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