the cervical vertebrae (uncinate processes)
-provide translatory motion between cervical vertebrae with forward bending |
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What are the principal functions of the spinal ligaments?
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-limit or modify movement
-resist postural and traumatic strains -slow movement -assist in regaining neutral position |
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What are the multisegmental ligaments of the spine?
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-anterior longitudinal
-posterior longitudinal -supraspinous ligament -ligamentum nuchae |
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Describe the origin, insertion, and segmental attachments of the anterior longitudinal ligament.
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-originates on anterior tubercles of atlas (C1)
-inserts on the periosteum of the sacrum -attaches to each vertebral rim and intervertebral disc |
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What are the functions of the anterior longitudinal ligament?
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-resists distraction
-resists backward bending -supports the weight of lumbar spine -resists tendency of lumbar vertebrae to slip forward |
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Describe the origin, insertion, and segmental attachments of the posterior longitudinal ligament.
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-originates on the posterior body of axis (C2)
-inserts on coccyx -attached to vertebral rim of each posterior body -closely interwoven with disc |
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What feature of the posterior longitudinal ligament may explain higher risk of L4/5 & L5/S1 nucleus prolapse?
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-PLL is often very narrow over lowest lumbar segments, providing little restraint to prolapsing nucleus
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What are the functions of the posterior longitudinal ligament?
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-minorly limits forward bending
-supports the intervertebral disc posteriorly |
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What effect does intervertebral disc degeneration have on the posterior longitudinal ligament?
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-slackens the ligament allowing it to bulge into the spinal canal
-may potentially cause myelopathy |
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Describe the origin, insertion, and segmental attachments of the supraspinous ligament.
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-blends with ligamentum nuchae cephalically
-caudally blends with erector spinae fascia around L3 & L4 -attaches to spinous processes and blends with interspinous ligament |
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What are the functions of the supraspinous ligament?
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-limits forward bending
-somewhat limits rotation |
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Describe the origin, insertion and segmental attachments of ligamentum nuchae.
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-origin at nuchal line/base of posterior occiput
-continuous with supraspinous lig at C7 -blends with cervical interspinous ligament |
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What is significant about ligamentum nuchae's structure?
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-comprised of "a good measure" of elastic tissue
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What are the segmental ligaments of the spine?
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-interspinous ligament
-ligamentum flava -intertransverse ligament -iliolumbar ligament |
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Describe the location of the interspinous ligament.
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-passes UPWARD & BACKWARD from superior aspect of lower spinous process to inferior aspect of upper spinous process
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Describe the location of the ligamentum flavum.
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-upper 1/3 of lower posterior lamina to the lower 1/3 of the anterior lamina above
-paired ligaments with slight septum -laterally attach to facet capsule |
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What are the functions of the ligamentum flavum?
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-permit forward bending and assist return to neutral
-capsule attachment prevents nipping |
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How does age affect ligamentum flavum and why is this significant?
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-loss of elasticity and degeneration occur with age, causing the ligament to fold inward to the spinal canal
-may pressure the spinal cord during backward bending |
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Where is the intertransverse ligament located? What motions does it limit?
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-spans between transverse processes
-tends to limit side bending and rotation |
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Describe the location of the iliolumbar ligament in men.
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-From L5 transverse process projects laterally to superior SI joint and adjacent ilium
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Describe the location of the iliolumbar ligament in women.
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-additional L4 attachment, from L4 & L5 to superior aspect of SI joint and adjacent ilium
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How does aging affect the iliolumbar ligament? Why is this significant?
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-begins life as a muscle, transitions to ligament in 20s, complete transformation by 40yo.
-structure can be targeted for exercise and stabilization of SI |
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What is the significance of gender differences of the iliolumbar ligament?
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-additional L4 attachment may explain increased female stability at L4/5 and greater incidence of lateral shift in men (19:1)
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What is the innervation of the facet joints?
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-sinuvertebral nerve
-mixed spinal nerve -posterior primary rami |
