Information limited to the Spine, IVD's, Spinal ligaments, and pelvic ligaments.
Quiz yourself by thinking what should be in
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| Bone is ________ - it is constantly degenerating and regenerating. | Dynamic
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| How does bone respond to stress placed apon it? | It responds by laying down new bone to better resist the applied force.
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| What happens when stresses are removed from bone? | The bone will de-mineralize.
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| Connects bone to bone. | Ligaments
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| Connects muscle to bone. | Tendons
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| An ________ occurs when two bones meet. | Articulation
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| What does an articulation form? | A joint
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| In most cases what surrounds a joint? | An articular capsule.
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| What is at the ends of bone to create a smooth surface for decreased resistance? | Articular Cartilage
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| How does Articular Cartilage receive its nutrition? | Synovial fluid
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| Cartilage has ____ nerves, blood supply, or lymphatic drainage. | No
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| Bone and Synovium have ____ blood supply and articular cartilage has ____ blood supply. | Rich, No
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| Joints are __________ with afferent fibers for proprioception, vibration, pressure, pain and temperature. | Richly innervated
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| __________ surround and penetrate joint capsules, ligaments, synovial membranes, and periosteum. | Nerve plexi
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| First to form in embryological development. | The nervous system.
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| Provides the largest amount of input into the central nervous system (CNS) | Innervation from joints of the spine.
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| Name the 5 functions of the Spine. | 1.Supporsts and stablizes the body. 2. Protects the spinal cord. 3. Moves the trunk. 4. Provides movement for the head, neck and body. 5. Innervation for spinal joints provide largest amount of input into the CNS.
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| How many true vertebrae is in the normal adult spine? | 24
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| How many movable segments are in the normal adult spine? | 26
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| Name the 26 segments of the adult spine by regions. | 7 cervicals, 12 thoracics, 5 lumbars, 1 sacrum, and 1 coccyx.
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| The primary curves of the spine are? | Thoracic and pelvic curves.
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| The primary curves of the spine are concave in what direction? | Anterier
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| Name the secondary spinal curves. | cervical and lumbar curves
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| The secondary spinal curves form when? | cervical forms aprox. 3 months and lumbar forms aprox. 12 months.
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| How do the secondary spinal curves form? | Cervical curve begins to form as the child begins to raise his/her head. Lumbar curves begin as the child begins to stand.
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| Name the location of the apex of each spinal region. | Cervical C4/C5, Thoracic T6/T7, and Lumbar L3
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| Name the AKA of secondar spinal curves. | Lordotic spinal curves
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| Name the AKA of primary spinal curves. | Kyphotic spinal curves
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| Name the typical cervicals. | C3-C6
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| The spinous processes of typical cervicals are _______. | Bifid
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| A bifid spinous process occures because? | There are 2 ossifications centers... typical of cervical spinous processes to allow for more muscle attatchments.
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| Superion Articular Process and the Inferior Articular Process of the typical cervicals joint together to form what? | Articular pillar.
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| What part of the spinal column has transverse forament? | Cervical spine.
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| Transverse processes of the cervical vertebrea are _______ to the articular pillars. | Anterior.
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| The bar of bone joining the anterior and posterior tubercles of the cervical spine is the? | Transverse bar (AKA) Lamella (AKA) Intertubercular lamella.
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| The uncinate processes function as a ___________ for spinal flexion and extension. | gliding mechanism
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| Uncovertebral joints are articulations of what? | Uncinate process and the sumilunar facet.
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| What is an aka of uncovertebral joints? | Joint of Luschka or joint of Von Luschka
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| Name the Atypical Cervical Vetebrae. | Atlas, Axis (aka Epistropheus), and C7
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| What is atlas missing that a typical cervical vertebrea has? | Body, pedicles, laminae, and spinous processes
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| What does the atlas consist of? | Anterior arch, posterior arch, and 2 lateral masses.
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| What transmits the 1st spinal nerve (suboccipital nerve.) | Superior vetebral groove/sulcus of Atlas.
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| Where is the Superior Sulcus on atlas? | Dorsal to the lateral masses.
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| Superior articular processes of atlas are? | Concave, face cranially, and articulate with the occipital condyles.
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| Inferior articular processes of atlas are? | Circular, slightly convex and articulate with C2.
