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KIN: Vertebral Clmn
KIN: Vertebral Clmn - Structure and Kinematics
| Question | Answer |
|---|---|
| How many IV discs are there? | 23 |
| What are the primary curves of the spine? | Thoracic and sacrum |
| Which regions of the spine are convex anteriorly? | Cervical and lumbar |
| When does lordosis occur in the spine? | After birth |
| What is lordosis after birth influenced by? | Head and neck extensors (Cervical lordosis), as well as action of hip flexors on pelvis (Lumbar lordosis) |
| Function of body of vertebrae? | Primary weight bearing structure of vertebrae |
| What type of joints are the superior and inferior articular processes? | Synovial (Plane) joints |
| What is the joint called between the superior and inferior articular processes? | ZPJ or Facet joint |
| Function of Transverse processes? | Muscle, ligament, and rib attachments |
| Function of the lamina? | Protects posterior aspect of SC |
| What does pedicle mean? | Footlike or stemlike |
| Function of pedicle? | Connects vertebral body to posterior elements of vertebra |
| What does lamina mean? | Flat, thin plate |
| Function of vertebral foramen? | Houses and protects SC |
| Function of spinous processes? | Midline attachments for muscles and ligaments |
| What does the posterior longitudinal ligament turn into? | Tectorial membrane |
| Where does the posterior longitudinal ligament turn into the tectorial membrane? | C2 |
| Where is the anterior longitudinal ligament best developed? | Lumbar region |
| Why is the ligamentum flavum yellow? | Because of the high amounts of elastin |
| Where is the ligamentum flavum best developed? | Lumbar region |
| How can the ligamentum flavum cause spinal stenosis? | Gets thick and encroaches in vertebral canal |
| Which motion do patients with spinal stenosis no like regarding the ligamentum flavum? | Flexion because it puts the ligament on slack |
| What is the function of the anterior longitudinal ligament? | Limits extension |
| What ligaments of the spine limit flexion? | Ligamentum flavum, supraspinous, interspinous, intertransverse, and posterior longitudinal ligaments |
| Which ligament is stronger, ALL or PLL? | ALL is about 2x as strong as PLL |
| Function of the transverse ligament of the atlas? | Prevents anterior displacement of C1 on C2 |
| Where is the transverse ligament of the atlas found? | On posterior side of dens |
| Which disorders is the transverse ligament of the atlas more susceptible to failure? | RA and DS |
| Where does ligamentum flavum run? | Along the posterior surface of the vertebral canal |
| What is the nucal ligament? | Cervical extension of the supraspinous ligaments |
| Which ligament is stronger, transverse ligament of the atlas or Alar ligament? | Transverse ligament of the atlas |
| What actions do intertransvese ligaments restrict? | Contralateral flexion and forward flexion |
| What actions do the alar ligaments restrict? | Contralateral flexion and rotation of occuput on spine |
| Where is the posterior longitudinal ligament run? | Along the posterior surfaces of all vertebral bodies |
| Which ligaments are anterior to the SC? | ALL, PLL |
| Where does the tectorial membrane attach? | Dens and occiput |
| Where does the ALL run? | Along the anterior surfaces of all vertebral bodies, including sacral |
| When are the capsules of the apophyseal joints tight and loose? | Loose in near-neutral position Taut at extremes of all other positions |
| Which type of vertebrae are the most mobile and why? | C-spine because they have no rib attachments |
| What is different about C7? | Not a bifid spinous process |
| What are the unicate processes? | Raises lateral hooks on C3-C6 vertebrae |
| What are uncovertebral joints? | The uncinate processes and their adjacent superior vertebra |
| What is another name for the uncovertebral joints? | Joints of Luschka |
| Which direction do the superior articular facets of the C spine face? | Posterior superior |
| Which direction do the inferior articular facets of the C spine face? | Anterior inferior |
| Which vertebrae supports the head? | C1 (Atlas) |
| What is another name for the dens of C2? | Odontoid process |
| Which cervical vertebrae is the largest? | C7 |
| What does C1 NOT have that other C spine have? | Body, pedicle, lamina, spinous process |
| What shape are the superior articular facets of C2? | Slightly convex |
| What are the ligaments of the AAJ? | Transverse ligament Alar ligament |
| What is another name for the transverse ligament? | Atlantal crusiform ligament |
| What do joints of luschka do? | Limit side bending, especially with age |
| Why are the transverse processes of T spine thickened? | For the costal tubercles |
| What does the T spine have for articulations with the ribs? | Demifacets |
| What limits movement in the T spine? | Ribs and spinous process formations |