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| In which cervical vertebrea does the vertebral artery pass through? | C1-C6
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| In which cervical vertebrea does the vertebral vein pass through? | C2-C7
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| What makes axis atypical? | The Odontoid process (AKA Dens)
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| What helps to form the synovial joint of C1/2 at the dens-fovea dentalis articulation? | Transverse ligament
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| Superior vertebral notches lie ______ to the articular processes of Axis. | Dorsal
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| Why is C7 an atypical cervical vertebrea? | It is a transitional segment into the thoracic region. Has a long prominent, non bifid spinous process.
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| What is C7 called in 70% of the population? | Vertebral Prominence.
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| What attaches to the tubercle on the C7's spinous process? | The caudal end of the ligamentum nuchae.
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| What is the most anterior portion of the occiput? | Basilary Process
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| The opening at the most inferior portion of the skull for the passage of the spinal cord and aligns with the vertebral forament. | Foramen Magnum
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| The flat portion of the occiput posterior to the foramen magnum. | Squamous portion of Occiput.
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| Small tubercle on the posterior portion of the occiput that is the attachment site for the ligamentum nuchae. | External Occipital Protuberance (EOP)
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| Small tubercle located directly internal from the EOP | Internal Occipital Protuberance (IOP)
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| Describe the body of typical thoracics. | Heart shaped with superior and inferior demicostal facets.
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| Which thoracic vertebral body is the smallest? | T3
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| Decribe thoracic pedicles. | Long and project posteriorly from the body. Arise more superiorly from the body resulting in an absence of hte superior vertebral notch.
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| Describe throacic spinous processes. | Long, slender and slope inferiorly (esp. T4-T8)
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| Describe the thoracic Superior Articular Processes. | Arise superiorly from the LPJ, faces posterior and slightly superior/lateral.
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| Describe the thoracic inferior articular processes. | Face anterior/ slightly inferior/ medial.
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| What most limits the motion of thoracic vertebrea? | Ribs
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| What articulates with thoracic transverse processes? | Ribs
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| What are the atypical thoracic vertebrae? | T1, 9, 10, 11, 12
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| What makes T1 atypical? | Transitional vertebra, has a pair of full costal facets on the superior lateral body and a pair of demicostal facets.
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| What makes T9 atypical? | Usualy has only one pair of superior demicostal facets with no inferior demicostal facets.
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| What makes T10 atypical? | Only has a pair of full or whole costal facets.
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| What makes T11 atypical? | Transition verebra from thoracics to lumbars, one pair of full costal facets on pedicle, TP does not articulate with the rib.
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| What makes T12 atypical? | It is more lumbar than thoracic, one pair of full costal facets for articulation with the 12th rib, no transverse processes (only 3 tubercles.
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| List the typical ribs. | ribs 2-9
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| List the atypical ribs. | ribs 1, 10, 11, 12
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| What does the typical rib head articulate with? | Superior demicostal facet of the correstponding vertebral level and the inferior demicostal facet of the vertebra above.
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| Where is the sharpest curve of the rib? | just distal to the transverse process articulation.
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| Describe rib 1. | Flat and lies almost entirely in the horizontal plane.
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| Rib 1, 10, 11, 12 only articulate with which vertebral segments? | Their corrosponding vertebral segment.
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| Which ribs are floating ribs? | Ribs 11 and 12
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| Name the true ribs and describe what makes them true ribs. | Ribs 1-7, they directly attach to the sternum.
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| Name the false ribs and describe what makes them false ribs. | Ribs 8-12, Indirect attachment to the sternum via costal cartilage of the rib above or no attachment at all.
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| What 2 types of articulations do the costovertebral ligaments have? | Costocentral articulations and Costotransverse articulations.
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| Ligament that surrounds each rib articulation. | Articular Capsul
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| Ligament from anterior rib head to body of corresponding level and for ribs 2-9 attach to the body above and IVD. | Radiate ligament
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| Ligament from the interarticular crest to the IVD at ribs 2-9. | Intra-articular ligament.
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| Ligament that attaches the neck of rib to the Transverse process one level above. | Superior costotransverse ligament.
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| Ligament that attaches rib tubercle to tip of TP at the correstponding level. | Lateral costotransverse ligament.
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| Describe a typical Lumbar. | Large body, strong pedicles with deep inferior vertebran notches, short lamina that are broad and strong, thick hatchet shaped spinous processes.
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| What process is used for a contact site for lumbar adjustments? | Mamillary process.
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| What atypical lumbar vertebrae are there? | L5
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| What is a forward displacement of the L5 body on the sacrum. | Anterior Spondylolisthesis.
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| How many segments of the sacrum are there before fusion? | 5
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| When does ossification of the Sacrum normaly occur? | By the age of 25 years old.
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| The anterior surface of the sacrum is _____. | concave.
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| Transverse ridges on the sacrum are rudimentary _______. | IVDs
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| The median Sacral Crest is the rudementary ___________. | Spinous Porcesses.
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| What part of the sacrum is formed by the union of the lamina and gives origin to the mulitfidi muscles? | Sacral groove.
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| Laminae of the 5th sacral segement fail to unite in the midline and form the ________. | Sacral Hiatus
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| The part of the sacrum that is formed from the the rudimentary articular processes. | Intermediate sacral crest.
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| The holes in the sacrum that allow the sacral nerves to exit. | Sacral foramina.
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| The ear shaped surface of the lateral sacrum. | Aricular surface.
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| What does the sacral aricular surface articulate with and what joint does it form? | the Ilium to form the sacral iliac joint.
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| Upper surface of the sacrum. | Sacral Promontory.
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| Lowest segment of the spinal column. | Coccyx
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| What membrane is from the anterior arch of C1 to the anterior margin of the foramen magnum and anterior to the apical odontoid ligament? | Anterior atlanto-occipital membrane.
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| What does the atlanto-occipital membrane do? | Limits extension of the occiput on atlas
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| What membrane attaches the posterior arch of atlas to posterior rim of foramen magnum? | posterior atlanto-occipital membrane.
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| What does the poserior atlanto-occipital membrane do? | Limits flexion of the occiput on atlas.
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| If the atlanto-occipital membrane where to ossify what would be formed? | arcuate forament (aka) poster ponticle.
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| What is homologue of the ligamentum flavum for C0-C1? | Posterior atlanto-occipital membrane.
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| Attaches anterior arch of C1 to the body of C2. | Anterior Atlanto-Axial Ligament.
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| Connects the posterior arch of C1 to lamina of C2? | Posterior Atlanto-axial Ligament.
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| Connects the lateral mass of C1 to lateral mass of C2 posterior to the dens. | Transverse Ligament.
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| Forms the Atlanto-Occipital Articulation. | Anterior atlanto-occipital membrane, Posterior atlanto-occipital membrane, and articular capsule.
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| Forms the Atlanto-Axial Articulation. | Anterior Atlanto-Axial Ligament, Posterior Atlanto-Axial Ligament, Transverse Ligament, and Capsular ligament.
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| Forms the Occipito-Axial Complex. | Tectorial Membrane, alar ligament, apical ligament, cruciate or cruciform ligament.
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| Connects the posterior body of C2 to the occiput at the anterior foramen magnum (superior extension of the PLL.) | Tectorial Membrane.
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| What does the tectorial membrane do? | limits flexion and extension of hte occiput and atlas.
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| Connects lateral apex of dens to the medial aspect of the condyle of the occiput and limits contralateral axial rotation. | Alar Ligament (AKA Check ligament, AKA Odontoid Ligament.)
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| Connects apex of dens to occiput at the anterior aspect of foramen magnum and prevents some vertical translation and anterior shear of the occiput. | Apical Ligament.
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| What are the three parts of the cruciate ligament? | Transverse ligament, superior longitudinal ligament, inferior longitudinal ligament.
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| What are the 5 ligament layers of the atlanto-occipital complex. | 1. ALL 2. Anterior Atlanto-Occipital Membrane. 3. Apical Ligament. 4. Superior Band of the Cruciform Ligament. 5. Tectorial Membrane.
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| What are the 9 common Ligaments? | 1. IVD 2. ALL 3. PLL 4. Supraspinous Ligament 5. Ligamentum nuchae 6. Interspinous ligament 7. Intertransverse ligament 8. Intertransverse ligament 9. Capsular Ligament.
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| Runs anterior from the basioccipital surface, along atlas, down to sacrum attaching firmly to the edges of the vertebral bodies. | Anterior Longitudinal Ligament. (ALL)
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| Anterior Longitudinal Ligament can be damaged by _________ or calcified by ________. | Can be damaged by hyperextention or when irritated can cause osteoblastic activity leading to calcification.
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| Extends from C2 to the sacrum over the posterior aspect of the vertebral bodies to the coccyx. | Posterior Longitudinal Ligament.
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| Posterior longitudinal ligament is .... | Richly innervated, resists flextion and prevents posterior IVD protrusion.
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| Originates in the ligamentum nuchaeat C7 and continues inferiorly along the tips of the SPs as a round slender stand down to sacrum. | Supraspinous Ligament.