| Which direction do the superior articular facets of the lumbar face? | Posterior medial |
| Which direction do the inferior articular facets of the lumbar face? | Anterior lateral |
| What happens to the lumbosacral angle during lordosis? | Increases |
| What happens to the lumbosacral angle with a flat back? | Decreases |
| Which lumbar vertebrea is wedge shaped and why? | 5th one because it helps to fit with the sacrum |
| What provides the greatest source of adhesion between vertebrae? | IV discs |
| What absorb and distribute loads across the vertebral column from body weight and muscle contraction? | IV discs |
| What carries 80% of the spinal load? | IV discs |
| What happens to the IV discs with age? | Dehydrate and less able to cushion loads |
| What is the correlation between the intervertebral space and the movement of one vertebral body on another? | The greater the intervertebral space, the greater the movement of one vertebral body on another |
| Each vertebra can move in how many directions? | 6 different directions - 3 translations, 3 rotations, around 3 axes |
| In youth, how much of the nucleus pulposus in the lumbar discs consists of water? | 70-90% |
| What is the nucleus pulposus thickened with? | Proteoglycans and type II collagen fibers |
| How many layers make u pthe annulus fibrosus of lumbar discs? | 15-25 layers of type I and II collagen |
| What are lamellae? | The layers of the annulus fibrosus |
| Which rings of the annulus contain blood vessels? | Only the peripheral ones (outer 1/3) |
| How do IV discs primarily receive nutrition? | Through diffusion of substance through vertebral endplates |
| What is a Schmorl's node? | Intrusion of the disc into the end plate and body of vertebrae |
| Dooes pure lateral flexion or pure rotation occur in any region of the spine? | No |
| What does bending cause? | Both compression and tension |
| What does torsion cause? | Axial rotation |
| What does shearing cause? | Side to side or anterior to posterior movements |
| How are C spine articular facets oriented? | Superior - posterior superior Inferior - anterior inferior |
| How are T spine articular facets oriented? | Superior - posterior Inferior - anterior |
| How are the L spine articular facets oriented? | Superior - medial posterior Inferior - lateral anterior |
| How do the inferior articular facets move during flexion? | Anterior and superior on the superior articular facets on the C vertebrae below and just opposite for extension |
| What plane are the L spine oriented in? | Sagittal plane |
| What movements do the L spine favor and restrict due to the orientation? | Favor - flex/ext Restrict - rotation |
| What plane are the T spine oriented in? | Coronal plane |
| What movements do the L spine favor and restrict due to the orientation? | Favor - lateral flex Restrict - flex/ext |
| How is motion described in the spine? | By the movement of the inferior articular facet on the superior articular facet |
| What does the ligamentum flavum turn into once it reaches C2? | AA ligament |
| What does the anterior longitudinal ligament turn into once it reaches C2? | Anterior AA ligament |
| What is another name for the OA joint? | Nodding joint, C0-C1 |
| When is the cervical vertebral canal volume the greatest and when is it the least? | Greatest - full flexion Least - full extension |
| Do you have more cervical flexion or extension? | Extension |
| Arthrokinematics of the occiptal condyles on the superior facets of C1 | Flexion - Rolls forward, slides posteriorly Extension - Rolls backwards, slides anteriorly |
| What do the inferior articular facets of the superior C vertebrae do during extension (C2-C7)? | Slide inferiorly and posteriorly |
| What is the close-packed position? | That which maximizes the area of joint contact and tension in the surrounding capsular ligaments |
| What do the inferior articular facets of the superior C vertebrae do during flexion (C2-C7) | Slide superiorly and anteriorly |
| What motion does the C spine do during protraction? | Lower C spine - flexion Upper C spine - extension |
| What motion does the C spine do during retraction? | Lower C spine - extension Upper C spine - flexion |
| Where does most of the rotation in the C spine come from? | AAJ |
| What do the R inferior facets of C2-C7 do during R rotation? | Slide posteriorly and inferiorly |
| What do the L inferior facets of C2-C7 do during R rotation? | Slide anteriorly and superiorly |
| What does it mean by cervical coupling? | Lateral flexion and rotation must occur to the same side due to the orientation of the articular facets |
| Arthrokinematics of occipitals on C1 during lateral flexion | Roll and slide is opposite |
| How much does full flexion increase the diameter of the IV foramen? | 19% |
| How much does full extension decrease the diameter of the IV foramen? | 11% |
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