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| Begins at the EOP and extends to C7 along the tips of the SP's as a fanned-out fibroelastic septum. Cervical's version of the supraspinous ligament. | Ligamentum Nuchae
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| Located between adjoining SPs from the root to the apex of each SP. | Interspinous Ligament
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| Poorly developed in teh cervical region and can tear during hyperflexion or hyperextension of hte neck. | Interspinous ligament.
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| Ligament that has a large amount of elastin, begins at C2/3 and L5/S1, and forms the posterior wal of the neural canal. | Ligamentum Flavum (aka yellow ligament)
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| Ligament that passes between the TPs and is characterized as round cords, prominent in the thoracic region and resists lateral flexion. | Intertransverse ligament
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| Ligament that attaches just behond the margins of the adjacent articular processes, oriented perpendicular to the plain of the facet joint and richly ivervated with mechanorecptors and nociceptors. | capsular ligament
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| Makes up 25% of the adult spine and attached to the vertebral body via Sharpey's fibers. | Intervertebral discs
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| How does the IVDs recieve its nutrients? | It recieves its nutrients from imbibition due to a lack of blood supply.
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| What three ligaments make up the Cruciate Ligaments? | Transverse ligament, Superior Longitudinal (AKA Cranial Crus), Inferior Longitudinal (AKA Caudal Crus)
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| What ligament runs from the L5 TP to the sacrum and iliac crest, also connecting to the sacral ala and becomes taut during hip extension? | Iliolumbar ligament
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| Ligament that attaches the ischial tuberosity to the lateral sacrum (apex) | Sacrotuberous ligament
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| Ligament that attaches the ischial spine to the lateral sacrum and forms the inferior border of the greater sciatic foramen. | Sacrospinous Ligament
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| Ligament that attaches the intermediate sacral crest to the ilium medial border. | Posterior Sacroiliac Brevis Ligament
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| Connects the PSIS to the Sacral Apex. | Posterior Sacrioiliac Longus Ligament
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| Ligament that attaches to the lateral sacral border to ilium medial border. | Anterior Sacroiliac Ligament.
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| Ligament similar to the ALL but in the sacrococcygeal location. | Anterior Sacrococcygeal Ligament
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| Ligament similar to the PLL but in the sacrococcygeal articulation? | Posterior Sacrococcygeal Ligament.
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| Ligaments of the Sacrococcygeal Articulation. | Intervertebral fibrocartilage, Anterior Sacrococcygeal Ligament, Posterior Sacrococcygeal Ligament, and the Intercornaul Ligament.
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| Name the three divisions of the Brainstem (rostal to caudal.) | Midbrain (aka mesencepthalon), Pons, and medulla Oblongata.
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| A continuation of the brain, this system of tracts conduct the transmission of nerve impulses from the brain to the various spinal levels. | Spinal Cord
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| What spinal segments house the spinal cord? | starting C1/2 and ending at L2
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| Sometimes called the "horses tail." | Cauda equina
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| Where are the 2 enlargements in the spinal cord which represent an increase in neural synapitic junctions? | Cervical enlargement C3-T2 and the Lumbar Enlargement T9-Conus Medullaris.
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| What does the grey matter of the spinal cord house and what is it called? | The Cell Bodies and it is called Rexed Lamina
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| What does the white matter of the spinal cord house? | Ascending and descending nerve pathways. (AKA Tracts)
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| The distal or caudal end of hte spinal cord. | Conus Medullaris
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| Why does the spinal cord not run the full length of an adult spinal collumn? | Embryologically it runs the full length, but bone growth rate is much faster than spinal cord growth rate, thus pulling the spinal cord cephalad.
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| Extension of the pia mater from conus medullaris, extends down through the lumbar cistern (subarachnoid space.) | Filum Terminale Interna
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| Dural sac that extends inferiorly from S2 to the Coccyx and anchors to the dorsum of the coccyx. | Filum Terminale Externa
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| How many pairs of spinal nerves are there? | 31
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| How many pairs of cranial nerves are there? | 12
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| What is most superior nerve capable of being affected by IVD protrusion? | C3
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| What are the three meninges layers? | Dura mater (aka Tough Mother), Arachnoid mater, Pia mater.
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| Coverings that surroud and protect the spinal cord. | Meninges
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| The outermost membrane of the spinal cord, strongest and not permeable to fluids. | Dura Mater
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| Membrane that firmly attaches to the foramen magnum, atlas, and bodies of C2 and C3, yet loose withing the spine (epidural sac). | Dura Mater
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| What is the lumbar cistern made of and what is it filled with? | It is made of the lower portion of the Dura Mater and contains cerbrospinal fluid (CSF) and contains the continuation of lumbar and sacral nerves.
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| Light and delicate membrane in the spinal cord that lines the dura mater. It is permeable to fluids and made of avascular elastic fibrous material. | Arachnoid mater.
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| What seperates the Pia mater from the Arachnoid mater and what does it contain? | The subarachnoid space which contains cerbrospinal fluid (CSF).
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| The space between the arachnoid and dura mater layers. | Subdural space.
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| Light and delicate layer of the spinal cord made up of fine areolar tissue, directly on the nervouse tissue. | Pia Mater.
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| What term is used to describe the pia and arachnoid mater layers together? | Leptomeninx
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| The ligaments that function to anchor the spinal cord to the dura sac and provide a pre-tensed suspension system against sudden jars and contains 22 pairs of pial extensions. | Dentate ligaments.
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| How much can the spinal cord move in the canal with hyperflexion? | 4 inches.
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| Name the 3 anatomical spaces in the vertebral canal. | Epidural space, Subdural space, subarachnoid space.
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| Space in the vertebral canal filled with fat, loose areolar tissue, and a rich venous plexus between the dural sac and the endosteum of the vertebra. | Epidural Space
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| Potential space between the dura and arachnoid maters. | Subdural space
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| Space located between the pia and the arachnoid maters, contains CSF and tiny venouse plexi. | Subarachnoid Space.
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| The vascular supply of the spinal cord. | 1 anterior spinal artery and 2 posterior spinal arteries. These run the length of the spinal cord and have several sources of supply.
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| How many IVDs are in the normal spine? | 23
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| Where in the vertebral column is there no IVDs? | Between Occiput/C1 and C1/2
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| IVDs are composed of what 3 parts? | Annulus fibrosis, nucleus pulposis, and cartilage end plates.
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| What do IVDs connect to? | Cartilaginous epiphseal plates of the vertebral body, ALL, PLL, and Rib Heads #2-9 via the intra-articular ligament.
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| The concentric layers of fibrous tissue, which forms the arround the circumference of the disc. | Annulus Fibrosis.
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| The outer 1/3 of the annulus fibrosis receives innervation from? | Recurrent menigeal nerve and a branch from the ventral primary ramus laterally and anteriorly.
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| Acts as a shock dispersing structure and located in the center of the IVD. | Nucleus pulposis
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| The nucleus pulposis is made up of _____ water in the normal, young, healthy adult IVD. | 70-90%
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| How does the IVD receive nutrition? | Early years of life there is sparce blood supply, but about 15 years of age the disc become avascular and nutrition-waste exchange occurs by imbibition of fluids through the endplates.
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| Describe Imbibtion in regards to the IVDs. | Compresive loading squeezes waste fluid from the disc and unloading allows the influx of nutrient fluid into the disc. Movement is key to a healthy disc.
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| Name the 6 functions of the IVD. | 1. Shock absorber 2. Attaches vertebral bodies together 3. Gives shape to the vertebral column 4. Powerful ligaments 5. Seperates the vertebral bodies 6. forms anter wall of the IVF.
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| What problems or disorders can be developed by loss of IVD height? | Facet arthropathy, ligamentous hypertrophy, spinal motion segment pathomechanics, spondylosis, and subsequent central and/or lateral stenosis.
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| Intradiscal Pressure in the lumbar region lying supine. | 25%
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| Intradiscal Pressure in the lumbar region reclining | 75%
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| Intradiscal Pressure in the lumbar region standing erect. | 100%
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| Intradiscal Pressure in the lumbar region sitting. | 140%
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| Intradiscal Pressure in the lumbar region standing while stooped forward. | 150%
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| Intradiscal Pressure in the lumbar region sitting while stooped forward. | 185%
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| Intradiscal Pressure in the lumbar region standing while stooped forward and holding weight. | 220%
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| Intradiscal Pressure in the lumbar region sitting while stooped forward and holding weight. | 275%
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| What is the ratio of disc height to the vertebral body height. | cervical 2/5, thoracic 1/5, lumbar 1/3
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| Coupled motion of the lumbar spine happens standing when... | lateral flextion and sp rotation to the concave side.
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| Coupled motion of the cervical spine happens when... | lateral fexion and SP rotation to the convex side.
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| Rotation of the atlas over axis is defined as _____ of the total cervical rotation. | 50%
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| Adverage cervical rotation is ____. | 80 degrees
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| Occipital motion in relation to atlas is mostly ______ and _____. | Flexion-extension and lateral flexion.
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| Rotation at individiual cervical segments other than C1/C2 is only ____. | 2-3 degrees.
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